Biomedical subjects

J M Simon

Publications and source records attributed to J M Simon.

87 records · Page 5Linked to original sources

PubMedDate not supplied

[Importance of radiotherapy in stereotactic conditions (radiosurgery) in brain metastasis: experience and results of the Hôpital Pitié-Salpêtrière Group].

PURPOSE: Retrospective analysis of the influence of clinical and technical factors on local control and survival after radiosurgery for brain metastasis. PATIENTS AND METHODS: From January 1994 to December 1996, 42 patients presenting with 71 metastases underwent radiosurgery for brain metastasis. The median age was 56 years and the median Karnofsky index 80. Primary sites included: lung (20 patients), kidney (seven), breast (five), colon (two), melanoma (three), osteosarcoma (one) and it was unknown for three patients. Seventeen patients had extracranial metastasis. Twenty-four patients were treated at recurrence which occurred after whole brain irradiation (12 patients), surgical excision (four) or after both treatments (eight). Thirty-six sessions of radiosurgery have been realized for one metastasis and 13 for two, three or four lesions. The median metastasis diameter was 21 mm and the median volume 1.7 cm3. The median peripheral dose to the lesion was 14 Gy, and the median dose at the isocenter 20 Gy. RESULTS: Sixty-five metastases were evaluable for response analysis. The overall local control rate was 82% and the 1-year actuarial rate was 72%. In univariate analysis, theoretical radioresistance (P = 0.001), diameter less than 3 cm (P = 0.039) and initial treatment with radiosurgery (P = 0.041) were significantly associated with increased local control. Only the first two factors remained significant in multivariate analysis. No prognostic factor of overall survival was identified. The median survival was 12 months. Six patients had a symptomatic oedema (RTOG grade 2), only one of which requiring a surgical excision. CONCLUSION: In conclusion, 14 Gy delivered at the periphery of metastasis seems to be a sufficient dose to control most brain metastases, with a minimal toxicity. Better results were obtained for lesions initially treated with radiosurgery, theoretically radioresistant and with a diameter less than 3 cm.

Adenocarcinoma↗

PubMedDate not supplied

[Brachytherapy in France in 1995. Final results of the national survey].

A survey questionnaire was sent to the 189 French departments of radiation Oncology and 166 responded by brachytherapy and 358 shielded rooms were available. In Low Dose Rate (LDR) 81 departments used Cesium sources (159 afterloaders, 1,060 sources). Iridium wires were used by 84 departments (673 meters used). Only six departments used other elements. Twenty-six departments were equipped with high dose rate after loaders (HDR) all of them also using LDR techniques for most of the patients. A total of 9,160 patients were treated: 7,868 with LDR and 1,292 with HDR. The common sites treated by LDR were uterovaginal (4,300), breast (1,415), head and neck (1,049), skin (610), anorectal (220) and urologic (70). HDR was used for vaginal cuff (628), bronchi (371), oesophagus (232). PDR just started (33 patients) for a feasibility trial. The rate of patients treated by brachytherapy is around 6-8% of the irradiated patients, but the indications vary is each department. The diffusion of the techniques, and new indications should increase the number of patients being treated by brachytherapy.

Brachytherapy↗

PubMedDate not supplied

Differential diagnostic validation: acute and chronic pain.

The authors sought to validate the defining characteristics of acute pain and chronic pain and to compare the differences between them. Expert nurses (N = 125) rated the importance of 55 clinical indicators for each diagnosis (acute pain and chronic pain). Differential diagnostic validity (DDV) scores were calculated for each clinical indicator for both diagnoses. Only acute pain had a DDV score greater than .80, indicating that the characteristic "communication of pain descriptors" was a critical indicator for acute pain. A majority of defining characteristics differentiated between acute pain and chronic pain, thereby supporting the identification of acute pain and chronic pain as separate nursing diagnoses.

Acute Disease↗

PubMedDate not supplied