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Peer victimisation has been associated with depressive symptoms during adolescence, however not all peer victimised adolescents will exhibit such symptoms. This study tested whether having a genetic predisposition to developing depression increased the risk of experiencing depressive symptoms in peer victimised youth. To date, no study has explored such gene-environment interaction using a polygenic risk score for depression (PRS-depression) in the context of peer victimisation and depressive symptoms in adolescence.The sample included 748 participants born in 1997/98 from the Quebec Longitudinal Study of Child Development with genotype data and prospectively collected information on peer victimisation (12-13 years) obtained from both self- and teacher-reports, as well as self-reported depressive symptoms (15-17 years). The PRS-depression was based on the genome-wide association meta-analysis of broad depression by Howard et al. (2019).Self- and teacher-reported peer victimisation in early adolescence were both associated with depressive symptoms in adolescence (β = 0.34, p .001; β = 0.14, p = .001 respectively), and this association remained significant when accounting for PRS-depression (β = 0.33, p .001; β = 0.13, p = .002 respectively). PRS-depression was independently associated with depressive symptoms, but there was no significant PRS-depression by peer victimisation interaction (self-reported and teacher-reported). PRS-depression was correlated with self-reported, but not teacher-reported, peer victimisation.Our findings suggested that a partial measure of an individual's genetic predisposition to depression, as measured by PRS-depression, and being exposed to peer victimisation (self- and teacher-reported) were independently associated with depressive symptoms in adolescence. Furthermore, PRS-depression did not exacerbate the risk of depressive symptoms among adolescents who had been peer victimised. Lastly, we found evidence of a gene-environment correlation between PRS-depression and self-reported peer victimisation. Future studies are needed to replicate this finding and to further understand the role of genetic predispositions in experiencing depressive symptoms following peer victimisation.

Pancreas transplantation exposes to high rates of complications, either vascular (thrombosis, stenosis, pseudoaneurysm, arteriovenous fistula) or nonvascular (fluid collection, graft rejection). With advances in percutaneous and endovascular techniques, interventional radiologists are increasingly involved in the management of these complications. In this article, we review the anatomical considerations relevant to pancreas transplantation, the techniques used for image-guided interventions for vascular and nonvascular complications, and the expected outcomes of these interventions.

Suicide and suicidal behaviors represent a leading cause of morbidity and mortality during adolescence. While several lines of evidence suggest that suicidal behaviors are associated with risky decisions and deficient cognitive control in laboratory tasks in adults, comparatively less is known about adolescents. Here, we systematically reviewed the literature on the association between these neurocognitive variables and adolescent suicidal behaviors. The online search strategy identified 17 neurocognitive studies examining either cognitive control or decision-making processes in adolescents with past suicidal behaviors. Several studies have reported that adolescents with a history of suicidal behaviors present neuropsychological differences in the cognitive control (using Go/NoGo, suicide Stroop Test, continuous performance test, suicide/death Implicit Association Test), and decision-making (Iowa Gambling Task, Cambridge Gambling Task, cost computation, delay discounting, loss aversion tasks) domains. Due to a lack of replication or conflicting findings, our systematic review suggests that no firm conclusion can be drawn as to whether altered decision-making or poor cognitive control contribute to adolescent suicidal behaviors. However, these results collectively suggest that further research is warranted. Limitations included scarcity of longitudinal studies and a lack of homogeneity in study designs, which precluded quantitative analysis. We propose remediating ways to continue neuropsychological investigations of suicide risk in adolescence, which could lead to the identification of novel therapeutic targets and predictive markers, enabling early intervention in suicidal youth.

BackgroundSuicide is a leading cause of mortality in youth, yet the course of suicide attempts is poorly documented. We explored the vulnerable transition from adolescence to emerging adulthood to identify group trajectories and risk factors.MethodsThe National Longitudinal Survey of Children and Youth is a prospective representative cohort of Canadian children. We followed participants aged 7–11 years in 1994–95 to age 23 (2008–09). We modelled self-reported past-year suicide attempts (ages 12 to 23 years) using growth mixture models. We analysed risk factors from self- and parent-report questionnaires at pre-adolescence (ages 10–11) and early adolescence (ages 12–13) using multinomial logistic regressions. Analyses were adjusted for sample non-response and attrition.ResultsIn 2233 participants answering questions on teen and adult suicide attempts, we identified three trajectories: never attempted (96.0%), adolescence-limited (2.0%) and persisting into adulthood (2.0%). Adolescent girls aged 12–13 with depression/anxiety symptoms, and with mothers experiencing depression had higher risks of adolescence-limited than never-attempted [relative risk RR 9.27 (95% confidence interval: 1.73–49.82); 2.03 (1.02–3.32), for each standard deviation increase; 1.07 (1.00–1.15); respectively]. Preteen ADHD symptoms increased the risk of attempts persisting into adulthood as compared to never-attempted [RR 2.05 (1.29–3.28) for each standard deviation increase]. Suicide death of schoolmate/acquaintance increased risks of an adulthood trajectory as compared to never-attempted and adolescence-limited [RR 8.41 (3.04–23.27) and 6.63 (1.29–34.06), respectively].ConclusionIn half the participants attempting suicide, attempts continued into adulthood. We stress the need for preventive strategies in early adolescence and differential clinical/educational interventions as identified for each trajectory.

Arthroscopic repair of subscapularis tendon tears has shown to be a reliable and reproducible technique and is now considered the gold standard method over open repair. However, most arthroscopic techniques use several working portals and the procedure can be technically challenging and time-consuming, especially when knot-tying is required and when multiple anchors are used. Recently, single-portal knotless techniques have been popularized for upper-third lesions (e.g. Lafosse type 1 or 2 tears). Here, we describe a technique of repairing complete tears of the subscapularis tendon (Lafosse type 3 and 4) using knotless suture anchors through a single portal. This technique is quick and allows a safe anatomic footprint repair to the lesser tuberosity.

Background Cross-sectional associations have been documented between cybervictimization and suicidal risk; however, prospective associations remain unclear. Methods Participants were members of the Quebec Longitudinal Study of Child Development (QLSCD), a prospective birth cohort of 2,120 individuals followed from birth (1997/98) to age 17 years (2014/15). Cybervictimization and face-to-face victimization experienced since the beginning of the school year, as well as serious suicidal ideation and/or suicide attempt were self-reported at ages 13, 15 and 17 years. Results In cross-sectional analyses at 13, 15 and 17 years, adolescents cybervictimized at least once had, respectively, 2.3 (95% CI = 1.64-3.19), 4.2 (95% CI = 3.27-5.41) and 3.5 (95% CI = 2.57-4.66) higher odds of suicidal ideation/attempt after adjusting for confounders including face-to-face victimization, prior mental health symptoms and family hardship. Sensitivity analyses suggested that cybervictimization only and both cyber- and face-to-face victimization were associated with a higher risk of suicidal ideation/attempt compared to face-to-face victimization only and no victimization; however, analyses were based on small n. In prospective analyses, cybervictimization was not associated with suicidal ideation/attempt 2 years later after accounting for baseline suicidal ideation/attempt and other confounders. In contrast, face-to-face victimization was associated with suicidal ideation/attempt 2 years later in the fully adjusted model, including cybervictimization. Conclusions The cross-sectional association between cybervictimization and suicidal ideation/attempt is independent from face-to-face victimization. The absence of a prospective association suggested short-term effects of cybervictimization on suicidal ideation/attempt.

Peer victimization is associated with an increased risk for depression, but there is less evidence on how certain factors such as friend support can buffer this association. This study investigated the associations between friend support and depressive symptoms among victimized and non-victimized adolescent girls and boys from South Korea.Participants includes 2258 students from the Korean Children and Youth Panel Survey, a nationally representative sample of middle school students in South Korea. Self-reported perceived friend support, depressive symptoms and peer victimization were measured using validated scales during middle school year 3 (mean age= 15.7 years).The association between peer victimization and depressive symptoms varied by sex (p for sex by peer victimization interaction0.05). Peer victimization was more strongly associated with same year depressive symptoms in girls (β=0.55) than boys (β=0.24). After controlling for key confounders, including prior year mental health symptoms, higher levels of friend support were found to attenuate the association between peer victimization and depressive symptoms (p for friend support by peer victimization interaction0.05). Peer victimization was associated with more depressive symptoms for adolescents with low and moderate friend support, but not those with high friend support.Peer victimization, depressive symptoms, and friend support, were self-reported and measured the same year.Friend support protects victimized South Korean adolescents from the negative effect of peer victimization on depressive symptoms, hence contributes to closing the gap in depression between victimized and non-victimized adolescents.

BACKGROUND:Obtaining recent estimates of the prevalence of suicide-related outcomes across adolescence and its associated mental health problems (MHPs) is important for clinical practice. We estimated the prevalence of suicide-related outcomes at ages 13, 15, 17, and 20 years (2011–2018) in a contemporary population-based cohort and documented associations with MHPs throughout adolescence.METHODS:Data came from 1618 participants in the Québec Longitudinal Study of Child Development. Internalizing (depression and anxiety) and externalizing (oppositional/defiance, conduct issues, and attention deficit and/or hyperactivity) MHPs were assessed with validated questionnaires. Outcomes were self-reported past-year passive and serious suicidal ideation and suicide attempt.RESULTS:Lifetime prevalence of passive suicidal ideation (13–17 years old), serious suicidal ideation, and suicide attempt (13–20 years old) were 22.2%, 9.8%, and 6.7%, respectively. Prevalence was twice as high for females as for males. Overall, rates of passive (15–17 years old; 11.8%–18.4%) and serious ideation (13–20 years old; 3.3%–9.5%) increased over time but were stable for attempt (13–20 years old; 3.5%–3.8%). In univariable analyses, all MHPs were associated with suicide-related outcomes at all ages (risk rate ratio range: 2.57–3.10 [passive ideation] and 2.10–4.36 [suicide attempt]), and associations were similar for male and female participants (sex interaction P > .05). Magnitude of associations were generally stronger for more severe suicide-related outcomes (passive ideation < serious ideation < attempt). In multivariable analyses, internalizing problems were associated with suicidal ideation, whereas both depressive and conduct symptoms were associated with attempt.CONCLUSIONS:Suicidal ideation and attempt were common, especially for females and youth presenting with depressive and conduct problem symptoms. Clinicians should systematically assess suicidal risk in teenagers, especially in those presenting with MHPs.

Background Irritability is gaining considerable attention as a risk factor for suicide-related outcomes (suicide mortality, attempt, and ideation). However, the evidence of this association is scant. We conducted a systematic review of the evidence regarding the associations between irritability and suicide-related outcomes across the life-course. Methods We conducted a systematic search on Medline and PsycINFO (up to January 2018) for original articles published in English investigating the association between irritability and suicide-related outcomes. Two researchers independently screened the articles, assessed the quality of the evidence (New-Castle-Ottawa Scale) and extracted study characteristics. Results Thirty-nine studies were retrieved, most were of low/medium quality. Twelve assessed irritability in childhood/adolescence (6 in community samples, 6 in clinical samples) and 27 in adulthood (7 in community samples, 20 in clinical samples). In both childhood/adolescence and adult samples, most community-based studies reported a positive association between irritability and suicidal ideation and/or attempt, while clinical studies reported mixed findings. More specifically, in clinical studies, the association of irritability with suicide-related outcomes (i) was not supported among adult depressed patients, (ii) findings were inconsistent in adult bipolar patients, (iii) for inpatients/outpatients with various psychiatric disorders/conditions, association was observed in adulthood but not in childhood/adolescence. Limitations Differences in methodology and definition/measurement of irritability limited the comparability of included studies. Conclusions Although irritability has been proposed as a promising transdiagnostic factor associated with suicide-related outcomes, the absence of consensus in the definition of irritability (vs anger or reactive/impulsive aggression), the poor methodological quality, and the lack of developmental considerations mitigate the conclusions.

BACKGROUND: Exposure to peer victimization is relatively common. However, little is known about its developmental course and its effect on impairment associated with mental illnesses. We aimed to identify groups of children following differential trajectories of peer victimization from ages 6 to 13 years and to examine predictive associations of these trajectories with mental health in adolescence. METHODS: Participants were members of the Quebec Longitudinal Study of Child Development, a prospective cohort of 2120 children born in 1997/98 who were followed until age 15 years. We included 1363 participants with self-reported victimization from ages 6 to 13 years and data available on their mental health status at 15 years. RESULTS: We identified 3 trajectories of peer victimization. The 2 prevailing groups were participants with little or moderate exposure to victimization (441/1685 [26.2%] and 1000/1685 [59.3%], respectively); the third group (244 [14.5%]) had been chronically exposed to the most severe and long-lasting levels of victimization. The most severely victimized individuals had greater odds of reporting debilitating depressive or dysthymic symptoms (odds ratio [OR] 2.56, 95% confidence interval [CI] 1.27–5.17), debilitating generalized anxiety problems (OR 3.27, CI 1.64–6.51) and suicidality (OR 3.46, CI 1.53–7.81) at 15 years than those exposed to the lowest levels of victimization, after adjustment for sex, childhood mental health, family hardship and victimization perpetration. The association with suicidality remained significant after controlling for concurrent symptoms of depression or dysthymia and generalized anxiety problems. INTERPRETATION: Adolescents who were most severely victimized by peers had an increased risk of experiencing severe symptoms consistent with mental health problems. Given that peer victimization trajectories are established early on, interventions to reduce the risk of being victimized should start before enrolment in the formal school system.

Resume La neurofibromatose de type 1 (NF1) est une maladie genetique predisposant au developpement de tumeurs malignes et benignes. La mutation du gene NF1 entraine une deregulation de la voie de signalisation RAS-MAP-kinase aboutissant a un dysfonctionnement du controle de la proliferation cellulaire et a la proliferation tumorale. L’epidemiologie des cancers chez les enfants atteints de neurofibromatose est tres differente de celle de la population pediatrique generale, imposant une surveillance specifique et rapprochee. Le neurofibrome est la tumeur benigne la plus frequente. Elle peut etre tres invalidante selon sa localisation et sa taille. Il n’existe actuellement pas de traitement specifique pour ces tumeurs. Les tumeurs malignes les plus frequentes sont les leucemies, les rhabdomyosarcomes, les gliomes et les tumeurs malignes des nerfs peripheriques. La prise en charge therapeutique doit prendre en compte le risque de developpement de tumeurs secondaires aux traitements. Nous rapportons le cas d’un enfant ayant developpe avant l’âge de 5 ans deux tumeurs.

Background Little is known about the sequence of onsets in patients affected by comorbid alcohol use and bipolar disorder. This study examines the risk factors associated with their co-occurrence and order of onset. Method The demographic, clinical, and temperament characteristics as well as the course of illness were analyzed within our sample of 1090 DSM-IV bipolar I manic patients. Our sample was categorized according to the presence of comorbid alcohol use disorder and the sequence of onsets of bipolar and alcohol use disorders i.e., alcohol first (AUD-BD) and bipolar first (BD-AUD). Results Regression analyses revealed that alcohol use disorder (52.5%) was associated with the male gender, additional substance use disorders, as well as an irritable and a hyperthymic temperament. The AUD-BD group (6.6%) was older than the BD-AUD group (45.8%) and showed higher rates of comorbid sedative use, organic, and anxiety disorders with higher levels of irritable temperament, and a bipolar subtype characterized by depressive polarity at onset. The BD-AUD group had high levels of hyperthymic temperament with higher rates of comorbid stimulant use disorder and a manic polarity at onset. Conclusions In the AUD-BD group, alcohol might have been used to reduce stress and tension caused by the presence of an irritable temperament as well as anxious and organic disorders, leading to first depressive episode. In the BD-AUD group, stimulant use might have triggered the first manic episode, and alcohol abuse result from mania severity.

International audience; The type 2 vesicular monoamine transporter (VMAT2), by regulating the storage of monoamines transmitters into synaptic vesicles, has a protective role against their cytoplasmic toxicity. Increasing evidence suggests that impairment of VMAT2 neuroprotection contributes to the pathogenesis of Parkinson's disease (PD). Several transgenic VMAT2 mice models have been developed, however these models lack specificity regarding the monoaminergic system targeting. To circumvent this limitation, we created VMAT2-KO mice specific to the dopamine (DA) nigrostriatal pathway to analyze VMAT2's involvement in DA depletion-induced motor features associated to PD and examine the relevance of DA toxicity in the pathogenesis of neurodegeneration. Adult VMAT2 floxed mice were injected in the substancia nigra (SN) with an adeno-associated virus (AAV) expressing the Cre-recombinase allowing VMAT2 removal in DA neurons of the nigrostriatal pathway solely. VMAT2 deletion in the SN induced both DA depletion exclusively in the dorsal striatum and motor dysfunction. At 16 weeks post-injection, motor symptoms were accompanied with a decreased in food and water consumption and weight loss. However, despite an accelerating death, degeneration of nigrostriatal neurons was not observed in this model during this time frame. This study highlights a non-cytotoxic role of DA in our genetic model of VMAT2 deletion exclusively in nigrostriatal neurons. Parkinson's disease (PD), is one of the most common neurodegenerative disorders affecting 1–2% of individuals older than 65 years old worldwide 1. PD is a progressive disorder clinically characterized by a large number of motor features in particular rest tremor, bradykinesia, rigidity and loss of postural reflexes 2,3. At the pathological level, processes leading to PD begin before the appearance of the typical motor symptoms, and by the time the disease is diagnosed about 70–80% of striatal dopamine (DA) is depleted and one third of substantia nigra (SN) DA neurons and striatal DA fibers are already lost 2,4–7. Understanding the biochemical markers relevant to the pathogenesis of neurodegeneration in PD remain essential. Oxidative stress contribution to PD neurodegeneration is currently well established 8. Post-mortem studies have shown an imbalance between reactive oxygen species (ROS) production and the antioxidant protective system resulting in oxidative stress in the SN of PD patients 9,10. Superoxide (O 2−), hydrogen peroxide (H 2 O 2), and the hydroxyl radical (OH •), three important ROS in mammalian cells, can damage macromolecules including nucleic acids, lipids and proteins, leading to DA neuron degeneration, and neuron network dysfunction, ultimately progressing to PD 11. For a better understanding of the oxidative stress mechanisms in PD, the MPTP

Resume De multiples techniques de radiologie interventionnelle sont utilisees pour proposer des solutions antalgiques, consolidatrices et carcinologiques aux patients atteints de metastases osseuses. Les indications de ces traitements doivent etre discutees en reunion de concertation pluridisciplinaire, en fonction de l’objectif (curatif ou palliatif), du risque fracturaire, ainsi que de l’etat general du patient. Cet article a pour but de presenter les principales methodes disponibles pour la prise en charge des metastases osseuses. La cimentoplastie consiste a injecter du polymethylmethacrylate au sein des lesions osseuses par voie percutanee, dans un but de consolidation et de soulagement de la douleur. La thermoablation a pour objectif de detruire la lesion tumorale par le chaud (radiofrequence et micro-ondes) ou par le froid (cryotherapie), dans un but curatif ou palliatif (soulagement de la douleur). L’embolisation et la chimioembolisation arterielle consistent a devasculariser une lesion tumorale hypervasculaire, a visee antalgique ou en prevision d’une chirurgie. Les differentes techniques peuvent etre combinees dans les cas les plus complexes.

Suicide and suicidal behaviors represent a leading cause of morbidity and mortality during adolescence. While several lines of evidence suggest that suicidal behaviors are associated with risky decisions and deficient cognitive control in laboratory tasks in adults, comparatively less is known about adolescents. Here, we systematically reviewed the literature on the association between these neurocognitive variables and adolescent suicidal behaviors. The online search strategy identified 17 neurocognitive studies examining either cognitive control or decision-making processes in adolescents with past suicidal behaviors. Several studies have reported that adolescents with a history of suicidal behaviors present neuropsychological differences in the cognitive control (using Go/NoGo, suicide Stroop Test, continuous performance test, suicide/death Implicit Association Test), and decision-making (Iowa Gambling Task, Cambridge Gambling Task, cost computation, delay discounting, loss aversion tasks) domains. Due to a lack of replication or conflicting findings, our systematic review suggests that no firm conclusion can be drawn as to whether altered decision-making or poor cognitive control contribute to adolescent suicidal behaviors. However, these results collectively suggest that further research is warranted. Limitations included scarcity of longitudinal studies and a lack of homogeneity in study designs, which precluded quantitative analysis. We propose remediating ways to continue neuropsychological investigations of suicide risk in adolescence, which could lead to the identification of novel therapeutic targets and predictive markers, enabling early intervention in suicidal youth.

Literature review of studies investigating vitamin D status in individuals with a spinal cord injury (SCI). Prevalence of vitamin D deficiency seems to be high in the general population. Little is known regarding such a deficiency in individuals with a SCI. This review aimed to examine the literature that investigated vitamin D status in this population. Switzerland. A literature review was performed to investigate the prevalence of vitamin D deficiency in individuals with a SCI and to determine the factors leading to deficiency. Sixteen studies which met all the inclusion criteria were identified. All of these studies assessed total serum 25-hydroxy vitamin D status in individuals with an acute or chronic SCI. Overall, the prevalence of vitamin D deficiency or insufficiency seems to be high (range: 32–93%) in this population compared with that in able-bodied persons. The main factors are immobility, low physical activity and bedrest, and therefore not enough exposure to sunlight. In addition, age, skin pigmentation, lesion level, occurrence of pressure ulcers, body mass index, season and latitude appeared to be further determinants for vitamin D deficiency. In athletes, playing their sport indoors or outdoors may have an additional role in developing vitamin D deficiency. The available studies suggest that individuals with a SCI are at increased risk for vitamin D insufficiency/deficiency. Nutritional strategies and supplementation recommendations need to be developed to prevent these conditions in SCI. Not applicable.

International audience; Dopamine (DA) neurons in the ventral tegmental area (VTA) help mediate stress susceptibility and resilience. However, upstream mechanisms controlling these neurons remain unknown. Noradrenergic (NE) neurons in the locus coeruleus, implicated in the pathophysiology of depression, have direct connections within the VTA. Here we demonstrate that NE neurons regulate vulnerability to social defeat through inhibitory control of VTA DA neurons.

Introduction Plusieurs etudes ont montre que le syndrome de fragilite et les troubles neurocognitifs (TN) etaient frequents chez les patients hemodialyses (HD) âges mais le bilan geriatrique n’est actuellement pas systematique dans les unites de dialyse. Description Grâce au soutien d’un reseau de sante, un service de nephrologie et un service de geriatrie ont mis en place une evaluation geriatrique standardisee (EGS) systematisee chez tous les patients de plus de 70 ans en HD-centre, avec pour objectif d’ameliorer leur prise en charge et de leur offrir une education therapeutique (ETP) adaptee. Methodes Dans un 1er temps, depistage de la fragilite (SEGA) chez tous les patients HD (≥ 70 ans) par des infirmier(e)s de dialyse (IDE-D) forme(e)s. Les patients depistes fragiles beneficiaient alors d’une EGS par l’equipe de geriatrie. Ensuite, EGS, par l’equipe de geriatrie, de tout nouveaux patients (≥ 70 ans) mis en HD. Une reevaluation entre 6 et 12 mois etait realisee. Resultats Vingt-sept patients ont ete evalues (âge median : 79 ans, 18 hommes) : 7 sans TN, 17 avec TN averes, 3 avec TN severes. Cinquante-huit pour cent des patients etaient dependants (IADL ≥ 2), 44 % etaient consideres comme tres fragiles. Chez 51 %, un risque d’iatrogenie a ete identifie, justifiant une modification du traitement. Seize patients ont ete reevalues : 9 etaient stables (dont 4 sans TN), 5 ont aggrave leurs TN, 2 ont developpe des TN. Vingt-deux patients pouvaient suivre un parcours ETP : standard pour 6, adapte pour 12 et propose a leurs aidants pour 4. Conclusion Cette etude confirme la grande frequence du syndrome de fragilite, des TN et du risque iatrogenique chez des patients âges hemodialyses en centre. La collaboration geronto-nephrologique a permis d’adapter et de centrer notre programme d’ETP sur les savoirs utiles. Nous envisageons d’etendre cette collaboration pour une meilleure prise en charge des patients en pre-suppleance.

Background:Osteoporotic fractures are a major public health concern because of their consequences in morbidity, costs and mortality. In the meantime, historically postfracture osteoporosis medication use rates have been poor.Objectives:The aim is to analyze the management of osteoporosis in patients hospitalized for osteoporotic fractures (OF) at Nancy University Hospital (France) in 2017.Methods:Total number of hospitalized patients and hospital stays were extracted by the Department of Medical Information (DIM) which selected departments with at least forty hospitalizations with Medical Unit Summary related to a diagnosis of fracture or osteoporosis. Hospitalizations not concerned by a recent OF were excluded. Data on fractures, patient characteristics, risk factors for OF and fall, management of osteoporosis, discharge status, stay duration, were studied from patient medical records. Prevalence of OF stays, management of osteoporosis and factors associated with duration of stay were analyzed.Results:Out of a total of 153,840 hospitalizations, 918 hospitalizations (844 patients, mean age 74.5 years ± 13.6, 74.5% women) concern an OF. The prevalence of hospitalizations for OF was 0.6% of total hospitalizations and 17.9% of total hospitalizations for fractures. Among the 844 patients, 85.7% had a severe fracture (vertebral fracture: 56.2%, hip fracture: 24.1%), 16.5% had a non-severe fracture, and 8.5% had a fracture cascade in the year. At discharge from hospital, 11.7% of patients received a specific treatment for osteoporosis. Longer stay duration was associated with age, severe fractures, Groll index and discharge status.Conclusion:Nearly one hospitalized fracture in five is osteoporotic, while only one in ten patients is treated for osteoporosis. Stay duration increased with age and comorbidities. This encourages the development of early prevention, screening and treatment strategies for osteoporosis.References:[1]Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2013;8:136.[2]Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006 Oct 19;17(12):1726–33.[3]Giangregorio L, Papaioannou A, Cranney A, Zytaruk N, Adachi JD. Fragility Fractures and the Osteoporosis Care Gap: An International Phenomenon. Semin Arthritis Rheum. 2006 Apr;35(5):293–305.Disclosure of Interests:None declared

Purpose The purpose of our study was to retrospectively assess the safety and efficacy of percutaneous real-time ultrasound guidance for portal vein puncture during transjugular intrahepatic portosystemic shunt (TIPS) placement. Materials and methods Between January 2011 and November 2018, procedure details and outcome were retrospectively analyzed for 224 patients who underwent TIPS placement using real-time ultrasound guidance for portal vein puncture. There were 175 men and 49 women with a mean age of 52.7 ± 10.6 (SD) years (range: 22–82 years). For each procedure, technical success, primary ultrasound guidance success, portosystemic pressure gradient, duration of the intervention, procedural complications, radiation exposure, mortality and morbidity rates at day 30 post-procedure were recorded for data analysis. Results Technical success rate was 100.0% with a success rate of the primary ultrasound guidance of 97.8% (219/224; 95% CI: 95.8–99.7). Mean duration of the procedure was 86.2 ± 41.7 (SD) min (range: 22.0–267.0 min). Mean dose-area product was 62.0 ± 50.2 (SD) Gy.cm2 (range: 3.7–306.5 Gy.cm2). Twelve complications (12/224; 5.4%) occurred in ten patients during TIPS procedures including 8 arterial punctures (3.6%) and 4 biliary punctures (1.8%). Four complications (4/224; 1.8%) were clinically significant. Mortality rate at day 30 after the procedure was 9.8% (22/224), without any patient dying from technical complications. Conclusion Real-time ultrasound guidance is a safe technique to assist in the creation of TIPS and may allow for lower radiation exposure.

Quantum-confined Stark effect with a record absorption contrast of 2.5 for 1V swing is demonstrated in Ge/GeSi quantum well stacks grown on Si using ultra-thin buffer layers, targeting future integration in a silicon photonics platform.

Toxoplasma gondii est un protozoaire parasite intracellulaire qui peut affecter tous les homeothermes, y compris les humains. Nous avons realise une enquete de seroprevalence animale au Senegal, a l’aide du test d’agglutination directe haute sensibilite (ADHS). L’etude a ete menee dans quatre regions (Dakar, Sine Saloum, Kedougou, Basse Casamance), de 2011 a 2013, sur un total de 419 animaux domestiques : 103 bovins, 43 ovins, 52 caprins, 63 chevaux, 13 ânes et 145 chiens. La presence d’anticorps anti-Toxoplasma gondii a ete mise en evidence chez 13 % des bovins, 16 % des ovins, 15 % des caprins, 30 % des chevaux, 23 % des ânes et 67 % des chiens. La seroprevalence des chiens vivant dans des villages est plus elevee que celle des chiens vivant a Dakar et nourris avec des aliments industriels. La seroprevalence chez les equides est elevee, elle revele l’intense circulation des toxoplasmes. La chaleur et l’humidite sont des facteurs favorisant la maturation et la survie des oocystes dans le sol et participent ainsi au maintien d’une prevalence elevee.

Resume Introduction Le syndrome CLOVES (Congenital Lipomatous asymmetric Overgrowth of the trunk with lymphatic, capillary, venous, and combined-type Vascular malformations, Epidermal naevi, Skeletal anomalies) est un syndrome malformatif sporadique recemment decrit (mutation de PIK3CA), associant une hemi-hypertrophie corporelle, des hamartomes lipomateux du tronc et des malformations multiples. Observation Nous rapportons un cas de syndrome CLOVES initialement confondu avec un syndrome de Protee, revele par un episode de surinfection d’un hamartome lipomateux du dos. La patiente avait une hypertrophie et des malformations capillaires et veino-lymphatiques du membre inferieur droit, des malformations capillaires dorsales, une hemi-hypertrophie cervico-faciale gauche et un hamartome epidermique cervical, compatibles avec un syndrome de Protee. Le diagnostic de syndrome CLOVES etait pose plus tard, devant la mise en evidence par l’imagerie de l’hamartome lipomateux du dos associe aux malformations capillaires mais aussi a des malformations veino-lymphatiques sous-jacentes et a une syringomyelie. Discussion Plusieurs syndromes malformatifs peuvent etre evoques devant une hypertrophie tissulaire associee a des hamartomes et a des malformations vasculaires. Ainsi, le diagnostic de syndrome CLOVES peut etre retarde car ce syndrome est assez proche phenotypiquement du syndrome de Protee. Cependant, le pronostic et les complications sont differents. Il est important d’evoquer le diagnostic de syndrome CLOVES devant l’association d’hamartomes lipomateux du dos, d’une hemi-hypertrophie corporelle et d’un hamartome epidermique, afin de mettre en place un suivi adapte et une surveillance des complications propres a cette maladie.

Resume Objectifs Cette etude presente deux objectifs. Le premier, base sur une etude de minimisation des couts, compare les techniques de chimio-embolisation conventionnelle au lipiodol (TACE) a celle utilisant des particules prechargees (TACE-DEB). Le second permet de definir le caractere financable de la TACE-DEB et de definir les conditions de rentabilite de celle-ci. Patients et methodes Les patients traites par chimio-embolisation (n = 31 : TACE ; n = 32 : TACE-DEB), au cours de l’annee 2010, ont ete suivis retrospectivement. Le point de vue hospitalier a ete retenu pour l’etude de minimisation des couts. Les couts directs medicaux ont ete determines et compares selon la methode de l’ENCC reajustee. La rentabilite des deux techniques et la definition d’une hypothese de rentabilite (point mort) ont egalement ete determinees. Resultats Tous groupes homogenes de malade (GHM) confondus, les durees de sejour (TACE : 4,90 ± 3,36 ; TACE-DEB : 5,03 ± 3,36) ne varient pas significativement. Un cout total moyen superieur pour la TACE-DEB est decrit (TACE : 2869,05 € ; TACE-DEB : 3960,10 €). L’etude de rentabilite demontre que globalement, la technique TACE-DEB est financable quel que soit le GHM. Un ratio de 1,3 interventions avec la methode conventionnelle (TACE) permet d’envisager le financement des interventions de type TACE-DEB. Conclusion La presente analyse medico-economique permet de demontrer le caractere financable de la technique TACE-DEB.

In an analogy from symmetric ordinary differential equation numerical integrators, we derive a three-stage, weak 2nd-order procedure for Monte-Carlo simulations of Itô stochastic differential equations. Our composite procedure splits each time step into three parts: an h/2-stage of trapezoidal rule, an h-stage martingale, followed by another h/2-stage of trapezoidal rule. In n time steps, an h/2-stage deterministic step follows another n−1 times. Each of these adjacent pairs may be combined into a single h-stage, effectively producing a two-stage method with partial overlap between successive time steps., BIT Numerical Mathematics, 54 (3), ISSN:0006-3835, ISSN:1572-9125

Background Anaesthesia Databank Switzerland (ADS) is a voluntary data registry introduced in 1996. Its ultimate goal is to promote quality in anaesthesiology. Methods The ADS registry analyses routinely recorded adverse events and provides benchmark comparisons between anaesthesia departments. Data collection comprises a set of 31 variables organised into three modules, one mandatory and two optional. Results In 2010, the database included 2,158,735 anaesthetic procedures. Over time, the proportions of older patients have increased, the largest group being aged 50–64 years. The percentage of patients with American Society of Anesthesiologists (ASA) status 1 has decreased while the percentage of ASA status 2 or 3 patients has increased. The most frequent comorbidities recorded were hypertension (21%), smoking (16%), allergy (15%) and obesity (12%). Between 1996 and 2010, 125,579 adverse events were recorded, of which 34% were cardiovascular, 7% respiratory, 39% technical and 20% non-specific. The most severe events were resuscitation (50%), oliguria (22%), myocardial ischaemia (17%) and haemorrhage (10%). Conclusion Routine ADS data collection contributes to the monitoring of trends in anaesthesia care in Switzerland. The ADS system has proved to be usable in daily practice, although this remains a constant challenge that is highly dependent on local quality management and quality culture. Nevertheless, success in developing routine regular feedback to users to initiate discussions about anaesthetic events would most likely help strengthen departmental culture regarding safety and quality of care.

Resume Propos Cet article presente le developpement et les premieres donnees de validation de la version francaise d’un nouveau questionnaire de mesure de la sante percue ou de la qualite de vie des personnes âgees (> 60 ans) : le module WHOQOL-OLD. Ce questionnaire, mis au point dans le cadre d’un projet international sous l’egide de l’OMS avec le soutien de l’Union europeenne, est destine a completer le questionnaire de qualite de vie generique WHOQOL-BREF. Il comporte 24 questions regroupees en six dimensions. Methodes Le developpement initial du questionnaire et les etudes pilotes realisees ont conduit a un premier questionnaire qui a fait l’objet d’etudes de terrain dans 20 centres repartis dans le monde entier. Elles ont concerne 5566 personnes et permis la validation du WHOQOL-OLD dans sa version finale. En ce qui concerne la version francaise, 281 sujets, d’âge moyen 74 ans, ont ete recrutes par trois centres (Paris, Nancy et Geneve). Resultats Les resultats de l’analyse des proprietes psychometriques du questionnaire, notamment l’analyse multitrait, sont compatibles avec les hypotheses sous-jacentes a la construction des scores. Par ailleurs, les scores presentent une precision suffisante pour utiliser cet instrument dans les comparaisons de groupes. Conclusion Au total, le questionnaire WHOQOL-OLD peut etre utilise aupres des personnes âgees dans les etudes de service de sante, la recherche clinique et les etudes epidemiologiques.

Neuregulin-1 (NRG1) and ErbB receptors have been associated with psychopathology, and NRG1-ErbB3 signaling has been shown to increase hippocampal neurogenesis and induce antidepressant-like effects. In this study, we aimed to determine whether deficits in NRG1 or ErbBs might be present in the hippocampus of suicide completers. In well-characterized postmortem hippocampal samples from suicides and matched sudden-death controls, we assessed gene expression and methylation using qRT-PCR and EpiTYPER, respectively. Moreover, in hippocampal tissues stained with cresyl violet, stereology was used to quantify numbers of granule cells and of glia. Granule cell body size was examined with a nucleator probe, and granule cell layer volume with a Cavalieri probe. Unmedicated suicides showed sharply decreased hippocampal ErbB3 expression and decreased numbers of ErbB3-expressing granule cell neurons in the anterior dentate gyrus; a phenomenon seemingly reversed by antidepressant treatment. Furthermore, we found ErbB3 expression to be significantly decreased in the dentate gyrus of adult mice exposed to chronic social defeat stress. Taken together, these results reveal novel suicidal endophenotypes in the hippocampus, as well as a putative etiological mechanism underlying suicidality, and suggest that antidepressant or NRG1 treatment may reverse a potential deficit in anterior dentate gyrus granule cell neurons in individuals at risk of dying by suicide.

Background Infection by Toxoplasma gondii postnatally can occur after ingestion of contaminated meat or water (tissue cysts/oocysts). In Europe, percentage of meat borne infections is estimated between 30 and 63 %, out of which pork makes the most important source. The aim of this study was to (i) investigate the seroprevalence of T. gondii in intensive pig farms from western France; and (ii) identify the risk factors associated with seropositivity. Methods Data were collected between November 2006 and February 2008 in 60 intensive farrow-to-finish farms, where sera were taken from 3595 fattening pigs, weaned and suckling piglets. Information about three classes of potential seropositivity risk factors were obtained through a questionnaire concerning: (i) breeding characteristics; (ii) farm management; and (iii) husbandry and hygiene. The modified agglutination test (MAT) was used for detection of specific anti T. gondii antibodies in pig sera, starting from 1/6 dilution. Results The overall proportion of seropositive animals was 6.9 %, but the proportion of herds with at least one positive pig was 100 %. Multivariate logistic mixed model showed an increased seropositivity risk in weaned compared to suckling piglets, and a decreasing risk for mid-sized and large farms. The presence of a Danish entry facility, that clearly separates clean and dirty areas, had a protective effect on T. gondii seropositivity as well. Conclusions The observed proportion of herds with at least one T. gondii seropositive animal provides further evidence that even in confined conditions of pig breeding, infection occurs, and is common. The highest risk for acquiring T. gondii is at the end of weaning period. Smaller confined pig farms demonstrate higher T. gondii seropositivity levels. This study also showed that Danish entry on farm buildings provides effective protection against T. gondii. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1753-5) contains supplementary material, which is available to authorized users.

International audience; Background The monoaminergic transmitters dopamine (DA), noradrenaline (NE) and serotonin (5-HT) modulate cerebral functions via their extensive effects in the brain. Investigating their roles has led to the creation of vesicular monoaminergic transporter-2 (VMAT2) knockout (KO) mice. While this mutation results in postnatal death, VMAT2-heterozygous (HET) mice are viable and show a complex behavioural phenotype. However, the simultaneous alteration of the 3 systems prevents investigations into their individual functions. Methods To assess the specific role of NE, 5-HT and DA, we genetically disrupted their neurotransmission by creating conditional VMAT2-KO mice with targeted recombination. These specific recombinations were obtained by breeding VMAT2(lox/lox) mice with DBHcre, SERTcre and DATcre mice, respectively. We conducted a complete neurochemical and behavioural characterization of VMAT2-HET animals in each system. Results Conditional VMAT2-KO mice revealed an absence of VMAT2 expression, and a specific decrease in the whole brain levels of each monoamine. Although NE- and 5-HT-depleted mice are viable into adulthood, DA depletion results in postnatal death before weaning. Interestingly, alteration of the DA transmission fully accounted for the increased amphetamine response formerly observed in the VMAT2-HET mice, whereas alteration of the 5-HT system was solely responsible for the increase in cocaine response. Limitations We used VMAT2-HET mice that displayed a mild phenotype. Because the VMAT2-KO in DA neurons is lethal, it precluded a straightforward comparison of the full KOs in the 3 systems. Conclusion Given the intermingled functions of NE, 5-HT and DA in regulating cognitive and affective functions, this model will enhance understanding of their respective roles in the pathophysiology of psychiatric disorders.