108 research outputs found
Les cancers de lâorbite etude retrospective Ă propos de 31 cas
locorĂ©gionale rendant le traitement difficile et mutilant. Dans ce travail, nous rapportons notre expĂ©rience dans la prise en charge diagnostique et thĂ©rapeutique de ces tumeurs. MatĂ©riels et mĂ©thodes : Notre Ă©tude rĂ©trospective a concernĂ© 31 cas de cancers de lâorbite colligĂ©s sur 13 ans (1993- 2005). Tous les patients ont bĂ©nĂ©ficiĂ© dâun examen clinique complet, dâune imagerie du massif facial (TDM et/ou IRM) et dâune biopsie de la tumeur. Le traitement a Ă©tĂ© basĂ© sur la chirurgie, la radiothĂ©rapie et/ou la chimiothĂ©rapie. RĂ©sultats : La symptomatologie clinique Ă©tait dominĂ©e par les signes ophtalmologiques et les algies faciales. Lâimagerie a montrĂ© dans tous les cas un processus expansif tissulaire Ă point de dĂ©part orbitaire, avec lyse osseuse orbitaire chez 16 patients (51,6%), une extension au massif facial chez 7 patients (22,6%), endocrĂąniennes chez 6 patients (19,4%) et des formes bilatĂ©rales atteignant les deux orbites dans 3 cas (9,7%) lâanatomopathologie montrait une prĂ©dominance des lymphomes malins non hodgkiniens (32,3%) et des carcinomes Ă©pidermoĂŻdes (32,3%), suivis des rhabdomyosarcomes embryonnaires (19,4 %). Douze patients ont Ă©tĂ© traitĂ©s par chirurgie et radiothĂ©rapie postopĂ©ratoire, dix patients par une association radio-chimiothĂ©rapie, et neuf autres par une chimiothĂ©rapie nĂ©o-adjuvante. La survie globale Ă©tait de 67,8% Ă 3 ans, 48,4% Ă 5 ans et 22,6% Ă 10 ans. Conclusion : Les cancers de lâorbite sont de mauvais pronostic. Un diagnostic prĂ©coce et un traitement radical et adaptĂ© au type histologique permet dâamĂ©liorer la survie et la qualitĂ© de vie chez les patients atteints de ces tumeurs.Mots-clĂ©s : Orbite, cancer, lymphome, carcinome Ă©pidermoĂŻde, rhabdomyosarcom
Structure-Preserving Smooth Projective Hashing
International audienceSmooth projective hashing has proven to be an extremely useful primitive, in particular when used in conjunction with commitments to provide implicit decommitment. This has lead to applications proven secure in the UC framework, even in presence of an adversary which can do adaptive corruptions, like for example Password Authenticated Key Exchange (PAKE), and 1-out-of-m Oblivious Transfer (OT). However such solutions still lack in efficiency, since they heavily scale on the underlying message length. Structure-preserving cryptography aims at providing elegant and efficient schemes based on classical assumptions and standard group operations on group elements. Recent trend focuses on constructions of structure- preserving signatures, which require message, signature and verification keys to lie in the base group, while the verification equations only consist of pairing-product equations. Classical constructions of Smooth Projective Hash Function suffer from the same limitation as classical signatures: at least one part of the computation (messages for signature, witnesses for SPHF) is a scalar. In this work, we introduce and instantiate the concept of Structure- Preserving Smooth Projective Hash Function, and give as applications more efficient instantiations for one-round PAKE and three-round OT, and information retrieval thanks to Anonymous Credentials, all UC- secure against adaptive adversaries
Adaptive Oblivious Transfer and Generalization
International audienceOblivious Transfer (OT) protocols were introduced in the seminal paper of Rabin, and allow a user to retrieve a given number of lines (usually one) in a database, without revealing which ones to the server. The server is ensured that only this given number of lines can be accessed per interaction, and so the others are protected; while the user is ensured that the server does not learn the numbers of the lines required. This primitive has a huge interest in practice, for example in secure multi-party computation, and directly echoes to Symmetrically Private Information Retrieval (SPIR). Recent Oblivious Transfer instantiations secure in the UC framework suf- fer from a drastic fallback. After the first query, there is no improvement on the global scheme complexity and so subsequent queries each have a global complexity of O(|DB|) meaning that there is no gain compared to running completely independent queries. In this paper, we propose a new protocol solving this issue, and allowing to have subsequent queries with a complexity of O(log(|DB|)), and prove the protocol security in the UC framework with adaptive corruptions and reliable erasures. As a second contribution, we show that the techniques we use for Obliv- ious Transfer can be generalized to a new framework we call Oblivi- ous Language-Based Envelope (OLBE). It is of practical interest since it seems more and more unrealistic to consider a database with uncontrolled access in access control scenarii. Our approach generalizes Oblivious Signature-Based Envelope, to handle more expressive credentials and requests from the user. Naturally, OLBE encompasses both OT and OSBE, but it also allows to achieve Oblivious Transfer with fine grain access over each line. For example, a user can access a line if and only if he possesses a certificate granting him access to such line. We show how to generically and efficiently instantiate such primitive, and prove them secure in the Universal Composability framework, with adaptive corruptions assuming reliable erasures. We provide the new UC ideal functionalities when needed, or we show that the existing ones fit in our new framework. The security of such designs allows to preserve both the secrecy of the database values and the user credentials. This symmetry allows to view our new approach as a generalization of the notion of Symmetrically PIR
Epidemiology and treatment outcomes of diabetic retinopathy in a diabetic population from Cameroon
Evidence for Widespread Genomic Methylation in the Migratory Locust, Locusta migratoria (Orthoptera: Acrididae)
The importance of DNA methylation in mammalian and plant systems is well established. In recent years there has been renewed interest in DNA methylation in insects. Accumulating evidence, both from mammals and insects, points towards an emerging role for DNA methylation in the regulation of phenotypic plasticity. The migratory locust (Locusta migratoria) is a model organism for the study of phenotypic plasticity. Despite this, there is little information available about the degree to which the genome is methylated in this species and genes encoding methylation machinery have not been previously identified. We therefore undertook an initial investigation to establish the presence of a functional DNA methylation system in L. migratoria. We found that the migratory locust possesses genes that putatively encode methylation machinery (DNA methyltransferases and a methyl-binding domain protein) and exhibits genomic methylation, some of which appears to be localised to repetitive regions of the genome. We have also identified a distinct group of genes within the L. migratoria genome that appear to have been historically methylated and show some possible functional differentiation. These results will facilitate more detailed research into the functional significance of DNA methylation in locusts
Increased 30-Day Mortality in Very Old ICU Patients with COVID-19 Compared to Patients with Respiratory Failure without COVID-19
Purpose: The number of patients â„ 80 years admitted into critical care is increasing. Coronavirus disease 2019 (COVID-19) added another challenge for clinical decisions for both admission and limitation of life-sustaining treatments (LLST). We aimed to compare the characteristics and mortality of very old critically ill patients with or without COVID-19 with a focus on LLST.
Methods: Patients 80 years or older with acute respiratory failure were recruited from the VIP2 and COVIP studies. Baseline patient characteristics, interventions in intensive care unit (ICU) and outcomes (30-day survival) were recorded. COVID patients were matched to non-COVID patients based on the following factors: age (± 2 years), Sequential Organ Failure Assessment (SOFA) score (± 2 points), clinical frailty scale (± 1 point), gender and region on a 1:2 ratio. Specific ICU procedures and LLST were compared between the cohorts by means of cumulative incidence curves taking into account the competing risk of discharge and death.
Results: 693 COVID patients were compared to 1393 non-COVID patients. COVID patients were younger, less frail, less severely ill with lower SOFA score, but were treated more often with invasive mechanical ventilation (MV) and had a lower 30-day survival. 404 COVID patients could be matched to 666 non-COVID patients. For COVID patients, withholding and withdrawing of LST were more frequent than for non-COVID and the 30-day survival was almost half compared to non-COVID patients.
Conclusion: Very old COVID patients have a different trajectory than non-COVID patients. Whether this finding is due to a decision policy with more active treatment limitation or to an inherent higher risk of death due to COVID-19 is unclear.info:eu-repo/semantics/publishedVersio
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised
Intra-household agreement of urinary elemental concentrations in Tanzania and Kenya: potential surrogates in caseâcontrol studies
Element deficiencies and excesses play important roles in non-communicable disease aetiology. When investigating their roles in epidemiologic studies without prospective designs, reverse-causality limits the utility of transient biomarkers in cases. This study aimed to investigate whether surrogate participants may provide viable proxies by assessing concentration correlations within households. We obtained spot urine samples from 245 Tanzanian and Kenyan adults (including 101 household pairs) to investigate intra-household correlations of urinary elements (As, Ba, Ca, Cd, Co, Cs, Cu, Fe, Li, Mn, Mo, Ni, Pb, Rb, S, Se, Sr, Tl, V and Zn) and concentrations (also available for: Bi, Ce, Sb, Sn and U) relative to external population-levels and health-based values. Moderate-strong correlations were observed for As (râ=â0.65), Cs (râ=â0.67), Li (râ=â0.56), Mo (râ=â0.57), Se (râ=â0.68) and Tl (râ=â0.67). Remaining correlations were <0.41. Median Se concentrations in Tanzania (29â”g/L) and Kenya (24â”g/L) were low relative to 5738 Canadians (59â”g/L). Exceedances (of reference 95th percentiles) were observed for: Co, Mn, Mo, Ni and U. Compared to health-based values, exceedances were present for As, Co, Mo and Se but deficiencies were also present for Mo and Se. For well correlated elements, household members in East African settings provide feasible surrogate cases to investigate element deficiencies/excesses in relation to non-communicable diseases
A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)
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Ossification of the ligamentum flavum in a nineteenth-century skeletal population sample from Ireland:Using bioarchaeology to reveal a neglected spine pathology
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