Toxicity profile of bevacizumab in the UK Neurofibromatosis Type 2 cohort

Bevacizumab is considered an established part of the treatment strategies available for schwannomas in patients with Neurofibromatosis Type 2(NF2). In the UK, it is available through NHS National Specialized Commissioning to NF2 patients with a rapidly growing target schwannoma. Regrowth of the tumour on suspension of treatment is often observed resulting in prolonged periods of exposure to bevacizumab to control the disease. Hypertension and proteinuria are common events with bevacizumab use and there are concerns with regards to the long-term risks of prolonged treatment. Dosing, demographic and adverse event(CTCAE 4.03) data from the UK NF2 bevacizumab cohort are reviewed with particular consideration of renal and cardiovascular complications. Eighty patients (48 male:32female), median age 24.5 years (range 11-66years), were followed for a median of 32.7 months (range 12.0–60.2months). The most common adverse events were fatigue, hypertension and infection. A total of 19/80 patients (24%) had either a grade 2 or grade 3 hypertension event and 14/80 patients (17.5%) had proteinuria. Of 36 patients followed for 36 months, 78% were free from hypertension and 86% were free of proteinuria. Logistic regression modeling identified age and induction dosing regime to be predictors of development of hypertension with dose of 7.5mg/kg three weekly and age >30years having higher rates of hypertension. Proteinuria persisted in one of three patients after cessation of bevacizumab. One patient developed congestive heart failure and the details of this case are described. Further work is needed to determine optimal dosing regimes to limit toxicity without impacting on efficacy

Chronic Lipoid Pneumonia in a 9-Year-Old Child Revealed by Recurrent Chest Pain

Lipoid pneumonia in children is a rare disorder due to accumulation of fatty oily material in the alveoli and usually associated with an underlying condition. In absence of obvious context, diagnosis remains difficult with nonspecific clinical and radiological features. We report the first case of voluntary chronic aspiration of olive oil responsible for exogenous lipoid pneumonia, in a previously healthy 9-year-old boy. Clinical presentation was atypical; LP was revealed by isolated chest pain. We discuss radiological and bronchial alveolar lavage characteristics suggestive of lipoid pneumonia. Conclusion. Lipoid pneumonia is a disease to be reminded of in children, which can occur with original findings in terms of etiology and clinical presentation

Nature: R Dissemination level: PU Version: 19

4 Objectives of MORYNE...................................................................................................9 5 Synthesis of State-of-the-art..........................................................................................10 5.1 Traffic management.................................................................................................10 5.1.1 Instruments for traffic management (ITM)................................................................... 10 5.1.2 Main Advantages of traffic management systems...................................................... 12 5.1.3 Existing systems and solutions................................................................................... 12 5.1.4 Berlin situation: VMZ................................................................................................... 22 5.1.5 Open issues and challenges addressed by MORYNE................................................ 23 5.2 Transport management...........................................................................................24 5.2.1 State-of-the art............................................................................................................. 2

Dramatic impact of morbid obesity on child lung development

International audienceOBJECTIVE: To assess the respiratory function and sleep characteristics of obese adults and children.METHODS: All patients with non-syndromic, severe obesity (BMI ≥3 z-scores for children and ≥40.00kg/m2RESULTS: A total of 69 children (mean±SD BMI 36.8±6.7 and mean BMI z-score 4.7±1.0) and 70 adults were included (mean BMI 45.7±6.2). Metabolic syndrome was diagnosed in 13 children (26%) and 40 adults (80%). Reduced lung volumes were observed in 34 children (50.0%) and 16 adults (24.0%) and both the mean functional residual capacity (FRC) and the mean residual volume (RV) were lower in children than in adults (FRC: -1.7±2.1 z-score in children vs. -1.0±1.1 in adults, P=0.026; and RV: -0.8±1.2 z-score in children vs. -0.1±1.1 in adults, P=0.002). The prevalence of severe obstructive sleep apnea syndrome was greater in adults (40.7% vs. 18.8%, P=0.007). Children had a higher average oxygen saturation (median of 96.0% [91.0-98.0] vs. 93.0% [76.0-97.0] in adults, P<0.0001).CONCLUSIONS: Obesity has consequences for lung volumes in children; however, a longitudinal study is needed to determine the impact on pulmonary expansion and growth

Present Day Engins Pollutant Emissions: Proposed Model for Refinery Bases Impact

Air quality improvement, especially in urban areas, is one of the major concerns for the coming years. For this reason, car manufacturers, equipment manufacturers and refiners have explored development issues to comply with increasingly severe anti-pollution requirements. In such a context, the identification of the most promising improvement options is essential. A research program, carried out by IFP (Institut français du pétrole), and supported by the French Ministry of Industry, PSA-Peugeot-Citroën, Renault and RVI (Renault Véhicules Industriels), has been built to study this point. It is based on a four years program with different steps focused on new engine technologies which will be available in the next 20 years in order to answer to more and more severe pollutant and CO2 emissions regulations. This program is divided into three main parts: the first one for Diesel car engines, the second for Diesel truck engines and the third for spark ignition engines. The aim of the work reported here is to characterize the effect of fuel formulation on pollutant emissions and engine tuning for different engine technologies. The originality of this study is to use refinery bases as parameters and not conventional physical or chemical parameters. The tested fuels have been chosen in order to represent the major refinery bases expected to be produced in the near future. These results, expressed with linear correlations between fuel composition and pollutant emissions, will help to give a new orientation to refinery tool. The engines presented in this publication are, for spark ignition engines an EuroII lean-burn engine (Honda VTEC which equips the Honda Civic) and an EuroIII 1. 8 l stoichiometric-running Renault engine which equips the Laguna vehicles and, for diesel engines an EuroII Renault Laguna 2. 2 l indirect injection diesel engine and an EuroII RVI truck engine. For the fuel formulation, an original approach is proposed: while the classical studies are based on the properties of the fuel, this one is built only on a refinery bases approach. For diesel fuels, six refinery bases (a straight-run diesel fuel, an hydro-cracked diesel fuel, a LCO, a diesel fuel obtained by hydro-conversion of vacuum distillation residue, a kerosene and a diesel fuel issued from a Fischer-Tropsch process) have been selected to produce a fuel matrix which was determined according to an experimental blend design. For gasoline fuels, seven bases have been chosen, which are representative of the batch that will be used in the next years: a fuel from isomeration process (mainly constituted of C5/C6 isoparafins), an alkylate (constituted of C7+ isoparafins), a fuel from olefins oligomerization process, a fuel from catalytic cracking process (mainly composed of C7+ olefins and aromatic compounds), a light reformate (C7/C8 aromatic compounds), an heavy reformate (C9+ aromatic compounds) and an oxygenated compound (ETBE). For each engine, tests have been run on a steady state bench with variations of some tuning parameters. Vehicle tests with the same engines have also been carried out on the European MVEG cycle, where regulated and unregulated pollutant emissions have been recorded