Pancreatic cancer(PC)is a devastating malignancy with fewer than 10%of patients being alive at 5 years after diagnosis.Venous thromboembolism(VTE)occurs in approximatively 20%of patients with PC,resulting in increased...Pancreatic cancer(PC)is a devastating malignancy with fewer than 10%of patients being alive at 5 years after diagnosis.Venous thromboembolism(VTE)occurs in approximatively 20%of patients with PC,resulting in increased morbidity,mortality and significant health care costs.The management of VTE is particularly challenging in these frail patients.Adequate selection of the most appropriate anticoagulant for each individual patient according to the current international guidelines is warranted for overcoming treatment challenges.The International Initiative on Thrombosis and Cancer multi-language web-based mobile application(downloadable for free at www.itaccme.com)has been developed to help clinicians in decision making in the most complex situations.In this narrative review,we will discuss the contemporary epidemiology and burden of VTE in PC patients,the performances and limitations of current risk assessment models to predict the risk of VTE,as well as evidence from recent clinical trials for the primary prophylaxis and treatment of cancer-associated VTE that support updated clinical practice guidelines.展开更多
Background Knowledge gaps across literature prevent current guidelines from providing the profile of elderly patients most likely to derive benefit fi^om invasive strategy （IS） in non ST-elevation myocardial infarct...Background Knowledge gaps across literature prevent current guidelines from providing the profile of elderly patients most likely to derive benefit fi^om invasive strategy （IS） in non ST-elevation myocardial infarction （NSTEMI）. Furthermore, the benefit of IS in a real-world elderly population with NSTEMI remains unclear. The aims of this study were to determine factors that lead the cardiologist to opt for an IS in elderly patients with NSTEMI, and to assess the impact of IS on the 6-month all-cause mortality. Methods This multicenter prospective study enrolled all consecutive patients aged 〉 75 years old who presented a NSTEMI and were hospitalized in cardiology intensive care unit between February 2014 and February 2015. Patients were compared on the basis of reperfusion strategy （invasive or conservative） and living status at six months, in order to determine multivariate predictors of the realization of an IS and multivariate predictors of 6-month mor- tality. Results A total of 141 patients were included; 87 （62%） underwent an IS. The strongest independent determinants of IS were younger age [odds ratio （OR）： 0.85, 95%-confidence interval （CI）： 0.78-0.92; P 〈 0.001） and lower ＂Cumulative Illness Rating Scale-Geriatric＂ number of categories score （OR： 0.83, 95%CI： 0.73-0.95; P = 0.002）. IS was not significantly associated with 6-month survival （OR： 0.80, 95%CI： 0.27-2.38; P = 0.69）. Conclusions In real-world elderly patients with NSTEMI, younger patients with fewer comorbidities profited more often from an IS. However, IS did not modify 6-month all-cause mortality.展开更多
The case of a forty-five year old woman is presented who consulted for spontaneous haematomas of the thighs. The diagnosis of acquired haemophilia A associated to renal cancer was retained. She received anti CD20 mono...The case of a forty-five year old woman is presented who consulted for spontaneous haematomas of the thighs. The diagnosis of acquired haemophilia A associated to renal cancer was retained. She received anti CD20 monoclonal antibody treatment allowing her to undergo partial nephrectomy 4 months later without major complication. One year after surgery there is no sign of tumour recurrence.展开更多
Multiple regions of the genome have been associated with the risk of prostate cancer in Caucasians, particularly including several polymorphisms located at 8q24. Region 2 of 8q24 has been repeatedly found to be associ...Multiple regions of the genome have been associated with the risk of prostate cancer in Caucasians, particularly including several polymorphisms located at 8q24. Region 2 of 8q24 has been repeatedly found to be associated with the risk of prostate cancer among men of African descent, although one study performed in the Caribbean island of Jamaica did not report this finding. In this study, the single nucleotide polymorphism rs16901979, located in region 2 of 8q24, was genotyped in 498 cases of histologically confirmed prostate cancer and 541 controls from the French Caribbean islands of Guadeloupe, where the population is largely of African descent. The AA genotype and the A allele at rs16901979 were associated with elevated risks of prostate cancer （odds ratios [ORs] = 1.84, 95% confidence interval [95% CI] = 1.26-2.69, P= 0.002 and OR = 1.36, 95% CI = 1.13-1.64, P= 0.001, respectively）. Following stratification of the patients by disease aggressiveness, as defined by the Gleason score, the pooled genotypes AC ＋ AA were associated with a higher risk of a Gleasen score 〉7 at diagnosis （OR = 1.79, 95% CI = 1.17-2.73, P= 0.007）. In summary, the A allele at rs16901979 was associated with the risk of prostate cancer in the Caribbean population of Guadeloupe, confirming its involvement in populations of African descent. Moreover, our study provides the first evidence of an association between this variant and the risk of aggressive prostate cancer.展开更多
文摘Pancreatic cancer(PC)is a devastating malignancy with fewer than 10%of patients being alive at 5 years after diagnosis.Venous thromboembolism(VTE)occurs in approximatively 20%of patients with PC,resulting in increased morbidity,mortality and significant health care costs.The management of VTE is particularly challenging in these frail patients.Adequate selection of the most appropriate anticoagulant for each individual patient according to the current international guidelines is warranted for overcoming treatment challenges.The International Initiative on Thrombosis and Cancer multi-language web-based mobile application(downloadable for free at www.itaccme.com)has been developed to help clinicians in decision making in the most complex situations.In this narrative review,we will discuss the contemporary epidemiology and burden of VTE in PC patients,the performances and limitations of current risk assessment models to predict the risk of VTE,as well as evidence from recent clinical trials for the primary prophylaxis and treatment of cancer-associated VTE that support updated clinical practice guidelines.
文摘Background Knowledge gaps across literature prevent current guidelines from providing the profile of elderly patients most likely to derive benefit fi^om invasive strategy （IS） in non ST-elevation myocardial infarction （NSTEMI）. Furthermore, the benefit of IS in a real-world elderly population with NSTEMI remains unclear. The aims of this study were to determine factors that lead the cardiologist to opt for an IS in elderly patients with NSTEMI, and to assess the impact of IS on the 6-month all-cause mortality. Methods This multicenter prospective study enrolled all consecutive patients aged 〉 75 years old who presented a NSTEMI and were hospitalized in cardiology intensive care unit between February 2014 and February 2015. Patients were compared on the basis of reperfusion strategy （invasive or conservative） and living status at six months, in order to determine multivariate predictors of the realization of an IS and multivariate predictors of 6-month mor- tality. Results A total of 141 patients were included; 87 （62%） underwent an IS. The strongest independent determinants of IS were younger age [odds ratio （OR）： 0.85, 95%-confidence interval （CI）： 0.78-0.92; P 〈 0.001） and lower ＂Cumulative Illness Rating Scale-Geriatric＂ number of categories score （OR： 0.83, 95%CI： 0.73-0.95; P = 0.002）. IS was not significantly associated with 6-month survival （OR： 0.80, 95%CI： 0.27-2.38; P = 0.69）. Conclusions In real-world elderly patients with NSTEMI, younger patients with fewer comorbidities profited more often from an IS. However, IS did not modify 6-month all-cause mortality.
文摘The case of a forty-five year old woman is presented who consulted for spontaneous haematomas of the thighs. The diagnosis of acquired haemophilia A associated to renal cancer was retained. She received anti CD20 monoclonal antibody treatment allowing her to undergo partial nephrectomy 4 months later without major complication. One year after surgery there is no sign of tumour recurrence.
文摘Multiple regions of the genome have been associated with the risk of prostate cancer in Caucasians, particularly including several polymorphisms located at 8q24. Region 2 of 8q24 has been repeatedly found to be associated with the risk of prostate cancer among men of African descent, although one study performed in the Caribbean island of Jamaica did not report this finding. In this study, the single nucleotide polymorphism rs16901979, located in region 2 of 8q24, was genotyped in 498 cases of histologically confirmed prostate cancer and 541 controls from the French Caribbean islands of Guadeloupe, where the population is largely of African descent. The AA genotype and the A allele at rs16901979 were associated with elevated risks of prostate cancer （odds ratios [ORs] = 1.84, 95% confidence interval [95% CI] = 1.26-2.69, P= 0.002 and OR = 1.36, 95% CI = 1.13-1.64, P= 0.001, respectively）. Following stratification of the patients by disease aggressiveness, as defined by the Gleason score, the pooled genotypes AC ＋ AA were associated with a higher risk of a Gleasen score 〉7 at diagnosis （OR = 1.79, 95% CI = 1.17-2.73, P= 0.007）. In summary, the A allele at rs16901979 was associated with the risk of prostate cancer in the Caribbean population of Guadeloupe, confirming its involvement in populations of African descent. Moreover, our study provides the first evidence of an association between this variant and the risk of aggressive prostate cancer.
