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Chevallay M, Brasset C, Marcelis J, Toso C, Jung M, Mönig SP. [Esophageal cancer: standards and innovations in multidisciplinary treatment]. Rev Med Suisse 2023; 19:1169-1174. [PMID: 37314255 DOI: 10.53738/revmed.2023.19.831.1169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Esophageal cancer is a severe disease that requires a combined therapeutic approach to improve the prognosis. Once the initial assessment is completed, the patient's case should be discussed in a multidisciplinary conference in a specialized center to decide on an appropriate therapeutic strategy taking into account the stage of the disease and the patient's general condition. Several advances in treatment, both from a surgical technique standpoint, with the advent of minimally invasive and robotic surgery, and from a medical perspective, with the use of immunotherapy under certain conditions, have dramatically improved mortality rates. In this article, we explore the standards and latest innovations in the multimodal treatment of esophageal cancer.
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Affiliation(s)
- Mickael Chevallay
- Service de chirurgie viscérale, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Camille Brasset
- Service de chirurgie viscérale, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Jordan Marcelis
- Service de chirurgie viscérale, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Christian Toso
- Service de chirurgie viscérale, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Minoa Jung
- Service de chirurgie viscérale, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Stefan Paul Mönig
- Service de chirurgie viscérale, Hôpitaux universitaires de Genève, 1211 Genève 14
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Spindler-Raffel E, Benjamin RJ, McDonald CP, Ramirez-Arcos S, Aplin K, Bekeredjian-Ding I, de Korte D, Gabriel C, Gathof B, Hanschmann KM, Hourfar K, Ingram C, Jacobs MR, Keil SD, Kou Y, Lambrecht B, Marcelis J, Mukhtar Z, Nagumo H, Niekerk T, Rojo J, Marschner S, Satake M, Seltsam A, Seifried E, Sharafat S, Störmer M, Süßner S, Wagner SJ, Yomtovian R. Enlargement of the WHO international repository for platelet transfusion-relevant bacteria reference strains. Vox Sang 2017; 112:713-722. [PMID: 28960367 DOI: 10.1111/vox.12548] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 05/25/2017] [Accepted: 05/26/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Interventions to prevent and detect bacterial contamination of platelet concentrates (PCs) have reduced, but not eliminated the sepsis risk. Standardized bacterial strains are needed to validate detection and pathogen reduction technologies in PCs. Following the establishment of the First International Reference Repository of Platelet Transfusion-Relevant Bacterial Reference Strains (the 'repository'), the World Health Organization (WHO) Expert Committee on Biological Standardisation (ECBS) endorsed further repository expansion. MATERIALS AND METHODS Sixteen bacterial strains, including the four repository strains, were distributed from the Paul-Ehrlich-Institut (PEI) to 14 laboratories in 10 countries for enumeration, identification and growth measurement on days 2, 4 and 7 after low spiking levels [10-25 colony-forming units (CFU)/PC bag]. Spore-forming (Bacillus cereusPEI-B-P-07-S, Bacillus thuringiensisPEI-B-P-57-S), Gram-negative (Enterobacter cloacaePEI-B-P-43, Morganella morganiiPEI-B-P-74, PEI-B-P-91, Proteus mirabilisPEI-B-P-55, Pseudomonas fluorescensPEI-B-P-77, Salmonella choleraesuisPEI-B-P-78, Serratia marcescensPEI-B-P-56) and Gram-positive (Staphylococcus aureusPEI-B-P-63, Streptococcus dysgalactiaePEI-B-P-71, Streptococcus bovisPEI-B-P-61) strains were evaluated. RESULTS Bacterial viability was conserved after transport to the participating laboratories with one exception (M. morganiiPEI-B-P-74). All other strains showed moderate-to-excellent growth. Bacillus cereus, B. thuringiensis, E. coli, K. pneumoniae, P. fluorescens, S. marcescens, S. aureus and S. dysgalactiae grew to >106 CFU/ml by day 2. Enterobacter cloacae, P. mirabilis, S. epidermidis, S. bovis and S. pyogenes achieved >106 CFU/ml at day 4. Growth of S. choleraesuis was lower and highly variable. CONCLUSION The WHO ECBS approved all bacterial strains (except M. morganiiPEI-B-P-74 and S. choleraesuisPEI-B-P-78) for repository enlargement. The strains were stable, suitable for spiking with low CFU numbers, and proliferation was independent of the PC donor.
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Affiliation(s)
| | | | - C P McDonald
- National Health Service Blood and Transplant, London, UK
| | | | - K Aplin
- National Health Service Blood and Transplant, London, UK
| | | | - D de Korte
- Sanquin Blood Supply Foundation, Amsterdam, The Netherlands
| | - C Gabriel
- Blood Centre Linz, Austrian Red Cross, Linz, Austria
| | - B Gathof
- Institute of Transfusion Medicine, University Hospital of Cologne, Cologne, Germany
| | | | - K Hourfar
- German Red Cross, Frankfurt/Main, Germany
| | - C Ingram
- Constantia Kloof, South African National Blood Service, Johannesburg, South Africa
| | - M R Jacobs
- Case Western Reserve University, Cleveland, OH, USA
| | - S D Keil
- Terumo BCT Biotechnologies, Lakewood, CO, USA
| | - Y Kou
- Canadian Blood Service, Ottawa, ON, Canada
| | - B Lambrecht
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - J Marcelis
- Elisabeth Hospital, Tilburg, The Netherlands
| | - Z Mukhtar
- Dow Safe Blood Transfusion Services, DUHS, Khi, Pakistan
| | - H Nagumo
- Japanese Red Cross, Tokyo, Japan
| | - T Niekerk
- Constantia Kloof, South African National Blood Service, Johannesburg, South Africa
| | - J Rojo
- Centro Nacional de la Transfusión Sanguínea, Mexico, Mexico
| | - S Marschner
- Terumo BCT Biotechnologies, Lakewood, CO, USA
| | - M Satake
- Japanese Red Cross, Tokyo, Japan
| | - A Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - E Seifried
- German Red Cross, Frankfurt/Main, Germany
| | - S Sharafat
- Dow University of Health Sciences, Khi, Pakistan
| | - M Störmer
- Institute of Transfusion Medicine, University Hospital of Cologne, Cologne, Germany
| | - S Süßner
- Blood Centre Linz, Austrian Red Cross, Linz, Austria
| | - S J Wagner
- Holland Laboratory, Transfusion Innovation Department, American Red Cross, Rockville, MD, USA
| | - R Yomtovian
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA
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Störmer M, Arroyo A, Brachert J, Carrero H, Devine D, Epstein JS, Gabriel C, Gelber C, Goodrich R, Hanschmann KM, Heath DG, Jacobs MR, Keil S, de Korte D, Lambrecht B, Lee CK, Marcelis J, Marschner S, McDonald C, McGuane S, McKee M, Müller TH, Muthivhi T, Pettersson A, Radziwon P, Ramirez-Arcos S, Reesink HW, Rojo J, Rood I, Schmidt M, Schneider CK, Seifried E, Sicker U, Wendel S, Wood EM, Yomtovian RA, Montag T. Establishment of the first international repository for transfusion-relevant bacteria reference strains: ISBT working party transfusion-transmitted infectious diseases (WP-TTID), subgroup on bacteria. Vox Sang 2011; 102:22-31. [PMID: 21732948 DOI: 10.1111/j.1423-0410.2011.01510.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bacterial contamination of platelet concentrates (PCs) still remains a significant problem in transfusion with potential important clinical consequences, including death. The International Society of Blood Transfusion Working Party on Transfusion-Transmitted Infectious Diseases, Subgroup on Bacteria, organised an international study on Transfusion-Relevant Bacteria References to be used as a tool for development, validation and comparison of both bacterial screening and pathogen reduction methods. MATERIAL AND METHODS Four Bacteria References (Staphylococcus epidermidis PEI-B-06, Streptococcus pyogenes PEI-B-20, Klebsiella pneumoniae PEI-B-08 and Escherichia coli PEI-B-19) were selected regarding their ability to proliferate to high counts in PCs and distributed anonymised to 14 laboratories in 10 countries for identification, enumeration and bacterial proliferation in PCs after low spiking (0·3 and 0·03 CFU/ml), to simulate contamination occurring during blood donation. RESULTS Bacteria References were correctly identified in 98% of all 52 identifications. S. pyogenes and E. coli grew in PCs in 11 out of 12 laboratories, and K. pneumoniae and S. epidermidis replicated in all participating laboratories. The results of bacterial counts were very consistent between laboratories: the 95% confidence intervals were for S. epidermidis: 1·19-1·32 × 10(7) CFU/ml, S. pyogenes: 0·58-0·69 × 10(7) CFU/ml, K. pneumoniae: 18·71-20·26 × 10(7) CFU/ml and E. coli: 1·78-2·10 × 10(7) CFU/ml. CONCLUSION The study was undertaken as a proof of principle with the aim to demonstrate (i) the quality, stability and suitability of the bacterial strains for low-titre spiking of blood components, (ii) the property of donor-independent proliferation in PCs, and (iii) their suitability for worldwide shipping of deep frozen, blinded pathogenic bacteria. These aims were successfully fulfilled. The WHO Expert Committee Biological Standardisation has approved the adoption of these four bacteria strains as the first Repository for Transfusion-Relevant Bacteria Reference Strains and, additionally, endorsed as a project the addition of six further bacteria strain preparations suitable for control of platelet contamination as the next step of enlargement of the repository.
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Affiliation(s)
- M Störmer
- Paul Ehrlich Institute, Langen, Germany.
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Abstract
We describe 10 patients with idiopathic intracranial hypertension who did not have papilledema. Idiopathic intracranial hypertension without papilledema, although rarely reported, may well be a clinically important headache syndrome. Historical and demographic features of patients with idiopathic intracranial hypertension without papilledema are similar to those of patients with papilledema. Obese women with chronic daily headache and symptoms of increased intracranial pressure, pulsatile tinnitus, history of head trauma or meningitis, an empty sella on imaging studies, or a headache that is unrelieved by standard therapy should have a diagnostic lumbar puncture. Findings from laboratory and neurologic investigations are normal in most patients with idiopathic intracranial hypertension without papilledema. Initial management should include removal of possible inciting agents, weight loss if applicable, and standard headache therapy. Lumbar puncture and diuretic therapy should precede a trial of corticosteroids. Surgery (lumboperitoneal or ventriculoperitoneal shunt or perhaps optic nerve sheath fenestration) may be indicated for prolonged incapacitating headache that is not responsive to medical management or lumbar puncture.
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Affiliation(s)
- J Marcelis
- Department of Internal Medicine, Temple University Hospital, Philadelphia, PA
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