Annales de medecine interne最新文献_第10页

[Treatment of malignant non-Hodgkin's lymphoma. Economic impact of rituximab (Mabthera) versus conventional chemotherapy]. 恶性非霍奇金淋巴瘤的治疗。美罗华(Mabthera)与常规化疗的经济影响[j]。

Annales de medecine interne Pub Date : 2003-05-01

Miriam Malliti, Helga Junot, Marie-Hélène Fievet, Jean Gabarre, Namik Taright, Jean-Paul Vernant, Alain Thuillier

{"title":"[Treatment of malignant non-Hodgkin's lymphoma. Economic impact of rituximab (Mabthera) versus conventional chemotherapy].","authors":"Miriam Malliti, Helga Junot, Marie-Hélène Fievet, Jean Gabarre, Namik Taright, Jean-Paul Vernant, Alain Thuillier","doi":"","DOIUrl":"","url":null,"abstract":"The monoclonal antibody rituximab, targeted against the CD20 antigen, has shown efficacy in patients with follicular lymphoma who relapse or fail to response to conventional chemotherapy. We evaluated the economic impact of using rituximab for the treatment of non-Hodgkin's lymphoma (NLH) in comparison with conventional chemotherapy protocols (CHOP or CHVP). In this retrospective study conducted between 1998 and 2000, the direct costs of treating inpatients with NHL rituximab (n=20) or CHOP/CHVP (n=17) were compared. Results, including costs of administering chemotherapy and adverse events, showed that the average cost per patient was comparable for the two strategies (9700 euro for rituximab, versus 8487 euro for conventional chemotherapy). In the rituximab group, the cost was mostly due to drug purchases. In the conventional chemotherapy group, outlays were related to drug-induced toxicity and longer hospital stay. Our results were similar to others described in the literature. Prospective studies are nevertheless needed for confirmation. For first-line treatement, the difference in the cost-effectiveness-ratio between rituximab and conventional drugs might be smaller, but sound data are not yet available.","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"154 3","pages":"139-47"},"PeriodicalIF":0.0,"publicationDate":"2003-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22524231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Mesenteric venous thrombosis. A retrospective study of 23 cases]. 肠系膜静脉血栓形成。回顾性分析23例[j]。

Annales de medecine interne Pub Date : 2003-05-01

Virginie Rieu, Marc Ruivard, Armand Abergel, Denis Pezet, Alain-Charles Fouilhoux, Olivier Tournilhac, Pierre Philippe

{"title":"[Mesenteric venous thrombosis. A retrospective study of 23 cases].","authors":"Virginie Rieu, Marc Ruivard, Armand Abergel, Denis Pezet, Alain-Charles Fouilhoux, Olivier Tournilhac, Pierre Philippe","doi":"","DOIUrl":"","url":null,"abstract":"Unlabelled: Mesenteric venous thrombosis is uncommon. Diagnosis is difficult and much remains to be learned about clinical aspects, etiology and treatment options.Patients and methods: We conducted a retrospective study over 5 years concerning patients with isolated mesenteric venous thrombosis or with extension to the portal vein.Results: Twenty-three patients (12 women), mean age 55 years, were included. Abdominal pain (96%), bowel obstruction (35%), fever (26%), diarrhea (17%), gastrointestinal bleeding (13%) were the most common symptoms at presentation. In 78% of patients, at least one underlying condition was identified: thrombophilia, oral contraceptive, cancer, paroxysmal nocturnal hemoglobinuria, essential thrombocythemia, intra-abdominal processes. CT scan and ultrasound diagnostic sensitivity were 89% and 57% respectively. Outcome was favorable for the 18 patients treated with anticoagulants (associated with surgery in 4 patients). Three patients with neoplasm died early.Conclusion: Mesenteric venous thrombosis must be kept in mind as a possible diagnosis in patients with abdominal pain. Predisposing factors are frequently associated and should be searched for. Early diagnosis, using CT scan or ultrasound, enables immediate anticoagulation and seems to improve outcome.","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"154 3","pages":"133-8"},"PeriodicalIF":0.0,"publicationDate":"2003-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22524230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Hypersensitivity to celecoxib]. 对塞来昔布过敏。

Annales de medecine interne Pub Date : 2003-05-01

Gérard Fradet, Anne Robin-Le Nechet, Hélène Huguenin, Anne Chiffoleau

引用次数: 0

[Transposition of an American-designed comprehensive medical student examination within the framework of the forthcoming French nationwide comprehensive examination. A preliminary study]. [在即将到来的法国全国综合考试框架内对美国设计的综合医学生考试的转换。初步研究]。

Annales de medecine interne Pub Date : 2003-05-01

Jean-Paul Fournier, André F De Champlain, Daniel Benchimol, Pascal Staccini, Raja Subhiyah, Marc Braun, Chantal Kohler, Bertrand Guidet, Pascal Claudepierre, Marc Prevel, Peter Scoles, Kathy Holtzman, David Swanson, Kathy Angelucci, Cathy McGrenra, James Goldberg, Patrick Rampal, Donald Melnick

{"title":"[Transposition of an American-designed comprehensive medical student examination within the framework of the forthcoming French nationwide comprehensive examination. A preliminary study].","authors":"Jean-Paul Fournier, André F De Champlain, Daniel Benchimol, Pascal Staccini, Raja Subhiyah, Marc Braun, Chantal Kohler, Bertrand Guidet, Pascal Claudepierre, Marc Prevel, Peter Scoles, Kathy Holtzman, David Swanson, Kathy Angelucci, Cathy McGrenra, James Goldberg, Patrick Rampal, Donald Melnick","doi":"","DOIUrl":"","url":null,"abstract":"Medical training is undergoing extensive revision in France. A nationwide comprehensive clinical competency examination will be administered for the first time in 2004, relying exclusively on essay-questions. Unfortunately, these questions have psychometric shortcomings, particularly their typically low reliability. High score reliability is mandatory in a high-stakes context. The National Board of Medical Examiners-designed multiple choice-questions (MCQ) are well adapted to assess clinical competency with a high reliability score. The purpose of this study was to test the hypothesis that French medical students could take an American-designed and French-adapted comprehensive clinical knowledge examination with this MCQ format. Two hundred and eighty five French students, from four Medical Schools across France, took an examination composed of 200 MCQs under standardized conditions. Their scores were compared with those of American students. This examination was found assess French students' clinical knowledge with a high level of reliability. French students' scores were slightly lower than those of American students, mostly due to a lack of familiarity with this particular item format, and a lower motivational level. Another study is being designed, with a larger group, to address some of the shortcomings of the initial study. If these preliminary results are replicated, the MCQ format might be a more defendable and sensible alternative to the proposed essay questions.","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"154 3","pages":"148-56"},"PeriodicalIF":0.0,"publicationDate":"2003-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22523589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Respiratory syncytial infections in the elderly. Seven cases and review of the literature]. 老年人呼吸道合胞体感染。七个病例及文献回顾]。

Annales de medecine interne Pub Date : 2003-03-01

Nicole Haber, Najoua El Helali, Martine Février, Bernard Durand-Gasselin

{"title":"[Respiratory syncytial infections in the elderly. Seven cases and review of the literature].","authors":"Nicole Haber, Najoua El Helali, Martine Février, Bernard Durand-Gasselin","doi":"","DOIUrl":"","url":null,"abstract":"We report 7 cases of respiratory syncytial virus (RSV) infections among elderly patients hospitalized for acute lower tract infection during the winter months. The median age was 95 years (range: 79-106 years). 6 patients were living in nursing homes. All patients had chronic cardiopulmonary conditions. Clinical symptoms included upper respiratory tract symptoms for 3 of them and lower respiratory tract symptoms for all of them. Three patients developed a severe infection with acute respiratory failure. The chest X ray showed an interstitial infiltrate in 3 cases, a consolidation in one case. All patients received oxygen, respiratory physical therapy, nebulized B-agonists and antibiotics. Corticosteroids were used for 4 patients. Progress was favorable for all patients and none died. Diagnosis was obtained in a few hours by direct antigen detection by enzyme immunoassays (EIA) in sputum. Respiratory syncytial virus infection is a common cause of respiratory tract infection in the elderly, during the winter months. Clinical manifestations are similar to influenza infections. Detection of RSV antigens from sputum specimens may be a useful and rapid diagnostic method and merits further evaluation in the elderly. Early diagnosis of respiratory syncytial virus infection should be encouraged to allow the implementation of effective infection control procedures and avoid inadequate therapies.","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"154 2","pages":"78-84"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22384881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Superantigens and vasculitis]. 超级抗原和血管炎。

Annales de medecine interne Pub Date : 2003-03-01

Mohamed Hamidou, Cristina Belizna

引用次数: 0

[SERMs and uterus]. [SERMs和子宫]。

Annales de medecine interne Pub Date : 2003-03-01

Philippe Touraine

{"title":"[SERMs and uterus].","authors":"Philippe Touraine","doi":"","DOIUrl":"","url":null,"abstract":"The uterus is one of the target organs of sexual steroids synthesized in the ovary. Estrogen is known to stimulate cell proliferation in the endometrium while progesterone has an anti-estrogenic secretory effect on this tissue. Renewed interest in the action of new anti-estrogenic agents on the uterus has arisen over the last decade, but not simply in order to achieve new therapeutic strategies for the prevention or cure of uterine tumors. New compounds were developed for their action on other tissues such as the breast, but it rapidly became clear that they were a source of uterine disease. A clear example is tamoxifen which has a powerful anti-estrogenic effect on breast tissue. It was hoped however that this compound, which behaves either like an antagonist or an agonist, depending on the target tissue, could have an anti-estrogenic effect on the uterus and on the contrary an agonistic estrogenic protective effect on bony and vascular tissue. This approach progressively led to the development of SERMs (Selective Estrogen Receptor Modulators), non-steroidal compounds modulating the action of estrogens. The first member of this new pharmaceutical class was raloxifen, marketed in France under the brand name Evista, which has an estrogenic effect on vertebral bone, warranting its authorization for use in patients with vertebral osteoporosis with or without fracture. Raloxifen thus has a beneficial estrogenic effect, at least on trabecular bone, and an anti-estrogenic effect on the uterus and breast. The goal today is to continue the development of new compounds in the SERM family with well targeted, and well understood, agonistic and/or antagonistic actions on different body tissues.","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"154 2","pages":"103-8"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22384886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Crohn's disease plus Takayasu's arteritis: more than coincidence? 克罗恩病加高须动脉炎:不仅仅是巧合吗?

Annales de medecine interne Pub Date : 2003-03-01

Kathleen Maksimowicz-McKinnon, Gary S Hoffman

引用次数: 0

Association of Takayasu's arteritis and Crohn's disease. Results of a study on 44 Takayasu patients and review of the literature. 高须动脉炎与克罗恩病的关系44例Takayasu患者的研究结果及文献复习。

Annales de medecine interne Pub Date : 2003-03-01

Jean-Luc Reny, Jean-François Paul, Chantal Lefèbvre, Karine Champion, Joseph Emmerich, Olivier Blétry, Jean-Charles Piette, Jean-Noël Fiessinger

{"title":"Association of Takayasu's arteritis and Crohn's disease. Results of a study on 44 Takayasu patients and review of the literature.","authors":"Jean-Luc Reny, Jean-François Paul, Chantal Lefèbvre, Karine Champion, Joseph Emmerich, Olivier Blétry, Jean-Charles Piette, Jean-Noël Fiessinger","doi":"","DOIUrl":"","url":null,"abstract":"Takayasu's arteritis and Crohn's colitis are exceptionally associated and characteristics of patients affected with both diseases have not been fully described. In a group of 44 consecutive Takayasu patients, 4 also had Crohn's disease. This 9% prevalence (95% confidence interval=2.5-21.7%) of Crohn's disease in the group is significantly greater than the highest reported prevalence of the disease in the general population. In these 4 patients, fulfilling 5 or more ACR criteria for Takayasu's disease, Crohn's disease was confirmed with colonoscopic examination and biopsies. Takayasu-Crohn patients were younger at diagnosis and tended to have systemic symptoms more frequently. Other clinical, radiological and biological characteristics were not different between the 2 groups. In the literature, 16 cases of this unusual association have been reported. The diagnosis of Takayasu's disease was simultaneous or posterior to Crohn's disease in 87%. Data on vascular lesions was available in 6 out of 16 patients and in the 4 patients of the present study: the distribution of vascular lesions in Takayasu-Crohn patients did not appear to be different from Takayasu patients. Our results and previous reports suggest that this association of rare diseases is not fortuitous. With respect to the indolent course of Takayasu's arteritis, early diagnosis of vascular lesions in Crohn patients is encouraged.","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"154 2","pages":"85-90"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22384882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Early response to oral cobalamin therapy in older patients with vitamin B12 deficiency]. [老年维生素B12缺乏患者口服钴胺素治疗的早期反应]。

Annales de medecine interne Pub Date : 2003-03-01

Georges Kaltenbach, Marie Noblet-Dick, Emmanuel Andrès, Geneviève Barnier-Figue, Ester Noel, Thomas Vogel, Anne-Elisabeth Perrin, Catherine Martin-Hunyadi, Marc Berthel, Francis Kuntzmann

{"title":"[Early response to oral cobalamin therapy in older patients with vitamin B12 deficiency].","authors":"Georges Kaltenbach, Marie Noblet-Dick, Emmanuel Andrès, Geneviève Barnier-Figue, Ester Noel, Thomas Vogel, Anne-Elisabeth Perrin, Catherine Martin-Hunyadi, Marc Berthel, Francis Kuntzmann","doi":"","DOIUrl":"","url":null,"abstract":"Purpose: Standard treatment of vitamin B12 deficiency involves regular intramuscular cobalamin administration. The aim of this study was to determine whether oral cobalamin treatment may be an effective therapy for treating older patients with cobalamin deficiency related to nutritional deficiency and food-cobalamin malabsorption.Patients and methods: We prospectively studied 20 patients older than 80 years with established cobalamin deficiency related to food-cobalamin malabsorption (n=14) and nutritional deficiency (n=6) who received 1000 micro g of oral cyanocobalamin per day. Levels of serum cobalamin and blood counts were determined at baseline and after the first week of treatment.Results: After an average of 8 days of treatment, 17 out of 20 patients normalized their serum cobalamin levels; the patients had increased their serum cobalamin level (mean increase of 0.23 micro g/L; p<0.01 compared with baseline), reticulocyte count (mean increase of 27400/mm(3); p<0.05), hemoglobin levels (mean increase of 0.7 g/dL; NS), and decreased the mean erythrocyte volume (mean decrease of 0.7 fL; NS).Conclusion: Our findings suggest that cyanocobalamin given orally during one week may be an effective treatment for cobalamin deficiency related to food-cobalamin malabsorption and nutritional deficiency and may avoid painful intra-muscular injections in older patients.","PeriodicalId":75505,"journal":{"name":"Annales de medecine interne","volume":"154 2","pages":"91-5"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22384883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0