Audit about Medical Decision: Data Transmission Concerning Patients with Dementia Entering French Nursing Homes Does Not Confirm the Diagnosis

Background. Dementia was affecting 855.000 patients in France in 2007. Lanmeur's rural hospital population was representative of the French nursing home's population. The followup was assumed by local GPs, which is also usual care in France for nursing homes. The study looked at clinical and paraclinical data transmitted at the institutionalization time of patients suffering from dementia. Aim. showing that admission letters did allow establishing a diagnosis of dementia for the GPs. Method. we included all patients with dementia at the time of institutionalization between July 2000 and July 2007. We searched in the admission letters for 25 criteria extracted from the French guidelines for dementia and Alzheimer disease diagnosis (multiple cross-sectional analysis per year). Results. 293 patients were included. The median number of diagnostic criteria present in the letters of admission is 1 (first quartile: zero, third quartile: 4, and maximum: 12). Conclusions. the data in admission letters did not allow the diagnosis of dementia according to the French guidelines. We know that dementia is underchecked and undertreated in France according to the same guidelines. What consequences did this lack of basic data give on motivation for treatment and recurrent diagnosis process for GPs? This has to be evaluated

Reflux of Endoplasmic Reticulum proteins to the cytosol inactivates tumor suppressors

International audienceIn the past decades, many studies reported the presence of endoplasmic reticulum (ER)-resident proteins in the cytosol. However, the mechanisms by which these proteins relocate and whether they exert cytosolic functions remain unknown. We find that a subset of ER luminal proteins accumulates in the cytosol of glioblastoma cells isolated from mouse and human tumors. In cultured cells, ER protein reflux to the cytosol occurs upon ER proteostasis perturbation. Using the ER luminal protein anterior gradient 2 (AGR2) as a proof of concept, we tested whether the refluxed proteins gain new functions in the cytosol. We find that refluxed, cytosolic AGR2 binds and inhibits the tumor suppressor p53. These data suggest that ER reflux constitutes an ER surveillance mechanism to relieve the ER from its contents upon stress, providing a selective advantage to tumor cells through gain-of-cytosolic functions-a phenomenon we name ER to Cytosol Signaling (ERCYS)

Argo data 1999-2019: two million temperature-salinity profiles and subsurface velocity observations from a global array of profiling floats.

© The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Wong, A. P. S., Wijffels, S. E., Riser, S. C., Pouliquen, S., Hosoda, S., Roemmich, D., Gilson, J., Johnson, G. C., Martini, K., Murphy, D. J., Scanderbeg, M., Bhaskar, T. V. S. U., Buck, J. J. H., Merceur, F., Carval, T., Maze, G., Cabanes, C., Andre, X., Poffa, N., Yashayaev, I., Barker, P. M., Guinehut, S., Belbeoch, M., Ignaszewski, M., Baringer, M. O., Schmid, C., Lyman, J. M., McTaggart, K. E., Purkey, S. G., Zilberman, N., Alkire, M. B., Swift, D., Owens, W. B., Jayne, S. R., Hersh, C., Robbins, P., West-Mack, D., Bahr, F., Yoshida, S., Sutton, P. J. H., Cancouet, R., Coatanoan, C., Dobbler, D., Juan, A. G., Gourrion, J., Kolodziejczyk, N., Bernard, V., Bourles, B., Claustre, H., D'Ortenzio, F., Le Reste, S., Le Traon, P., Rannou, J., Saout-Grit, C., Speich, S., Thierry, V., Verbrugge, N., Angel-Benavides, I. M., Klein, B., Notarstefano, G., Poulain, P., Velez-Belchi, P., Suga, T., Ando, K., Iwasaska, N., Kobayashi, T., Masuda, S., Oka, E., Sato, K., Nakamura, T., Sato, K., Takatsuki, Y., Yoshida, T., Cowley, R., Lovell, J. L., Oke, P. R., van Wijk, E. M., Carse, F., Donnelly, M., Gould, W. J., Gowers, K., King, B. A., Loch, S. G., Mowat, M., Turton, J., Rama Rao, E. P., Ravichandran, M., Freeland, H. J., Gaboury, I., Gilbert, D., Greenan, B. J. W., Ouellet, M., Ross, T., Tran, A., Dong, M., Liu, Z., Xu, J., Kang, K., Jo, H., Kim, S., & Park, H. Argo data 1999-2019: two million temperature-salinity profiles and subsurface velocity observations from a global array of profiling floats. Frontiers in Marine Science, 7, (2020): 700, doi:10.3389/fmars.2020.00700.In the past two decades, the Argo Program has collected, processed, and distributed over two million vertical profiles of temperature and salinity from the upper two kilometers of the global ocean. A similar number of subsurface velocity observations near 1,000 dbar have also been collected. This paper recounts the history of the global Argo Program, from its aspiration arising out of the World Ocean Circulation Experiment, to the development and implementation of its instrumentation and telecommunication systems, and the various technical problems encountered. We describe the Argo data system and its quality control procedures, and the gradual changes in the vertical resolution and spatial coverage of Argo data from 1999 to 2019. The accuracies of the float data have been assessed by comparison with high-quality shipboard measurements, and are concluded to be 0.002°C for temperature, 2.4 dbar for pressure, and 0.01 PSS-78 for salinity, after delayed-mode adjustments. Finally, the challenges faced by the vision of an expanding Argo Program beyond 2020 are discussed.AW, SR, and other scientists at the University of Washington (UW) were supported by the US Argo Program through the NOAA Grant NA15OAR4320063 to the Joint Institute for the Study of the Atmosphere and Ocean (JISAO) at the UW. SW and other scientists at the Woods Hole Oceanographic Institution (WHOI) were supported by the US Argo Program through the NOAA Grant NA19OAR4320074 (CINAR/WHOI Argo). The Scripps Institution of Oceanography's role in Argo was supported by the US Argo Program through the NOAA Grant NA15OAR4320071 (CIMEC). Euro-Argo scientists were supported by the Monitoring the Oceans and Climate Change with Argo (MOCCA) project, under the Grant Agreement EASME/EMFF/2015/1.2.1.1/SI2.709624 for the European Commission

Pronostic chirurgical des hémangioblastomes sporadiques intracrâniens (une étude rétrospective)

Introduction: ce travail a pour but d'évaluer le pronostic à long terme des hémangioblastomes sporadiques intracrâniens (HSI). Matériel et méthode: entre 1998 et 2010, 38 patients ont été opérés dans notre service. Leurs dossiers ont été analysés rétrospectivement et les patients ont été contactés pour l'évaluation de leur qualité de vie. La durée moyenne de suivi a été de 40 mois. Résultats: les HSI ont représenté 0,9% des tumeurs primitives intracrâniennes opérées dans le service. Il y avait 23 hommes et 15 femmes, et l'âge moyen au diagnostic était de 47 ans. Aucune polyglobulie n'a été mise en évidence. A la fin du suivi, deux patients sont décédés des suites d'un HSI solide de la moelle allongée. Les scores de qualité de vie n'étaient pas inférieurs aux normes de la population française. Conclusion: la chirurgie des HSI confère une bonne qualité de vie. Néanmoins, le pronostic réservé des hémangioblastomes solides de la moelle allongée incite à une approche prudente et multimodale.Object: in this article, the authors evaluated the specific features and outcome of operated on intracranial sporadic hemangioblastomas (ISH) operated on in their institution. Methods: between 1998 and 2010, 38 patients with ISH were operated on at our department. Their files were retrospectively reviewed, and all patients were contacted for a quality of life survey. The mean duration of follow-up was 40 months. Result: ISH represented 0.9% of primary intracranial neoplasms. There were 23 men and 15 women with a mean age of 47 year-old. No patient had polycythemia. At last follow-up, two patients harboring solid medulla oblongata ISH were dead of related cause, and 5 patients of unrelated cause. Mean quality of life scores were similar to the general healthy population. Conclusions: surgery of ISH carries good quality of life and tumoral control excepted for solid medulla oblongata locations. Though, careful multimodal therapeutic approaches should be considered for this specific locationRENNES1-BU Santé (352382103) / SudocSudocFranceF

Should the clinic matter to nonphysician scientists?

International audienceTranslational medicine has been nurtured by the creation of M.D.-Ph.D. programs, a system that now needs to reinvent itself. Now, clinically oriented training programs targeting nonphysician scientists have opened new avenues to improve transdisciplinary approaches in health sciences

Fluorescein-guided resection of brain arteriovenous malformations: A short series

International audienceBrain arteriovenous malformations (AVM) are complex and highly challenging lesions, for which intra-operative indocyanin green fluorescence video angiography is widely used. Fluorescein video angiography (FVA) recently appeared as an alternative technique but the feasibility and usefulness of this technique is yet uncertain. This short series reports our preliminary experience of FVA in intracranial AVM surgery. We retrospectively studied the cases of seven patients who had FVA for an AVM surgery. The primary objective of this study was to assess the utility of FVA as judged by the surgeon. Secondary objectives were the evaluation of the tolerance of bolus injection of fluorescein in the context of cranial surgery, the comparison with ICG and the rate of complete removal. For each of the seven patients, FVA was performed after exposure of the AVM and before the resection; it was visualized directly through the eyepieces of the microscope and helped in the identification of arterial feeders and draining veins. In one case, post-resection FVA allowed the visualization of a residual shunt and the resection was completed. In two cases, ICG and FVA brought comparable information. The resection was complete in all cases, confirmed by post-operative imaging. There was no anaphylactic complication. This preliminary work suggests that FVA is a simple and well tolerated technique, comparable to ICG angiography. Prospective and larger studies are needed to confirm the clinical benefit of this tool

Steroids in chronic subdural hematomas (SUCRE trial): study protocol for a randomized controlled trial

International audienceBACKGROUND: Chronic subdural hematoma (CSDH) is a common neurological pathology, especially in older patients. The actual "gold standard" of treatment is surgical evacuation, with various techniques used across neurosurgical teams. Over the years, there has been growing evidence that inflammatory processes play a major role in the pathogenesis of CSDH. In that context, the use of corticosteroids has been proposed alone or as an adjuvant treatment to surgery. However, this practice remains very empirical and there is a need for high-quality-of-evidence studies to clarify the role of corticosteroids in the management of CSDH. METHODS/DESIGN: We propose a double-blind, randomized controlled trial comparing methylprednisolone versus placebo in the treatment of CSDH without clinical and/or radiological signs of severity. The treatment will be administered daily for a duration of 3 weeks, at a dose of 1 mg/kg. The primary endpoint will be the delay of occurrence of surgical treatment at 1 month following the introduction of the treatment. Secondary endpoints will include the rate of recourse to surgery, survival rate, quality of life and functional assessments, occurrence of systemic secondary effects and radiological assessment of the response to treatment. This multimodal assessment will be done at 1, 3 and 6 months. Two hundred and two patients (101 per arm) are expected to be included considering our primary hypotheses. DISCUSSION: This trial started in June 2016; its results may open interesting alternatives to surgery in the management of patients harboring a CSDH, and may provide insights into the natural history of this common pathology. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02650609 . Registered on 4 January 2016. Graphical output of the OBF boundaries