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S. Bouchikh J. Stirnemann V. Prendki R. Porcher H. Kesthmand A.-S. Morin P. Cruaud S. Rouaghe D. Farge O. Fain 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2012
Purpose
The recommended duration of pulmonary tuberculosis therapy is 6 months. For extrapulmonary tuberculosis, treatment duration depends on tuberculosis involvement and HIV status. The objective of this study was to describe the main characteristics of a cohort of extrapulmonary tuberculosis patients, to compare patients with a 6-month treatment to those with more than a 6-month treatment, and to analyze the compliance of medical centres with recommended duration of treatment.Methods
A retrospective cohort study of 210 patients with extrapulmonary tuberculosis was carried from January 1999 to December 2006 in two hospitals in the north-east of Paris. These patients were treated with quadruple therapy during two months, followed by dual therapy during 4 months (n = 77) or more (n = 66). The characteristics of each group were compared by uni- and multivariate analysis. The primary endpoint was the rate of relapse or treatment failure at 24-month follow-up after treatment completion.Results
No relapse was observed after 24 months of follow-up after the end of treatment in the two groups. In univariate analysis, patients with lymph node tuberculosis were more often treated for 6 months than at other sites of tuberculosis (respectively 61% versus 40.9%; P = 0.02); the decision of treatment duration was related to medical practices (79.2% treated 6 months in one hospital versus 20.7% in the other, P < 0.001); patients living in private residence were more often treated during 6 months than patients living in residence (24.2% versus 10.3%, P = 0.042). In multivariate analysis, only hospital (P = 0.046), sex (P = 0.007) and private residence were significantly different in each group.Conclusion
A period of 6 months seems to be sufficient to treat extrapulmonary tuberculosis (except for neuromeningeal localization). 相似文献43.
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Mekinian A Néel A Sibilia J Cohen P Connault J Lambert M Federici L Berthier S Fiessinger JN Godeau B Marie I Guillevin L Hamidou M Fain O;Club Rhumatismes et Inflammation French Vasculitis Study Group Société Nationale Française de Médecine Interne 《Rheumatology (Oxford, England)》2012,51(5):882-886
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Guilpain P Kettaneh A Chamouard JM Stirnemann J Thomas M Fain O 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2003,24(1):59-62
INTRODUCTION: Craniocervical junction damages may result in a compression of the spinal cord. They may be caused by infectious, tumoral or inflammatory processes. Rheumatoid arthritis is probably among rheumatic diseases the most frequent cause of atlantoaxial arthritis. Nevertheless involvement of the craniocervical junction as the presenting symptom of rheumatoid arthritis is a very rare feature. EXEGESIS: We report the case of a 61 years old woman who presented with atlantoaxial involvement and spinal cord compression one year before the diagnosis of a seronegative rheumatoid arthritis. CONCLUSION: Symptomatic craniocervical junction damages may appear. Patients with damages of the craniocervical junction and negative investigations should be followed long-term; an underlying inflammatory disease may become evident after significant delay. 相似文献
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Julien Rohmer Amélie Couteau-Chardon Julie Trichereau Kewin Panel Cyrielle Gesquiere Raouf Ben Abdelali Audrey Bidet Jean-Sébastien Bladé Jean-Michel Cayuela Pascale Cony-Makhoul Vincent Cottin Eric Delabesse Mikaël Ebbo Olivier Fain Pascale Flandrin Lionel Galicier Catherine Godon Nathalie Grardel Aurélien Guffroy Mohamed Hamidou Mathilde Hunault Etienne Lengline Faustine Lhomme Ludovic Lhermitte Irène Machelart Laurent Mauvieux Catherine Mohr Marie-Joelle Mozicconacci Dina Naguib Franck E. Nicolini Jerome Rey Philippe Rousselot Suzanne Tavitian Louis Terriou Guillaume Lefèvre Claude Preudhomme Jean-Emmanuel Kahn Matthieu Groh CEREO GBMHM collaborators 《American journal of hematology》2020,95(11):1314-1323
FIP1L1-PDGFRA-positive myeloid neoplasm with eosinophilia (F/P+ MN-eo) is a rare disease: robust epidemiological data are lacking and reported issues are scarce, of low sample-size and limited follow-up. Imatinib mesylate (IM) is highly efficient but no predictive factor of relapse after discontinuation has yet been identified. One hundred and fifty-one patients with F/P+ MN-eo (143 males; mean age at diagnosis 49 years; mean annual incidence: 0.18 case per million population) were included in this retrospective nationwide study involving all French laboratories who perform the search of F/P fusion gene (study period: 2003-2019). The main organs involved included the spleen (44%), skin (32%), lungs (30%), heart (19%) and central nervous system (9%). Serum vitamin B12 and tryptase levels were elevated in 74/79 (94%) and 45/57 (79%) patients, respectively, and none of the 31 patients initially treated with corticosteroids achieved complete hematologic remission. All 148 (98%) IM-treated patients achieved complete hematologic and molecular (when tested, n = 84) responses. Forty-six patients eventually discontinued IM, among whom 20 (57%) relapsed. In multivariate analysis, time to IM initiation (continuous HR: 1,01 [0.99-1,03]; P = .05) and duration of IM treatment (continuous HR: 0,97 [0,95-0,99]; P = .004) were independent factors of relapse after discontinuation of IM. After a mean follow-up of 80 (56) months, the 1, 5- and 10-year overall survival rates in IM-treated patients were 99%, 95% and 84% respectively. In F/P+ MN-eo, prompt initiation of IM and longer treatment durations may prevent relapses after discontinuation of IM. 相似文献