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    C. Bertolotto ; F. Lesueur ; S. Giuliano ; T. Strub ; M. de Lichy ; K. Bille ; P. Dessen ; B. d'Hayer ; H. Mohamdi ; A. Remenieras ; E. Maubec ; A. de la Fouchardiere ; V. Molinie ; P. Vabres ; S. Dalle ; N. Poulalhon ; T. Martin-Denavit ; L. Thomas ; P. Andry-Benzaquen ; N. Dupin ; F. Boitier ; A. Rossi ; J. L. Perrot ; B. Labeille ; C. Robert ; B. Escudier ; O. Caron ; L. Brugieres ; S. Saule ; B. Gardie ; S. Gad ; S. Richard ; J. Couturier ; B. T. Teh ; P. Ghiorzo ; L. Pastorino ; S. Puig ; C. Badenas ; H. Olsson ; C. Ingvar ; E. Rouleau ; R. Lidereau ; P. Bahadoran ; P. Vielh ; E. Corda ; H. Blanche ; D. Zelenika ; P. Galan ; F. Aubin ; B. Bachollet ; C. Becuwe ; P. Berthet ; Y. J. Bignon ; V. Bonadona ; J. L. Bonafe ; M. N. Bonnet-Dupeyron ; F. Cambazard ; J. Chevrant-Breton ; I. Coupier ; S. Dalac ; L. Demange ; M. d'Incan ; C. Dugast ; L. Faivre ; L. Vincent-Fetita ; M. Gauthier-Villars ; B. Gilbert ; F. Grange ; J. J. Grob ; P. Humbert ; N. Janin ; P. Joly ; D. Kerob ; C. Lasset ; D. Leroux ; J. Levang ; J. M. Limacher ; C. Livideanu ; M. Longy ; A. Lortholary ; D. Stoppa-Lyonnet ; S. Mansard ; L. Mansuy ; K. Marrou ; C. Mateus ; C. Maugard ; N. Meyer ; C. Nogues ; P. Souteyrand ; L. Venat-Bouvet ; H. Zattara ; V. Chaudru ; G. M. Lenoir ; M. Lathrop ; I. Davidson ; M. F. Avril ; F. Demenais ; R. Ballotti ; B. Bressac-de Paillerets
    Nature Publishing Group (NPG)
    Published 2011
    Staff View
    Publication Date:
    2011-10-21
    Publisher:
    Nature Publishing Group (NPG)
    Print ISSN:
    0028-0836
    Electronic ISSN:
    1476-4687
    Topics:
    Biology
    Chemistry and Pharmacology
    Medicine
    Natural Sciences in General
    Physics
    Keywords:
    Carcinoma, Renal Cell/*genetics ; Cell Movement/genetics ; Gene Frequency ; *Genetic Predisposition to Disease ; *Germ-Line Mutation ; Humans ; Melanoma/*genetics ; Microphthalmia-Associated Transcription Factor/*genetics ; Neoplasm Invasiveness/genetics ; Sumoylation
    Published by:
    Latest Papers from Table of Contents or Articles in Press
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    Latest Papers from Table of Contents or Articles in Press
  6. 6
    Staff View
    ISSN:
    1569-8041
    Keywords:
    gemcitabine ; pancreatic cancer ; phase I ; vinorelbine
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Abstract Purpose:Gemcitabine and vinorelbine are active drugs with broadspectrum of activity and manageable toxicity in clinical trials. The aims ofthis study were to describe the toxicity, to determine the dose-limitingtoxicity, and to define the doses of gemcitabine and vinorelbine to berecommended for phase II studies in patients with advanced cancers. Patients and methods:Drugs were given as 30–min infusions on day1 and 8 (vinorelbine before gemcitabine) every 3 weeks. Thirty-six patients(male : female ratio 25 : 11; mean age 54, PS 〉60) were treated including1 retroperitoneal sarcoma, 7 head and neck, 10 lung, 4 thyroid, 6 pancreatic,1 bladder, 2 ovary, 2 gastric, 1 rectum, 1 unknown primary, and 1 renal cellcarcinoma. Doses of gemcitabine/vinorelbine ranged from 800/20mg/m2 to 1500/30 mg/m2. Results:The dose-limiting toxicity was neutropenia. A transientgrade 2–3 elevation of transaminases was frequently observed at severaldose-levels, although this toxicity did not appear to be dose dependant andwas reversible at day 21 before the next cycle. Other toxicities were mild andeasily manageable, consisting of fatigue and flu-like syndromes. Since the MTDwas not reach at the higher dose-level, the recommended dose level of thegemcitabine–vinorelbine combination was 1500/30 mg/m2. Onetoxic death due to hematologic toxicity was reported in a heavily pretreatedpatient who underwent prior chemotherapy and pelvic radiotherapy. A total of12 patients were treated at the recommended dose level which was associatedwith grade 3–4 neutropenia in 3 of 12 patients and in 22.9% ofcycles. Conclusions:This study estimates that the recommended dose forphase II studies of gemcitabine–vinorelbine is 1500/30 mg/m2at day 1 and 8 every three weeks. A careful monitoring of the hematologictoxicity is recommended in heavily pretreated patients and in patients whoreceived pelvic radiotherapy. Partial responses observed in a patient with anadvanced cisplatin–5–fluorouracil-resistant pancreatic adenocarcinomaand in a patient with mesothelioma support further evaluation of thiscombination in patients with tumors refractory to classical antitumor agents.
    Type of Medium:
    Electronic Resource
    URL:
    Articles: DFG German National Licenses
  7. 7
    Staff View
    ISSN:
    1432-0851
    Keywords:
    “Spontaneous” regression ; Metastatic carcinoma ; Kidney graft
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Type of Medium:
    Electronic Resource
    URL:
    Articles: DFG German National Licenses
  8. 8
    Staff View
    ISSN:
    1433-7339
    Keywords:
    Catheter-related infection ; Interleukin-2 ; Staphylococcus aureus bacteremia
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Abstract A high incidence of bacterial infections has been previously reported during interleukin-2 (IL-2) treatment, mainly due to catheter-related infections. Antibiotic prophylaxis has been successfully used to decrease such infections. The goal of this study was to evaluate an alternative way to reduce catheter-related infections in IL-2-treated patients by the use of totally implanted catheters. A total of 74 patients with metastatic renal cell carcinoma, referred to our institution to receive IL-2 from March 1989 to July 1991, were included in this prospective study. IL-2 was given on a 2-days-a-week schedule (24x106 IU m-2 day-1) either alone (41 patients) or in association with interferon γ (33 patients). All these patients were prospectively evaluated for fever, bacteremia and line-site infection. Seven patients (9.5%) had one (2 patients) or more (5 patients) positive blood cultures with Staphylococcus aureus. Antibiotics were used only in 5 patients, and the catheter had to be removed in only 2 of these patients. In the other patients, no further infection developed despite the lack of antibiotics. Moreover, 9 patients had positive blood cultures with Staphylococcus epidermidis (1.9% of total number of blood cultures). In conclusion, a totally implanted catheter appears to reduce the incidence of infections in IL-2-treated patients, at least on a 2-days-a-week schedule.
    Type of Medium:
    Electronic Resource
    URL:
    Articles: DFG German National Licenses
  9. 9
    Staff View
    ISSN:
    1432-1238
    Keywords:
    Tracheotomy ; Edotracheal intubation ; Mechanical ventilation ; Neutropenia ; Cancer
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Abstract Objective To evaluate the safety of tracheotomy in neutropenic ventilated cancer patients, in terms of infectious and haemorrhagic complications. Design Retrospective study. Setting A medical-surgical intensive care unit in a Cancer-hospital.Patients and participants: 26 consecutive patients undergoing a tracheotomy in neutropenic period, from 1987 to 1990. Interventions Tracheotomy, performed at the bedside or in operating, room. Measurements and results In all neutropenic patients undergoing a tracheotomy, the characteristics and duration of both neutropenia and mechanical ventilation have been recorded. Stomal bleeding and infection, and infectious pneumonias and alveolar haemorrhage have been carefully reviewed. Platelets were transfused in 23 of the 26 patients at the time of the procedure; no local haemorrhage was observed. Neither stomal nor pulmonary infections secondary to traceotomy were noted. No respiratory worsening was attributable to the tracheotomy. Nineteen patients (73%) died in ICU, without direct link between tracheotomy and death. Conclusions These findings suggest that a tracheotomy can be safely performed in neutropenic patients requiring mechanical ventilation.
    Type of Medium:
    Electronic Resource
    URL:
    Articles: DFG German National Licenses
  10. 10
    Staff View
    ISSN:
    1432-1238
    Keywords:
    5-Fluorouracil ; Chemotherapy ; Cardiac failure
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Abstract A 38-year-old man with a colonic carcinoma experienced cardiogenic shock during continuous intravenous treatement with 5-fluorouracil (5-FU), without clinical or electrical sings of coronary insufficiency and with a normal coronary angiogram. His symptoms resolved after eight days of inotropic and vasoldilator therapy. Because of the severity of the shock, rechallenge was not performed. This is the first case of acute cardiac failure without coronary ischemia, associated with 5-FU monotherapy. Experimental studies suggest that this adverse effect could be due to myocardial accumulation of 5-FU leading to depletion of high energy phosphate compounds. This might also explain the more frequently seen acute coronary insufficiency due to 5-FU.
    Type of Medium:
    Electronic Resource
    URL:
    Articles: DFG German National Licenses
  11. 11
    Staff View
    ISSN:
    1432-1238
    Keywords:
    Wegener's granulomatosis ; Alveolar haemorrhage
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Abstract A 35-year-old woman experienced diffuse intraalveolar haemorrhage with respiratory distress and acute renal failure. Renal histology and evolution confirmed Wegener's granulomatosis. Early use of immunosuppressive drugs allowed weaning from mechanical ventilation and temporary improvement of the renal failure. A review of the literature emphazises the rarity of alveolar hemorrhage as an initial symptom of Wegener's granulomatosis and the necessity of aggressive management.
    Type of Medium:
    Electronic Resource
    URL:
    Articles: DFG German National Licenses
  12. 12
    Staff View
    ISSN:
    1433-7339
    Keywords:
    Tracheotomy ; Endotracheal intubation ; Mechanical ventilation ; Neutropenia ; Cancer
    Source:
    Springer Online Journal Archives 1860-2000
    Topics:
    Medicine
    Notes:
    Abstract Despite substantial advances in the management of such patients, the prognosis of ventilated neutropenic patients remains grim. The objective of our study was to evaluate the benefit of tracheotomy in this category of patients, in terms of mortality while they were in the intensive-care unit and nosocomial pneumonias. The charts of 53 consecutive, ventilated, neutropenic patients, or those destined to be imminently neutropenic, admitted to our intensive-care unit during a 4-year period, have been retrospectively reviewed. Tracheotomy was performed at the bedside or in the operating room: 20 patients underwent tracheotomy within 48 h of mechanical ventilation (ET group), while 33 were tracheotomized later or remained intubated (INT group). The two groups were comparable with regard to the underlying disease, respiratory failure, mechanical ventilation patterns and severity scores, but neutropenia was more profound in the ET group. Mortality while in the intensivecare unit was similar (ET:70%; INT:78.8%). However, the survival curves showed a trend towards longer survival in the ET group, even after adjustment for the degree of neutropenia (log-rank test: P=0.07). The incidence of pneumonias was similar in both groups. No major complications of tracheotomy were reported. These findings suggest that a tracheotomy could be proposed for neutropenic patients requiring mechanical ventilation, in order to prologn their survival beyond the end of the neutropenic period. A prospective study is underway to confirm these preliminary results.
    Type of Medium:
    Electronic Resource
    URL:
    Articles: DFG German National Licenses