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1.
Nature ; 537(7620): 399-402, 2016 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-27629644

RESUMEN

The early evolution of planetesimals and planets can be constrained using variations in the abundance of neodymium-142 ((142)Nd), which arise from the initial distribution of (142)Nd within the protoplanetary disk and the radioactive decay of the short-lived samarium-146 isotope ((146)Sm). The apparent offset in (142)Nd abundance found previously between chondritic meteorites and Earth has been interpreted either as a possible consequence of nucleosynthetic variations within the protoplanetary disk or as a function of the differentiation of Earth very early in its history. Here we report high-precision Sm and Nd stable and radiogenic isotopic compositions of four calcium-aluminium-rich refractory inclusions (CAIs) from three CV-type carbonaceous chondrites, and of three whole-rock samples of unequilibrated enstatite chondrites. The CAIs, which are the first solids formed by condensation from the nebular gas, provide the best constraints for the isotopic evolution of the early Solar System. Using the mineral isochron method for individual CAIs, we find that CAIs without isotopic anomalies in Nd compared to the terrestrial composition share a (146)Sm/(144)Sm-(142)Nd/(144)Nd isotopic evolution with Earth. The average (142)Nd/(144)Nd composition for pristine enstatite chondrites that we calculate coincides with that of the accessible silicate layers of Earth. This relationship between CAIs, enstatite chondrites and Earth can only be a result of Earth having inherited the same initial abundance of (142)Nd and chondritic proportions of Sm and Nd. Consequently, (142)Nd isotopic heterogeneities found in other CAIs and among chondrite groups may arise from extrasolar grains that were present in the disk and incorporated in different proportions into these planetary objects. Our finding supports a chondritic Sm/Nd ratio for the bulk silicate Earth and, as a consequence, chondritic abundances for other refractory elements. It also removes the need for a hidden reservoir or for collisional erosion scenarios to explain the (142)Nd/(144)Nd composition of Earth.

2.
BMC Cancer ; 21(1): 726, 2021 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-34167516

RESUMEN

OBJECTIVE: To analyze trends in cancer incidence and mortality (France, 1990-2018), with a focus on men-women disparities. METHODS: Incidence data stemmed from cancer registries (FRANCIM) and mortality data from national statistics (CépiDc). Incidence and mortality rates were modelled using bidimensional penalized splines of age and year (at diagnosis and at death, respectively). Trends in age-standardized rates were summarized by the average annual percent changes (AAPC) for all-cancers combined, 19 solid tumors, and 8 subsites. Sex gaps were indicated using male-to-female rate ratios (relative difference) and male-to-female rate differences (absolute difference) in 1990 and 2018, for incidence and mortality, respectively. RESULTS: For all-cancers, the sex gap narrowed over 1990-2018 in incidence (1.6 to 1.2) and mortality (2.3 to 1.7). The largest decreases of the male-to-female incidence rate ratio were for cancers of the lung (9.5 to 2.2), lip - oral cavity - pharynx (10.9 to 3.1), esophagus (12.6 to 4.5) and larynx (17.1 to 7.1). Mixed trends emerged in lung and oesophageal cancers, probably explained by differing risk factors for the two main histological subtypes. Sex incidence gaps narrowed due to increasing trends in men and women for skin melanoma (0.7 to 1, due to initially higher rates in women), cancers of the liver (7.4 to 4.4) and pancreas (2.0 to 1.4). Sex incidence gaps narrowed for colon-rectum (1.7 to 1.4), urinary bladder (6.9 to 6.1) and stomach (2.7 to 2.4) driven by decreasing trends among men. Other cancers showed similar increasing incidence trends in both sexes leading to stable sex gaps: thyroid gland (0.3 to 0.3), kidney (2.2 to 2.4) and central nervous system (1.4 to 1.5). CONCLUSION: In France in 2018, while men still had higher risks of developing or dying from most cancers, the sex gap was narrowing. Efforts should focus on avoiding risk factors (e.g., smoking) and developing etiological studies to understand currently unexplained increasing trends.


Asunto(s)
Neoplasias/epidemiología , Femenino , Identidad de Género , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Incidencia , Masculino , Neoplasias/mortalidad
3.
Prog Urol ; 30(5): 288-295, 2020 Apr.
Artículo en Francés | MEDLINE | ID: mdl-32234422

RESUMEN

INTRODUCTION: Partial nephrectomy (NP) after embolization of tumor vessels (NPESH) in a hybrid room combines embolization of tumor vessels and enucleation of the tumor under laparoscopy in the same operative time. The purpose of this study was to assess the impact of the use of NPESH in the management of patients treated with surgery for a localized kidney tumor. MATERIAL AND METHODS: Using the uroCCR database, we included all consecutive patients operated in a university hospital for localized kidney tumor. From 2011 to May 2015, patients were treated by Standard Partial Nephrectomy (NPS) Laparoscopic or Open and from May 2015 to May 2019 by NPESH. We evaluated characteristics of patients, tumors, perioperative data and complications. These data were compared by Student and Khi2 tests. RESULTS: 87 NPS were performed during Period 1 and 137 NPS were performed during period 2. The ASA score of patients undergoing NPESH was higher than NPS (P<0.0001). The tumor complexity and median tumor size were similar in the two groups (P=0.852 and P=0.48). The complication rate for NPS and NPESH was 55.2% and 33.6% (P=0.002). There were less severe complications in the NEPSH group (P=0.012). The median length of stay was 8 and 4 days for the NPS and NPESH groups (P<0.0001). Positive surgical margins were 2 (2.3%) and 6 (4.6%) for the NPS and NPESH group (P=0.713). DISCUSSION: NPESH is an efficient technique compared to NPS. It seems to be an interesting alternative to limit renal ischemia, complication rate and length of stay for the management of localized kidney tumors.


Asunto(s)
Embolización Terapéutica , Neoplasias Renales/terapia , Laparoscopía , Nefrectomía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Terapia Combinada , Femenino , Humanos , Neoplasias Renales/irrigación sanguínea , Masculino , Persona de Mediana Edad , Quirófanos/organización & administración , Complicaciones Posoperatorias/epidemiología , Resultado del Tratamiento
4.
HIV Med ; 20(3): 222-229, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30693646

RESUMEN

OBJECTIVES: We examined trends in the incidence rates of invasive cervical cancer (ICC) and in the rate of survival after ICC among women living with HIV (WLHIV) in France and compared them to those of the general population. METHODS: Histologically validated incident cases of ICC in the period 1992-2009 from the French Hospital Database on HIV (FHDH-ANRS CO4) were included in the study. Age-standardized incidence rates were estimated for FHDH and the general population in France for 1992-1996 [pre-combination antiretroviral therapy (cART) period], 1997-2000 (early cART period), 2001-2004 (intermediate cART period), and 2005-2009 (late cART period). Age-standardized incidence ratios (SIRs) were calculated. Five-year survival was compared with that of the general population for ICC diagnosed in 2005-2009 after standardization for age. RESULTS: Among 28 977 WLHIV, 60 incident ICCs were histologically validated. There was a nonsignificant decreasing trend for the incidence across the cART periods (P = 0.07), from 60 to 36/100 000 person-years. The risk of ICC was consistently significantly higher in WLHIV than in the general population; the SIR was 5.4 [95% confidence interval (CI) 3.0-8.9] during the pre-cART period and 3.3 (95% CI 2.2-4.7) in 2005-2009. Survival after ICC did not improve across periods (log-rank P = 0.14), with overall estimated 5-year survival of 78% (95% CI 0.67-0.89%). Five-year survival was similar for WLHIV and the general population for women diagnosed with ICC in 2005-2009, after standardization (P = 0.45). CONCLUSIONS: ICC risk is still more than three times higher in WLHIV than in the general population. Survival after ICC did not improve over time and was similar to that of the general population during the most recent period. Such results call for promotion of the uptake of screening in WLHIV.


Asunto(s)
Antirretrovirales/administración & dosificación , Infecciones por VIH/tratamiento farmacológico , Neoplasias del Cuello Uterino/epidemiología , Adulto , Antirretrovirales/uso terapéutico , Estudios de Cohortes , Femenino , Francia/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/mortalidad , Humanos , Incidencia , Persona de Mediana Edad , Medición de Riesgo , Análisis de Supervivencia , Neoplasias del Cuello Uterino/etiología , Neoplasias del Cuello Uterino/mortalidad
5.
Prog Urol ; 27(14): 841-844, 2017 Nov.
Artículo en Francés | MEDLINE | ID: mdl-28867583

RESUMEN

Hybrid operating rooms (HOR) are rooms that mix interventional radiology and surgical equipments. They are usually used in heart, vascular, orthopedic and neurosurgery, and make it possible to consider new minimally invasive procedures in urology. Thanks to these, we developed a new partial nephrectomy technique without renal pedicle clamping and without ischemia. Renal cancer is now diagnosed at localized stage in most of the cases, and its treatment is mostly based on nephron sparing surgery. However, the hemorrhagic character of this intervention requires a renal pedicle clamping whose long-term consequences on renal function are discussed. It also exposes to a classical complication: the renal artery pseudoaneurysm. Therefore, we developed a new laparoscopic partial nephrectomy technique without clamping or approach of renal pedicle, by a selective embolization of tumor vessels through an endovascular route, immediately before the surgery. HOR allowed the combination of the two procedures in the same time and space unit. Tumor staining by Bleu Patenté also aids the surgeon in its spotting. HOR allow a new approach in localized renal cancer management, and should be used in many other urologic surgeries in years to come. They represent a technological advancement by combining interventional radiologists and surgeons' expertise.


Asunto(s)
Laparoscopía , Nefrectomía/métodos , Quirófanos , Embolización Terapéutica , Humanos , Neoplasias Renales/cirugía , Radiología Intervencionista
6.
Dis Colon Rectum ; 58(8): 743-52, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26163953

RESUMEN

BACKGROUND: Modern chemotherapy aims to improve long-term survival for selected patients with peritoneal carcinomatosis. Publications suggest promising results, but the spread of these new aggressive treatment strategies in the general population is not well known. OBJECTIVE: The aim of this study was to draw a picture of epidemiology, management, and survival in synchronous and metachronous peritoneal carcinomatosis from colorectal cancer. DESIGN: The cumulative risk of metachronous peritoneal carcinomatosis was estimated in patients resected for cure. Net survival rates were calculated for synchronous and metachronous peritoneal carcinomatosis. SETTINGS: The study was conducted with the use of the Burgundy Digestive Cancer Registry. PATIENTS: Overall, 9174 primary colorectal cancers registered between 1976 and 2011 by the population-based digestive cancer registry were considered. RESULTS: In total, 7% of patients were diagnosed with synchronous peritoneal carcinomatosis. The 5-year cumulative risk of metachronous peritoneal carcinomatosis was 6%, and the stage of the colorectal cancer at diagnosis was the major risk factor. Other independent risk factors were mucinous adenocarcinoma, ulceroinfiltrating tumors, and diagnosis after obstruction or perforation. The proportion of patients resected for cure was 11% and 9% for synchronous and metachronous peritoneal carcinomatosis, and 3-year overall net survival was 8% and 5%. The corresponding rates after resection for cure were 21% and 17%. There was a dramatic increase in the proportion of patients receiving systemic chemotherapy: from 11% before 1997 to 48% in 2011 for synchronous peritoneal carcinomatosis and from 3% to 38% for metachronous peritoneal carcinomatosis. LIMITATIONS: This is a retrospective observational population-based study. CONCLUSION: Peritoneal carcinomatosis complicating colorectal cancer is a major reason for treatment failure. This study identified patients at a high risk of developing peritoneal carcinomatosis who may benefit from specific surveillance. New therapeutic modalities are also needed to improve the prognosis.


Asunto(s)
Adenocarcinoma Mucinoso/epidemiología , Antineoplásicos/uso terapéutico , Neoplasias Colorrectales/epidemiología , Neoplasias Peritoneales/epidemiología , Peritoneo/cirugía , Sistema de Registros , Adenocarcinoma/epidemiología , Adenocarcinoma/secundario , Adenocarcinoma/terapia , Adenocarcinoma Mucinoso/secundario , Adenocarcinoma Mucinoso/terapia , Anciano , Carcinoma/epidemiología , Carcinoma/secundario , Carcinoma/terapia , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/terapia , Procedimientos Quirúrgicos de Citorreducción , Femenino , Francia/epidemiología , Humanos , Masculino , Neoplasias Peritoneales/secundario , Neoplasias Peritoneales/terapia , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia
7.
Nature ; 462(7271): 331-4, 2009 Nov 19.
Artículo en Inglés | MEDLINE | ID: mdl-19865083

RESUMEN

A cornerstone of Einstein's special relativity is Lorentz invariance-the postulate that all observers measure exactly the same speed of light in vacuum, independent of photon-energy. While special relativity assumes that there is no fundamental length-scale associated with such invariance, there is a fundamental scale (the Planck scale, l(Planck) approximately 1.62 x 10(-33) cm or E(Planck) = M(Planck)c(2) approximately 1.22 x 10(19) GeV), at which quantum effects are expected to strongly affect the nature of space-time. There is great interest in the (not yet validated) idea that Lorentz invariance might break near the Planck scale. A key test of such violation of Lorentz invariance is a possible variation of photon speed with energy. Even a tiny variation in photon speed, when accumulated over cosmological light-travel times, may be revealed by observing sharp features in gamma-ray burst (GRB) light-curves. Here we report the detection of emission up to approximately 31 GeV from the distant and short GRB 090510. We find no evidence for the violation of Lorentz invariance, and place a lower limit of 1.2E(Planck) on the scale of a linear energy dependence (or an inverse wavelength dependence), subject to reasonable assumptions about the emission (equivalently we have an upper limit of l(Planck)/1.2 on the length scale of the effect). Our results disfavour quantum-gravity theories in which the quantum nature of space-time on a very small scale linearly alters the speed of light.

8.
Phys Rev Lett ; 112(15): 151103, 2014 Apr 18.
Artículo en Inglés | MEDLINE | ID: mdl-24785023

RESUMEN

Recent accurate measurements of cosmic-ray (CR) species by ATIC-2, CREAM, and PAMELA reveal an unexpected hardening in the proton and He spectra above a few hundred GeV, a gradual softening of the spectra just below a few hundred GeV, and a harder spectrum of He compared to that of protons. These newly discovered features may offer a clue to the origin of high-energy CRs. We use the Fermi Large Area Telescope observations of the γ-ray emission from Earth's limb for an indirect measurement of the local spectrum of CR protons in the energy range ∼90 GeV-6 TeV (derived from a photon energy range 15 GeV-1 TeV). Our analysis shows that single power law and broken power law spectra fit the data equally well and yield a proton spectrum with index 2.68±0.04 and 2.61±0.08 above ∼200 GeV, respectively.

9.
Br J Cancer ; 108(4): 775-83, 2013 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-23392081

RESUMEN

BACKGROUND: Few international population-based studies have provided information on potential determinants of international disparities in cancer survival. This population-based study was undertaken to identify the principal differences in disease characteristics and management that accounted for previously observed poorer survival in English compared with French patients with colorectal cancer. METHODS: The study population comprised all cases of colorectal cancer diagnosed between 1997 and 2004 in the areas covered by three population-based cancer registries in France and one in England (N=40 613). To investigate the influence of clinical and treatment variables on survival, we applied multivariable excess hazard modelling based on generalised linear models with Poisson error. RESULTS: Poorer survival for English patients was primarily due to a larger proportion dying within the first year after diagnosis. After controlling for inter-country differences in the use of chemotherapy and surgical resection with curative intent, country of residence was no-longer associated with 1-year survival for advanced colon cancer patients (excess hazard ratio (EHR)=0.99 (0.92-1.01), P=0.095)). Longer term (2-5 years) excess hazards of death for colon and rectal cancer patients did not differ between France and England. CONCLUSION: This study suggests that difference in management close to diagnosis of colon and rectum cancer is related to differences in survival observed between France and England. All efforts (collection and standardisation of additional variables such as co-morbidity) to investigate the reasons for these disparities in management between these two countries, and more generally across Europe, should be encouraged.


Asunto(s)
Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/terapia , Anciano , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/patología , Inglaterra/epidemiología , Femenino , Francia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Análisis de Supervivencia , Factores de Tiempo
10.
Dis Colon Rectum ; 56(10): 1118-24, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24022528

RESUMEN

BACKGROUND: Net survival, the survival that might occur if cancer was the only cause of death, is a major epidemiological indicator. Recent findings have shown that the classical methods used for the estimation of net survival from cancer registry data, referred as to "relative-survival methods," provided biased estimates. OBJECTIVES: The aim of this study was to provide, for the first time, long-term net survival rates for colorectal cancer by using a population-based digestive cancer registry. DESIGN: This study is a population-based cancer registry analysis. The recently proposed unbiased nonparametric Pohar-Perme estimator was used. PATIENTS: Overall, 14,715 colorectal cancers diagnosed between 1976 and 2005 and registered in the population-based digestive cancer registry of Burgundy (France) were included. MAIN OUTCOME MEASURES: The primary outcome measured was cancer net survival, ie, the survival that might occur if all risks of dying of other causes than cancer were removed RESULTS: : Ten-year net survival increased from 31% during the 1976 to 1985 period to 47% during the 1986 to 1995 period and then leveled out (48% during the 1996-2005 period). There was a major improvement in 10-year net survival after resection for cure and for stage I to III. It was striking for stage III cancers, for which 10-year net survival increased from 21% (1976-1985) to 49% (1996-2005). The corresponding net survivals were 70% and 87% for stage I and 49% and 65% for stage II. These trends can be related to the decrease in operative mortality, the increase in the proportion of patients resected for cure, and the improvement in stage at diagnosis. They were mainly seen between 1976 and 1995, explaining why survival leveled out after 1995. LIMITATIONS: The study was limited by its retrospective and population-based nature. CONCLUSIONS: Further improvements for colorectal cancer management can be expected from more effective treatments and from the implementation of organized cancer screening.


Asunto(s)
Neoplasias Colorrectales/mortalidad , Factores de Edad , Anciano , Anciano de 80 o más Años , Sesgo , Neoplasias Colorrectales/patología , Femenino , Francia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Sistema de Registros , Estudios Retrospectivos , Estadísticas no Paramétricas , Análisis de Supervivencia , Tasa de Supervivencia , Factores de Tiempo
11.
Colorectal Dis ; 15(9): 1100-6, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23634749

RESUMEN

AIM: Little is known about patterns of recurrence in obstructing colon cancer (OCC) at a population level. The aim of this study was to determine the risk of recurrence following potentially curative surgery in OCC compared with that in uncomplicated colon cancer (CC). METHOD: Data were obtained from the population-based digestive cancer registry of Burgundy (France). Local and distant failure rates were calculated using actuarial methods. A multivariate analysis was performed using a Cox model. RESULTS: Obstructing colon cancer represented 8.5% of all colon cancers resected with curative intent (n = 3375). The 5-year cumulative local recurrence rate was 14.2% for OCC and 7.6% for nonobstructing CC (P = 0.003). In the multivariate analysis, obstruction was an independent risk factor for local recurrence [hazard ratio 1.53 (1.01-2.34), P = 0.047]. The risk of local recurrence increased with advanced stage and age at diagnosis. The 5-year cumulative rate for distant metastases was also higher in OCC than in nonobstructing CC (36.1 vs 23.1%; P < 0.001). The relative risk of distant metastasis was borderline significant in the multivariate analysis [hazard ratio 1.25 (0.99-1.59), P = 0.057]. Stage at diagnosis, macroscopic type of growth, period of diagnosis and sex were also significant prognostic factors. Age and subsite were not significant in the multivariate analysis. CONCLUSION: It is possible to conduct special surveys in population-based registries to determine the recurrence rate of CC. Recurrence remains a substantial problem and is more frequent in OCC than in nonobstructing CC. Efforts must be made to diagnose CC earlier. Mass screening is a promising approach.


Asunto(s)
Carcinoma/cirugía , Neoplasias del Colon/cirugía , Obstrucción Intestinal/etiología , Recurrencia Local de Neoplasia , Sistema de Registros , Factores de Edad , Anciano , Carcinoma/complicaciones , Carcinoma/patología , Enfermedades del Colon/etiología , Neoplasias del Colon/complicaciones , Neoplasias del Colon/patología , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Pronóstico , Modelos de Riesgos Proporcionales , Factores de Riesgo
12.
Phys Rev Lett ; 108(1): 011103, 2012 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-22304252

RESUMEN

We measured separate cosmic-ray electron and positron spectra with the Fermi Large Area Telescope. Because the instrument does not have an onboard magnet, we distinguish the two species by exploiting Earth's shadow, which is offset in opposite directions for opposite charges due to Earth's magnetic field. We estimate and subtract the cosmic-ray proton background using two different methods that produce consistent results. We report the electron-only spectrum, the positron-only spectrum, and the positron fraction between 20 and 200 GeV. We confirm that the fraction rises with energy in the 20-100 GeV range. The three new spectral points between 100 and 200 GeV are consistent with a fraction that is continuing to rise with energy.

13.
Clin Radiol ; 67(11): 1089-94, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22622352

RESUMEN

AIM: To evaluate the feasibility and efficacy of routine uterine artery embolization (UAE) immediately after planned caesareans performed in the cath lab for conservative treatment of placenta accreta. MATERIALS AND METHODS: A retrospective study included all patients who had a planned caesarean in the cath lab for conservative treatment of placenta accreta at Angers University Hospital, which is a tertiary care centre, from April 2001 to September 2010. Twelve patients underwent UAE immediately after caesarean with the placenta left partially or totally in situ. The success rate of embolization, blood loss, and complications were reported. RESULTS: Diagnosis of abnormal placentation was confirmed by caesarean findings in 14 cases. Four patients had a percreta form with bladder invasion. In seven cases blood loss was insignificant and UAE was prophylactic; no secondary haemorrhage was observed in this group. Postpartum haemorrhage occurred in five cases: control of immediate postpartum bleeding by embolization was successful in three and failed in two leading to hysterectomy. In one case uterine necrosis occurred 6 weeks after embolization, requiring a hysterectomy. Delayed complications resulted in hysterectomy and partial bladder resection 3 months after delivery for one of the patients with placenta percreta. CONCLUSION: UAE immediately after a caesarean performed in the cath lab is a feasible therapeutic option for conservative treatment of placenta accreta. Advantages include reducing stress and risks associated with transferring women with potentially unstable haemodynamics.


Asunto(s)
Cesárea/métodos , Placenta Accreta/cirugía , Radiología Intervencionista/métodos , Embolización de la Arteria Uterina/métodos , Adulto , Femenino , Humanos , Placenta Accreta/diagnóstico por imagen , Hemorragia Posparto/prevención & control , Embarazo , Estudios Retrospectivos , Resultado del Tratamiento , Ultrasonografía
14.
Actas Urol Esp (Engl Ed) ; 46(9): 577-583, 2022 11.
Artículo en Inglés, Español | MEDLINE | ID: mdl-35337767

RESUMEN

OBJECTIVE: Off-clamp laparoscopic partial nephrectomy in a hybrid operating room after superselective arterial embolization (hLPN) is a promising minimally invasive approach. In this study, we compared the perioperative surgical outcomes of this innovative technique with the conventional standard of care laparoscopic partial nephrectomy (cLPN) technique. PATIENTS AND METHODS: Overall, 86 and 127 patients treated with hLPN and cLPN, respectively, were included. These two techniques were compared in terms of surgical complications, estimated blood loss (EBL), operative time, length of stay (LOS), surgical margins, and Trifecta achievement rate (defined as warm ischemia duration <25 min, negative surgical margins and absence of complications). A propensity score based on age, gender, BMI, preoperative eGFR and tumor size was used for a 1:1 matching of patients of each group. After matching, 2 groups of 67 patients with similar characteristics were obtained. RESULTS: Conversion rate to open surgery, complications and EBL were similar in both groups. Conversely, operative time, LOS and Trifecta rates favored hLPN. The multivariate analysis showed that hLPN had a 70% higher chance of Trifecta achievement than cLPN in all age groups and for all tumor size across the study population. CONCLUSION: Compared to a conventional approach, off-clamp laparoscopic partial nephrectomy in a hybrid room after superselective arterial embolization showed satisfying immediate surgical outcomes and reached a higher rate of Trifecta achievement. Mid and long-term functional and oncological results are needed to establish this minimally invasive surgical alternative.


Asunto(s)
Neoplasias Renales , Laparoscopía , Humanos , Puntaje de Propensión , Neoplasias Renales/patología , Análisis por Apareamiento , Estudios Retrospectivos , Nefrectomía/métodos , Laparoscopía/métodos , Márgenes de Escisión
16.
Int J Cancer ; 126(12): 2928-34, 2010 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-19569047

RESUMEN

The aim of this study was to report on malignant digestive endocrine tumours (MDET) prognosis in several European countries. We analysed survival data from 19 cancer registries in 12 European countries on 3,715 MDET diagnosed between 1985 and 1994. The overall 5-year survival rate was 47.5%. It was 58.1% for differentiated MDET and 8.1% for small-cell MDET (p < 0.001), 55.9% for patients under 65 and 37.0% for older patients. Survival rates for small intestinal and colorectal were higher than for the other sites. The 5-year relative survival rates were 60.3% in Northern Europe, 53.6% in Western Continental Europe, 42.5% in the UK, 37.6% in Eastern Europe (p < 0.001). Among well-differentiated pancreatic tumours, 5-year relative survival was 55.6% for insulinoma, 48.4% for gastrinoma, 33.4% for glucagonoma, 28.8% for carcinoid tumours and 49.9% for non-functioning tumours. The relative excess risk of death was significantly lower in Western Continental Europe and Northern Europe and significantly higher in Easter European compared to the UK. MDET differentiation, site, geographic area, age and sex, were independent prognostic factors. Overall, in Europe approximately half of the patients with MDET survive 5 years after the initial diagnosis. Prognosis varies with tumour differentiation, anatomic site and histological type. There are significant differences in survival from MDET among European countries, independently of other prognostic factors.


Asunto(s)
Neoplasias del Sistema Digestivo/mortalidad , Neoplasias de las Glándulas Endocrinas/mortalidad , Anciano , Neoplasias del Sistema Digestivo/patología , Neoplasias de las Glándulas Endocrinas/patología , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Sistema de Registros , Tasa de Supervivencia
17.
Phys Rev Lett ; 104(9): 091302, 2010 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-20366979

RESUMEN

Dark matter (DM) particle annihilation or decay can produce monochromatic gamma rays readily distinguishable from astrophysical sources. gamma-ray line limits from 30 to 200 GeV obtained from 11 months of Fermi Large Area Space Telescope data from 20-300 GeV are presented using a selection based on requirements for a gamma-ray line analysis, and integrated over most of the sky. We obtain gamma-ray line flux upper limits in the range 0.6-4.5x10{-9} cm{-2} s{-1}, and give corresponding DM annihilation cross-section and decay lifetime limits. Theoretical implications are briefly discussed.

18.
Gastroenterol Clin Biol ; 34(2): 144-9, 2010 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-20079591

RESUMEN

BACKGROUND: Although clinical trials have demonstrated that adjuvant chemotherapy improves survival for stage-III colon cancer, the benefits remain controversial for stage-II lesions. The objective of the present study was to determine the extent to which adjuvant chemotherapy is used for patients with stage-II and -III colon cancers. METHODS: The study population comprised 1074 patients with stage-II and -III colon cancers diagnosed in 2000 in 12 French administrative districts and recorded in population-based cancer registries. Data were collected using a standardized procedure. RESULTS: Overall, 20.4% of patients with stage II and 61.9% with stage III received adjuvant chemotherapy. Age at diagnosis was the strongest determinant of chemotherapy. Among stage-II patients, those receiving chemotherapy decreased from 57.6% in patients aged or=85. The corresponding percentages with stage III were 93.6% and 1.4%. In multivariate analyses, other factors found to be independently and significantly associated with administration of adjuvant chemotherapy for stage II were extension of the cancer (stage IIA vs. stage IIB), clinical presentation (obstruction or perforation vs. uncomplicated cancer) and discussion of the case at a multidisciplinary case-review meeting. For stage III, apart from age, discussion of the case at a multidisciplinary meeting was the only factor independently associated with administration of chemotherapy. CONCLUSION: Adjuvant chemotherapy for stage-III colon cancer is used extensively for patients under 75 years of age. However, many elderly patients do not receive such treatment. On the other hand, a substantial percentage of stage-II colon cancer patients receive adjuvant chemotherapy despite its uncertain benefits.


Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/patología , Neoplasias del Colon/tratamiento farmacológico , Neoplasias del Colon/patología , Adenocarcinoma/epidemiología , Factores de Edad , Anciano , Anciano de 80 o más Años , Quimioterapia Adyuvante , Neoplasias del Colon/epidemiología , Femenino , Francia/epidemiología , Humanos , Obstrucción Intestinal/epidemiología , Obstrucción Intestinal/etiología , Perforación Intestinal/epidemiología , Perforación Intestinal/etiología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Grupo de Atención al Paciente , Sistema de Registros , Muestreo
20.
Rev Mal Respir ; 37(10): 769-775, 2020 Dec.
Artículo en Francés | MEDLINE | ID: mdl-33158640

RESUMEN

INTRODUCTION: The number of lung transplantations performed is increasing worldwide. With an improved experience and outcomes, the age of the recipient on its own has ceased to be an absolute contra-indication. We report our first experience with lung transplantation in patients aged 65 years or older. METHODS: From January 2014 to March 2019, the files of patients aged 65 years or older undergoing lung transplantation were retrospectively reviewed. RESULTS: During the study period, 241 patients underwent lung transplantation in Bichat hospital (Paris, France), including 25 recipients aged 65 years or older. Underlying diagnoses were interstitial (72%) and obstructive (28%) disease. The rate of single lung transplantation was 80%. Sixteen patients required ECMO assistance during the procedure. Early complications were mostly grade III primary graft dysfunction (12%) and cellular rejection (20%). Overall one-year survival rate was 76%. CONCLUSION: After a careful selection of the recipients, the early results of our retrospective single center series are encouraging. We continue to consider lung transplantation in rigorously selected recipients of aged 65 years and more.


Asunto(s)
Enfermedades Pulmonares Intersticiales/epidemiología , Enfermedades Pulmonares Intersticiales/terapia , Enfermedades Pulmonares Obstructivas/epidemiología , Enfermedades Pulmonares Obstructivas/terapia , Trasplante de Pulmón , Factores de Edad , Edad de Inicio , Anciano , Anciano de 80 o más Años , Femenino , Francia/epidemiología , Supervivencia de Injerto , Humanos , Enfermedades Pulmonares Intersticiales/mortalidad , Enfermedades Pulmonares Obstructivas/mortalidad , Trasplante de Pulmón/efectos adversos , Trasplante de Pulmón/métodos , Trasplante de Pulmón/mortalidad , Trasplante de Pulmón/estadística & datos numéricos , Masculino , Paris/epidemiología , Periodo Posoperatorio , Disfunción Primaria del Injerto/epidemiología , Estudios Retrospectivos , Tasa de Supervivencia , Factores de Tiempo , Resultado del Tratamiento
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