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Biomedical subjects

J Desrame

Publications and source records attributed to J Desrame.

17 recordsLinked to original sources
PubMed2006

FOLFIRI.3, a new regimen combining 5-fluorouracil, folinic acid and irinotecan, for advanced pancreatic cancer: results of an Association des Gastro-Enterologues Oncologues (Gastroenterologist Oncologist Association) multicenter phase II study.

BACKGROUND: The purpose of the study was to prospectively evaluate the efficacy and tolerability of the FOLFIRI.3 regimen in patients with unresectable pancreatic adenocarcinoma. PATIENTS AND METHODS: Chemotherapy-naive patients with histologically proven advanced pancreatic adenocarcinoma were treated with the FOLFIRI.3 regimen, consisting of irinotecan 90 mg/m(2) as a 60-min infusion on day 1, leucovorin 400 mg/m(2) as a 2-h infusion on day 1, followed by 5-fluorouracil (5-FU) 2000 mg/m(2) as a 46-h infusion and irinotecan 90 mg/m(2), repeated on day 3, at the end of the 5-FU infusion, every 2 weeks. RESULTS: Forty patients were enrolled, of whom 29 (73%) had metastatic disease. A total of 441 cycles were delivered (1-53). Grade 3-4 neutropenia occurred in 35% of the patients, accompanied by fever in two cases. Other relevant grade 3-4 toxic effects were nausea-vomiting (27%) and diarrhea (25%). Grade 2 alopecia occurred in 48% of the patients. There were no treatment-related deaths. The confirmed response rate was 37.5%. Stable disease was observed in 27.5% of the patients. The median progression-free and overall survivals were 5.6 months and 12.1 months, respectively. The 1-year survival rate was 51%. CONCLUSION: The FOLFIRI.3 regimen seems to be active on advanced pancreatic cancer and to have a manageable toxicity profile. The lack of cross-resistance between FOLFIRI.3 and gemcitabine-based regimens allows efficient second-line therapies.

Adult↗
PubMed2004

Acute laryngeal paralysis induced by the migration of a totally implantable venous access device's catheter tip.

The authors report a case of acute vagus nerve paralysis that appeared during a course of chemotherapy. The drugs had been administered through a totally implantable venous access device (TIVAD), whose catheter tip had migrated into the right internal jugular vein (IJV) and was surrounded by a complete venous thrombosis. The supposed aetiology of this paralysis was a leakage of the cytotoxic drug (5-fluorouracil) from the vessel wall into the surrounding carotid space, because of the stagnation of the chemotherapeutic agent above the thrombosis. Four months after cessation of chemotherapy, the laryngeal paralysis was still evident.

Aged↗
PubMed2003

[Non-Hodgkin's lymphoma and hepatitis C virus infection].

INTRODUCTION: The authors report four cases of non Hodgkin's lymphomas (NHL) among patients infected by the hepatitis C virus (HCV). They discuss the epidemiological, physiopathological and clinical features of this association. CURRENT KNOWLEDGE AND KEY POINTS: The role of the HCV in the development of B-cell NHL is probable but the reported frequency of the association with HCV infection is variable especially in different countries. Most of the reported cases are low-grade NHL with frequent extranodal involvement. FUTURE PROSPECTS AND PROJECTS: New studies will improve the understanding of the physiopathological mechanisms that might explain the occurrence of NHL in the course of HCV infection. The recent evidence that the antiviral treatment is effective in splenic lymphoma with villous lymphocytes leads to reconsider the relationship between HCV and NHL and to think about new therapeutic possibilities.

Female↗
PubMed2003

[Complications of implantable sites].

Approximately 50,000 implantable sites are prepared each year in France because of the undeniable advantage for the treatment of patients requiring long-duration intravenous infusions. The benefits of this technique must not overshadow the mechanical risks inherent in their installation and complications related to their use: infections, thromboembolic events. Clear, precise, and adapted treatment protocols must be established and rigorously implemented by the healthcare team. Information notes for the patients concerning the risks involved and warning signs must be written in order to be able to institute appropriate treatment rapidly.

Catheters, Indwelling↗
PubMed2001

[Small intestine bacterial overgrowth: six case reports and literature review].

INTRODUCTION: Small intestinal bacterial overgrowth syndrome (SIBOS) has various clinical and biological presentations. Six observations are described in this review which is aimed at reporting recent data on SIBOS and proposing diagnosis and therapeutic attitudes. CURRENT KNOWLEDGE AND KEY POINTS: Chronic diarrhea, malabsorption syndrome and exsudative enteropathy are the main criteria of diagnosis. Breath hydrogen testing is commonly performed to confirm diagnosis, with a 78% sensitivity and a 89% specificity. The aim of therapy is reparation of malabsorption consequences, reduction of intestinal bacterial overgrowth, and surgical correction of intestinal stasis. In the absence of consensus, norfloxacin or amoxicillin-clavulinic acid (administered for a mean of 7 to 15 days) seem the more appropriate antibiotics. When possible, surgery represents the primary treatment of SIBOS recurrences. FUTURE PROSPECTS AND PROJECTS: Diagnosis of small intestinal bacterial overgrowth syndrome must be evoked on the basis of either surgical or medical context, i.e., the existence of chronic diarrhea, malabsorption syndrome (complete or not), and exsudative enteropathy. This review reports essential factors for diagnosis and treatment.

Aged↗
PubMed1999

Oxaliplatin-induced haemolytic anaemia.

A case of haemolytic anaemia after therapy with oxaliplatin, an anticancer chemotherapeutic agent, was investigated. Haemolytic anaemia has been associated with cisplatin and carboplatin, two related drugs, but not with oxaliplatin.

Adenocarcinoma↗
PubMed1999

[Ifosfamide-related encephalopathy. Report of two cases].

INTRODUCTION: Due to ifosfamide urotoxicity, encephalopathy is a frequent complication accompanying treatment with this drug. The various clinical, physiological and therapeutical aspects of ifosfamide-related encephalopathy are reviewed. We report two cases and review current literature. EXEGESIS: Ifosfamide-related encephalopathy has polymorphous and non-specific clinical picture. The disease severity is variable, as related deaths have been reported. Clinical signs disappear with treatment discontinuation. Routes of administration, doses, tumoral site and gender have been implicated in the disease physiopathology. Admittedly, metabolite mitochondrial toxicity would be the underlying mechanism. Treatment would be based on intravenous methylene blue. A clinical trial aimed at studying prophylaxis is in progress. A few number of patients have been cured until now. CONCLUSION: Further studies are required to confirm the involved physiopathological mechanisms and methylene blue effects.

Adult↗
PubMed1998

[Eosinophilia and renal pathology].

Although rare, renal involvement during hypereosinophilic syndromes can lead to life-threatening situations. Since eosinophilic renal lesions can occur in a wide range of primary or secondary diseases, diagnosis can pose difficult clinical dilemmas. In some settings, renal lesions may be a predictable complication as in essential hypereosinophilic syndrome or angiolymphoid hyperplasia with eosinophilia. In other cases, renal lesions may be a highly unusual event secondary to cholesterol embolization, drug-induced reactions, immunoallergic responses, eosinophilic helminthic infection, or maintenance hemodialysis. The mechanisms of renal involvement are complex. In hypereosinophilic syndromes, renal involvement has been attributed to the deleterious effects of eosinophil granules and possibly to micro-emboli from the heart in patients presenting fibroplastic endocarditis or eosinophilic myocarditis. Most secondary forms are usually due to an immuno-allergic process leading to deposit of immune complexes in glomeruli. The effects of polynuclear eosinophils could also be due to release of cytokines and other mediators such as leukotriens. Cholesterol embolization involves a different mechanism in which hypereosinophilia is often moderate and accessory to arteriolar lesions. Eosinophiluria may be observed in any setting but the prognostic value of this finding as well as the mechanism underlying remain unclear.

Angiolymphoid Hyperplasia with Eosinophilia↗
PubMed1996

[Pleuropericarditis complicated of tamponade disclosing mixed connective tissue disease. Remission with non-steroidal anti-inflammatory agents. Apropos of a case].

Mixed connective tissue diseases or Sharp's syndrome are inflammatory diseases essentially presenting in the form of joint, muscle and skin manifestations. Pleuropericardial involvement is uncommon and rarely the presenting sign, and tamponade is exceptional. This clinical report concerns a case of pleuropericarditis complicated by tamponade in a 22-year-old man, constituting the presenting sign of Sharp's syndrome. The diagnosis of mixed connective tissue disease was based on the combination of clinical signs and a high serum anti-RNP antinuclear antibody titre. The treatment of the pericarditis is base on prescription of corticosteroids, but non-steroidal anti-inflammatory drugs were sufficient in our case. Larger effusions may require corticosteroids and pericardial drainage. We report the value of immunological assays in the aetiological assessment of pleuropericarditis in young subjects.

Adult↗
PubMedDate not supplied

[Cholelithiasis in homozygous sickle cell anemia. Review of the literature].

Cholelithiasis in homozygous sickle cell disease is a common complication. Mean prevalence rate recorded is 27.4% with a greater frequency in the second part of life. It is a peculiar lithiasis, made of pigmentary stones either purs or duals, caused by hypersaturation of indirect bilirubin. Systematic detection of such a lithiasis by echography is part of monitoring homozygous drepanocytic.

Adolescent↗