Impacted and Fractured Biliary Basket: A Second Basket Rescue Technique

A 59-year-old woman was treated with ERCP, ES, and biliary plastic stent, for large and multiple common bile duct stones. During a second ERCP basket extraction was impacted with a round entrapped stone. The basket handle was cut off; a metal sheath of extraendoscopic lithotriptor was advanced over the basket. The mechanical lithotripsy was complicated with basket traction wires fracturing, without breakage of the stone. A rescue standard basket was pushed until it caught the basket/stone complex. Using this method disengagement of the whole fractured basket/stone complex was achieved without need of surgery. It is the third case reported in the English literature

Case Report Impacted and Fractured Biliary Basket: A Second Basket Rescue Technique

A 59-year-old woman was treated with ERCP, ES, and biliary plastic stent, for large and multiple common bile duct stones. During a second ERCP basket extraction was impacted with a round entrapped stone. The basket handle was cut off; a metal sheath of extraendoscopic lithotriptor was advanced over the basket. The mechanical lithotripsy was complicated with basket traction wires fracturing, without breakage of the stone. A rescue standard basket was pushed until it caught the basket/stone complex. Using this method disengagement of the whole fractured basket/stone complex was achieved without need of surgery. It is the third case reported in the English literature

Safety and efficacy of granulocyte/monocyte apheresis in steroid-dependent active ulcerative colitis with insufficient response or intolerance to immunosuppressants and/or biologics (ART trial): 12-week interim results

International audienceBACKGROUND AND AIMS: Patients with active, steroid-dependent ulcerative colitis with insufficient response or intolerance to immunosuppressants and/or biologic therapies have limited treatment options. Adacolumn, a granulocyte/monocyte adsorptive apheresis device, has shown clinical benefit in these patients. This study aimed to provide additional clinical data regarding the safety and efficacy of Adacolumn in this patient subgroup.METHODS: This single arm, open-label, multicentre trial (ART) was conducted at 18 centres across the UK, France and Germany. Eligible patients were 18-75 years old with moderate-to-severe, steroid-dependent active ulcerative colitis with insufficient response or intolerance to immunosuppressants and/or biologics. Patients received ≥5 weekly apheresis sessions with Adacolumn. The primary endpoint was clinical remission rate (clinical activity index ≤4) at Week 12.RESULTS: Eighty-six patients were enrolled. At Week 12, 33/84 (39.3%) of patients in the intention-to-treat population achieved clinical remission, with 47/84 (56.0%) achieving a clinical response (clinical activity index reduction of ≥3). Clinical remission was achieved in 30.0% of patients with prior immunosuppressant and biologic failure; steroid-free clinical remission and response were observed in 22.6% and 35.7% of these patients, respectively. Quality of life (Short Health Scale) significantly improved at Week 12 (p\textless0.0001). The majority of adverse events were of mild/moderate intensity.CONCLUSIONS: At Week 12, Adacolumn provided significant clinical benefit in a large cohort of steroid-dependent ulcerative colitis patients with previous failure to immunosuppressant and/or biologic treatment, with a favourable safety profile. These results are consistent with previous studies and support Adacolumn use in this difficult-to-treat patient subgrou

Evaluation du traitement par dilatation pneumatique du mégaoesophage idiopathique

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

RESULTAT DU TRAITEMENT PAR REMICADE DES FISTULES ANO-PERINEALES DANS LA MALADIE DE CROHN.

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

L'apport du modèle de concurrence monopolistique à l'économie bancaire

The monopolistic competition model and banking theory We show that the Salop [1979] monopolistic competition model can reveal very useful in banking theory. We first recall several of its recent applications to the modeling of competition between bank branches (Chiappori et ali [1992], Grimaud-Rochet [1993a], Matutes-Padilla [1991]). Then we show that it can provide as well simple and robust specifications for the monetary and financial part of a macro-model with an explicit description of deposit, credit and asset markets.L'apport du modèle de concurrence monopolistique à l'économie bancaire Le modèle de concurrence monopolistique de Salop [1979] est très utilisé en économie industrielle. Il peut s'avérer également très utile en économie bancaire. Après avoir rappelé quelques applications récentes de ce modèle à la formalisation de la concurrence entre réseaux bancaires (Chiappori et al. [1992], Grimaud-Rochet [1993a], Matutes-Padilla [1991]), nous montrons qu'il peut fournir aussi des spécifications simples et solides à la partie monétaire et financière d'un modèle macro-économique où sont décrits explicitement les marchés des dépôts, des crédits et des titres financiers.Grimaud André, Rochet Jean-Charles. L'apport du modèle de concurrence monopolistique à l'économie bancaire. In: Revue économique, volume 45, n°3, 1994. pp. 715-726

Evaluation des facteurs prédictifs de réponse au traitement initial du reflux gastro-oesophagien

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF