[Very old patients in multidisciplinary team meeting in PACA: a one-year survey]. / Patients très âgés dans les RCP en région PACA : observation sur une année.

INTRODUCTION: In 2011, 11% of all cancers were diagnosed in people over 85 years old. With the current aging of the French population associated with health progress, we will be confronted more and more frequently with the treatment of very old patients, and this until the horizon 2050, when the population over 75 years old will represent approximately 15% of the total French population (compared to 9.1% in 2015). METHODS: To understand the management methods for patients over 85 years old with cancer, we carried out an observational study, based on data collected in the OncoPACA-Corse network, with the objective to describe the demographic data of very elderly patients, the characteristics of their pathology and to analyze the therapeutic strategies proposed by oncologists to patients in this population. RESULTS: One thousand three hundred and fifty five cases were analyzed. The mean age of the patients was 88.9 years with 3% of patients over 95 years old and only one was over 100 years old. 51.6% were women. Digestive tumors were the most represented (23.4%), followed by breast tumors (17.7%) and prostate tumors (10.5%), with a diagnosis made at a metastatic stage in 20% of cases. We note that treatment was offered for nearly 85% of patients with a wide range of options, exclusive palliative care was offered in 15% of cases; and whena treatment considered to be not very aggressive, such as hormone therapy, was offered, it seems to be preferred as monotherapy.

The VALEO vascular stent for cardiovascular lesions in children.

AIMS: The VALEO vascular stent is a stainless steel, pre-mounted, open-cell stent. Redilation to large diameters and low profile are advantages in growing children. Clinical experience is scarce. This study aimed to analyse our experience with the use of the VALEO vascular stent in children. METHODS AND RESULTS: Between June 2010 and December 2012, 41 VALEO stents were inserted during 30 transcatheter (group 1) and three perioperative procedures (group 2). Data were retrospectively analysed. Median age at implantation was 3.8 years (four days - 23 years), and median weight was 13.3 kg (2.2-53 kg). Indications were: pulmonary artery (n=23), pulmonary vein (n=1) or subhepatic vein (n=1) stenosis, and ductus arteriosus stenting (n=8). Stent placement was achieved in all but one. Acute complications (n=11) included stent dislodgement in two patients and fracture in three patients, with vessel predilatation as a risk factor. Median "stent" follow-up reached 7.83 months (0.4-34.3 months) and included 26 recatheterisations (23 patients, median interval 6.2 months, range 0.2-33 months). Ten stents were redilated. Surgery in six patients (interval 1.9 to 10 months) showed patent endothelialised stents. No "late" type II or III stent fractures were seen. CONCLUSIONS: The VALEO stent is useful in children. Low radial force is counterbalanced by high flexibility, allowing implantation in distal and tortuous lesions. Early fractures occur. Longer-term follow-up is needed.

[Increase of mortality associated with emergency relocation of elderly nursing homes residents following flooding in the Var district, France, 2010]. / Surmortalité associée à un déplacement en urgence des personnes âgées hébergées en institution suite aux inondations du Var en 2010.

On June 15th, 2010, the Var district was hit by heavy rain causing floods and mudslides. A nursing home for elderly people was subject to an emergency evacuation and had to relocate 140 residents in other hosting facilities in the region. A prospective cohort study was conducted through two evaluations of the residents' health conditions: before the flood and five months after they had returned in their homes. The monthly mortality data recorded in the facility in 2010 was compared with data from 2004 to 2009 of the same facility, and with the 2010 data from two other facilities located in the disaster area that had not evacuated their residents. The number of deaths recorded in the month following the floods was three times higher than the average number of expected deaths over the study period, and even twice higher during the second month. This excess mortality was not observed in the two other facilities studied in the disaster area. Most deceased arised in older people, more often in men, in state of high dependance and living in medical care units. These results suggest that despite the measures implemented by the rescue teams, the emergency displacement and relocation of elderly people, inevitable in this context, can have serious consequences. Where possible, the need for displacement must be discussed, prepared in advance, and followed by specific support for more vulnerable people.