Épidémiologie et prise en charge du virus de l'immunodéficience humaine chez les jeunes (15-24 ans) en France

PARIS7-Xavier Bichat (751182101) / SudocSudocFranceF

Behavioral profiles of clinically referred children with intellectual giftedness.

International audienceIt is common that intellectually gifted children--that is, children with an IQ ≥ 130--are referred to paediatric or child neuropsychiatry clinics for socio-emotional problems and/or school underachievement or maladjustment. These clinically-referred children with intellectual giftedness are thought to typically display internalizing problems (i.e., self-focused problems reflecting overcontrol of emotion and behavior), and to be more behaviorally impaired when "highly" gifted (IQ ≥ 145) or displaying developmental asynchrony (i.e., a heterogeneous developmental pattern, reflected in a significant verbal-performance discrepancy on IQ tests). We tested all these assumptions in 143 clinically-referred gifted children aged 8 to 12, using Wechsler's intelligence profile and the Child Behavior Checklist. Compared to a normative sample, gifted children displayed increased behavioral problems in the whole symptomatic range. Internalizing problems did not predominate over externalizing ones (i.e., acted-out problems, reflecting undercontrol of emotion and behavior), revealing a symptomatic nature of behavioral syndromes more severe than expected. "Highly gifted" children did not display more behavioral problems than the "low gifted." Gifted children with a significant verbal-performance discrepancy displayed more externalizing problems and mixed behavioral syndromes than gifted children without such a discrepancy. These results suggest that developmental asynchrony matters when examining emotional and behavioral problems in gifted children

Association between dietary polyphenols intake and an oxidative stress biomarker: interest of multiple imputation for handling missing covariates and outcomes

BACKGROUND: We aimed to illustrate the importance of imputation models specifications, based on a study exploring the associations between subclasses of dietary polyphenols and the thiobarbituric-acid-reactive substances (TBARS). METHODS: Data were collected in a long-term cohort study based on a double-blind randomized placebo-controlled nutritional trial (SU.VI.MAX 2 study). The association between polyphenols intakes and TBARS were studied using linear regression models. Missing data were handled using multiple imputation with chained equations. RESULTS: A total of 4,129 subjects were included in the analysis, 2,116 of whom had an available outcome measure (TBARS). Differences in selected predictors of TBARS according to the handling of missing data on both covariates and outcome (complete case analysis or multiple imputation) were observed. In the complete case analysis, none of the dietary polyphenol subclasses was found to be associated with TBARS while based on multiple imputed datasets, two polyphenol subclasses, namely catechins and hydroxybenzoic acids, could be selected as associated with TBARS. Of note, while there was a positive association between catechins and TBARS, the hydroxybenzoic acids were negatively associated with TBARS. CONCLUSIONS: Adequate modelling of missing data on both covariates and outcome allowed dietary catechins intake to be selected as associated with a biomarker of oxidative stress

Dyspnea in patients receiving noninvasive ventilation for acute respiratory failure: prevalence, risk factors and prognostic impact – a prospective observational study

International audienc

Patients Characteristics.

<p>Patients Characteristics.</p

Bladder Cancer in HIV-infected Adults: An Emerging Issue? Case-Reports and Systematic Review

<div><p>Objectives</p><p>Non-AIDS-related malignancies now represent a frequent cause of death among HIV-infected patients. Albeit bladder cancer is one of the most common malignancies worldwide, it has been rarely reported among HIV-infected patients. We wished to assess the prevalence and characteristics of bladder cancer in HIV-infected patients.</p><p>Methods</p><p>We conducted a single center retrospective study from 1998 to 2013 in a university hospital in Paris. Cases of bladder cancer among HIV-infected patients were identified using the electronic records of the hospital database and of the HIV-infected cohort. Patient characteristics and outcomes were retrieved from patients charts. A systematic review of published cases of bladder cancers in patients with HIV-infection was also performed.</p><p>Results</p><p>During the study period we identified 15 HIV-infected patients (0.2% of the cohort) with a bladder cancer. Patients were mostly men (73%) and smokers (67%), with a median age of 56 years at cancer diagnosis. Bladder cancer was diagnosed a median of 14 years after HIV-infection. Most patients were on ART (86%) with median current and nadir CD4 cell counts of 506 and 195 cells/mm³, respectively. Haematuria (73%) was the most frequent presenting symptom and HPV-associated lesions were seen in 6/10 (60%) patients. Histopathology showed transitional cell carcinoma in 80% and a high proportion of tumors with muscle invasion (47%) and high histologic grade (73%). One-year survival rate was 74.6%. The systematic review identified 13 additional cases of urothelial bladder cancers which shared similar features.</p><p>Conclusions</p><p>Bladder cancers in HIV-infected patients remain rare but may occur in relatively young patients with a low nadir CD4 cell count, have aggressive pathological features and can be fatal.</p></div

Cases of urothelial bladder cancers in HIV-infected patients reported in the Literature.

<p>Cases of urothelial bladder cancers in HIV-infected patients reported in the Literature.</p

Clinicians’ Perception and Experience of Organ Donation From Brain-Dead Patients

International audienceOBJECTIVE:ICU clinicians are primarily involved in organ donation after brain death of ICU patients. Their perceptions of organ donation may affect outcomes. Our objective was to describe ICU clinician's perceptions and experience of organ donation.DESIGN AND SETTING:Cross-sectional study among physicians and nurses (90 ICUs in France). We used factorial correspondence analysis to describe categories of clinicians regarding their perceptions and experience of organ donation. Factors associated with a positive (motivating) or negative (stressful) experiences were studied using multivariate logistic regression.PARTICIPANTS:Physicians and nurses.MEASUREMENTS AND MAIN RESULTS:Three thousand three hundred twenty-five clinicians working in 77 ICUs returned questionnaires. Professionals who experienced organ donation as motivating were younger (odds ratio, 0.41; 95% CI, 0.32-0.53; p < 0.001), more often potential organ donors (odds ratio, 1.92; 95% CI, 1.56-2.35; p < 0.001), less likely to describe inconsistency (odds ratio, 0.43; 95% CI, 0.23-0.8) or complexity (odds ratio, 0.55; 95% CI, 0.45-0.67) of their feelings versus their professional activity, less likely to report that organ donation was not a priority in their ICU (odds ratio, 0.68; 95% CI, 0.55-0.84), and more likely to have participated in meetings of transplant coordinators with relatives (odds ratio, 1.71; 95% CI, 1.37-2.14; p < 0.001). Professionals who felt organ donation was stressful were older (odds ratio, 1.84; 95% CI, 1.34-2.54; p < 0.001), less often physicians (odds ratio, 0.58; 95% CI, 0.44-0.77; p < 0.001), more likely to describe shift from curative care to organ donation as emotionally complex (odds ratio, 1.83; 95% CI, 1.52-2.21; p < 0.001), care of relatives of brain-dead patients as complex (odds ratio, 1.59; 95% CI, 1.32-1.93; p < 0.001), and inconsistency and complexity of personal feelings about organ donation versus professional activity (odds ratio, 3.25; 95% CI, 1.92-5.53; p < 0.001), and more likely to have little experience with caring for potential organ donors (odds ratio, 1.49; 95% CI, 1.09-2.04).CONCLUSIONS:Significant differences exist among ICU clinician's perceptions of organ donation. Whether these differences affect family experience and consent rates deserves investigation