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Jimam NS, David S, Galam NZ, Joseph BN, Buoye OS. Patients′ perception of the quality of malaria treatment in primary health care centers of Jos and Environs. MEDICAL JOURNAL OF DR. D.Y. PATIL UNIVERSITY 2015. [DOI: 10.4103/0975-2870.160782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ernoult M, David S, Doligez X, Meplan O, Leniau B, Bidaud A, Nuttin A, Mouginot B, Wilson J, Capellan N, Thiolliere N. Advanced plutonium management in PWR, complementarity of thorium and uranium. PROGRESS IN NUCLEAR ENERGY 2015. [DOI: 10.1016/j.pnucene.2014.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mercante O, Gagliardi C, Spazzafumo L, Gaspari A, David S, Cingolani D, Castellani C, D'Augello L, Baldoni R, Silvaroli R. Loss of autonomy of hospitalized elderly patients: does hospitalization increase disability? Eur J Phys Rehabil Med 2014; 50:703-708. [PMID: 24858036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The study of the determinants of loss of autonomy during hospitalization may be valuable in the identification of the most effective interventions and to achieve better outcomes. The aim of this study was to describe changes in the level of autonomy of the elderly admitted to the hospital at the entrance and at discharge in relation to a rehabilitation program. METHODS Prospective observational study conducted at the INRCA Geriatric Hospital of Ancona. The study included patients aged 65 years and over, daily admitted to INRCA Hospital of Ancona between September and December 2010. Criteria for inclusion were age ≥ 65 years, length of stay > 24 hours and signed informed consent. Patients admitted for less than 24 hours or in day hospital or day surgery were excluded from the beginning. A total of 1266 elderly patients were recruited in the period. From this sample, 74 people who died during hospitalization were excluded. At the time of hospitalization (within 24 hours) and at discharge, patients were evaluated with the Barthel Index (BI), the Rankin scale, and a short assessment of cognitive status derived from the Mini Mental State Examination (MMSE). RESULTS Referring to 1192 subjects who participated to the study, the mean age was 82.13 years ±7.39, age range between 65 and 100 years. The average BI was 56.6±36.16 (SD) (median value =60) at admission and 63.84±34.7 (SD) (median value=70) at discharge. The average Rankin score at admission was 2.63±1.5 (SD) (median value=3). CONCLUSION Patients presented better score of the BI at discharge and this figure was associated to the implementation of a rehabilitation treatment. Hospitalization of the elderly patient in a suitable environment, such as a geriatric hospital, contrary to some theories highlighting only the negative aspects of removal from the living environment, can be a measure of benefit for the reduction of disability and the recovery of compromised activities along and after the acute event. The collection of data on the level of autonomy of the subjects before and after hospitalization can be a useful element for clinical evaluation in a geriatric hospital.
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David S. Das Interaktionsmodell Digitaler Arbeitsschutz – Prävention aus medienwissenschaftlicher Perspektive. DAS GESUNDHEITSWESEN 2014. [DOI: 10.1055/s-0034-1386885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ng S, David S, Alamgeer M, Ganju V. Impact of Pretreatment Combined 18F-Fluorodeoxyglucose (FDG) Positron Emission Tomography/ Computed Tomography Staging on Radiation Therapy Treatment Decisions in Locally Advanced Breast Cancer: A Prospective Evaluation. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Laanani M, Dozol A, Meyer L, David S, Camara S, Segouin C, Troude P. Factors associated with failure to return for HIV test results in a free and anonymous screening centre. Int J STD AIDS 2014; 26:549-55. [PMID: 25085276 DOI: 10.1177/0956462414545795] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 07/07/2014] [Indexed: 11/17/2022]
Abstract
Free and anonymous screening centres (CDAG: Centres de Depistage Anononyme et Gratuit) are public facilities set up for HIV infection diagnosis in France. Some people visiting CDAG fail to return for test results and are not informed of their serology. This study aimed to assess factors associated with failure to return for HIV test results. Patients visiting the Fernand-Widal CDAG (Paris) for an HIV test in January-February 2011 were eligible to take part in the study. Data were collected with an anonymous self-administered questionnaire. Factors associated with failure to return were assessed using logistic regression models. Of the 710 participants (participation rate 88%), 46 patients failed to return. Not specifying birthplace and not living in the region of Paris were associated with failure to return. Those who perceived no risk of HIV infection and those who felt they were more at risk than other people were both statistically associated with failure to return. Self-perceived risk seemed to be of chief concern for failure to return for HIV test results and should be considered during pre-test counselling.
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Locatelli F, Altieri P, Andrulli S, Sau G, Bolasco P, Pedrini LA, Basile C, David S, Gazzanelli L, Tampieri G, Isola E, Marzolla O, Memoli B, Ganadu M, Reina E, Bertoli S, Ferrara R, Casu D, Logias F, Tarchini R, Mattana G, Passaghe M, Fundoni G, Villa G, Di Iorio BR, Pontoriero G, Zoccali C. Phosphate levels in patients treated with low-flux haemodialysis, pre-dilution haemofiltration and haemodiafiltration: post hoc analysis of a multicentre, randomized and controlled trial. Nephrol Dial Transplant 2014; 29:1239-1246. [DOI: 10.1093/ndt/gfu031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Détraz M, Garrec F, Ducasse C, Lamotte L, Gaudin P, Helias S, Evain A, David S, Riviere C, Departe J, Allegre W. “Transitional” apartments: Place to live and research/training platform. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.1152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Détraz M, Garrec F, Ducasse C, Lamotte L, Gaudin P, Helias S, Evain A, David S, Riviere C, Departe JP, Allegre W. Appartements « Tremplin » : mise en situation de vie, formation et plate-forme de recherche. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.1165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Boukari F, Butori C, Cardot-Leccia N, David S, Sillard L, Lacour JP. [Atypical histiocytoma in a child]. Ann Dermatol Venereol 2014; 141:279-84. [PMID: 24703642 DOI: 10.1016/j.annder.2014.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Revised: 12/01/2013] [Accepted: 01/10/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Histiocytoma (HC) is a very common benign tumour generally seen in the lower limbs of adults, particularly women. There are, however, atypical forms of HC that behave like locally aggressive tumours, occasionally with relapse or even metastasis. Herein we report a case of locally aggressive HC in a child, which, on account of its clinical extension, required seven surgical procedures to achieve complete excision. PATIENTS AND METHODS A 13-year-old child consulted for a hard purplish papule measuring 8 mm in diameter located in the right lumbar region. Punch biopsy revealed a poorly delineated dermal-hypodermic tumour comprising randomly distributed moderately pleomorphic fusiform cells, arranged in bands or with storiform architecture, certain of which were multi-nucleated. The mitotic index was high (11 mitoses in 10 fields at high magnification). There was no expression by the tumour of melanocytic markers (PS100, Melan-A), histiocytic markers (CD68) or CD34. FISH analysis showed the absence of COL1A1-PDGFB fusion gene. Based on these immunohistochemical and molecular findings, a diagnosis was made of atypical HC with high cellular density. Since the lower margins of the section showed tumoural foci, surgical excision was performed with 5-mm margins. Because the lateral and vertical limits were reached in all cases, a series of five further procedures (the last of was preceded by multiple peripheral biopsies) was necessary to achieve complete excision. These multiple excision procedures resulted in total excision of 25 cm across the longest side. No clinical relapse was seen after 25 months. DISCUSSION Cellular or atypical forms of HC carry a high likelihood of post-surgical relapse. They are characterised by marked pleomorphism and high cellular density. In our patient, the extent of the lesion had been greatly underestimated initially, resulting in the need for several surgical procedures in order to achieve complete excision. It is thus important to highlight the predictive factors for this type of tumour in order to enable sufficiently extensive excision, or excision guided by previous biopsies, to be contemplated from the outset. These predictive factors are: young patient age, unusual location (trunk, face, neck), high cellularity, marked mitotic activity and deep extension.
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Bellavia M, Rappa F, Lo Bello M, Brecchia G, Tomasello G, Leone A, Spatola G, Uzzo ML, Bonaventura G, David S, Damiani P, Hajj Hussein I, Zeenny MN, Jurjus A, Schembri-Wismayer P, Cocchi M, Zummo G, Farina F, Gerbino A, Cappello F, Traina G. Lactobacillus casei and bifidobacterium lactis supplementation reduces tissue damage of intestinal mucosa and liver after 2,4,6-trinitrobenzenesulfonic acid treatment in mice. J BIOL REG HOMEOS AG 2014; 28:251-261. [PMID: 25001657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Probiotics (PB) are living microorganisms that act as a commensal population in normal intestines and confer numerous beneficial effects on the host. The introduction of probiotics in the treatment of inflammatory bowel disease (IBD) prolongs remission. The aim of this study was to investigate the intestinal and hepatic effects of PB supplementation in an experimental IBD model in mice induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS). In the first step of the experimental procedure, CD-1 male mice, 5 to 6 weeks old, were randomly divided into 3 groups and inoculated intrarectally with, respectively, saline, alcohol, or TNBS to assess the experimental IBD model. In the second step, mice treated, or not, with TNBS inoculation, were treated with PB (Lactobacillus Casei, Bifidobacterum Lactis) for 1, 2 or 3 weeks, on a daily basis. Large bowel (colon and rectum) and liver were processed for histological alterations, according to a scoring system. Large bowel was also assessed for apoptosis by TUNEL assay. TNBS induced, as expected, severe damage and inflammation in the large bowel, including nuclear alterations and apoptosis, and, to a lesser extent, to the liver. Administration of PB determined significant reduction of both histological alterations and apoptosis. PB administration in advance protects from inflammation. In conclusion, supplementation with Lactobacillus casei, Bifidobacterum lactis PB is able to ameliorate the colitis by reversing the histological changes caused by TNBS in mice. Experimentation in human subjects in needed to prove their efficacy in reducing histological alterations that may be present in subjects with IBD.
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Auta A, Banwat SB, David S, Dangiwa DA, Ogbole E, Tor-anyiin AJ. Antibiotic Use in Some Nigerian Communities: Knowledge and Attitudes of Consumers. TROP J PHARM RES 2014. [DOI: 10.4314/tjpr.v12i6.33] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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113
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Delimani G, Georgiou M, Papadimitroulas P, Papamichalis P, Mikropoulos K, David S, Loudos G. Energy resolution of the GAGG:Ce single crystals with various thickness coupled to a SiPM. Phys Med 2014. [DOI: 10.1016/j.ejmp.2014.07.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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David S, Georgiou M, Fysikopoulos E, Loudos G. Evaluation of a siPm array coupled to a Gd3Al2Ga3O12:Ce (GAGG:Ce) discrete scintillator. Phys Med 2014. [DOI: 10.1016/j.ejmp.2014.07.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Brimont C, Guillet T, Rousset S, Néel D, Checoury X, David S, Boucaud P, Sam-Giao D, Gayral B, Rashid MJ, Semond F. Imaging of photonic modes in an AlN-based photonic crystal probed by an ultra-violet internal light source. OPTICS LETTERS 2013; 38:5059-5062. [PMID: 24281509 DOI: 10.1364/ol.38.005059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The spatial distribution of photon modes confined in a 0D cavity and a 1D W1 waveguide is investigated on AlN-based photonic crystal (PC) membranes by spectrally resolved scanning confocal microscopy in the ultra-violet spectral range. The influence of the fabrication-induced disorder of the PC on the photon modes is analyzed. The cavity modes are shown to be robust with respect to disorder, whereas the 1D modes of the W1 waveguide are localized near its cut-off frequency. Those modifications of the lowest energy photonic modes are compared to simulations of weakly disordered photonic structures.
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Kielstein JT, David S. Pro: Renal replacement trauma or Paracelsus 2.0. Nephrol Dial Transplant 2013; 28:2728-2733. [DOI: 10.1093/ndt/gft049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
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Sanchez-Salas R, Prapotnich D, Ingels A, Olivier F, Fhima M, Descamps P, David S, Secin F, Barret E, Galiano M, Rozet F, Cathelineau X. Modélisation du PSA en période d’arrêt de traitement chez les patients sous traitement hormonal intermittent. Est-ce que le temps de doublement du PSA est un outil de mesure fiable ? Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Venturini C, Orlandoni P, Jukic Peladic N, Giorgini N, Cola C, Sparvoli D, Fagnani D, Costantini A, Busco F, Galeazzi R, David S. PP174-MON PREVALENCE OF MALNUTRITION AMONG HOSPITALIZED GERIATRIC PATIENTS AND ITS MANAGEMENT. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60485-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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David S. AB0858-PARE “Ageing healthy”-obtain know-how to live and age healthy. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.3180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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David S. OP0258-PARE Families, partners and friends, the ones’ left out. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mazzocato C, David S, Benaroyo L, Monod S. [Polypharmacy and the elderly: neither too much nor too little]. REVUE MEDICALE SUISSE 2013; 9:1026-1031. [PMID: 23745236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Elderly persons are at high risk of polypharmacy. Polypharmacy has been associated with numerous adverse outcomes, such as poorer quality of life, higher morbidity and mortality. However, deciding to stop or to continue a treatment is a difficult task, which confronts the physician to complex clinical and ethical choices. Such a decision requires a geriatric multidimensional assessment of the patient, an estimation of his or her prognosis, the definition of the goals of care and a careful assessment of the time to benefit of each drug. Diverse methods and tools to support the physician in this process are discussed in this article. However these can not replace a reflexive approach of the physician that integrates the values and representations of the patient with regard to his or her health and end of life, as well as his or her needs, fears and choices.
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Bantis C, Heering P, Kouri NM, Siekierka-Harreis M, Stangou M, Schwandt C, Efstratiadis G, Rump LC, Ivens K, Haddiya I, Houssaini Squalli T, Laouad I, Ramdani B, Bayahia R, Dimas GG, Tegos TJ, Spiroglou SG, Pitsalidis CG, Sioulis AS, Karamouzis IM, Savopoulos CG, Karamouzis MI, Orologas AG, Hatzitolios AI, Grekas DM, Maixnerova D, Jancova E, Rychlik I, Rysava R, Merta M, Reiterova J, Kolsky A, Honsova E, Skibova J, Tesar V, Kendi Celebi Z, Calayoglu R, Keven K, Kurultak I, Mescigil P, Erbay B, Karatan O, Duman N, Erturk S, Nergizoglu G, Kutlay S, Sengul S, Ates K, Marino F, Martorano C, Bellantoni M, Tripepi R, Zoccali C, Ishizuka K, Harita Y, Kajiho Y, Tsurumi H, Asano T, Nishiyama K, Sugawara N, Chikamoto H, Akioka Y, Yamaguchi Y, Igarashi T, Hattori M, Bantis C, Heering PJ, Kouri NM, Stangou M, Siekierka-Harreis M, Efstratiadis G, Rump LC, Ivens K, Sahay M, Monova DV, Monov SV, Wang YY, Cheng H, Wang GQ, Dong HR, Chen YP, Wang CJ, Tang YL, Buti E, Dervishi E, Bergesio F, Ghiandai G, Mjeshtri A, Paudice N, Caldini AL, Nozzoli C, Minetti EE, Sun L, Feng J, Yao L, Fan Q, Ma J, Wang L, Kirsanova T, Merkusheva L, Ruinihina N, Kozlovskaya N, Elenshleger G, Turgutalp K, Karabulut U, Ozcan T, Helvaci I, Kiykim A, Kaul A, Bhadhuaria D, sharma R, Prasad N, Gupta A, Clajus C, Schmidt J, Haller H, Kumpers P, David S, Sevillano AM, Molina M, Gutierrez E, Morales E, Gonzalez E, Hernandez E, Praga M, Conde Olasagasti JL, Vozmediano Poyatos C, Illescas ML, Tallon S, Uson Carrasco JJ, Roca Munoz A, Rivera Hernandez F, Ismail G, Jurubita R, Andronesi A, Bobeica R, Zilisteanu D, Rusu E, Achim C, Sevillano AM, Molina M, Gutierrez E, Morales E, Huerta A, Hernandez E, Caro J, Gutierrez-Solis E, Praga M, Pasquariello A, Pasquariello G, Innocenti M, Grassi G, Egidi MF, Ozturk O, Yildiz A, Gul CB, Dilek K, Monov SV, Monova DV, Tylicki L, Jakubowska A, Weber E, Lizakowski S, Swietlik D, Rutkowski B, Postorino A, Costa S, Cristadoro S, Magazzu G, Bellinghieri G, Savica V, Buemi M, Santoro D, Lu Y, Shen P, Li X, Xu Y, Pan X, Wang W, Chen X, Zhang W, Ren H, Chen N, Mitic BP, Cvetkovic T, Vlahovic P, Velickovic Radovanovic R, Stefanovic V, Kostic S, Djordjevic V, Ao Q, Ma Q, Cheng Q, Wang X, Liu S, Zhang R, Ozturk S, Ozmen S, Akin D, Danis R, Yilmaz M, Hajri S, Barbouche S, Okpa H, Oviasu E, Ojogwu L, Fotouhi N, Ghaffari A, Hamzavi F, Nasri H, Ardalan M, Stott A, Ullah A, Anijeet H, Ahmed S, Kohli HS, Rajachandran R, Rathi M, Jha V, Sakhuja V, Yenigun E, Dede F, Turgut D, Koc E, Akoglu H, Piskinpasa S, Ozturk R, Odabas A, Bajcsi D, Abraham G, Kemeny E, Sonkodi S, Legrady P, Letoha A, Constantinou K, Ondrik Z, Ivanyi B, Lucisano G, Comi N, Cianfrone P, Summaria C, Piraina V, Talarico R, Camastra C, Fuiano G, Proletov I, Saganova E, Galkina O, Bogdanova E, Zubina I, Sipovskii V, Smirnov A, Bailly E, Pierre D, Kerdraon R, Grezard O, Gnappi E, Delsante M, Galetti M, Maggiore U, Manenti L, Hasan MJ, Muqueet MA, Mostafi M, Chowdhury I, Haque W, Khan T, Kang YJ, Bae EJ, Cho HS, Chang SH, Park DJ, Li X, Xu G, Lin H, Hu Z, Yu X, Xing C, Mei C, Zuo L, Ni Z, Ding X, Li D, Chen N, Ren H, Shen P, Li X, Pan X, Zhang Q, Feng X, Lin L, Zhang W, Chen N. Clinical nephrology - miscellaneous. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sumitha E, Jayandharan GR, Arora N, Abraham A, David S, Devi GS, Shenbagapriya P, Nair SC, George B, Mathews V, Chandy M, Viswabandya A, Srivastava A. Molecular basis of quantitative fibrinogen disorders in 27 patients from India. Haemophilia 2013; 19:611-8. [DOI: 10.1111/hae.12143] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2013] [Indexed: 11/30/2022]
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Le Divenah A, David S, Bertrand D, Chatel T, Viallards ML. [Multidisciplinary consultation meetings: decision-making in palliative chemotherapy]. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2013; 25:129-135. [PMID: 23964537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Multidisciplinary consultation meetings provide an opportunity for specialists from different disciplines to engage in formal discussions over diagnostic and therapeutic strategies in oncology. In complex clinical situations, specialists discuss medical decisions collectively, particularly in cases involving palliative chemotherapy. The purpose of this study was to identify the factors considered in multidisciplinary consultation meetings in deciding whether palliative chemotherapy is needed. METHODS A study was conducted over a three-month period in an adult hematology department in order to identify the criteria used in weekly multidisciplinary consultation meetings to determine whether palliative chemotherapy is required. The study only included patients who were confirmed to be in the palliative phase by all the doctors present at the multidisciplinary consultation meetings. The criteria cover 5 areas related to patient's characteristics, patients'environment, the disease, scientific data and the objectives of palliative chemotherapy. RESULTS The criteria considered in 100% of cases were related to the disease, the expected benefits of chemotherapy with palliative intent and patients' characteristics. The least important criteria were related to the patients' environment. Scientific data were not discussed during the multidisciplinary consultation meetings. CONCLUSION The results show that the criteria used to determine whether chemotherapy with palliative intent is required are essentially of a medical nature. However, in palliative situations, factors related to patients' environment must be taken into account. In order to meet this requirement, it may be necessary to increase the participation of paramedical professionals and palliative care teams in multidisciplinary consultation meetings and to promote dialogue and collaboration with doctors and coordinating nurses.
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Saglimbene V, D'Alonzo D, Ruospo M, Vecchio M, Natale P, Gargano L, Nicolucci A, Pellegrini F, Craig JC, Triolo G, Procaccini DA, Santoro A, Di Giulio S, La Rosa S, Murgo A, Di Toro Mammarella R, Sambati M, D'Ambrosio N, Greco V, Giannoccaro G, Flammini A, Boccia E, Montalto G, Pagano S, Amarù S, Fici M, Lumaga GB, Mancini E, Veronesi M, Patregnani L, Querques M, Schiavone P, Chimienti S, Palumbo R, Di Franco D, Della Volpe M, Gori E, Salomone M, Iacono A, Moscoloni M, Treglia A, Casu D, Piras AM, Di Silva A, Mandreoli M, Lopez A, Quarello F, Catizone L, Russo G, Forcellini S, Maccarone M, Catucci G, Di Paolo B, Stingone A, D'Angelo B, Guastoni C, Pasquali S, Minoretti C, Bellasi A, Boscutti G, Martone M, David S, Schito F, Urban L, Di Iorio B, Caruso F, Mazzoni A, Musacchio R, Andreoli D, Cossu M, Li Cavoli G, Cornacchiari M, Granata A, Clementi A, Giordano R, Guastoni C, Barzaghi W, Valentini M, Hegbrant J, Tognoni G, Strippoli GFM. [Effects of dose of erythropoiesis stimulating agents on cardiovascular outcomes, quality of life and costs of haemodialysis. the clinical evaluation of the DOSe of erythropoietins (C.E. DOSE) Trial]. GIORNALE ITALIANO DI NEFROLOGIA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI NEFROLOGIA 2013; 30:gin/00072.21. [PMID: 23832463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Anaemia is a risk factor for death, adverse cardiovascular outcomes and poor quality of life in patients with chronic kidney disease (CKD). Erythropoietin Stimulating Agents (ESA) are the most used treatment option. In observational studies, higher haemoglobin (Hb) levels (around 11-13 g/dL) are associated with improved survival and quality of life compared to Hb levels around 9-10 g/dL. Randomized studies found that targeting higher Hb levels with ESA causes an increased risk of death, mainly due to adverse cardiovascular outcomes. It is possible that this is mediated by ESA dose rather than haemoglobin concentration, although this hypothesis has never been formally tested. METHODS We present the protocol of the Clinical Evaluation of the Dose of Erythropoietins (C.E. DOSE) trial, which will assess the benefits and harms of a high versus a low ESA dose therapeutic strategy for the management of anaemia of end stage kidney disease (ESKD). This is a randomized, prospective open label blinded end-point (PROBE) design trial due to enroll 900 haemodialysis patients. Patients will be randomized 1:1 to 4000 UI/week i. v. versus 18000 UI/week i. v. of epoetin alfa, beta or any other epoetin in equivalent doses. The primary outcome of the trial is a composite of cardiovascular events. In addition, quality of life and costs of these two strategies will be assessed. The study has been approved and funded by the Italian Agency of Drugs (Agenzia Italiana del Farmaco (AIFA)) within the 2006 funding plan for independent research on drugs (registered at www.clinicaltrials.gov (NCT00827021)).
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