Éclaircissement dentaire sur dents vitales : avec ou sans intervention du chirurgien-dentiste

In the current society, patients are increasingly concerned about the color of their teeth and are turning to the practice of tooth bleaching. Some tooth discoloration can be supported by the dentist by tooth bleaching in chair or ambulatory technique on vital teeth. These techniques using hydrogen peroxide can be very effective but can be also a source of undesirable effects on oral health. Otherwise, patients can also use products that don’t require the supervision of the dentist. These products are available over the counter or can be “homemade”. There are also “smile bars” which the opening is not conditioned by any recognized diploma. However, all these techniques, with or without resort to a dentist, are regulated by the European Union on their composition and their utilization. Thus, we tried to take stock of the different techniques available in order to determine their effectiveness and possible complications.Dans la société actuelle, les patients sont de plus en plus préoccupés par la couleur de leurs dents et se tournent vers la pratique de l’éclaircissement dentaire. Certaines dyschromies dentaires peuvent être prises en charge par le chirurgien-dentiste par éclaircissement dentaire au fauteuil ou par technique ambulatoire sur dents vitales. Ces techniques, utilisant du peroxyde d’hydrogène, peuvent présenter une réelle efficacité mais peuvent aussi être source d’effets indésirables pour la santé bucco-dentaire. Par ailleurs, les patients peuvent également avoir recours à des produits ne nécessitant pas la supervision du chirurgien-dentiste. Ces produits sont en vente libre ou peuvent être « faits maison ». Il existe également des « bars à sourire » dont l’ouverture n’est conditionnée par aucun diplôme reconnu. Néanmoins, toutes ces techniques, qu’elles soient avec ou sans recours au chirurgien-dentiste, sont réglementées par l’Union Européenne sur leur composition et leur utilisation. Ainsi, nous avons tenté de faire le point sur les différentes techniques disponibles afin d’en déterminer leur efficacité et complications éventuelles

De la sénéscence à la démence (pathologie et traitement)

MONTPELLIER-BU Pharmacie (341722105) / SudocSudocFranceF

L'alimentation des Guadeloupéens

MONTPELLIER-BU Pharmacie (341722105) / SudocSudocFranceF

A propos de quelques drogues hallucinogènes à alcaloïdes indoliques

MONTPELLIER-BU Pharmacie (341722105) / SudocSudocFranceF

Thrombophilie et grossesse ( Quelle place pour le bilan de thrombophilie en obstétrique en 2013)

REIMS-BU Santé (514542104) / SudocSudocFranceF

Papillome mammaire : comment je fais… une pyramidectomie guidée par un fil de crin

International audienc

Serum CA125 and HE4 levels as predictors for optimal interval surgery and platinum sensitivity after neoadjuvant platinum-based chemotherapy in patients with advanced epithelial ovarian cancer

International audienceBackground: The aim of this study is to evaluate a new tumour marker, HE4, and to compare it with CA125 in predicting optimal cytoreduction and response to chemotherapy. Thirty patients with advanced epithelial ovarian cancer and multiple sera harvested during neoadjuvant chemotherapy (NAC) were included. Results: Based on ROC curves analysis, CA125 ≤ 75 UI/ml and HE4 ≤ 252 pmol/L after the 3rd cycles of NAC, with a sensitivity of 93.7 % and a specificity of 92.3 % (PPV = 93.7 % and NPV = 92.3 %), offered the best combination for predicting optimal cytoreduction. In addition, the HE4 value of 115 pmol/L is the best cut-off level for identifying platinum-sensitive patients. Conclusions: The introduction of HE4 as a new tool for predicting platinum-sensitivity and interval optimal cytoreduction is promising

Syndrome du choc toxique staphylococcique après chirurgie du sein

International audienceThe surgical site infection occurs within 30 days after surgery. It is the most common complication of surgery, with a rate of 1 to 5% without antibiotic prophylaxis and less than 1% with antibiotic prophylaxis. The toxic shock syndrome (TSS) is a dramatic complication. We report the case 39-year-old woman who presented a life-threatening TSS acquired after breast surgery. We describe the signs and symptoms of this condition as well as treatment principles

Value of diaphragmatic surgery during interval debulking surgery

International audienceBackground/Aim: The aim of this study was to assess the value of diaphragmatic surgery to achieve optimal debulking in patients with advanced ovarian cancer treated by neoadjuvant chemotherapy (NAC). Patients and Methods: This is a retrospective review of the medical records of 182 patients. Diaphragmatic surgery was performed during interval debulking surgery (IDS) in 74 patients between January 2002 and December 2014. The patients were divided in 2 groups: with or without histological residual diaphragmatic disease. The time-course of serum CA125 levels, cytoreductive outcome, overall survival (OS) and relapse-free survival (RFS) were analyzed. Patients without diaphragmatic peritonectomy (DP) during IDS were included in the survival analysis. Results: One hundred thirty-two (72.5%) patients had FIGO stage III disease and 43 (23.6%) patients had stage IV disease. Histological examination of DP was positive in 45 patients and negative in 29 patients. CA125 normalization after the 3rd cycle of NAC was significantly associated with negative DP. OS tended to be higher in the DP-negative group (37.8 months vs 19 months, p=0.1). Median OS was 40.7 months in the case of IDS without DP and 22 months in the case of IDS with DP (p=0.048). Conclusion: Evaluation of residual diaphragmatic disease can be difficult after NAC. The CA125 tumor marker appears to be a useful tool to define the indications for DP. Diaphragmatic surgery after NAC may be of limited val

Impact of neoadjuvant chemotherapy on the rate of bowel resection in advanced epithelial ovarian cancer

International audienceAim: To assess the decrease in the number of bowel resections (BR) necessary to achieve complete cytoreduction (CC-0) in advanced epithelial ovarian cancer (EOC) permitted by neoadjuvant chemotherapy (NAC). Patients and Methods: Patients were selected from a population of advanced EOC cases diagnosed between 2002 and 2009 at the Curie Institute: 97 patients with Federation International of Gynecology and Obstetrics IIIc and IV with unresectable disease treated with NAC followed by interval debulking surgery were included. We proceeded to a systematic blinded review of all the surgical reports pre-and post-NAC by two different surgeons to assess the surgical procedures required to obtain CC-0. Results: Before NAC, at least 84 patients (87%) would have required BR to obtain a CC-0 resection. At interval debulking surgery, 47 (49%) still required a BR, which corresponds to a decrease of 38% (p<0.0001). The same decrease was observed for resection of small bowel, colon and rectosigmoid, as follows: 54 to 17 (77% to 24%, p<0.0001), 45 to 19 (56% to 24%, p<0.0001) and 72 to 25 (90% to 31%, p<0.0001), respectively. The median overall survival (OS) among CC-0 patients with and without BR was 57 months [95% confidence interval (CI)=25-90 months] and 50 months [95% CI=43-57 months], respectively (p=0.71). The OS among patients without complete resection was significantly worse, with a median of 21 months (95% CI=17-32 months, p<0.0001). Conclusion: NAC significantly reduces the need and rate of BR in advanced EOC, but also of small bowel, colon and rectosigmoid resection. There is no loss of OS, after BR especially if the debulking surgery is comple