Facteurs Predictifs De Malignite D\'un Nodule Thyroidien

Buts : étudier les facteurs prédictifs de malignité des nodules thyroïdiens et comparer nos résultats à ceux de la littérature. Patients et méthodes : Il s\'agit d\'une étude rétrospective a propos de 282 cas de nodules thyroïdiens opérés à l\' hôpital de Mahdia entre 1988 et 2003. Résultats : L\'âge moyen était de 44 ans. Le risque de malignité des nodules thyroïdiens était de 15,6% . Ce risque était plus important chez les hommes (50%) que chez les femmes (13,3%). Certains facteurs étaient hautement prédictifs de malignité comme l\'âge supérieur à 60 ans, les signes de compression, les adénopathies cervicales et le caractère fixe et dure du nodule thyroidien Conclusion : Certains signes cliniques et para cliniques ont une grande valeur en matière de bénignité ou de malignité des nodules thyroïdiens.Aim : Study the predictive factors of malignancy of thyroid gland nodules and compare our results to those of the literature. Patients and methods : A retrospective study about 282 cases of thyroid gland nodules treated in Madhya hospital between 1988 and 2003. Results : The middle age was 44 years. The risk of malignancy was 15,6 %. This risk was higher in men (50 %) then in women (13,3 %). Some factors were highly predictive of malignancy like age superior then 60 years, neck lymph nodes … Conclusion: Some clinic and para clinic signs have an important value in benignancy or malignancy of thyroid gland nodules. Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 18 2007: pp. 20-2

Iron(III) Complexes on a Dendrimeric Basis and Various Amine Core Investigated by Mössbauer Spectroscopy

Dendrimers of various generations were synthesized by the divergent method. Starting from various amine cores (G(0a), G(0b), G(0c)) the generations were built by reaction of the amine with acrylnitrile followed by hydrogenation with DIBAL-H. Treatment with salicylaldehyde creates a fivefold coordination sphere for iron in the molecular periphery. The resulting multinuclear coordination compounds are investigated by Mossbauer spectroscopy

Asteroid Redirect Mission (ARM) Formulation Assessment and Support Team (FAST) Final Report

The Asteroid Redirect Mission (ARM) Formulation Assessment and Support Team (FAST) was a two-month effort, chartered by NASA, to provide timely inputs for mission requirement formulation in support of the Asteroid Redirect Robotic Mission (ARRM) Requirements Closure Technical Interchange Meeting held December 15-16, 2015, to assist in developing an initial list of potential mission investigations, and to provide input on potential hosted payloads and partnerships. The FAST explored several aspects of potential science benefits and knowledge gain from the ARM. Expertise from the science, engineering, and technology communities was represented in exploring lines of inquiry related to key characteristics of the ARRM reference target asteroid (2008 EV5) for engineering design purposes. Specific areas of interest included target origin, spatial distribution and size of boulders, surface geotechnical properties, boulder physical properties, and considerations for boulder handling, crew safety, and containment. In order to increase knowledge gain potential from the mission, opportunities for partnerships and accompanying payloads were also investigated. Potential investigations could be conducted to reduce mission risks and increase knowledge return in the areas of science, planetary defense, asteroid resources and in-situ resource utilization, and capability and technology demonstrations. This report represents the FAST"TM"s final product for the ARM

Risk factors for tuberculosis treatment failure, default, or relapse and outcomes of retreatment in Morocco

<p>Abstract</p> <p>Background</p> <p>Patients with tuberculosis require retreatment if they fail or default from initial treatment or if they relapse following initial treatment success. Outcomes among patients receiving a standard World Health Organization Category II retreatment regimen are suboptimal, resulting in increased risk of morbidity, drug resistance, and transmission.. In this study, we evaluated the risk factors for initial treatment failure, default, or early relapse leading to the need for tuberculosis retreatment in Morocco. We also assessed retreatment outcomes and drug susceptibility testing use for retreatment patients in urban centers in Morocco, where tuberculosis incidence is stubbornly high.</p> <p>Methods</p> <p>Patients with smear- or culture-positive pulmonary tuberculosis presenting for retreatment were identified using clinic registries in nine urban public clinics in Morocco. Demographic and outcomes data were collected from clinical charts and reference laboratories. To identify factors that had put these individuals at risk for failure, default, or early relapse in the first place, initial treatment records were also abstracted (if retreatment began within two years of initial treatment), and patient characteristics were compared with controls who successfully completed initial treatment without early relapse.</p> <p>Results</p> <p>291 patients presenting for retreatment were included; 93% received a standard Category II regimen. Retreatment was successful in 74% of relapse patients, 48% of failure patients, and 41% of default patients. 25% of retreatment patients defaulted, higher than previous estimates. Retreatment failure was most common among patients who had failed initial treatment (24%), and default from retreatment was most frequent among patients with initial treatment default (57%). Drug susceptibility testing was performed in only 10% of retreatment patients. Independent risk factors for failure, default, or early relapse after initial treatment included male gender (aOR = 2.29, 95% CI 1.10-4.77), positive sputum smear after 3 months of treatment (OR 7.14, 95% CI 4.04-13.2), and hospitalization (OR 2.09, 95% CI 1.01-4.34). Higher weight at treatment initiation was protective. Male sex, substance use, missed doses, and hospitalization appeared to be risk factors for default, but subgroup analyses were limited by small numbers.</p> <p>Conclusions</p> <p>Outcomes of retreatment with a Category II regimen are suboptimal and vary by subgroup. Default among patients receiving tuberculosis retreatment is unacceptably high in urban areas in Morocco, and patients who fail initial tuberculosis treatment are at especially high risk of retreatment failure. Strategies to address risk factors for initial treatment default and to identify patients at risk for failure (including expanded use of drug susceptibility testing) are important given suboptimal retreatment outcomes in these groups.</p

Emerging Capabilities for Detection and Characterization of Near-Earth Objects (NEOs)

Here we describe the status for the detection and characterization of Near- Earth Objects (NEO) with current and future observatories. A summary of the capabilities, limitations, and obtainable NEO parameters is provided. <p/

Impact of Vutrisiran on Quality of Life and Physical Function in Patients with Hereditary Transthyretin-Mediated Amyloidosis with Polyneuropathy

INTRODUCTION: Hereditary transthyretin (ATTRv; v for variant) amyloidosis, also known as hATTR amyloidosis, is a progressive and fatal disease associated with rapid deterioration of physical function and patients' quality of life (QOL). Vutrisiran, a subcutaneously administered RNA interference (RNAi) therapeutic that reduces hepatic production of transthyretin, was assessed in patients with ATTRv amyloidosis with polyneuropathy in the pivotal HELIOS-A study. METHODS: The phase 3 open-label HELIOS-A study investigated the efficacy and safety of vutrisiran in patients with ATTRv amyloidosis with polyneuropathy, compared with an external placebo group from the APOLLO study of the RNAi therapeutic patisiran. Measures of QOL and physical function were assessed. RESULTS: At month 18, vutrisiran improved Norfolk Quality of Life-Diabetic Neuropathy (Norfolk QOL-DN) total score (least squares mean difference [LSMD] in change from baseline [CFB]: –21.0; p = 1.84 × 10–10) and Norfolk QOL-DN domain scores, compared with external placebo. This benefit relative to external placebo was evident across all baseline polyneuropathy disability (PND) scores and most pronounced in patients with baseline PND scores I–II. Compared with external placebo, vutrisiran also demonstrated benefit in EuroQoL-Visual Analog Scale (EQ-VAS) score (LSMD in CFB: 13.7; nominal p = 2.21 × 10–7), 10-m walk test (LSMD in CFB: 0.239 m/s; p = 1.21 × 10–7), Rasch-built Overall Disability Score (LSMD in CFB: 8.4; p = 3.54 × 10–15), and modified body mass index (mBMI) (LSMD in CFB: 140.7; p = 4.16 × 10–15) at month 18. Overall, Norfolk QOL-DN, EQ-VAS, and mBMI improved from pretreatment baseline with vutrisiran, whereas all measures worsened from baseline in the external placebo group. At month 18, Karnofsky Performance Status was stable/improved from baseline in 58.2/13.1% with vutrisiran versus 34.7/8.1% with external placebo. CONCLUSION: Vutrisiran treatment provided significant clinical benefits in multiple measures of QOL and physical function in patients with ATTRv amyloidosis with polyneuropathy. Benefits were most pronounced in patients with earlier-stage disease, highlighting the importance of early diagnosis and treatment

Emerging Capabilities for Detection and Characterization of Near-Earth Objects (NEOs)

Here we describe the status for the detection and characterization of Near- Earth Objects (NEO) with current and future observatories. A summary of the capabilities, limitations, and obtainable NEO parameters is provided. <p/

Collateral circulation: Past and present

Following an arterial occlusion outward remodeling of pre-existent inter-connecting arterioles occurs by proliferation of vascular smooth muscle and endothelial cells. This is initiated by deformation of the endothelial cells through increased pulsatile fluid shear stress (FSS) caused by the steep pressure gradient between the high pre-occlusive and the very low post-occlusive pressure regions that are interconnected by collateral vessels. Shear stress leads to the activation and expression of all NOS isoforms and NO production, followed by endothelial VEGF secretion, which induces MCP-1 synthesis in endothelium and in the smooth muscle of the media. This leads to attraction and activation of monocytes and T-cells into the adventitial space (peripheral collateral vessels) or attachment of these cells to the endothelium (coronary collaterals). Mononuclear cells produce proteases and growth factors to digest the extra-cellular scaffold and allow motility and provide space for the new cells. They also produce NO from iNOS, which is essential for arteriogenesis. The bulk of new tissue production is carried by the smooth muscles of the media, which transform their phenotype from a contractile into a synthetic and proliferative one. Important roles are played by actin binding proteins like ABRA, cofilin, and thymosin beta 4 which determine actin polymerization and maturation. Integrins and connexins are markedly up-regulated. A key role in this concerted action which leads to a 2-to-20 fold increase in vascular diameter, depending on species size (mouse versus human) are the transcription factors AP-1, egr-1, carp, ets, by the Rho pathway and by the Mitogen Activated Kinases ERK-1 and -2. In spite of the enormous increase in tissue mass (up to 50-fold) the degree of functional restoration of blood flow capacity is incomplete and ends at 30% of maximal conductance (coronary) and 40% in the vascular periphery. The process of arteriogenesis can be drastically stimulated by increases in FSS (arterio-venous fistulas) and can be completely blocked by inhibition of NO production, by pharmacological blockade of VEGF-A and by the inhibition of the Rho-pathway. Pharmacological stimulation of arteriogenesis, important for the treatment of arterial occlusive diseases, seems feasible with NO donors