Promoting the use of the PRECISE score for prostate MRI during active surveillance: results from the ESOR Nicholas Gourtsoyiannis teaching fellowship

OBJECTIVES: The PRECISE criteria for serial multiparametric magnetic resonance imaging (MRI) of the prostate during active surveillance recommend the use of a dedicated scoring system (PRECISE score) to assess the likelihood of clinically significant radiological change. This pilot study assesses the effect of an interactive teaching course on prostate MRI during active surveillance in assessing radiological change in serial imaging. METHODS: Eleven radiology fellows and registrars with different experience in prostate MRI reading participated in a dedicated teaching course where they initially evaluated radiological change (based on their previous training in prostate MRI reading) independently in fifteen patients on active surveillance (baseline and follow-up scan), and then attended a lecture on the PRECISE score. The initial scans were reviewed for teaching purposes and afterwards the participants re-assessed the degree of radiological change in a new set of images (from fifteen different patients) applying the PRECISE score. Receiver operating characteristic analysis was performed. Confirmatory biopsies and PRECISE scores given in consensus by two radiologists (involved in the original draft of the PRECISE score) were the reference standard. RESULTS: There was a significant improvement in the average area under the curve (AUC) for the assessment of radiological change from baseline (AUC: 0.60 [Confidence Intervals: 0.51-0.69] to post-teaching (AUC: 0.77 [0.70-0.84]). This was an improvement of 0.17 [0.016-0.28] (p = 0.004). CONCLUSIONS: A dedicated teaching course on the use of the PRECISE score improves the accuracy in the assessment of radiological change in serial MRI of the prostate

A Methodological Perspective on Genetic Risk Prediction Studies in Type 2 Diabetes: Recommendations for Future Research

Fueled by the successes of genome-wide association studies, numerous studies have investigated the predictive ability of genetic risk models in type 2 diabetes. In this paper, we review these studies from a methodological perspective, focusing on the variables included in the risk models as well as the study designs and populations investigated. We argue and show that differences in study design and characteristics of the study population have an impact on the observed predictive ability of risk models. This observation emphasizes that genetic risk prediction studies should be conducted in those populations in which the prediction models will ultimately be applied, if proven useful. Of all genetic risk prediction studies to date, only a few were conducted in populations that might be relevant for targeting preventive interventions

Organisation symposium international "situations de vulnérabilités et apprentissages existentiels"

International audienc

Analysis of Microglia and Monocyte-derived Macrophages from the Central Nervous System by Flow Cytometry

International audienceNumerous studies have demonstrated the role of immune cells, in particular macrophages, in central nervous system (CNS) pathologies. There are two main macrophage populations in the CNS: (i) the microglia, which are the resident macrophages of the CNS and are derived from yolk sac progenitors during embryogenesis, and (ii) the monocyte-derived macrophages (MDM), which can infiltrate the CNS during disease and are derived from bone marrow progenitors. The roles of each macrophage subpopulation differ depending on the pathology being studied. Furthermore, there is no consensus on the histological markers or the distinguishing criteria used for these macrophage subpopulations. However, the analysis of the expression profiles of the CD11b and CD45 markers by flow cytometry allows us to distinguish the microglia (CD11b+CD45med) from the MDM (CD11b+CD45high). In this protocol, we show that the density gradient centrifugation and the flow cytometry analysis can be used to characterize these CNS macrophage subpopulations, and to study several markers of interest expressed by these cells as we recently published. Thus, this technique can further our understanding of the role of macrophages in mouse models of neurological diseases and can also be used to evaluate drug effects on these cells

In a tertiary maternity hospital, when should a paediatrician be present in the delivery room?

International audienceObjective: 10% of newborns require positive pressure ventilation (PPV) at birth. There are few data on prenatal or early postnatal factors that are predictive of the need for a paediatrician in the delivery room. The study analysed prenatal obstetric and early postnatal factors associated with the requirement for paediatrician assistance in this setting.Methods: Over a three-month period, all consecutive births in a tertiary hospital's maternity unit were prospectively evaluated with regard to the need for paediatrician assistance (requested either before or after the delivery), the requirement for resuscitation, and transfer to a neonatal intensive care unit (NICU).Results: For a total of 584 consecutive births, paediatrician assistance was requested before delivery in 170 cases (30.5%) and after in 78 cases (13.3%). 78% of the newborns requiring PPV, 95.8% of those requiring endotracheal intubation and 86.3% of those requiring transfer to the NICU matched recently published prenatal criteria for paediatrician assistance. Along with a low Apgar score and a cord blood pH<7.20, these criteria covered 95% of the prenatal and early postnatal requests for paediatrician assistance.Conclusions: These criteria for neonatal resuscitation in the delivery room would enable medical staff to anticipate the need for paediatrician assistance

Polyethylene bag wrapping to prevent hypothermia during percutaneous central venous catheter insertion in the preterm newborn under 32 weeks of gestation

International audienceAim: In preterm neonates, during nursing procedures, body temperature decreases. This study evaluates the interest of polyethylene bag wrapping to prevent this decrease during percutaneous central venous catheter (PCVC) insertion procedure, in preterm neonates under 32 weeks of gestation nursed in closed incubators. Methods: This prospective observational study compared two periods: [May 2009-September 2009]: ``without polyethylene bag wrapping'' and [October 2009-March 2010]: ``with polyethylene bag wrapping''. The main criterion was newborn skin temperature at the end of the procedure. Results: There was no difference between the two groups for skin temperature before the procedure (36.9 +/- 0.3 degrees C versus 36.9 +/- 0.3 degrees C; p = NS). The skin temperature at the end of the procedure was lower in the ``without bag wrapping'' group (36.0 +/- 0.5 degrees C) compared to the ``bag wrapping'' group (36.4 degrees C +/- 0.5 degrees C; p = 0.01). Furthermore, no skin temperature at the end was higher than 37.4 degrees C in the bag wrapping group. Conclusion: The use of a polyethylene bag was effective in decreasing skin temperature fall during a PCVC insertion procedure in our population. No side effects were observed. The benefit of prolonged wrapping or for shorter procedure should be evaluated

Combined MS-NMR approach for the quality control of food supplements containing amino acids

International audienceA global analytical control of dietary supplements has become essential. In this field, additives containing amino acids (AAs) are of growing interest in the food industry. AAs are important in human nutrition and in maintaining health; they play a key role in metabolizing nutrients, building muscle tissue and protecting the body against disease. The preferred methods for their quality control use chromatographic techniques, which are often difficult to set up and not really adapted to the characterization and quantification of other ingredients and contaminants in commercial formulations. In this study, we demonstrated the efficiency of a combined Mass Spectrometry-Nuclear Magnetic Resonance (MS-NMR) approach for the qualitative and quantitative analysis of home-made and commercial AA supplements (Amino 75 (R), Primene (R) 10% and BCAA + Glutamine Advanced (R)). The proposed workflow enables the quantification of AAs and other components at concentrations of less than 1 mM with tolerances of +/- 10% for NMR and +/- 20% for MS, which correspond to European recommendations. In our work, we point out the complementarity of MS and NMR for a global and stringent analysis of food supplement content. (C) 2018 Elsevier Ltd. All rights reserved