Endovascular treatment of pulmonary arteriovenous malformations in hereditary haemorrhagic telangiectasia.

PRINCIPLES: To assess the efficiency and complication rates of vaso-occlusion of pulmonary arteriovenous malformations (PAVMs) in Rendu-Osler-Weber disease (hereditary haemorrhagic telangectasia; HHT). METHODS: Seventy-two patients were investigated in our institution for HHT between March 2000 and November 2011. Sixteen presented PAVMs (22.2%), and 11 (68.8%) were treated with vaso-occlusion for a total of 18 procedures. Procedures included coils, plugs and combined approaches. Immediate success and recurrence rate, complication were recorded, as well as persistent and new PAVMs during clinical and computed tomography (CT) follow-up. RESULTS: Eighteen procedures were performed and a total of 37 PAVMs were treated, 19 with coils, 16 with plugs and 2 with combined treatment. Mean CT follow-up time was 41 months (1‒164). No major complication was observed. One distal translocation was treated during the same intervention. Two PAVMs persisted after treatment (5.7%), both treated by means of plug embolisation. One new PAVM was observed during follow-up CT. PAVMs with an afferent artery of less than 3mm or asymptomatic PAVMs were not treated. CONCLUSION: Recent studies have demonstrated that vaso-occlusion has become the gold standard treatment for PAVM. This study is in accordance with previous results and shows a minimal complication rate and little recurrence, whether by coils, plugs, or combined treatments

Influence of model based iterative reconstruction algorithm on image quality of multiplanar reformations in reduced dose chest CT.

Model-based iterative reconstruction (MBIR) reduces image noise and improves image quality (IQ) but its influence on post-processing tools including maximal intensity projection (MIP) and minimal intensity projection (mIP) remains unknown. To evaluate the influence on IQ of MBIR on native, mIP, MIP axial and coronal reformats of reduced dose computed tomography (RD-CT) chest acquisition. Raw data of 50 patients, who underwent a standard dose CT (SD-CT) and a follow-up RD-CT with a CT dose index (CTDI) of 2-3 mGy, were reconstructed by MBIR and FBP. Native slices, 4-mm-thick MIP, and 3-mm-thick mIP axial and coronal reformats were generated. The relative IQ, subjective IQ, image noise, and number of artifacts were determined in order to compare different reconstructions of RD-CT with reference SD-CT. The lowest noise was observed with MBIR. RD-CT reconstructed by MBIR exhibited the best relative and subjective IQ on coronal view regardless of the post-processing tool. MBIR generated the lowest rate of artefacts on coronal mIP/MIP reformats and the highest one on axial reformats, mainly represented by distortions and stairsteps artifacts. The MBIR algorithm reduces image noise but generates more artifacts than FBP on axial mIP and MIP reformats of RD-CT. Conversely, it significantly improves IQ on coronal views, without increasing artifacts, regardless of the post-processing technique

Essays on Violence, Health and Family Dynamics

Programa de Doctorat en Economia[eng] Violence is a pervasive societal challenge with profound economic implications. The experience of violence can have durable impacts on the life-outcomes of victims: their health; labor market opportunities, educational attainment - but also on their descendants and their peers, thereby contributing to the transmission of inequality and large costs for society. Violence's toll goes beyond its immediate, negative effects on victims. Episodes of collective violence (wars, conflicts, colonization) can also have durable effects on long-run development and societies. The experience of violence is, in addition, not random. Economically, socially and politically disadvantaged communities are much more likely to experience violence, whether it be collective - through political repression, wars, labor coercion... - or inter-personal (e.g gender-based violence or racial violence). The experience of violence is, therefore, highly intertwined with the transmission of inequality. The general goal of my thesis is to contribute to a better understanding of the causes and consequences of violence against minorities, with a particular focus on the expression of violence in the familiar setting. I use both historical and contemporary data and adopt a multifaceted approach: both in terms of the events of violence studied (institutional or interpersonal), the targeted minority (racial or gender), and the context (historical or contemporary). The first section focuses on the lingering effects of institutional violence in a historical setting: New World Slavery. I focus on the French Caribbean islands of Guadeloupe and Martinique, and study the determinants of violence during Slavery (Chapter 2) and its lingering effects on the immediate descendants of former slaves (Chapter 3). The work presented in this section is the fruit of a large scale digitization effort of handwritten administrative archives (nearly 50,000 pages) on enslaved individuals and their descendants. To collect this new data, I built an optical character recognition pipeline tailored for French Handwritten Archives, which I present in Chapter 4. Given the persistent effects of violence, investigating the efficiency of current policies in identifying and protecting victims of violence is of primary importance. The second section turns a contemporary context, and focuses on state's responses to systemic violence against women and children during the COVID-19 pandemic (Chapter 5). Both sections focus on two potential drivers of violence in the familiar setting: intergenerational transmission of trauma, and exogenous stressful shocks. These two sections are also complementary in their approach to the problem of violence. While the first section focuses on the mechanisms through which violence has lingering effects, the second section focuses on the efficiency of institutional responses to intra-familial abuse. The health dimension is also highly present in all chapters: either as consequence of violence, using mortality as outcome of interest in Chapter 2 and 3; or as a cause of violence - the COVID-19 health shock - and institution of interest (the health sector) in Chapter 5

Essays on Violence, Health and Family Dynamics

[eng] Violence is a pervasive societal challenge with profound economic implications. The experience of violence can have durable impacts on the life-outcomes of victims: their health; labor market opportunities, educational attainment - but also on their descendants and their peers, thereby contributing to the transmission of inequality and large costs for society. Violence's toll goes beyond its immediate, negative effects on victims. Episodes of collective violence (wars, conflicts, colonization) can also have durable effects on long-run development and societies. The experience of violence is, in addition, not random. Economically, socially and politically disadvantaged communities are much more likely to experience violence, whether it be collective - through political repression, wars, labor coercion... - or inter-personal (e.g gender-based violence or racial violence). The experience of violence is, therefore, highly intertwined with the transmission of inequality. The general goal of my thesis is to contribute to a better understanding of the causes and consequences of violence against minorities, with a particular focus on the expression of violence in the familiar setting. I use both historical and contemporary data and adopt a multifaceted approach: both in terms of the events of violence studied (institutional or interpersonal), the targeted minority (racial or gender), and the context (historical or contemporary). The first section focuses on the lingering effects of institutional violence in a historical setting: New World Slavery. I focus on the French Caribbean islands of Guadeloupe and Martinique, and study the determinants of violence during Slavery (Chapter 2) and its lingering effects on the immediate descendants of former slaves (Chapter 3). The work presented in this section is the fruit of a large scale digitization effort of handwritten administrative archives (nearly 50,000 pages) on enslaved individuals and their descendants. To collect this new data, I built an optical character recognition pipeline tailored for French Handwritten Archives, which I present in Chapter 4. Given the persistent effects of violence, investigating the efficiency of current policies in identifying and protecting victims of violence is of primary importance. The second section turns a contemporary context, and focuses on state's responses to systemic violence against women and children during the COVID-19 pandemic (Chapter 5). Both sections focus on two potential drivers of violence in the familiar setting: intergenerational transmission of trauma, and exogenous stressful shocks. These two sections are also complementary in their approach to the problem of violence. While the first section focuses on the mechanisms through which violence has lingering effects, the second section focuses on the efficiency of institutional responses to intra-familial abuse. The health dimension is also highly present in all chapters: either as consequence of violence, using mortality as outcome of interest in Chapter 2 and 3; or as a cause of violence - the COVID-19 health shock - and institution of interest (the health sector) in Chapter 5