Późny przerzut do wątroby raka rdzeniastego tarczycy z niskim stężeniem kalcytoniny skutecznie wyleczony metodą radioablacji

  A 28-year-old female consulted in 1994 for a left thyroid nodule known for two years with documented progression. Left lobe resection was performed initially followed by total thyroidectomy without lymph node dissection in September 1994. Pathological examination concluded on unilateral 10 × 40 mm medullary thyroid carcinoma (MTC). RET mutation was negative. Basal and pentagastrin-stimulated CT levels had been normal from 1994 to 2008 when her CT level was found to be elevated at 33 ng/L and increased subsequently to 111 ng/L in 2010. In accordance with guidelines, cervical ultrasound was performed repeatedly with negative results. After discussion in a multidisciplinary meeting and with patient’s consent, an F-Dopa PET scan was proposed in disagreement with guidelines. This scan showed unique uptake in liver segment VI, which was confirmed by MRI. CT levels reached to 253 ng/L when she finally accepted treatment. In February 2013 we performed radiofrequency ablation of the lesion, which allowed normalisation of CT levels. This observation highlights the possibility of late recurrence of MTC. We could propose that for MTC patients with low-calcitonin levels-recurrences F-DOPA-PET/CT is a good diagnostic tool to use in case of repeatedly negative US neck studies. (Endokrynol Pol 2016; 67 (3): 326–329)    Chora w wieku 28 lat zgłosiła się do lekarza w 1994 roku z powodu lewostronnego guzka tarczycy wykrytego 2 lata wcześniej, z potwierdzoną progresją. Wykonano resekcję lewego płata tarczycy. Totalną tyreoidektomię wykonano we wrześniu 1994 roku bez usunięcia węzłów chłonnych. W badaniu patomorfologicznych stwierdzono jednostronnego raka rdzeniastego tarczycy (MTC) o wymiarach 10 × 40 mm. Wynik badania w kierunku mutacji RET był ujemny. Stężenia kalcytoniny (CT, calcitonin), podstawowe i po stymulacji pentagastryną, były prawidłowe od 1994 roku. Do 2008 roku, kiedy stwierdzono podwyższone stężenie CT wynoszące 33 ng/l, a następnie jego dalszy wzrost do 111 ng/l w 2010 roku. Zgodnie z zaleceniami powtórnie wykonano badanie USG szyi, w którym nie stwierdzono nieprawidłowości. Po omówieniu przypadku na spotkaniu wielodyscyplinarnego zespołu i uzyskaniu zgody chorej przeprowadzono badanie F-Dopa PET (niezgodnie z zaleceniami), w którym wykazano pojedyncze ognisko wychwytu w segmencie VI wątroby, co zostało potwierdzone w badaniu MRI. Kiedy chora w końcu zaakceptowała leczenie, stężenia CT zwiększyły się do 253 ng/l. W lutym 2013 roku wykonano ablację zmiany prądem o częstotliwości radiowej, co pozwoliło uzyskać normalizację stężeń CT w 2015 r. Ta obserwacja zwraca uwagę na możliwość późnej wznowy. Autorzy sugerują, że u chorych z MTC z ponownie stwierdzonym niskim stężeniem kalcytoniny wybór F-DOPA-PET/CT jako metody diagnostycznej jest dobrym rozwiązaniem w przypadku powtórnych ujemnych wyników USG szyi. (Endokrynol Pol 2016; 67 (3): 326–329)

Differences in anti-malarial activity of 4-aminoalcohol quinoline enantiomers and investigation of the presumed underlying mechanism of action

International audienc

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Effect of organic and conventional practices on the insects natural enemies communities in agricultural landscapes

Food security and biodiversity conservation are among the main challenges of modern agriculture. Organic Farming (OF) is considered as a promising type of production to meet these challenges due to the use of alternative practices on organic systems. In particular, biological control of pests by their natural enemies is considered as a possible way to reduce pesticide use in Conventional Farming (CF). The aim of this work is to describe the diversity of practices on winter wheat in organic and conventional farms, and to understand their effects on natural enemies, at field and landscape scales. Entomological surveys and agronomic surveys were carried out in forty fields (twenty under OF and twenty under CF) located in different landscape contexts. The results showed that both farmers under OF or CF implemented a diversity of management strategies on winter wheat, although the dichotomy between the two production types remained well marked. At the field scale, organic practices seemed to be more favorable to the presence of beneficial insects than conventional practices, suggesting a more effective biological control. However, no effect of the proportion of OF in the landscape context of fields was found

Intérêt du dosage du cortisol salivaire à minuit chez les patients diabétiques de type 2

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Spatial organization of organic and conventional farming in agricultural landscapes: impacts on beneficial insects

The present study aims at measuring the influence of the diversity and spatial organization of organic and conventional farming practices on aphids and their natural enemies (ladybirds, predatory carabid beetles and parasitoids) in winter wheat. Higher abundances of beneficial insects were expected in organic fields and “organic landscapes” but with important variations due to practices diversity. Moreover, fields directly surrounded by extensive practices, either organic or conventional, were expected to present high abundance of natural enemies

Conduite du blé d’hiver en Ille-et Vilaine : Lien entre pratiques agricoles et auxiliaires. Brèves de la Zone Atelier Armorique

il s'agit d'un type de produit dont les métadonnées ne correspondent pas aux métadonnées attendues dans les autres types de produit : REPORTConduite du blé d’hiver en Ille-et Vilaine : Lien entre pratiques agricoles et auxiliaires. Brèves de la Zone Atelier Armoriqu

Effet des pratiques biologiques et conventionnelles sur les communautés d’insectes auxiliaires dans les paysages agricoles

La sécurité alimentaire ainsi que la conservation de la biodiversité font partie des principaux enjeux de l’agriculture moderne. En raison de ses pratiques alternatives, l’Agriculture Biologique (AB) constitue un mode de production prometteur pour répondre à ces problématiques. En particulier, le contrôle biologique des ravageurs par leurs ennemis naturels semble être une alternative possible aux insecticides utilisés en Agriculture Conventionnelle (AC). L’objectif de cette étude est de décrire la diversité des pratiques de conduite du blé d'hiver en AB et en AC, et d’en comprendre les effets sur les insectes auxiliaires, à l’échelle de la parcelle et du paysage. Des relevés entomologiques et agronomiques ont été réalisés dans quarante parcelles (vingt en AB et vingt en AC) situées dans des contextes paysagers différents. Les résultats montrent qu’il existe une diversité de stratégies de conduite du blé chez les exploitants en AB et en AC, même si la dichotomie entre les deux modes de production reste bien marquée. Au niveau parcellaire, les stratégies en AB semblent plus favorables à la présence d’auxiliaires que les stratégies en AC, suggérant un contrôle biologique efficace. Néanmoins, aucun effet de la proportion de surface en AB dans le paysage environnant n’a été mis en évidence

Spatial organization of organic and conventional farming in agricultural landscapes: impacts on beneficial insects

The present study aims at measuring the influence of the diversity and spatial organization of organic and conventional farming practices on aphids and their natural enemies (ladybirds, predatory carabid beetles and parasitoids) in winter wheat. Higher abundances of beneficial insects were expected in organic fields and “organic landscapes” but with important variations due to practices diversity. Moreover, fields directly surrounded by extensive practices, either organic or conventional, were expected to present high abundance of natural enemies

Are ladybirds affected by farming practices at different spatial scales?

Given the current decline of biodiversity, modern agriculture is facing a new challenge: ensuring the food supply of a human population increasingly large whilst maintaining the ecological balance of agro-ecosystems to preserve their sustainability. Because of a strong reduction of inputs, organic farming is considered as a promising solution to promote auxiliaries communities at field and landscape scales and ensure crop protection thanks to biological control service. The present study aims to measure the impact of agricultural practices (organic vs. conventional) and of their spatial organization on aphids and their natural enemies. Twenty 1km² landscapes were selected in Ille et Vilaine (Western France), characterized by varying surface areas of organic vs. conventional farming. In each landscape, ladybirds, carabids, parasitoids and aphids communities were sampled from April to July 2012 in one organic winter wheat field and one conventional winter wheat field. Moreover, detailed agricultural practices of sampled and surrounding fields were collected. At field scale, the results demonstrate a beneficial effect of organic practices on auxiliaries. This result seems to be due to a more favorable microclimate in organic fields thanks to the structure of the vegetation and the lack of pesticides. At landscape scale, the farming practices don’t seem to affect insects communities