Objective The objective of the study was to prospectively evaluate the accuracy of laparoscopy performed in satellite centers (SCs) to describe intraabdominal diffusion of advanced ovarian cancer ...(AOC). Study Design Patients with a clinical/radiological suspicion of AOC were included in the protocol. SCs were selected among those surgeons, spending a short intensive training period at the coordinator center (CC) to learn the application of staging laparoscopy (S-LPS) in AOC. All women underwent S-LPS at the SCs, and the surgical procedure was recorded and blindly reviewed at the CC. Calculating specificity, positive and negative predictive values, and the accuracy for each parameter with respect to the CC assessed the diagnostic performance of S-LPS. The Cohen's kappa was used to test the interobserver agreement of each parameter. Results One hundred sixty-eight cases were considered eligible for the study. A per-protocol analysis was performed on 120 cases. The worst laparoscopic assessable feature was mesenteric retraction, whereas the remaining variables ranged from 99.2% (peritoneal carcinomatosis) to 90% (bowel infiltration). All but 1 SC (SC number 4) reached an accuracy rate of 80% or greater for both single parameters and overall score. The Cohen's kappa and the P value for overall predicitive index value were 0.685 and .01, respectively, but improved to 0.773 and .388 after removing the SC number 4 from the analysis. Conclusion S-LPS allows an accurate and reliable assessment of intraperitoneal diffusion of disease in AOC patients in trained gynecological oncology centers.
Dans Le Disciple (1 889), critique romanesque des maîtres à penser de l’époque, Paul Bourget évoque Ernest Renan en type de la décadence française. Dans une certaine mesure, son esprit se trouve ...transposé dans les deux personnages principaux : Adrien Sixte, le psychologue de Dieu, et son disciple, le multiple Robert Greslou. Ces fanatiques de la dissection intime en héritent des traits intellectuels, moraux et biographiques. Par les conséquences de leur action toute intellectuelle, ils représentent l’impossibilité d’une géométrie de l’esprit et, en même temps, la déshumanisation produite par le rationalisme, la critique et le positivisme au sein d’une modernité irréligieuse. Ils sont ainsi semblables à Renan, qui en 1849, peu d’années après avoir abandonné le séminaire pour la carrière scientifique, avait touché le côté mortifère de la raison jusqu’à proclamer d’avoir tué en soi sa jeunesse et sa naïve spontanéité.
Petruzzelli Francesco. Ernest Renan face à Augustin et Rousseau : le manuscrit des Confessions (1842). In: Études Renaniennes, N°116, octobre 2015. Lire Renan aujourd'hui : les archives / les idées. ...Actes des séminaires Renan 2013-2014 de l'ITEM. pp. 69-83.
Petruzzelli Francesco. Le manuscrit des Confessions d'Ernest Renan. In: Études Renaniennes, N°116, octobre 2015. Lire Renan aujourd'hui : les archives / les idées. Actes des séminaires Renan ...2013-2014 de l'ITEM. pp. 85-88.
Petruzzelli Francesco. La Rome d'Ernest Renan et de Charles Daremberg dans leurs carnets de voyage (1849-1850). In: Études Renaniennes, N°115, juillet 2014. Renan, Rome et les Bonaparte. pp. 97-111.
We report the initial results from a phase I clinical trial for ALS. We transplanted GMP-grade, fetal human neural stem cells from natural in utero death (hNSCs) into the anterior horns of the spinal ...cord to test for the safety of both cells and neurosurgical procedures in these patients. The trial was approved by the Istituto Superiore di Sanità and the competent Ethics Committees and was monitored by an external Safety Board.
Six non-ambulatory patients were treated. Three of them received 3 unilateral hNSCs microinjections into the lumbar cord tract, while the remaining ones received bilateral (n = 3 + 3) microinjections. None manifested severe adverse events related to the treatment, even though nearly 5 times more cells were injected in the patients receiving bilateral implants and a much milder immune-suppression regimen was used as compared to previous trials.
No increase of disease progression due to the treatment was observed for up to18 months after surgery. Rather, two patients showed a transitory improvement of the subscore ambulation on the ALS-FRS-R scale (from 1 to 2). A third patient showed improvement of the MRC score for tibialis anterior, which persisted for as long as 7 months. The latter and two additional patients refused PEG and invasive ventilation and died 8 months after surgery due to the progression of respiratory failure. The autopsies confirmed that this was related to the evolution of the disease.
We describe a safe cell therapy approach that will allow for the treatment of larger pools of patients for later-phase ALS clinical trials, while warranting good reproducibility. These can now be carried out under more standardized conditions, based on a more homogenous repertoire of clinical grade hNSCs. The use of brain tissue from natural miscarriages eliminates the ethical concerns that may arise from the use of fetal material.
EudraCT:2009-014484-39 .
The main objective of this phase I trial was to assess the feasibility and safety of microtransplanting human neural stem cell (hNSC) lines into the spinal cord of patients with amyotrophic lateral ...sclerosis (ALS). Eighteen patients with a definite diagnosis of ALS received microinjections of hNSCs into the gray matter tracts of the lumbar or cervical spinal cord. Patients were monitored before and after transplantation by clinical, psychological, neuroradiological, and neurophysiological assessment. For up to 60 months after surgery, none of the patients manifested severe adverse effects or increased disease progression because of the treatment. Eleven patients died, and two underwent tracheotomy as a result of the natural history of the disease. We detected a transitory decrease in progression of ALS Functional Rating Scale Revised, starting within the first month after surgery and up to 4 months after transplantation. Our results show that transplantation of hNSC is a safe procedure that causes no major deleterious effects over the short or long term. This study is the first example of medical transplantation of a highly standardized cell drug product, which can be reproducibly and stably expanded ex vivo, comprising hNSC that are not immortalized, and are derived from the forebrain of the same two donors throughout this entire study as well as across future trials. Our experimental design provides benefits in terms of enhancing both intra‐ and interstudy reproducibility and homogeneity. Given the potential therapeutic effects of the hNSCs, our observations support undertaking future phase II clinical studies in which increased cell dosages are studied in larger cohorts of patients. Stem Cells Translational Medicine 2019;8:887&897
In this manuscript we present data from a phase I clinical trial on 18 ALS patients treated with human neural stem cells. Treatment has been performed transplanting cells directly into anterior horn of spinal cord. Results suggested that the procedure is feasible, safe and induce a transitory decline of ALS‐FRS‐R score progression.
Abstract Objective To draw a reliable picture of the surgical management of advanced ovarian cancer (AOC) within the MITO Group, trying to correlate the disease extent at presentation, the category ...of center, and surgical outcome. Methods Three tertiary referral centers for gynecologic oncology and four non-oncologic referral gynecologic surgical centers, participated in the project. A questionnaire was adopted to register perioperative data on AOCs (FIGO Stage IIIC IV) consecutively operated on for a period of 12 months. Results A total of 205 patients were registered into the study: 140 and 65 were recruited in oncological referral centers and non-referral centers, respectively. Following a multivariate analysis, the Eisenkop score and the category of center resulted the most potent predictors of complete surgical cytoreduction followed by PCI, preoperative CA125, and ASA score. Complete surgical cytoreduction was associated with oncological referral centers (60% vs 24.6%, p < 0.001). The proportion of patients undergoing additional surgical procedures was significantly different comparing the two categories of centers (at least one additional procedure was performed in 81.4% vs 50.8% in oncological referral centers compared to the others, p < 0.001). Despite the more aggressive surgery performed in oncological referral centers, the perioperative outcome measures were not significantly different in the two groups. Conclusions The chance of obtaining a complete cytoreduction mainly depends on patient characteristics, tumor spread, and quality of treatment. The latter is amenable for direct influence, and therefore, seems to be of utmost importance when considering efforts aiming at improvement in the outcome of this disease.
Renan en Orient Balcou, Jean; Bigaignon, Arnaud; Botouropoulou, Iphigénie ...
Presses universitaires de Rennes eBooks,
02/2022
eBook, Book
Odprti dostop
Ce livre suit l’irrésistible mouvement qui entraîne Ernest Renan de la mission de 1860-1861 en Liban-Palestine à la circumnavigation de 1864-1865 au Proche-Orient, mouvement qui s’inscrit dans un ...cycle majeur qui va de la rédaction en 1864-1874 de la Mission de Phénicie aux sept volumes des Origines du christianisme écrits entre 1861 et 1882. Le propre des contributions réunies ici est précisément de se focaliser sur Renan en Orient, qui relève d’une sorte de roman expérimental, d’où jaillit la vie. Des lieux mêmes : une Phénicie sortie des fouilles, Jésus rencontré en Palestine, le départ foudroyant de Paul par monts et par flots, l’arrêt à Athènes avant de repartir, le christianisme s’allumant de port en port. Du voyageur lui-même : archéologue, poète de Jésus à Ghazir au Liban, suiveur infatigable de l’apôtre, pèlerin de l’Acropole, conquérant celte au pays du Levant. Ces deux grands voyages ont produit les matériaux de deux beaux monuments qu’on n’en finit plus de visiter. Avec, au cœur, passionaria christique, Henriette Renan, en repos là-bas, aux abords de l’antique Byblos.
Transfusion of red blood cells is associated with superficial vein thrombosis (SVT) and venous thromboembolism (deep vein thrombosis and/or pulmonary embolism, VTE). The present study investigated ...the prevalence of SVT and VTE in women transfused in the peri-partum period.
We carried out an observational study in a tertiary level obstetrics department in the Apulia Region of Southern Italy to investigate VTE in women transfused during or after labour. The study included all women who delivered between January 1
and November 30
, 2018. A thrombotic event was defined as an admission with an ICD-9 code of SVT and VTE as a primary or secondary diagnosis. Maternal "near-miss" rate, as defined by the World Health Organization, was calculated and outcome of transfused women was recorded.
From January 1
to November 30
, a total of 1,028 women delivered, 39% of them by caesarean section (CS). One-hundred and thirty-two women (12.8%) had been classified with one or more complication codes. Most complications occurred in women who underwent CS with an odds ratio (OR) of 7.0 (95% CI: 4.0-12.5; p=0.000). Twelve women (1.2%) were transfused in the peri-partum period, 7 of them had delivered by CS. The only thrombotic events recorded in the entire cohort of 1,028 patients were isolated pulmonary embolisms observed in 2 out of 12 transfused women. Overall, patients had received a mean of 7.5 units of packed red blood cells (1 patient also received 7 plasma units, while 1 patient also received 1 platelet unit). Consequently, the near-miss rate was 2.0/1,000 deliveries, which is not significantly different from that expected in Italy and in high-income countries.
Pulmonary embolism is a life-threatening complication, which can be associated with transfusion in the peri-partum period.
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