W-band TWTs for new generation high capacity wireless networks

The congestion of the spectrum actually devoted to wireless networks has stimulated the exploitation of the wide availability of frequencies in the millimeter wave range. The high atmospheric attenuation and the strong detrimental rain effect require level of power not available by solid state power amplifiers typically used at microwave frequency. The lack of power has so far limited the use of millimeter wave range. The massive use of Traveling Wave Tubes as power amplifier in high capacity wireless networks will be the breakthrough in the development of the future millimeter wave network fundamental for the 5G development. The H2020 TWEETHER project aims at a new wireless network concept based on TWTs to distribute data in the millimeter wave portion of the spectrum

Evaluation de l intérêt de la consultation d oncogériatrie auprès des médecins généralistes (étude rétrospective sur les données de l unité de coordination d oncogériatrie de Bourgogne)

Contexte : Face au vieillissement de la population française et l incidence croissante des cancers chez les personnes âgées de 75 ans et plus, l oncogériatrie est une véritable discipline en devenir.Cette étude rétrospective avait pour objectif principal d évaluer l intérêt de la consultation d oncogériatrie auprès des médecins généralistes.Matériels et méthodes : Un questionnaire, validé par le comité scientifique de l Unité de Coordination en OncoGériatrie de Bourgogne, a été envoyé à tous les médecins traitants de patients, âgés de 75 ans et plus, ayant bénéficié d une consultation en 2012.Résultats : Sur les 284 questionnaires envoyés, 126, correspondants aux données de 126 patients suivis par 94 médecins traitants, étaient exploitables, soit un taux de réponse analysable de 44,4%.Les cancers gynécologiques dont une forte proportion du cancer du sein (82,6%) était le type de cancer le plus représenté (40,7%) chez les patients des médecins répondeurs.Les médecins, majoritairement âgés de 50-60 ans, exerçaient principalement en Côte d Or et en milieu urbain. Il n existait pas de différence significative selon le sexe, le lieu d exercice (urbain/rural) et la localisation cancéreuse des patients en ce qui concerne les médecins répondeurs et non répondeurs.Au total, 79,8% des médecins adressaient systématiquement leur patient âgé cancéreux à un spécialiste d organe.Les médecins déclaraient avoir reçu un compte-rendu de consultation dans 70,4% des cas, dans un délai qui leur paraissait raisonnable. Un plan de soin était proposé dans 85,6% des cas et influençait la prise en charge dans 70,5% des cas.Les propositions faites par l oncogériatre avaient pu être mise en œuvre sans difficultés dans des cas, ceci, indépendamment du type de cancer ou du lieu d exercice du médecin. Dans 97,6% des cas, les médecins traitants étaient satisfaits de ces propositions et dans 76% des cas satisfaits ou très satisfaits de la consultation d oncogériatrie. Ainsi, dans 92,6% des cas les médecins traitants étaient désireux d une nouvelle consultation pour un de leur patient et de formation dans ce domaine.Conclusion : La consultation d oncogériatrie semble être utile aux médecins généralistes dans la mesure où un plan de soins est proposé et que les recommandations peuvent être mise en place sans trop de difficultés. Reste, cependant, le problème du manque de communication et de la réception du courrier qui peut mettre en danger le concept de soins partagés dont le but premier est d améliorer la prise en charge de ces patients.DIJON-BU Médecine Pharmacie (212312103) / SudocSudocFranceF

L' hospitalisation à domicile (historique, données actuelles et étude de la faisabilité sur une population gériatrique)

DIJON-BU Médecine Pharmacie (212312103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Troubles cognitifs chez le sujet âgé atteint de cancer

DIJON-BU Médecine Pharmacie (212312103) / SudocSudocFranceF

A case of meningitis due to Achromobacter xylosoxidans denitrificans 60 years after a cranial trauma

Import JabRef | WosArea Research and Experimental MedicineInternational audienceBackground: Achromobacter xylosoxidans (AX) is a non-fermentative aerobic Gram-negative bacillus. It is an opportunistic pathogen and the causative agent of various infections. We report an original case of late posttraumatic meningitis due to AX denitrificans. Case Report: An 83-year-old man was hospitalized for acute headache, nausea and vomiting. The emergency brain computer tomography (CT) scan did not reveal any anomaly. In his medical history, there was an auditory injury due to a cranial trauma incurred in a skiing accident 60 years earlier. Cytobiochemical analysis of the cerebrospinal fluid (CSF) revealed increased levels of neutrophils and proteins. The CSF bacterial culture was positive: the Gram stain showed a Gram-negative bacillus, oxidase + and catalase +, and the biochemical pattern using the API 20 NE strip revealed AX dentrificans. Late posttraumatic meningitis on a possible osteomeningeal breach was diagnosed even though the breach was not confirmed because the patient declined a second brain CT scan. The patient was successfully treated with meropenem. Conclusions: This report demonstrates the importance of searching for unusual or atypical organisms when the clinician encounters meningitis in a particular context, as well as the importance of adequate follow-up of craniofacial traumas

Assessment of the interest of the geriatric oncology consultation among French general practitioners

International audienceOBJECTIVE: We assessed the interest of the geriatric oncology (GO) consultation (GOC) among general practitioners (GPs). MATERIALS AND METHODS: We conducted a survey among GPs whose patients had had a GOC in 2012. A questionnaire was sent to GPs. The 1st part collected GPs' characteristics including medical education in geriatrics and GO, and knowledge of GOC. The following parts concerned the GOC and included the cancer type, GOC report and care plan. RESULTS: One-hundred twenty-six questionnaires corresponding to 94 GPs were collected. Concerning the GPs' characteristics, age range 50-59 (44.7%), men (62.8%) and urban practice (79.8%) were the most represented, 80.8% had no expertise in geriatrics, 60.6% knew of the existence of GOCs, and 14.9% had received medical education in GO. The most frequent cancer location was gynecological (40.7%) (82.6% were breast cancers). Of the GPs, 69.8% had received a GOC report and 92% were (very) satisfied with the delivery time. A care plan was proposed after the GOC in 83% of cases. It was satisfactory in 96.4% of cases, and applied by 74.7% of GPs. Sixteen percent of GPs were called by the GO team. The less the GP was satisfied with the GOC, the more he or she wanted phone contact (p=0.02); 94% of GPs considered the GOC (very) satisfactory. Sixty-seven percent of GPs wanted to be trained in GO. CONCLUSION: Very few GPs had been trained in geriatrics and/or GO. They were mostly satisfied with GOC and expressed a wish to be trained in GO

Management of elderly patients suffering from cancer: Assessment of perceived burden and of quality of life of primary caregivers

International audienceObjective: To evaluate the perceived burden and the quality of life (QoL) at 3 and 6 months of the primary caregiver (PC) of patients aged 70 and over suffering from cancer and the predictors of QoL in this population.Methods: In this prospective observational study, 98 patients aged 70 and older with cancer and 96 PCs were included between 01/06/2014 and 18/03/2015. The Medical Outcomes Study 12-item Short Form Health Survey (SF-12) was used to assess the QoL of PCs and the Zarit Burden Interview (ZBI) was used to measure the perceived burden at 3 and 6 months. The major determinants of QoL were identified using mixed linear models for the dimensions of the SF-12 that showed an average difference of at least 5 points between baseline and follow-up at 6 months.Results: The QoL scores of PCs showed a decrease in the dimensions "role emotional" and "bodily pain" over 6 months. In multivariate analysis, the main determinants of QoL for "role emotional" were the PC's age (p = 0.005), a low perceived burden (p < 0.0001) and a functionally independent patient (p = 0.01), and for "bodily pain" was a low perceived burden (p < 0.0001) and the non-use of hormone therapy during the treatment (p < 0.0001).Conclusion: The main determinants of the QoL of PCs concerned factors inherent to the PC (age and perceived burden) and patient (functional independence)

Folfirinox in elderly patients with pancreatic or colorectal cancer-tolerance and efficacy

International audienceAIMTo study the tolerance and the efficiency of FOLFIRINOX in elderly patients diagnosed with colorectal or pancreatic cancer.METHODSThis retrospective study included elderly patients aged over 70 years of age treated at Georges-Francois Leclerc Center by FOLFIRINOX for histological proved colorectal or pancreatic cancer between January 2009 and January 2015. Chemotheapy regimen consisted of oxaliplatin (85 mg/m(2) in over 120 min) followed by leucovorin (400 mg/m(2) in over 120 min), with the addition, after 30 min of irinotecan (180 mg/m(2) in over 90 min) then 5 fluorouracil (5FU) (400 mg/m(2) administred intravenous bolus), followed by 5FU (2400 mg/m2 intraveinous infusion over 46 h) repeated every 2 wk. Geriatric parameters were recorded at the beginning. Toxicities were evaluated with the Common Terminology Criteria for Adverse Events 4.03. Tumor response was evaluated by CT scan. Treatment continued until disease progression, unacceptable toxicities or patient refusal.RESULTSFifty-two patients aged from 70 to 87 years were treated by FOLFIRINOX, 34 had colorectal cancer and 18 had pancreatic cancer. Most of them were in good general condition, 82.7% had a 0-1 performance status and 61.5% had a Charlson Comorbidity Index < 10. The most frequent severe toxicities were neutropenia (17 patients, n = 32.7%) and diarrhea (35 patients n = 67.3%); 10 of the case of neutropenia and 5 of diarrhea registered a grade 4 toxicity. Thirty-nine patients (75%) initially received an adapted dose of chemotherapy. The dosage was adjusted for 26% of patients during the course of treatment. Tumor response evaluated by RECIST criteria showed a controlled disease for 25 patients (48.1%), a stable disease for 13 and a partial response for 12 patients. Time under treatment was higher for colorectal cancer with a median time of 2.44 mo (95% CI: 1.61-3.25). Overall survival was 43.88 mo for colorectal cancer and 12.51 mo for pancreatic cancer. In univariate or multivariate analysis, none of geriatric parameters were linked to overall survival. Only the type of tumor (pancreatic/colorectal) was linked in both analysis.CONCLUSIONFor people over 70 years old, FOLFIRINOX regimen seems to induce manageable toxicities but similar, even higher, median survival rates compared to younger people

Long-term quality of life and sexual function of elderly people with endometrial or ovarian cancer

International audienceBackground: With the growing number of older endometrial cancer (EC) and ovarian cancer (OC) survivors, data on long-term health-related quality of life (HRQoL) became an important issue in the management of older patients. So, the aim of this study was to describe and compare according to age long-term HRQoL, sexual function, and social deprivation of adults with either EC or OC. Methods: A cross-sectional study was set up using data from the Côte d’Or gynecological cancer registry. A series of questionnaires assessing HRQoL (SF-12), sexual function (FSFI), anxiety/depression (HADS), social support (SSQ6) and deprivation (EPICES) were offered to women with EC or OC diagnosed between 2006 and 2013. HRQoL, sexual function, anxiety/depression, social support and deprivation scores were generated and compared according to age (< 70 years and ≥ 70 years). Results: A total of 145 women with EC (N = 103) and OC (N = 42) participated in this study. Fifty-six percent and 38% of EC and OC survivors respectively were aged 70 and over. Treatment did not differ according to age either in OC or EC. The deprivation level did not differ between older and younger survivors with OC while older survivors with EC were more precarious. The physical HRQoL was more altered in older EC survivors. This deterioration concerned only physical functioning (MD = 24, p = 0.012) for OC survivors while it concerned physical functioning (MD = 30, p < 0.0001), role physical (MD = 22, p = 0.001) and bodily pain (MD = 21, p = 0.001) for EC survivors. Global health (MD = 11, p = 0.011) and role emotional (MD = 12, p = 0.018) were also deteriorated in elderly EC survivors. Sexual function was deteriorated regardless of age and cancer location with a more pronounced deterioration in elderly EC survivors for desire (p = 0.005), arousal (p = 0.015) and orgasm (p = 0.007). Social support, anxiety and depression were not affected by age regardless of location. Conclusion: An average 6 years after diagnosis, the impact of cancer on HRQoL is greatest in elderly survivors with either EC or OC