A Seropositive Nodular Rheumatoid Polyarthritis without Arthritis: Does It Exist?

The rheumatoid polyarthritis is the most frequent chronic polyarthritis. It affects essentially the woman between 40 and 60 years. Rheumatic subcutaneous nodules and tenosynovitis are usually associated with seropositive symptomatic rheumatoid polyarthritis. It is, however, rare that they constitute the essential clinical expression of the disease. In this case, it makes dispute another exceptional form of rheumatoid arthritis such as rheumatoid nodulosis. A 60-year-old woman was hospitalized for tumefaction of the dorsal face of the right hand evolving two months before. The clinical examination found subcutaneous nodules from which the exploration ended in rheumatoid nodules with tenosynovitis. The evolution after four years was favourable under corticosteroid therapy, methotrexate, and colchicine

Castleman's Disease: An Intrapulmonary Form with Intrafissural Development

Castleman's disease (CD) is an uncommon, mainly benign, lymphoproliferative disorder of unknown etiology, mostly involving the mediastinum. Parenchymal lung involvement of the disease is exceedingly rare. We describe a case of CD in a 23-year-old woman with a 4-year history of recurring dyspnea and nonproductive cough, whose chest X-ray showed an abnormal shadow of the right hilum. Chest computed tomography confirmed the presence of a tissue-density mass of the right lower lobe, demonstrating poor contrast enhancement, associated with multiple laterotracheal and mediastinal lymphadenopathies. The patient underwent curative surgery, revealing a right hilar compressive mass, with an intrafissural development between the superior and middle lobes. Pneumonectomy was performed due to profuse bleeding. This case of CD is particular because of its unusual intrapulmonary location and its intrafissural development. Poor contrast enhancement is atypical in CD

The effect of post-lunch napping on mood, reaction time, and antioxidant defense during repeated sprint exercice

To compare the effects of two nap opportunities (20 and 90 min) to countermeasure the transient naturally occurring increased sleepiness and decreased performances during the post-lunch dip (PLD). Fourteen highly trained judokas completed in a counterbalanced and randomized order three test sessions (control (No-nap), 20- (N20) and 90-min (N90) nap opportunities). Test sessions consisted of the running-based anaerobic sprint test (RAST), simple and multiple-choice reaction times (MCRT) and the Epworth sleepiness scale (ESS). From the RAST, the maximum (Pmax), mean (Pmean) and minimum (Pmin) powers were calculated. Blood samples were taken before and after the RAST to measure the effect of pre-exercise napping on energetic and muscle damage biomarkers and antioxidant defense. N20 increased Pmax and Pmean compared to No-nap (p < 0.001, d = 0.59; d = 0.66) and N90 (p < 0.001, d = 0.98; d = 0.72), respectively. Besides, plasma lactate and creatinine increased only when the exercise was performed after N20. Both N20 (p < 0.001, d = 1.18) and N90 (p < 0.01, d = 0.78) enhanced post-exercise superoxide dismutase activity compared to No-nap. However, only N20 enhanced post-exercise glutathione peroxidase activity (p < 0.001, d = 1.01) compared to pre-nap. Further, MCRT performance was higher after N20 compared to No-nap and N90 (p < 0.001, d = 1.15; d = 0.81, respectively). Subjective sleepiness was lower after N20 compared to No-nap (p < 0.05, d = 0.92) and N90 (p < 0.01, d = 0.89). The opportunity to nap for 20 min in the PLD enhanced RAST, MCRT performances, and antioxidant defense, and decreased sleepiness. However, the opportunity of 90 min nap was associated with decreased repeated sprint performances and increased sleepiness, probably because of the sleep inertia

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Conception et mise en oeuvre d'une culture sécurité des systèmes d'information : le cas des PME

This research seeks to understand, conceptualize and instill the security culture of information systems (IS) users in SMEs, as the literature review in this field has highlighted the fact that employees represent the "weak link" in information systems security (ISS). First, we conducted an intervention within an SME; this intervention consists in raising awareness and training a group of users on IS security and then, in evaluating the effect of this intervention on the culture and behaviors of these users. This assessment showed an improvement in the culture and behavior of the users. Nevertheless, after going back and forth between theory and practice, it turns out that the improvement of the security culture is not limited to awareness-raising and/or training alone, but also depends on other factors, hence the need to take into account the security culture in its entirety and to analyze this culture in a more systemic perspective. For this purpose, in a second stage, we developed our conceptual model of safety culture based on the literature review and our first field results. Then, in order to confront our conceptual model with reality, we carried out a qualitative study through the case study of eight SMEs, by conducting 32 semi-directive interviews with the leadership and the IS users of each SME studied. The results of this study confirmed that exogenous factors (legal context, sector of activity, etc.), endogenous factors (risk management, training and awareness) and the SME leader positively influence the security culture of IS users and, as a result, that a positive security culture is beneficial in creating security-related behavior. Other factors, such as the user's age and position, emerged from this study as moderating factors in the relationship between the user's security culture and actual behavior.Cette recherche vise à comprendre, conceptualiser et insuffler la culture sécurité des utilisateurs des systèmes d’information (SI) dans les PME, puisque la revue de littérature dans ce domaine a mis en évidence que les employés représentent le « maillon faible » de la sécurité des systèmes d’information (SSI). Dans un premier temps, nous avons réalisé une intervention au sein d’une PME, cette intervention consiste à sensibiliser et former un groupe d’utilisateurs sur la sécurité des SI ensuite évaluer l’effet de cette intervention sur la culture et les comportements de ces utilisateurs. Cette évaluation a montré une amélioration au niveau de la culture et des comportements des utilisateurs. Néanmoins, après des allers retours entre théorique et pratique, il s’avère que l’amélioration de la culture sécurité ne se limite pas uniquement à une sensibilisation et/ou une formation mais dépend aussi d’autres facteurs, d’où la nécessité de la prise en compte de la culture sécurité dans sa globalité et d’analyser cette culture dans une logique plus systémique. A cet effet, nous avons dans un deuxième temps élaboré notre modèle conceptuel de la culture sécurité à partir de la revue de littérature et de nos premiers résultats du terrain. Ensuite, pour confronter notre modèle conceptuel au terrain, nous avons réalisé une étude qualitative à travers l’étude de cas de huit PME en réalisant 32 entretiens semi directifs avec la direction et les utilisateurs SI de chaque PME étudiée. Les résultats de cette étude ont confirmé que des facteurs exogènes (Contexte légal, le secteur d’activité, etc.), des facteurs endogènes (gestion des risques, formation et sensibilisation) et le dirigeant de la PME influencent positivement la culture sécurité des utilisateurs du SI et en conséquence, une culture de sécurité positive est favorable à créer un comportement lié à la sécurité. D’autres facteurs tels que l’âge de l’utilisateur et son poste ont émergé de cette étude comme facteurs modérateurs dans la relation entre la culture sécurité de l’utilisateur et son comportement effectif

Conception et mise en oeuvre d'une culture sécurité des systèmes d'information : le cas des PME

This research seeks to understand, conceptualize and instill the security culture of information systems (IS) users in SMEs, as the literature review in this field has highlighted the fact that employees represent the "weak link" in information systems security (ISS). First, we conducted an intervention within an SME; this intervention consists in raising awareness and training a group of users on IS security and then, in evaluating the effect of this intervention on the culture and behaviors of these users. This assessment showed an improvement in the culture and behavior of the users. Nevertheless, after going back and forth between theory and practice, it turns out that the improvement of the security culture is not limited to awareness-raising and/or training alone, but also depends on other factors, hence the need to take into account the security culture in its entirety and to analyze this culture in a more systemic perspective. For this purpose, in a second stage, we developed our conceptual model of safety culture based on the literature review and our first field results. Then, in order to confront our conceptual model with reality, we carried out a qualitative study through the case study of eight SMEs, by conducting 32 semi-directive interviews with the leadership and the IS users of each SME studied. The results of this study confirmed that exogenous factors (legal context, sector of activity, etc.), endogenous factors (risk management, training and awareness) and the SME leader positively influence the security culture of IS users and, as a result, that a positive security culture is beneficial in creating security-related behavior. Other factors, such as the user's age and position, emerged from this study as moderating factors in the relationship between the user's security culture and actual behavior.Cette recherche vise à comprendre, conceptualiser et insuffler la culture sécurité des utilisateurs des systèmes d’information (SI) dans les PME, puisque la revue de littérature dans ce domaine a mis en évidence que les employés représentent le « maillon faible » de la sécurité des systèmes d’information (SSI). Dans un premier temps, nous avons réalisé une intervention au sein d’une PME, cette intervention consiste à sensibiliser et former un groupe d’utilisateurs sur la sécurité des SI ensuite évaluer l’effet de cette intervention sur la culture et les comportements de ces utilisateurs. Cette évaluation a montré une amélioration au niveau de la culture et des comportements des utilisateurs. Néanmoins, après des allers retours entre théorique et pratique, il s’avère que l’amélioration de la culture sécurité ne se limite pas uniquement à une sensibilisation et/ou une formation mais dépend aussi d’autres facteurs, d’où la nécessité de la prise en compte de la culture sécurité dans sa globalité et d’analyser cette culture dans une logique plus systémique. A cet effet, nous avons dans un deuxième temps élaboré notre modèle conceptuel de la culture sécurité à partir de la revue de littérature et de nos premiers résultats du terrain. Ensuite, pour confronter notre modèle conceptuel au terrain, nous avons réalisé une étude qualitative à travers l’étude de cas de huit PME en réalisant 32 entretiens semi directifs avec la direction et les utilisateurs SI de chaque PME étudiée. Les résultats de cette étude ont confirmé que des facteurs exogènes (Contexte légal, le secteur d’activité, etc.), des facteurs endogènes (gestion des risques, formation et sensibilisation) et le dirigeant de la PME influencent positivement la culture sécurité des utilisateurs du SI et en conséquence, une culture de sécurité positive est favorable à créer un comportement lié à la sécurité. D’autres facteurs tels que l’âge de l’utilisateur et son poste ont émergé de cette étude comme facteurs modérateurs dans la relation entre la culture sécurité de l’utilisateur et son comportement effectif

La culture sécurité des utilisateurs des systèmes d’information : Recherche-intervention en PME

This communication aims first of all to present the main results of the case studies carried out in SME’s where we have investigated what factors can influence a security culture of users of information systems. Then, we present our second research method which is the intervention-research that we will carry out within two SMEs. The objective and expectations of the second method are developed in this communication. Cette communication vise à présenter en premier lieu les principaux résultats des études de cas réalisées dans des PME où nous avons cherché quels facteurs peuvent influencer une culture sécurité des utilisateurs des systèmes d’informations. Ensuite, nous présentons notre deuxième méthode de recherche qui est la recherche-intervention que nous allons réaliser au sein de deux PME. L’objectif et les attentes de la deuxième méthode sont développés dans cette communication