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P Descamps

Publications and source records attributed to P Descamps.

At least 91 records · Page 5Linked to original sources
PubMed1992

Comparative assessment of quantitative HIV viraemia assays.

OBJECTIVE: To compare two published methods for determining plasma viraemia in HIV-seropositive patients, with reference to a cellular viraemia assay. PATIENTS, PARTICIPANTS: Three patient groups were defined according to CD4 cell count: group I, less than 200 x 10(6)/l (23 patients); group II, 200-500 x 10(6)/l (18 patients); and group III, greater than 500 x 10(6)/l (13 patients). METHODS: The two reported methodologies were applied to all fresh samples, simultaneously and on the same day. RESULTS: The two techniques did not differ significantly in the detection of plasma viraemia: 82.3% of group I patients and 55% of group II patients were positive, while all group III patients were negative. Cellular viraemia was positive for 96% of the overall population. CONCLUSIONS: These results, obtained in a network of seven French laboratories involved in clinical trials, confirm that both plasma viraemia and cellular viraemia are useful virological markers.

AIDS Serodiagnosis↗
PubMed1992

[Are there still indications for an abdominal hysterectomy? 340 cases].

This retrospective study of 340 hysterectomies carried out abdominally concern cases only where the pathology was benign and strictly limited to the body of the uterus. This has made it possible to review the 240 cases carried out for fibroids (70.6%), 63 for simple endometrial hyperplasia (18.5%), 28 for adenomyosis (8.2%) and 9 for atrophy of the endometrium (2.6%). We looked for lesions that could have been treated laparoscopically among these pathologies: submucous fibroids with a diameter of less than 4 cms and where the uterus was less than 10 cms in height and weighted less than 200 g, simple endometrial hyperplasia (the height of the uterus less than 10 cms and the weight less than 200 g, adenomyosis (uterus less than 10 cms in height and less than 200 g weight), this last criteria still "debatable", We found that 110 lesions were selected because they could have been treated conservatively. This means that 32.5% where there seemed to have been indications for hysterectomy out of 340 cases, could have been treated otherwise. These can be divided aetiologically in to: 54 cases of simple hyperplasia of the endometrium (15.9%), 34 cases with submucous fibroids (10.6%), 26 cases of adenomyosis (5.9%). If the cases of adenomyosis are excluded 90 out of 340 hysterectomies carried out abdominally (about a quarter) could have been treated conservatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1991

Radical hysterectomy for stage I and II endometrial carcinoma: a retrospective analysis of 179 cases.

Total hysterectomy with bilateral salpingo oophorectomy is the traditional treatment for endometrial carcinoma. In an effort to improve local control rates, we have surgically treated our Stage I and II patients with radical hysterectomy and pelvic lymphadenectomy (RH-PL). Between 1976 and 1987 we have treated 179 patients with endometrial adenocarcinoma (125 Stage I and 54 Stage II) with the following modalities. Uterovaginal brachytherapy (60 Gy) was performed first and then 6 weeks later an RH-PL was performed. Twenty-nine patients received external pelvic irradiation (45 Gy) because of tumor invasion beyond the internal two-thirds of the myometrium and/or lymph node involvement. The local control rate was 87% (92% for Stage I, 76% for Stage II). Distant metastases occurred in 24 patients (13%). Five-year actuarial survival rates were 80% for Stage I and 61% for Stage II patients. Prognostic factors were nodal status, histological grading, depth of tumor myometrial invasion, histologic status of the hysterectomy specimen, and peritoneal cytology. Late severe complications occurred for 13 patients (7%). These results are comparable to those published for patients treated with less extensive surgery. We conclude that such an extensive surgery (especially pelvic lymphadenectomy) appears to be useless for all patients with bad prognostic factors requiring pelvic external irradiation. We only still perform external iliac node samples for patients with Stage I grade 1 tumors without deep tumor invasion into the myometrium.

Brachytherapy↗
PubMed1991

Influence of the measurement location on the resistance index in the umbilical arteries: a hemodynamic approach.

A computer model was used to study the primary factors generating the reduction in resistance index, (S-D)/S, values observed by ultrasonic Doppler measurements in the umbilical artery, from the fetal insertion to the placental insertion (S represents the amplitude of the systolic peak and D the amplitude of the diastolic peak). This hemodynamic approach shows that the placental resistance is the primary factor, the viscosity and the cord length playing secondary roles. Clinically, the position of the measurement along the cord is an important factor. To increase the sensitivity of the index, the Doppler measurement must be performed near the fetal insertion, whereas a measurement near the placental insertion will make the Doppler examination more specific.

Blood Flow Velocity↗
PubMed1991

[Adenocarcinoma of the endometrium. The role of vaginal brachytherapy in the therapeutic sequence].

Surgery is the traditional treatment for endometrial carcinoma stage I and II. Radiotherapy is given to improve local control rate. Vaginal vault curietherapy can reduce vaginal recurrences rate. Chronology of curietherapy (pre or post operative) is under discussion. We have retrospectively analyzed treatment results of patients treated either with pre operative curietherapy (60 Gy) and then radical hysterectomy with bilateral salpingo oophorectomy (RH-BSO) (group 1), or with RH-BSO and then vaginal curietherapy (60 Gy) (group 2). Patients with bad prognostic factors (grade 3 and deep tumor invasion into the myometrium) received pelvic external irradiation and were excluded. 121 patients were in group 1, 63 patients were in group 2. All patients received curietherapy using Cesium 137 sources (one uterine and two vaginal sources in group 1, three vaginal sources in group 2). Total dose delivered to the reference volume was 60 Gy. Doses delivered to some reference points (vagina, rectum, bladder, pelvic wall) were calculated according to the ICRU recommendations. Surgery was at least RH-BSO performed either before or after curietherapy. 82 patients in group 1 and 44 in group 2 had a pelvic lymphadenectomy. Curietherapy data were comparable in the two groups according to the dose distribution to the vagina, rectum and bladder. Reference volume was smaller in the group 2. Local failure rate was 13% in group 1 and 10% in group 2. Distant metastases rate was 12% in group 1 and 9% in group 2. Five year actuarial survival rate was not statistically different between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1991

[Stage I and II endometrial adenocarcinomas. Prognostic value of lymph node invasion].

In our institution endometrial carcinomas stage I and II were treated with uterovaginal brachytherapy and radical hysterectomy with pelvic lymphadenectomy. We have studied in a retrospective analysis the results of the lymphadenectomy in order to precise his place in the treatment strategy. Between 1976 and 1986, 155 patients were treated these modalities (107 were stage I, 48 were stage II). The mean age was 60.2 years. Brachytherapy delivered 60 Gy and then radical hysterectomy with pelvic lymphadenectomy was performed. 26 patients received a pelvic external beam irradiation on account of lymph node involvement and or deep tumor invasion into the myometrium. 14 patients (9%) had a lymph node involvement. External iliac lymph nodes were involved in 78.5% of these cases. Lymph node involvement rate was higher for stage II, grade 3 tumors and when there was a deep tumor invasion into the myometrium. Pelvic failure rate was 12% for N- patients and 36% for N+ patients. Five years actuarial survival rate was 83% for N- and 41% for N+ patients. Now, we carry out a pelvic external radiotherapy for all stage II, grade 2 or 3 patients and when there is a deep tumor invasion into the myometrium and we do not perform lymphadenectomy for these patients. We perform only external iliac sample for patients with stage I grade 1 tumour without deep tumour invasion.

Adenocarcinoma↗
PubMed1990

Is lymphadenectomy useful in the treatment of endometrial carcinoma?

In our institution endometrial carcinoma stages I and II is treated with uterovaginal brachytherapy and radical hysterectomy with pelvic lymphadenectomy. We have made a retrospective analysis of the results of lymphadenectomy to determine its place in the treatment strategy. Between 1976 and 1986, 155 patients were treated with these modalities (107 were stage I, 48 were stage II). The mean age was 60.2 years. Brachytherapy delivered 60 Gy, and then radical hysterectomy with pelvic lymphadenectomy was performed. Twenty-six patients received pelvic external-beam irradiation because of lymph node involvement and or deep tumor invasion into the myometrium. Fourteen patients (9%) had lymph node involvement. External iliac lymph nodes were involved in 78.5% of these cases. The lymph node involvement rate was higher for patients with stage II disease, patients with grade 3 tumors, and patients in whom there was deep tumor invasion into the myometrium. Pelvic failure rate was 12% for node-negative patients and 36% for node-positive patients. The 5-year actuarial survival rates were 83% for node-negative and 41% for node-positive patients. We administer pelvic external-beam radiotherapy to all stage II patients, grade 2 or 3 patients, and patients in whom there is deep tumor invasion into the myometrium. We do not perform lymphadenectomy on these patients. We perform only external iliac sampling for patients with stage I, grade 1 tumor without deep tumor invasion.

Adenocarcinoma↗
PubMed1990

Catheter related sepsis during long-term parenteral nutrition in paediatric gastroenterology patients: a study of 185 consecutive central venous catheters.

We report the results of a prospective study of catheter-related sepsis (CRS) in 154 gastroenterology paediatric patients treated for medical (n = 102) or surgical (n = 52) disorders. Over 2 years, 185 central venous catheters (CVC) were placed, including 155 Broviac and 30 Jonathan Shaw CVC. CVC remained in place 13,331 days (6,539 days of cyclic parenteral nutrition), with a mean catheter life of 72 days. Forty-eight episodes of CRS occurred, most of them due to coagulase-negative staphylococci (n = 29) and Staphylococcus aureus (n = 17). CRS rate was 0.26, with an overall incidence of 1 infection per 278 days of parenteral nutrition (PN). Factors significantly associated with CRS were: age 1-5 years (p < 0.01), a medical indication for treatment (p < 0.001) and summer months of PN (p < 0.01). Interestingly, CRS occurred predominantly (65%) within the first 2 months following CVC placement and the risk of infection correlated with local haemorrhage at the time of insertion (p < 0.01). Appropriate systemic therapy, without removing the catheter, permitted resolution of 90.9% (40/44) of all CRS and 100% (28/28) of CRS due to coagulase-negative staphylococci.

Journal Article↗
PubMed1990

Preoperative or postoperative brachytherapy for patients with endometrial carcinoma stage I and II.

In endometrial carcinoma, vaginal vault brachytherapy is performed to improve the local control rate and to decrease vaginal recurrences. To assess the best chronology of this brachytherapy compared to surgery, we have retrospectively analyzed results of treatment of patients treated either with preoperative brachytherapy (60 Gy) and then radical hysterectomy with bilateral salpingo oophorectomy (RH-BSO) (Group 1), or with RH-BSO and then postoperative brachytherapy (60 Gy) (Group 2). There were one hundred twenty-one patients in Group 1 and 63 in Group 2. The mean age was 61.8 years in Group 1 and 64.3 in Group 2. In Group 1, 73% of the patients were Stage I, and 77.6% were in Group 2. The two groups were comparable for histological grading and depth of tumoral invasion into the myometrium. Brachytherapy was delivered with one uterine and two vaginal sources in Group 1 and with three vaginal sources in Group 2. Doses to the reference volume and to reference points were calculated according to ICRU recommendations. Brachytherapy data were similar in the two groups except reference volume, which was smaller in Group 2. Local control rate was 87% in Group 1 and 91% in Group 2. Distant metastasis occurred in 12% of patients in Group 1 and 9% in Group 2. The 5-year actuarial survival rate was 84% in Group 1 and 89% in Group 2. Regarding stage, histological grading, and depth of tumoral invasion, no differences were observed between the two therapeutic groups. The only prognostic factor in the entire population was Stage. The 5-year actuarial survival rate was 91% for Stage I patients and 69% for Stage II (p value less than 0.03). The late severe complication rate was 14% in Group 1 and 7.9% in Group 2, a difference which was not statistically significant. We concluded that since no differences were observed between the two techniques, vaginal brachytherapy should be performed postoperatively when surgery is the first treatment (Stage I or II, grade 1 or 2, and no deep tumoral invasion into the myometrium).

Brachytherapy↗
PubMed1990

Lymphadenectomy in the management of endometrial carcinoma stage I and II. Retrospective study of 155 cases.

In our institution endometrial carcinomas Stage I and II were treated with initial uterovaginal brachytherapy 60 Gy followed by modified radical hysterectomy with pelvic lymphadenectomy. We have studied the results in order to assess the value of lymphadenectomy in the treatment strategy. Between 1976 and 1986, 155 patients were treated (107 Stage I, 48 Stage II mean age 60.2 years). Twenty-six patients also received postoperative pelvic external beam irradiation on account of lymph node involvement and/or deep tumour invasion into the myometrium. Fourteen patients (9%) had lymph node involvement. External iliac lymph nodes were involved in 78.5% of these cases. Lymph node involvement rate was higher for stage II, grade 3 tumours and when there was deep tumour invasion of the myometrium. The rate of local (pelvic) treatment failure was 12% for node-negative patients and 36% for node-positive patients and the 5-year actuarial survival rates for the two groups were 83% and 41% respectively. As a consequence of our interpretation of the findings and influenced by the high complication rate which we attribute to lymphadenectomy and the information given by other prognostic indicators, we have changed to a policy of carrying out pelvic external radiotherapy for all Stage II, grade 2 or 3 cases and those with deep myometrial invasion. Lymphadenectomy is not performed in these cases. For patients with Stage I grade 1 tumours without deep tumour invasion only external iliac node sampling is performed. If this shows tumour, external irradiation is given in addition to vaginal vault brachytherapy.

Adenocarcinoma↗
PubMed1990

[Breast recurrence after conservative treatment of cancers of the breast: predictive factors and prognostic significance].

The prognostic significance of local relapse after conservative treatment of early stage breast cancer has been controversial. To determine the prognostic value of breast relapse occurrence and the factors predisposing to local failure, we analysed the results obtained in a series of 324 patients conservatively treated for breast invasive carcinomas of 2 cm or less. All patients were treated by tumorectomy and axillary dissection, radiation therapy, and adjuvant medical treatment in 85 of 109 patients with involved nodes. The overall 5-yr survival rate was 91.5%. The actuarial 5-yr local control rate was 91.9%. Local relapses occurred in 25 patients. In these patients, the overall 5-yr survival rate was significantly decreased as compared to that of patients without local relapse (76.9% versus 93.4%, P less than 0.001). Recurrence in the breast within 2 yr of initial treatment of severely affected the risk of metastasis occurrence as compared to later relapses (metastasis-free survival rate of 14.3% versus 63.9% at 3-yr from local relapse, P less than 0.01). Local relapse occurred more frequently in premenopausal patients, in patients with low bodymass index, and in patients with small breast size. Local control was not significantly affected by age, tumor size or node involvement. We conclude that the occurrence of a breast relapse after a local conservative treatment has a negative significance and is predictive of a high risk of distant metastasis development, especially when local relapse occurred within 2 yr of initial treatment. There is a need to determine individual factors that could allow discrimination of patients with a high probability of local relapse and subsequent metastasis.

Adult↗
PubMed1990

[Primary fibroblastic tumor of the breast. Review of the literature apropos of a case of desmoid tumor of the breast posing nosologic problems with a low-grade fibrosarcoma].

The authors present a case of fibromatosis in the breast in a young nulliparous patient. These are rare tumours comparable to abdominal desmoid tumours. They are characterised by their ability to recur if spread locally, that is why they have to be widely removed. After having studied the anatomical and clinical characteristics as well as the biological ones of breast fibromatoses the authors discuss the problems of nosology which are often very difficult for this kind of a tumour and also of the therapy that has to be adapted.

Adolescent↗
PubMed1989

Lack of HPA-23 antiviral activity in HIV-infected patients without AIDS.

A randomized study of 12 treated patients and seven controls was conducted in order to evaluate HPA-23 anti-HIV activity in HIV-infected patients. The antiviral activity was assessed by determining HIV p24 antigenemia. A persistence or even increase in antigenemia was shown in treated patients and thrombocytopenia was observed in nine out of the 12 patients. This suggests that HPA-23 should not be used in anti-HIV therapy.

Antimony↗
PubMed1988

In vitro quantitative model of catheter infection during simulated parenteral nutrition.

We developed a quantitative in vitro model of catheter infection. Colonization was initiated by inoculating the catheter lumen with a small number of bacteria (approximately 5 x 10(3) viable organisms). Then the inoculated catheters were used for simulated total parenteral nutrition therapy consisting of infusions for 9 h a day, and bacteria were counted in the effluent fluid against time, enabling us to monitor catheter colonization quantitatively. Bacterial colonization of prosthetic devices is a progressive process, as evidenced by the slow day-to-day increase of bacterial release seen here. On the other hand, bacterial strains of various representative species exhibited significant differences in their ability to infect catheters. These results suggest that the in vitro model presented here is a reliable tool for monitoring the degree of catheter colonization under standardized conditions and could be used for further studying the main factors of catheter-related sepsis or the treatment of this information.

Bacteria↗