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MTDM dedicated to geriatric oncology are held at the E. Herriot hospital in Lyon. They bring together oncologist and geriatrician to optimize, through their complementary expertise, the care plan for elderly cancer patients. The aim is to demonstrate the value of these MTDMs and to describe the follow-up of oncological and geriatric recommendations.This is a descriptive, prospective, non-interventional study analyzing the MTDMs dedicated to patients over 70years old with cancer. All patients underwent a comprehensive geriatric assessment (CGA) with a four-month follow-up.One hundred twenty-one patients were included with a G8 score≤14 (93 %), a slightly diminishing independence ADL6 (36%) and IADL4 (42%). The median CIRS-G is eight with on average, three geriatric syndromes/patient. Most cancers are non-metastatic. When oncological treatment is recommended (80 %), it is mostly curative (58 %). Geriatric recommendations were made for 75 % of patients. At four months, four patients were lost to follow-up and 34 died. No significant change in the dependency level was found. In 75 % of cases, at least one geriatric recommendation were followed and 77 % of oncological recommendations.The recommendations could be followed at four months; they were carried out in a comparable way whether they were oncological or geriatric. These MTDMs specializing in geriatric oncology appear to be beneficial in the geriatric oncology decision-making process. It is important to continue and strengthen this co-management.

Holm oak Quercus rotundifolia Lam. is a species of the Mediterranean basin which develops mainly in its western part in general and in North Africa in particular. It presents a remarkable altitudinal distribution and also a wide plasticity with respect to the mesological factors. It is found mainly at mesomediterranean and supramediterranean levels where it forms sylvatic structures in humid and subhumid bioclimates. Holm oak vegetation in the mesomediterranean and thermomediterranean regions has been studied on the eastern Dahra massifs. After studying the bioclimatic characteristics, using the bioclimatic data extracted from WorldClim and the WBCS parameters, a phytosociological typology has been proposed. The correlation between bioclimatic data, phytosociological typology and the altitudinal factor allows elaborating an ecological classification of the Quercus rotundifolia vegetation. The results are presented and discussed with a perspective to integrate them into a future dynamic catenal phytosociological work of Eastern Dahra., Le chêne vert Quercus rotundifolia Lam. est une espèce du bassin méditerranéen qui se développe essentiellement dans sa partie occidentale en général et en Afrique du Nord en particulier. Il présente une répartition altitudinale remarquable et une très large plasticité vis-à-vis des facteurs mésologiques, et se trouve surtout au niveau des étages mésoméditerranéen et supraméditerranéen, où il forme des structures sylvatiques en bioclimats humides et subhumides. Les végétations à chêne vert dans le mésoméditerranéen et le thermoméditerranéen ont été étudiées sur les massifs du Dahra oriental. Après avoir analysé les caractéristiques bioclimatiques, en utilisant les données bioclimatiques extraites de WorldClim et les paramètres de WBCS, une typologie phytosociologique a été élaborée. La corrélation entre les données bioclimatiques, les groupements végétaux obtenus et le facteur altitudinal a permis d’élaborer une classification écologique des étages de végétation de Quercus rotundifolia. Les résultats sont présentés et discutés en vue de leur intégration dans un prochain travail de phytosociologie dynamicocaténale du Dahra oriental., Bouzahar Chafika, Kadid Yamina, Siab-Farsi Badia, Bioret Frédéric, Boulenouar Yacine, Boubaker Zoubir. Bioclimatologie et syntaxonomie des forêts de chêne vert (Quercus rotundifoliaLam.) du Dahra oriental dans la région de Tipaza (Algérie) / Bioclimatology and syntaxonomy of the Holm Oak forests (Quercus rotundifolia Lam.) of eastern Dahra in the Tipaza region (Algeria). In: Ecologia mediterranea, tome 47 n°2, 2021. pp. 5-26.

La maîtrise d’outils technologiques reste un atout important pour la réalisation et la réussite de l’intégration des TICE dans l’enseignement-apprentissage du français. Pour cette raison nous avons jugé judicieux que cette recherche porte sur l’évaluation de l’usage et de la maîtrise de ces technologies chez les enseignants de français du secondaire qualifiant en évaluant leurs habiletés techniques et en exposant les différents usages et utilisations qu’ils en font des TICE dans leurs pratiques pédagogiques. Ainsi que la description de la fréquence d’emploi de ces technologies et la vérification des différents facteurs qui l’influencent., Laboratore de Recherche Société Langage, Art et Médias, No 2 (2019): L'évaluation en contextes

The context and constraints of modern medicine (hospital beds and caregivers' reductions, ambulatory shift, new therapeutic approaches, integration of supportive care…) combined with new societal and Health system changes (ageing population, chronic diseases, new requirements of the patients…) redefine the orientations of care and question professional practices. The participative approach (PA) as a model of team organization proposes solutions involving the skills of the various interacting caregivers and experimental knowledge and consideration of patient needs. The multi-professional staff (MPS) is a collaborative tool of this participative approach that federates a team around a health or care project personalized from the crosschecked eyes of care professionals and from a shared decision-making process. Its objective is to combine the improvement of quality of care with quality of life at work. It requires a transversal mindset of teams, intrinsic values and specific characteristics. Its organization is simple but requires some rules and we will develop the main steps to success. This article, which is the result of a joint reflection and experience of health professionals, shows the principles and wants to demonstrate the weakness of MPS. The interest of the French National Cancer Institute for this collaborative tool is an asset for further work in the perspective of generalization of MPS for all patients with chronic disease and not only for patients at palliative phase.

Objectives: As a result of organizational and therapeutic progress in the management of cancer, retail pharmacies are faced with numerous challenges in the follow-up of cancer patients. This study was designed to provide a better understanding of the way in which retail pharmacists define their role in the management of cancer patients and to identify actions that would promote more efficient coordination with other oncology professionals.Methods: Semi-structured qualitative interviews were conducted with retail pharmacists and data were analysed by thematic analysis.Results: The majority (53%) of retail pharmacists provide patients with explanations concerning their treatments. Participants in this study described in detail patients’ questions concerning adverse effects (79%) as well as certain forms of alternative medicine (37%). Difficulties with an impact on patient follow-up were also reported, such as the lack of medical information concerning cancer treatments (21%) and their relationship with the hospital (26%).Conclusion: The availability of information tools shared by all healthcare professionals therefore appears to be essential to address the difficulties of follow-up of cancer patients by retail pharmacists.

Objectives: As a result of organizational and therapeutic progress in the management of cancer, retail pharmacies are faced with numerous challenges in the follow-up of cancer patients. This study was designed to provide a better understanding of the way in which retail pharmacists define their role in the management of cancer patients and to identify actions that would promote more efficient coordination with other oncology professionals.Methods: Semi-structured qualitative interviews were conducted with retail pharmacists and data were analysed by thematic analysis.Results: The majority (53%) of retail pharmacists provide patients with explanations concerning their treatments. Participants in this study described in detail patients’ questions concerning adverse effects (79%) as well as certain forms of alternative medicine (37%). Difficulties with an impact on patient follow-up were also reported, such as the lack of medical information concerning cancer treatments (21%) and their relationship with the hospital (26%).Conclusion: The availability of information tools shared by all healthcare professionals therefore appears to be essential to address the difficulties of follow-up of cancer patients by retail pharmacists.

International audience

National audience; La stéganographie est l'art de la communication secrète [1]. Depuis l'avènement de la stéganographie moderne, dans les années 2000, de nombreuses approches basées sur les codes correcteurs d'erreurs (Hamming, BCH, RS...) ont été proposés pour réduire le nombre de modifications du support de couverture tout en insérant le maximum de bits. Les travaux de Jessica Fridrich ont montré que les codes à matrices creuses approchent le mieux la limite théorique d'efficacité d'insertion. Nos travaux de recherches sont dans la continuité de ceux sur les codes à faible densité (LDGM) proposés par T. Filler en 2007. Dans cet article nous proposons une nouvelle approche avec l'utilisation des codes correcteurs LDPC plutôt que les codes LDGM. La complexité de notre approche est bien moindre que celle de T. Filler ce qui la rend utilisable en pratique.

Our survey was designed to evaluate the satisfaction of patients treated in French Comprehensive Cancer Centers (CCC) with the communication of their cancer diagnosis and treatments, and to use the data obtained to optimize current practices.One thousand six hundred (and) six CCC patients participated in a telephone survey. Eligible patients were attending a visit to a CCC for initial care of their disease (i.e. not a relapse). The questionnaire assessed patient satisfaction with the communication of diagnosis and treatment options, globally and with respect to potential individual determinants of satisfaction.Complete satisfaction was recorded by 77% of patients with their overall care at the CCC and by 63% of patients with the initial consultation when diagnosis was communicated and/or treatment discussed. Overall, 90% of patients were satisfied with the level of their implication in discussions about their care. A model established by Partial Least Squares (PLS) regression analysis, identified four major areas and their relative contributions to patient satisfaction: patient's relationship with their physician (64%); nature of the information provided (14%; influenced strongly by information on type, duration and practical organization of planned treatment); agenda/diary issues (14%; influenced strongly by waiting room delay); accompaniment (8%; influenced equally by support from close family and patient association/self-help groups).Overall satisfaction was high in cancer patients attending visits for initial care in French CCC. The model we devised to understand components of satisfaction could serve as a benchmark for evolution of outcomes in this field.

Bisphosphonates are indicated for the treatment of bone lesions in patients with solid tumours or multiple myeloma. Bisphosphonates have proven their effectiveness in reducing the number of bone complications (hypercalcemia, pain, disease-related fractures, spinal cord compression) and delaying their occurrence in patients with bone tumours; they have also been shown to reduce the need for bone surgery and palliative or pain-relieving radiotherapy in these patients. International recommendations for the treatment of bone lesions related to malignant solid tumours and multiple myeloma have been established. We have elaborated clinical practice guidelines on the use of bisphosphonates to assist treatment decision-making in bone oncology. The guide contains decision trees and tables with information to guide pre-treatment evaluation and patient follow-up, as well as indications and conditions of use of bisphosphonates. In 2007, the regional cancer network of Rhône-Alpes, ONCORA, formed a working group (GIP ONCORA) to elaborate the guideline. The final version was then discussed and adopted at a plenary session in July 2009, during a collaborative workshop on supportive care recommendations organized by ONCORA and the regional cancer network of Lorraine.

Despite the publication of guidelines for handling antineoplastic agents, measurable amounts of these drugs are still found at various hospital sites. In this context, the French cancer network ONCORA supported the present study to assess the impact of environmental contamination controls on the quality of practices during the preparation of cytotoxic drugs. The first part of the study was conducted at five voluntary hospitals. A total of 65 wipe samples of objects and surfaces were taken in the drug preparation rooms and analyzed for the presence of 5-fluorouracil (5-FU). Measurable amounts of 5-FU were detected in 21 samples (32%). Many surfaces within Biological Safety Cabinets and isolators were found contaminated (36%). The worse results were obtained on gloves and on the outside of infusion bags. The same method was applied during the second part of the study, conducted six months after the end of the first audit. Global contamination was reduced to 17%. This study shows that appropriate handling helps decrease the number of samples contaminated, making it possible to recommend these controls for evaluating and improving the quality of practices. Since 2007, the network's laboratory has extended its activities to all French hospitals interested in this quality assurance programme.

L'objet du présent séjour post-doctoral porte sur la conduite d'une étude de faisabilité d'un système frigorifique à impact minimal sur l'environnement et équipé à cet effet d'échangeurs de chaleur à minicanaux. Ce travail a été conduit dans le cadre d'un projet de recherche financé par la convention ADEME-Cemagref/GRETh² n°01 74 085. Cette convention a débuté en décembre 2001 et s'achève courant juin 2005. L'objectif de la présente étude porte sur l'introduction de la technologie des échangeurs de chaleur à minicanaux dans le domaine du froid alimentaire, avec la volonté de diminuer l'impact des systèmes frigorifiques sur l'environnement (effet de serre) tout en améliorant leurs performances énergétiques.

The operation of our health care system is in the midst of a major crisis. There is a significantly unacceptable level of health inequities and access to care, high premature mortality rates, lack of a coherent health policy, a weakness in the professional demographic projections, increasing financial deficits, quasi-revolt of professionals, complete disregard for the law (Parliament's vote on the National Insurance's budget)--these are just a few of the symptoms of chaos which have embedded themselves right before our very eyes. This article aims to offer a glimmer of light on this gloomy horizon. It is the first outcome of a new working group which was originally referred to as "les Vignerons d'Uzès", a title which could be seen as lacking substance and has therefore become "The Transdisciplinary Working Group on the Organisation of Health and Care". The group's purpose and objective is to reflect upon the values, practices, regulations, evaluation and what is at stake in the context of our health care system.

Although the benefit of adjuvant therapy has largely been demonstrated for patients with local breast cancer, therapeutic indications remain controversial. The French regional cancer network Oncora investigated the decision-making process for this disease. Based on a thorough review of the literature, the risk of relapse and the potential benefit of adjuvant treatments for each group of patients were evaluated. A consensus decision-tree was drawn in which chemotherapy is proposed only to patients in whom it is expected to decrease the risk of relapse by at least 5 %. This approach, based on a widely accepted decision-making model, makes it possible to offer all patients of the network homogeneous treatment options. However, due to the subjectivity of risk/benefit estimations, patients themselves should become more involved in the decision-making process.

The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centers (FNCLCC), the 20 French Cancer Centers, and specialists from French Public Universities, General Hospitals and Private Clinics, and some specialists learned societies. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The SORs are developed using a methodology based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery.To develop clinical practice guidelines for the management of patients with carcinoma of the endometrium according to the definitions of the Standards, Options and Recommendations project.Data were identified by searching Medline , web sites, and using the personal reference lists of members of the expert groups. Once the guidelines were defined, the document was submitted for review to 63 independent reviewers.The main recommendations for the management of carcinoma of the endometrium are: 1) The diagnosis of carcinoma of the endometrium is based on biopsy and histological examination. However, as first intention, the first elements for diagnosis can be obtain from a hysterography, or particularly, a endovaginal ultrasound examination. Ultrasound allows locoregional metastases to be detected, the CT scan allows the lymph node involvement to be assessed and magnetic resonance imaging allows the myometrium invasion to be evaluated. 2) For the majority of patients, surgery is the initial treatment, both for localised and advanced-stage carcinomas. The excised sample can be used for pathological analysis and tumour staging, using the FIGO (Fédération internationale de gynécologie obstétrique) classification. Surgery for patients with stage I and II carcinomas involves total extrafascial hysterectomy with bilateral salpingo-oophorectomy., In patients with stage III and IV carcinomas radical surgery should be performed, when possible. If this is not possible, then surgery should be as complete as possible and be associated with a complementary treatment. In patients with the most advanced carcinomas, tumour reduction by surgery should be performed. 3) Complementary treatment includes external-beam radiotherapy and brachytherapy. The decision concerning the extent and type of irradiation should be taken taking into consideration the stage and the prognostic factors present. For patients with stage I and II carcinoma, complementary treatment with brachytherapy can be performed, if the myometrium invasion is not deep, or if the carcinoma is grade 2 or 3. Patients with stage III carcinomas can be treated with pelvic or abdominal-pelvic complementary irradiation. In patients that cannot undergo surgery, exclusive radiotherapy can be performed. 4) In the absence of any symptoms, surveillance should include a general clinical and gynaecological examination. All patients with symptoms should undergo an additional work-up.

To develop clinical practice guidelines according to the definitions of the Standards, Options and Recommendations project for the radiotherapy of carcinoma of the endometrium.Data were identified by searching Medline and personal reference lists of members of the expert groups. Once the guidelines were defined, the document was submitted for review to independent reviewers, and to the medical committees of the 20 French Cancer Centres.The main recommendations for the radiotherapy of carcinoma of the endometrium are: 1) For grade 1 and 2 stage IA tumours, follow-up alone is standard as additional treatment. For grade 1 and 2 stage IB tumours, vaginal brachytherapy or follow-up alone are options. For grade 3, stage IB tumours and stage IC disease, there are two treatment options: external pelvic radiotherapy with a brachytherapy boost or vaginal brachytherapy. 2) Treatment for stage II disease can be preoperative when stage II disease has been suggested by a positive endometrial curettage. Postoperative vaginal brachytherapy is given for stage IIA tumours if the penetration of the myometrium is less than 50% or if the tumour is grade 1 or 2. In the case of deep penetration, or higher grade disease, or for stage IIB external radiotherapy with brachytherapy boosting must be undertaken routinely. 3) After surgery, for stage IIIA disease, either external pelvic radiotherapy or abdomino-pelvic radiotherapy is indicated, along with medical treatment in certain patients. For stage IIIB tumours, postoperative external radiotherapy with brachytherapy (if possible) should be undertaken. For stage IIIC tumours, standard treatment is external (pelvic or pelvic and para-aortic) radiotherapy followed or not by a brachytherapy boost. In case of extrauterine sites involved abdomino-pelvic irradiation is recommended. 4) Standard treatment for inoperable stage I and II disease is external radiotherapy and brachytherapy. For patients with inoperable stage III or IV disease, treatment is often symptomatic, combining external radiotherapy and medical treatment.

The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres and specialists from French Public Universities, General Hospitals and Private Clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery.To develop clinical practice guidelines according to the definitions of the Standards, Options and Recommendations project for the surgical management of carcinoma of the endometrium.Data were identified by searching Medline and personal reference lists of members of the expert groups. Once the guidelines were defined, the document was submitted for review to independent reviewers, and to the medical committees of the 20 French Cancer Centres.The main recommendations for the surgical management of carcinoma of the endometrium are: 1) where-ever possible, surgery is the primary treatment of both localised and advanced disease; 2) surgery is performed according to the stage of the cancer and the status of the patient; 3) surgery for stages I and II disease entails total abdominal hysterectomy and bilateral salpingo-oophorectomy. A modified radical hysterectomy is undertaken in cases of macroscopic cervical involvement. An omenectomy is recommended for serous papillary types. Pelvic lymphadenectomy for the purposes of precise staging is undertaken if the patient is of good performance status and without bad pronostic factors. Para-aortic lymphadenectomy can be undertaken to determine involvement of para-aortic nodes; 4) surgery for stages III and IV: radical surgery must be undertaken if at all possible with additional treatment as indicated. In the case of advanced disease, debulking surgery is indicated.

The "Standards, Options and Recommendations" (SOR), initiated in 1993, is a collaborative project between the Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres and specialists from French Public Universities, General Hospitals and Private Clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary expert group, with feedback from specialists in cancer care delivery.To develop clinical practice guidelines for the diagnosis, management and treatment of patients with renal cancer. This review is part of previously published complete guidelines and focuses on the place of radiotherapy in this disease.The data was identified by literature search using Medline (up to June 1999) and personal reference lists. The main endpoints considered were survival, risk factors for late effects of radiotherapy, safety and quality of life.The key recommendations are: 1) In localised renal cancer, adjuvant radiotherapy has a limited role: it is not indicated for T1 and T2 tumours and there is no proof of a survival benefit for T3 N1-N2 tumours. Postoperative radiotherapy can be considered in young patients without risk factors for the development of post-radiotherapy complications and without loco-regional invasion (renal capsule, renal pelvis, vena cava, regional lymph nodes); 2) For metastatic tumours, the multidisciplinary team must decide whether palliative radiotherapy is appropriate after consideration of the prognostic factors. An isolated metastasis can be treated by radiosurgery and stereotaxic radiosurgery may be of benefit in the case of one or two cerebral metastasis. The optimal dose for palliative treatment is not known. Radiotherapy followed by immunotherapy can also be considered if the patient has no contraindication to such treatments.

The Standards, Options and Recommendations (SOR), initiated in 1993, is a collaborative project between the Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres and specialists from French Public Universities, General Hospitals and Private Clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and outcomes for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary experts group, with feedback from specialists in cancer care delivery.To develop clinical practice guidelines for dentistry and oral hygiene in head and neck cancer patients.Data have been identified by literature search using Medline (up to January 1999) and personal reference lists. The main end points considered were risk factors for treatment related late effects, safety and quality of life, efficacy of dental preventative measures and treatment. Once the guidelines were defined, the document was submitted to reviewers for peer review and to the medical committees of the 20 French Cancer Centres for review and agreement.The key recommendations are: 1) before receiving radiotherapy, surgery and chemotherapy for head and neck cancer, patients must benefit from a multidisciplinary approach including dental evaluation; 2) the patients must be informed of precautions and educated about oral hygiene; 3) after radiotherapy, the most important dental late effect to prevent is radionecrosis, in accordance with the oral and dental state, the dentist may propose conservation or extraction of teeth, fluoridation and regular follow-up; 4) during chemotherapy, the principal complications are mucositis, haemorrhage and infection risk; 5) after surgery, the dentist may propose prosthetic measures with the aim functional, aesthetic and psychological benefit; 6) in the particular case of children, treatment and prevention are the same as for adults but the follow-up is specific because of the dental development.

The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres and specialists from French Public Universities, General Hospitals and Private Clinics. For pediatric issues, this project is a collaboration between the FNCLCC and the French Society of Pediatric Oncology (SFOP). The main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery.To develop clinical practice guidelines according to the definitions of Standards, Options and Recommendations for the clinical care of osteosarcoma in children and adult.Data have been identified by literature search using Medline (1985-december 1998) and the expert groups personal reference lists. The main criteria considered were incidence, risk factors, prognostic factors and efficacy of treatment. Once the guidelines were defined, the document was submitted for review to 27 national and international independent reviewers, and to the medical committees of the 20 French Cancer Centres and, in particular, the 4 which have particular expertise in pediatric cancer management.The main recommendations for osteosarcoma management are that: 1) the clinical diagnosis is based on appropriate clinical and radiological findings; 2) the final diagnosis is pathological and the biopsy should be performed by the surgeon who will subsequently perform the definitive surgery; 3) surgical biopsy must be of adequate size and performed by an experienced surgeon; 4) the therapeutic strategy for osteosarcoma is based on surgery with neoadjuvant and adjuvant chemotherapy given in experienced centres. Inclusion of high dose methotrexate is recommended for children, and the dose of methotrexate must be adapted for adults. Inclusion of children in SFOP protocols and adults in EORTC and FNCLCC clinical trials is recommended; 5) treatment of metastatic osteosarcoma is based on chemotherapy and surgery to lung metastases which may be curative. Amputation is rarely appropriate. Inclusion of children in SFOP and of adult in EORTC and FNCLCC clinical trials for metastatic osteosarcoma is recommended; 6) at the present time, there are no clear data on which to base guidelines for timing and duration of follow-up studies in this condition.

The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres and specialists from French Public Universities, General Hospitals and Private Clinics. For pediatric issues, this project is a collaboration between the FNCLCC and the French Society of Pediatric Oncology (SFOP). The main objective is the development of clinical practice guidelines to improve the quality of health care and outcomes for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery.To develop a clinical practice guideline according to the definitions of Standards, Options and Recommendations for the clinical care of rhabdomyosarcoma and other soft tissue sarcoma in children and adolescents.Data have been identified by literature search using Medline (1985-may 1997) and experts group personal references lists. The main criteria considered were incidence, risk factors, prognostic factors and efficacy of cancer treatment. Once the guideline was defined, the document was submitted for review to 14 national and international independent reviewers, and to the medical committees of the 20 French Cancer Centres and, in particular the 4 which have expertise in pediatric cancer management, for agreement.The main recommendations for rhabdomyosarcoma management are: 1/ diagnosis is based on appropriate clinical and radiological findings; 2/ pathological and immunohistochemical studies are essential to confirm the diagnosis; 3/ surgery must be performed by an experienced surgeon. Surgery and radiotherapy must be as conservative as possible; 4/ therapeutic strategies for rhabdomyosarcoma depend on location and extends and are based on chemotherapy, surgery and radiotherapy. Inclusion of patients in SFOP, SIOP and IRS clinical trials is recommended; 5/ treatment of metastatic rhabdomyosarcoma is based on intensive chemotherapy, and surgery with or without radiotherapy; 6/ the management of non-rhabdomyosarcoma is based on the likelihood of sensitivity to chemotherapy; 7/ at the present time, there are no clear data on which to base guidelines for timing and duration of follow-up studies in these conditions.

Le but de ce travail est de développer des outils pour la déterminalion des caractéristiques vibratoires des structures de Génie Civil. et leur application en vue d'une amélioration de la réglementation parasismique, voire d'une estimation de la vulnérabilité du bâti existant . Une technique d'identification "multi-excitations" est présentée, permettant la prise en charge des couplages entre les différents types de mouvements, et également celle de l'interaction sol-structure. Elle est ensuite appliquée à deux types de données: le premier provient d'une expérience sur table vibrante (données "CASSBA"), et le second d'un ensemble de 49 bâtiments californiens ayant subi divers séismes récents. L'analyse des données CASSBA montre, outre des nonlinéarités pour l'essentiel réversibles, un très fort contrôle des mouvements par le décollement de la base. L'importance numérique de données californiennes permet d'établir des relations statistiques corrélant la période et l'amortissement des modes fondamentaux aux dimensions géométriques (dont la plus importante est la hauteur), et à la structure du bâtiment. Leur comparaison avec certaines formules réglementaires (UBC88. RPA88. AFPS90), montre clairement le caractère conservatif des formules françaises. Par ailleurs, l'analyse comparative des erreurs résiduelles entre les identifications mono et multi-excitations suggère l'importance des couplages entre les différents mouvements et de l'interaction sol-structure. Un troisième volet amorce une étude de vulnérabilité du bâti existant dans l'agglomération grenobloise. Les différentes méthodes utilisées conduisent toutes à des résultats similaires, indiquant un risque sismique non-négligeable dans cette ville, compte tenu des phénomènes d'amplification qui affectent l'ensemble de la cuvette. En outre, les mesures de bruits de fond réalisées sur quelques dizaines de bâtiments grenoblois montrent d'une part la fiabilité de cette méthode simple pour l'estimation des fréquences propres et des dé formées modales et d'autre part, la meilleure représentativité des formules AFPS90 pour les bâtiments à murs-voiles., pas de résumé

The results obtained with Brucella B19 strain, used as adjuvant and stimulant in the preparation of hyperimmune anti-foot-and-mouth disease serums on guinea pigs, have led the authors to carry out a series of experiments with a combined anti-foot-and-mouth disease and anti-brucellosis vaccine (strain B 19 Buck and Cotton). The search for neutralizing antibodies for foot-and-mouth disease has been undertaken by different methods. In the search for antibrucellic antibodies reactions such as seroagglutination, fixation of the complement, etc. have been used. The results obtained with combined vaccine are identical with those obtained with each of the monovalent vaccines.