PubMed Health⌕ Search

Biomedical subjects

S Bastuji-Garin

Publications and source records attributed to S Bastuji-Garin.

At least 19 recordsLinked to original sources
PubMed2002

[Publications of French dermatology professors from 1996 to 1998].

INTRODUCTION: The number and level of the publications reflect the scientific activity of physicians. The assessment of this activity is required for nomination and for the internal promotion of University Professors--Hospital Practitioners (UP-HP). We present the results of such an assessment. MATERIAL AND METHODS: The list of the individual publications of 62 UP-HP was established from research on the Medline on the PubMed website. We eliminated the journals without an Impact Factor and the articles of continued medical training. A score was obtained for each of the authors on each of their publications. This was calculated by multiplying the rank coefficient of the author by the coefficient of the type of publication (letter, clinical case or article) and by the coefficient of the journal (ranging from 1 to 4). The global score of a UP-HP was the sum of the scores per publication. The mean score of each UP-HP was assessed by dividing their global score by the number of their publications. RESULTS: One thousand thirty-one scientific publications in 3 years was divided into 502 articles, 316 clinical cases and 213 letters. The yearly number of publications per UP-HP was a mean of 5.5 (+/- 4.2) ranging from 0 to 17.3. The publications were mainly written in English (p=10(-2)). There were more articles than clinical case reports and letters (p=10(-1)). The yearly number of publications was greatest among those aged 46-55. No difference was noted in gender, function (head of a department or not) or the size of the town. The UP-HP working in a team including other UPs had written a greater number of publications (p=10(-2)). The global scores did not significantly differ between the 3 age ranges considered; conversely, the mean score decreased significantly with age (p=0.04). The UP-HP working in teams including several UPs had significantly higher global score (p=0.03). DISCUSSION: These results show the heterogeneity of the "publishing" activity. The method used in this study for the scientific assessment could be subject to improvement; its principle is indisputable, but its methods of use remain to be specified. The best "publication structure" of young UP-HP may be related to age, demonstrating a decline in scientific activity during the working life, or a cohort-effect--i.e., the progressive improvement in recruitment conditions and scientific activity over the past 20 years. The better performance of the UP-HP working in a team including several UP-HP must be interpreted with care; however, it may help to define a geographical policy of Dermatology.

Dermatology↗
PubMed2001

Severity of illness scores: are they useful in febrile neutropenic adult patients in hematology wards? A prospective multicenter study.

OBJECTIVE: To assess the prognostic value of two severity of illness scores, commonly used for critically ill patients, Simplified Acute Physiology Score (SAPS II) and Organ Dysfunctions and Infection (ODIN), in predicting mortality in febrile neutropenic patients in hematology wards. DESIGN: A 2-month prospective multicenter study. SETTING: Thirty-six hematologic and/or stem cell transplant units in France. PATIENTS: All adult patients with a first febrile neutropenic episode (polymorphonuclear cells <500/mm(3)) were included. INTERVENTIONS: SAPS II was calculated on day 1 of fever, and ODIN on days 1 and 8. The end point was the mortality rate on day 28. MEASUREMENTS AND MAIN RESULTS: Twenty-eight (6.6%) of the 421 patients included died before day 28. The mortality rate predicted by SAPS II was 23.8%, indicating a poor calibration. The SAPS II score at day 1 was greater in nonsurvivors than in survivors (44 +/- 11 vs. 38 +/- 7, p <.0001), as was the number of patients with one or more organ failures at day 1 (14 vs. 2%, p <.0001), and day 8 (42 vs. 3%, p <.0001). The pattern of change in the scores over the first 8 days differed significantly between survivors and nonsurvivors. In multivariate analysis, only ODIN on day 1 and day 8, and spontaneous neutropenia were independent predictors for death. CONCLUSIONS: SAPS II and ODIN scores are inaccurate for predicting individual outcome of febrile neutropenic patients in hematology wards. Serial measurements of these scores during the first week of hospitalization could be more accurate than a single measurement. Besides severity scores and organ failures, the type of neutropenia is at least as important in assessing the prognosis.

Adolescent↗
PubMed2000

HLA class II polymorphism contributes to specify desmoglein derived peptides in pemphigus vulgaris and pemphigus foliaceus.

Susceptibility to Pemphigus, an autoimmune disease of the skin, has been previously linked to DRB1*0402, 1401/04 and DQB1*0503 in pemphigus vulgaris (PV), to DRB1*0102, 0404, 1402/06 in endemic pemphigus foliaceus in Brazil and to DRB1*04 in Italian patients suffering from pemphigus foliaceus (PF). The disease is caused by autoantibodies against desmoglein (Dsg1 in PF, Dsg3 in PV). Molecular typing of 57 French patients suffering from PV (37) and from PF (20) confirmed previous results concerning PV and showed that DRB1*0102 and 0404 are susceptible molecules to PF in France. We have analysed the characteristics of the 'pockets' of the susceptibility-associated molecules to PV and PF and we showed that (i) in PV, two kinds of Dsg3 derived peptides may be presented by HLA-DR according to HLA polymorphism (DRB1*0402 or DRB1*14/0406), (ii) the same Dsg1 peptides may be presented by DRB1*0102, DQB1*0404 or DRB1*14 in PF, (iii) the DRB1*14/0406 PV-related molecules may be able to present Dsg1 and Dsg3 peptides thereby providing an explanation for the cases of PV with combined responses to Dsg1 and to Dsg3 which are typified by a muco-cutaneous clinical phenotype.

Alleles↗
PubMed2000

SCORTEN: a severity-of-illness score for toxic epidermal necrolysis.

The mortality of toxic epidermal necrolysis is about 30%. Our purpose was to develop and validate a specific severity-of-illness score for cases of toxic epidermal necrolysis admitted to a specialized unit and to compare it with the Simplified Acute Physiology Score and a burn scoring system. A sample of 165 patients was used to develop the toxic epidermal necrolysis-specific severity-of-illness score and evaluate the other scores, a sample of 75 for validation. Model development used logistic regression equations that were translated into probability of hospital mortality; validation used measures of calibration and discrimination. We identified seven independent risk factors for death and constituted the toxic epidermal necrolysis-specific severity-of-illness score: age above 40 y, malignancy, tachycardia above 120 per min, initial percentage of epidermal detachment above 10%, serum urea above 10 mmol per liter, serum glucose above 14 mmol per liter, and bicarbonate below 20 mmol per liter. For each toxic epidermal necrolysis-specific severity-of-illness score point the odds ratio was 3.45 (confidence interval 2.26-5.25). Probability of death was: P(death) = elogit/1 + elogit with logit = -4.448 + 1.237 (toxic epidermal nec-rolysis-specific severity-of-illness score). Calibration demonstrated excellent agreement between expected (19. 6%) and actual (20%) mortality; discrimination was also excellent with a receiver operating characteristic area of 82%. The Simplified Acute Physiology Score and the burn score were also associated with mortality. The discriminatory powers were poorer (receiver operating characteristic area: 72 and 75%) and calibration of the Simplified Acute Physiology Score indicated a poor agreement between expected (9.1%) and actual (26.7%) mortality. This study demonstrates that the risk of death of toxic epidermal necrolysis patients can be accurately predicted by the toxic epidermal necrolysis-specific severity-of-illness score. The Simplified Acute Physiology Score and burn score appear to be less adequate.

Aged↗
PubMed2000

Low E-cadherin expression in bladder cancer at the transcriptional and protein level provides prognostic information.

We studied E-cadherin down-regulation at the protein level in frozen sections of 111 bladder tumours and 13 normal bladder specimens by means of immunohistochemistry, and at the mRNA level by semi-quantitative RT-PCR in 40 of the same tumours. Results indicate that E-cadherin expression detected by immunohistochemistry correlated with both stage and grade (P < 0.0001 and P < 0.001, respectively). Analysis of recurrence, progression and survival over a mean period of 36 months after surgery in the entire cohort showed that abnormal E-cadherin immunoreactivity correlated strongly with poor outcome (log-rank test: P = 0.001, P = 0.0001 and P = 0.0003, respectively). In multistep logistic regression analysis, only E-cadherin status and stage had significant additional prognostic value (P= 0.008 and OR = 0.2; P= 0.03 and OR = 3.6, respectively). Survival estimates derived from RT-PCR transcript quantification differed significantly for low and high expression (log-rank test: P = 0.0006). These results suggest that the alteration occurs at the transcriptional level and support the clinical and biological relevance of cell adhesion molecules in bladder cancer.

Adult↗
PubMed2000

Reply

Explore the source record for details and available documents.

Journal Article↗
PubMed1999

Risk factors for erysipelas of the leg (cellulitis): case-control study.

OBJECTIVE: To assess risk factors for erysipelas of the leg (cellulitis). DESIGN: Case-control study. SETTING: 7 hospital centres in France. SUBJECTS: 167 patients admitted to hospital for erysipelas of the leg and 294 controls. RESULTS: In multivariate analysis, a disruption of the cutaneous barrier (leg ulcer, wound, fissurated toe-web intertrigo, pressure ulcer, or leg dermatosis) (odds ratio 23.8, 95% confidence interval 10.7 to 52.5), lymphoedema (71.2, 5.6 to 908), venous insufficiency (2.9, 1.0 to 8.7), leg oedema (2.5, 1.2 to 5.1) and being overweight (2.0, 1.1 to 3.7) were independently associated with erysipelas of the leg. No association was observed with diabetes, alcohol, or smoking. Population attributable risk for toe-web intertrigo was 61%. CONCLUSION: This first case-control study highlights the major role of local risk factors (mainly lymphoedema and site of entry) in erysipelas of the leg. From a public health perspective, detecting and treating toe-web intertrigo should be evaluated in the secondary prevention of erysipelas of the leg.

Analysis of Variance↗
PubMed1999

Melanoma prevention: evaluation of a health education campaign for primary schools.

OBJECTIVE: To evaluate the effectiveness of an educational campaign aimed toward limiting children's sun exposure. DESIGN: Prospective, multicenter trial with before-after comparison. A school-based campaign was presented as a game during a 4-week period (May 25 to June 1992) with primary school teachers as game hosts. Children were interviewed with a standardized questionnaire in September before (1991) and after (1992) the campaign. Comparisons between the children's answers before and after the campaign were made using paired chi2 tests and analysis of variance. SETTING: Five French primary schools. SUBJECTS: All children in their fourth year of primary school (228 children aged 9 years). MAIN OUTCOME MEASURES: Changes after the campaign in children's answers concerning their knowledge, attitude, and behavior toward the sun during summer holidays. RESULTS: Compared with the precampaign answers, more children after the campaign claimed to protect themselves from the sun with a hat (33.7% vs 23.8%; P = .01) or sunscreen (34.8% vs 25.4%; P = .03), avoided going outside during the sunniest hours (76.8% vs 66.0%; P = .02), reapplied sunscreens (22.1% vs 10.6%; P<.001), considered that a T-shirt and shade provided better protection than sunscreen (82.7% vs 74.8%; P = .05), considered sunlight as a risk factor for skin cancer (74.9% vs 50.7%; P<.001), and spent significantly less time in the sun with their arms (P = .005), trunk, legs, and head uncovered (P<.001). Children with a fair complexion, who were the target of this campaign, showed the best improvement in their responses. CONCLUSION: Health education campaigns can be effective in terms of improving the knowledge, attitude, and behavior of young children.

Child↗
PubMed1999

Comparative analysis of severe aphthosis and Behçet's disease: 104 cases.

BACKGROUND: The nosologic field of aphthosis is not well defined. While criteria for Behçet's disease (BD) are lacking in severe unipolar or bipolar aphthosis, these disorders however lead to an important impairment of quality of life. The aim of this study was to assess the relationship between severe aphthosis and BD. METHODS: Records of all patients hospitalized for aphthosis or BD during a 20-year period were reviewed. RESULTS: According to clinical data, cases (n = 104) were classified as unipolar aphthosis (group I, n = 53), bipolar aphthosis (group II, n = 30) or BD (group III, n = 21). The characteristics of aphthae (number, localization, recurrences, presence of scars) were similar in all groups. Specific cutaneous manifestations (erythema nodosum, pseudofolliculitis, papulonodules) were present in 15, 17 and 95% of patients of groups I, II and III. Cutaneous puncture hypersensitivity was present in 14 out of 18 patients of group III and no patient of the two other groups. At least one extramucous specific manifestation (cutaneous, ophthalmologic, neurologic, articular, vascular) was present in 43% of patients of group I and II, and 100% in group III. CONCLUSION: These data support the hypothesis of a continuous spectrum linking severe aphthosis to BD.

Adolescent↗
PubMed1998

High risk of death in elderly patients with extensive bullous pemphigoid.

OBJECTIVE: To evaluate survival and factors predicting death in bullous pemphigoid. DESIGN: Retrospective analysis of cohort. SETTING: Three referral centers (university hospitals). PATIENTS: Among 237 patients recruited between January 1, 1985, and December 31, 1992, 20 were excluded because of doubtful diagnosis. The 217 remaining patients were 79+/-11 years old (mean+/-SD); 120 were women and 97 were men; and 79% had been treated with oral corticosteroids, 40 to 90 mg/d. INTERVENTIONS: Missing information on follow-up was minimized by letters and/or telephone calls to patients, families, nursing homes, and physicians. MAIN OUTCOME MEASURES: Actuarial survival curve, compared with the expected curve as derived from census data, and evaluation of prognostic factors by comparing initial characteristics between patients alive at 6 months and these who died before that point. RESULTS: Survival curve demonstrated an early increased mortality: 17% at 3 months and 31% at 6 months, mainly from sepsis and cardiovascular diseases. Of the factors related to bullous pemphigoid activity (duration; pruritus; and number and extent of blisters, eosinophilia, and serum antibodies) only generalized pemphigoid was predictive of death in comparison with localized forms. In multivariate analysis, age of 86 years or more (relative risk, 7.1; 95% confidence interval [CI], 2.0-25.4; P < or = .01), poor general condition (relative risk, 8.2; 95% CI, 3.0-22.4; P < or = .001), female sex (relative risk, 2.4; 95% CI, 1.1-5.4; P < or = .05), and generalized disease (relative risk, 4.4; 95% CI, 1.4-13.7; P < or = .01) were associated with increased risks of death at 6 months. CONCLUSION: In this series, generalized bullous pemphigoid had a poor prognosis especially in older patients and those in poor general condition.

Aged↗
PubMed1998

Pulmonary embolism; lung scanning interpretation: about words.

OBJECTIVE: To assess clinicians' agreement on how they interpret lung scan reports with regard to the diagnosis of pulmonary embolism. DESIGN: In this prospective study, nuclear medicine physicians provided two types of reports for each lung scan: a routine descriptive report and a short form with a standardized conclusion on the likelihood of pulmonary embolism: "high probability," "no conclusion," and "diagnosis excluded." Three independent blinded senior clinicians reviewed all routine reports and chose one of the following conclusions: "high probability," "no conclusion," or "diagnosis excluded." SETTING: An acute care teaching hospital near Paris. SUBJECTS: Eighty-two lung scans were studied. MAIN OUTCOME MEASUREMENTS: Inter-clinician agreement and agreement between clinicians' conclusions and the nuclear medicine physicians' standardized reports were analyzed using the kappa index. RESULTS: The distribution of the clinicians' conclusions from routine reports strongly differed (p < 0.001). Agreement among the three clinicians was observed in 40.2% of the routine reports, and the inter-clinician agreement was poor to moderate (kappa range, 0.28 to 0.52). A complete agreement among the three clinicians and the nuclear medicine physicians' standardized conclusions was observed for 32.9% of the reports. The agreement between each clinician and the standardized conclusions was also poor to moderate (kappa range, 0.32 to 0.55). CONCLUSION: Reading the same routine reports, clinicians reached different conclusions. Furthermore these differed greatly from the nuclear medicine physicians' standardized conclusions. These results support the notion that physicians should be given standardized reports.

Adult↗
PubMed1997

The prognostic value of p53 nuclear overexpression and MIB-1 as a proliferative marker in transitional cell carcinoma of the bladder.

BACKGROUND: There is controversy regarding the value of biologic markers as prognostic indicators independent of clinicopathologic parameters in transitional cell carcinoma (TCC) of the bladder. The authors examined the prognostic value of p53 tumor suppressor gene expression and the proliferative marker MIB-1 in TCC of the bladder. METHODS: Fresh frozen samples from 114 TCCs of the bladder and 13 normal bladders were studied by immunohistochemistry, using monoclonal antibodies MIB-1 for proliferation and PAb 1801 for p53 nuclear overexpression. Scores were determined in each case by counting at least 500 nuclei per slide in 3-5 selected regions. Patients were stratified for both markers into two groups for time-event analysis, according to the median number of nuclei stained. Patients with nuclear staining below the median value of the score were considered negative in the statistical analysis. Quantitative immunostaining was analyzed in relation to the time to recurrence, progression, and cancer death, and compared with clinical and pathologic parameters for prognostic significance in univariate and multivariate analysis (stepwise logistic regression). RESULTS: Median nuclear overexpression of p53 was 22% and that of MIB-1 28%. There was a strong association between proliferation and p53 nuclear overexpression (P < 0.0001). Progression free and disease specific survival rate estimates (log rank test) were significantly lower in patients with p53 or MIB-1 scores above 22% and 28%, respectively. Multivariate analysis indicated that stage as well as p53 and MIB-1 immunostaining provided independent prognostic information. CONCLUSIONS: Quantitative immunohistochemical evaluation of nuclear p53 and MIB-1 immunostaining inexpensively provides prognostic indicators in cases of TCC of the bladder.

Antibodies, Monoclonal↗