Les artériopathies périphériques juvéniles (revue de la littérature)

BESANCON-BU Médecine pharmacie (250562102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Preoperative radiotherapy and radical surgery as combined treatment in rectal cancer.

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Interim analysis of a phase III study on preoperative radiation therapy in resectable rectal carcinoma. Trial of the Gastrointestinal Tract Cancer Cooperative Group of the European Organization for Research on Treatment of Cancer (EORTC)

To improve surgical results of potentially operable rectal cancer (T2, T3, T4, Mo), the European Organization for Research on Treatment of Cancer (EORTC) conducted a two-arm randomized clinical trial to evaluate the effect of administering radiotherapy before radical surgery. Four hundred ten patients were allocated to be treated either by surgery alone or by 34.5 Gy of radiotherapy (in 19 days overall) followed by surgery. The tolerance of the adjuvant radiation therapy was fairly good. The 5-year survival rate was 65% overall and showed no difference between both therapeutic regimens. Similarly, the metastases-free rate was the same in both groups. In contrast, the preoperative radiation therapy showed a marked effect on local control of the disease, the comparison of the time to local recurrence being highly significant between the two treatment groups (P = 0.001). The proportion of patients free of local recurrence at 5 years was 85% in the combined treatment versus 65% in the group of patients treated by surgery alone.SCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe

Novel risk factors for premature peripheral arterial occlusive disease in non-diabetic patients: a case-control study.

BACKGROUND: This study aimed to determine the prevalence of genetic and environmental vascular risk factors in non diabetic patients with premature peripheral arterial disease, either peripheral arterial occlusive disease or thromboangiitis obliterans, the two main entities of peripheral arterial disease, and to established whether some of them are specifically associated with one or another of the premature peripheral arterial disease subgroups. METHODS AND RESULTS: This study included 113 non diabetic patients with premature peripheral arterial disease (diagnosis <45-year old) presenting either a peripheral arterial occlusive disease (N = 64) or a thromboangiitis obliterans (N = 49), and 241 controls matched for age and gender. Both patient groups demonstrated common traits including cigarette smoking, low physical activity, decreased levels of HDL-cholesterol, apolipoprotein A-I, pyridoxal 5'-phosphate (active form of B6 vitamin) and zinc. Premature peripheral arterial occlusive disease was characterized by the presence of a family history of peripheral arterial and carotid artery diseases (OR 2.3 and 5.8 respectively, 95% CI), high lipoprotein (a) levels above 300 mg/L (OR 2.3, 95% CI), the presence of the factor V Leiden (OR 5.1, 95% CI) and the glycoprotein Ia(807T,837T,873A) allele (OR 2.3, 95% CI). In thromboangiitis obliterans group, more patients were regular consumers of cannabis (OR 3.5, 95% CI) and higher levels in plasma copper has been shown (OR 6.5, 95% CI). CONCLUSIONS: According to our results from a non exhaustive list of study parameters, we might hypothesize for 1) a genetic basis for premature peripheral arterial occlusive disease development and 2) the prevalence of environmental factors in the development of thromboangiitis obliterans (tobacco and cannabis). Moreover, for the first time, we demonstrated that the 807T/837T/873A allele of platelet glycoprotein Ia may confer an additional risk for development of peripheral atherosclerosis in premature peripheral arterial occlusive disease

PCR analysis of genomic DNA encoding the glycoprotein Ia gene surrounding the 807, 837 and 873 polymorphisms.

<p><i>(A)</i> Amplified products (1332 bp) were resolved by 1% agarose gel electrophoresis and stained with ethidium bromide. Lane 1: molecular weight marker; lane 2: blank; lanes 3 to 11: different genotyped individuals. <i>(B)</i> Analysis of <i>ITGA2^{807C/T, 837C/T, 873 G/A}</i> polymorphisms by PCR-RFLP using <i>Bgl II</i> and <i>Asn I</i> endonucleases on 1.5% agarose gel. Lane 7: molecular weight marker; other lanes: different genotypes according to reference 29 (lanes 1, 4, 5: 2/2, lanes 2, 3, 6: 1/2, lane 7: 1/3, lane 8: 2/3, lane 9: 1/1).</p

Clinical Characteristics of the Study Sample.

<p>Results as mean ± SD; ns: no significant different when p>0.05.</p><p>(PPAD, premature peripheral arterial diseases; PAOD, peripheral arterial occlusive disease; TAO, thromboangiitis obliterans).</p

Risk Factors for PAOD Patients and TAO.

*<p>p<0.001, †p<0.01, ‡ p<0.05, ns: no significant different when p>0.05.</p><p>(PAOD, peripheral arterial occlusive disease; TAO, thromboangiitis obliterans).</p

Cardiovascular Risk Factors in the Study Sample.

<p> <b>Results as mean ± SD; ns: no significant different when p>0.05.</b></p>*<p>THC: tetrahydrocannabinol, † Lp(a): lipoprotein(a), ‡ hsCRP: ultrasensible C-reactive protein.</p><p>(PPAD, premature peripheral arterial diseases; PAOD, peripheral arterial occlusive disease; TAO, thromboangiitis obliterans).</p