[Project management of the implementation of intracranial stereotactic body radiotherapy at the "Centre finistérien de radiothérapie et d'oncologie"]. / Gestion du projet de mise en place de la radiothérapie stéréotaxique intracrânienne au Centre finistérien de radiothérapie et d'oncologie.

The Centre Finistérien de radiothérapie et d'oncologie, based in Brest (France), wanted to expand its activity by offering intracranial stereotactic radiation therapy to improve patient care. The desire of the Centre was to invest in this innovative and efficient technique and thus modernize its technical platform and its offer of care. The introduction of intracranial stereotactic radiation therapy requires vigilance for the technical and human organization. Therefore, the Centre prepared the implementation of this technique upstream by a structured and timed preliminary project management.

Microalbuminuria and markers of the atherosclerotic process: the D.E. S.I.R. study.

The relationship between microalbuminuria and tissue-type plasminogen activator antigen (tPA-ag) and fibrinogen was evaluated in non-diabetic subjects. Subjects were participants of the D.E.S.I. R. (Data from an Epidemiological Study on the Insulin Resistance syndrome) Study. Analyses were carried out on 2248 women and 2402 men for fibrinogen and on 272 women and 284 men for tPA-ag. Microalbuminuria was defined as urinary albumin concentration greater than 20 mg/l. Men with microalbuminuria had a 6% higher fibrinogen concentration than those without (3.07 g/l (95% confidence interval: 2.99,3.15) vs. 2.89 g/l (2.87,2.91), adjusted for age and smoking). This relationship existed in hypertensive as well as non-hypertensive subjects. The association between microalbuminuria and tPA-ag existed only in hypertensive men, those with microalbuminuria having a 21% higher tPA-ag than those without (4.39 ng/ml (3.70,5.08) vs. 3.63 ng/ml (3.32,3.94), adjusted for age and smoking). Adjustment for other risk markers for cardiovascular disease did not change the results. There was no relationship between microalbuminuria and these haemostatic factors in women. The results of this study suggest that in non-diabetic men, microalbuminuria is associated with fibrinogen, but with tPA-ag only when concomitant with hypertension.

The metabolic syndrome in smokers. The D.E.S.I.R. study.

OBJECTIVES: To test the hypothesis that smokers have a higher frequency of the metabolic syndrome, and a syndrome with different characteristics than non-smokers. MATERIAL AND METHODS: The 2,569 men and 2,637 women included in the D.E.S.I.R. study, aged 30-64 years, volunteers from ten French Social Security Health Examination Centres, were studied. The World Health Organization definition of the metabolic syndrome was adapted for this analysis, and insulin resistance was defined by a concentration above the 75(th) centile of the sex-specific distribution of fasting insulin. RESULTS: 28.1% of men and 15.1% of women were current smokers. The metabolic syndrome was twice as frequent in men than in women (22.8% vs 11.0%). Smokers and never-smokers were compared in age stratified samples. In men, the frequencies of hyperglycaemia or hypoglycaemic treatment, dyslipidaemia, microalbuminuria, and central obesity were significantly higher in smokers and 22.5% of smokers and 15.3% of non-smokers had this syndrome (p=0.001). In women, only dyslipidaemia was more frequent in smokers; in contrast smokers had lower insulin concentrations and hence a lower frequency of hyperinsulinemia. The frequency of the syndrome did not differ between women who smoked and those who did not (6.3% vs 6.0%). CONCLUSIONS: In men, the metabolic syndrome was more frequent in smokers than in non-smokers; in contrast, there was no difference for women. For both sexes, syndrome abnormalities tended to be more frequent in smokers than in non-smokers.