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Biomedical subjects

O Dupuis

Publications and source records attributed to O Dupuis.

26 records · Page 2Linked to original sources
PubMed1999

[Value of cervical echography in the prediction of premature delivery: literature review].

Preterm delivery is the leading cause of neonatal mortality. Thus predicting a preterm delivery is a major obstetrical problem. Endovaginal ultrasonography is a highly reliable and reproducible method of cervical examination. Unlike with a digital cervical examination the entire length of the endocervical canal can be measured. Using this tool, measuring the dilatation of the internal os does not require the examining finger to be placed inside the endocervical canal. Therefore, the internal os can be measured even if the external os is closed. While a digital examination assesses the "dilatability" of the internal os, an ultrasonography assesses the "true degree of dilatation". In a low-risk population endovaginal cervical ultrasonography helps rule out a preterm delivery if cervical length is long enough. It can also detect cervical incompetence. In a high-risk population, women whose cervix is longer than 30 millimeters can be identified. These women have over 80% chance to deliver on or after 36 weeks of pregnancy. Preliminary studies suggest that performing an endovaginal ultrasonography could decrease the number of false positive clinical diagnosis of modified cervix and thus, save long, expensive and inefficient hospital stays. Prospective randomized, controlled studies are needed to confirm these results.

Cervical Ripening↗
PubMed1997

[Late effects of radiotherapy in children].

Although most pediatric tumors can be cured with lower doses of radiation than their adult counterparts, long-term radiation-induced complications and sequelae remain a major concern both in terms of frequency and intensity. Most of them have been extensively documented in the pre-chemotherapeutic era like those affecting bone, cartilage and soft tissue growth or CNS and endocrine glands. More recently the emphasis has been put on the apparent increasing incidence of reported second malignancies. This could have been favored by the chemo-radiation combinations used in most children but also has been made possible mainly by the extensive follow-up of the increasing cohort of cured children.

Adolescent↗
PubMed1996

[Accelerated radiotherapy: initial results in a series of locally very advanced carcinomas of the upper respiratory and digestive tracts].

From 1992 to 1993, 46 patients with very locally advanced (74% T4) head and neck carcinomas and extensive cervical involvement (82% N2-3) were treated at the Institute Gustave Roussy with a very accelerated radiotherapy regimen: 62 Gy in three weeks with two daily 1.75 Gy fractions. Early mucosal reactions were severe but manageable in this population of patients with frequent alteration of initial performance status. Nearly every patient experienced a grade 3 or 4 (WHO) mucositis and 80% required tube feeding. Follow-up is not sufficient to draw firm conclusion about late reactions but they do not seem different from those induced by conventional radiotherapy. The overall 2-year survival rate of 49.4% and loco-regional control rate of 67% seem superior to the results of conventional radiotherapy for such advanced tumors. These results have led to a multi-center randomized controlled trial comparing this regimen of accelerated radiotherapy with conventional fractionated radiotherapy.

Adult↗
PubMed1995

Undifferentiated nasopharyngeal cancer (UCNT): current diagnostic and therapeutic aspects.

Undifferentiated carcinoma of the nasopharynx (UCNT) is a particular head and neck epidermoid lineage tumor related to the Epstein Barr Virus (EBV). It has geographically selective endemic epidemiologic features, without relation to external carcinogens. Its systemic agressiveness is the source of most disease-related demises, because radiotherapy achieves excellent local control and a significant percentage of cure in patients with exclusive locoregional disease. Difference in the staying systems currently in use, the recent changes in imaging and radiotherapy technology, and the lack of distinction between UCNT and squamous cell carcinoma (SCC) of the nasopharynx in Western literature reports make for some difficulty in therapeutic results evaluation when analyzing available literature. Its chemosensitivity is a relatively recent acknowledged fact, and its use in metastatic patients results in a high percentage of objective responses, many of long duration. Neoadjuvant cisplatin-based chemotherapy seems to be of benefit, but outstanding controversies in this regard will be soon answered through ongoing phase III trials. After a review of the current literature of all the above-mentioned aspects of this fascinating nosologic entity, our own experience, both in metastatic and locoregional disease patients is analyzed.

Adolescent↗
PubMed1995

Very accelerated radiation therapy: preliminary results in locally unresectable head and neck carcinomas.

PURPOSE: To report preliminary results of a very accelerated radiation therapy Phase I/II trial in locally advanced head and squamous cell carcinomas (HNSCC). METHODS AND MATERIALS: Between 01/92 and 06/93, 35 patients with an unresectable HNSCC were entered in this study. Thirty-two (91%) had Stage IV, and 3 had Stage III disease. The mean nodal diameter, in patients with clinically involved nodes (83%), was 6.3 cm. The median Karnovsky performance status was 70. The treatment consisted of a twice daily schedule (BID) giving 62 Gy in 20 days. RESULTS: In all cases, confluent mucositis was observed, which started about day 15 and resolved within 6 to 10 weeks. Eighty percent of patients had enteral nutritional support. The nasogastric tube or gastrostomy was maintained in these patients for a mean duration of 51.8 days. Eighteen patients (53%) were hospitalized during the course of treatment due to a poor medical status or because they lived far from the center (mean 25 days). Nineteen patients (56%) (some of whom were initially in-patients) were hospitalized posttreatment for toxicity (mean 13 days). Five patients (15%) were never hospitalized. During the follow-up period, 12 local and/or regional failures were observed. The actuarial 18-month loco-regional control rate was 59% (95% confidence interval, 45-73%). CONCLUSIONS: The dramatic shortening of radiation therapy compared to conventional schedules in our series of very advanced HNSCC resulted in: (a) severe acute mucosal toxicity, which was manageable but required intensive nutritional support in all cases; and (b) high loco-regional response rates, strongly suggesting that the time factor is likely to be critical for tumor control in this type of cancer.

Aged↗
PubMed1994

[Virus and human oncogenesis].

Only a limited number of human viruses have been shown to have oncogenic properties, including the retrovirus HTLV1 and 2, the hepatitis B virus (HBV), the Epstein-Barr virus (EBV), and some human papillomas virus (HPV). Epidemiologic and molecular biological studies have shown that these viruses were involved as cofactors in the multistep process of carcinogenesis. Viral DNA probes or antibodies against viral proteins can prove to be useful tools for diagnostic (HTLV1, EBV, HBV) or prognosis (HPV) of some cancers. A better knowledge of these viruses may also have therapeutic implications in a not too distant future such as the vaccination against HBV in order minimize the incidence of hepatocellular carcinoma in endemic countries.

Animals↗
PubMed1994

[Undifferentiated carcinoma of the nasopharynx: epidemiological, clinical and therapeutic aspects].

Undifferentiated carcinoma of the nasopharynx (UCNT) is a particular head and neck epidermoïd lineage tumor related to the Epstein-Barr Virus (EBV). It has geographically selective endemic epidemiologic features, without relation to external carcinogens. Its systemic agressiveness is the source of most disease related demises, since radiotherapy achieves excellent local control and a significant percentage of cure in patients with exclusive locoregional disease. Differences in the staging systems currently in use, the recent changes in imaging and radiotherapy technology, and the lack of distinction between UCNT and SCC of the nasopharynx in Western literature reports make for some difficulty in therapeutic results evaluation when analyzing available literature. Its chemosensitivity is a relatively recent acknowledged fact, and its use in metastatic patients results in a high percentage of objective responses, many of long duration. Neoadjuvant cisplatin based chemotherapy seems to be of benefit, but outstanding controversies in this regard will be soon answered through ongoing phase III trials. After a review of the current literature of all the above mentioned aspects of this fascinating nosologic entity, our own experience in over 250 patients seen during the past 8 years, both in metastatic and locoregional disease patients is analyzed.

Adolescent↗