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Relecom A, Federico M, Connors JM, Coiffier B, Biasoli I, Moccia A, Salles G, McKee T, Miralbell R, Borchmann P, Kuruvilla J, Johnson P, Cavalli F, Delavy M, Dietrich PY, Flahault A. Resources-Stratified Guidelines for Classical Hodgkin Lymphoma. Int J Environ Res Public Health 2020; 17:ijerph17051783. [PMID: 32182952 PMCID: PMC7084688 DOI: 10.3390/ijerph17051783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/19/2020] [Accepted: 02/28/2020] [Indexed: 01/23/2023]
Abstract
Hodgkin lymphoma is a haematological malignancy predominantly affecting young adults. Hodgkin lymphoma is a highly curable disease by current treatment standards. Latest treatment guidelines for Hodgkin lymphoma however imply access to diagnostic and treatment modalities that may not be available in settings with restricted healthcare resources. Considerable discrepancies in Hodgkin lymphoma patient survival exist, with poorer outcomes reported in resources-constrained settings. Resources-stratified guidelines for diagnosis, staging and treatment of Hodgkin lymphoma were derived in an effort to optimize patient outcome provided a given setting of available resources. These guidelines were derived based on the framework of the Breast Health Global Initiative stratifying resource levels in basic, core, advanced and maximal categories.
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Affiliation(s)
- Allan Relecom
- Department of Oncology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland; (A.R.); (P.-Y.D.)
| | - Massimo Federico
- Medical Oncology, CHIMOMO Department, University of Modena and Reggio Emilia, Via Università 4, 41121 Modena, Italy;
| | - Joseph M. Connors
- BC Cancer Agency, Vancouver Centre, 600 West 10th Avenue, Vancouver, BC V5Z 1G1, Canada;
| | - Bertrand Coiffier
- Department of Hematology, Hospices Civils de Lyon, 3 Quai des Celestins, 69002 Lyon, France;
| | - Irene Biasoli
- Internal Medicine Department, Federal Univsersity of Rio de Janeiro, Av. Pedro Calmon, 550-Cidade Universitária-Rio de Janeiro, RJ 21941-901, Brazil;
| | - Alden Moccia
- Oncology Institute of Southern Switzerland (IOSI) Ospedale Regionale di Locarno “La Carità”, Via Ospedale 1 CH-6600 Locarno;
| | - Gilles Salles
- Groupe d’étude des lymphomes de l’adulte, CHU de Lyon HCL-GH Sud, 165 Chemin du Grand Revoyet, 69495 Pierre-Benite Cedex, France;
| | - Thomas McKee
- Clinical Pathology Unit, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva Switzerland
- Faculté de Médecine, Geneva University, Rue Michel-Servet 1, 1206 Genève, Switzerland
| | - Raymond Miralbell
- Department of Oncology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland; (A.R.); (P.-Y.D.)
| | - Peter Borchmann
- Department of Internal Medicine, University Hospital of Cologne, Karpener Str 62, 50924 Cologne, Germany;
| | - John Kuruvilla
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Center, Toronto, ON M5G 2C1, Canada;
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Peter Johnson
- Faculty of Medicine, University of Southampton, Southampton S017 1BJ, UK;
| | - Franco Cavalli
- Institute of Oncology Research (IOR), Via Vela 6, 6500 Bellinzona, Switzerland;
| | - Martine Delavy
- Institute of Global Health, Faculty of Medicine, University of Geneva, Campus Biotech, Chemin des Mines 9, 1202 Geneva, Switzerland;
| | - Pierre-Yves Dietrich
- Department of Oncology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland; (A.R.); (P.-Y.D.)
- Faculté de Médecine, Geneva University, Rue Michel-Servet 1, 1206 Genève, Switzerland
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, Campus Biotech, Chemin des Mines 9, 1202 Geneva, Switzerland;
- Correspondence:
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Benski AC, Delavy M, Rochat CH, Viviano M, Catarino R, Elsig V, Doulougou A, Petignat P, Vassilakos P. Prognostic factors and long-term outcomes of obstetric fistula care using the Tanguiéta model. Int J Gynaecol Obstet 2019; 148:331-337. [PMID: 31778211 DOI: 10.1002/ijgo.13071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 03/08/2019] [Revised: 09/18/2019] [Accepted: 11/26/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To identify factors influencing the long-term prognosis after surgical repair of obstetric fistula, establish a prognosis-based classification system, and examine changes in quality of life after surgery. METHODS A retrospective study of 308 women who underwent obstetric fistula repair at Saint Jean de Dieu Hospital, Tanguiéta, Benin, between 2008 and 2016, and were supported by a multidisciplinary management model. All participants were from rural areas of Burkina Faso. The women completed interviews before, immediately after, and 2, 4-6, and 12 months after surgery to assess their clinical state and socioeconomic and psychologic status. RESULTS Overall, the fistulae of 230/274 (83.9%) women were considered to be repaired after 12 months. Factors associated with poor repair outcome included the presence of sclerotic tissue (odds ratio [OR], 0.25; 95% confidence interval [CI], 0.11-0.53) and intraoperative complications (OR, 0.16; 95% CI, 0.07-0.39). Women with successful surgery had a better quality of life as compared with women with an unrepaired fistula (Ditrovie score, 1.1 vs 3.9; P<0.001). CONCLUSION The multidisciplinary Tanguiéta model for management of obstetric fistula allowed successful fistula closure, thereby facilitating the women's long-term social reintegration, and improved quality of life.
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Affiliation(s)
- Anne-Caroline Benski
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Martine Delavy
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Charles-Henry Rochat
- Generale Beaulieu Clinic, Geneva, Switzerland.,Geneva Foundation for Medical Education and Research, Geneva, Switzerland.,Faculty of Health Sciences, Cotonou, Benin
| | - Manuela Viviano
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Rosa Catarino
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | | | | | - Patrick Petignat
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre Vassilakos
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,Geneva Foundation for Medical Education and Research, Geneva, Switzerland
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Urner E, Delavy M, Catarino R, Viviano M, Meyer-Hamme U, Benski AC, Jinoro J, Heriniainasolo JL, Undurraga M, De Vuyst H, Combescure C, Vassilakos P, Petignat P. A Smartphone-Based Approach for Triage of Human Papillomavirus-Positive Sub-Saharan African Women: A Prospective Study. JMIR Mhealth Uhealth 2017; 5:e72. [PMID: 28554879 PMCID: PMC5468541 DOI: 10.2196/mhealth.6697] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/30/2017] [Accepted: 04/10/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sub-Saharan African countries are marked by a high incidence of cervical cancer. Madagascar ranks 11th among the countries with the highest cervical cancer incidence worldwide. OBJECTIVE The aim of the study was to evaluate the performances of digital smartphone-based visual inspection with acetic acid (D-VIA) and Lugol's iodine (D-VILI) for diagnosing cervical precancer and cancer. METHODS Human papillomavirus (HPV)-positive women recruited through a cervical screening campaign had D-VIA and D-VILI examinations with endocervical curettage (ECC) and cervical biopsy. Three images were captured for each woman (native, D-VIA, D-VILI) using a smartphone camera. The images were randomly coded and distributed on 2 online databases (Google Forms). The D-VIA form included native and D-VIA images, and the D-VILI form included native and D-VILI images. Pathological cases were defined as cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Physicians rated the images as non-pathological or pathological. Using the ECC and cervical biopsy results as references, the sensitivity and specificity of D-VIA and D-VILI examinations for each and all physicians were calculated. RESULTS Altogether, 15 clinicians assessed 240 images. Sensitivity was higher for the D-VIA interpretations (94.1%; 95% CI 81.6-98.3) than for the D-VILI interpretations (78.8%; 95% CI 54.1-92.1; P=.009). In contrast, the specificity was higher for the D-VILI interpretations (56.4%; 95% CI 38.3-72.9) than for the D-VIA interpretations (50.4%; 95% CI 35.9-64.8; P=.005). CONCLUSION Smartphone-based image for triage of HPV-positive women is more accurate for detecting CIN2+ lesions with D-VIA than D-VILI, although with a small loss of specificity.
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Affiliation(s)
- Esther Urner
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Martine Delavy
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Rosa Catarino
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Manuela Viviano
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Ulrike Meyer-Hamme
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Anne-Caroline Benski
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Jeromine Jinoro
- Laboratory Division, Saint Damien Healthcare Centre, Ambanja, Madagascar
| | - Josea Lea Heriniainasolo
- Gynecology Division, Department of Gynecology and Obstetrics, Saint Damien Healthcare Centre, Ambanja, Madagascar
| | - Manuela Undurraga
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Hugo De Vuyst
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | | | - Pierre Vassilakos
- Geneva Foundation for Medical Education and Research, Geneva, Switzerland
| | - Patrick Petignat
- Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
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