[Prognostic value of toxicities induced by targeted therapies in patients treated for a metastatic renal cell carcinoma]. / Valeur pronostique de la toxicité induite par les thérapies ciblées dans le carcinome rénal métastatique.

OBJECTIVE: To assess the prognostic value of clinical and biological variables in the era of targeted therapies, especially induced toxicity in patients treated for metastatic renal cell carcinoma (RCC). PATIENTS AND METHODS: A retrospective single-center study was performed in patients treated in our center from 2006 to 2012. The clinical and biological variables and toxicity data were retrospectively collected. Survival rates were calculated using the Kaplan-Meier method and compared by the Log-Rank test. Multivariate analysis was also performed using the Cox model. RESULTS: One hundred and two patients were included, with a median follow-up of 20 months. The median overall survival (OS) was 21 months, and 6 months for the progression free survival (PFS). As expected, the variables included in the Mozter prognostic score had a significant impact on OS (P < 0.0001) and PFS (P < 0.0001). However, hypoalbuminemia (P < 0.0001), brain metastasis (P = 0.003) and the absence of nephrectomy (P < 0.0001) were found as poor prognosis factors for OS. In addition, severe toxicity (grade 3-4) was significantly associated with higher OS (P < 0.0001) and PFS (P = 0.0003) and appeared as an independent factor in multivariate analysis for OS (P = 0.02) and PFS (P = 0.01). CONCLUSION: Severe toxicity induced by targeted therapies was found as a prognostic factor increasing significantly the survival. Further studies are needed to assess the real value of this factor in the development of sequential therapies for the treatment of RCC.

[Functional manifestations associated to corticosteroid therapy among the elderly]. / Manifestations fonctionnelles associées à la prise de corticoïdes chez les sujets âgés.

PURPOSE: Corticosteroid therapy is frequently prescribed in the elderly with potentially significant consequences in this frail population. The objective of this study was to describe the functional manifestations associated and the preventive measures prescribed with corticosteroid therapy among patients over 75 years old. PATIENTS AND METHODS: We conducted an exposed/non-exposed, prospective, multi-centre, observational study. Each exposed patient was sex and age (± 2 years) matched to two unexposed subjects. The sample included patients aged over 75 years treated with long-term corticosteroid therapy and hospitalized in an acute geriatric unit between June 2006 and November 2009. Sociodemographic and geriatric characteristics, history of corticosteroid therapy, clinical manifestations and preventive measures prescribed were collected. RESULTS: Fifty exposed and 100 unexposed patients were included. Mean age was 85±6 years. Prevalence of falls, osteoarticular complications, amyotrophy, vertebral fractures, lipodystrophy, purpura, hematomas and cataracts, and the number of medications were higher among patients taking corticosteroid therapy than in controls. Preventive measures were more often prescribed to patients under taking corticosteroid therapy (calcium and vitamin supplementation, potassium supplementation, anti-osteoporosis medication and gastroprotective agents). CONCLUSION: Functional manifestations associated with corticosteroid therapy are frequent among the elderly and may have serious consequences in this frail population. Attention should be paid to the prescription of preventive measures through comprehensive care.

Determination of 3-chloropropane-1,2-diol as its 1,3-dioxolane derivative at the microg kg-1 level: application to a wide range of foods.

This paper reports the application of a GC/MS method for the quantification of 3-chloropropane-1,2-diol (3-MCPD) at low microg kg-1 levels through the determination of its 1,3-dioxolane derivative to a wide range of foodstuffs. The proposed protocol is based on the methods generally performed in control laboratories. The two main stages of the method - the solid-phase extraction and the purification of the derivatives - have been optimized. The within-laboratory reproducibility meets the official performance criteria for verifying 3-MCPD at the 20 microg kg(-1) limit stipulated by the European Community for soy sauce. The limit of quantification was below 5 microg kg(-1) for all the foodstuffs analysed. This method offers a valuable alternative to the draft CEN European Standard: instead of diethyl ether, much safer ethyl acetate is used; derivatization is more selective; and reagents are common stable chemicals. This method was successfully applied to toasted bread, savoury crackers, cheese, soups, including vegetable-based soups, meat products such as salami, vegetable oils, sauces, soy sauce and related products. Upon checking the method performance in the case of vegetable oils, the unexpected presence of monobromopropanediols was detected.

Health-care use by rheumatoid arthritis patients compared with non-arthritic subjects.

OBJECTIVE: To compare the use of health-care by rheumatoid arthritis (RA) patients and non-arthritic subjects (NA) and to look for factors determining their patterns of health-care use. METHODS: A multicentre cohort of 223 RA and 446 NA subjects matched for age, gender, period of data collection and residence were questioned about their use of health-care services. Patterns of health-care use were identified by principal components analysis. Factors determining the use of health-care services were assessed by multiple linear and logistic regression analysis. RESULTS: The proportions of RA subjects who declared having had at least one contact with the health-care system in the previous 12 months and in the previous 4 weeks were higher than those for NA subjects for all health and social professionals except dentists and homeopaths. Types of health-care use explored were hospital, prescribed, general ambulatory and specialized ambulatory care. Factors determining health-care use were disease status, administrative area, employment status and age. CONCLUSIONS: RA subjects use health-care services more widely than NA subjects. Variation in recourse behaviour is related to differences within administrative areas.

Genetic risk factor in primary open-angle glaucoma: a case-control study.

PURPOSE: To evaluate the link between primary open-angle glaucoma (POAG) and potential genetic and environmental risk factors. METHODS: A case/control study was carried out using 175 POAG patients and 175 controls, all Caucasians of at least 40 years of age. The diagnosis of POAG was established based on the presence of characteristic defects in the visual field and on glaucomatous cupping. The presence of risk factors was established by means of a questionnaire. RESULTS: Using a conditional logistic regression, we found that a family history of POAG in first-degree relatives was a major risk factor (OR = 7.67; 95% CI: [3.25-18.1]; p < 10(-5)). We found no link between diabetes and POAG, high blood pressure and POAG, heart disease and POAG, myopia and POAG, or the use of alcohol or tobacco and POAG. CONCLUSION: Our results indicate a strong genetic influence in the development of POAG and suggest the hypothesis of a polygenic or multifactorial mechanism.