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J Watine

Publications and source records attributed to J Watine.

71 records · Page 4Linked to original sources
PubMedDate not supplied

[Laboratory variables and stratification of small-cell lung cancer patients: recommendations for therapeutic trials and for clinical practice guidelines].

OBJECTIVE: To identify, through a systematic review of the literature, the laboratory variables that, in addition to performance status and to extent of the disease, would allow a more accurate stratification of small-cell lung cancer patients who participate in chemotherapy trials, with or without radiotherapy. Secondary aim: to compare the results of our systematic review with the recommendations made in current clinical practice guidelines. METHODS: Update of two recently published systematic reviews, without meta-analysis, following the recommendations of the International Federation of Clinical Chemistry and Laboratory Medicine, and taking into account the Consolidated Standards of Reporting Trials statement. RESULTS: Of 1143 publications retrieved, exclusion and inclusion criteria allow us to include 13 studies in our review. The three variables which were the most often found significant in multivariate statistical analysis, were: pre-therapeutic levels of laboratory variables (13/13), performance status (12/13), and degree of tumour invasion (10/10). Among the laboratory variables, serum lactate dehydrogenase (LDH) is the only one that was quite consistently found to be of independent prognostic significance, with p values or hazard ratios quite close to those obtained with performance status, or with extent of the disease. The recommendations made in the four clinical practice guidelines that we retrieved, are often vague regarding laboratory variables, and sometimes they even contradict each others. CONCLUSIONS: Available evidence would support the recommendation that pretreatment LDH should be systematically measured in order to stratify patients in therapeutic trials. If other laboratory variables were to be measured in addition to LDH for this purpose, it seems that alkaline phosphatase (ALP), and to a lesser extent, sodium and white blood cell counts, might be the best suited ones. Nevertheless, further studies are necessary to more clearly support this latter recommendation. Available evidence would not support the measurement of any other laboratory variable in this context, before, during, or after treatment. Our recommendations are more in agreement with the recommendations made in the clinical practice guidelines that use evidence-based methods than with the guidelines that do not.

Carcinoma, Small Cell↗
PubMedDate not supplied

[Systematic reviews and meta-analysis in laboratory medicine: principles and methods].

BACKGROUND: Systematic reviews and meta-analyses can help health-care professionals to base their decisions on the highest levels of evidence, and are therefore the cornerstone in practicing evidence-based medicine. In the field of diagnosis in general, and in laboratory medicine in particular, systematic reviews are scarcer, and often of lower quality than in other areas of medicine. AIM: To summarize the principles and methods that can be advised to perform systematic reviews of good quality in laboratory medicine. METHODS: A narrative review of the literature and discussions with members of the Committee on Evidence-Based Laboratory Medicine of the International Federation of Clinical Chemistry and Laboratory Medicine, in particular during our last three meetings, enabled us to adapt to laboratory medicine the methods which are currently being advocated to perform systematic reviews of good quality in other medical areas. RESULTS: The process of systematic reviewing consists of six key steps: 1) preparation: formulation of question(s); 2) systematic search of the literature; 3) selection of primary studies; 4) critical appraisal of the quality of the selected literature; 5) extraction and synthesis of data; 6) interpretation. The main differences between systematic reviews of diagnostic interventions and those of therapeutic interventions bear on question formulation, the choice of study designs to be included or excluded, the assessment of study quality and the statistical methods used to combine their results. The quoted references will help interested readers to deepen by themselves the most technical or controversial points. CONCLUSION: In order to improve quality of care as well as the balance between benefits, harms and costs of practice, each recommendation in guidelines should be based on a systematic review. In addition, such reviews can help to better identify gaps in biomedical knowledge, and improve critical skills, education, and training of professionals. One can therefore reasonably expect that the current multiplication of systematic reviews in laboratory medicine will favor the diffusion of diagnostic technologies with the highest levels of proven efficacy and effectiveness, at the detriment of the others.

Biology↗
PubMedDate not supplied

[Chromobacterium violaceum peritonitis: case report and literature review].

We report a case of Chromobacterium violaceum infection and we review the literature for all published cases. C. violaceum grew from a peritoneal fluid of a 47-year-old woman operated on for peritonitis following perforative gastroduodenal ulcer. She was just coming back from a 1-month-holyday in French Guyana, where she might have been in contact with this micro-organism. The patient fully recovered after surgical management associated with antibiotic therapy consisting of ofloxacin plus piperacillin-tazobactam. Among the more than a hundred of published cases of human infections with C. violaceum that we retrieved, there was not any other case of peritonitis.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Bibliographic analysis of the use of laboratory blood parameters for the prognosis of primary lung cancer].

In the daily clinical practice, serum calcium, albumin, and cyfra 21-1, are the only laboratory parameters officially recommended for the prognostic evaluation of primary lung cancer patients by the American, European or French respiratory/thoracic societies (and only in non-small cell lung cancer). The present review of the biomedical literature suggests that serum calcium for non operable non-small cell lung cancer, serum orosomucoid (alpha1-acid-glycoprotein) and serum cyfra 21-1 for non-small cell lung cancer, and perhaps plasma prothrombin time, might be the best laboratory parameters for the pre-therapeutic prognostic evaluation of the lung cancer patients, independently from the usual radio-clinical and histological parameters. Further prognostic evaluation studies are necessary in order notably to compare the prognostic values of the aforementioned parameters, not only aimed at evaluating the value of their pre-therapeutic levels, but also aimed at evaluating the value of their post-therapeutic changes. A higher pluridisciplinarity for such future publications also seem necessary.

Antigens, Neoplasm↗