A Retrospective Analysis of Multiple Affected Salivary Gland Diseases: Diagnostic and Therapeutic Benefits of Interventional Sialendoscopy.

OBJECTIVES Multiple affected salivary gland diseases are rare compared to single gland diseases and represent a major diagnostic challenge. These cases are commonly neglected in the scientific literature, despite the considerable suffering of these patients. The aim of this retrospective study was to report disease characteristics, diagnostic pathways, and therapeutic options, including sialendoscopic treatment of multiple affected salivary gland disorders. METHODS Patients experiencing multiple affected salivary gland diseases treated between 2013 and 2020 were consecutively identified. Data regarding demographics, clinical presentation, disease characteristics, treatment, complications, and follow-up were analyzed retrospectively. RESULTS In total, 71 patients were identified with these diseases and included obstructive disease without sialolithiasis (n = 22), inflammation (n = 15), immune disease (n = 19), radioiodine-induced sialadenitis (RAI) (n = 5), sialadenosis (n = 2), and juvenile recurrent parotitis (JRP) (n = 8). Diagnostic and therapeutic sialendoscopy was performed on 113 salivary glands in 42 patients, leading to completely (n = 27, 64.3%) or partially (n = 11, 26.2%) improved symptoms in most cases. In total, 4 patients did not improve after interventional therapy. CONCLUSIONS Multiple affected salivary gland diseases are rare and diagnostically challenging. Interventional sialendoscopy offers an effective and safe therapeutic option and should be considered in this specific cohort

Comment des parents d’élèves et des enseignants spécialisés voient la réussite et la difficulté scolaires

L’objectif de cette étude est d’explorer la manière dont des acteurs du système scolaire profanes (parents d’élèves) ou experts (enseignants spécialisés) se représentent l’élève en réussite scolaire et l’élève en difficulté scolaire. Pour ce faire, nous avons interrogé 29 parents d’élèves et 33 enseignants spécialisés. Les résultats indiquent que la représentation de la difficulté se décompose en trois catégories (environnement, caractéristiques personnelles et culture), alors que celle de la réussite se compose de deux catégories (environnement et caractéristiques personnelles). Les autres résultats montrent que la représentation d’un élève en difficulté scolaire n’est pas l’inverse de celle d’un élève en réussite, et que les causes évoquées pour expliquer ces statuts ne sont pas non plus opposées. Enfin la représentation des parents et des enseignants spécialisés diffèrent globalement, avec notamment une homogénéité et un consensus plus grands dans la représentation de ces derniers.The purpose of this study is to look closely at the way people within the school system–uninitiated (parents) or expert (special education teachers)–see successful students and those having learning difficulties. To do so we have questioned 29 parents and 33 special education teachers. The results show that in those people’s minds, difficulties are sorted out into three categories: backgrounds, personal and cultural features whereas success is divided into two categories: backgrounds, and personal features. Other results show that the mental representation that people have of a child with learning difficulties is not the opposite of that of a successful one, and the reasons given to explain these phenomena are not opposed either. Finally the parents’ and teachers’ mental representations are on the whole rather different, with, for instance, better homogeneity and wider consensus in teachers.El objetivo de este estudio estriba en explorar cómo actores profanos del sistema escolar (padres de alumnos) o expertos (docentes especializados) se representan al alumno en situación de éxito escolar y al alumno con dificultades escolares. Para ello, interrogamos a 29 padres de alumnos y a 33 docentes especializados. Los resultados indican que la representación de las dificultades se descompone en tres categorías (entorno, características personales y cultura), mientras el éxito se compone de dos categorías (entorno y características personales). Los otros resultados muestran que la representación de un alumno con dificultades escolares no es inversa a la de un alumno que conoce el éxito escolar, y que los motivos mencionados para explicar esos estatus tampoco se oponen. Por fin, la representación de los padres y de los docentes especializados difiere globalmente, en particular con una homogeneidad y un consenso más importantes en la representación de los docentes.Das Ziel dieser Studie ist, die Art und Weise zu beobachten, wie Laien (Eltern) oder Profis (Sonderschullehrer) im Schulsystem sich den erfolgreichen Schüler und den Schüler mit Schwierigkeiten vorstellen. Zu diesem Zweck haben wir 29 Eltern und 33 Sonderschullehrer befragt. Die Ergebnisse zeigen, dass die Vorstellung der Schwierigkeit sich in drei Kategorien gliedert (Umfeld, persönliche Merkmale und Kultur), während der Erfolg aus zwei Kategorien besteht (Umfeld und persönliche Merkmale). Die übrigen Ergebnisse zeigen, dass die Vorstellung eines Schülers mit Schwierigkeiten nicht das genaue Gegenteil von der eines erfolgreichen Schülers ist, und dass die Gründe, die diese beiden Status erklären können auch nicht entgegengesetzt sind. Zum Schluss unterscheiden sich insgesamt die Vorstellungen der Eltern und die der Sonderschullehrer, insbesondere mit größerer Homogenität und größerem Konsens in den Vorstellungen der Lehrer

Stéréotypes de la difficulté scolaire : un outil de recueil

Les recherches actuelles dans le domaine de l’éducation attestent de l’influence des stéréotypes sociaux sur les résultats académiques des élèves. Afin de connaître les stéréotypes liés aux « élèves en difficulté scolaire » au cycle 3, nous avons construit un outil auprès de psychologues scolaires, d’étudiants, de parents d’élèves, d’élèves de cycle 3, d’enseignants spécialisés et de stagiaires professeurs des écoles (PE2). L’analyse a permis d’obtenir quarante-neuf traits généraux mais aussi spécifiques aux groupes interrogés. Différentes méthodologies permettant de mesurer les stéréotypes avec cet outil sont présentées en discussion.Current research in the field of education shows the effects of social stereotypes on students’ academic performances. To determine the stereotypes of “5th grade students having learning disabilities”, we built an instrument with a sample of educational psychologists, undergraduate students, 5th grade students’ parents, 5th grade students, specialised teachers, and student teachers. Forty-nine traits that are general and sometimes specific to the respondent groups were obtained. The discussion section presents different ways to measure these stereotypes using this instrument

Quantification of Adverse Drug Reactions Related to Drug Switches in The Netherlands

Contains fulltext : 220534.pdf (publisher's version ) (Open Access)We performed a retrospective cohort study in the Dutch patient population to identify active substances with a relatively high number of adverse drug reactions (ADRs) potentially related to drug switching. For this, we analyzed drug switches and reported ADRs related to switching between June 1, 2009, and December 31, 2016, for a selection of 20 active substances. We also compared pharmacovigilance analyses based on the absolute, switch-corrected, and user-corrected numbers of ADRs. In total, 1,348 reported ADRs and over 23.8 million drug switches were obtained from the National Health Care Institute in The Netherlands and from Lareb, which is The Netherlands Pharmacovigilance Centre. There was no correlation between the number of ADRs and the number of switches, but, on average, we found 5.7 reported ADRs per 100,000 switches. The number was relatively high for rivastigmine, levothyroxine, methylphenidate, and salbutamol, with 74.9, 50.9, 47.6, and 26.1 ADRs per 100,000 switches, respectively. When comparing analyses using the absolute number and the switch-corrected number of ADRs, we demonstrate that different active substances would be identified as having a relatively high number of ADRs, and different time periods of increased numbers of ADRs would be observed. We also demonstrate similar results when using the user-corrected number of ADRs instead of the switch-corrected number of ADRs, allowing for a more feasible approach in pharmacovigilance practice. This study demonstrates that pharmacovigilance analyses of switch-related ADRs leads to different results when the number of reported ADRs is corrected for the actual number of drug switches

Contemporary Management of Severe Symptomatic Aortic Stenosis

There were gaps between guidelines and practice when surgery was the only treatment for aortic stenosis (AS).This study analyzed the decision to intervene in patients with severe AS in the EORP VHD (EURObservational Research Programme Valvular Heart Disease) II survey.Among 2,152 patients with severe AS, 1,271 patients with high-gradient AS who were symptomatic fulfilled a Class I recommendation for intervention according to the 2012 European Society of Cardiology guidelines; the primary end point was the decision for intervention.A decision not to intervene was taken in 262 patients (20.6%). In multivariate analysis, the decision not to intervene was associated with older age (odds ratio [OR]: 1.34 per 10-year increase; 95% CI: 1.11 to 1.61; P = 0.002), New York Heart Association functional classes I and II versus III (OR: 1.63; 95% CI: 1.16 to 2.30; P = 0.005), higher age-adjusted Charlson comorbidity index (OR: 1.09 per 1-point increase; 95% CI: 1.01 to 1.17; P = 0.03), and a lower transaortic mean gradient (OR: 0.81 per 10-mm Hg decrease; 95% CI: 0.71 to 0.92; P < 0.001). During the study period, 346 patients (40.2%, median age 84 years, median EuroSCORE II [European System for Cardiac Operative Risk Evaluation II] 3.1%) underwent transcatheter intervention and 515 (59.8%, median age 69 years, median EuroSCORE II 1.5%) underwent surgery. A decision not to intervene versus intervention was associated with lower 6-month survival (87.4%; 95% CI: 82.0 to 91.3 vs 94.6%; 95% CI: 92.8 to 95.9; P < 0.001).A decision not to intervene was taken in 1 in 5 patients with severe symptomatic AS despite a Class I recommendation for intervention and the decision was particularly associated with older age and combined comorbidities. Transcatheter intervention was extensively used in octogenarians

Rift Valley Fever during Rainy Seasons, Madagascar, 2008 and 2009

The virus reemerged during an outbreak in Madagascar in 2008

Animal et religion

This book questions again the links between animals and religions, from a diachronic and comparative perspective

Requirements for generic anti-epileptic medicines: a regulatory perspective

Contains fulltext : 81660.pdf (publisher's version ) (Closed access

Systematic discovery of gene fusions in pediatric cancer by integrating RNA-seq and WGS

Background: Gene fusions are important cancer drivers in pediatric cancer and their accurate detection is essential for diagnosis and treatment. Clinical decision-making requires high confidence and precision of detection. Recent developments show RNA sequencing (RNA-seq) is promising for genome-wide detection of fusion products but hindered by many false positives that require extensive manual curation and impede discovery of pathogenic fusions. Methods: We developed Fusion-sq to overcome existing disadvantages of detecting gene fusions. Fusion-sq integrates and “fuses” evidence from RNA-seq and whole genome sequencing (WGS) using intron–exon gene structure to identify tumor-specific protein coding gene fusions. Fusion-sq was then applied to the data generated from a pediatric pan-cancer cohort of 128 patients by WGS and RNA sequencing. Results: In a pediatric pan-cancer cohort of 128 patients, we identified 155 high confidence tumor-specific gene fusions and their underlying structural variants (SVs). This includes all clinically relevant fusions known to be present in this cohort (30 patients). Fusion-sq distinguishes healthy-occurring from tumor-specific fusions and resolves fusions in amplified regions and copy number unstable genomes. A high gene fusion burden is associated with copy number instability. We identified 27 potentially pathogenic fusions involving oncogenes or tumor-suppressor genes characterized by underlying SVs, in some cases leading to expression changes indicative of activating or disruptive effects. Conclusions: Our results indicate how clinically relevant and potentially pathogenic gene fusions can be identified and their functional effects investigated by combining WGS and RNA-seq. Integrating RNA fusion predictions with underlying SVs advances fusion detection beyond extensive manual filtering. Taken together, we developed a method for identifying candidate gene fusions that is suitable for precision oncology applications. Our method provides multi-omics evidence for assessing the pathogenicity of tumor-specific gene fusions for future clinical decision making

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups