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1.
ESMO Open ; 6(1): 100044, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33516148

RESUMO

BACKGROUND: Second primary cancers (SPCs) are diagnosed in over 5% of patients after a first primary cancer (FPC). We explore here the impact of immune checkpoint inhibitors (ICIs) given for an FPC on the risk of SPC in different age groups, cancer types and treatments. PATIENTS AND METHODS: The files of the 46 829 patients diagnosed with an FPC in the Centre Léon Bérard from 2013 to 2018 were analyzed. Structured data were extracted and electronic patient records were screened using a natural language processing tool, with validation using manual screening of 2818 files of patients. Univariate and multivariate analyses of the incidence of SPC according to patient characteristics and treatment were conducted. RESULTS: Among the 46 829 patients, 1830 (3.9%) had a diagnosis of SPC with a median interval of 11.1 months (range 0-78 months); 18 128 (38.7%) received cytotoxic chemotherapy (CC) and 1163 (2.5%) received ICIs for the treatment of the FPC in this period. SPCs were observed in 7/1163 (0.6%) patients who had received ICIs for their FPC versus 437/16 997 (2.6%) patients receiving CC and no ICIs for the FPC versus 1386/28 669 (4.8%) for patients receiving neither CC nor ICIs for the FPC. This reduction was observed at all ages and for all histotypes analyzed. Treatment with ICIs and/or CC for the FPC are associated with a reduced risk of SPC in multivariate analysis. CONCLUSION: Immunotherapy with ICIs alone and in combination with CC was found to be associated with a reduced incidence of SPC for all ages and cancer types.


Assuntos
Inibidores de Checkpoint Imunológico , Segunda Neoplasia Primária , Humanos , Incidência , Segunda Neoplasia Primária/epidemiologia
2.
J Pediatr Urol ; 9(1): e94-7, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23141002

RESUMO

Conventional and robotic-assisted laparoscopy is being used for more and more complex urological procedures in children. There have recently been reports of laparoscopic or laparoscopic-assisted appendicovesicostomies in children. We report a case of combined laparoscopic-assisted nephrectomy, augmentation ureterocystoplasty and Mitrofanoff appendicovesicostomy in a 5-year-old boy with valve bladder syndrome.


Assuntos
Cistostomia/métodos , Laparoscopia/métodos , Nefrectomia/métodos , Doenças Ureterais/cirurgia , Doenças da Bexiga Urinária/cirurgia , Derivação Urinária/métodos , Apêndice/cirurgia , Pré-Escolar , Humanos , Masculino , Robótica/métodos
3.
Ann Fr Anesth Reanim ; 24(3): 270-3, 2005 Mar.
Artigo em Francês | MEDLINE | ID: mdl-15792560

RESUMO

Lithium treatment, which is still extensively used in bipolar affective disorders, may give rise to hypercalcaemia induced by hyperparathyroidism. We present a patient of 50-year-old treated with lithium for 19 years for bipolar illness and who developed an important hypercalcaemia. After symptomatic treatment of the hypercalcaemia and extrarenal dialysis the clinical evolution was favorable but measurements of serum calcium and parathormon showed that he had developed hyperparathyroidism. Neck exploration was performed and parathyroid adenomas, which had been detected by scintigraphy was removed. The lithium treatment expose to many side effects. Among other biologically and clinically important effects of lithium the possible induction of hyperparathyroidism was first suggested in 1973. Since, 1973, since about forty case reports have been described. Few cross-sectional studies show a relationship of lithium to hyperparathyroidism. Unusual metabolic features are associated with hyperparathyroidism and long-term lithium treatment: low urinary calcium excretion, normal urinary cyclic AMP excretion. The mechanism probably results from lithium linking with the calcium receptor on the parathyroid and then stimulating PTH secretion. The cessation of lithium therapy does not lead to normocalocaemia and a parathyroidectomy is usually indicated.


Assuntos
Antimaníacos/efeitos adversos , Hipercalcemia/etiologia , Hiperparatireoidismo/induzido quimicamente , Hiperparatireoidismo/complicações , Lítio/efeitos adversos , Transtorno Bipolar/complicações , Transtorno Bipolar/tratamento farmacológico , Cálcio/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo/sangue
4.
Ann Fr Anesth Reanim ; 21(9): 728-30, 2002 Nov.
Artigo em Francês | MEDLINE | ID: mdl-12494807

RESUMO

We report the case of a 71-year-old man receiving anticoagulant treatment because of a mechanical aortic valve. Because of an unsuccessful weaning after abdominal surgery, a translaryngeal tracheostomy was realised without incident. The patient died few days later after a hypoxic cardiac arrest due to a severe haemorrhage after the first recannulation. This case illustrates a severe complication because of the recannulation after a translaryngeal tracheostomy and how cautions one should be before realizing a percutaneous tracheostomy in a patient under anticoagulant treatment.


Assuntos
Complicações Pós-Operatórias/terapia , Traqueostomia/efeitos adversos , Adulto , Anticoagulantes/efeitos adversos , Anticoagulantes/uso terapêutico , Evolução Fatal , Parada Cardíaca/etiologia , Hemorragia/etiologia , Humanos , Masculino , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia
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