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1.
J Clin Med ; 13(12)2024 Jun 15.
Article in English | MEDLINE | ID: mdl-38930048

ABSTRACT

Background/Objectives: ACTION-FRANCE (Awareness, Care, and Treatment In Obesity maNagement in France) aims to identify the perceptions, attitudes, behaviors, and potential barriers to effective obesity management in France and guide collaborative actions. Methods: ACTION-FRANCE is a cross-sectional survey of people with obesity (PwO) and healthcare professionals (HCPs) in France. The PwO and HCP survey questionnaire periods ran from 27 September 2022 to 1 February 2023 and from 19 December 2022 to 31 March 2023, respectively. Results: The study, encompassing 1226 PwO and 166 HCPs, reveals a shared recognition of obesity as a chronic condition. However, despite being requested by most PwO, weight-related discussions are surprisingly infrequent, leading to delayed diagnosis and care. PwO and HCPs held different views as to why: HCPs often attributed it to PwO's lack of motivation or disinterest, whereas PwO avoided them because they felt weight management was their own responsibility and were uncomfortable discussing it. When weight was discussed, primarily with general practitioners (GPs), discussions mostly focused on physical activity and diet. However, results identified the strong psychosocial impact of obesity: 42% of respondents reported anxiety/depressive symptoms, and many more hesitated to engage in certain social activities because of their weight. Psychotherapy was only discussed by 55% of HCPs. Pharmaceutical options were also rarely discussed (19.5% of HCPs), though 56.1% of PwO reported they would want to. Conclusions: HCPs' and PwO's perceptions differed significantly and need to converge through enhanced communication. A holistic approach, integrating comprehensive training for GPs and recognizing psychological comorbidities, would help to bridge perceptual gaps effectively and foster more empathetic and effective patient care.

2.
J Clin Med ; 12(3)2023 Jan 25.
Article in English | MEDLINE | ID: mdl-36769573

ABSTRACT

Obepi-Roche 2020 by the "Ligue Contre l'Obésité" (League Against Obesity) estimated overweight and obesity prevalence in France. The adopted methodology was chosen to be as similar as possible to that of a series of quota-based surveys conducted every three years from 1997 to 2012 (Obepi-Roche studies). The 2020 survey was conducted online from 24th September to 5th October 2020 by the Odoxa polling institute on a sample of metropolitan French subjects aged 18 years or over. Participants (n = 9598) self-measured their height and weight according to detailed instructions. Prevalence estimates were produced for all categories of body mass index. The prevalence of excess weight was 47.3% (17.0% of subjects with obesity), with higher values in the north and east of France. When comparing these 2020 estimates to previous Obepi-Roche estimates in order to visualize trends since 1997, it appeared that overweight fluctuated around 30%, and obesity prevalence increased steadily at a rapid pace. The increase was even steeper in the youngest age groups and for severe and complex obesity. Given the slightly different methodologies between the 1997-2012 studies and the 2020 survey, the worrying trends in obesity prevalence since 1997 must be confirmed, calling for a reedition of the Obepi-Roche series.

3.
Gastroenterol Clin Biol ; 30(11): 1297-300, 2006 Nov.
Article in French | MEDLINE | ID: mdl-17185971

ABSTRACT

Peritoneal carcinomatosis has been treated by extensive cytoreduction surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). We report here our experience of 5 patients treated twice or three times by recurrent procedure of HIPEC and cytoreduction. The mortality rate was 0% and morbidity one 30%. Three patients have died at 6, 10, 18 months respectively after the second cytoreduction surgery and HIPEC, and two patients are still alive at 40 and 67 months. Our results might suggest that recurrent peritoneal carcinomatosis after cytoreduction and HIPEC, could be usefully treated by another cytoreduction and HIPEC procedure in a curative approach superior to more conventional treatments.


Subject(s)
Carcinoma/therapy , Chemotherapy, Cancer, Regional Perfusion/methods , Hyperthermia, Induced , Neoplasm Recurrence, Local/therapy , Peritoneal Neoplasms/therapy , Adult , Carcinoma/mortality , Combined Modality Therapy/methods , Feasibility Studies , Female , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/mortality , Peritoneal Neoplasms/mortality , Survival Analysis , Treatment Outcome
4.
Eur J Obstet Gynecol Reprod Biol ; 110(1): 107-10, 2003 Sep 10.
Article in English | MEDLINE | ID: mdl-12932884

ABSTRACT

Colouterine fistula, secondary to diverticulitis, is an extremely rare complication, and only few cases have been reported in the literature. We report the case of 76-year-old woman, who presented with vaginal discharge over a three-month period. Pelvic examination and laboratory investigations suggested a colouterine fistula, that was confirmed by non-invasive imaging. Surgical treatment was a one-stage, en bloc resection of the uterus and sigmoid colon. In the presence of severe inflammatory reaction or paracolic abscess, a two-stage procedure should be safer. Otherwise, a one-stage procedure, en bloc resection of the uterus and sigmoid colon is preferred, as we cannot rule out a malignancy prior to surgery.


Subject(s)
Colonic Diseases/etiology , Diverticulitis, Colonic/complications , Fistula/etiology , Intestinal Fistula/etiology , Uterine Diseases/etiology , Aged , Colonic Diseases/diagnosis , Colonic Diseases/surgery , Female , Fistula/diagnosis , Fistula/surgery , Humans , Intestinal Fistula/diagnosis , Intestinal Fistula/surgery , Tomography, X-Ray Computed , Uterine Diseases/diagnosis , Uterine Diseases/surgery , Vaginal Discharge
5.
Gastroenterol Clin Biol ; 26(11): 1047-50, 2002 Nov.
Article in French | MEDLINE | ID: mdl-12483142

ABSTRACT

We report two cases of familial juvenile polyposis coli. SMAD4 gene mutation was found in our two patients, leading to the definite diagnosis. Colonic cancer occurred in the first patient. Long-term outcome was favorable after colectomy. In the second patient, prophylactic total colectomy was performed. Rectal bleeding, diarrhea, stomach obstruction and vomiting developed during the follow-up. Proctectomy, distal partial gastrectomy and total gastrectomy were successively performed.


Subject(s)
Adenomatous Polyposis Coli , Adenomatous Polyposis Coli/genetics , Adenomatous Polyposis Coli/pathology , Adenomatous Polyposis Coli/surgery , Adult , Child , Colectomy , Colon/pathology , Electrocoagulation , Female , Gastrectomy , Humans , Male , Mutation , Pedigree , Phenotype , Pyloric Antrum/pathology , Risk Factors
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