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Resume Une cause rare de dyspnee a ete diagnostiquee chez un chiot Epagneul breton de 1,5 mois. Le chiot presentait une dyspnee et une dysphagie evoluant depuis 1 semaine et s’aggravant. Une hypothese de bronchopneumonie par fausse deglutition a d’abord ete emise face a la presentation clinique. Devant l’absence d’amelioration clinique avec un traitement antibiotique, le diagnostic a ete reconsidere. Les examens radiographique et tomodensitometrique ont permis de diagnostiquer un emphyseme congenital du lobe moyen droit. La lobectomie de ce lobe a permis une resolution rapide et definitive des signes. Le suivi a 1 mois ne montre aucune anomalie clinique et la radiographie met en evidence une reexpansion correcte des lobes restants. Seulement 13 cas d’emphyseme lobaire congenital sont decrits dans la litterature veterinaire, mais il s’agit vraisemblablement d’une maladie sous diagnostiquee. Ce cas permet de souligner que toutes les dyspnees chez le jeune animal ne sont pas toujours de mauvais pronostic et que l’emphyseme lobaire congenital doit etre integre dans les hypotheses diagnostiques. Les anomalies radiographiques sont tres evocatrices. Le traitement est chirurgical et curatif, et le pronostic a long terme est excellent.

Aims: Overall survival (OS) of patients with recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) is extremely poor. New therapeutic options emerge but need to establi...

Resume Objectifs L’objectif de cette etude etait d’estimer le ratio cout-efficacite de l’aripiprazole injectable a liberation prolongee compare au palmitate de paliperidone administres mensuellement dans le traitement de la schizophrenie en France a partir des resultats et des donnees de l’etude clinique QUALIFY. Methodes Les donnees de consommation de ressources mesurees avec un questionnaire specifique et les resultats sur les echelles de qualite de vie (Quality of Life Scale [QLS]) et d’evaluation psychiatrique (Clinical Global Impressions-Severity [CGI-S], Clinical Global Impressions-Improvement [CGI-I]) de l’etude QUALIFY ont ete combinees avec des estimations de couts unitaires francais de chacune des ressources consommees observees dans QUALIFY pour estimer les ratios cout-efficacite des deux produits. Des analyses de sensibilite multivariees ont permis de tester l’impact conjoint des differentes hypotheses. Resultats Les resultats de l’etude montrent une efficacite superieure sur les echelles de qualite de vie (QLS) et d’evaluation psychiatrique (CGI-S, CGI-I) observee dans QUALIFY de l’aripiprazole par rapport au palmitate de paliperidone. Par ailleurs, on constate une tendance (p = 0,0733) a la diminution des couts totaux lies a une diminution significative (p Conclusions L’aripiprazole apparait plus cout-efficace que le palmitate de paliperidone dans le contexte francais. Les limites de cette etude sont principalement liees a la duree de l’essai clinique et aux hypotheses de transposabilite des ressources mesurees dans l’essai clinique international au systeme de sante francais.

Grass awn foreign bodies are a common cause of rhinitis in dogs. Early detection and complete removal of these foreign bodies are important for minimizing risks of long term complications. The objective of this retrospective, descriptive cross-sectional study was to determine whether discriminating CT findings exist between dogs with grass awn foreign body rhinitis and dogs with non-foreign body rhinitis. Computed tomography scans of 47 dogs with a confirmed diagnosis of non-foreign body rhinitis (25 cases) or of a nasal grass awn foreign body (22 cases) were reviewed. In the latter group, grass seeds were visualized directly on CT images for one of 22 (5%) cases. Focal lysis was more strongly associated with the presence of a grass awn foreign body (P = .012, LR = 3.0) and widespread lysis (involving more than one-third of the nasal cavity and/or bilateral) appeared associated with non-foreign body rhinitis (P = .046, LR = 2.0). Maxillary recess filling was associated with non-foreign body rhinitis (LR = 4.4) as was widespread lysis (LR = 2.0). Findings supported prioritizing grass awn foreign body rhinitis as a differential diagnosis for dogs with the former CT characteristics, even if a grass awn cannot be directly visualized.

Pour illustrer le dynamisme des populations insulaires face à la nécessité vitale de la transition énergétique, trois projets marquants développés dans l’océan Indien sont présentés ici.

Objective To assess the effectiveness and costs associated with contraceptive methods based on real-world data in France. Study design A cross-sectional cohort study based on data from a representative sample of the French National Healthcare Insurance Database (Echantillon Generalistes des Beneficiaires (EGB)) was performed between January 1st 2006 and December 31st 2012. Women aged 15 years or older and users of at least one reimbursed contraceptive method between January 1st 2012 and December 31st 2012 were selected. The outcome of interest was unintended pregnancy, defined as pregnancies occurring after at least one month since the dispensation of a contraceptive method. The mean annual costs of contraceptive methods (in 2012 Euros) were collected in the database from a health system perspective. Costs were expressed for the first year of use, considering the next years of use and taking into account or not the cost of unplanned pregnancies. Results A population of 48,090 women representative of the 4,664,730 French women with a reimbursed contraceptive method was identified in the EGB in 2012: 68.6% used at least one reimbursed oral contraception (OC), 30.2% used at least one intrauterine devices (IUD) (LGN-IUS 52 mg, 17.6%; copper, 13.1%) and 5.1% used at least one etonogestrel implant. Unplanned pregnancies rates ranged from 0.6% with LNG-IUS 52 mg and 0.8% with the etonogestrel implant to 4.8% with 1st and 2nd generation combined OCs. The mean annual costs of contraception for the first year of use ranged from €145 for 1st-2nd generation combined oral contraceptions (COCs) to €308 for LNG-IUS 52 mg taking into account the next years of use, the etonogestrel implant was associated with the lowest mean annual cost (€88). When costs of unplanned pregnancies were taken into account, the mean annual cost of contraception for the first year of use was lower for progestin-only OC (€251) and copper IUD (€257) compared to etonogestrel implant (€300) and LNG-IUS 52 mg(€323). Conclusion This real-world study suggests that Long-acting reversible contraceptives (LARCs) (i.e. implant and IUDs) should be considered for a broader use to prevent unplanned pregnancies and related abortions in France both from a public health and economic perspective.