Tumeur urothéliale de vessie chez le patient " fragile ". [Management of bladder cancer in unfit patients.]

International audienceAdjuvant therapies in bladder cancer are based on risk of recurrence and associated comorbidities (renal failure). Lymph node involvement is the most important prognostic factor for decision. Two adjuvant chemotherapies exist: MVAC or GC. In unfit patients, association (Gemcitabine and Taxanes) could be proposed. Indication of adjuvant radiotherapy depends on metastatic risk and resection margins. Concomitant chemotherapy and radiotherapy should be proposed to selected patients who refuse or are not candidate for radical cystectomy

Intermediate analysis of a phase II trial assessing gemcitabine and cisplatin in locoregional or metastatic penile squamous cell carcinoma

International audienceOBJECTIVE:To perform a phase II study evaluating a combination of gemcitabine and cisplatin in a population of patients with squamous cell carcinoma (SCC) of the penis and unresected locoregional lymph nodes and/or distant metastases, who had a poor prognosis with no standard of chemotherapy.PATIENTS AND METHODS:Eligible patients had histologically confirmed SCC of the penis with unresected locoregional lymph nodes and/or distant metastases, at initial diagnosis or at relapse, and measurable disease as defined by Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Patients were treated with a combination of gemcitabine 1250 mg/m(2) on day 1 over 30 min and cisplatin 50 mg/m(2) on day 1 over 1 h, every 2 weeks. The primary endpoint was the objective response rate; secondary endpoints were time to progression (TTP) and overall survival (OS).RESULTS:In all, 25 patients were included in the first phase of the study between February 2004 and January 2010 and received a median of five cycles. For the intent-to-treat population, two patients (95% confidence interval [CI] 0.98-26.0) presented an objective response and 13 patients (52%) had stable disease (95% CI 35.5-76.8). The median TTP was at 5.48 months (95% CI 2.40-11.73). After a median follow-up of 26.97 months (95% CI 17.77, not reached), nine patients were still alive. The median OS and 2-year OS rate were respectively estimated at 14.98 months (95% CI 9.76-32.9) and 39.32% (95% CI 19.15-59.03). Eleven patients had a serious adverse event (44%), 24% being relied to chemotherapy.CONCLUSION:Every 2 weeks' administration of the combination of gemcitabine and cisplatin showed non-significant responses in patients with unresected locoregional or metastatic penile SCC. Despite manageable side-effects, this combination cannot be recommended as a standard of care, due to disappointing response rates seen in this negative study. Further regimens should be explored to improve the OS of these patients with poor prognosis

Hydrodynamisme dans les aquifères de socle cristallin et cristallophyllien du Sud-Ouest de la Côte d'Ivoire (cas du département de Soubré)

Les outils de la télédétection, de la géomorphologie et de l hydrogéochimie ont été utilisés pour caractériser la circulation des eaux souterraines dans les aquifères de socle d une partie du bassin versant du Sassandra située dans le Sud-Ouest de la Côte d Ivoire. La distribution des espacements entre les linéaments observés obéit à un processus de poisson et il a été estimé que 17 % de linéaments de taille inférieure à 2,1 km n ont pas été cartographiés. Ce champ de linéaments a été étudié par analyse d image pour aboutir à une structuration des aquifères en blocs individualisés. Cette approche a permis d étudier de l hydrodynamisme dans les aquifères discontinus à l échelle locale. Les conditions d emmagasinement et de circulation des eaux souterraines ont été approchées par l utilisation des ions majeurs de l eau. Les eaux calciques, peu ou moyennement minéralisées, sont issues des zones en amont du bassin versant où la recharge des nappes, se fait assez vite à travers certains chemins préférentiels. Les eaux sodiques sont localisées pour la majorité en aval du bassin versant où l infiltration des eaux fortement évaporées et les échanges des cations prédominent. Les terrains présentent des altitudes s échelonnant de 70 m à 210 m avec des pics ponctuels par endroits qui s élèvent jusqu à 450 m avec et des pentes qui oscillent de 2 à 4 %. L analyse des épaisseurs d altérites met en évidence un contrôle par la lithologie et une épaisseur est moins forte dans les vallées des principaux cours d eau. La modélisation piézométrique montre que le bassin versant hydrogéologique reproduit le bassin versant hydrologique à une dizaine de mètres de profondeur avec quelques variations.Remote sensing, geomorphology, and hydrogeochemistry methods were used to characterize the ground water flow in this part of the Sassandra River watershed that lies in the Southwest of Ivory Coast. The distribution of the spacing between the lineaments obeys a process of Poisson which allowed estimating that 17 % of lineaments of size inferior to 2.1 km were not mapped. This network of lineaments has been analysed in order to obtain a statistical characterisation of the geometry of the aquifer blocs in the bedrock. This approach allowed studying the hydrodynamism to the local scale. The groundwater is mainly of type Ca-HCO3 or Na-HCO3. The conditions of the groundwater storage and circulation in the bedrock are studied here by using major ions. The calcic water, little or moderately mineralized is ensued from some zones of the watershed where the recharge is quite fast through some preferential paths. The sodic water is largely located at the downstream of the watershed, where the water infiltration strongly evaporated, and the cations exchange are the prevailing phenomena. The altitudes of the grounds spreading out from 70 to 210 m, with some punctual peaks of 450 m in places, and some slopes ranging from 2 to 4%. The regolith thickness pointed out a control by the lithology, and a layer less thick in the main stream s channel valleys. From borehole data and the water level in the hydrographical network, we show that the hydrogeological watershed is a subdued version of the hydrological watershed at a depth of 10 m with some variations.PARIS-CNAM (751032301) / SudocSudocFranceF

Contribution of the triple oxygen isotope composition of precipitation to the identification of surface-atmosphere interactions in the sub-humid part of West Africa

International audienceThis study aims at evaluating the information carried by the 17O-excess composition of precipitation in the sub-humid part of West Africa. Located at the southern border of the Sahelian band, the so-called “Sudanian Climatic Zone”, characterized by annual precipitation of 1200-1400mm, plays a crucial role in providing water to large African watersheds such as the Niger river’s one, and the Lake Chad catchment. Surface-atmosphere interactions were shown to influence convective processes in the semi-arid Sahelian band, with positive feedbacks between vegetation land cover and rainfall. Less focus has been put on the more humid Sudanian Zone, although surface-atmosphere interactions may have an important influence on the control of rainfall variations, and therefore on water resource availability in these watersheds

Art contemporain et Cultural studies

Les Cultural studies recouvrent des domaines et perspectives d’investigation extrêmement variés. La revue Marges a choisi de se pencher sur les relations que ce champ de recherche entretient avec le domaine de l’art contemporain. La démarche se focalise à la fois sur des démarches singulières d’artistes et sur des questions plus larges (le statut de la danse contemporaine dans les pays du tiers monde ou les pratiques artistiques féministes et/ou pornographiques). « Art contemporain et Cultural Studies » s’inscrit dans une suite d’études menées par la revue Marges sur les conditions de la création en ce début de 21e siècle. Après « Valeurs de l’art contemporain », « Expositions sans artistes », « Langages de l’œuvre et de l’art », « Au-delà du Land Art » et « Démocratiser l’art [contemporain] », il est question cette fois-ci de poser le problème des limites entre art (contemporain) et pratiques culturelles (légitimes et illégitimes)

Extraction and quantification of pesticides and metals in palm wines by HS-SPME/GC–MS and ICP-AES/MS

International audienc

Prognosis of patients receiving induction chemotherapy for locally advanced or lymph node metastatic bladder cancer

International audienceBackground: Induction chemotherapy is recommended before surgery for unresectable muscle-invasive bladder cancer, locally advanced or lymph node disseminated disease. These patients’ prognoses cannot be extrapolated from data regarding neoadjuvant chemotherapy, which is performed in operable patients. Objective: We assessed the prognosis of patients undergoing induction chemotherapy for locally advanced or lymph node metastatic bladder cancer. Methods: We analysed patients with cT4NxM0 or cTxN+M0 bladder cancer treated by induction chemotherapy between 2006 and 2016. The tumour extension and node invasion was determined by imaging or histologically after upfront lymph node dissection. Clinical, biological, pathological and patient follow-up data were identified. Kaplan–Meier survival curves were compared by log rank test. Factors associated with the response to induction chemotherapy, operability of patients and survival were determined by multivariable logistic regression. Results: Among 70 patients included in the analysis, 51 (73%) showed response to induction chemotherapy. Progression-free and overall survival were improved in responder patients compared with non-responders (P<0.0001 and P=0.025, respectively) and for patients who underwent surgery compared with non-operated patients (both P<0.001). On multivariable analysis, poor response was associated with chemotherapy other than methotrexate, vinblastine, doxorubicin and cisplatin (P=0.016), operability with late response (P=0.0024) and overall survival with surgery after induction chemotherapy (P=0.0014). Conclusions: Surgery after induction chemotherapy with methotrexate, vinblastine, doxorubicin and cisplatin may improve prognosis with locally advanced or lymph node metastatic bladder cancer. Level of evidence: 4