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Pancreatic head cancer in patients with chronicpancreatitis

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Hepatobiliary & Pancreatic Diseases International 2014年第2期13卷 192-197页

作者： Aude Merdrignac laurent Sulpice Michel Rayar Tanguy Rohou Emmanuel Quéhen Ayman Zamreek karim boudjema bernard Meunier Service de Chirurgie Hépatobiliaire et Digestive H pital PontchaillouCentre Hospitalier Universitaire INSERM UMR991 FoieMétabolismes et Cancer Service d'Imagerie Médicale H pital Pontchaillou

bACKGROUND: Chronic pancreatitis (CP) is a risk factor of pancreatic adenocarcinoma (PA). The discovery of a pancreatic head lesion in CP frequently leads to a pancreaticoduo denectomy (PD) which preceded by a multidisciplinary meeting(MM). The aim of this study was to evaluate the relevance between this indication of PD and the definitive pathological ***: between 2000 and 2010, all patients with CP who underwent PD for suspicion of PA without any histological proof were retrospectively analyzed. The operative decision has always been made at an MM. The definitive pathological finding was retrospectively confronted with the decision made at an MM, and patients were classified in two groups according to this concordance (group 1) or not (group 2). Clinical and biological parameters were analyzed, preoperative imaging were reread and confronted to pathological findings in order to identify predictive factors of malignant ***: During the study period, five of 18 (group 1) patients with CP had PD were histologically confirmed to have PA, and the other 13 (group 2) did not have PA. The median age was52.5 ±8.2 years (gender ratio 3.5). The main symptoms were pain (94.4%) and weight loss (72.2%). There was no patient’s death. Six (33.3%) patients had a major complication (ClavienDindo classification ≥3). There was no statistical difference in clinical and biological parameters between the two groups. The rereading of imaging data could not detect efficiently all patients with ***: Our results confirmed the difficulty in detecting malignant transformation in patients with CP before surgery and therefore an elevated rate of unnecessary PD was found. A uniform imaging protocol is necessary to avoid PD as a less invasive treatment could be proposed.

关键词： chronic pancreatitis adenocarcinoma pancreaticoduodenectomy

Distribution of atrial cardiomyopathy markers and association with atrial fibrillation detected after ischaemic stroke in the SAFAS study

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Stroke & Vascular Neurology 2024年第2期9卷 165-173,I0426,I0427页

作者： Romain Didier Lucie Garnier Gauthier Duloquin Alexandre Meloux Audrey Sagnard Mathilde Graber Geoffrey Dogon karim benali Thibaut Pommier Gabriel laurent Catherine Vergely Yannick bejot Charles Guenancia Cardiology CHU Dijon BourgogneDijonFrance Dijon Stroke Registry Department of NeurologyUniversity Hospital Centre DijonDijonFrance PEC 2 Universitéde BourgogneDijonFrance Cardiology CHU Saint EtienneSaint EtienneFrance

background Atrial cardiomyopathy(AC)is an emerging concept explaining the pathophysiology of cardioembolic strokes in absence of atrial fibrillation(AF).A definition based on the presence of electrical abnormality(P-wave terminal force in lead V1(PTFV1)>5000µV×ms),N-Terminal pro-b-type natriuretic peptide(NT pro bNP)>250pg/mL and/or indexed left atrial diameter(LADI)>3cm/m^(2)is currently tested in the ARCADIA(AtRial Cardiopathy and Antithrombotic Drugs In prevention After cryptogenic stroke)*** set out to estimate the prevalence of AC as defined in the ARCADIA trial,its determinants and its association with AF detected after stroke(AFDAS).Methods Stepwise screening for silent Atrial Fibrillation After Stroke(SAFAS)study prospectively included 240 ischaemic stroke *** markers were complete for 192 of them and 9 were not included in this analysis because AF had been diagnosed on *** A total of 183 patients were analysed,of whom 57%(104 patients)met the AC criteria(79 NT-probNP,47 PTFV1,4 LADI).In the multivariate logistic regression,C reactive protein>3mg/L(OR(95%CI)2.60(1.30 to 5.21),p=0.007)and age(OR(95%CI)1.07(1.04 to 1.10),pbe independently associated with *** 6 months of follow-up,AFDAS was detected in 33%of AC patients and in 14%of the remaining ones(p=0.003).However,AC was not independently associated with AFDAS,contrary to left atrial volume index(>34mL/m^(2),OR 2.35(CI 1.09 to 5.06)p=0029).Conclusion AC as defined in ARCADIA is mostly based on NT pro bNP elevation(76%of patients)and is associated with age and ***,AC was not independently associated with AFDAS at *** ARCADIA trial,which compares aspirin to apixaban in patients with embolic strokes of undetermined source with AC markers and must,therefore be analysed in the light of these limitations.

关键词： atrial cardiomyopathy prevention

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Health 2014年第11期6卷 1277-1285页

作者： Asma Kacem Foued Ftaiti karim Chamari Mohamed Dogui laurent Grélot Zouhair Tabka Department of Physiology and Functional Explorations IBN EL JAZZAR Medicine Faculty Sousse Tunisia Department of Physio-Neurology University Hospital of Sahloul Sousse Tunisia Institute of Movement Sciences Faculty of Sport Sciences University of Mediterranean Marseille France Research Unit “Evaluation Sport Health” National Centre of Medicine and Science in Sport Tunis Tunisia

Purpose: This study examined the possible causal mechanisms of fatigue during intense exercise in the heat in a group of nine sedentary women. Methods: Two strenuous cycling sessions were performed, at 100% of maximal aerobic power, either in neutral (N-Ex, air temperature: 22°C ± 0.4°C, air humidity: 53% ± 8%) or in heat conditions (H-Ex, air temperature: 35°C ± 0.3°C, air humidity: 59 ± 6). Tympanic temperature (Tty), heart rate (HR), body mass loss (bML), lactate concentration [La] and brain electrical activity (EEG: α and β waves and α/β ratio) were recorded. Results: Tty, HR and [La] increases (p ﹣1) than that during N-Ex (0.08 ± 0.02°C·min﹣1), and time to exhaustion (Time Limit at 100%) was significantly (p β waves decreased (p α/β ratio increased (p before exhaustion. Conclusion: During exercise in the heat, the high rate of core temperature rising might be a critical factor triggering faster brain changes.

关键词： Fatigue Women brain Intense Exercise Hyperthermia

Long Term Survival after Resection of a Small bowel Metastasis of Lung Adenocarcinoma: A Case Report

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Journal of Cancer Therapy 2011年第5期2卷 686-689页

作者： laurent Sulpice Emanuele D’Errico Alexis Arnaud Michel Rayar karim boudjema bernard Meunier 不详

background: Small bowel metastases of lung adenocarcinoma represent a rare clinical entity, often diagnosed after complications due to obstruction, bleeding or bowel perforation. Case Report: We report a case of ileal metastasis discovered during an intestinal perforation. The patient was a 47-year-old man hospitalized in emergency for acute abdominal pain, with right lower quadrant abdominal defense and a clinical history of left lower pulmonary lobectomy for lung adenocarcinoma 6 months before. Exploratory laparotomy for peritonitis revealed a single ileal tumor which was resected with lymph nodes excision. Pathology finding revealed that it was compatible with an ileal metastasis of his lung adenocarcinoma. Conclusions: The suspicion of a small bowel metastasis of lung carcinoma, although rare, must be taken in consideration and to carry out an extensive surgery, because only this will have an improvement on the survival of these patients. The purpose of this investigation is to add a new case report to the few that exist in order to provide a therapeutic approach to these exceptional cases.

关键词： Ileal Metastasis Lung Cancer Metastasis Acute Abdominal Pain Lymph Nodes Excision

低剂量白细胞介素-2在11种自身免疫疾病中的免疫学和临床疗效:单中心开放临床试验

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英国医学杂志中文版 2019年第2期22卷 123-123页

作者： Michelle Rosenzwajg Roberta Lorenzon Patrice Cacoub Hang Phuong Pham Fabien Pitoiset karim El Soufi Claire RIbet Claude bernard Selim Aractingi beatrice banneville laurent beaugerie Francis berenbaum Julien Champey Olivier Chazouilleres Christophe Corpechot bruno Fautrel Arsfene Mekinian Elodie Regnier David Saadoun Joe-Elie Salem Jeremie Sellam Philippe Seksik Anne Daguenel-Nguyen Valene Doppler Jeremie Mariau Eric Vicaut David Klatzmann 杨新蕾(译) 张卓莉(校) 不详北京大学第一医院

背景调节性T(Tregs)细胞可以预防自身免疫并控制炎症,在各种自身免疫性或自身炎症性疾病中的研究都表明Treg细胞不足。由于低剂量白细胞介素-2(low-dose interleukin-2,ld-IL2)能够扩增并激活Tregs细胞,因此ld-IL2具有广泛的治疗潜力。... 详细信息

背景调节性T(Tregs)细胞可以预防自身免疫并控制炎症,在各种自身免疫性或自身炎症性疾病中的研究都表明Treg细胞不足。由于低剂量白细胞介素-2(low-dose interleukin-2,ld-IL2)能够扩增并激活Tregs细胞,因此ld-IL2具有广泛的治疗潜力。目的我们通过一项临床试验观察ld-IL2治疗11种自身免疫性疾病中1种的效果,旨在评估ld-IL2的治疗潜力并选择疾病,以用于进一步的临床开发。方法本研究为前瞻开放性Ⅰ~Ⅱa期临床观察,入选了46例轻中度患者,诊断分别为类风湿关节炎、强直性脊柱炎、系统性红斑狼疮、牛皮癣、白塞病、肉芽肿性多血管炎、大动脉炎、克罗恩病、溃疡性结肠炎、自身免疫性肝炎或硬化性胆管炎。所有患者都接受了ld-IL2(100万IU/天)5天,然后每两周注射一次,维持6个月。所有患者均接受了深入的免疫监测和临床评估。结果在任何疾病类型以及任何合并药物治疗的患者中,ld-IL2都显示出了良好的耐受性。通过经典的免疫表型分析和广泛的免疫表型分析发现所有患者的Tregs细胞均被特异性地扩增激活,而效应T细胞没有被活化,提示ld-IL2具有临床疗效的前景。结论本研究中所采用的IL-2剂量和治疗方案可以选择性地激活和扩增Tregs细胞,并且对于不同的疾病种类以及不同的合并用药都是安全的。这一临床疗效以及初步结果可以为ld-IL2在各种自身免疫和自身炎症性疾病中开展Ⅱ期临床试验观察疗效提供了依据。试验注册号NCT01988506.

关键词：白细胞介素-2 自身免疫疾病临床疗效临床试验低剂量自身免疫性疾病免疫学免疫表型分析

多器官床旁即时超声在新型冠状病毒肺炎中的应用:国际专家共识

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中国呼吸与危重监护杂志 2021年第2期20卷 77-84页

作者：王臻(译) Arif Hussain Gabriele Via Lawrence Melniker Alberto Goffi Guido Tavazzi Luca Neri Tomas Villen Richard Hoppmann Francesco Mojoli Vicki Noble laurent Zieleskiewicz Pablo blanco Irene W.Y.Ma Mahathar Abd.Wahab Abdulmohsen Alsaawi Majid AI Salamah Martin balik Diego barca karim bendjelid belaid bouhemad Pablo bravo-Figueroa Raoul breitkreutz Juan Calderon Jim Connolly Roberto Copetti Francesco Corradi Anthony J.Dean AndréDenault Deepak Govil Carmela Graci Young-Rock Ha Laura Hurtado Toru Kameda Michael Lanspa Christian b Laursen Francis Lee Rachel Liu Massimiliano Meineri Miguel Montorfano Peiman Nazerian bret P.Nelson Aleksandar N.Neskovic Ramon Nogue Adi Osman JoséPazeli Elmo Pereira-Junior Tomislav Petrovic Emanuele Pivetta Jan Poelaert Susanna Price Gregor Prosen Shalim Rodriguez Philippe Rola Colin Royse Yale Tung Chen Mike Wells Adrian Wong Wang Xiaoting Wang Zhen Yaseen Arabi 中国人民解放军空军军医大学航空航天医学系陕西西安710032 Department of Cardiac Sciences King Abdulaziz Medical City and King Abdullah International Medical Research Center 不详

新型冠状病毒肺炎(简称新冠肺炎,COVID-19)自首次报道以来,已造成全球超一亿人感染,给各国的公共卫生体系造成了巨大威胁。新冠肺炎的临床表现以呼吸系统体征和症状为主,80%的患者症状轻微,约5%为危重症患者,常表现为急性呼吸窘迫综合征... 详细信息

新型冠状病毒肺炎(简称新冠肺炎,COVID-19)自首次报道以来,已造成全球超一亿人感染,给各国的公共卫生体系造成了巨大威胁。新冠肺炎的临床表现以呼吸系统体征和症状为主,80%的患者症状轻微,约5%为危重症患者,常表现为急性呼吸窘迫综合征(ARDS)。前期,由于缺乏相关研究,面对日益紧迫的临床困境,医务人员不得不借鉴采取一些经验性措施以应对疫情。

关键词：体征和症状肺炎公共卫生体系呼吸系统首次报道专家共识疫情