B1 — Médecins lyonnais et momies égyptiennes

Lyon physicians have long shown an interest in Egyptian mummies but their studies were never widely published. During the last century Dr Louis Lortet who was both Director of the Natural History Museum in Lyon and the first Dean of the Faculté Mixte de Médecine et de Pharmacie in this very town, was the first to carry out scientific research on mummies. Other physicians specialising in chemistry or botany such as Dr Louis Hugounenq (who succeeded Dr Lortet as Dean of the Faculty) or Dr Albert Florence who together with the renowned Egyptologist Victor Loret studied collyria found in the tombs, also played their part in this field of Egyptian studies. In a more recent period Dr J. Enselme working with an Egyptologist from Lyon, Professor Paul Barguet, carried out the X-ray study of the mummy in the Museum of Medical History in Lyon.L'intérêt des médecins lyonnais envers les momies égyptiennes a été marqué par quelques travaux anciens restés peu connus du public. Au siècle dernier, c'est le Dr Louis Lortet, à la fois Directeur du Muséum d'Histoire naturelle de Lyon et premier Doyen de la Faculté Mixte de Médecine et de Pharmacie dans cette même ville, qui commença les premières recherches scientifiques sur les momies. D'autres médecins, chimistes ou botanistes, tels que le Dr Louis Hugounenq qui succéda à Lortet comme doyen de la Faculté, ou le Dr Albert Florence qui étudia avec le grand égyptologue Victor Loret, les collyres trouvés dans les tombes, apportèrent aussi leur contribution à l'égyptologie. A une époque plus récente, le Dr Jean Enselme entreprit en association avec un égyptologue lyonnais, le professeur Paul Barguet, l'étude radiographique d'une momie du Musée d'Histoire de la Médecine de Lyon.Depierre Germaine, Bouchet Alain. B1 — Médecins lyonnais et momies égyptiennes. In: Nouvelles archives du Muséum d'histoire naturelle de Lyon, tome 25, 1987. pp. 9-13

B1 — Médecins lyonnais et momies égyptiennes

Lyon physicians have long shown an interest in Egyptian mummies but their studies were never widely published. During the last century Dr Louis Lortet who was both Director of the Natural History Museum in Lyon and the first Dean of the Faculté Mixte de Médecine et de Pharmacie in this very town, was the first to carry out scientific research on mummies. Other physicians specialising in chemistry or botany such as Dr Louis Hugounenq (who succeeded Dr Lortet as Dean of the Faculty) or Dr Albert Florence who together with the renowned Egyptologist Victor Loret studied collyria found in the tombs, also played their part in this field of Egyptian studies. In a more recent period Dr J. Enselme working with an Egyptologist from Lyon, Professor Paul Barguet, carried out the X-ray study of the mummy in the Museum of Medical History in Lyon.L'intérêt des médecins lyonnais envers les momies égyptiennes a été marqué par quelques travaux anciens restés peu connus du public. Au siècle dernier, c'est le Dr Louis Lortet, à la fois Directeur du Muséum d'Histoire naturelle de Lyon et premier Doyen de la Faculté Mixte de Médecine et de Pharmacie dans cette même ville, qui commença les premières recherches scientifiques sur les momies. D'autres médecins, chimistes ou botanistes, tels que le Dr Louis Hugounenq qui succéda à Lortet comme doyen de la Faculté, ou le Dr Albert Florence qui étudia avec le grand égyptologue Victor Loret, les collyres trouvés dans les tombes, apportèrent aussi leur contribution à l'égyptologie. A une époque plus récente, le Dr Jean Enselme entreprit en association avec un égyptologue lyonnais, le professeur Paul Barguet, l'étude radiographique d'une momie du Musée d'Histoire de la Médecine de Lyon.Depierre Germaine, Bouchet Alain. B1 — Médecins lyonnais et momies égyptiennes. In: Nouvelles archives du Muséum d'histoire naturelle de Lyon, tome 25, 1987. pp. 9-13

Prise en charge des cancers bronchiques (de l'approche individuelle à l'approche populationnelle)

BESANCON-BU Médecine pharmacie (250562102) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF

Le mal joli (une histoire de la prise en charge des douleurs de l'accouchement)

De tous temps, l'accouchement a été une épreuve douloureuse pour la femme. Chaque société a tenté d'atténuer ces souffrances : aux invocations divines ont progressivement succédé des remèdes empiriques puis des méthodes rationnelles et scientifiques élaborés par de grands précurseurs. Cependant, l'histoire de l'obstétrique n'a pas connu une évolution superposable à celle de la Médecine : l'application des progrès techniques s'est heurtée au dolorisme et au mysticisme concernant la femme et sa génitalité. La maîtrise du mal joli à l'échelle de la population, en Occident, n'a été possible qu'avec l'essor de l'anesthésie et l'émancipation des femmes ; elle supposait une sécurisation préalable des naissances grâce aux progrès de l'obstétrique, une volonté politique et des moyens économiques. Ces facteurs font encore défaut dans les pays pauvres, où ont lieu la majorité des naissances mondiales.TOULOUSE3-BU Santé-Centrale (315552105) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Negative impact of rurality on lung cancer survival in a population-based study.

International audienceINTRODUCTION: Several studies have suggested that rurality is a risk factor for worse prognosis in cancer. METHODS: The study population included the 2268 lung cancer cases collected between 1981 and 1996 in the Doubs Cancer Registry (France). RESULTS: The numbers of patients were 849 (31.8%) in rural areas and 89 (3.3%) in very rural areas. The relative 5-year survival was 15.2% in rural areas and 13.4% in urban areas (p = 0.5), and 2.7% in very rural areas and 14.4% in extended urban areas (p = 0.02). Multivariate analyses of observed and relative survival showed that patients living in very rural areas (p < 0.0001), 65 years of age and older and having small cell carcinoma had a significantly shorter survival. CONCLUSIONS: This study showed that the multidimensional definition of rurality identified a population with unfavorable prognoses

Pathologic Complete Response to Preoperative Chemotherapy Predicts Cure in Early-Stage Non-Small-Cell Lung Cancer: Combined Analysis of Two IFCT Randomized Trials.

International audienceINTRODUCTION:: Our study aimed to evaluate whether pathologic complete response (pCR) in early-stage non-small-cell lung cancer (NSCLC) after neoadjuvant chemotherapy resulted in improved outcome, and to determine predictive factors for pCR. METHODS:: Eligible patients with stage-IB or -II NSCLC were included in two consecutive Intergroupe Francophone de Cancérologie Thoracique phase-III trials evaluating platinum-based neoadjuvant chemotherapy, with pCR defined by the absence of viable cancer cells in the resected surgical specimen. RESULTS:: Among the 492 patients analyzed, 41 (8.3%) achieved pCR. In the pCR group, 5-year overall survival was 80.0% compared with 55.8% in the non-pCR group (p = 0.0007). In multivariate analyses, pCR was a favorable prognostic factor of overall survival (relative risk = 0.34; 95% confidence interval = 0.18-0.64) in addition to squamous-cell carcinoma, weight loss less than or equal to 5%, and stage-IB disease. Five-year disease-free survival was 80.1% in the pCR group compared to 44.8% in the non-pCR group (p < 0.0001). Two patients (4.9%) in the pCR group experienced disease recurrence compared to 193 patients (42.8%) in the non-pCR group. SCC subtype was the only independent predictor of pCR (odds ratio [OR] = 4.30; 95% confidence interval = 1.90-9.72). CONCLUSION:: Our results showed that pCR after preoperative chemotherapy was a favorable prognostic factor in stage-IB-II NSCLC. Our study is the largest published series evaluating pCRs after preoperative chemotherapy. The only factor predictive of pCR was squamous-cell carcinoma. Identifying molecular predictive markers for pCR may help in distinguishing patients likely to benefit from neoadjuvant chemotherapy and in choosing the most adequate preoperative chemotherapy regimen

Third-line chemotherapy in advanced non-small cell lung cancer: identifying the candidates for routine practice.

International audienceBACKGROUND: The interest of first- and second-line treatments in non-small cell lung cancer (NSCLC) has been demonstrated by successive randomized trials. Improvements in lung cancer care have routinely allowed a significant proportion of patients to be considered for third-line treatment. METHODS: A retrospective analysis was performed, including all consecutive patients with advanced NSCLC, who received at least three lines of systemic antineoplastic treatment at our institution. RESULTS: From a population of 613 patients treated with first-line treatment, a total of 173 patients received third-line treatment (cytotoxic chemotherapy in 131 patients; epidermal growth factor (EGFR) tyrosine kinase inhibitors in 42 patients). Only 13 patients (8%) received less than 75% of the theoretical dose intensity; 22 patients (13%) presented with severe toxicities. Symptom relief and performance status (PS) improvement were observed in 121 (92% of the 131 patients with symptoms) and 90 patients (52%), respectively. Using multivariate analysis, survival after third-line treatment was significantly increased in patients younger than 70 years-old (hazard ratio [HR] = 0.73, 95% confidence interval [CI]: 0.53-0.99, p = 0.047), who smoked less than 10 pack-years (HR = 0.82, 95% CI: 0.57-0.93, p = 0.036), with no cancer-related symptoms (HR = 0.75, 95% CI: 0.61-0.92, p = 0.007), a weight loss inferior to 5 kg since the beginning of second-line (HR = 0.63, 95% CI: 0.52-0.75, p = 0.013), a PS 0 to 1 (HR = 0.81, 95% CI: 0.76-0.86, p = 0.008), and no extrathoracic tumor spread at initiation of third-line treatment (HR = 0.67, 95% CI: 0.47-0.94, p = 0.042). Disease control after both first- and second-line treatments was the strongest predictor of prolonged survival after third-line treatment (HR = 0.47, 95% CI: 0.33-0.67, p = 0.001). CONCLUSIONS: Patients with advanced NSCLC may benefit from third-line treatment. The best candidates can be identified using standard prognostic factors, such as PS, and disease control after first- and second-line treatments

Le religieux sans la religion

L’actualité semble mettre en cause les pronostics d’un déclin du religieux. Comprendre les phénomènes de permanence, voire de « retours » multiformes de ce type de croyance, exige un recul historique. Or de nombreux philosophes et sociologues, à la charnière du XIXe et du XXe siècle, se sont efforcés de penser les soubresauts idéologiques d’une sécularisation de la société. C’est le cas en Europe de Comte, Bami, Buisson, Durkheim, Guyau, Quinet, Renan ou Weber, mais également de Dewey aux États-Unis, de Tolstoï en Russie ou de Rang Youwei en Chine. Toutes ces doctrines ont comme point commun de tenter d’arracher le religieux aux religions traditionnelles pour le réinterpréter dans un sens humaniste. Comment ces penseurs peuvent-ils éviter les dérives opposées du moralisme et du relativisme ? Et comment – eux qui se soucient d’éducation, à des titres divers – peuvent-ils concevoir d’éduquer sans absolu, du moins sans l’absolu des religions ? Ces penseurs ont quelque chose à nous dire aujourd’hui pour définir ou redéfinir notre rapport philosophique, politique ou éducatif aux religions et au religieux

[Appropriate cytotoxic drug usages in solid tumors: conformity to official labelling and level of scientific evidence]

International audienceThe definition of appropriate use of drugs is questioned in oncology. Daily therapeutic practices were compared to official labelling and to published scientific data in this retrospective study. It was carried out in two respective specialised centers, from January to September 2004. All chemotherapies administered for adult solid tumours and including one of the eleven studied drugs were evaluated. The analysis of use was performed by drug : conformity to the validated labelling and level of scientific evidence (at the period study). The study included 1,561 drug uses in 1,211 patients. The overall rate of conformity to official labelling was 81.7 % (67.1 % of strict conformity). In 73.8 % of cases, the indications were supported by at least one randomized phase III trial. The results appeared to be significantly different in rare tumours. The potential economic stake of the "contrat de bon usage" was estimated as less than 5 % in our study. This analysis showed an appropriate and controlled use of onerous drugs in solid tumours. The official labelling of drugs are unable to answer to all clinical situations. The definition of a sufficient level of evidence is mandatory for the use of scientific data in clinical practice. This process has to be adapted for rare tumours