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3.
Cancer Radiother ; 23(6-7): 496-499, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31471251

RESUMO

Stereotactic radiotherapy of oligometastases, mono- or hypofractionated, represents a fundamental change in the practice of the specialty as it was developed for a century. Despite the great heterogeneity of sites, techniques, and doses, most studies found a high local control rate, around 70 to 90% at 2 years, and reduced toxicity, around 5% of grade 3 at 2 years. Four main phase II and III trials are underway in France. Future research concerns the association of stereotactic radiotherapy with immunotherapy or different conventional chemotherapy protocols, the identification of the best clinical presentations, and optimization of fractionation and biological dose for poor prognosis localizations.


Assuntos
Ensaios Clínicos Fase II como Assunto , Ensaios Clínicos Fase III como Assunto , Neoplasias/radioterapia , Radiocirurgia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Anticorpos Monoclonais/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/secundário , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/radioterapia , Terapia Combinada/métodos , Previsões , França , Humanos , Imunoterapia , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/radioterapia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/radioterapia , Masculino , Metástase Neoplásica , Neoplasias/patologia , Neoplasias/terapia , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/radioterapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/tratamento farmacológico , Carcinoma de Células Escamosas de Cabeça e Pescoço/radioterapia
4.
Cancer Radiother ; 23(6-7): 517-519, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31471256

RESUMO

Ten years after the beginning of CREX in radiotherapy departments we wanted to know about users' feeling. We sent a survey to 168 centers in the whole country and a hundred of them answer. The time, top management's involvement and professionals' training seem to be the key success factors. Systemic analysis methods and mainly the Orion© one are not identified as an issue. The main challenge for the next years will be the effectiveness check of actions.


Assuntos
Comitês Consultivos/organização & administração , Institutos de Câncer , Pesquisas sobre Serviços de Saúde , Gestão de Riscos/estatística & dados numéricos , França , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Humanos , Comitê de Profissionais , Gestão de Riscos/métodos
5.
Water Sci Technol ; 80(2): 203-212, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31537756

RESUMO

On-site wastewater treatment systems are approved by the French regulation based on the results of platform tests following the European standard NF EN 12566-3. In addition to this approval for the treatment system, at least 90% of outlet concentrations have to be below 30 mg L-1 for total suspended solids (TSS) and 35 mg L-1 for biochemical oxygen demand. The aim of this study is to evaluate the effluent quality of these treatment systems on site, i.e. under real operating conditions, and to assess their performances. Between 2011 and 2016, 1,286 treated wastewater samples were taken from 231 on-site sanitation facilities in France. Data collected are heterogeneous and a robust statistical methodology (using a generalized log-linear model) was used to study the effects of four explanatory variables (treatment systems, loading rate, aging and sampling methods) on the distribution of treated wastewater concentrations. The model calculates median outlet concentrations depending on the effects identified. Its application allowed studying and comparing the outlet median concentrations of 21 on-site sanitation systems classified into nine categories and three groups. Four treatment systems out of the 21 monitored showed TSS median outlet concentrations below 10 mg L-1 and four treatment systems have TSS medians higher than the regulatory threshold of 30 mg L-1.


Assuntos
Eliminação de Resíduos Líquidos/estatística & dados numéricos , Poluição da Água/estatística & dados numéricos , Monitoramento Ambiental , França , Saneamento , Águas Residuárias
6.
Soins ; 64(838): 36-39, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31542118

RESUMO

Protecting personal information provided by a patient must now be automatic for all health professionals, whether they work in a health or medical-social facility or in private practice, alone or alongside other professionals. While their level of responsibility may vary depending on the chosen method of practice, the health professional is an essential link in the chain with regard to data security as well as patients' rights. Understanding what constitutes personal information or sensitive information and the different obligations resulting from its processing is essential in order to be able to comply with data security and protection regulations imposed by French and European law.


Assuntos
Confidencialidade/legislação & jurisprudência , Europa (Continente) , França , Pessoal de Saúde , Humanos , Direitos do Paciente
7.
Soins ; 64(838): 48-50, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31542122

RESUMO

Artificial intelligence and its applications in healthcare inevitably raise ethical questions. The 'human guarantee' is at the heart of the discussions. Interview with Cynthia Fleury-Perkins, member of the French national advisory ethics committee and holder of the Humanities and Health Chair of the Conservatoire national des arts et métiers.


Assuntos
Inteligência Artificial/ética , Assistência à Saúde , Comissão de Ética/organização & administração , França , Humanos
9.
Cancer Radiother ; 23(6-7): 617-624, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31477441

RESUMO

Among over 100 proton therapy centres worldwide in operation or under construction, French proton therapy is coming to full maturity with the recent opening of the Nice (1991, upgrade in 2016) and Caen (2018) facilities next to the Orsay (1991, upgrade in 2010) centre. Proton therapy is a national priority for children and young adults in all three centres. The patient-related activity of the three French centres is coordinated via the Protonshare portal to optimise referral by type of indication and available expertise in coordination with the French society of radiation oncology SFRO and French radiotherapy centres. The centres are recognised by the French Health Care excellence initiative, promoted by the ministry of Foreign Affairs. The three centres collaborate structurally in terms of clinical research and are engaged at the international level in the participation to European databases and research initiatives. Concerted actions are now also promoted in preclinical research via the Radiotransnet network. Ongoing French developments in proton therapy are well presented in international hadron therapy meetings, including European Proton Therapy Network and Particle Therapy Cooperative Oncology Group. Proton therapy teaching in France is offered at several levels and is open to colleagues from all radiation oncology centres, so that they are fully informed, involved and trained to facility recognition of possible indications and thereby to contribute to appropriate patient referral. This close collaboration between all actors in French radiation oncology facilitates the work to demonstrate the required level of medical and scientific evidence for current and emerging indications for particle therapy. Based on that, the future might entail a possible creation of more proton therapy facilities in France.


Assuntos
Institutos de Câncer , Neoplasias/radioterapia , Terapia com Prótons , Radioterapia (Especialidade) , Adolescente , Adulto , Pesquisa Biomédica/organização & administração , Institutos de Câncer/organização & administração , Institutos de Câncer/provisão & distribução , Criança , Ciclotrons/provisão & distribução , Apoio Financeiro , França , Humanos , Cooperação Internacional , Terapia com Prótons/economia , Terapia com Prótons/instrumentação , Terapia com Prótons/métodos , Radioterapia (Especialidade)/educação , Radioterapia (Especialidade)/organização & administração , Adulto Jovem
10.
J Environ Radioact ; 208-209: 106029, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31491586

RESUMO

Long term radioactivity monitoring programs contribute to the understanding of the behavior of radionuclides in the environment. This work aims to investigate the long term behavior of Cesium-137 in pasture ecosystem (root soil, grass and cow's milk) by using of more than twenty five years monitoring data collected at ten of French pasture sites contaminated by atmospheric fallouts from Chernobyl and nuclear atmospheric tests. We estimated with a simple exponential model the long term effective half-lives of radiocesium in root soil, grass vegetation and cow's milk along with their associated uncertainties. The average values of the effective half-lives over all the investigated sites were determined as 17, 11 and 9 years for soil, grass and milk respectively. Those values compare favorably to those estimated in previous studies in literature. These findings further enable us to quantify the decrease of 137Cs bioavailability which ranges from 0.008 to 0.044 year-1 with an average value of 0.026 year-1 (i.e. effective half lives ranging from 16 to 87 years with an average value of 26 years in soil).


Assuntos
Radioisótopos de Césio/análise , Monitoramento de Radiação , Cinza Radioativa/análise , Poluentes Radioativos do Solo/análise , França , Pradaria
11.
Pan Afr Med J ; 33: 90, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489068

RESUMO

Introduction: Syphilis rapid test results may be influenced by numerous environmental and genetic factors. Methods: The proportion of false positive syphilis non-treponemal (NT) and treponemal (T) test results using immuno-chromatographic dual syphilis rapid test on serum from Cameroonian blacks (n=103) versus French blacks (n=104) or French caucasians (n=51), all HIV-negative and free of clinical syphilis, was examined. Results: Black individuals in Cameroon had a significantly higher frequency of false positive NT or T tests than black individuals in France. black individuals in France had a higher frequency of indeterminate NT tests as compared to caucasians in France. Conclusion: Both racial and environmental factors may affect immuno-chromatographic dual syphilis rapid testing.


Assuntos
Antígenos de Bactérias/imunologia , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Treponema pallidum/imunologia , Grupo com Ancestrais do Continente Africano , Camarões , Grupo com Ancestrais do Continente Europeu , Reações Falso-Positivas , França , Humanos , Estudos Prospectivos , Sífilis/imunologia
12.
Bull Cancer ; 106(10): 847-859, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31521255

RESUMO

INTRODUCTION: The Cancer Observatory, from the OMEDITs (Observatory for Medicines and Medical Devices and Treatment Innovations) of Bretagne and Pays de la Loire areas has conducted a survey aiming to know and map the current practices of management of patients by Oral Anti-cancer Drug (OAD) in inter-region. METHODS: Forty eight cancer centers received by e-mail in July and October 2016 a questionnaire concerning the management of OADs : from prescription by the specialist of oncology, to the intervention of the pharmacist (analysis and pharmaceutical consulting), to follow-up by nurse, as well as the financing of this activity and the feelings of the actors about this organizational set up. RESULTS: Fifty-seven professionals from 31 centers, including the most important ones, responded to the survey. As a result, half of the establishments carry out a pharmaceutical analysis for some or all of the OAD prescriptions and only 30% carry out a pharmaceutical consulting. The nurse consultation is, on the other hand, more largely implanted (74% of the centers) as well as the telephone follow-up (6%). More than 90% of professionals believe that the organizational set up could be improved and more secure by, at least, the stronger involvement of pharmacists, the development of tools for nurse (for monitoring, therapeutic education…) and by improving the city-hospital link. CONCLUSION: This survey shows the variability in the management of patients under OAD because of the lack of resources to ensure the fairness and sustainability of the organizational set up. The hospital/city link could still be optimized to secure patient care.


Assuntos
Antineoplásicos/administração & dosagem , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Neoplasias/tratamento farmacológico , Administração Oral , Institutos de Câncer/estatística & dados numéricos , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Prescrições de Medicamentos , França , Humanos , Papel do Profissional de Enfermagem , Objetivos Organizacionais , Satisfação do Paciente , Farmacêuticos , Padrões de Prática em Enfermagem/estatística & dados numéricos , Telefone
14.
Stud Health Technol Inform ; 264: 1425-1426, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438163

RESUMO

We present the regional professional network to support the Renal Epidemiology Information Network (REIN) registry in maintaining high quality data production and information analyses in Ile-De-France region. The network is based on a long term partnership between the nephrologists and a regional methodology support unit. It integrates clinical research assistants for data quality control. We also present organizational methods on maintaining the registry and enhancing information analyses and automating analyses reports.


Assuntos
Sistema de Registros , Confiabilidade dos Dados , França , Serviços de Informação
15.
Stud Health Technol Inform ; 264: 793-797, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438033

RESUMO

Potentially inappropriate prescribing of direct oral anticoagulants is frequent with the most common errors being dosage, administration, and duration of therapy. We developed RecosDoc-MTeV, a documentary-based clinical decision support system (CDSS) for the management of direct oral anticoagulant prescription to prevent and treat venous thromboembolism. Simultaneously, the network of Parisian public hospitals (AP-HP, France) developed narrative clinical practice guidelines (CPGs) and a companion smartphone application to enhance medication and patient safety related to direct oral anticoagulant prescription. To assess the effectiveness of these CDS tools, we performed a retrospective review of 274 random patients hospitalized in 2017, which were either at risk of venous thromboembolism or actually treated for the disease. Consistency between the two CDS tools was measured at 96.7%. Administered treatments were compliant in 67.2% and 72.3% of the cases, with AP-HP CPGs and RecosDoc-MTeV, respectively. These results support that implementing CDSSs for the prescription of direct oral anticoagulants may ensure safe prescribing of high-risk medications.


Assuntos
Anticoagulantes/uso terapêutico , Tromboembolia Venosa , Administração Oral , França , Humanos , Estudos Retrospectivos , Tromboembolia Venosa/tratamento farmacológico
16.
Stud Health Technol Inform ; 264: 1882-1883, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438390

RESUMO

The multidisciplinary aspect of patient care is not yet sufficiently taken into account in hospital ward management. By gathering data from the administrative database of hospital stays and the operating theaters management software, we developed a graphical user interface to visualize and analyze the pathways of patients who underwent thoracic surgery in the Nantes University Hospital of France in 2016 and 2017.


Assuntos
Cirurgia Torácica , Bases de Dados Factuais , França , Humanos , Tempo de Internação , Software , Interface Usuário-Computador
17.
Stud Health Technol Inform ; 264: 1970-1971, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438433

RESUMO

mHealth apps use is rapidly increasing and has high potential value for people with chronic conditions, supporting behaviour change for self-management and improving patient-provider communication. To build a well-functioning app development environment, we need to examine the range of available apps according to their variability and content. A review of Google Play apps revealed limited availability for chronic self-management in France among substantial unrelated content. Most apps' content was difficult to understand and act upon.


Assuntos
Aplicativos Móveis , Autogestão , Telemedicina , Doença Crônica , França , Humanos
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