Transatlantic intelligence and security cooperation

Despite recent advances in transatlantic intelligence and security cooperation, significant problems remain. The bombings in Madrid in March 2004 have demonstrated how terrorists and criminals can continue to exploit the limits of hesitant or partial exchange to dangerous effect. Intelligence and security cooperation remain problematic because of the fundamental tension between an increasingly networked world, which is ideal terrain for the new religious terrorism, and highly compartmentalized national intelligence gathering. If cooperation is to improve, we require a better mutual understanding about the relationship between privacy and security to help us decide what sort of intelligence should be shared. This is a higher priority than building elaborate new structures. While most practical problems of intelligence exchange are ultimately resolvable, the challenge of agreeing what the intelligence means in broad terms is even more problematic. The last section of this article argues that shared NATO intelligence estimates would be difficult to achieve and of doubtful value

Screening for GJB2 and GJB6 mutations in the Slovak deaf population

Introduction: Mutations of connexin genes account for up to 50% of prelingual bilateral sensorineural hearing loss (SNHL). In Slovakia the deaf population is estimated to reach about 9000 individuals. However, reliable data on bilateral SNHL etiology in Slovakia are not available to date. The aim of presented study was to analyze the GJB2 and GJB6 genes and describe their mutation spectrum in patients with bilateral SNHL and thus to determine epidemiology of one of the most dominant causes of SNHL in Slovakia. Methods: Since 2010 we performed molecular-genetic testing for GJB2 and GJB6 mutations in >500 subjects suffering from bilateral SNHL, that included 375 unrelated individuals selected for epidemiology analyses. Patients were recruited at 2 ORL clinics in Bratislava and special schools for hearing impaired children throughout Slovakia. Inclusion criteria were bilateral SNHL and age below 60 years at the time of hearing loss diagnosis. Direct sequencing and MLPA was used for DNA analysis. Results: We identified 11 mutations and six polymorphisms in GJB2 gene. Homozygous mutations occurred in 22% and compound heterozygotes in 9% of subjects. Negative subjects, without any pathogenic allele found accounted for 61%. Mutations c.35delG and c.71G>A were recorded most frequently (60.4% and 15.8% respectively). The large GJB6 deletion (delD13S1830) was found in 1 family.Conclusions: DNA analysis of patients with SNHL revealed mutation spectrum of GJB2 and GJB6 genes in our cohort and also confirmed exact genetic cause of hearing loss in almost one third of investigated subjects. Our results represent fundamental data for genetic counseling, clinical prognosis, improvement of diagnostic tools for clinical practice and possible personalized treatment in future.Supported by: Grants APVV 0148-10 and VEGA 1/0465/11Der Erstautor gibt keinen Interessenkonflikt an

TEP/TDM et récidive biologique d’adénocarcinome prostatique : apport du ⁶⁸Ga-PSMA-11 lorsque la ¹⁸F-fluorocholine n’est pas contributive

International audienceIntroduction: Since April 201, we have introduced PET/CT using a ligand of prostate-specific membrane antigen labeled with gallium-68 (PSMA-11). We aimed to evaluate its positivity rate and impact in patients presenting biochemical recurrence of prostate cancer whose 18F-fluorocholine (FCH) PET/CT was non-contributive.Patients and method: Patients were prospectively included between April and December 2016. PET/CT was performed 60 min after injection of 2 MBq/kg of body mass of 68Ga-PSMA-11. Three anatomical areas were considered: prostatic lodge, pelvic lymph nodes and distant locations. The impact of PSMA-11 PET/CT was assessed by comparing changes in therapeutic strategy decided during multidisciplinary meeting.Results: Thirty-three patients were included. The mean PSA serum level measured on the month of the PSMA-11 PET/CT was 2,8 ng/mL. Twenty-five (76%) PSMA-11 PET/CT were positive, 7 (21%) negative and 1 (3%) equivocal. Of 11 patients whose FCH PET/CT showed equivocal foci, PSMA-11 PET/CT confirmed those foci in 5 cases. Follow-up was available for 18 patients (55%). PSMA-11 PET/CT results led to a change in management in 12 patients (67%).Conclusion: 68Ga-PSMA-11 PET/CT is useful in detecting recurrence of prostate cancer, by identifying residual disease which was not detected on other imaging modalities and by changing management of 2 patients out of 3.Level of evidence: 5.Introduction: Depuis avril 2016, nous avons introduit la TEP/TDM avec ligand de l’antigène membranaire spécifique de la prostate marqué au gallium-68 (PSMA-11). Nous avons évalué son taux de positivité et son impact chez les patients en récidive biologique de cancer de prostate, sans lésion affirmable en TEP/TDM à la 18F-fluorocholine (FCH).Patients et méthodes: Ces patients ont été prospectivement inclus d’avril à décembre 2016. La TEP/TDM a été effectuée 60 min après injection de 2 MBq/kg de 68Ga-PSMA-11. Trois sites anatomiques ont été considérés : loge prostatique, ganglions pelviens, et localisations à distance. L’impact des résultats de la TEP/TDM-PSMA-11 sur la prise en charge a été évalué en comparant les stratégies thérapeutiques proposées lors des réunions de concertation pluridisciplinaires.Résultats: Trente-trois patients ont été inclus. La concentration sérique moyenne du PSA mesurée au cours du mois de la TEP/TDM-PSMA-11 était de 2,8 ng/mL. Vingt-cinq TEP/TDM-PSMA-11 (76 %) étaient positives, 7 (21 %) négatives et 1 (3 %) douteuse. Sur 11 patients dont la TEP/TDM-FCH était douteuse, la TEP/TDM-PSMA-11 a confirmé les lésions douteuses dans 5 cas. Un suivi était disponible pour 18 patients (55 %). Les résultats des TEP/TDM-PSMA-11 ont conduit à un changement de la prise en charge chez 12 patients (67 %).Conclusion: La TEP/TDM au 68Ga-PSMA-11 est efficace dans la localisation de la récidive du cancer de la prostate, identifiant des cibles de maladie résiduelle non visualisées par les autres méthodes d’imagerie, changeant ainsi la prise en charge de 2 patients sur 3.Niveau de preuve: 5