31 research outputs found
Outcomes in newly diagnosed elderly glioblastoma patients after concomitant temozolomide administration and hypofractionated radiotherapy
This study aimed to analyze the treatment and outcomes of older glioblastoma patients. Forty-four patients older than 70 years of age were referred to the Paul Strauss Center for chemotherapy and radiotherapy. The median age was 75.5 years old (range: 70-84), and the patients included 18 females and 26 males. The median Karnofsky index (KI) was 70%. The Charlson indices varied from 4 to 6. All of the patients underwent surgery. O6-methylguanine-DNA methyltransferase (MGMT) methylation status was determined in 25 patients. All of the patients received radiation therapy. Thirty-eight patients adhered to a hypofractionated radiation therapy schedule and six patients to a normofractionated schedule. Neoadjuvant, concomitant and adjuvant chemotherapy regimens were administered to 12, 35 and 20 patients, respectively. At the time of this analysis, 41 patients had died. The median time to relapse was 6.7 months. Twenty-nine patients relapsed, and 10 patients received chemotherapy upon relapse. The median overall survival (OS) was 7.2 months and the one- and two-year OS rates were 32% and 12%, respectively. In a multivariate analysis, only the Karnofsky index was a prognostic factor. Hypofractionated radiotherapy and chemotherapy with temozolomide are feasible and acceptably tolerated in older patients. However, relevant prognostic factors are needed to optimize treatment proposals
Pronostic neurologique en cas dâarrivĂ©e retardĂ©e des premiers secours lors dâun arrĂȘt cardiaque extra-hospitalier
Introduction: We aimed to evaluate effect of a delay between the call and first emergency medical services (EMS) arrival longer than 20 minutes, on 30-days survival with favourable neurological outcome after out-of-hospital cardiac arrest (OHCA). We studied whether bystander cardiopulmonary resuscitation (CPR) influences this relationship or not. Methods: This is a retrospective, observational and multicentric study from the RENAU Cardiac Arrest Register between 2015 and 2020 in France. Exclusion criteria were EMS-witnessed OHCA, non-witnessed OHCA, no medical resuscitation attempted, and missing data. Favourable neurological outcome was defined as a cerebral performance category (CPC) score of 1 or 2. Results: 3410 patients were included. Among them, EMS response time was inferior to 20 minutes in 2 883 cases and superior or equal to 20 minutes in 527 cases. In univariate analysis, early EMS response time was significantly associated with increased 30-days survival with favourable neurological outcome (p < 0,01), as well as with 30-days survival, survival at discharge, and occurrence of return of spontaneous circulation. In multivariate analysis, early EMS response time was still significantly associated with 30-days favourable neurological outcome (adjusted OR 2,26, IC 95% [1,30 â 3,91]).Secondary analysis showed that 30-days favourable neurological outcome decreased as EMS response time increased, even after 5 minutes. Concerning bystander CPR, we found that EMS response time was significantly associated with CPC 1 or 2 survival only in case of bystander CPR. Conclusion: Delayed EMS response time was associated with decreased 30-days survival with favourable neurological outcome. Bystander CPR remained associated with 30-days favourable neurological outcome, even in case of late EMS arrival.Introduction : Lâobjectif de notre Ă©tude est dâĂ©valuer lâeffet dâun dĂ©lai dâarrivĂ©e des premiers secours non mĂ©dicalisĂ©s tardif (supĂ©rieur ou Ă©gal Ă 20 minutes) sur la survie Ă 30 jours avec un pronostic neurologique favorable (score CPC Ă 1 ou 2) aprĂšs la survenue dâun arrĂȘt cardiaque extra-hospitalier (ACEH). Nous nous sommes Ă©galement intĂ©ressĂ©s Ă lâinfluence de la rĂ©alisation dâune rĂ©animation cardiopulmonaire (RCP) par le tĂ©moin sur cette relation. MĂ©thodes : Il sâagit dâune Ă©tude rĂ©trospective, observationnelle et multicentrique Ă partir du registre des arrĂȘts cardiaques du RENAU entre 2015 et 2020. Les critĂšres dâexclusion Ă©taient la survenue de lâACEH devant les secours professionnels, lâabsence de tĂ©moin, lâabsence de tentative de rĂ©animation mĂ©dicale, et les donnĂ©es manquantes. RĂ©sultats : 3 410 patients ont Ă©tĂ© inclus, dont 2 883 avec un dĂ©lai dâarrivĂ©e des premiers secours infĂ©rieur Ă 20 minutes et 527 avec un dĂ©lai supĂ©rieur ou Ă©gal Ă 20 minutes. En analyse univariĂ©e, un dĂ©lai dâarrivĂ©e des secours infĂ©rieur Ă 20 minutes Ă©taient significativement associĂ© Ă une augmentation de la survie Ă 30 jours avec un pronostic neurologique favorable (p < 0,01), ainsi quâĂ une augmentation de la survie Ă 30 jours, de la survie Ă la sortie de lâhĂŽpital, et de la survenue dâune rĂ©cupĂ©ration dâactivitĂ© cardiaque spontanĂ©e. En analyse multivariĂ©e, une rĂ©ponse des premiers secours infĂ©rieure Ă 20 minutes restait significativement associĂ©e Ă une augmentation de la survie Ă 30 jours avec pronostic neurologique favorable, avec un Odds Ratio ajustĂ© Ă 2,26 (IC 95% [1,30 â 3,91]). En analyse secondaire, la survie avec pronostic neurologique favorable dĂ©croit avec lâaugmentation du dĂ©lai dâarrivĂ©e des secours, dĂšs 5 minutes. En sâintĂ©ressant Ă la rĂ©alisation dâune RCP par le tĂ©moin ou non, nous nâavons trouvĂ© une relation significative entre le dĂ©lai dâarrivĂ©e des secours et la survie Ă 30 jours avec pronostic neurologique favorable seulement en cas de RCP par le tĂ©moin. Conclusion : Un dĂ©lai dâarrivĂ©e des premiers secours tardif est associĂ© Ă une baisse de la survie Ă 30 jours avec pronostic neurologique favorable. La rĂ©alisation dâune RCP par le tĂ©moin reste associĂ©e Ă la survie avec bon pronostic neurologique, mĂȘme en cas dâarrivĂ©e tardive des premiers secours
RÎle des inhibiteurs de CDK dans la différenciation conjointe de l'ovocyte et des cellules du cumulus chez le bovin
Chez le bovin, l'ovocyte bloquĂ© en prophase mĂ©iotique acquiĂšre sĂ©quentiellement son aptitude Ă reprendre la mĂ©iose, puis Ă se dĂ©velopper. Cette pĂ©riode de diffĂ©renciation terminale permet le stockage d'ARN et de protĂ©ines, probablement nĂ©cessaires au dĂ©veloppement embryonnaire prĂ©coce. Les ovocytes sortis du follicule reprennent spontanĂ©ment la mĂ©iose. Une Ă©tape de prĂ©-culture, mimant le blocage mĂ©iotique, pourrait leur permettre d'achever cette diffĂ©renciation in vitro. Nous avons montrĂ© que l'utilisation de la roscovitine, inhibiteur spĂ©cifique du MPF, permet de cultiver des ovocytes en arrĂȘt mĂ©iotique sans dĂ©tĂ©riorer leur compĂ©tence au dĂ©veloppement, ni la fonctionnalitĂ© des cellules du cumulus. Cette molĂ©cule nous a aussi permis d'amĂ©liorer notre comprĂ©hension des rĂ©gulations du cycle cellulaire de l'ovocyte bovin et plus prĂ©cisĂ©ment de mettre en Ă©vidence l'existence d'au moins une voie de signalisation non directement liĂ©e Ă l'activitĂ© du MPF. Ces connaissances devraient permettre de dĂ©finir des conditions de culture optimisĂ©es mais aussi la comprĂ©hension des mĂ©canismes de reprise de la mĂ©iose des ovocytes et le discernement des Ă©vĂ©nements liĂ©es Ă l'activitĂ© du MPF durant cette reprise.In bovine, oocytes which are blocked in meiotic prophase acquire sequentially their competence to resume and complete meiosis and the potential for development. This period of oocyte terminal differentiation allows the storage of maternal RNA and proteins necessary for embryos development. In vitro, as son as extracted from their follicular environment, oocytes spontaneously resume meiosis. A preliminary culture allowing the maintenance of oocytes at meiotic prophase might allow them to complete this differentiation step in vitro. We showed that the use of roscovitine allowed maintaining oocytes in meiotic block without loss of developmental potential, nor cumulus cells functionalities. This work will allow improving the culture conditions of bovine oocytes in order to increase their final developmental competence and will allow a better understanding the mechanisms of meiosis resumption control in oocytes and to distinguish between the events that are related to MPF activation or not in this complex process.TOURS-BU Sciences Pharmacie (372612104) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF
Médulloblastomes (étude rétrospective portant sur 52 enfants et 21 adultes)
STRASBOURG-Medecine (674822101) / SudocSudocFranceF
Evaluation of the chemical and optical perturbations induced by Ar plasma on InP surface
International audienc
Development of a multi-technique approach for an accurate and advanced physico-chemical characterization of solar modules: from absorbers to cells
International audienc
Coupling GD-OES and XPS profiling to perform advanced physico-chemical characterizations of III-V layers for photovoltaic applications
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