[Pleural effusion].
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Diagnosis, Differential↗
Biomedical subjects
Jean-Claude Meurice
Publications and source records attributed to Jean-Claude Meurice.
[Influence of doctors' smoking habits on minimal advice for smoking cessation. A survey of 369 general practitioners in the department of Vienne, France].
INTRODUCTION: French doctors' smoking habits may interfere with the effectiveness of smoking prevention measures and particularly when providing minimal advice. OBJECTIVES: To assess the smoking habits of general practitioners in the department of Vienne, France, and to study how they affect minimal advice for smoking cessation. METHOD: 257 general practitioners took part in a phone survey (26.5%) or answered a written questionnaire (73.5%). The questions bore on socio-demographic characteristics, smoking habits and the of minimal advice provided whether partial or whole. Do you smoke? If so, have you ever thought of quitting? RESULTS: The participation rate was 70%. 26% of the participants were current smokers--16 % regular smokers, 10% infrequent smokers, 30% had quit and 44% had never smoke. 44.4% investigated smoking habits as a matter of course, and 41% provided intensive advice for smoking cessation. Doctors who had never smoked gave more advice than those who currently smoked or had quit. DISCUSSION: A comparison with former studies reveals that the number of doctors who smoke has decreased. However, minimal intervention on smoking cessation is put into practice by less than half of the doctors. CONCLUSION: The incidence of smoking among doctors in the Department of Vienne remains too high and minimal intervention on smoking cessation is still insufficient. However, doctors who had never smoked provided minimal advice more often than those who currently smoked or had quit.
Adult↗
Phase I study with dose escalation of gemcitabine and cisplatin in combination with ifosfamide (GIP) in patients with non-small-cell lung carcinoma.
Gemcitabine (G) and cisplatin (P) are active reference agents in patients with non-small-cell lung cancer (NSCLC). Ifosfamide (I) has also been approved for NSCLC treatment. This phase I trial aimed to determine the dose-limiting toxicity (DLT), maximum tolerated dose [maximum tolerated dosage (MTD)], and recommended dose (RD) of a GIP combination in patients with advanced/metastatic NSCLC. In this study, one cycle of chemotherapy combined the following: ifosfamide: 3 g/m2 fixed dose (24-hour intravenous infusion) combined with mesna, day 1; gemcitabine: starting dose 1,000 mg/m2/d, escalating by 250 mg/m2 increments, days 1 and 15; cisplatin: starting dose 80 mg/m2, subsequently 100 mg/m2, day 15; in cohorts of at least 3 patients. Cycles were repeated every 28 days and no hematopoietic growth factors were administered. DLT was evaluated after the first chemotherapy cycle. Thirty-three patients (30 men, 3 women) with stage III (14 patients)/IV (19 patients) NSCLC were treated at eight dose levels, receiving 109 cycles of chemotherapy. Neutropenia was the only DLT reported. Although the MTD was not reached at the highest tested dose level, the RD chosen corresponds to the full doses of the GP3000 doublet standard (G: 3,000 mg/m2; P: 100 mg/m2 per cycle) every 28 days. Nonhematologic toxicities were mainly grade I-II. Relative dose intensities of G, I, and P at the RD were 96%, 98%, and 96%, respectively. Sixteen of 33 patients with measurable/evaluable disease had an objective response including two complete responses. In conclusion, GIP chemotherapy is safe and appears to be active in patients with NSCLC. The RD is gemcitabine: 1,500 mg/m2 days 1 and 15; ifosfamide: 3 g/m2 day 1; cisplatin: 100 mg/m2 day 15. A confirmatory phase II study is currently under way, before a phase III trial of GIP versus GP.
Adult↗
[Acute and chronic dyspnea].
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Acute Disease↗