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World-first phage therapy treats teenager with drug-resistant bacterial infection

09/05/2019

A British teenager has become the first person in the world to have a drug-resistant bacterial infection treated by genetically engineered viruses. Isabelle Holdaway, 17, was given just a 1% chance of survival after a double lung transplant to treat her cystic fibrosis left her with an intractable bacterial infection that could not be treated with antibiotics. Her arms, legs and buttocks had numerous big, black, festering lesions where the bacteria were pushing up through her skin. She finally ended up in intensive care after her liver began to fail. Every previous patient in Isabelle’s situation died – some within a year, despite aggressive treatment. Desperate for a solution, Isabelle’s mother researched alternative treatments online and came across phage therapy. It’s not new; doctors have been using it for nearly a century, but its use has been eclipsed by antibiotics because they are much easier to use. Isabelle’s care team at Great Ormond Street Hospital contacted Prof Graham Hatfull at the Howard Hughes Medical Institute, in the US, who had the world's largest collection of phages (approximately 15,000). Hatfull and his team identified three potential phages that would be effective in tackling Isabelle’s bacterial infection and genetically modified two of them to make them more effective. Isabelle was injected with the cocktail of phages twice daily and they were also applied to the lesions on her skin. Within just six weeks, a liver scan showed that the infection had essentially disappeared. Phage therapy involves injecting bacteria-killing viruses into a patient’s body which track down, infect and ultimately kill bacteria. The phages hijack the bacterial cell and turn it into a phage factory until the viruses burst out of the bacteria killing it in the process. While Isabelle’s fatal infection has not been completely cured, it is under control and she is beginning to lead a normal life. She still has two infusions of phages every day and is currently waiting for a fourth phage to be added to the mix, which will hopefully clear the infection completely.

Une bactérie est responsable de 90% des cas de cancer de l’estomac

10/08/2018

Par  Martine Lochouarn Publié le 17/06/2018 à 06:00   INFOGRAPHIE - Un diagnostic précoce de ce cancer permettrait d’améliorer la prise en charge. Au cinquième rang mondial par sa fréquence, le cancer de l’estomac figure en troisième place par le nombre de morts, près de 9 % de tous les décès par cancer. Son incidence varie selon les régions du globe, les ethnies et le niveau de développement. L’Asie de l’Est, Japon, Corée et Chine surtout, est fortement touchée, mais aussi l’Amérique du Sud. «Intermédiaire en Europe de l’Est, son incidence est plus faible en Europe de l’Ouest, à l’exception du Portugal, fortement touché», explique le Pr Tamara Matysiak-Budnik, gastro-entérologue et cancérologue (CHU Nantes). En France, de 6000 à 7000 nouveaux cas sont diagnostiqués chaque année, pour 4500 décès. C’est un cancer du sujet âgé, de pronostic médiocre. En quelques décennies, les progrès de l’hygiène alimentaire ont beaucoup réduit son incidence, qui est aujourd’hui assez stable.   «L’association démontrée entre infection par H.pylori et cancer gastrique est aussi forte que celle entre tabac et cancer du poumon.» Pr Tamara Matysiak-Budnik,  gastro-entérologue et cancérologue (CHU Nantes) La forme la plus fréquente, qui touche le corps et la partie basse de l’estomac, diminue encore peu à peu, mais les cancers de la jonction estomac-oesophage (cardia) plus rares, augmentent avec l’épidémie d’obésité qui favorise le reflux gastro-œsophagien. Moins de 5 % des cancers sont d’origine génétique. Il s’agit souvent de cancers «diffus», infiltrant l’estomac, de très mauvais pronostic, qui touchent des sujets jeunes. Mais le premier facteur de risque de cancer de l’estomac, c’est l’infection par Helicobacter pylori, responsable de près de 90 % des cas. Cette bactérie acquise dans l’enfance colonise la muqueuse gastrique, le plus souvent sans symptôme. «L’association démontrée entre infection par H. pylori et cancer gastrique est aussi forte que celle entre tabac et cancer du poumon», explique la gastro-entérologue. En France, de 20 à 30 % des individus sont infectés, mais 80 % le sont en Afrique et 10 % dans les pays nordiques.   Parmi les personnes infectées, de 2 à 20 % auront un ulcère, et parmi elles 1 % aura un cancer gastrique. «Ce processus complexe de carcinogenèse s’étend sur des décennies et passe par une cascade d’étapes, dont la première, la gastrite superficielle, ne survient pas sans infection par H. pylori, ce qui ne signifie pas que cette infection est suffisante», explique le Pr Matysiak-Budnik. L’excès de sel, de viande rouge, d’aliments fumés, le tabac favorisent aussi ce processus, les fruits et légumes ayant un effet protecteur. Les antibiotiques pour éradiquer la bactérie «L’éradication par antibiotiques de l’infection à H. pylori guérit et fait régresser les gastrites superficielles et la plupart des gastrites atrophiques, prévenant ainsi le cancer de l’estomac.» Comme l’incidence de ce cancer est faible en France, un dépistage sur toute la population ne paraît pas adapté. Mais il existe au Japon, et la Slovénie l’envisage. En revanche, la recherche de H. pylori et son éradication sont indispensables dans les formes héréditaires, chez les parents au premier degré de personnes ayant un cancer gastrique, chez les personnes ayant un ulcère, une gastrique atrophique, précancéreuse, ou ayant subi une ablation partielle de l’estomac pour cancer, et chez celles traitées au long cours par certains médicaments anti-acide, les IPP (inhibiteurs de la pompe à protons). La lésion peut être retirée par endoscopie Si le cancer gastrique a un pronostic médiocre, c’est d’abord à cause de son diagnostic tardif, les cancers précoces ne donnant pas de symptômes. Parfois, une lésion précoce est découverte par des signes très généraux comme une anémie. «Mais le plus souvent ils sont détectés à un stade évolué, parce que surviennent une hémorragie digestive, des douleurs qui ressemblent à un ulcère, un amaigrissement, des difficultés d’alimentation… C’est l’examen endoscopique et la biopsie des lésions qui confirment ce diagnostic, explique le Pr Thomas Aparicio, gastro-entérologue et cancérologue (hôpital Saint-Louis, Paris). Si la lésion est petite et superficielle, elle est parfois enlevée par endoscopie dans des centres très expérimentés. Mais la laparoscopie est moins utilisée que dans le cancer du côlon, et l’ablation chirurgicale se fait le plus souvent en ouvrant l’abdomen.» Le principal progrès de ces quinze dernières années dans l’amélioration de la survie, c’est la chimiothérapie périopératoire, avec en général deux mois de chimiothérapie préopératoire pour réduire la tumeur et éliminer les micrométastases, et deux mois de chimiothérapie postopératoire. Les 30 % de cancers métastatiques d’emblée ne sont pas opérés. Comme pour d’autres tumeurs, ces formes métastatiques commencent à bénéficier des avancées des thérapies ciblées et de l’immunothérapie. Mais, globalement, les progrès sont modestes et les essais souvent décevants. «Notre arme principale reste la détection, le plus précoce possible, qui a un peu progressé puisqu’on identifie 10 % de cancers superficiels précoces, contre 4 % il y a dix ans», insiste le Pr Matysiak-Budnik. De nouveaux tests en cours d’évaluation pourraient aider à améliorer ce dépistage…        

Long-term aspirin use associated with significant reduction in colorectal cancer risk

31/10/2017

A new large-scale study has found that using aspirin long-term could slash the chances of developing gastrointestinal cancer. Of all the gastrointestinal cancers, which include pancreatic cancer, liver cancer, oesophageal cancer, stomach (or gastric) cancer and small intestine cancer, colorectal cancer is the most common in the western world. While there are a number of lifestyle changes people can make to reduce their risk of developing cancer, including avoiding tobacco, limiting their alcohol consumption, eating healthier and exercising more, an increasing number of studies suggest the use of aspiring could also help. For this latest study, Prof. Kelvin Tsoi, of the Chinese University of Hong Kong, and his team set out to investigate the effect of aspirin use on gastrointestinal cancers. Over a 10-year period, the team of scientists examined over 600,000 participants and analysed how aspirin use affected their chances of developing gastrointestinal cancer. They found that aspirin users were 47% less likely to have liver and oesophageal cancer, 38% less likely to have stomach cancer, 34% less likely to have pancreatic cancer and 24% less likely to have colorectal cancer. In addition, aspirin use also significantly reduced the risk of leukaemia, lung cancer and prostate cancer.

Breath Test Can Save Lives by Detecting Stomach and Esophageal Cancers Early

07/02/2017

A simple breath test which measures the levels of five specific chemicals in a person's breath could detect stomach and esophageal cancer, a new study has found. At present, the only way to diagnose cancers of the stomach and oesophagus is with endoscopy, an invasive, expensive method, which isn’t without its complication risks. It's hoped that the new breath test method could not only save thousands of lives each year, but also negate the need for patients to undergo painful endoscopy exams. The breath test works by measuring the levels of butyric, pentanoic and hexanoic acids, butanal, and decanal in people's breath samples. These can then be compared to a 'chemical signature' indicative of stomach and esophageal cancer. Presenting her team's findings at the European Cancer Congress 2017 in Amsterdam, Dr Sheraz Markar, an NIHR Clinical Trials Fellow from Imperial College London, said the breath test "could be used as a non-invasive, first-line test to reduce the number of unnecessary endoscopies. In the longer term this could also mean earlier diagnosis and treatment, and better survival." The clinical trial involved 335 patients from three different London hospitals, 163 of which had been diagnosed with stomach or esophageal cancer and 172 who had showed no evidence of cancer when they underwent an endoscopy. The researchers found that the breath test had an overall accuracy level of 85%, with a sensitivity of 80% and a specificity of 81%. This means that not only was the breath test good at picking up those who had cancer (sensitivity), it was also good at correctly identifying who did not have cancer (specificity). Dr Justine Alford from Cancer Research UK welcomed the findings. "The next step is to see if it can detect the disease at its earliest stages," she said.

The Health Benefits of Honey

17/11/2015

Honey is one of the sweetest and most natural food products there is. It’s made by bees through a process of regurgitation and evaporation, then stored as a primary food source in wax honeycombs within the beehive. This is usually from where it is harvested for human consumption. But whether you’re a huge fan of honey, or will happily pass it up, there’s no denying the strong association it has long held with health benefits. First up, there’s the fact that many health experts believe that consuming honey instead of sugar results in a more gradual rise in blood sugar levels, which in turn helps to regulate your hunger levels. Honey is also recommended as a natural cough remedy by both the World Health Organisation (WHO) and the American Academy of Paediatrics. In fact, a 2007 study by Penn State College of Medicine found that honey consumption led to reduced night time coughing and improved sleep quality for children suffering with upper respiratory tract infections. If you suffer with heartburn, you may already know about honey’s effectiveness as a treatment. Experts believe its viscose nature enable it to coat the upper gastroesophageal tract, preventing stomach acid from rising. Lastly, there are honey’s antibacterial properties. It contains the protein defensin-1, which can actually kill bacteria. Furthermore, unpasteurised, raw honey can actually be used as a topical agent on open wounds because of its antibacterial qualities, but should never be used in place of a topical solution prescribed by a doctor.

Sleeve Gastrectomy

03/06/2015

SLEEVE GASTRECTOMY Sleeve Gastrectomy is a restrictive technique which consists of removing approximately two thirds of the stomach and, in particular, the part containing the cells that secrete the hormone that stimulates appetite (ghrelin). The stomach is reduced to a vertical tube and food passes quickly into the intestine. Appetite is also reduced. This technique does not interfere with the digestion process. Sleeve gastrectomy is sometimes the first step in a biliopancreatic diversion procedure. Expected Weight Loss: Around 45 to 65 % excess weight loss after 2 years, corresponding to a weight loss of approximately 25 to 35 kg. (studies with 2 years follow-up, for a person of average height (1.7 m) with a BMI of 40 kg/m) Mean operating time: 2 hours (Provided there are no complications during the operation). Mean length of hospital stay: 3 to 8 days (Provided there are no complications after the operation). Main complications risks : Ulcers, leakage or stenosis of the remnant stomach. Early postoperative bleeding. Possible nutritional deficiencies (to be monitored). Gastrooesophageal reflux (acids and foods coming back up the oesophagus) and inflammation of the oesophagus.Dilation of the stomach.   French health facilities represented by France Surgery are all recognized Surgery Center of Excellence in European obesity surgery by the EAC-BS European Accreditation Council for Bariatric Surgery.   CONSIDERING SLEEVE GASTRECTOMY IN FRANCE ?  CLICK HERE FOR A FREE QUOTE   To find out more about the advantages and disadvantages of the different Bariatric surgical techniques: http://www.laparoscopic-surgeon.com/ www.soffco.fr Société française et francophone de chirurgie de l’obésité www.mangerbouger.fr (French National Nutrition Health Programme) www.has-sante.fr (French Health Authority)  

Clinique du Trocadéro

03/09/2014

Clinique du Trocadéro, Paris The clinic of Trocadéro is a centre of excellence in gastroenterology. Experienced practitioners recognized for their expertise, promoters of innovative treatments and leaders in the speciality operate within the endoscopy and proctology unit. Key figures Surgical operation beds 50 Surgical ambulatory places 26 Surgical operating rooms 5 Diagnostic and interventional endoscopy operation rooms 5 Recovery rooms 2 Imaging service including two full digital radiology 1 Ultrasound room 1 Doppler ultrasound 1 Pharmacy 1   Quality indicators   The Joint Commission Haute Autorité de la Santé (HAS)  X ISQUA Nosocomial Infection Prevention Committee X  The Trocadéro Clinic is using latest-generation equipment and techniques and it specialises in: Diagnostic and therapeutic endoscopy (colonoscopy, endoscopy) Echoendoscopy (high and low) Retrograde catheterization Prostheses (esophageal, rectal, etc.) Proctology Other surgical specialties are: Orthopaedics Gynaecology and senology Digestive surgery E.N.T. Vascular surgery (varicose veins) Maxillofacial surgery and stomatology Plastic, cosmetic and restorative surgery

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