Purpose
The identification and referral of patients in need of palliative care should be improved. The French society for palliative support and care recommended to use the PALLIA‐10 questionnaire and its score greater than 3 to refer patients to palliative care. We explored the use of the PALLIA‐10 questionnaire and its related score in a population of advanced cancer patients.
Methods
This prospective multicentric study is to be conducted in authorized French comprehensive cancer centers on hospitalized patients on a given day. We aimed to use the PALLIA‐10 score to determine the proportion of palliative patients with a score >3. Main secondary endpoints were to determine the proportion of patients already managed by palliative care teams at the study date or referred to palliative care in six following months, the prevalence of patients with a score greater than 5, and the overall survival using the predefined thresholds of 3 and 5.
Results
In 2015, eighteen French cancer centers enrolled 840 patients, including 687 (82%) palliative patients. 479 (69.5%) patients had a score >3, 230 (33.5%) had a score >5, 216 (31.4%) patients were already followed‐up by a palliative care team, 152 patients were finally referred to PC in the six subsequent months.
The PALLIA‐10 score appeared as a reliable predictive (adjusted ORRef≤3: 1.9 [1.17‐3.16] and 3.59 [2.18‐5.91]) and prognostic (adjusted HRRef≤3 = 1.58 [95%CI 1.20‐2.08] and 2.18 [95%CI 1.63‐2.92]) factor for patients scored 4‐5 and >5, respectively.
Conclusion
The PALLIA‐10 questionnaire is an easy‐to‐use tool to refer cancer inpatients to palliative care in current practice. However a score greater than 5 using the PALLIA‐10 questionnaire would be more appropriate for advanced cancer patients hospitalized in comprehensive cancer center.
The influence of environmental factors on atopic dermatitis (AD) has been investigated in many cross-sectional studies. It remains however unclear if they could influence AD development early in life. This prospective birth cohort study aimed to monitor aspects of family lifestyle and child's nutrition within a Caucasian population and to assess its association with AD development over the first two years of life. Genetic predisposition was evaluated based on family history and profilaggrin genotyping. Of 149 included children, 36 developed AD.Infants with a family history of atopy developed AD 2.6 times more frequently (30 of 97) than infants without atopic predisposition (6 of 52). Genotyping was carried out on 50% of the children included. Profilaggrin mutations (R501X, 2282del4, R2447X and S3247X) were infrequent in our population. Lower incidence of AD was observed in infants exposed to a damp housing environment, lower household income and smoking mothers with a higher but not with a lower education level.
Conclusion :Family history of atopy was a significant risk factor for AD regardless of the most common, currently defined, FLG mutations. Humidity at home and passive smoking seem associated with AD development in infancy.
Dear Editor, Whether randomly scattered or agminated on a pre-existing café-au-lait macule (nevus spilus), multiple Spitz nevi (SN) are rarely seen. The diagnosis of SN is often clinical and confirmed by histopathological examination. 1 Although techniques such as dermoscopy may improve the clinical
La peau vue par différentes méthodes d'imagerie cutanée non invasive Le développement de technologies d'imagerie cutanée in vivo est en plein essor depuis plusieurs dizaines d'années. Leurs avantages sont indéniables compte tenu notamment de leur caractère non invasif. Leur place est déjà bien établie en onco-dermatologie et leur utilité est également prometteuse dans beaucoup de domaines en dermatologie, y compris en dermatologie pédiatrique. Nous allons détailler ici trois de ces techniques utilisées en dermatologie au CHUV, à savoir la tomographie en cohérence optique (OCT), la microscopie confocale par réflectance (MCR) et la plus récente : la tomographie en cohérence optique confocale en champ linéaire (LC-OCT).
Cutaneous visualization by different non-invasive skin imaging methodsThe development of in vivo skin imaging technologies has been booming for several decades. Their advantages are indisputable, especially as they are non-invasive. Their place is already well established in onco-dermatology and it is just a question of time for them to be used with success in other fields of dermatology, including pediatric dermatology. In this paper we will discuss 3 of these skin imaging techniques used in dermatology at the CHUV, including Optical Coherence Tomography (OCT), Reflectance Confocal Microscopy (RCM) and the most recent: Line-field Confocal Optical Coherence Tomography (LC-OCT).
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