Search

L'objectif de cette étude qualitative était d'explorer l'impact de l'HBP dans la vie quotidienne des patients et des aidants et d'identifier leurs attentes et leurs besoins à partir du contenu des discussions d'une communauté digitale de patients et d'aidants. Une plateforme digitale conçue comme un forum de discussion sécurisé incluant trois espaces (patients, aidants, patients et aidants) a été créée. Un guide d'animation servait à animer la communauté, faciliter l'expression des membres autour de différentes thématiques, encadrer les sujets de discussion. Le contenu des discussions était analysé selon les deux objectifs de l'étude. Du 16 au 29 novembre 2020, 13 patients souffrant d'HBP âgés de 50 à 76 ans et 10 aidants (conjointes exclusivement) ont échangé leurs points de vue à travers plus de 50 discussions et 500 commentaires. L'HBP restait un sujet dont les patients ne parlaient pas en dehors du cercle familial, alors même que le bénéfice moral du partage avec des personnes rencontrant le même problème était mis en avant. Pour les patients, l'HBP impactait l'image qu'ils avaient d'eux-mêmes, freinait leur spontanéité au quotidien, et engendrait de la gêne, voire de la honte, dans certaines situations. Patients et conjointes soulignaient le manque d'information et de communication autour de l'HBP. Outre la démonstration de l'impact de l'HBP sur l'image que les patients ont d'eux-mêmes et sur leur qualité de vie, cette étude met en évidence leurs attentes en termes d'échanges, de communication et d'information autour de cette pathologie. The present qualitative study was to explore the impact of benign prostatic hyperplasia (BPH) in the daily life of patients and family caregivers and to identify their expectations and unmet needs based on comments on discussions of a digital community of patients and caregivers. A digital platform designed as a secure discussion forum including three spaces (patients, caregivers, and patients and caregivers) was created. A moderation guide was used to animate the community, facilitate the expression of its members around different themes, and frame the discussion topics. The content of the discussion was analyzed qualitatively according to the two study objectives. From 16 to 29 November 2020, 13 BPH patients aged 50-76 and 10 caregivers (only spouses) shared their views through more than 50 discussions and 500 comments. BPH remained a topic that patients did not talk about outside the family circle, although the moral benefit of sharing with other people suffering from the same condition was emphasized. For patients, BPH significant changed their self-image, inhibited their spontaneity in everyday life, and caused embarrassment (even shame) in certain situations. Patients and spouses emphasized the lack of information and communication about BPH. In addition to demonstrating the impact of BPH on patients' self-image and quality of life, this study highlights their expectations in terms of exchanges, communication, and information about this pathology. [ABSTRACT FROM AUTHOR]

Three main non-invasive imaging methods are routinely used for the assessment of liver fibrosis and steatosis in patients with nonalcoholic fatty liver disease (NAFLD): the vibration-controlled transient elastography (VCTE) using the FibroScan device, the magnetic resonance imaging (MRI) based on proton density fat fraction (PDFF), and the magnetic resonance elastography (MRE). The purpose of our study is to evaluate the efficiency of the VCTE findings compared to the two others methods, and to analyze the impact of hepatic iron overload on these comparisons. A clinical study was performed on 94 patients with NAFLD in the radiology department of ACRIM-Polyclinic Saint-Côme (France). The study also included 17 patients with hemochromatosis, measured from T 2 ⁎ MRI. The liver tissues of all the patients were evaluated with 1) VCTE (including the controlled attenuation (CAP) and stiffness parameters), 2) MRI (fat fraction parameter), and 3) MRE (stiffness parameter) techniques. The performance of VCTE was assessed by estimating the area under the ROC curve (AUC) for patients without or with hemochromatosis. Spearman's correlation was used for the comparison of VCTE measurements to MRI and MRE. VCTE-based stiffness and CAP were significantly correlated with PDFF and MRE measurements (P < 0.01) for the subgroup without hemochromatosis. The correlations failed for the subgroup with hemochromatosis. VCTE and CAP measurements were not correlated with those from MR PDFF and MRE for patients with hemochromatosis. VCTE, PDFF and MRE modalities don't give concordant results for patients with hemochromatosis. • Complementary imaging modalities are key to evaluate liver fibrosis and steatosis. • Hepatic iron overload is a limitation for US and MR elastographies measurements. • Adaptation of liver MRI protocol to provide quantitative cartography of iron. • Radiologist's awareness on the effect of iron level on the diagnostic result. [ABSTRACT FROM AUTHOR]

Résumé Objectifs Tout comme la maternité biologique, l’adoption peut entraîner des difficultés auprès des mères. Cette étude exploratoire visait à étudier les symptômes anxiodépressifs, les difficultés dans l’établissement de la relation à l’enfant et l’estime de soi maternelle auprès de mères ayant adopté leur enfant depuis moins de 18 mois. Méthodes Quatre-vingt-seize mères adoptantes ont complété un questionnaire anamnestique et quatre échelles évaluant : l’estime de soi maternelle (MSI), les troubles de la relation mère–enfant (PBQ), la présence de troubles anxiodépressifs (HADS) et la dépression postadoption. Résultats Vingt-six pour cent de femmes ont déclaré avoir connu un épisode de dépression postadoption. Les scores globaux d’estime de soi maternelle, de troubles de la relation à l’enfant d’anxiété et de dépression étaient significativement corrélés. Des analyses de régression multiples ont montré que l’âge de l’enfant lors de l’adoption et l’anxiété étaient des prédicteurs significatifs de l’estime de soi maternelle et des troubles de la relation à l’enfant. Ces derniers étaient également en partie expliqués par le manque de soutien de l’entourage, une mauvaise évaluation du moment de la rencontre avec l’enfant et le fait de ne pas percevoir de ressemblance avec l’enfant. Conclusion Ces résultats montrent la pertinence de créer des outils d’évaluation spécifiques à l’adoption et de favoriser un accompagnement postadoption afin de prévenir de possibles troubles de la relation mère–enfant et du bien-être maternel. Objective As well as biological motherhood, adoption can lead to difficulties for mothers. The purpose of this exploratory study was to study symptoms of depression and anxiety, difficulties in the building of the mother–child bond and the maternal self-esteem of mother who adopted their child less than 18 months ago. Methods Ninety-six adopting mothers filled in an anamnestic questionnaire which allowed collecting sociodemographic data and information on the procedure and the experience of adoption. Four scales were used to assess: maternal self-esteem (MSI), mother child relationship disorders (PBQ), presence of anxiety and depression disorders (HADS), and history of postadoption depression. Results Twenty-six percent of women declared having suffered from postadoption depression. Global scores of maternal self-esteem, mother child relationship disorder, anxiety and depression were significantly correlated. Multiple regression analyses showed that having a young child and anxiety were significant predictors of maternal self-esteem and mother child relationship disorder. Moreover, lack of social support perceived concerning adoption, negative feelings about the meeting with the child, and lack of perception of a resemblance with the child explained the variance of relationship issues. Conclusion These results show that creating specific assessment tools for adoption is relevant and underline the importance of developing places of open communication outside of the adoption procedure to prevent possible psychiatric disorders. [ABSTRACT FROM AUTHOR]

Abstract: Multipotent mesenchymal cells (MMCs) differentiate into osteoblasts or adipocytes through RUNX2 and PPARγ2, respectively. Strontium ranelate has been shown to promote osteoblastogenesis and prevent adipogenesis in long-term experiments using MMCs. The present study involved in-vitro and in-vivo investigations of whether Sr might first be an inhibitor of adipogenesis, thus explaining late osteoblastogenesis. It was established in vivo that Sr reduces adipogenesis in mice treated only for 3weeks with a 6mmol/kg/day dose of Sr while the trabecular bone volume is increased. In order to decipher molecular mechanisms during inhibition of adipogenesis, we used murine MMCs C3H10T1/2 cultured under adipogenic conditions (AD) and treated Sr of a concentration up to 3mM. It was shown that early on (day 1), Sr dose-dependently reduced PPARγ2 and CEBPα mRNA without affecting the RUNX2 gene expression whereas it repressed ALP mRNA. Later (day 5), PPARγ2 and CEBPα mRNA remained inhibited by Sr, preventing adipocyte lipid accumulation, while Runx2 and ALP mRNA were increased. Moreover, under the mentioned conditions, Sr was able to quickly induce the Cyclin D1 gene expression, proliferation and fibronectin fibrillogenesis, both involved in the inhibition of adipogenesis. The inhibition of the ERK pathway by U0126 blunted the Sr-induced PPARγ2 repression while restoring the lipid accumulation. These results demonstrated that Sr was capable of rapidly reducing adipogenesis by a selective PPARγ2 repression that can be explained by its ability to promote MMC proliferation. This article is part of a Special Issue entitled: Interactions Between Bone, Adipose Tissue and Metabolism. [Copyright &y& Elsevier]

Abstract: Background: Totally Implantable Venous Access Port Systems (TIVAPS) are widely used in oncology, but complications are frequent, sometimes necessitating device removal and consequently delays in chemotherapy. The aim of this study was to investigate possible risk factors for morbidity. Methods: A total of 815 consecutive cancer patients (median age: 56.2 years [0.8–85.2]; 522 female) were enrolled in this observational, single-centre study between May 2nd 2006 and April 30th 2007. TIVAPS implantation involved principally cephalic or external jugular vein access. Patients were followed up for one year unless the device was removed earlier. Results: The overall morbidity rate was 16.1% (131/815). Complications necessitated device removal in 55 patients a mean of 3.7 months [0.2–12.0] after implantation. These comprised TIVAPS-related infection (19), port expulsion (14), catheter migration (6), venous thrombosis (5), mechanical problems (3), skin disorders (2), pain (2), drug extravasation (2) infection unrelated to TIVAPS (1) and inflammation (1). No patient died during the study. The factor most strongly predictive of complications was the interval between insertion and first use of the TIVAPS, ranging from 0 to 135 days (median: 8.0 days). The morbidity rate was 24.4% when this interval was 0–3 days, 17.1% when it was 4–7 days and 12.1% when it exceeded 7 days (p < 0.01; Chi2 test). The median interval was 6 days (0–53) and 8 days (0–135), respectively, in patients with and without complications (p < 0.001). Conclusion: To reduce complications, an interval of at least 8 days between placement of the TIVAPS and its first use may be advisable. [Copyright &y& Elsevier]

Abstract: Based on our clinical experience on bovine mastitis, we hypothesized that subtypes of Staphylococcus aureus (S. aureus) exist which differ in their contagious and pathogenic properties. In order to investigate this hypothesis, we analyzed strains of S. aureus isolated from spontaneous intramammary infection (IMI) with their virulence gene patterns and genotypes obtained by PCR amplification of the 16S–23S rRNA intergenic spacer (RS–PCR). The genotypes were then associated with epidemiological and clinical data including 26 herds. The results demonstrated a high association between genotypes and virulence gene patterns as well as between epidemiological and pathogenic properties of S. aureus. In particular, genotype B was related to high contagiosity and increased pathogenicity whereas the other types (C, OG) were found with infection of single cows. Because of the high clinical relevance, our results indicate the need to subtype the IMI-associated strains of S. aureus in the future. [Copyright &y& Elsevier]

Abstract: The optimal management of adult soft-tissue sarcomas is not clearly established. To assess prognostic factors and survival, the experience of 45 recent successive cases was reviewed. Data were collected from a retrospective database (1993–2005) and statistically analyzed. Rhabdomyosarcomas were excluded. The mean age was 50.1 years; there were 24 men and 21 women. The main histological subtypes were undifferentiated sarcoma (14) and angiosarcoma (10); 21 tumours were grade 3 (46%). The most frequent primary sites were neck muscles (15, 33%) and scalp (11, 24%). At presentation, 5 (20%) cases with lymph-node involvement and another 11 cases (24%) with distant metastasis were observed. The treatment was with curative intent in 33 cases (73%). This entailed surgery, with adjuvant radiotherapy in 15 cases and adjuvant chemotherapy in 5 cases. The 5-year overall survival was 52% (±8%). In univariate analysis, the poor prognostic factors were high grade, initial metastasis or lymph nodes, absence of surgery, and number of surgical procedures. In multivariate analysis, two factors remained significant: grade (P=0.006) and absence of surgery (P=0.005). After taking into account grade and metastasis at presentation, quality of surgery has prognostic value. The primary aim of a multidisciplinary approach to these tumours must favour complete resection. [Copyright &y& Elsevier]

Abstract: Fibroscan® is a new medical device that measures liver stiffness noninvasively. The method is based on one-dimensional transient elastography. Ultrasound signals (3,5 MHz) are used to follow the propagation of a low-frequency shear elastic wave (50 Hz) that propagates at a velocity that depends on liver stiffness. Measurement is performed on the right lobe of the liver using a probe that is placed on the skin surface. Result is obtained at the end of examination that takes about 5 minutes. Pilot and multicentre studies have shown that liver stiffness is strongly correlated to fibrosis stage obtained from liver biopsy on patients with chronic hepatitis C. Fibroscan® could be used to improve the evaluation of patients with liver chronic diseases by reducing the number of liver biopsies and by allowing the following of treatments. [Copyright &y& Elsevier]

The cognitive event-related potentials were studied in a group of 55 alcoholic patients, paired in age and sex with a group of 18 control subjects, using a protocol oddball (visual and auditory) and a protocol VCN Go/Nogo. The N200 obtained using an auditory oddball paradigm had lower amplitude in alcoholics than in controls. A significant amplitude decrease of visual P300 was also observed in alcoholic male subjects. There was however no difference in auditory P300 between alcoholics and control subjects. Using a Go/Nogo paradigm, a significant difference on the final part of the VCN appears between alcoholic and pilot subjects. In addition, the longitudinal follow-up of the same alcoholic patients showed an electrophysiological profile that allowed dividing them into two different groups. On the initial recording (17 days after weaning), the auditory oddball P300 amplitude was significantly higher at Cz and Pz among patients who relapsed during the 3 months follow-up. The same effect appeared on the CNV protocol, where the amplitude of P300 was higher in patients who subsequently relapsed than for those who remained abstemious. Cognitive ERPs may be clinically useful to improve the prediction of risk of relapse among alcoholic patients. [Copyright &y& Elsevier]

Abstract: When a hypersensitivity reaction to a drug is diagnosed and the drug is absolutely needed, then desensitization may be indicated. Several desensitization protocols with allopurinol have been described but the procedure is usually carried out over several days. We describe ultra-rush desensitization to allopurinol carried out with success in a 70-year-old man who had experienced urticaria, tachycardia, and syncope a few hours after ingestion of allopurinol. Our protocol allowed us to administer a cumulative dose of 193 mg of allopurinol in 2 1/2 hours on the first day. This was followed by a dose of 200 mg per day for two weeks and then 300 mg per day thereafter. The patient tolerated the desensitization without any adverse reaction. With continued treatment, the patient''s arthritis improved significantly and he had none of the previously noted cutaneous or generalized reactions. Because of its rapidity and simplicity, we suggest that this protocol could have wider use in re-introducing allopurinol after such adverse reactions. [Copyright &y& Elsevier]

Abstract: Inulin is a carbohydrate more and more used in food industry because of well known dietetical properties. We describe 2 cases of allergy from inulin in vegetables and diet food. First patient is a 52-year-old woman who had 2 episodes of anaphylaxis (generalized wheal and flare reaction, laryngeal oedema, vomiting and breathing difficulties) a few minutes after the ingestion of artichokes and two kinds of cakes with chocolate and dietary potage.. In the cake and potage’s receipt, the presence of Inulin appeared among the ingredients. Second patient is a 59-year-old woman who presented during an hyperproteined diet, a generalised urticar a few minutes after eating the processed meal (Inulin appeared among the ingredients). She described also cutaneous reactions with prurit after consuming artichoke and different kind of vegetables. [Copyright &y& Elsevier]

Summary: Purpose: Up to now only few studies on high LET radiation-induced cell cycle arrest are available. Open questions still remain concerning magnitude, persistence and control of the cell cycle inhibition after high-LET exposure. The intention of this review is to focus on the cell cycle distribution of the irradiated populations and the cell systems used (normal vs. mutant and tumor cells). The relevant published data are summarized. Conclusions: Comparing isodoses, high-LET irradiation is a more potent inducer of cell cycle delays than low-LET irradiation. Generally, more pronounced delays in S- and G2-phase have been observed with increasing LET. The role of TP53 in relation to these effects is still controversial. A dose- and LET- dependent increase in cells arrested in G1-phase has as well been observed. Studies are presented indicating that a large fraction of normal fibroblasts irradiated in G1-phase and reseeded after exposure, did not re-enter the cell cycle but remained permanently arrested. The expression of cell cycle regulatory proteins in this case appeared more pronounced at high LET, but no fundamental differences were observed between low- and high-LET irradiation. [Copyright &y& Elsevier]

Abstract: Objectives: Assessment of pregnancy outcomes after bariatric surgery and analysis of follow-up particularities of such pregnancies. Patients and methods: A retrospective study of 63 post-bariatric surgery pregnancies compared to 259 pregnancies of obese un-operated patients. Pregnancy outcomes, neonatal datas, delay influence between surgery and pregnancy beginning, bariatric surgery type and gastric banding (GB) loosening consequences were analysed. Results: In the surgical brand were developed less gestational diabetes (DG) (P =0,05), deliveries were more often normal (P =0,004) and births shown less macrosomias and small for gestational age newborns (P =0,04). Neonatal state was improved among operated patients: less Apgar scores less than 7 at 1minute (P =0,05) and less cord blood pH less than 7,2 (P =0,03). They gained more weight during the pregnancy (P =0,0003) and only 53% had a nutritional management and assessment. Patients with GB loosening gained more weight (P =0,0003). Lastly, there were no difference due to the different bariatric surgery techniques or nutritional follow-up in the pregnancy course and neonatal state. Discussion and conclusion: Bariatric surgery improves obstetric and neonatal prognosis. Improvements have to be developed in the multidisciplinary follow-up in order to avoid nutritional deficiencies or important weight gain pregnancy in case of GB. [Copyright &y& Elsevier]

Abstract: The aim of the study was to compare KI67 in young breast cancer patients (pts) (35 years or less), and in older ones. Forty-three young pts treated between January 1, 2006 and December 31, 2008 as well as pts more than 35 years treated in the same institution in 2006 were considered. Biomarker studies were carried out on a surgical specimen or on a biopsy before neoadjuvant chemotherapy if any. Young pts had a higher median value of KI67 (30% [3–95] versus 10% [0–90] P <0.0001) a higher rate of SBR3 (44 versus 28% P <04), of mitotic index 3 (35 versus 13% P <0.001). ER was less frequently positive (56 versus 87%, P <0.001) as well as PR (38 versus 68% P <0.001). HER2 was more frequently amplified in young pts (24 versus 10% P <0.007). Young pts more frequently had a triple negative breast cancer (TNBC) (31 versus 8% P <0.001). In TNBC pts, KI67 was higher in younger pts (70% [10–95] versus 38% [2–80] P =0.06). Among young pts, TNBC had a higher KI67 than non TNBC (70% [10–95 versus 20% [3–60] P <0.001). Conclusion: KI67 is significantly higher in young pts than in older ones. TNBC is significantly more frequent; among young pts, and KI67 is significantly higher in TNBC. [Copyright &y& Elsevier]

Abstract: The kinetics of extension of individual leaves and component laminae and sheaths in maize were studied in two field experiments at Gatton (Australia) using two cultivars, Pioneer 3527 and Pioneer C87, in one experiment and Pioneer C87 only in the second. Destructive sampling based on non-destructive observations to ensure accurate representation of the population was used to establish timing of leaf initiation, leaf tip appearance, ligule being able to be discerned and full extension of organs. The appearance and extension of leaves were related to thermal time, calculated from temperature measured in the region of cell division and extension. Extension of leaves and sheaths was analysed using the first three phases of a four phase framework consisting of two exponential phases, rapid (linear) extension and transition to final organ length. The last phase was not examined as there were insufficient data. Final organ length was related to leaf position, and linear extension rates of leaves and laminae were linearly related to final organ length, with differing equations for upper and lower leaves. The study has proposed extensions to an existing analytical approach, and argues that regular patterns of extension of leaves and sheaths can be explained in relation to the position of the ear using a physiological approach. [Copyright &y& Elsevier]

Most crop models simulate the crop canopy as an homogeneous medium. This approach enables modelling of mass and energy transfer through relatively simple equations, and is useful for understanding crop production. However, schematisation of an homogeneous medium cannot address the heterogeneous nature of canopies and interactions between plants or plant organs, and errors in calculation of light interception may occur. Moreover, conventional crop models do not describe plant organs before they are visible externally e.g. young leaves of grasses. The conditions during early growth of individual organs are important determinants of final organ size, causing difficulties in incorporating effects of environmental stresses in such models. Limited accuracy in describing temporal source-sink relationships also contributes to difficulty in modelling dry matter distribution and paramaterisation of harvest indices. Functional-architectural modelling aims to overcome these limitations by (i) representing crops as populations of individual plants specified in three dimensions and (ii) by modelling whole plant growth and development from the behaviour of individual organs, based on models of organs such as leaves and internodes. Since individual plants consist of numerous organs, generic models of organ growth applicable across species are desirable. Consequently, we are studying the development of individual organs, and parameterising it in terms of environmental variables and plant characteristics. Models incorporating plant architecture are currently applied in education, using dynamic visual representation for teaching growth and development. In research, the 3D representation of plants addresses issues presented above and new applications including modelling of pesticide distribution, fungal spore dispersal through splashing and plant to plant heterogeneity. [Copyright &y& Elsevier]

Aim of the study. – Primary thoracic soft tissue sarcomas (PTSTS) include parietal, pulmonary and mediastinal tumors. Management and prognostic factors of these rare tumors are poorly known. The aim of the study was to report a series of 40 patients with PTSTS, with analysis of their clinico-pathological characteristics, management, and prognostic factors.Design. – Data were collected from a prospective database. Survival were analyzed by Kaplan-Meier method and compared with log-rank test. Prognostic factors were identified with a Cox model.Results. – The median age was 48 years. The male/female ratio was 15/25. The most common subtype was malignant histiocytofibroma (11 cases). Twenty-one tumors were high-grade sarcomas. The commonest location was chest wall (26 cases). Thirty-two sarcomas were treated surgically, including 22 who had radical resections (free margins). Associated treatments were neoadjuvant (n = 8) or adjuvant (n = 8) chemotherapy, and postoperative radiotherapy (n = 17). The 5-year overall survival was 45%. In univariate analysis, prognostic factors were age (p = 0.05), Karnofsky index (p = 0.008), absence of metastases at initial presentation (p = 0.0003), radical resection (p = 0.043), and adjuvant chemotherapy (p = 0.04). The tumor location had no prognostic value.Conclusions. – Management of PTSTS needs a multidisciplinary approach, and is mainly based on radical resection. Prognosis of pulmonary, chest wall and mediastinal sarcomas is similar. [Copyright &y& Elsevier]

Introduction – Verification of absorbed dose in target volume is a key factor for quality assurance in radiotherapy. In vivo measurements allow evaluation of the variations in dose with time and variations between measured doses and calculated doses by TPS. The aim of this work were to evaluate reproducibility of patient positioning and to compare calculated doses by 2 different TPS.Patients and methods – Twenty patients were divided in 2 groups according to the thickness of their breast (mean SSD = 92,9 cm). In vivo measurement was performed within the first two sessions.Results – Reproducibility of SSD evaluation was made on 12 beams between 2 fractions. With a tolerance margin of 0,5 cm, positioning errors were present in 33% (4/12). The 2 TPS were in agreement in 75% (30/40).Conclusion – In vivo dosimetry can be a very interesting tool to assess patients positioning variations and TPS dose calculation. [Copyright &y& Elsevier]

L'objectif de cette étude était de proposer une prise en charge psychomotrice basée sur des mises en situation rythmique et de tester son impact sur les capacités attentionnelles et exécutives d'enfants TDA/H. Vingt-et-un enfants âgés de 8 à 13 ans (moyenne : 9,4 ans ± 1,8 ans ; 3 filles) diagnostiqués avec un TDA/H ont bénéficié d'une prise en charge psychomotrice (8 à 12 séances) axée sur des mises en situation rythmique (exercices de synchronisation à des rythmes externes de type métronome ou musiques). Un design test-retest a permis d'évaluer le niveau des fonctions attentionnelles et exécutives à l'aide de batteries d'évaluation neuropsychologiques avant et après l'intervention. Les performances attentionnelles et exécutives ont été améliorées après la mise en place du programme : capacités d'inhibition, maîtrise de l'impulsivité cognitive, et mémoire de travail visuo-spatiale. Le niveau de l'attention divisée s'est légèrement amélioré également, alors que l'attention soutenue auditive, l'attention sélective visuelle, et l'aversion au délai sont restées inchangées. Cette étude établit des liens entre un entraînement des capacités rythmiques et l'amélioration de plusieurs fonctions attentionnelles et exécutives chez des enfants TDA/H. Ce type d'intervention psychomotrice apparaît donc prometteur dans l'accompagnement thérapeutique des enfants souffrant de TDA/H, en complément ou alternativement à un traitement par méthylphénidate chez certains sujets. This study aimed at investigating the effects of a rhythm-based therapeutic program among ADHD children by assessing performance in attentional and executive domains. Twenty-one children (mean age: 9.1, SD: 1.8; 3 females) who previously received a diagnosis of ADHD benefited from a rhythm-based training program (8 to 12 training sessions) delivered during a psychomotor therapy. The program consisted of rhythmic perceptuo-motor exercises, including sensorimotor synchronization to external beats (metronome, music). Attentional and executive performances were assessed with a test-retest experimental design. Attentional and executive performance improved in different domains: inhibition, cognitive impulsiveness and visuo-spatial working memory. A slight improvement was visible for divided attention, whereas sustained auditory attention, selective visual attention and delay aversion did not change after intervention. These results are in favor of tight relations between a rhythmic training program and some attentional and executive functions among ADHD children, with beneficial effects of the training on a variety of cognitive performances. This study seems promising for the purpose of supplementing chemical treatments among a range of ADHD patients in cognitive domain. [ABSTRACT FROM AUTHOR]

Introduction Chez les patients en attente de transplantation rénale, les recommandations de prévention anti-infectieuses sont mal suivies, justifiant d’une amélioration des pratiques, tant pour la vaccination que pour le traitement des tuberculoses latentes. Nous avons donc mis en place dans notre centre une consultation de maladies infectieuses dédiée. Matériels et méthodes Il s’agit d’une étude monocentrique prospective, incluant les patients de plus de 18 ans, en attente de transplantation rénale. Les sérologies vaccinales ont été réalisées chez tous les patients et le calendrier vaccinal mis à jour selon les recommandations. Tous les patients ont eu un scanner thoracique et un Elispot tuberculose (test T-Spot-TB ® ) a été effectué chez tous les patients ayant séjourné plus de 3 mois dans un pays de forte endémie tuberculeuse. Nous décrivons notre expérience. Résultats Nous avons inclus 305 patients ( n = 182 hommes), âgés en moyenne de 55 ans , dont 201 étaient dialysés. Il s’agissait d’une 1 re transplantation pour 253 (83 %) d’entre eux. Les patients étaient nés principalement en France métropolitaine ( n = 121), Maghreb ( n = 70), Afrique subsaharienne ( n = 49) et Antilles ( n = 14). Les vaccins suivants, non à jour, ont été prescrits : tétravalent diphtérie, tétanos, coqueluche, poliomyélite ( n = 228), trivalent diphtérie, tétanos, poliomyélite ( n = 9), antipneumococcique conjugué 13 valences, suivi du vaccin polysaccharidique 23 valences ( n = 268) et les vaccins contre la grippe ( n = 40), hépatite B ( n = 40), hépatite A ( n = 35), zona ( n = 29), varicelle ( n = 7), haemophilus ( n = 14), fièvre jaune ( n = 12), méningites ACWY135 et B ( n = 3), HPV ( n = 1). Au total, seuls 9 % des patients avaient tous leurs vaccins à jour. Nous avons dépisté 68 tuberculoses latentes, dont 65 ont été traitées par isoniazide 9 mois ( n = 39), ou bithérapie rifampicine-isoniazide 3 mois ( n = 26). Ce traitement a été interrompu chez 12 patients pour effet secondaire, dont 3 sévères (insuffisance rénale aiguë, allergie sévère, hémorragie digestive). Conclusion La vaccination des patients en attente de transplantation rénale est très insuffisante chez ces patients à haut risque infectieux. Une consultation dédiée avant la transplantation rénale permet la mise à jour des vaccins chez plus de 90 % des patients. Le traitement de tuberculose latente avant la transplantation, recommandé chez ces patients, doit encore être évalué au regard de ses complications et de son efficacité incertaine après la transplantation. [ABSTRACT FROM AUTHOR]

Relapse after treatment of a spinal infection is infrequent and difficult to diagnose. The aim of this study was to assess the diagnostic performance of [ 18 F]fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in this setting. Thirty patients (21 men, nine women; median age 61.2 years) with a suspected spinal infection relapse were prospectively included between March 2010 and June 2013. The initial diagnosis of spinal infection was confirmed by positive bacterial cultures. The patients underwent [ 18 F]FDG PET/CT and magnetic resonance imaging (MRI) 1 month after antibiotic treatment interruption. PET/CT data were interpreted both visually and semi-quantitatively (SUV max ). The patients were followed for ≥12 months and the final diagnosis of relapse was based on new microbiological cultures. Seven patients relapsed during follow up. Sensitivity, specificity, positive predictive value and negative predictive value were 66.6%, 61.9%, 33.3% and 86.6%, respectively for MRI and 85.7, 82.6, 60.0 and 95.0 for PET/CT. Although these values were higher for PET/CT than for MRI, the difference was not statistically significant (p=0.3). [ 18 F]FDG PET/CT may be useful for diagnosing a relapse of spinal infections, in particular if metallic implants limit the performance of MRI. [ABSTRACT FROM AUTHOR]