Complications of bone metastases from malignant melanoma

Introduction: Metastatic bone disease (MBD) carries significant morbidity for patients with cancer. MBD from malignant melanoma (MM) is understudied. We examined the characteristics, morbidity, management and outcome of MBD in patients with MM. Methods: Patients with metastatic MM managed at two referral cancer centres in England were identified. Those with bone metastases (BMs) were selected. Patient and disease characteristics including skeletal related events (SREs) were extracted from medical records. The Kaplan Meier method was used to calculate median survival. Results: Five hundred and eighteen patients with metastatic MM were managed between years 2000 and 2008. Eighty nine (17.2%) patients had BMs and are the subject of this study. Median age at diagnosis was 53 years and 55% were males. BMs were identified at the time of diagnosis of metastatic disease in 68.5% patients. Sixty-six (74.2%) had multiple bone lesions and 80.9% had axial skeleton involvement. One hundred and twenty nine skeletal related events occurred in 59 (66.3%) patients (50 radiotherapy, 28 hypercalcaemia, 20 bone fractures, 18 spinal cord compression and 13 orthopaedic surgery). The annual skeletal morbidity rate was 2.5. Median survival from diagnosis of BMs was 17.3 weeks and was 5.6 weeks from the first episode of hypercalcaemia. Conclusion: MBD affects a clinically important proportion (17.2%) of patients with metastatic MM. It carries a substantial morbidity and mortality exceeding that caused by BMs from breast and prostate cancer. These patients should receive the currently licensed bone modifying agents and should be included in clinical trials addressing MBD

Adult Height in Patients with Advanced CKD Requiring Renal Replacement Therapy during Childhood.

BACKGROUND AND OBJECTIVES: Growth and final height are of major concern in children with ESRD. This study sought to describe the distribution of adult height of patients who started renal replacement therapy (RRT) during childhood and to identify determinants of final height in a large cohort of RRT children. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A total of 1612 patients from 20 European countries who started RRT before 19 years of age and reached final height between 1990 and 2011 were included. Linear regression analyses were performed to calculate adjusted mean final height SD score (SDS) and to investigate its potential determinants. RESULTS: The median final height SDS was -1.65 (median of 168 cm in boys and 155 cm in girls). Fifty-five percent of patients attained an adult height within the normal range. Adjusted for age at start of RRT and primary renal diseases, final height increased significantly over time from -2.06 SDS in children who reached adulthood in 1990-1995 to -1.33 SDS among those reaching adulthood in 2006-2011. Older age at start of RRT, more recent period of start of RRT, cumulative percentage time on a functioning graft, and greater height SDS at initiation of RRT were independently associated with a higher final height SDS. Patients with congenital anomalies of the kidney and urinary tract and metabolic disorders had a lower final height than those with other primary renal diseases. CONCLUSIONS: Although final height remains suboptimal in children with ESRD, it has consistently improved over time

The ERA-EDTA Registry Annual Report 2017 : a summary

Background. This article presents a summary of the 2017 Annual Report of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry and describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 37 countries. Methods. The ERA-EDTA Registry received individual patient data on patients undergoing RRT for ESRD in 2017 from 32 national or regional renal registries and aggregated data from 21 registries. The incidence and prevalence of RRT, kidney transplantation activity and survival probabilities of these patients were calculated. Results. In 2017, the ERA-EDTA Registry covered a general population of 694 million people. The incidence of RRT for ESRD was 127 per million population (pmp), ranging from 37 pmp in Ukraine to 252 pmp in Greece. A total of 62% of patients were men, 52% were >= 65 years of age and 23% had diabetes mellitus as the primary renal disease. The treatment modality at the onset of RRT was haemodialysis for 85% of patients. On 31 December 2017, the prevalence of RRT was 854 pmp, ranging from 210 pmp in Ukraine to 1965 pmp in Portugal. The transplant rate in 2017 was 33 pmp, ranging from 3 pmp in Ukraine to 103 pmp in the Spanish region of Catalonia. For patients commencing RRT during 2008-12, the unadjusted 5-year patient survival probability for all RRT modalities combined was 50.8%.Peer reviewe

The European Renal Association - European Dialysis and Transplant Association Registry Annual Report 2014 : a summary

Background: This article summarizes the European Renal Association - European Dialysis and Transplant Association Registry's 2014 annual report. It describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 2014 within 35 countries. Methods: In 2016, the ERA-EDTA Registry received data on patients who in 2014 where undergoing RRT for ESRD, from 51 national or regional renal registries. Thirty-two registries provided individual patient level data and 19 provided aggregated patient level data. The incidence, prevalence and survival probabilities of these patients were determined. Results: In 2014, 70 953 individuals commenced RRT for ESRD, equating to an overall unadjusted incidence rate of 133 per million population (pmp). The incidence ranged by 10-fold; from 23 pmp in the Ukraine to 237 pmp in Portugal. Of the patients commencing RRT, almost two-thirds were men, over half were aged >= 65 years and a quarter had diabetes mellitus as their primary renal diagnosis. By day 91 of commencing RRT, 81% of patients were receiving haemodialysis. On 31 December 2014, 490 743 individuals were receiving RRT for ESRD, equating to an unadjusted prevalence of 924 pmp. This ranged throughout Europe by more than 10-fold, from 157 pmp in the Ukraine to 1794 pmp in Portugal. In 2014, 19 406 kidney transplantations were performed, equating to an overall unadjusted transplant rate of 36 pmp. Again this varied considerably throughout Europe. For patients commencing RRT during 2005-09, the 5-year-adjusted patient survival probabilities on all RRT modalities was 63.3% (95% confidence interval 63.0-63.6). The expected remaining lifetime of a 20-to 24-year-old patient with ESRD receiving dialysis or living with a kidney transplant was 21.9 and 44.0 years, respectively. This was substantially lower than the 61.8 years of expected remaining lifetime of a 20-year-old patient without ESRD.Peer reviewe

La Turquie et l'Organisation de la Coopération Economique de la Mer Noire (CEMN)

Rapport de stage réalisé par Alban des Grottes sous la direction de Jean Marcou Istanbul Août 2007 Télécharger La Turquie et l'Organisation de la Coopération Économique de la Mer Noire (CEMN) SOMMAIRE 1. L’organisation de la CEMN : une initiative de la Turquie destinée à asseoir sa puissance dans une région pacifiée et ouverte à ses exportations. 1.1. La création de la CEMN, ou comment la Turquie tente d’asseoir sa puissance dans une mer Noire renaissante. 1.1.1. Dans le contexte de la Guer..

Istanbul, capitale éphémère de la mer Noire

Le 25 juin dernier, Istanbul a accueilli le quinzième sommet annuel de l’organisation de Coopération Economique de la Mer Noire (CEMN). Chaque Etat membre y était représenté par son chef d’Etat ou de gouvernement, à l’exception de l’Arménie qui avait choisi de n’envoyer que son ministre des Affaires étrangères. Il s’agissait d’un sommet symbolique puisqu’il intervenait quinze ans jour pour jour après la réunion des chefs d’Etat des onze pays fondateurs qui lancèrent le processus qui devait ab..

Istanbul, capitale éphémère de la mer Noire

Le 25 juin dernier, Istanbul a accueilli le quinzième sommet annuel de l’organisation de Coopération Economique de la Mer Noire (CEMN). Chaque Etat membre y était représenté par son chef d’Etat ou de gouvernement, à l’exception de l’Arménie qui avait choisi de n’envoyer que son ministre des Affaires étrangères. Il s’agissait d’un sommet symbolique puisqu’il intervenait quinze ans jour pour jour après la réunion des chefs d’Etat des onze pays fondateurs qui lancèrent le processus qui devait ab..

Comment la littérature de jeunesse s’approprie-t-elle un objet scientifique tel qu’un animal comme la poule, et comment joue-t-elle sur ses caractéristiques ?

Les recherches concernant l'animal au coeur de la littérature de jeunesse sont principalement d'ordre général : il s'agit alors de « l'animal » et non « des animaux » et l'analyse se concentre plus précisément sur les contes. Des auteurs comme Georges Jean (1990) et Sylvie Loiseau (1992) s'interrogent sur l'origine de la présence animale dans les contes et leur valeur symbolique. Ce sont en particulier les travaux de Paulette Lequeux (1976) qui permettent une observation de différents animaux traditionnels dans la littérature de jeunesse et leur lien particulier qu'elle exploite. Le personnage de la poule dans la littérature de jeunesse est un animal intéressant à analyser car il n'a jamais été le sujet de recherches (Paulette Lequeux choisit d'accorder un long chapitre au coq et non à la poule). Il s'agit d'un animal populaire et familier. Si la poule, est d'abord un objet scientifique, son traitement à travers la littérature de jeunesse est riche et divers. Dans ce mémoire, nous tentons de décrire les différentes utilisations et représentations de la poule en lien avec les stéréotypes, les expressions populaires concernant l'animal. Nous cherchons également à savoir ce qu'elle devient en tant qu'objet de création littéraire. Dans cette perspective, qui n'a pas pour but d'être exhaustive, le critère de sélection des œuvres est principalement l'accessibilité et la disponibilité des ouvrages dans les lieux publics. L'analyse de ces nombreux ouvrages a permis de dégager des tendances mais également des traitements originaux. Ce dispositif permet un large décryptage du personnage de la poule à travers différents auteurs