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Showing papers by "CHU Ambroise Paré published in 2017"


Journal ArticleDOI
TL;DR: This Viewpoint analyses the recent studies on the role of ultrasound in rheumatoid arthritis management, and discusses potential limitations in study designs as well as the methodological challenges of assessing the added value of an imaging technique.
Abstract: For over a decade, a large number of studies have highlighted the benefits of ultrasound (US) in the diagnosis and management of rheumatic diseases, especially rheumatoid arthritis (RA) However, its benefits in routine practice have been less studied and trials examining US as part of various clinical strategies are just emerging, with recent randomised trials examining the added value of US in tight-control paradigms The conclusions of these trials have raised questions on the role of US in RA management This Viewpoint analyses the recent studies, and discusses potential limitations in study designs as well as the methodological challenges of assessing the added value of an imaging technique

29 citations


Journal ArticleDOI
TL;DR: There is a need for an international agreed consensus on what modalities are necessary and how best to deliver training in CCUS, and some of these are discussed along with potential solutions from a number of national European professional societies.
Abstract: Over the past decades, ultrasound (US) has gained its place in the armamentarium of monitoring tools in the intensive care unit (ICU). Critical care ultrasonography (CCUS) is the combination of general CCUS (lung and pleural, abdominal, vascular) and CC echocardiography, allowing prompt assessment and diagnosis in combination with vascular access and therapeutic intervention. This review summarises the findings, challenges lessons from the 3rd Course on Acute Care Ultrasound (CACU) held in November 2015, Antwerp, Belgium. It covers the different modalities of CCUS; touching on the various aspects of training, clinical benefits and potential benefits. Despite the benefits of CCUS, numerous challenges remain, including the delivery of CCUS training to future intensivists. Some of these are discussed along with potential solutions from a number of national European professional societies. There is a need for an international agreed consensus on what modalities are necessary and how best to deliver training in CCUS.

17 citations


Journal ArticleDOI
TL;DR: The purpose of this prospective observational study was to evaluate the efficacy and tolerability of transarterial chemoembolization for neuroendocrine liver metastases using a combination of streptozocin, Lipiodol, and tris-acryl microspheres.
Abstract: The purpose of this prospective observational study was to evaluate the efficacy and tolerability of transarterial chemoembolization (TACE) for neuroendocrine liver metastases using a combination of streptozocin, Lipiodol, and tris-acryl microspheres. A total of 16 men and 9 women aged 59.6 ± 11.3 years, all with predominant liver disease, underwent 54 courses of TACE using an emulsion of 1.5 g of streptozocin and 10 ml of Lipiodol. Additional embolization was performed using 300–500 µm tris-acryl microspheres. Morphological response was evaluated using the RECIST criteria on multi-detector computed tomography or MRI. Clinical efficacy was evaluated particularly in patients with carcinoid syndrome. The primary tumor was located in the small bowel or pancreas in 21 (84%) patients. Eleven (44%) patients presented with a carcinoid syndrome. Nineteen (76%) patients presented with more than 10 liver nodules. One delayed case of ischemic cholecystitis was treated conservatively. After a median follow-up of 36.1 months, 1 (4%) patient had a complete response, 12 (48%) patients had a partial response, and 7 (28%) patients had a stable disease corresponding to a disease control rate of 80%. All patients with carcinoid syndrome had significant improvement. Median time to progression was 18.8 months and overall survival was 100, 100, and 92% at 1, 2, and 3 years, respectively. Seven patients presented with extrahepatic progression with abdominal lymphadenopathies or metastases to the brain, ovary, adrenal gland, or lung. Optimized TACE using a combination of streptozocin, Lipiodol, and tris-acryl microspheres is effective and well tolerated.

11 citations


Book ChapterDOI
01 Jan 2017
TL;DR: Recurrences are observed in the majority of patients who undergo liver resection despite developed surgical technique and improved surgical skills, in particular chemotherapy-associated liver injury.
Abstract: Surgical resection is the only method for treating colorectal liver metastases, because it can ensure long-term survival and cure in some patients. Only approximately 20 % of colorectal cancer patients with liver metastases can undergo liver resection at the time of diagnosis. Modern chemotherapy regimens are received by other patients, which could achieve high response rates but are insufficient for cure. Recurrences are observed in the majority of patients who undergo liver resection despite developed surgical technique and improved surgical skills. Many patients with resectable metastases undergo neoadjuvant chemotherapy before liver resection. Its benefit in terms of long-term disease control has been recently demonstrated, but neoadjuvant chemotherapy has also potential disadvantages, in particular chemotherapy-associated liver injury.

1 citations