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Interstitial lung disease (ILD) has been reported with many cancer drugs including some recent antibody-drug conjugates (ADCs). The mechanisms of ILD induced by many chemotherapy drugs, other drug classes and ADCs used in cancer, including breast cancer, are not clearly elucidated. In the absence of specific clinical or radiological signs, the diagnosis of drug-induced ILD is often a diagnosis of exclusion. When present, the most frequent symptoms are respiratory signs (cough, dyspnea, chest pain) and general signs (fatigue, fever). Any suspicion of ILD should be evaluated by imaging and, if in doubt, the CT scan should be evaluated by a pulmonologist and a radiologist. A network of multidisciplinary experts for proactive early management of ILD is important, including oncologist, radiologist, pulmonologist, infectious disease specialist and nurses. Patient education is essential to report new or exacerbated lung symptoms and prevent high-grade ILD. Study drug is discontinued temporarily or permanently according to ILD severity and type of ADC. For asymptomatic cases (Grade 1), the efficacy of corticosteroids is not clearly established; for higher grades, the benefit/risk balance of long-term corticosteroid therapy should be considered for the dose and treatment duration. Hospitalization and oxygen supplementation are required for severe cases (Grades 3-4). For patient follow-up, the expertise of a pulmonologist is necessary with repeated chest scans, spirometry and DLCO. Preventing ADC-induced ILDs and evolution to high grade rests on a network of multidisciplinary experts for assessment of individual risk factors, early management, close follow-up and patient education., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

New ministerial decree restricts driving motorized vehicles for patients with Alzheimer's disease and related disorders. Reisberg stage 3, threshold used to contraindicate driving, appears to correspond to a mild stage of major neurocognitive impairment. A single scale gives an idea of the level of risk but does not provide a holistic assessment. The aim of this consensus is to put forward recommendations from several French learned societies for individualized cognitive assessments to minimize the risks associated with driving and its cessation. Fitness to drive should be raised at the earliest stages of the diagnostic process, and regularly throughout the follow-up. Consult a registered doctor is recommended to all patients wishing to continue driving. All documents must be given to the patient only. An alternative must always be offered to patients who are recommended a modal shift.

Paper patient file sharing has clearly been identified as a risk behavior for the COVID-19 virus transmission in radiotherapy units. In order to overcome this, the ONCORAD radiotherapy units worked on total dematerialization of the paper patient file, within 3 weeks. The methodology is based on a quality approch. This work has led to a convincing improvement in the management of risks a priori and a smoother patient care workflow., (Copyright © 2021 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.)

Background: The objective was to describe a possible cancer mortality risk in relation with the occupational exposure within an International study co-ordinated by the International Agency for Research on Cancer., Methods: An epidemiological cohort study was set up to assess the mortality in four French pulp and paper companies. The four cohorts were followed up from January 1st 1968 to December 31st 1992. The causes of death were ascertained by matching with the national file of causes of death., Results: The full cohort consisted in 5,529 men and 876 women. The total numbers of subjects deceased between 1968 and 1992 were respectively 708 and 34. Causes of death could be traced for 98%. The observed mortality was significantly lower than the expected for all causes of deaths (SMR = 0.86) as well for all deaths by cancer (SMR = 0.87). The analysis by departments showed an excess mortality by cancer of the pancreas in the wood preparation department (SMR = 3.14) as well as in the paper production department (SMR = 2.04)., Conclusions: In absence of any prior hypothesis, it is difficult to assign an occupational origin to these observed excesses. The future results of the international study will enable us to interpret these results more precisely.

Introduction: The use of blotting paper as a support for quantification of viral load could improve the virological monitoring of patients on Human Immunodeficiency Virus treatment in Mali. The urgency is obvious to us that the coverage in charge is only 10% for the achievement of the 3rd 90., Objective: To assess the performance of viral load screening (sensitivity, specificity, concordance) of DBS from the one spot DBS protocol according to plasma in people living with the human immunodeficiency virus (PLHIV) in Bamako., Methods: A total of 130 blotting papers were made from blood samples received from five sites for monitoring live persons with HIV. These blotting papers thus made were analyzed with the Abbott m2000 apparatus for the purpose of quantifying the viral load with plasma as reference sample. The extraction was done with the m2000SP automatic extractor, following the protocol 1.0 mL HIV-RNA DBS Protocol for paper. Furthermore, the extraction of plasma RNA on the m2000SP was done according to the 0.6 mL HIV-1 RNA protocol., Results: With 130 samples with detectable viral loads, we obtained a correlation of r = 0.837 (p <0.001). In addition, the average difference between the viral load on blotting paper and plasma was 0.512 log / virological copies with a kappa coefficient = 0.708. The threshold of 1000 copies / mL defined as virological success in our study allowed us to obtain a sensitivity of 87% and a specificity of 100%., Conclusion: Decentralized zones or virological plasma monitoring is not accessible, the new Protocol one spot of Abbott laboratory offers an interesting opportunity for the follow-up of these patients with good performance at the threshold of 1000 copies. The use of DBS as a virological support can contribute effectively to the achievement of the 3rd 90., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

This article focuses on some representations of the origin of AIDS and Ebola in Burkina Faso, against a new background of Covid-19 which began in early 2020 in connection with two animals: the spider and the bat. These are also, if not first and foremost, heroes of oral literature (from tales to myths) from this region of West Africa. It is up to anthropologists to explore the meandering symbolism and imagination of these liminal animals that move back and forth between the worlds inhabited by humans and the "bush" worlds of non-humans. Here arises a mythological anamnesis. These "trickster" animals challenge categories and understanding of both virologists and anthropologists., Competing Interests: The authors have no conflicts of interest to declare

Atrial fibrillation (AF) is common in the elderly. The treatment of this condition is based on anticoagulation in preventing Stroke and systemic arterial embolism. Vitamin K antagonists (VKAs) have long been the only anticoagulants available for the management of AF. Difficulties handling VKAs have made them one of the main causes of iatrogenic disease in the elderly. In the last 10 years, direct-acting oral anticoagulants (DOACs) have emerged and large randomized trials (RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE-AF) have demonstrated their superiority over VKAs in the management of AF. These trials were conducted with large numbers of patients (n=71,683), including 27,500 aged ≥75 years and nearly 8,000 subjects aged >80 years. Results from 11 recent meta-analyses of randomized trials and observational real-world studies of 660,896 elderly patient indicate that DOACs are more effective than VKA-based prophylaxis in preventing stroke (risk reduction ranging from 13% to 26%) and carry a lower risk of cerebral hemorrhage (risk reduction 50%). The risk of major hemorrhage appears to be similar to or lower with DOACs than with VKAs (depending on the dosage, renal function, hemorrhagic site or type of DOACs). Moreover, a greater benefit of DOACs over VKA therapy has been found in subgroup analyses in subjects aged over 75 years, in patients with renal insufficiency (creatinine clearance 30-50 mL/min) and in those with a history of falls. Analyses indicate that DOACs are a better choice than VKAs in the elderly because elderly patients are those with the highest risk of stroke and cerebral hemorrhages. In summary, DOACs have a better efficacy/tolerance profile than VKAs, which justifies their first-line use in subjects over 75 years of age.

Introduction: Fabry disease (FD) is an X-linked lysosomal storage disorder caused by mutations in the GLA gene, which leads to a deficient activity of α-galactosidase A. α-galactosidase A activity can be assayed on dried blood spots on filter paper but the original method has been associated with a number of false positive due in great part to quenching of fluorescence. Here, we describe an adaptation of the original fluorimetric method reducing quenching of the fluorescence., Results: A simple and sensitive fluorimetric method has been described for the determination of the α-galactosidase A activity in dried blood spots on filter paper, convenient for screening of FD in at-risk populations. The procedure uses 4-methylumbelliferyl-α-D-galactose, as a synthetic substrate for the enzyme. In this study, protein precipitation was added after incubation both to stop the enzymatic reaction and eliminate interfering proteins. With the novel method the risk of false-positive due to fluorescence quenching was minimized. A cut-off level of 2.1 μmol.h(-1).L(-1) (control values: 5.6 ± 2.0 μmol.h(-1).L(-1), mean ± SD) was chosen corresponding to 40 % of median control value. In all 60 hemizygotes males, α-gal A activities were below 1.1 μmol.h(-1).L(-1) (0.11 ± 0.2 μmol.h(-1).L(-1)). In the 68 heterozygous females, α-gal A activity ranged from 0 to 7.8 μmol.h(-1).L(-1) (2.2 ± 1.7 μmol.h(-1).L(-1)). Using the improved methodology, one third of the females were not identified using the enzymatic assay, due to significant residual enzyme activity., Conclusion: This improved method for the assay of α-gal A was robust and reduced the number of false-positive results. It can be applied for the screening of at-risk populations. α-galactosidase A enzymatic assay should not be used for screening for FD in women or, if used, should be interpreted cautiously together with the results of genotyping., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

The aim of this study was to measure the prevalence of hypothyroidism in 239 elderly patients and to determine the validity of TSH assay on blood dried on filter paper (spot-test) for the diagnosis of hypothyroidism. The sensitivity and specificity of the spot-test were evaluated in a subgroup of 177 subjects. The prevalence of hypothyroidism was 14.2% (34/239). The spot-test did not give satisfactory results for the diagnosis of hypothyroidism in elderly subjects. Due to the lack of specificity, most of the positive results were false positives and the clinician had to rely on laboratory determination of plasma TSH level to confirm hypothyroidism in half of the patients. We do not recommend the spot-test for the diagnosis of hypothyroidism in the elderly. Laboratory assay of plasma TSH is required for confirming hypothyroidism in the elderly.

Prevention and screening recommendations have to be adapted on a regular basis to the latest scientific data and should be completed by tools made to facilitated the implication of patients in decision-making. The prevention and screening webpages hosted on the website of the Department of community medicine and ambulatory care of the University of Lausanne facilitate access to clinical recommendations identified by members of the five medical faculties in Switzerland (EviPrev national program), and to various information sources for physicians and patients, including patient decision aids. These webpages have been developed with primary care physicians who have participated in a pilot project in the canton of Vaud. The webpages have also been tested and welcome by a participatory group of citizen-users., Competing Interests: Ce projet a reçu un financement par le Service de Santé publique du canton de Vaud dans le cadre du projet « Vieillissement et Santé ».