Réflexions sur l’organisation de l’oncogériatrie et rôle des réseaux

Résumé:  Le réseau d’oncogériatrie devra comprendre toutes les personnes et toutes les structures qui gèrent la prise en charge clinique de la personne agée atteinte de cancer à toutes les étapes de la maladie. Les outils cliniques les plus importants sont l’évaluation gériatrique multidimensionnelle et l’évaluation oncologique complète. L’objectif est d’améliorer l’état de santé des personnes agées atteintes de cancer.      

Brain metastases in breast cancer. Epidemiology and natural history. The Institut Curie experience

Breast cancer is the second cause for brain metastases. Their incidence is rising, partly due to the therapeutic improvements which alter the natural history of breast cancer. Predictive factors for brain metastases have been identified: HER2 oncogene overexpression, lack of expression of hormone receptors, young age and triple negative status. Brain metastases prognosis remains poor with a median survival shorter than 1 year, except for solitary lesions treated by surgery or radiosurgery. We have analysed two series of data from Institut Curie (Paris and Saint-Cloud). In women younger than 65 years, with HER2 negative breast carcinoma, median survival was 7.1 months. In women older than 65 years, median survival was 4 months.     

Acceptation de la vaccination antigrippale par les soignants au sein d’une institution gériatrique et médicosociale

Introduction

Seasonal influenza is a viral transmissible infectious disease causing increased morbidity or mortality in frail subjects, especially those living in institutions. Measures to prevent the impact of infectious diseases were proposed based on the use of influenza vaccination among health-care professionals. We wanted to evaluate the acceptance of our institutional vaccination procedure initiated in 2005 and possible improvement.

Methods

A questionnaire was sent in May 2007 to all health-care professionals (n = 730) to identify their current vaccine status in 2006 and their opinion concerning vaccination against influenza in 2007.

Results

Subsequently, 369 (50.2%) responses were obtained. Amongst those responding, 31.7% were vaccinated in 2006, 77.8% using the institutional procedure. Also, 221 (87.7%) nonvaccinated health-care professionals indicated their position concerning influenza vaccination: 37% of them would accept the vaccination in 2007 (on the condition that our current institutional procedure be improved), 63% of them would refuse influenza vaccines in spite of any improvement.

Conclusion

Our study emphasizes that the use of an adapted procedure for influenza vaccination among health-care professionals could improve vaccine coverage. It also emphasizes that a margin of those professionals are still reluctant to vaccination.     

La cystite emphysémateuse : à propos d’un cas

Introduction

Emphysematous cystitis is a rare urinary tract infection characterized by gas in the bladder wall and lumen.