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Pla H, Felip E, Obadia V, Pernas S, Viñas G, Margelí M, Fort-Culillas R, Del Barco S, Sabaté N, Fort E, Lezcano C, Cirauqui B, Quiroga V, Stradella A, Gil Gil M, Esteve A, Recalde S. Elderly patients with hormone receptor-positive HER2-negative metastatic breast cancer treated with CDK4/6 inhibitors in a multicentre cohort. Clin Transl Oncol 2024:10.1007/s12094-024-03399-3. [PMID: 38519708 DOI: 10.1007/s12094-024-03399-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/24/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Cyclin-dependent kinases 4/6 inhibitors (CDK 4/6i) combined with endocrine therapy have become the gold standard in hormone receptor-positive (HR +) HER2-negative (HER2-) metastatic breast cancer (MBC). However, there is a significant lack of data regarding the efficacy and safety of these treatments in elderly patients. We present the results of a real-world data (RWD) cohort stratified by age at treatment initiation (≥ 70 years compared to patients < 70 years). METHODS Clinico-pathological data of HR + HER2- MBC patients who were candidates for CDK4/6i therapy between January 2017 and December 2020 at the Institut Català d'Oncologia (Spain) were retrospectively collected. The primary goal was to assess Progression-Free Survival (PFS), Overall Survival (OS), and safety outcomes within this patient population. RESULTS A total of 274 patients with MBC who received CDK4/6i treatment were included in the study. Among them, 84 patients (30.8%) were aged ≥ 70 years, with a mean age of 75, while 190 patients (69.2%) were under the age of 70, with a mean age of 55.7 years. The most frequently observed grade 3-4 toxicity was neutropenia, with similar rates in both the < 70 group (43.9%) and the ≥ 70 group (47.9%) (p = 0.728). The median Progression-Free Survival (mPFS) for the first-line CDK4/6i treatment was 22 months (95% CI, 15.4-39.8) in the < 70 group and 20.8 months (95% CI 11.2-NR) in the ≥ 70 group (p = 0.67). Similarly, the median PFS for the second-line CDK4/6i treatment was 10.4 months (95% CI, 7.4-15.1) and 7.1 months (95% CI 4.4-21.3) (p = 0.79), respectively. Median overall survival (mOS) was not reached either for the first- and second-line treatment. CONCLUSIONS Our RWD suggests that elderly patients, when compared to those under 70, experience similar survival outcomes and exhibit comparable tolerance for CDK4/6i therapy.
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Affiliation(s)
- Helena Pla
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Doctor Josep Trueta, Girona, Spain
- Precision Oncology Group (OncoGIR-Pro), Institut d'Investigació Biomèdica de Girona (IDIBGI), Universitat de Girona, Girona, Spain
| | - Eudald Felip
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain
| | - Verónica Obadia
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Sonia Pernas
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Gemma Viñas
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Doctor Josep Trueta, Girona, Spain
- Precision Oncology Group (OncoGIR-Pro), Institut d'Investigació Biomèdica de Girona (IDIBGI), Universitat de Girona, Girona, Spain
| | - Mireia Margelí
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain
| | - Roser Fort-Culillas
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Doctor Josep Trueta, Girona, Spain
- Precision Oncology Group (OncoGIR-Pro), Institut d'Investigació Biomèdica de Girona (IDIBGI), Universitat de Girona, Girona, Spain
| | - Sonia Del Barco
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Doctor Josep Trueta, Girona, Spain
- Unitat d'Epidemiologia i Registre de càncer de Girona (UERCG), Institut d'Investigació Institut d'InvestigacióBiomèdica de Girona (IDIBGI), Universitat de Girona, Girona, Spain
| | - Nuria Sabaté
- Department of Pharmacy, Institut Català d'Oncologia (ICO)-H.U.Doctor Josep Trueta, Girona, Spain
| | - Eduard Fort
- Department of Pharmacy, Institut Català d'Oncologia (ICO)-H.U.Bellvitge, Barcelona, Spain
| | - Clara Lezcano
- Department of Pharmacy, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain
| | - Beatriz Cirauqui
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain
| | - Vanesa Quiroga
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain
| | - Agostina Stradella
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Miguel Gil Gil
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Anna Esteve
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain.
| | - Sabela Recalde
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain.
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Peiró I, Milla J, Arribas L, Hurtós L, González-Tampán AR, Bellver M, Fort E, Molina-Mata K, Joudanin JR, Valcarcel J, González-Barboteo J. Venting percutaneous radiologic gastrostomy in malignant bowel obstruction: safety and effectiveness in a comprehensive cancer centre. BMJ Support Palliat Care 2024; 13:e851-e854. [PMID: 36104161 DOI: 10.1136/spcare-2022-003895] [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: 07/26/2022] [Accepted: 08/31/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Approximately 20% of established malignant bowel obstruction (MBO) patients do not respond to pharmacological treatment. In these cases, venting percutaneous radiologic gastrostomy (VPRG) may be useful. Existing evidence is based on retrospective studies with methodological limitations. The purpose of this study is to describe safety and effectiveness for symptom control after VPRG placement in a prospective cohort of MBO patients. METHODS Complications of VPRG placement, symptom control, destination on discharge and survival were analysed. RESULTS Twenty-one patients were included, 13 (61.9%) of whom were women. Mean age was 62.7 years (36-85). Local pain (n=8, 38.1%) and peristomal leakage (n=4, 19%) were the most frequent minor complications. No major complications occurred. Nausea and vomiting were relieved in most patients (n=20, 95.2%) after VPRG, and small quantities of liquid diet were introduced to these patients. Median time to death after VPRG was 13 days (IQR 8.6-17.4). Thirteen patients (61.9%) were discharged, with seven of them (33.3%) returning home. CONCLUSIONS When pharmacological treatment fails, the use of VPRG in MBO patients may be feasible, safe and effective.
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Affiliation(s)
- Inmaculada Peiró
- Clinical Nutrition Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
- Bellvitge Institute for Biomedical Research, Barcelona, Spain
| | - Jennifer Milla
- Palliative Care Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | - Lorena Arribas
- Clinical Nutrition Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
- Bellvitge Institute for Biomedical Research, Barcelona, Spain
| | - Laura Hurtós
- Clinical Nutrition Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | | | - Marta Bellver
- Clinical Nutrition Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | - Eduard Fort
- Clinical Nutrition Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | - Kevin Molina-Mata
- Medical Oncology Department, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | - Jonathan R Joudanin
- Department of Radiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - Joana Valcarcel
- Department of Radiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - Jesús González-Barboteo
- Bellvitge Institute for Biomedical Research, Barcelona, Spain
- Palliative Care Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
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Pons-Riverola A, Morillas H, Berdejo J, Pernas S, Pomares H, Asiain L, Garay A, Fernandez-Ortega A, Oliveira AC, Martínez E, Jiménez-Marrero S, Pina E, Fort E, Ramos R, Alcoberro L, Hidalgo E, Antonio-Rebollo M, Alcober L, Enjuanes Grau C, Comín-Colet J, Moliner P. Developing Cardio-Oncology Programs in the New Era: Beyond Ventricular Dysfunction Due to Cancer Treatments. Cancers (Basel) 2023; 15:5885. [PMID: 38136428 PMCID: PMC10742309 DOI: 10.3390/cancers15245885] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Cardiovascular disease is a common problem in cancer patients that is becoming more widely recognized. This may be a consequence of prior cardiovascular risk factors but could also be secondary to the anticancer treatments. With the goal of offering a multidisciplinary approach to guaranteeing optimal cancer therapy and the early detection of related cardiac diseases, and in light of the recent ESC Cardio-Oncology Guideline recommendations, we developed a Cardio-Oncology unit devoted to the prevention and management of these specific complications. This document brings together important aspects to consider for the development and organization of a Cardio-Oncology program through our own experience and the current evidence.
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Affiliation(s)
- Alexandra Pons-Riverola
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Cardiology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (L.A.); (E.H.); (C.E.G.); (J.C.-C.)
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Herminio Morillas
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Cardiology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (L.A.); (E.H.); (C.E.G.); (J.C.-C.)
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Javier Berdejo
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Cardiology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (L.A.); (E.H.); (C.E.G.); (J.C.-C.)
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Sonia Pernas
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Medical Oncology Department, Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Helena Pomares
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Clinical Haematology Department, Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Leyre Asiain
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Radiation Oncology Department, Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Alberto Garay
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Cardiology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (L.A.); (E.H.); (C.E.G.); (J.C.-C.)
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Adela Fernandez-Ortega
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Medical Oncology Department, Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Ana Carla Oliveira
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Clinical Haematology Department, Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Haematopoietic and Lymphoid Tumours Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Evelyn Martínez
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Radiation Oncology Department, Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Radiobiology and Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Santiago Jiménez-Marrero
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Cardiology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (L.A.); (E.H.); (C.E.G.); (J.C.-C.)
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Elena Pina
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Thrombosis and Haemostasis Unit, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Eduard Fort
- Pharmacy Department, Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
| | - Raúl Ramos
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Cardiology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (L.A.); (E.H.); (C.E.G.); (J.C.-C.)
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Lídia Alcoberro
- Cardiology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (L.A.); (E.H.); (C.E.G.); (J.C.-C.)
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Encarnación Hidalgo
- Cardiology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (L.A.); (E.H.); (C.E.G.); (J.C.-C.)
| | - Maite Antonio-Rebollo
- Oncogeriatrics Department, Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
| | - Laia Alcober
- Primary Care Service Delta del Llobregat and IDIAP, Catalan Health Service, 08007 Barcelona, Spain;
| | - Cristina Enjuanes Grau
- Cardiology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (L.A.); (E.H.); (C.E.G.); (J.C.-C.)
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Josep Comín-Colet
- Cardiology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (L.A.); (E.H.); (C.E.G.); (J.C.-C.)
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Pedro Moliner
- Cardio-Oncology Unit, Bellvitge University Hospital—Catalan Institute of Oncology, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (A.P.-R.); (H.M.); (J.B.); (S.P.); (H.P.); (L.A.); (A.G.); (A.F.-O.); (A.C.O.); (E.M.); (S.J.-M.); (E.P.); (R.R.)
- Cardiology Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (L.A.); (E.H.); (C.E.G.); (J.C.-C.)
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
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Naïli M, Fort E, Rollin L, Leroyer A, Gavoille A, Desbas A, Charbotel B. Évaluation des conditions de travail et de l’état de santé des travailleurs en entrepôts et plateformes logistiques. ARCH MAL PROF ENVIRO 2023. [DOI: 10.1016/j.admp.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Pélissier C, Villemagne F, Tebbeb N, Prieur T, Dorier S, Fort E, Celarier T, Barth N, Fontana L. Évaluation d’un dispositif de repérage de l’altération de l’état de santé psychique du personnel des maisons de retraite impliqué dans la crise sanitaire : une enquête qualitative et quantitative. ARCH MAL PROF ENVIRO 2022. [DOI: 10.1016/j.admp.2022.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Roger C, Spinosi J, Fort E, Charbotel B, Paul A. Indicateur PE pour l’identification des effets perturbateurs endocriniens des substances actives phytopharmaceutiques utilisées en agriculture en France : la base CIPATOX-PE. ARCH MAL PROF ENVIRO 2022. [DOI: 10.1016/j.admp.2022.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Fort E, Otero S, Moliner P, Bleda C, Prats J, Nadal E, Palmero R, Jimenez L, Piulats JM, Rey M, Fontanals S. Incidence of drug-drug interactions of QT-prolonging drugs in an onco-hematological outpatient. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2726] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Oral anticancer therapy is increasingly integrated into the care of patients (pts) with cancer. Recognition and management of pharmacodynamic drug-drug interactions is critical to provide efficacious and safe anticancer treatment.
Purpose
We aimed to gain insight into the real-world prevalence of potentially significant drug-drug interactions of QT-prolonging with oral antineoplastic agents used in an Oncohematological Hospital
Methods
We performed a prospective observational study in an oncohematological hospital between October 2020 and June 2021. Consecutive pts diagnosed with an oncohematological neoplasia and who were evaluated before start treatment with an oral anticancer drug or suport treatment (antibiotics, antivirals) were included. Cancer treatment data were obtained from our prescription software System. Demographic data and concomitant medication were obtained from our electronic medical record software. Micromedex was used to find potencial QT-prolonging interactions between anticancer drugs and chronic medication, and were classified as major or moderate.
Results
Oncohematological treatment was started in 1.217 pts during the study period. A total of 266 potential drug-drug interactions were detected in 171 patients (14.5%). A total of 46 drug-drug interactions of QT-prolonging (17.3%) were detected in 37 pts (21.6%), 22 men and 15 women, with a median age of 66.6 (range 40.9–87.3). Twenty-one (45.7%) and 25 (56.3%) drug interactions of QT-prolonging were classified as major and moderate, respectively, with a median interaction per pts 1.24 (1–3). The 3 most common cancers were: Renal carcinoma in 12 pts (32.4%), non-small cell lung carcinoma in 9 pts (24.7%) and prostate carcinoma in 4 pts (10.8%). The most commonly detected interacting drugs were sunitinib 12 pts (26.1%), osimertinib 10 pts (21.7%), and cabozantinib 5 pts (10.9%) among oncohematological drugs, and citalopram 8 (17.4%), quetiapine 6 (13%) and tramadol 5 (10.8%) among concomitant drugs.
Conclusion
Drug-drug interactions can play a significant role in drugs' cardiac safety in oncohematological pts, specially in renal, lung and prostate cancers, with more than one potential interacting drug or at least one major interaction. Cardiac monitorizacion should be considered when potential drug drug interaction is detected.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Fort
- Catalan Institute of Oncology , Barcelona , Spain
| | - S Otero
- Catalan Institute of Oncology , Barcelona , Spain
| | - P Moliner
- Catalan Institute of Oncology , Barcelona , Spain
| | - C Bleda
- Catalan Institute of Oncology , Barcelona , Spain
| | - J Prats
- Catalan Institute of Oncology , Barcelona , Spain
| | - E Nadal
- Catalan Institute of Oncology , Barcelona , Spain
| | - R Palmero
- Catalan Institute of Oncology , Barcelona , Spain
| | - L Jimenez
- Catalan Institute of Oncology , Barcelona , Spain
| | - J M Piulats
- Catalan Institute of Oncology , Barcelona , Spain
| | - M Rey
- Catalan Institute of Oncology , Barcelona , Spain
| | - S Fontanals
- Catalan Institute of Oncology , Barcelona , Spain
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Wei K, Fort E, Rollin L, Leroyer A, Charbotel B. Expositions professionnelles et santé des conducteurs professionnels, quelles spécificités pour les chauffeurs de bus urbains ? ARCH MAL PROF ENVIRO 2022. [DOI: 10.1016/j.admp.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Parody R, Sánchez-Ortega I, Ferrá C, Guardia R, Talarn C, Encuentra M, Fort E, López D, Morgades M, Alonso E, Ortega S, Sarrá J, Gallardo D, Ribera JM, Sureda A. Mobilization of Hematopoietic Stem Cells into Peripheral Blood for Autologous Transplantation Seems Less Efficacious in Poor Mobilizers with the Use of a Biosimilar of Filgrastim and Plerixafor: A Retrospective Comparative Analysis. Oncol Ther 2020; 8:311-324. [PMID: 32700041 PMCID: PMC7683658 DOI: 10.1007/s40487-020-00115-3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction Biosimilars of granulocyte colony-stimulating factors (G-CSF) have shown similar efficacy to originator filgrastim (Neupogen® [NEU]; Amgen Inc.) as prophylaxis in neutropenia and in the mobilization of stem cells in patients receiving combination chemotherapy with G-CSF. Methods This was a retrospective study in which the characteristics of stem cell mobilization treated with a G-CSF alone were compared in 216 patients and 56 donors. The two G-CSF compared were NEU and the biosimilar filgrastim Zarzio® (Sandoz GmbH) (referred to hereafter as BIO). Primary objectives were mobilization rate (minimum of 10 × 103/ml CD34+ on day 4 of treatment [day +4]) and use of the immunostimulant plerixafor (PLEX) in each group. Results The general characteristics of the patients receiving NEU (n = 138) and those receiving BIO (n = 78) did not differ significantly. PLEX was used in 24% of BIO patients and in 25.7% of NEU patients. The median CD34+ cell count on day +4 was significantly lower in BIO patients who needed PLEX than in those who did not (2.4 vs. 4.8 × 103/ml; p = 0.002), as was the final CD34+ cell count (2.5 vs. 3.3 × 106/kg; p 0.03). Mobilization failure rate was higher in the BIO group than in the NEU group (20 vs. 0%; p = 0.01). With respect to donors, more than one apheresis was needed in three BIO donors, one of them with PLEX. The use of BIO was the only risk factor for mobilization failure in patients who needed PLEX (hazard ratio 10.3; 95% confidence interval 1.3–77.8). Conclusion The study revealed that BIO had a lower efficacy for stem cell mobilization when the only treatment was G-CSF, especially in poor mobilizers needing PLEX.
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Affiliation(s)
- Rocío Parody
- Clinical Hematology Department, Institut Català d'Oncologia, L'Hospitalet, Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), Barcelona, Spain.
| | - Isabel Sánchez-Ortega
- Clinical Hematology Department, Institut Català d'Oncologia, L'Hospitalet, Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Christelle Ferrá
- Hematology Department, Institut Català d'Oncologia-Badalona, Hospital Universitari Germans Trias I Pujol, Josep Carreras Leukemia Research Institute,, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Carme Talarn
- Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Maite Encuentra
- Clinical Hematology Department, Institut Català d'Oncologia, L'Hospitalet, Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), Barcelona, Spain.,Institut Català d'Oncologia, L'Hospitalet, IDIBELL, Barcelona, Spain
| | - Eduard Fort
- Pharmacy Department, Institut Català d'Oncologia, L'Hospitalet, IDIBELL, Barcelona, Spain
| | - David López
- Pharmacy Department, Institut Català d'Oncologia, L'Hospitalet, IDIBELL, Barcelona, Spain
| | - Mireia Morgades
- Hematology Department, Institut Català d'Oncologia-Badalona, Hospital Universitari Germans Trias I Pujol, Josep Carreras Leukemia Research Institute,, Universitat Autònoma de Barcelona, Barcelona, Spain.,Institut Català d'Oncologia, L'Hospitalet, IDIBELL, Barcelona, Spain
| | - Eva Alonso
- Banc de Sang I Teixits de Catalunya, Barcelona, Spain
| | - Sandra Ortega
- Banc de Sang I Teixits de Catalunya, Barcelona, Spain
| | - Josep Sarrá
- Hospital Universitari Joan XXIII, Tarragona, Spain
| | | | - Josep M Ribera
- Hematology Department, Institut Català d'Oncologia-Badalona, Hospital Universitari Germans Trias I Pujol, Josep Carreras Leukemia Research Institute,, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Sureda
- Clinical Hematology Department, Institut Català d'Oncologia, L'Hospitalet, Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), Barcelona, Spain
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Pélissier C, Fort E, Fontana L, Hours M. Medical and socio-occupational predictive factors of psychological distress 5 years after a road accident: a prospective study. Soc Psychiatry Psychiatr Epidemiol 2020; 55:371-383. [PMID: 31628512 DOI: 10.1007/s00127-019-01780-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 10/09/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE Psychosocial consequences of road accidents are a major clinical problem that incurs significant social, occupational, and economic costs. The purpose of our study was to assess medical and socio-occupational factors of psychological distress in the severely injured 5 years after a road accident. METHODS A total of 691 of the 1168 subjects enrolled in a prospective cohort of road accident casualties (ESPARR cohort) responded to both standardized follow-up questionnaires at 1 and 5 years, assessing socio-occupational characteristics, physical and psychological sequelae, pain and perceived quality of life. RESULTS One quarter of participants exhibited psychological distress 5 years after the road accident; most of whom are women, with low educational level, and suffering from spinal lesions. After adjusting for several factors, psychological distress at 5 years was predicted by female gender and low educational level, and by several other factors observed 1 year after the road accident: poor self-reported quality of life, attention deficit and symptoms of anxiety. CONCLUSIONS Early-stage improvement in the screening and care of mental disorders in road accident casualties should help to reduce long-term psychological distress.
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Affiliation(s)
- C Pélissier
- Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, Université Jean Monnet, UMRESTTE, UMR T_9405, 42100, St Etienne, France.
- Pole de Santé Publique, Service de Médecine et Santé au Travail, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 69495, Pierre-Bénite, France.
| | - E Fort
- Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, UMR T_9405, 69373, Lyon, France
| | - L Fontana
- Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, Université Jean Monnet, UMRESTTE, UMR T_9405, 42100, St Etienne, France
- Service de Santé au Travail, CHU de Saint-Etienne, Saint-Priest-en-Jarez, France
| | - M Hours
- Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, UMR T_9405, 69500, Bron, France
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Massardier-Pilonchéry A, Battail T, Fort E, Denis MA, Fassier JB. Nombre et déclaration des AES dans la population médicale. ARCH MAL PROF ENVIRO 2020. [DOI: 10.1016/j.admp.2019.12.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Fort E, Gadegbeku B, Gat E, Pelissier C, Hours M, Charbotel B. Working conditions and risk exposure of employees whose occupations require driving on public roads - Factorial analysis and classification. Accid Anal Prev 2019; 131:254-267. [PMID: 31336313 DOI: 10.1016/j.aap.2019.07.001] [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] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Several studies of the working conditions of drivers, and in particular on their pace of work, have enabled a better understanding of the risk factors for road accidents that occur during work. However, few studies are available on the risk exposure and working conditions of employees whose occupations involve driving. The purpose of this paper is to identify the different groups of employees occupationally exposed to road risk and to classify them according to working conditions. METHODOLOGY A Multiple Correspondence Analysis (MCA) was implemented on the 41,727 individuals from the SUMER 2010 survey (Medical Monitoring of Occupational Risk Exposure: SUrveillance Médicale des Expositions aux Risques professionnels) and for 45 variables about working conditions. The analysis used 5 categories of weekly driving exposure as a supplementary variable (variable which is not used to perform the MCA): Non-exposure; Exposed <2 h; Exposed 2-10 hours; Exposed 10-20 hours; and Exposed >20 h. The results of the MCA were used to construct an ascending hierarchical classification. RESULTS The first factorial axis differentiates between conventional and unconventional work schedules. Axis 2 differentiates modalities corresponding to the working hours of the most recent working week. The third axis chiefly contrasts persons who have rules to follow with those who have none. An ascending hierarchical classification distinguishes 10 clusters of individuals according to working conditions. Four clusters of employees were excessively exposed to occupational driving. Clusters also have distinct demographic, occupational and psychosocial characteristics. CONCLUSION Analysis of data from the SUMER survey confirms that employees exposed to road risk are particularly affected by atypical work time characteristics, but can be found in all activity sectors and in all types of job.
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Affiliation(s)
- E Fort
- Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, UMR T_9405, F- 69373, Lyon, France.
| | - B Gadegbeku
- Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, UMR T_9405, F- 69373, Lyon, France
| | - E Gat
- Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, UMR T_9405, F- 69373, Lyon, France
| | - C Pelissier
- Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, Université Jean Monnet, UMRESTTE, UMR T_9405, F- 42100 St Etienne, France
| | - M Hours
- Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, UMR T_9405, F- 69373, Lyon, France
| | - B Charbotel
- Univ Lyon, Université Claude Bernard Lyon1, Ifsttar, UMRESTTE, UMR T_9405, F- 69373, Lyon, France
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White M, Charbotel B, Fort E, Bastuji H, Franco P, Putois B, Mazza S, Peter-Derex L. Academic and professional paths of narcoleptic patients: the Narcowork study. Sleep Med 2019; 65:96-104. [PMID: 31739232 DOI: 10.1016/j.sleep.2019.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/12/2019] [Accepted: 07/23/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVE/BACKGROUND To study educational and professional pathways of narcoleptic patients and examine demographic, disease-related and environmental factors associated with a better academic and professional prognosis. PATIENTS/METHODS In sum, 69 narcoleptic patients (51 narcolepsy type 1 and 18 narcolepsy type 2, age 42.5 ± 18.2 years) were enrolled in this pilot monocentric cross-sectional study with a comparison group (80 age- and sex-matched controls) between October 2017 and July 2018 in Lyon Center for Sleep Medicine. They completed questionnaires about their academic and professional trajectories and specific scales of quality of life (EuroQol quality of life scale EQ-5D-3L), depression (beck depression inventory, BDI), sleepiness (Epworth Sleepiness Scale, ESS) and narcoleptic symptoms severity (narcolepsy severity scale, NSS). RESULTS No difference in grade repetition or final obtained diploma was observed between patients and controls, but patients evaluated their academic curricula as more difficult (45.5% vs 16.9%, p = 0.0007), complained for more attentional deficits (75% vs 22.1%, p < 0.0001), and had needed more educational reorientation (28.6% vs 9.9%, p = 0.01). Even if no difference was observed in occupational category and professional status, patients expressed significantly less satisfaction about their work. Patients had more signs of depression [OR severe depression = 4.4 (1.6-12.6), p = 0.02] and their quality of life was significantly decreased (67.3 ± 18.4 vs 80.6 ± 13.2, p = 0.0007) as compared to controls. Multivariate analysis showed that a more favorable professional career was associated with a better quality of life. CONCLUSIONS Educational and professional pathways do not seem to be significantly impaired in narcoleptic patients, but their experience and quality of life are affected. These findings may allow to reassure patients and should lead to a more comprehensive management of the disease. CLINICAL TRIAL REGISTRATION Narcowork, https://clinicaltrials.gov/ct2/show/NCT03173378, N° NCT03173378.
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Affiliation(s)
- M White
- Claude Bernard Lyon 1 University, Lyon, France
| | - B Charbotel
- Claude Bernard Lyon 1 University, Lyon, France; Occupational Diseases Unit, Lyon Sud Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard Lyon 1 University, IFSTTAR, UMRESTTE, UMR T_9405, F-69373, Lyon, France
| | - E Fort
- Claude Bernard Lyon 1 University, IFSTTAR, UMRESTTE, UMR T_9405, F-69373, Lyon, France
| | - H Bastuji
- Center for Sleep Medicine and Respiratory Diseases, Competence Center for Orphan Diseases, Narcolepsy and Rare Hypersomnia, Croix-Rousse Hospital, Hospices civils de Lyon, Lyon, France; Lyon Neuroscience Research Center, CNRS 5292 INSERM U1028, Lyon, France; Department of Functional Neurology and Epileptology, Neurological Hospital, Lyon, France
| | - P Franco
- Claude Bernard Lyon 1 University, Lyon, France; Lyon Neuroscience Research Center, CNRS 5292 INSERM U1028, Lyon, France; National Reference Center for Orphan Diseases, Narcolepsy and Rare Hypersomnia & Pediatric Sleep Center, HFME, Hospices civils de Lyon, Bron, France
| | - B Putois
- National Reference Center for Orphan Diseases, Narcolepsy and Rare Hypersomnia & Pediatric Sleep Center, HFME, Hospices civils de Lyon, Bron, France
| | - S Mazza
- Claude Bernard Lyon 1 University, Lyon, France; HESPER (Health Services and Performance Research), EA 7425, Lyon, France
| | - L Peter-Derex
- Claude Bernard Lyon 1 University, Lyon, France; Center for Sleep Medicine and Respiratory Diseases, Competence Center for Orphan Diseases, Narcolepsy and Rare Hypersomnia, Croix-Rousse Hospital, Hospices civils de Lyon, Lyon, France; Lyon Neuroscience Research Center, CNRS 5292 INSERM U1028, Lyon, France.
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Bacot V, Perrard S, Labousse M, Couder Y, Fort E. Multistable Free States of an Active Particle from a Coherent Memory Dynamics. Phys Rev Lett 2019; 122:104303. [PMID: 30932640 DOI: 10.1103/physrevlett.122.104303] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 12/14/2018] [Indexed: 06/09/2023]
Abstract
We investigate the dynamics of a deterministic self-propelled particle endowed with coherent memory. We evidence experimentally and numerically that it exhibits several stable free states. The system is composed of a self-propelled drop bouncing on a vibrated liquid driven by the waves it emits at each bounce. This object possesses a propulsion memory resulting from the coherent interference of the waves accumulated along its path. We investigate here the transitory regime of the buildup of the dynamics which leads to velocity modulations. Experiments and numerical simulations enable us to explore unchartered areas of the phase space and reveal the existence of a self-sustained oscillatory regime. Finally, we show the coexistence of several free states. This feature emerges both from the spatiotemporal nonlocality of this path memory dynamics as well as the wave nature of the driving mechanism.
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Affiliation(s)
- V Bacot
- Matière et Systèmes Complexes, CNRS UMR 7057, Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France
- Institut Langevin, CNRS UMR 7587, ESPCI Paris and PSL University, 75005 Paris, France
- LadHyX, CNRS UMR 7646, École Polytechnique, 91128 Palaiseau, France
| | - S Perrard
- Laboratoire de Physique Statistique, CNRS UMR 8550 ENS and PSL University, 75005 Paris, France
| | - M Labousse
- Gulliver, CNRS UMR 7083, ESPCI Paris and PSL University, 75005 Paris, France
| | - Y Couder
- Matière et Systèmes Complexes, CNRS UMR 7057, Université Paris Diderot, Sorbonne Paris Cité, 75013 Paris, France
| | - E Fort
- Institut Langevin, CNRS UMR 7587, ESPCI Paris and PSL University, 75005 Paris, France
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Botokeky E, Freymond N, Gormand F, Le Cam P, Chatte G, Kuntz J, Liegeon MN, Gaillot-Drevon M, Massardier-Pilonchery A, Fiquemont A, Fort E, Marcu M, Petitjean T, Charbotel B. Benefit of continuous positive airway pressure on work quality in patients with severe obstructive sleep apnea. Sleep Breath 2019; 23:753-759. [PMID: 30685849 DOI: 10.1007/s11325-018-01773-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 07/30/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND The objective of this prospective study was to assess the effect of CPAP therapy on job productivity and work quality for patients with severe obstructive sleep apnea (OSA). METHODS A convenience sample of patients diagnosed with severe OSA using polysomnography or polygraphy and with a therapeutic indication for CPAP was enrolled in our study. Patients completed two self-administered questionnaires: the first before CPAP therapy and the second during the first 6 months after CPAP treatment. OSA symptoms were evaluated through self-administered questionnaires assessing potential effects on occupational activity: excessive daytime sleepiness was rated by the Epworth Sleepiness Scale (ESS), emotional status was rated by the Hospital Anxiety and Depression (HAD) scale, work quality was rated by the Work Role Functioning Questionnaire (WRFQ). RESULTS Forty patients (30 men, mean age 47.3 ± 8.3, mean BMI 31.6 ± 7.4, mean apnea-hypopnea index 51.8 ± 16.3) showed a beneficial effect of CPAP therapy on ESS score (mean 11.6 to 8.2, p < 0.0001), the anxiety dimension (mean 57.5% to 20%, p = 0.0002), and the overall anxiety-depressive score (mean 50% to 22.5%, p = 0.0006). Mean WRFQ scores were significantly improved in the second questionnaire for the dimensions of timetable requirements (69.3% to 83.5%, p < 0.0001), productivity requirements (71.4% to 82.2%, p < 0.0001), mental requirements (72.0% to 84.3%, p < 0.0001), and social requirements (82.6% to 91.4%, p < 0.003). CONCLUSIONS We observed that adherence to CPAP therapy for patients with severe OSA mitigates the impact of symptoms on work including excessive daytime sleepiness, impairment of work ability, and anxiety and depressive disorders.
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Affiliation(s)
- Elsa Botokeky
- Department of Occupational Diseases, CHU Lyon, Pierre-Bénite, France. .,Université de Lyon, Université Claude Bernard Lyon 1, IFSTTAR, UMRESTTE, UMR T_9405, 8 avenue Rockefeller, 69373, Lyon, France.
| | - N Freymond
- Department of Respiratory Medicine, Centre Hospitalier Lyon Sud, CHU Lyon, Pierre-Bénite, France
| | - F Gormand
- Department of Sleep Disorders, Centre Hospitalier Croix Rousse, CHU Lyon, Lyon, France
| | - P Le Cam
- Department of Sleep Disorders, Centre Hospitalier Croix Rousse, CHU Lyon, Lyon, France
| | - G Chatte
- Private Practice Pneumology, 42 Rue Jean Moulin, 69300, Caluire-et-Cuire, France
| | - J Kuntz
- Private Practice Pneumology, 42 Rue Jean Moulin, 69300, Caluire-et-Cuire, France
| | - M N Liegeon
- Private Practice Pneumology, 42 Rue Jean Moulin, 69300, Caluire-et-Cuire, France
| | - M Gaillot-Drevon
- Department of Respiratory Medicine, Centre Hospitalier Lyon Sud, CHU Lyon, Pierre-Bénite, France
| | - A Massardier-Pilonchery
- Department of Occupational Diseases, CHU Lyon, Pierre-Bénite, France.,Université de Lyon, Université Claude Bernard Lyon 1, IFSTTAR, UMRESTTE, UMR T_9405, 8 avenue Rockefeller, 69373, Lyon, France
| | - A Fiquemont
- University Claude Bernard Lyon 1, 8 avenue Rockefeller, 69008, Lyon, France
| | - E Fort
- Université de Lyon, Université Claude Bernard Lyon 1, IFSTTAR, UMRESTTE, UMR T_9405, 8 avenue Rockefeller, 69373, Lyon, France
| | - M Marcu
- Department of Respiratory Medicine, Centre Hospitalier Lyon Sud, CHU Lyon, Pierre-Bénite, France
| | - T Petitjean
- Department of Sleep Disorders, Centre Hospitalier Croix Rousse, CHU Lyon, Lyon, France
| | - B Charbotel
- Department of Occupational Diseases, CHU Lyon, Pierre-Bénite, France.,Université de Lyon, Université Claude Bernard Lyon 1, IFSTTAR, UMRESTTE, UMR T_9405, 8 avenue Rockefeller, 69373, Lyon, France
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Pelletan J, Fort E, Delabre L, Massardier-Pilonchéry A, Pilorget C. Évolution de l’exposition au bruit chez des salariés suivis par audiométrie entre 1968 et 2000 en France. ARCH MAL PROF ENVIRO 2018. [DOI: 10.1016/j.admp.2018.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Khalis M, Charbotel B, Fort E, Chajes V, Charaka H, Rhazi KE. Occupation and female breast cancer: A case-control study in Morocco. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Fort E, Pélissier C, Fanjas A, Charnay P, Charbotel B, Bergeret A, Fontana L, Hours M. Road casualties in work-related and private contexts: occupational medical impact. Results from the ESPARR cohort. Work 2018; 60:117-128. [PMID: 29843295 DOI: 10.3233/wor-182720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Road accidents may impact victims' physical and/or mental health and socio-occupational life, notably including return to work. OBJECTIVES To assess whether the occupational medical consequences sustained by subjects injured in road accidents occurring in a work-related context differ from those associated with private accidents. METHODS 778 adults who were in work or occupational training at the time of their accident were included. Two groups were distinguished: 354 (45.5%) injured in road accidents occurring in a work-related context (commuting or on duty) and 424 (54.5%) injured in a private accident. The groups were compared on medical and occupational factors assessed on prospective follow-up at 6 months and 1 and 3 years. Multivariate analysis explored for factors associated at 6 months and 1 year with sick leave following the accident and duration of sick leave. RESULTS There were no significant differences between groups for demographic data apart from a slightly higher injury severity in private accidents (32.5% of private accidents with MAIS3+(Maximum Abbreviated Injury Scale greater or equal to 3) vs. 23.7% for work-related accidents, p = 0.007). Victims of work-related accidents were more often on sick leave (OR = 1.8; 95% CI, 1.1-2.9). Although the length of sick leave is higher for work-related accidents that for private accidents, multivariate analysis showed that the injury severity and the post-traumatic stress disorder (PTSD) are significant factors to explain the time to return to work. There were no significant differences according to occupational impact during follow-up, notably including sick-leave duration, number of victims returning to work within 3 years and number of victims out of work due to incapacity. CONCLUSIONS In the ESPARR (follow-up study of a road-accident population in the Rhône administrative county: Etude de Suivi d'une Population d'Accidentés de la Route dans le Rhône) cohort, the fact that a road accident occurred in a work-related context did not affect the occupational consequences.
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Affiliation(s)
- E Fort
- University of Lyon, Université Claude Bernard Lyon 1, Ifsttar, UMR T_9405, F-69373, Lyon, France
| | - C Pélissier
- University of Lyon, Université Claude Bernard Lyon 1, Ifsttar, Université Jean Monnet, UMR T_9405, F-42100 St Etienne, France
| | - A Fanjas
- University of Lyon, Université Claude Bernard Lyon 1, Ifsttar, Université Jean Monnet, UMR T_9405, F-42100 St Etienne, France
| | - P Charnay
- University of Lyon, Université Claude Bernard Lyon 1, Ifsttar, UMR T_9405, F-69500, Bron, France
| | - B Charbotel
- University of Lyon, Université Claude Bernard Lyon 1, Ifsttar, UMR T_9405, F-69373, Lyon, France
| | - A Bergeret
- University of Lyon, Université Claude Bernard Lyon 1, Ifsttar, UMR T_9405, F-69373, Lyon, France
| | - L Fontana
- University of Lyon, Université Claude Bernard Lyon 1, Ifsttar, Université Jean Monnet, UMR T_9405, F-42100 St Etienne, France
| | - M Hours
- University of Lyon, Université Claude Bernard Lyon 1, Ifsttar, UMR T_9405, F-69500, Bron, France
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Botokeky E, Freymond N, Gormand F, Petitjean T, Lecam P, Chatte G, Kuntz J, Liegeon M, Gaillot-Drevon M, Fort E, Marcu M, Charbotel B. Évaluation du bénéfice du traitement par ventilation en pression positive continue (PPC) sur la qualité du travail chez les patients présentant un Syndrome d’apnées–hypopnées obstructives du sommeil (SAHOS) sévère. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Peiró I, González-Tampán R, Hurtós L, Fort E, López-Urdiales R, Creus G, Arribas L, Sánchez C, Laquente B. SUN-P101: Nutritional Assessment in Pancreatic Cancer Patients Treated in an Oncological Monographic Hospital. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30526-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bounin A, Fervers B, Fevotte J, Fort E, Charbotel B. Exposition à l’amiante et cancer de l’ovaire. ARCH MAL PROF ENVIRO 2017. [DOI: 10.1016/j.admp.2017.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pélissier C, Fort E, Fontana L, Charbotel B, Hours M. Factors associated with non-return to work in the severely injured victims 3 years after a road accident: A prospective study. Accid Anal Prev 2017; 106:411-419. [PMID: 28728063 DOI: 10.1016/j.aap.2017.06.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 06/07/2017] [Accepted: 06/29/2017] [Indexed: 06/07/2023]
Abstract
Road accidents may impact victims' physical and/or mental health and socio-occupational life, particularly the capacity to return to work. The purpose of our study is to assess modifiable medical and socio-occupational factors of non-return to work in the severely injured 3 years after a road accident. Among1,168 road accidents casualties in the Rhône administrative Département of France followed for five years, 141 of the 222 severely injured (Maximal Abbreviated Injury Scale ≥ 3) aged more than 16 years who were in work at the time of the accident, reported whether they had returned to work in the 3 years following the accident. The subgroups of those who had (n=113) and had not returned to work (n=28) were compared for socio-occupational (gender, age, educational level, marital status, socio-occupational group) accident-related medical factors (type of road user, type of journey, responsibility in the accident, initial care) and post-accident medical factors (pain intensity, post-traumatic stress disorder, physical sequelae, quality of life) by using standardized tools. Severity of initial head, face and lower-limb injury, intense persistent pain, post-traumatic stress disorder, poor self-assessed quality of life and health status at 3 years were associated with non-return to work on univariate analysis. On multivariate analysis, severity of initial head and lower-limb injury, intense persistent pain at 3 years and post-traumatic stress disorder were significantly associated with non-return to work 3 years following severe road-accident injury. Post-traumatic stress disorder and chronic pain were essential modifiable medical determinants of non-return to work in the severely injured after a road accident: early adapted management could promote return to work in the severely injured. Improve early adapted treatment of pain and PTSD in the rehabilitation team should help the severely injured return to work following a road accident.
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Affiliation(s)
- C Pélissier
- Université de Lyon, Université Lyon 1, Université de St Etienne, IFSTTAR, UMRESTTE, UMR_T9405, 42005 Saint Etienne, France; Service de Santé au Travail, CHU de Saint-Etienne, France.
| | - E Fort
- Université de Lyon, Université Lyon 1, IFSTTAR, UMRESTTE, UMR_T9405, F-69373 Lyon, France
| | - L Fontana
- Université de Lyon, Université Lyon 1, Université de St Etienne, IFSTTAR, UMRESTTE, UMR_T9405, 42005 Saint Etienne, France; Service de Santé au Travail, CHU de Saint-Etienne, France
| | - B Charbotel
- Université de Lyon, Université Lyon 1, IFSTTAR, UMRESTTE, UMR_T9405, F-69373 Lyon, France; Hospices Civils de Lyon, Service de Santé au Travail, France
| | - M Hours
- Univ Lyon, IFSTTAR, Univ Lyon 1, UMRESTTE, UMR_T9405, F-69675 Bron, France
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Affiliation(s)
- E. Fort
- DRNR/SPCI/LEPh, Bâtiment 230, CEN Cadarache, 13108 Saint-Paul-Lez-Durance, Cedex, France
| | - J. Fréhaut
- Centre d’Etudes de Bruyères-le-Châtel, Service De Physique Neutronique et Nucléaire, B.P. No. 561, 92542 Montrouge Cedex, France
| | - H. Tellier
- Centre d’Etudes Nucléaires de Saclay, Service d’Etudes des Réacteurs et de Mathématiques Appliquées, 91191 Gif sur Yvette Cedex, France
| | - P. Long
- DRNR/SPCI/LEPh, Bâtiment 230, CEN Cadarache, 13108 Saint-Paul-Lez-Durance, Cedex, France
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Font R, Espinas J, Layos L, Martinez Villacampa M, Capdevila J, Tobeña M, Pisa A, Pericay C, Lezcano C, Fort E, Cardona I, Berga N, Solà J, Borras J. Adherence to capecitabine in preoperative treatment of stage II and III rectal cancer: do we need to worry? Ann Oncol 2017; 28:831-835. [DOI: 10.1093/annonc/mdx006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
The investigation of dynamical systems has revealed a deep-rooted difference between waves and objects regarding temporal reversibility and particlelike objects. In nondissipative chaos, the dynamic of waves always remains time reversible, unlike that of particles. Here, we explore the dynamics of a wave-particle entity. It consists in a drop bouncing on a vibrated liquid bath, self-propelled and piloted by the surface waves it generates. This walker, in which there is an information exchange between the particle and the wave, can be analyzed in terms of a Turing machine with waves as the information repository. The experiments reveal that in this system, the drop can read information backwards while erasing it. The drop can thus backtrack on its previous trajectory. A transient temporal reversibility, restricted to the drop motion, is obtained in spite of the system being both dissipative and chaotic.
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Affiliation(s)
- S Perrard
- Laboratoire Matière et Systèmes Complexes, Université Paris Diderot, CNRS UMR 7057, Bâtiment Condorcet, 10 rue Alice Domon et Léonie Duquet, 75013 Paris, France
| | - E Fort
- Institut Langevin, ESPCI Paris, PSL Research University, CNRS UMR 7587, 1 rue Jussieu, 75238 Paris, France
| | - Y Couder
- Laboratoire Matière et Systèmes Complexes, Université Paris Diderot, CNRS UMR 7057, Bâtiment Condorcet, 10 rue Alice Domon et Léonie Duquet, 75013 Paris, France
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Pélissier C, Fontana L, Fort E, Vohito M, Sellier B, Perrier C, Glerant V, Couprie F, Agard JP, Charbotel B. Impaired mental well-being and psychosocial risk: a cross-sectional study in female nursing home direct staff. BMJ Open 2015; 5:e007190. [PMID: 25829371 PMCID: PMC4386217 DOI: 10.1136/bmjopen-2014-007190] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The present study sought to quantify the impaired mental well-being and psychosocial stress experienced by nursing home staff and to determine the relationship between impaired mental well-being assessed on the 12-item General Health Questionnaire (GHQ-12) and exposure to psychosocial stress assessed on Siegrist's effort/reward and overcommitment model. METHODS A transverse study was conducted in France on 2471 female employees in 105 nursing homes for the elderly. Personal and occupational data were collected by questionnaire for 668 housekeepers, 1454 nursing assistants and 349 nurses. RESULTS 36.8% of participants (n=896) showed impaired mental well-being, 42.7% (n=1039) overcommitment and 9% (n=224) effort/reward imbalance. Overcommitment (prevalence ratio (PR)=1.27; 95% CI (1.21 to 1.34)) and effort-reward imbalance (PR=1.19; 95% CI (1.12 to 1.27)) were significantly associated with presence of impaired mental well-being after adjustment for personal factors (age and private life events). Taking effort and reward levels into account, the frequency of impaired mental well-being was highest in case of exposure to great extrinsic effort and low rewards of any type: esteem, PR=3.53, 95% CI (3.06 to 4.08); earnings, PR=3.48, 95% CI (2.99 to 4.06); or job security, PR=3.30, 95% CI (2.88 to 3.78). Participants in situations of overcommitment and of effort/reward imbalance were at the highest risk of impaired mental well-being: PR=3.86, 95% CI (3.42 to 4.35). CONCLUSIONS Several changes in nursing home organisation can be suggested to reduce staff exposure to factors of psychosocial stress. Qualitative studies of the relation between impaired mental well-being and psychosocial stress in nursing home staff could guide prevention of impaired mental well-being at work.
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Affiliation(s)
- C Pélissier
- Université Lyon 1, UMRESTTE (IFSTTAR/UCLB joint unit), Domaine Rockefeller, Lyon, France
- Service de Santé au Travail, CHU de Saint-Etienne, Saint-Etienne, France
| | - L Fontana
- Université Lyon 1, UMRESTTE (IFSTTAR/UCLB joint unit), Domaine Rockefeller, Lyon, France
- Service de Santé au Travail, CHU de Saint-Etienne, Saint-Etienne, France
| | - E Fort
- Université Lyon 1, UMRESTTE (IFSTTAR/UCLB joint unit), Domaine Rockefeller, Lyon, France
| | - M Vohito
- AST Grand Lyon, Villeurbanne, Cedex, France
| | | | - C Perrier
- AST Grand Lyon, Villeurbanne, Cedex, France
| | | | - F Couprie
- AST Grand Lyon, Villeurbanne, Cedex, France
| | | | - B Charbotel
- Université Lyon 1, UMRESTTE (IFSTTAR/UCLB joint unit), Domaine Rockefeller, Lyon, France
- Hospices Civils de Lyon, Service des Maladies Professionnelles, Centre Hospitalier Lyon Sud, Pierre Bénite, France
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Abstract
The transmission of information can couple two entities of very different nature, one of them serving as a memory for the other. Here we study the situation in which information is stored in a wave field and serves as a memory that pilots the dynamics of a particle. Such a system can be implemented by a bouncing drop generating surface waves sustained by a parametric forcing. The motion of the resulting "walker" when confined in a harmonic potential well is generally disordered. Here we show that these trajectories correspond to chaotic regimes characterized by intermittent transitions between a discrete set of states. At any given time, the system is in one of these states characterized by a double quantization of size and angular momentum. A low dimensional intermittency determines their respective probabilities. They thus form an eigenstate basis of decomposition for what would be observed as a superposition of states if all measurements were intrusive.
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Affiliation(s)
- S Perrard
- Laboratoire Matière et Systèmes Complexes, Université Paris Diderot, CNRS-UMR 7057, Bâtiment Condorcet, 10 rue Alice Domon et Léonie Duquet, 75013 Paris, France, EU
| | - M Labousse
- Institut Langevin, ESPCI ParisTech, CNRS-UMR 7587, 1 rue Jussieu, 75005 Paris Cedex 05, France, EU
| | - E Fort
- Institut Langevin, ESPCI ParisTech, CNRS-UMR 7587, 1 rue Jussieu, 75005 Paris Cedex 05, France, EU
| | - Y Couder
- Laboratoire Matière et Systèmes Complexes, Université Paris Diderot, CNRS-UMR 7057, Bâtiment Condorcet, 10 rue Alice Domon et Léonie Duquet, 75013 Paris, France, EU
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Arribas L, Hurtós L, Sanchez-Migallon J, Salleras N, Fort E, Peiró I. PP076-MON: New Nutritional Screening in Onco-Hematological Patients (Nutriscore): Quicker and Accurate. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50411-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Fanjas A, Fort E, Pélissier C, Charnay P, Fontana L, Charbotel B, Bergeret A, Hours M. Accidents de la route dans le cadre du travail et conséquences sur le travail. Résultats de la cohorte ESPARR. ARCH MAL PROF ENVIRO 2014. [DOI: 10.1016/j.admp.2014.03.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Fort E, Ndagire S, Charbotel B. Conditions de travail des salariés ayant une activité de conduite sur la voie publique dans le cadre de leurs activités professionnelles : contraintes organisationnelles et relationnelles. ARCH MAL PROF ENVIRO 2014. [DOI: 10.1016/j.admp.2014.03.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Denis MA, Fort E, Massardier-Pilonchery A. Facteurs de risques psycho-sociaux des situations de souffrance au travail dans la population d’un établissement hospitalier. ARCH MAL PROF ENVIRO 2014. [DOI: 10.1016/j.admp.2014.03.197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Arribas L, Hurtós L, Milà R, Fort E, Peiró I. [Predict factors associated with malnutrition from patient generated subjective global assessment (PG-SGA) in head and neck cancer patients]. NUTR HOSP 2014; 28:155-63. [PMID: 23808444 DOI: 10.3305/nh.2013.28.1.6168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Patient Generated Subjective Global Assessment (PG-SGA) is a validated tool for nutrition evaluation in patients with cancer. AIM The aim of our study was to estimate the prevalence of malnutrition in head and neck cancer patients at diagnosis and evaluate the independent prognostic factors for malnutrition from PG-SGA. MATERIAL AND METHODS All outpatients attending at the Head and Neck Cancer Multidisciplinary Meeting for primary diagnosis, staging and treatment were evaluated by an oncology dietitian using the patient generated subjective global assessment (PG-SGA). Patients with recurrences or secondary tumours will be excluded. RESULTS 64 patients were evaluated (55 men and 9 women) with an average age of 63 years and body mass index (BMI) of 25.3 kg/m(2) (SD ± 5.18). After the nutritional assessment we observed that 43.8% of patients were malnourished or at risk of malnutrition. The most frequent symptom at diagnosis was dysphagia (48.4%) and anorexia (26.6%). From PG-SGA, the main prognostic factors (p<0,001) were the percentage of weight loss, serum albumin levels, BMI and the presence of dysphagia or/and anorexia prior diagnosis. CONCLUSIONS Parameters as BMI, weight loss and low albumin levels at the time of diagnosis in head and neck cancer patients are independent predictors for malnutrition as well as the presence of anorexia or dysphagia.reaffirms the need for sustainability of interventions over time.
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Affiliation(s)
- L Arribas
- Unidad Funcional de Nutrición Clínica, Institut Català d Oncologia, L Hospitalet de Llobregat, Barcelona.
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Peiró I, Arribas L, Fort E, Saldaña J, Antonio M, Formiga F, Fernández P, Lozano A, González J, Barbero E. [National Meeting in Working Multisdisciplinary Oncogeriatrics for development of a sensus document: present and future role of the Nutrition in units Oncogeriatrics]. NUTR HOSP 2013; 27:1670. [PMID: 23478725 DOI: 10.3305/nh.2012.27.5.5954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Antonio M, Saldaña J, Formiga F, Lozano A, González-Barboteo J, Fernández P, Arias F, Arribas L, Barbero E, Bescós MDM, Boya MJ, Bueso P, Casas A, Dotor E, Fort E, García-Alfonso P, Herruzo I, Llonch M, Morlans G, Murillo MT, Ossola G, Peiró I, Saiz F, Sanz J, Serra JA, Trelis J, Yuste A. [1st National Meeting of Multidisciplinary Work in Oncogeriatrics: expert consensus document]. Rev Esp Geriatr Gerontol 2012; 47:279-283. [PMID: 23044361 DOI: 10.1016/j.regg.2012.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 05/21/2012] [Indexed: 06/01/2023]
Abstract
On 2nd of June 2011 the Institut Català d' Oncologia l'Hospitalet--Hospital Duran i Reynals hosted the first Meeting of Multidisciplinary Work in Oncogeriatrics. The reason for the meeting, which follows on from an initiative of the Medical Societies of Radiotherapy, Oncology, Geriatrics and Gerontology and Palliative Care and Medical Oncology, was to initiate a joint line of work among the different specialties that generally take part in the handling of the elderly patient suffering from oncologic pathologies. This document summarises the different subjects covered during the Meeting.
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Affiliation(s)
- Maite Antonio
- Comisión de Onco-Geriatría, Institut Català d'Oncologia l'Hospitalet, Hospital Duran i Reynals, Barcelona, España.
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Abstract
A walker is a classical self-propelled wave particle association moving on a fluid interface. Two walkers can interact via their waves and form orbiting bound states with quantized diameters. Here we probe the behavior of these bound states when setting the underlying bath in rotation. We show that the bound states are driven by the wave interaction between the walkers and we observe a level splitting at macroscopic scale induced by the rotation. Using the analogy between Coriolis and Lorentz forces, we show that this effect is the classical equivalent to Zeeman splitting of atomic energy levels.
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Affiliation(s)
- A Eddi
- Laboratoire Matière et Systèmes Complexes, Université Paris Diderot, CNRS-UMR 7057, Bâtiment Condorcet, 10 rue Alice Domon et Léonie Duquet, 75013 Paris, France
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Massardier-Pilonchery A, Fort E, Dananche B, Confavreux-Romestaing C, Charbotel B. Exposition professionnelle au trichloroéthylène et pathologies cancéreuses du col utérin, une étude cas témoins. ARCH MAL PROF ENVIRO 2012. [DOI: 10.1016/j.admp.2012.03.336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fort E, Lobies P, Bergeret A. Phénomène de rupture professionnelle chez des salariés en consultation en service de maladie professionnelle. Analyse factorielle et classification. ARCH MAL PROF ENVIRO 2011. [DOI: 10.1016/j.admp.2011.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fassier JB, Charbotel B, Fort E, Rebillard X, Moreau JL, Borgogno C, Devonec M, Paparel P, Ruffion A. [A survey from the French Urology Association about sick leave prescriptions by 145 surgeons]. Prog Urol 2011; 21:479-85. [PMID: 21693360 DOI: 10.1016/j.purol.2011.02.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2010] [Revised: 12/28/2010] [Accepted: 02/01/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To describe and evaluate prescriptions of sick leave by urology surgeons for different kinds of interventions. METHODS Between January and April 2006, a web-based survey was completed by urology surgeons on a voluntary basis. The analyzed data pertained to personal characteristics of the surgeons, mean duration of sick leave for 15 interventions and the type of job of the patient (strenuous or not). Analyses were performed with software SAS™ version 9.2. Descriptive analyses were performed and Kruskal-Wallis test was used to search for statistically significant differences between variables (p<0,05). RESULTS One hundred and forty-eight surgeons were involved and 145 answers could be analyzed. Mean age of the surgeons was 46,3±9,4years. Urology surgeons were in the public sector (n=73/140; 52%), in private practice (n=43/140; 31%) or both (n=24/140; 17%). Kruskal-Wallis test showed that all patients who had a job considered as strenuous had significantly longer sick leave prescriptions. Younger surgeons (under 40) used to prescribe shorter sick leaves than their older counterparts. CONCLUSION Sick leave prescriptions of the urology surgeons were globally homogeneous in this survey. Only a few interventions were the occasion of discordant prescriptions depending upon the age or practice (public/private) of the surgeons. Several hypotheses could be further explored as regard the source of variation in sick leave prescriptions. These results are usable for those stakeholders who are interested in continuous medical education and evaluation.
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Affiliation(s)
- J-B Fassier
- UMRESTTE, Unité mixte INRETS/UCBL/InVS, France
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Pucci G, Fort E, Ben Amar M, Couder Y. Mutual adaptation of a Faraday instability pattern with its flexible boundaries in floating fluid drops. Phys Rev Lett 2011; 106:024503. [PMID: 21405233 DOI: 10.1103/physrevlett.106.024503] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2010] [Revised: 10/21/2010] [Indexed: 05/30/2023]
Abstract
Hydrodynamic instabilities are usually investigated in confined geometries where the resulting spatiotemporal pattern is constrained by the boundary conditions. Here we study the Faraday instability in domains with flexible boundaries. This is implemented by triggering this instability in floating fluid drops. An interaction of Faraday waves with the shape of the drop is observed, the radiation pressure of the waves exerting a force on the surface tension held boundaries. Two regimes are observed. In the first one there is a coadaptation of the wave pattern with the shape of the domain so that a steady configuration is reached. In the second one the radiation pressure dominates and no steady regime is reached. The drop stretches and ultimately breaks into smaller domains that have a complex dynamics including spontaneous propagation.
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Affiliation(s)
- G Pucci
- Matière et Systèmes Complexes, Université Paris Diderot, CNRS-UMR 7057, Bâtiment Condorcet, 10 rue Alice Domon et Léonie Duquet, 75013 Paris, France
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Hours M, Fort E, Bouffard E, Charnay P, Bernard M, Boisson D, Laumon B. Return to work following road accidents: Factors associated with late work resumption. J Rehabil Med 2011; 43:283-91. [DOI: 10.2340/16501977-0670] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Garrigues V, Ortiz V, Casanova C, Bujanda L, Moreno-Osset E, Rodríguez-Téllez M, Montserrat A, Brotons A, Fort E, Ponce J. Disease-specific health-related quality of life in patients with esophageal achalasia before and after therapy. Neurogastroenterol Motil 2010; 22:739-45. [PMID: 20482702 DOI: 10.1111/j.1365-2982.2010.01515.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND To evaluate disease-specific health-related quality of life (HRQoL) in patients with symptomatic esophageal achalasia before and after therapy. METHODS Symptoms and disease-specific HRQoL were evaluated before and 3 months after therapy. Therapy selection, either dilatation or myotomy, depended exclusively on the opinion of the physician on charge of the patient. Symptom severity was graded from 0 to 3, using a scoring system. A disease-specific questionnaire for achalasia developed and validated in Spanish language with 18 items and four subscales (AE-18) was used to evaluate HRQoL. Changes after therapy in HRQoL and its association with clinical improvement were analyzed. KEY RESULTS Sixty-five patients were prospectively included in eight hospitals in Spain. Of them, 47 were treated with dilatation, and 18 with laparoscopic Heller myotomy. After therapy, AE-18 global and subscales scores improved significantly. Changes in HRQoL were associated with improvement in symptoms. An important improvement in symptoms (>or=50%) was needed to obtain a minimal clinically important improvement (>or=20%) in HRQoL. CONCLUSIONS & INFERENCES Disease-specific HRQoL improves in patients with symptomatic achalasia after therapy with dilatation or myotomy. The degree of improvement of HRQoL depends on the degree of improvement of esophageal symptoms.
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Affiliation(s)
- V Garrigues
- Servicio de Medicina Digestiva, Hospital Universitari La Fe, Valencia, Spain.
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García M, Clopés A, Bruna J, Martínez M, Fort E, Gil M. Critical appraisal of temozolomide formulations in the treatment of primary brain tumors: patient considerations. Cancer Manag Res 2009; 1:137-50. [PMID: 21188132 PMCID: PMC3004664 DOI: 10.2147/cmr.s5598] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Indexed: 01/13/2023] Open
Abstract
Chemotherapy is assuming an increasingly important role in the treatment of malignant gliomas, of which temozolomide (TMZ) is a key part. TMZ belongs to a class of second-generation imidazotetrazinone prodrugs that exhibit linear pharmacokinetics and do not require hepatic metabolism for activation to the active metabolite. New intravenous (iv) TMZ formulations have recently been approved based on studies of bioequivalence between iv and oral TMZ. The efficacy of TMZ was initially evaluated in patients with recurrent disease but phase II and III trials in newly diagnosed gliomas are available. The results of a large phase III trial that compared RT alone vs RT concomitant with oral TMZ created a new standard of adjuvant treatment. Efficacy data for iv TMZ on which its approval was based are those extrapolated from clinical trials with oral TMZ. No comparative data are available on the differences in tolerability and patient satisfaction between oral and iv formulations of TMZ, or for quality of life. New oral formulations could encourage the adherence of patients to treatment. Although patients presumably would prefer oral treatment, iv formulations may be an alternative in noncompliant patients or patients for whom good adherence could not be expected.
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Affiliation(s)
- Margarita García
- Clinical Research Unit, Institut Català d'Oncologia-IDIBELL, L'Hospitalet, Barcelona, Spain
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Abstract
A droplet bouncing on a vibrated bath becomes a "walker" moving at constant velocity on the interface when it couples to the surface wave it generates. Here the motion of a walker is investigated when it collides with barriers of various thicknesses. Surprisingly, it undergoes a form of tunneling: the reflection or transmission of a given incident walker is unpredictable. However, the crossing probability decreases exponentially with increasing barrier width. This shows that this wave-particle association has a nonlocality sufficient to generate a quantumlike tunneling at a macroscopic scale.
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Affiliation(s)
- A Eddi
- Matières et Systèmes Complexes, Université Paris Diderot, CNRS-UMR 7057, Bâtiment Condorcet, 75013 Paris, France
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46
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Ratajczak P, Fort E. Les quantum dots fluorescents et l’amplification physique de la luminescence. Ann Pathol 2007. [DOI: 10.1016/s0242-6498(07)92864-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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47
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Casas M, Mora J, Fort E, Aracil C, Busquets D, Galter S, Jáuregui CE, Ayala E, Cardona D, Gich I, Farré A. [Total enteral nutrition vs. total parenteral nutrition in patients with severe acute pancreatitis]. Rev Esp Enferm Dig 2007; 99:264-9. [PMID: 17650935 DOI: 10.4321/s1130-01082007000500004] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare the efficacy of early total enteral nutrition (TEN) vs. total parenteral nutrition (TPN) in patients with severe acute pancreatitis (SAP). METHODS A total of 22 consecutive patients with SAP were randomized to receive TPN (group I) or TEN (group II). SAP was defined applying APACHE II score, C-reactive protein (CRP) measurements and/or Balthazar CT scan score. Acute inflammatory response (CRP, TNF-a, IL-6), visceral proteins (pre-albumin, albumin), complications (systemic inflammatory response syndrome, multiorgan failure, infections), surgical interventions, length of hospital stay and mortality were evaluated. RESULTS No significant differences were found between the two groups in the APACHE II score, in CRP, TNF-a and IL-6 concentrations or in pre-albumin and albumin levels over the first 10 days. Seven patients in group I and 4 in group II suffered severe complications. Three patients in group I required surgical intervention. Length of hospital stay was alike in the two groups. Two patients from group I died in the course of the hospitalization. CONCLUSIONS SAP patients with TEN feeding showed a tendency towards a better outcome than patients receiving TPN.
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Affiliation(s)
- M Casas
- Servicios de Patología Digestiva, Hospital de la Santa Creu i Sant Pau, Barcelona
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48
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Abstract
Fluorescence labeling is the prevailing imaging technique in cell biology research. When they involve statistical investigations on a large number of cells, experimental studies require both low magnification to get a reliable statistical population and high contrast to achieve accurate diagnosis on the nature of the cells' perturbation. Because microscope objectives of low magnification generally yield low collection efficiency, such studies are limited by the fluorescence signal weakness. To overcome this technological bottleneck, we proposed a new method based on metal-coated substrates that enhance the fluorescence process and improve collection efficiency in epifluorescence observation and that can be directly used with a common microscope setup. We developed a model based on the dipole approximation with the aim of simulating the optical behavior of a fluorophore on such a substrate and revealing the different mechanisms responsible for fluorescence enhancement. The presence of a reflective surface modifies both excitation and emission processes and additionally reshapes fluorescence emission lobes. From both theoretical and experimental results, we found the fluorescence signal emitted by a molecular cyanine 3 dye layer to be amplified by a factor approximately 30 when fluorophores are separated by a proper distance from the substrate. We then adapted our model to the case of homogeneously stained micrometer-sized objects and demonstrated mean signal amplification by a factor approximately 4. Finally, we applied our method to fluorescence imaging of dog kidney cells and verified experimentally the simulated results.
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Affiliation(s)
- E Le Moal
- Laboratoire Matériaux et Phénomènes Quantiques (UMR 7162, Paris VII), Paris cedex 05, France
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Hours M, Henrotin J, Fort E. Caractéristiques des accidents de la circulation en lien avec le travail : une analyse à partir des données 2001 du Registre des victimes d’accidents de la circulation du Rhône. ARCH MAL PROF ENVIRO 2006. [DOI: 10.1016/s1775-8785(06)78114-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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50
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Berlana D, Vidaller A, Jódar R, Fort E, Domingo A, Pastó L. Changes in biochemical, hematological and immunological profiles after low-dose intravenous immunoglobulin administration in patients with hypogammaglobulinemia. Transfus Clin Biol 2006; 12:433-40. [PMID: 16616571 DOI: 10.1016/j.tracli.2006.02.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2005] [Accepted: 02/24/2006] [Indexed: 10/24/2022]
Abstract
We assessed the immediate effect of intravenous immunoglobulins (IVIG) on the biochemical, immunological and hematological profiles in patients with hypogammaglobulinemia. Over a period of three months, patients with antibody deficiencies, who had been established on stable IVIG treatment as replacement therapy in our hospital, were enrolled in the study. Participants underwent pre-therapy determinations of their biochemical, immunological and hematological profiles. Laboratory determinations were repeated after completion of IVIG infusions. Over the study period, fourteen patients were enrolled and a total of 34 pre- and post-IVIG infusion determinations were performed and results compared. We found that low-dose IVIG treatment in patients with hypogammaglobulinemia results in post-infusion biochemical and hematological changes, as follows: an increase in total protein concentration and a reduction in albumin, total cholesterol, sodium and alkaline phosphatase concentrations as well as lymphocyte and platelet counts. All these biochemical and cellular changes seems to be transient, since they were not observed in the subsequent pre-infusion determination. However, in other patient populations, some of these changes might differ, depending on the dose of IVIG administered and the baseline condition and immunological status of the patient.
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Affiliation(s)
- David Berlana
- Pharmacy Service, Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
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