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Cherifi F, Gernier F, Jardin F, Lefevre-Arbogast S, Bastien E, Lequesne J, Rigal O, Quilan F, Clarisse B, Grellard JM, Binarelli G, Fernette M, Lange M, Richard D, Morel A, Griffon B, Pepin LF, Leconte A, Faveyrial A, Leheurteur M, Beauplet B, Joly F. Post-traumatic stress disorder symptoms and quality of life among older patients with cancer during the COVID-19 pandemic. J Geriatr Oncol 2023; 14:101634. [PMID: 37757587 DOI: 10.1016/j.jgo.2023.101634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 08/08/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION The Coronavirus (COVID-19) pandemic and its associated health restrictions have harmed the population psychologically. We aimed to compare the post-traumatic stress disorder (PTSD) symptoms and Quality of Life (QoL) in older French patients with cancer to the younger ones. MATERIALS AND METHODS This longitudinal multicenter study named COVIPACT began in April 2020 during the first French lockdown and has included 579 outpatients receiving treatment for a solid or hematological malignancy. Data were collected every three months, namely at the first release period (M3), at the second lockdown (M6), at the second release period (M9), and finally at the last curfew period (M12) in France. Standardized validated self-questionnaires were used to assess PTSD symptoms (using the Event Scale-Revised self-questionnaire), insomnia (through the Insomnia Severity Index questionnaire), QoL (using the Functional Assessment of Cancer Therapy - General questionnaire), and cognitive complaints (through the Functional Assessment of Cancer Therapy - Cognition questionnaire). Student (or Wilcoxon) tests and Chi-squared tests were used for continuous or discrete variables, respectively. We conducted linear mixed model to study the change during follow-up. RESULTS Out of 579 included patients, 157 (27%) were ≥ 70 years old at baseline, of whom 104 participated in the longitudinal study. At baseline, older patients reported fewer PTSD symptoms (17% versus 23%, p = .06), insomnia (17% versus 27%, p = .02), and cognitive complaint (3% versus 16%, p < .01) than younger patients. QoL at baseline was similar between age subgroups. We observed no significant difference in the trajectory of PTSD symptoms, insomnia, or emotional well-being between both groups during the follow-up. Cognitive complaints were lower at baseline in older patients but steadily increased during the follow-up and reached the same level as younger patients at one year. DISCUSSION One in five older patients reported PTSD symptoms, evolving similarly to younger patients during the first year of the COVID-19 pandemic. While cognitive complaints tend to recover in a bell-shaped curve at one year in younger patients, the trend is increasing in older ones. Screening for PTSD symptoms and late cognitive impairment should be given special attention in older patients. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT04366154.
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Affiliation(s)
- Francois Cherifi
- Medical Oncology Department, Centre Francois Baclesse, UNICANCER, Caen 14076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
| | - François Gernier
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France.
| | - Fabrice Jardin
- Clinical Research Department, Centre Henri Becquerel, UNICANCER, Rouen 76038, France; Hematology Department, Centre Henri Becquerel, UNICANCER, Rouen 76038, France
| | - Sophie Lefevre-Arbogast
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
| | - Etienne Bastien
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Justine Lequesne
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
| | - Olivier Rigal
- Hematology Department, Centre Henri Becquerel, UNICANCER, Rouen 76038, France; Medical Oncology Department, Centre Henri Becquerel, UNICANCER, Rouen 76308, France
| | - Florian Quilan
- Medical Oncology Department, Centre Francois Baclesse, UNICANCER, Caen 14076, France
| | - Bénédicte Clarisse
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Jean-Michel Grellard
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Giulia Binarelli
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
| | - Marie Fernette
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Marie Lange
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
| | - Doriane Richard
- Clinical Research Department, Centre Henri Becquerel, UNICANCER, Rouen 76038, France
| | - Adeline Morel
- Medical Oncology Department, Centre Francois Baclesse, UNICANCER, Caen 14076, France
| | - Bénédicte Griffon
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Louis-Ferdinand Pepin
- Clinical Research Department, Centre Henri Becquerel, UNICANCER, Rouen 76038, France
| | - Alexandra Leconte
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Audrey Faveyrial
- Medical Oncology Department, Centre Francois Baclesse, UNICANCER, Caen 14076, France
| | - Marianne Leheurteur
- Medical Oncology Department, Centre Henri Becquerel, UNICANCER, Rouen 76308, France
| | - Bérengère Beauplet
- Department of Geriatric Medicine, Centre Hospitalier Universitaire de Caen Normandie, Normandie Univ, UNICAEN, INSERM U1086, ANTICIPE, Caen F-14000, France; Normandy Interregional Oncogeriatric Coordination Unit, Caen 14000, France
| | - Florence Joly
- Medical Oncology Department, Centre Francois Baclesse, UNICANCER, Caen 14076, France; Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
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Prevost R, Chretien B, Minoc EM, Dolladille C, Da-Silva A, Nehme A, Joly F, Lelong-Boulouard V, Bastien E. Neurocognitive impairment in females with breast cancer treated with endocrine therapy and CDK4/6 inhibitors: a pharmacovigilance study using the World Health Organization's database. Front Pharmacol 2023; 14:1278682. [PMID: 37927591 PMCID: PMC10622981 DOI: 10.3389/fphar.2023.1278682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Importance: Endocrine therapies (ETs) and inhibitors of cyclin-dependent kinases-4/6 (iCDK4/6s) are a standard treatment in breast cancer. However, data on potential neurocognitive impacts remain inconsistent for ET and are scarce for iCDK4/6s. Objective: To evaluate whether ET and iCDK4/6s are associated with neurocognitive impairment (NCI). Methods: We used observational, real-world cases of NCI from the World Health Organization's database VigiBase® to perform disproportionality analysis. Cases were defined as any symptom of NCI in females treated with ETs or iCDK4/6s. The study period was from the date of the first adverse event reported in VigiBase® with iCDK4/6s (1 January 2014) until the date of data extraction (16 March 2022). In our primary analysis, we calculated the reporting odds ratio (ROR) adjusted for age to identify a potential association between NCI and individual ETs in isolation or in combination with iCDK4/6s. We also performed subgroup analyses by the NCI class. Results: We identified 2.582 and 1.943 reports of NCI associated with ETs and iCDK4/6s, respectively. NCI was significantly associated with each ET [anastrozole: n = 405, aROR = 1.52 (95% CI: 1.37-1.67); letrozole: n = 741, aROR = 1.37 (95% CI: 1.27-1.47); exemestane: n = 316, aROR = 1.37 (95% CI: 1.22-1.53); tamoxifen: n = 311, aROR = 1.25 (95% CI: 1.12-1.40); and fulvestrant: n = 319, aROR = 1.19 (95% CI: 1.06-1.33)] and only with palbociclib for iCDK4/6s [n = 1,542, aROR = 1.41 (95% CI: 1.34-1.48)]. Conclusion: These findings suggest that in females treated for breast cancer, all ETs may be associated with NCI. However, amongst iCDK4/6s, NCI may be specific to palbociclib. NCI most frequently involved learning and memory as well as language. Neurocognitive impact of treatments requires better consideration and management.
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Affiliation(s)
- Rachel Prevost
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, Caen, France
| | - Basile Chretien
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, Caen, France
| | - Elise-Marie Minoc
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, Caen, France
- Normandie University, UNICAEN, INSERM COMETE, U1075, Caen, France
| | - Charles Dolladille
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, Caen, France
- Normandie University, UNICAEN, INSERM U1086 “Interdisciplinary Research Unit for Cancers Prevention and Treatment” (ANTICIPE), Caen, France
| | - Angélique Da-Silva
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, Caen, France
| | - Ahmad Nehme
- Department of Neurology, University Teaching Hospital of Caen-Normandie, Caen, France
| | - Florence Joly
- Normandie University, UNICAEN, INSERM U1086 “Interdisciplinary Research Unit for Cancers Prevention and Treatment” (ANTICIPE), Caen, France
- Comprehensive Cancer Center Baclesse, Unicancer, Caen, France
| | - Véronique Lelong-Boulouard
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, Caen, France
- Normandie University, UNICAEN, INSERM COMETE, U1075, Caen, France
| | - Etienne Bastien
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, Caen, France
- Comprehensive Cancer Center Baclesse, Unicancer, Caen, France
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Quilan F, Lequesne J, Cherifi F, Bastien E, Morel A, Delcambre C, Da Silva A, Grellard J, Leconte A, Faveyrial A, Clarisse B, Joly F. Does COVID-19 pandemic impact cancer outcomes in metastatic setting? A comparative cohort study among metastatic patients treated at day care hospital. Cancer Med 2023; 12:17603-17612. [PMID: 37492987 PMCID: PMC10523941 DOI: 10.1002/cam4.6378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023] Open
Abstract
INTRODUCTION COVID-19 outbreak rapidly spread since early 2020 leading to the implementation of nationwide lockdowns. To cope with this sudden change, management guidelines were quickly published to adapt oncological care, with potential impact on cancer outcomes. METHODS We conducted a retrospective comparative cohort study to assess the impact of the COVID-19 outbreak in 2020 on cancer outcomes in metastatic patients. Two cohorts of metastatic patients receiving intravenous (iv) therapy in a French oncological day care hospital were assessed: a 2020 cohort during the first French lockdown, and a 2018 historical cohort before the COVID-19 pandemic. We performed a propensity score analysis to match patients from the two cohorts. After one-year follow-up, we compared progression-free survival (PFS) and overall survival (OS) between cohorts. Adaptations of medical oncological treatments in 2020 were also analysed. RESULTS The 376 patients of the 2020 cohort were matched with 376 of the 2018 cohort. No SARS-CoV-2 infection was observed in the 2020 cohort. The adjusted PFS was significantly shorter in 2020 compared to 2018 (HR = 1.23; 95% CI: 1.03-1.46), as well as among patients without treatment adaptation compared to matched patients of the 2018 cohort (HR = 1.33; 95% CI: 1.10-1.61). We did not observe any significant difference of PFS among the group with treatment adaptations. OS was not significantly different. CONCLUSION Metastatic cancer patients treated during the first lockdown had a higher risk of disease progression 1 year after COVID-19 outbreak. However, oncological treatment adaptations or SARS-CoV-2 infections do not explain these results. A longer follow-up is needed to observe the impact on OS.
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Affiliation(s)
- Florian Quilan
- Medical Oncology DepartmentCentre François BaclesseCaenFrance
| | | | | | - Etienne Bastien
- Medical Oncology DepartmentCentre François BaclesseCaenFrance
| | - Adeline Morel
- Medical Oncology DepartmentCentre François BaclesseCaenFrance
| | | | | | | | | | | | | | - Florence Joly
- Medical Oncology DepartmentCentre François BaclesseCaenFrance
- Clinical Research DepartmentCentre François BaclesseCaenFrance
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086CaenFrance
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Bastien E, Lefèvre-Arbogast S, Lequesne J, Gernier F, Cherifi F, Rigal O, Guittet L, Grellard JM, Binarelli G, Lange M, Fernette M, Tron L, Morel A, Richard D, Griffon B, Leconte A, Quilan F, Pépin LF, Jardin F, Leheurteur M, Faveyrial A, Clarisse B, Joly F. Posttraumatic Stress Symptoms in Patients With Cancer During the COVID-19 Pandemic: A One-Year Longitudinal Study. J Natl Compr Canc Netw 2023; 21:265-272.e7. [PMID: 36812938 DOI: 10.6004/jnccn.2023.7085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 10/11/2022] [Indexed: 02/24/2023]
Abstract
BACKGROUND Patients with cancer may be particularly vulnerable to psychological consequences of the COVID-19 pandemic. We studied the prevalence and evolution of posttraumatic stress symptoms (PTSS) in patients with cancer during the pandemic waves, and we investigated factors associated with high symptoms. METHODS COVIPACT is a 1-year longitudinal prospective study of French patients with solid/hematologic malignancies receiving treatment during the first nationwide lockdown. PTSS were measured every 3 months from April 2020 using the Impact of Event Scale-Revised. Patients also completed questionnaires on their quality of life, cognitive complaints, insomnia, and COVID-19 lockdown experience. RESULTS Longitudinal analyses involved 386 patients with at least one PTSS assessment after baseline (median age, 63 years; 76% female). Among them, 21.5% had moderate/severe PTSS during the first lockdown. The rate of patients reporting PTSS decreased at lockdown release (13.6%), increased again at second lockdown (23.2%), and slightly declined from the second release period (22.7%) to the third lockdown (17.5%). Patients were grouped into 3 trajectories of evolution. Most patients had stable low symptoms throughout the period, 6% had high baseline symptoms slowly decreasing over time, and 17.6% had moderate symptoms worsening during the second lockdown. Female sex, feeling socially isolated, worrying about COVID-19 infection, and using psychotropic drugs were associated with PTSS. PTSS were associated with impaired quality of life, sleep, and cognition. CONCLUSIONS Approximately one-fourth of patients with cancer experienced high and persistent PTSS over the first year of the COVID-19 pandemic and may benefit from psychological support. CLINICALTRIALS gov identifier: NCT04366154.
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Affiliation(s)
- Etienne Bastien
- Medical Oncology Department, François Baclesse Center, Caen, France
| | - Sophie Lefèvre-Arbogast
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France
- Clinical Research, François Baclesse Center, Caen, France
- National Clinical Research Platform for Quality of Life in Oncology, Besançon, France
| | | | - François Gernier
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France
- Clinical Research, François Baclesse Center, Caen, France
| | - François Cherifi
- Medical Oncology Department, François Baclesse Center, Caen, France
| | - Olivier Rigal
- Medical Oncology, Henri Becquerel Center, Rouen, France
- Clinical Research, Henri Becquerel Center, Rouen, France
| | - Lydia Guittet
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France
| | | | - Giulia Binarelli
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France
- Clinical Research, François Baclesse Center, Caen, France
| | - Marie Lange
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France
- Clinical Research, François Baclesse Center, Caen, France
| | - Marie Fernette
- Clinical Research, François Baclesse Center, Caen, France
| | - Laure Tron
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France
| | - Adeline Morel
- Medical Oncology Department, François Baclesse Center, Caen, France
| | | | | | | | - Florian Quilan
- Medical Oncology Department, François Baclesse Center, Caen, France
| | | | - Fabrice Jardin
- Clinical Research, Henri Becquerel Center, Rouen, France
- Hematology, Henri Becquerel Center, Rouen, France
| | | | - Audrey Faveyrial
- Medical Oncology Department, François Baclesse Center, Caen, France
| | | | - Florence Joly
- Medical Oncology Department, François Baclesse Center, Caen, France
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France
- Clinical Research, François Baclesse Center, Caen, France
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Nguyen S, Bastien E, Chretien B, Sassier M, Defer G, Nehme A, Lelong-Boulouard V, Alexandre J, Fedrizzi S, Morice PM. Transverse myelitis following SARS-CoV-2 vaccination: a pharmacoepidemiological study in the World Health Organization's database. Ann Neurol 2022; 92:1080-1089. [PMID: 36054163 PMCID: PMC9538824 DOI: 10.1002/ana.26494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022]
Abstract
Background Transverse myelitis (TM) has recently been associated by health authorities with Ad26.COV2.S (Janssen/Johnson & Johnson), one of the 5 US Food and Drug Administration (FDA) or European Medicines Agency (EMA) labeled severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) vaccines. It is unknown whether a similar association exists for the other FDA or EMA labeled SARS‐CoV‐2 vaccines (BNT162b2 [Pfizer/BioNTech], mRNA‐1273 [Moderna], ChAdOx1nCov‐19 [Oxford–AstraZeneca], and NVX‐CoV2373 [Novavax]). This study aimed to evaluate the association between SARS‐CoV‐2 vaccine class and TM. Methods This observational, cross‐sectional, pharmacovigilance cohort study examined individual case safety reports from VigiBase, the World Health Organization's pharmacovigilance database. We first conducted a disproportionality analysis with the information component (IC) using the reports of TM that occurred within 28 days following exposure to the FDA or EMA labeled SARS‐CoV‐2 vaccines, from December 1, 2020 (first adverse event related to a SARS‐CoV‐2 vaccine) to March 27, 2022. Second, we analyzed the clinical features of SARS‐CoV‐2 vaccine‐associated TM cases reported in VigiBase. Results TM was significantly associated both with the messenger ribonucleic acid (mRNA)‐based (n = 364; IC025 = 0.62) and vector‐based (n = 136; IC025 = 0.52) SARS‐CoV‐2 vaccines that are authorized by the FDA or the EMA. Conclusions Findings from this observational, cross‐sectional pharmacovigilance study showed that mRNA‐based and vector‐based FDA/EMA labeled SARS‐CoV‐2 vaccines can be associated with TM. However, because TM remains a rare event, with a previously reported rate of 0.28 cases per 1 million vaccine doses, the risk–benefit ratio in favor of vaccination against SARS‐CoV‐2 virus remains unchallenged. Rather, this study suggests that clinicians should consider the diagnosis of TM in patients presenting with early signs of spinal cord dysfunction after SARS‐CoV‐2 vaccination. ANN NEUROL 2022
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Affiliation(s)
- Sophie Nguyen
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France.,Department of Neurology, MS Expert Centre, University Teaching Hospital of Caen-Normandie, France
| | - Etienne Bastien
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France
| | - Basile Chretien
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France
| | - Marion Sassier
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France
| | - Gilles Defer
- Department of Neurology, MS Expert Centre, University Teaching Hospital of Caen-Normandie, France
| | - Ahmad Nehme
- Normandie Univ, UNICAEN, INSERM U1086 'Interdisciplinary Research Unit for Cancers Prevention and Treatment' (ANTICIPE), Caen, France
| | | | - Joachim Alexandre
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France.,Normandie Univ, UNICAEN, INSERM U1086 'Interdisciplinary Research Unit for Cancers Prevention and Treatment' (ANTICIPE), Caen, France
| | - Sophie Fedrizzi
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France
| | - Pierre-Marie Morice
- Department of Pharmacology, University Teaching Hospital of Caen-Normandie, France.,Normandie Univ, UNICAEN, INSERM U1086 'Interdisciplinary Research Unit for Cancers Prevention and Treatment' (ANTICIPE), Caen, France
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6
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Joly F, Rigal O, Guittet L, Lefèvre-Arbogast S, Grellard JM, Binarelli G, Lange M, Rieux C, Fernette M, Tron L, Gernier F, Travers R, Morel A, Richard D, Griffon B, Leconte A, Bastien E, Quilan F, Pépin LF, Jardin F, Leheurteur M, Clarisse B, Lequesne J, Faveyrial A. Post-traumatic stress symptomatology and adjustment of medical oncology practice during the COVID-19 pandemic among adult patients with cancer in a day care hospital. Cancer 2021; 127:4636-4645. [PMID: 34398970 PMCID: PMC8426939 DOI: 10.1002/cncr.33856] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 12/20/2022]
Abstract
Background The COVID‐19 pandemic may induce post‐traumatic stress disorder (PTSD) symptoms among patients with cancer, who also face adaptations to their treatment. The authors assessed the occurrence of PTSD symptoms, investigated pandemic‐induced adjustments in medical oncology practice in patients with cancer, and explored risk factors for PTSD and the association between PTSD symptoms, insomnia, and quality of life (QoL). Methods This prospective French study was conducted in patients with solid/hematologic tumors who were receiving medical treatment in the day care departments of 2 cancer centers during the lockdown. Adjustments to medical oncology practice were collected from medical records. PTSD (measured using the Impact of Event Scale‐Revised), insomnia (measured using the Insomnia Severity Index), QoL (measured using the Functional Assessment of Cancer Therapy‐General instrument), and cognitive complaints (measured using the Functional Assessment of Cancer Therapy–Cognitive Function instrument) were collected through validated questionnaires. Results Clinical data and questionnaires were available for 734 and 576 patients, respectively. The median patient age was 64 years, and 69% of patients were women. Twenty‐one percent of patients had PTSD. Twenty‐seven percent (95% CI, 23%‐30%) had an adjustment in their medical oncology program, including adjournments (29%), treatment interruptions (16%), modified treatment plans (27%), or adapted monitoring (27%). Women and patients experiencing an adjustment in oncology practice had a higher odds of PTSD (odds ratio= 2.10 [95% CI, 1.07‐4.14] and 1.65 [95% CI, 1.03‐2.63]; P < .05). PTSD symptoms were correlated with worse scores for QoL, cognition, and insomnia. Conclusions Twenty‐one percent of patients with cancer experienced PTSD symptoms associated with poor QoL during the first COVID‐19–induced lockdown. Medical oncology practice was adjusted in approximately one‐quarter of patients and was associated with the occurrence of PTSD symptoms. Psychosocial support should be offered in cancer centers to promote emotional resilience and avoid PTSD symptoms in patients. Post‐traumatic stress disorder symptomatology occurred in 21% of patients with cancer during the first lockdown due to COVID‐19, was more frequent among women, and was associated with adjustment in medical oncology treatments. Caregivers should pay special attention to the psychological needs of patients with cancer to prevent or manage post‐traumatic stress disorder symptoms.
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Affiliation(s)
- Florence Joly
- Medical Oncology Department, Francois Baclesse Center, Caen, France.,Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France.,Clinical Research, Francois Baclesse Center, Caen, France
| | - Olivier Rigal
- Medical Oncology, Henri Becquerel Center, Rouen, France.,Clinical Research, Henri Becquerel Center, Rouen, France
| | - Lydia Guittet
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France
| | - Sophie Lefèvre-Arbogast
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France.,Clinical Research, Francois Baclesse Center, Caen, France
| | | | - Giulia Binarelli
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France.,Clinical Research, Francois Baclesse Center, Caen, France
| | - Marie Lange
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France.,Clinical Research, Francois Baclesse Center, Caen, France
| | - Chantal Rieux
- Clinical Research, Francois Baclesse Center, Caen, France
| | - Marie Fernette
- Clinical Research, Francois Baclesse Center, Caen, France
| | - Laure Tron
- Anticipe (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France
| | | | | | - Adeline Morel
- Medical Oncology Department, Francois Baclesse Center, Caen, France
| | | | | | | | - Etienne Bastien
- Medical Oncology Department, Francois Baclesse Center, Caen, France
| | - Florian Quilan
- Medical Oncology Department, Francois Baclesse Center, Caen, France
| | | | - Fabrice Jardin
- Clinical Research, Henri Becquerel Center, Rouen, France.,Hematology, Henri Becquerel Center, Rouen, France
| | | | | | | | - Audrey Faveyrial
- Medical Oncology Department, Francois Baclesse Center, Caen, France
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7
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Joly F, Lefèvre-Arbogast S, Rigal O, Bastien E, Guittet L, Grellard JM, Lange M, Leconte A, Quilan F, Travers R, Morel A, Pépin LF, Jardin F, Leheurteur M, Lequesne J, Clarisse B, Binarelli G, Faveyrial A. Evolution of post-traumatic stress disorder and patient reported-outcomes during the COVID-19 pandemic among cancer patients of the French longitudinal COVIPACT study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.12123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12123 Background: Sudden COVID-19 pandemic has enforced social restrictions across the globe, including social distancing, curfews and total lockdowns, which persist in many parts of the world. Beyond these measures, cancer patients have faced up to the threat of the risk of severe COVID-19 infections and the adaptations of medical oncology practices, with potential impact on their psychological well-being. We aimed to follow Post-Traumatic Stress Disorder (PTSD) symptoms and other Patient-Reported Outcomes (PROs) over this period among cancer patients from the French COVIPACT study. Methods: The COVIPACT study (NCT04366154) included patients with solid/hematologic malignancy receiving medical treatment during the first lockdown in outpatient departments of two cancer centers. Patients were asked to fulfill validated questionnaires on PTSD symptoms (IES-R), insomnia (ISI), quality of life (FACT-G) and cognition (FACT-Cog) at baseline (M0, first lockdown, Apr/May 2020), 3 months (M3, post-lockdown, Jul/Aug 2020) and 6 months (M6, second lockdown, Oct/Nov 2020). PTSD was defined as an IES-R score ≥33 and moderate/severe insomnia as an ISI score ≥15. Higher values on the FACT-G (range 0-108) and FACT-Cog (PCI subscale range 0-72) indicated better quality of life and cognition, respectively. Changes in PROs over time were assessed using mixed models for repeated measures. Results: Among the 734 patients included in COVIPACT, 579, 347 and 328 completed the questionnaires at M0, M3 and M6, respectively: median age, 64 years, 72% women, 59% metastatic status. Patients were mostly treated for breast (44%), lung, head and neck (20%), digestive (16%) and gynecologic cancers (11%). We observed a J-shaped evolution of PTSD over time, affecting 21.2% of patients during the first lockdown, 13.6% the post-lockdown and 23.6% during the second lockdown (p for time < 0.001). Moreover, patients reported linear deterioration of cognitive function over follow-up (p < 0.001). No change was observed in any dimension of quality of life (p for time = 0.06). 24.3%, 27.1% and 28.1% of the patients reported insomnia at M0,M3 and M6 (p for time = 0.35). At each time, PTSD was associated with more insomnia, worst quality of life and cognitive complain. At all the times, ≥50% of patients with PTSD reported insomnia compared to ≤23% in non-PTSD patients (p < 0.001). In addition, there was a clinically significant difference of ≥16 points on the FACT-G and ≥8 points on the FACT-Cog PCI between PTSD and non-PTSD patients (p < 0.001) at the all times. Conclusions: More than 20% of patients have developed PTSD during the different periods of lockdown, with strong association with poor quality of life, cognitive complain and insomnia. Psychosocial support promoting emotional resilience should be largely offered to cancer patients to prevent and/or reduce PTSD. Clinical trial information: NCT04366154.
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Affiliation(s)
- Florence Joly
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | | | | | - Etienne Bastien
- Centre François Baclesse, Medical Oncology Department, Caen, France
| | - Lydia Guittet
- Caen University Hospital, Inserm U1086, Caen, France
| | | | - Marie Lange
- Centre François Baclesse, Clinical Research Department, Inserm U1086, Caen, France
| | - Alexandra Leconte
- Centre François Baclesse, Clinical Research Department, Caen, France
| | - Florian Quilan
- Centre François Baclesse, Medical Oncology Department, Caen, France
| | | | - Adeline Morel
- Centre François Baclesse, Medical Oncology Department, Caen, France
| | | | - Fabrice Jardin
- Department of Hematology, Inserm U918, Centre henri Becquerel, University of Normandy, Rouen, France
| | | | - Justine Lequesne
- Centre François Baclesse, Clinical Research Department, Caen, France
| | | | - Giulia Binarelli
- Centre François Baclesse, Clinical Research Deparmtent, Inserm U1086, Caen, France
| | - Audrey Faveyrial
- Centre François Baclesse, Medical Oncology Department, Caen, France
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Babič A, Herceg V, Bastien E, Lassalle HP, Bezdetnaya L, Lange N. 5-Aminolevulinic Acid-Squalene Nanoassemblies for Tumor Photodetection and Therapy: In Vitro Studies. Nanoscale Res Lett 2018; 13:10. [PMID: 29327259 PMCID: PMC5764903 DOI: 10.1186/s11671-017-2408-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 12/10/2017] [Indexed: 05/22/2023]
Abstract
Protoporphyrin IX (PpIX) as natural photosensitizer derived from administration of 5-aminolevulinic acid (5-ALA) has found clinical use for photodiagnosis and photodynamic therapy of several cancers. However, broader use of 5-ALA in oncology is hampered by its charge and polarity that result in its reduced capacity for passing biological barriers and reaching the tumor tissue. Advanced drug delivery platforms are needed to improve the biodistribution of 5-ALA. Here, we report a new approach for the delivery of 5-ALA. Squalenoylation strategy was used to covalently conjugate 5-ALA to squalene, a natural precursor of cholesterol. 5-ALA-SQ nanoassemblies were formed by self-assembly in water. The nanoassemblies were monodisperse with average size of 70 nm, polydispersity index of 0.12, and ζ-potential of + 36 mV. They showed good stability over several weeks. The drug loading of 5-ALA was very high at 26%. In human prostate cancer cells PC3 and human glioblastoma cells U87MG, PpIX production was monitored in vitro upon the incubation with nanoassemblies. They were more efficient in generating PpIX-induced fluorescence in cancer cells compared to 5-ALA-Hex at 1.0 to 3.3 mM at short and long incubation times. Compared to 5-ALA, they showed superior fluorescence performance at 4 h which was diminished at 24 h. 5-ALA-SQ presents a novel nano-delivery platform with great potential for the systemic administration of 5-ALA.
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Affiliation(s)
- Andrej Babič
- School of Pharmaceutical Sciences, University of Geneva, Rue Michel Servet 1, 1211, Geneva 4, Switzerland.
- School of Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland.
| | - V Herceg
- School of Pharmaceutical Sciences, University of Geneva, Rue Michel Servet 1, 1211, Geneva 4, Switzerland
- School of Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland
| | - E Bastien
- Centre de Recherche en Automatique de Nancy (CRAN), CNRS UMR 7039 (Centre National de la Recherche Scientifique), Université de Lorraine, Campus Sciences, Vandœuvre-lès-Nancy, France
- Research Department, Institut de Cancérologie de Lorraine, Avenue de Bourgogne, 54519, Vandœuvre-lès-Nancy, France
| | - H-P Lassalle
- Centre de Recherche en Automatique de Nancy (CRAN), CNRS UMR 7039 (Centre National de la Recherche Scientifique), Université de Lorraine, Campus Sciences, Vandœuvre-lès-Nancy, France
- Research Department, Institut de Cancérologie de Lorraine, Avenue de Bourgogne, 54519, Vandœuvre-lès-Nancy, France
| | - L Bezdetnaya
- Centre de Recherche en Automatique de Nancy (CRAN), CNRS UMR 7039 (Centre National de la Recherche Scientifique), Université de Lorraine, Campus Sciences, Vandœuvre-lès-Nancy, France
- Research Department, Institut de Cancérologie de Lorraine, Avenue de Bourgogne, 54519, Vandœuvre-lès-Nancy, France
| | - Norbert Lange
- School of Pharmaceutical Sciences, University of Geneva, Rue Michel Servet 1, 1211, Geneva 4, Switzerland.
- School of Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland.
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Bellemare S, Morin M, Bastien E, Girard R, Blais R, Dubé S. [Could we trust clinical statistics from data banks of the National Health Service (NHS)?]. Ann Chir 2004; 129:11-3. [PMID: 15019848 DOI: 10.1016/j.anchir.2003.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2003] [Accepted: 11/07/2003] [Indexed: 04/29/2023]
Abstract
Can we accept the statistics provided by the Ministry of Health, which uses large computerized databases? Through MEDECHO, the Ministry provides to hospital managers, reports cards on different interventions. These reports compare different hospitals performances. Surgeons involved in the process hesitate to accept this information. Using the results of the performance of cholecystectomy provided by this system (Gr: A), we compared the same cohort (1 April-31 December 1996 = 346 cholecystectomies) but using specific criteria determined as relevant to our surgeons (Gr: B). The rate of complication gives a crude aftermath and no attempt was used to adjust for severity. The MEDECHO data are adjusted for severity. The global rate of complications is similar Gr: A 11%, Gr: B 12%. Major complication rate for pulmonary embolism, hemorrhage and biliary duct trauma are identical. The rate of surgical site infection is higher in Gr: B (5% vs. 2%). The patients are seen in the outpatient clinic and these observations are not included by the analytical system unless the patient has been readmitted. For our hospital, the MEDECHO data are valid and reliable even though they underestimated the wound infection rate. These results could be explained by an appropriate interpretation of the code system by the archivist and by the surgeons' precision to complete the summary sheet of hospitalization. We can conclude that these data can be used as a means to evaluate the quality of outcome of a surgical service.
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Affiliation(s)
- S Bellemare
- Département chirurgie, hôpital Maisonneuve-Rosemont, université de Montréal, 5415, boulevard de L'Assomption, Montréal QC H1T 2M4, Canada
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10
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Madore F, Hébert MJ, Leblanc M, Girard R, Bastien E, Morin M, Beaudry C, Boucher A, Dandavino R. Determinants of late allograft nephrectomy. Clin Nephrol 1995; 44:284-9. [PMID: 8605707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
When loss of graft function occurs more than six months after transplantation, allograft nephrectomy is not routinely performed at the time of graft failure. It is usually performed only on those patients who subsequently develop specific complications. However, little is known about the characteristics that make patients more likely to require allograft nephrectomy. The purpose of our study was to identify risk factors for the subsequent need for allograft nephrectomy in patients with graft failure occurring more than 6 months after transplantation. Forty-one patients were studied. Inclusion criteria were: loss of graft function > or = 6 months after transplantation, resumption of dialysis and initiation of weaning from immunosuppression. Thirty patients were treated with cyclosporine + prednisone +/- azathioprine and 11 with azathioprine + prednisone. Mean follow-up time was 17.8 months, ranging from 6 months to 6.1 years. Recipient age, sex and race, original renal disease, donor, donor source (cadaveric vs living related), HLA compatibility, levels of panel reactive antibodies, occurrence of initial delayed graft function, causes of graft failure and tapering of immunosuppression were similar in patients with and without allograft nephrectomy. Using univariate analysis, allograft nephrectomy was found to be significantly more frequent in patients with a history of 2 or more episodes of acute rejection than in patients with no rejection episode: 83% vs 30% (p = 0.03). In addition, allograft nephrectomy was found to be significantly more frequent if the immunosuppressive regimen included cyclosporine (62% vs 27.3%; p = 0.04). Using multivariate analysis however, the number of previous episodes of rejection was found to be the only significant predictor for allograft nephrectomy. None of the other variables considered in the multivariate analysis, including the type of immunosuppressive therapy, was identified as a significant predictor for the need to perform allograft nephrectomy. In summary, the need for late allograft nephrectomy was correlated with the number of previous episodes of acute rejection. Patients with a history of numerous rejection episodes should thus be considered more likely to require allograft nephrectomy once immunosuppression is withdrawn. Possible interventions to reduce or prevent the need for nephrectomy include more gradual tapering of immunosuppression at the time of graft failure or indefinite low-dose immunosuppressive therapy.
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Affiliation(s)
- F Madore
- Service de Néphrologie, Hôpital Maisonneuve-Rosemont, Université de Montréal, Québec, Canada
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11
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Ferraro P, Beauchamp G, Lord F, Emond C, Bastien E. Spontaneous primary and secondary pneumothorax: a 10-year study of management alternatives. Can J Surg 1994; 37:197-202. [PMID: 8199936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To study the outcome of conservative and surgical management of spontaneous pneumothorax. DESIGN Retrospective study between January 1980 and December 1990, with a mean follow-up of 6.5 years. SETTING A tertiary-care university hospital with a referral thoracic surgical unit. PATIENTS All patients seen in the study period with spontaneous pneumothorax. Those with traumatic, iatrogenic or ventilator-associated pneumothoraces were excluded. There were 366 consecutive patients who had 508 episodes of spontaneous pneumothorax. Two hundred and thirty-nine patients had primary spontaneous pneumothorax (group 1); 127 had secondary spontaneous pneumothorax (group 2). INTERVENTIONS Tube thoracostomy, apical resection with either pleurectomy or pleural abrasion. MAIN OUTCOME MEASURES Recurrence and outcome after surgical management relative to recurrence, complications, operative technique and mean hospital stay were evaluated by clinical review and questionnaire by an independent observer. RESULTS No significant differences were noted between the two groups with respect to the incidence of recurrent spontaneous pneumothorax after the first or second episode, and no significant differences were noted between the two operative techniques with respect to recurrence, complications, operative technique or death rate. However the mean hospital stay was doubled for group 2 patients (9.9 versus 4.3 days). CONCLUSIONS Conservative treatment, including tube thoracostomy, was effective for primary and secondary spontaneous pneumothorax. Open surgery was effective in preventing recurrence in 95% of cases in both groups.
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Affiliation(s)
- P Ferraro
- Division of Thoracic Surgery, Hôpital Maisonneuve-Rosemont, Université de Montréal, Que
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12
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Perrault L, Beauchamp G, Bastien E, Laurendeau F, Jobin G, Archambault A. Surgical treatment of achalasia in a general hospital. Can J Surg 1991; 34:487-90. [PMID: 1913396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The authors report their experience with 43 patients treated for achalasia of the esophagus in a general hospital between 1971 and 1986. Patients were divided into two groups according to the type of surgery performed: group 1--29 patients treated by Heller myotomy, performed by nine general surgeons between 1971 and 1983; and group 2--14 patients treated by transthoracic Heller myotomy with the addition of a Belsey Mark-IV fundoplication. Dysphagia was reduced postoperatively in 82.6% of patients in group 1 and 92.8% of patients in group 2. Three patients in group 1 and one patient in group 2 had persistent dysphagia. Ten patients in group 1 had symptoms of gastroesophageal reflux (5 of them required a second antireflux procedure). In group 2, one patient had symptoms of gastroesophageal reflux, but was treated successfully medically. There was no difference in the degree of relief of dysphagia between the abdominal and thoracic approach, or in whether the operation was performed by a general surgeon without specific experience in the treatment of achalasia. The addition of a fundoplication to a Heller myotomy appeared to lessen the problem of postoperative gastroesophageal reflux. Since the Heller myotomy is technically difficult and may lead to obstruction of the poorly emptying esophagus the authors recommend that it be used selectively and only by the experienced esophageal surgeon.
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Affiliation(s)
- L Perrault
- Division of General Surgery, Hôpital Maisonneuve-Rosemont, Montreal, Que
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13
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Touré CT, Beauchamp G, Bastien E. [Palliative treatment of cancer of the esophagus using an endoluminal prosthesis]. Can J Surg 1987; 30:32-4. [PMID: 2434200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Between 1973 and 1984, 27 patients with a cancer of the esophagus or the cardia and suffering dysphagia underwent palliation with an endoluminal prosthesis. Intubation under esophagoscopy or through a gastrotomy, or both, allowed the placement of 23 Celestin tubes and 4 Mousseau-Barbin prostheses. The early postoperative death rate was 11%. The overall morbidity was 37%. It included such complications as tube displacement (18.5% of patients), tracheal compression by the tube (7.4%), obstruction of the prosthesis (11%), esophageal fistula (7.4%), aspiration (7.4%) and wound infection (7.4%). The ability to swallow was acceptable in 24 patients.
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Dandavino R, Beaudry C, Girard R, Bastien E, Pison C, Houde M. Growth response of an adult hypoplastic kidney transplanted in a living-related recipient. Transplantation 1985; 40:723-4. [PMID: 3907047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Dandavino R, Barcelo R, Beaudry C, Cardinal J, Carriere S, Friborg J, Houde M, Ouimet D, Bastien E, Girard R, Laplante L. Cadaver kidney transplantation: a retrospective comparison of two immunosuppressive regimens. Transplant Proc 1982; 14:635-9. [PMID: 6762720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Girard RM, Bastien E, Beaudry C, Dandavino R, Houde M, Laplante L. [Calcinosis in the renal transplant patient]. Union Med Can 1981; 110:443-51. [PMID: 7020201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Beaudry C, Bracelo R, Cardinal J, Carrière S, Dandavino R, Friborg J, Houde M, Laplante L, Bastien E, Girard R. [Renal transplantation in insulin-dependent diabetic patients]. Union Med Can 1981; 110:221-8. [PMID: 7018044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Laplante L, Barcelo R, Beaudry C, Carrière S, Cardinal J, Friborg J, Houde M, Bastien E, Girard R, Dandavino R. [Renal transplant and rehabilitation]. Union Med Can 1981; 110:88-90. [PMID: 7010743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Girard RM, Laplante L, Dandavino R, Houde M, Beaudry C, Bastien E. [Surgical complications of renal transplant]. Union Med Can 1981; 110:92-102. [PMID: 7010744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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20
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Dandavino R, Barcelo R, Beaudry C, Cardinal J, Carrière S, Friborg J, Houde M, Girard R, Bastien E, Laplante L. [Renal transplantation at the Maisonneuve-Rosemont Hospital: 10-year experience]. Union Med Can 1981; 110:104-8. [PMID: 7010741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Laplante L, Bastien E, Giroux Y, Girard R. Intravenous treatment of systemic infections in 20 patients with cefoxitin sodium. J Antimicrob Chemother 1978; 4:219-22. [PMID: 357391 DOI: 10.1093/jac/4.suppl_b.219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Abstract
The difficulties encountered in the diagnosis of solitary pancreatic injury when there is no other indication for surgical exploration of the abdomen are discussed. We suggest that endoscopic transduodenal pancreatography is a reliable diagnostic tool of great help in evaluating such injuries with little morbidity.
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Houde M, Beaudry C, Bastien E, Laplante L. [Kidney transplants. 50 cases]. Union Med Can 1974; 103:1051-6. [PMID: 4601141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Stuart FP, Garrick T, Holter A, Lynch A, Bastien E. Delayed rejection of renal allografts in the rat and dog by reduction of passenger leukocytes. Surgery 1971; 70:128-34. [PMID: 4933441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Stuart FP, Bastien E, Holter A, Fitch FW, Elkins WL. Role of passenger leukocytes in the rejection of renal allografts. Transplant Proc 1971; 3:461-4. [PMID: 4937919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Bastien E, Brière J. [Granulomatous peritonitis due to glove powder]. Union Med Can 1969; 98:1307-13. [PMID: 5396997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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