Developmental predictors of inattention-hyperactivity from pregnancy to early childhood

Objective The objective of the study was to characterize the developmental sequence of pre- and postnatal risk factors for inattention-hyperactivity symptoms in preschoolers. Materials and Methods Longitudinal data came from a French population based birth cohort study (EDEN; N = 1311 mother-child pairs followed from the pregnancy onwards). Inattention-hyperactivity symptoms were assessed with the Strengths and Difficulties Questionnaire when participating children were 3 years of age. Potential risk factors were classified in four domains (fetal exposures and child somatic characteristics, child temperament, child neurodevelopmental status, psychosocial environment) and four periods (before pregnancy, prenatal/birth, infancy, toddlerhood). Their role as potential moderator or mediator was tested with path analysis to determine the developmental sequence.Results A low family socioeconomic status before pregnancy was the main environmental risk factor for inattention-hyperactivity symptoms at 3 years, and its effect occurred via two pathways. The first was a risk pathway, where lower SES was associated with higher maternal depression and anxiety during pregnancy; then to higher maternal and child distress and dysregulation in infancy; and in turn to higher levels of inattention-hyperactivity at 3 years. The second was a protective pathway, where higher SES was associated with longer duration of breastfeeding during infancy; then to better child neurodevelopmental status in toddlerhood; and in turn to lower levels of inattention-hyperactivity at 3 years. Discussion This study identified psychosocial factors at several developmental periods that represent potential targets for preventing the emergence of inattention-hyperactivity symptoms in early childhood

Phase II study of mTORC1 inhibition by everolimus in neurofibromatosis type 2 patients with growing vestibular schwannomas

Neurofibromatosis type 2 (NF2) is a genetic disorder with bilateral vestibular schwannomas (VS) as the most frequent manifestation. Merlin, the NF2 tumor suppressor, was identified as a negative regulator of mammalian target of rapamycin complex 1. Pre-clinical data in mice showed that mTORC1 inhibition delayed growth of NF2-schwannomas. We conducted a prospective single-institution open-label phase II study to evaluate the effects of everolimus in ten NF2 patients with progressive VS. Drug activity was monitored every 3 months. Everolimus was administered orally for 12 months and, if the decrease in tumor volume was >20 % from baseline, treatment was continued for 12 additional months. Other patients stopped when completed 12 months of everolimus but were allowed to resume treatment when VS volume was >20 % during 1 year follow-up. Nine patients were evaluable. Safety was evaluated using CTCAE 3.0 criteria. After 12 months of everolimus, no reduction in volume ≥20 % was observed. Four patients had progressive disease, and five patients had stable disease with a median annual growth rate decreasing from 67 %/year before treatment to 0.5 %/year during treatment. In these patients, tumor growth resumed within 3-6 months after treatment discontinuation. Everolimus was then reintroduced and VS decreased by a median 6.8 % at 24 months. Time to tumor progression increased threefold from 4.2 months before treatment to > 12 months. Hearing was stable under treatment. The safety of everolimus was manageable. Although the primary endpoint was not reached, further studies are required to confirm the potential for stabilization of everolimus

Le Dinophysis en ostréiculture (une énigme sanitaire)

MONTPELLIER-BU Pharmacie (341722105) / SudocSudocFranceF

Datation par thermoluminescence d'un niveau néolithique ancien à la Lède du Gurp (Gironde), comparaison avec les dates radiocarbone

ABSTRACT A piece of pottery extracted from an early Neolithic level belonging to the Atlantic Cardial Culture at La Lède du Gurp (Gironde, France) has been dated by thermoluminescence. The archaeological dose (i.e. palaeo- dose) was determined using the fine grain technique; the annual dose was assessed from the data obtained by low background gamma spectrome- try and by on site environmental do- simetry. The TL (ThermoLumines- cence) result : BDX 2024 : 6450 ± 520 years before 1991, i.e. around 4460 ВС, agrees with the radiocarbon dates of wood pieces which were found in the close surroundings of the sherds of pottery : 4680-4380 ВС (Ly-5320) after calibration — 95% probability level — and 4800-4530 ВС (Ly-5319).RÉSUMÉ La thermoluminescence a permis la datation d'une céramique mise au jour dans un niveau néolithique ancien attribué au Cardial Atlantique, à la Lède du Gurp en Gironde. La détermination de la dose d'irradiation archéologique a été effectuée sur les inclusions de granulométrie inférieure à 20 \jm (méthode des "petites inclusions") et celle de la dose annuelle par spectrométrie gamma à bas bruit de fond et dosimétrie par thermoluminescence. Le résultat obtenu : BDX 2024 - TL : 6450 ± 520 années par rapport à 1991, soit autour de 4460 av. J.C., est en bon accord avec deux datations radiocarbone d'éléments de bois mis au jour à proximité immédiate de la céramique 4680-4380 av. J.C. (Ly-5320) après calibration — intervalle de confiance à 95 % de probabilité — et 4800- 4530 av. J.C. (Ly-5319).Guibert Pierre, Szepertyski Béatrice, Schvoerer Max, Roussot-Larroque Julia. Datation par thermoluminescence d'un niveau néolithique ancien à la Lède du Gurp (Gironde), comparaison avec les dates radiocarbone. In: Bulletin de la Société préhistorique française, tome 93, n°2, 1996. pp. 217-224

Developmental predictors of inattention-hyperactivity from pregnancy to early childhood

OBJECTIVE

Maternal tobacco smoking in pregnancy and children's socio-emotional development at age 5: the EDEN mother-child birth cohort study

The EDEN Mother-Child Cohort Study Group: I. Annesi-Maesano, J. Botton, M.A. Charles, P. Dargent-Molina, B. de Lauzon-Guillain, P. Ducimetière, M. de Agostini, B. Foliguet, A. Forhan, X. Fritel, A. Germa, V. Goua, R. Hankard, B. Heude, M. Kaminski, B. Larroque, N. Lelong, J. Lepeule, G. Magnin, L. Marchand, C. Nabet, R. Slama, M.J. Saurel-Cubizolles, M. Schweitzer, O. Thiebaugeorge.International audienceBackground : There is debate as to whether maternal tobacco use in pregnancy is related to offspring behaviour later on. We tested this association examining multiple aspects of children's behaviour at age 5 and accounting for parental smoking outside of pregnancy, as well as child and family characteristics.Methods : Data come from a prospective community based birth cohort study (EDEN; n = 1113 families in France followed since pregnancy in 2003–2005 until the child's 5th birthday). Maternal tobacco use in pregnancy was self-reported. Children's socio-emotional development (emotional symptoms, conduct problems, symptoms of hyperactivity/inattention, peer relationship problems, prosocial behaviour) was assessed by mothers using the Strengths and Difficulties Questionnaire (SDQ) at age 5 years. Logistic regression analyses controlled for Inverse Probability Weights (IPW) of maternal tobacco use calculated based on study center, children's characteristics (sex, premature birth, low birth weight, breastfeeding), maternal characteristics (age at the child's birth, psychological difficulties and alcohol use in pregnancy, post-pregnancy depression, and smoking), paternal smoking in and post-pregnancy, parental educational attainment, family income, parental separation, and maternal negative life events.Results : Maternal smoking in pregnancy only predicted children's high symptoms of hyperactivity/inattention (sex and study center-adjusted ORs: maternal smoking in the 1st trimester: 1.95, 95%CI: 1.13–3.38; maternal smoking throughout pregnancy: OR = 2.11, 95%CI: 1.36–3.27). In IPW-controlled regression models, only children of mothers who smoked throughout pregnancy had significantly elevated levels of hyperactivity/inattention (OR = 2.20, 95%CI: 1.21–4.00).Conclusions : Maternal tobacco smoking in pregnancy may contribute directly or through epigenetic mechanisms to children's symptoms of hyperactivity/inattention

Natural History of Small Sporadic Non-Functioning Pancreatic Neuroendocrine Tumors: An Observational Bi-Centric Study

Context Asymptomatic sporadic non-functioning well-differentiated pancreatic neuroendocrine tumors (AS-NF-PNET) are increasingly diagnosed, and their management is controversial because of their overall good but heterogeneous prognosis. Objective The aim of the present study was to assess the natural history of AS-NF-PNET below 2 cm in size, and the benefit-risk balance of a non-operative management. Methods From January 2000 to June 2012, 46 patients with proven AS-NF-PNET below 2 cm in size were followed-up for at least 18 months with serial imaging. Results Patients were mainly female (65%), with a median age of 60 years. Tumors were mainly located in the pancreatic head (52%), with a median lesion size of 13 mm (range: 9-15 mm). Distant or nodal metastases appeared on imaging in none of the patients after a median follow-up of 34 months (range: 24-52 mm) and an average of 4 (range: 3-6) serial imaging. A ≥20% increase in size was observed in 6 (13%) patients. Overall median tumor growth was 0.12 mm per years and nor patients neither tumor characteristics were found to be significant predictors of tumor growth. Overall, 8 patients (17%) underwent surgery after a median time from initial evaluation of 41 months (range: 27-58 months); all resected lesions were ENETS T stage 1 (n=7) or 2 (n=1), grade 1, node negative, with neither vascular nor peripancreatic fat invasion. Conclusion In selected patients non-operative management of AS-NF-PNET below 2 cm in size is safe. Larger and prospective multicentre studies with long-term follow-up are now needed to validate this “wait and see” policy

Maternal depression trajectories and children's behavior at age five years

International audienceObjectiveTo assess the relationship between trajectories of maternal depression from pregnancy to the child’s age 5 and children’s emotional and behavioral difficulties at age 5.Study design1183 mother-child pairs from the EDEN mother-child birth cohort study based in France were followed from 24-28 weeks of pregnancy to the child’s fifth birthday. Children’s behavior at age 5 was assessed using the Strengths and Difficulties Questionnaire. Maternal depression was repeatedly assessed with the Center for Epidemiological Studies Depression questionnaire (pregnancy, 3 and 5 years) and the Edinbourgh Postnatal Depression Scale (4, 8, and 12 months postpartum). Homogeneous latent trajectory groups of maternal depression were identified within the study population and correlated with SDQ scores using multivariate linear regression analyzes.ResultsFive trajectories of maternal symptoms of depression were identified: no symptoms (62.0%); persistent intermediate-level depressive symptoms (25.3%); persistent high depressive symptoms (4.6%); high symptoms in pregnancy only (3.6%); high symptoms in the child’s preschool period only (4.6%). Children whose mothers had persistent depressive symptoms – either intermediate or high - had the highest levels of emotional and behavioral difficulties at age 5. Additionally, compared to children whose mothers were never depressed, those whose mothers had high symptoms in the preschool period also had elevated levels of emotional symptoms, conduct problems, and peer problems.Conclusions Maternal depression symptoms are related to children’s emotional and behavioral problems, particularly if they are persistent (29.9%) or occur during early childhood (4.6%)