Malignant paraganglioma of the mesentery: a case report and review of literature

Paragangliomas represent only 10% of chromaffin tissue tumors and those arising from the mesentery seem to be a rare occurrence. We report a case of a 55 year old man in whom an abdominal mass was discovered fortuitously by ultrasonography during a routine health exam. He presented occasional heart palpitations and diaphoresis as well as a well-demarcated mass upon abdominal physical examination. CT scan revealed a solid polylobulated mass in the right lower quadrant. Exploration laparotomy revealed a voluminous multi-nodular tumoral mass, which contained hemorrhagic spots. Histopathological studies confirmed the presence of a paraganglioma. The excision of the mass as well as the surrounding intestine and mesentery also revealed two lymphatic metastases, the first among 14 documented cases to be described concerning mesenteric paragangliomas. One year follow up and CT scan revealed neither recurrence nor the presence of distant metastases

Complexes de coordination, matériaux moléculaires et dispositifs électroniques commutables intégrant le système photochrome diméthyldihydropyrène /cyclophanediène

Ce mémoire est consacré à la conception et la caractérisation de molécules, matériaux et dispositifs électroniques commutables incorporant le système photochrome diméthyldihydropyrène (DHP) / cyclophanediène (CPD). La première partie est dédiée à la synthèse et à la caractérisation de photochromes originaux basés sur l'unité diméthyldihydropyrène. En particulier, la modification chimique de ce motif par des groupements électroattracteurs de type pyridinium induit une nette amélioration des cinétiques de conversion photoinduites tout en constituant une unité aisément fonctionnalisable. Dans une seconde partie, le motif photochrome est associé à des complexes métalliques dérivés du ligand terpyridine qui confèrent des propriétés rédox à l'architecture moléculaire. Ces assemblages sont mis en œuvre pour la conception de films minces organisés obtenus par auto-assemblage de métallopolymères sur des surfaces solides. Les complexes et les films étudiés possèdent des propriétés photochromes et une activité rédox particulièrement prometteuses pour la conception de matériaux et dispositifs moléculaires multicommutables. Enfin, nous présentons l'étude de la conductance des isomères DHP et CPD. Un dispositif électronique à molécule unique a ainsi été mis en œuvre en utilisant le motif photochrome fonctionnalisé par deux unités pyridine, utilisées comme fonctions d'ancrage dans le dispositif. Il apparaît que l'isomère DHP possède une conductance d'environ quatre ordres de grandeur supérieurs à celle de l'isomère CPD correspondant. Ces deux états peuvent être commutés de manière très reproductible par application de stimulus optiques et thermiques.This thesis is devoted to the design and characterization of switchable molecular systems (molecules, materials and electronic devices) incorporating the dimethyldihydropyrene / cyclophanediene (DHP/CPD) photochromic couple. The first part deals with the synthesis and characterization of original photochromic molecules based on the dimethyldihydropyrene unit. In particular, the chemical functionalisation of these molecular systems with electron-withdrawal pyridinium groups leads to an improvement of the kinetics of photo-induced conversion while providing an easily functionalizable unit, for example with metal cations complexing units. In the second part, the photochromic core is covalently linked with metal complexes based on terpyridine derivatives, conferring redox-active properties to the molecular architecture. These assemblies are applied for the design of organized thin films obtained by self-assembly of metallopolymers on solid surfaces. The model complexes and films display photochromic properties and redox activity particularly promising for the design of responsive materials and molecular devices. Finally, we present the study of the conductance of the isomers DHP and CPD. A single molecule electronic device in which individual molecules are utilized as active electronic components has been implemented using the photochromic group functionalized with two pyridine units, used as anchoring functions. It appears that the DHP isomer has a conductance of about four orders of magnitude higher than the corresponding isomer CPD. These two states can be switched very reproducibly and reversibly upon application of optical and thermal stimulus.SAVOIE-SCD - Bib.électronique (730659901) / SudocGRENOBLE1/INP-Bib.électronique (384210012) / SudocGRENOBLE2/3-Bib.électronique (384219901) / SudocSudocFranceF

Correction: Reactivity of a pyridinium-substituted dimethyldihydropyrene switch under aerobic conditions: self-sensitized photo-oxygenation and thermal release of singlet oxygen

Correction for 'Reactivity of a pyridinium-substituted dimethyldihydropyrene switch under aerobic conditions: self-sensitized photo-oxygenation and thermal release of singlet oxygen' by Saioa Cobo et al., Chem. Commun., 2015, 51, 13886–13889

Effectiveness and resource requirements of test, trace and isolate strategies for COVID in the UK.

We use an individual-level transmission and contact simulation model to explore the effectiveness and resource requirements of various test-trace-isolate (TTI) strategies for reducing the spread of SARS-CoV-2 in the UK, in the context of different scenarios with varying levels of stringency of non-pharmaceutical interventions. Based on modelling results, we show that self-isolation of symptomatic individuals and quarantine of their household contacts has a substantial impact on the number of new infections generated by each primary case. We further show that adding contact tracing of non-household contacts of confirmed cases to this broader package of interventions reduces the number of new infections otherwise generated by 5-15%. We also explore impact of key factors, such as tracing application adoption and testing delay, on overall effectiveness of TTI

Protecting the privacy of individual general practice patient electronic records for geospatial epidemiology research

Background: General practitioner (GP) practices in Australia are increasingly storing patient information in electronic databases. These practice databases can be accessed by clinical audit software to generate reports that inform clinical or population health decision making and public health surveillance. Many audit software applications also have the capacity to generate de-identified patient unit record data. However, the de-identified nature of the extracted data means that these records often lack geographic information. Without spatial references, it is impossible to build maps reflecting the spatial distribution of patients with particular conditions and needs. Links to socioeconomic, demographic, environmental or other geographically based information are also not possible. In some cases, relatively coarse geographies such as postcode are available, but these are of limited use and researchers cannot undertake precision spatial analyses such as calculating travel times. Methods: We describe a method that allows researchers to implement meaningful mapping and spatial epidemiological analyses of practice level patient data while preserving privacy. Results: This solution has been piloted in a diabetes risk research project in the patient population of a practice in Adelaide. Conclusions and Implications: The method offers researchers a powerful means of analysing geographic clinic data in a privacy-protected manner

Protocol for the PACE trial: A randomised controlled trial of adaptive pacing, cognitive behaviour therapy, and graded exercise as supplements to standardised specialist medical care versus standardised specialist medical care alone for patients with the chronic fatigue syndrome/myalgic encephalomyelitis or encephalopathy

<p>Abstract</p> <p>Background</p> <p>Chronic fatigue syndrome (CFS, also called myalgic encephalomyelitis/encephalopathy or ME) is a debilitating condition with no known cause or cure. Improvement may occur with medical care and additional therapies of pacing, cognitive behavioural therapy and graded exercise therapy. The latter two therapies have been found to be efficacious in small trials, but patient organisations' surveys have reported adverse effects. Although pacing has been advocated by patient organisations, it lacks empirical support. Specialist medical care is commonly provided but its efficacy when given alone is not established. This trial compares the efficacy of the additional therapies when added to specialist medical care against specialist medical care alone.</p> <p>Methods/Design</p> <p>600 patients, who meet operationalised diagnostic criteria for CFS, will be recruited from secondary care into a randomised trial of four treatments, stratified by current comorbid depressive episode and different CFS/ME criteria. The four treatments are standardised specialist medical care either given alone, or with adaptive pacing therapy or cognitive behaviour therapy or graded exercise therapy. Supplementary therapies will involve fourteen sessions over 23 weeks and a 'booster session' at 36 weeks. Outcome will be assessed at 12, 24, and 52 weeks after randomisation. Two primary outcomes of self-rated fatigue and physical function will assess differential effects of each treatment on these measures. Secondary outcomes include adverse events and reactions, subjective measures of symptoms, mood, sleep and function and objective measures of physical activity, fitness, cost-effectiveness and cost-utility. The primary analysis will be based on intention to treat and will use logistic regression models to compare treatments. Secondary outcomes will be analysed by repeated measures analysis of variance with a linear mixed model. All analyses will allow for stratification factors. Mediators and moderators will be explored using multiple linear and logistic regression techniques with interactive terms, with the sample split into two to allow validation of the initial models. Economic analyses will incorporate sensitivity measures.</p> <p>Discussion</p> <p>The results of the trial will provide information about the benefits and adverse effects of these treatments, their cost-effectiveness and cost-utility, the process of clinical improvement and the predictors of efficacy.</p

Epidemiology of Escherichia coli bacteraemia in England: results of an enhanced sentinel surveillance programme

Background: Escherichia coli causes over one third of the bacteraemia cases in England each year, and the incidence of these infections is increasing. Aim: To determine the underlying risk factors associated with E. coli bacteraemia. Methods: A three month enhanced sentinel surveillance study involving 35 National Health Service hospitals was undertaken in the winter of 2012/13 to collect risk factor information and further details on the underlying source of infection to augment data already collected by the English national surveillance programme. Antimicrobial susceptibility results for E. coli isolated from blood and urine were also collected. Findings: A total of 1,731 cases of E. coli bacteraemia were included. The urogenital tract was the most commonly reported source of infection (51.2% of cases) with prior treatment for a urinary tract infection being the largest independent effect associated with this infection source. Half of all patients had prior healthcare exposure in the month prior to the bacteraemia with antimicrobial therapy and urinary catheterisation being reported in one third and one fifth of these patients. Prior healthcare exposure was associated with a higher proportion of antibiotic non-susceptibility in the blood culture isolates (P=0.001). Conclusion: Analysis of risk factors suggests potential community and hospital-related interventions particularly better use of urinary catheters and improved antibiotic management of urinary tract infections. As part of the latter strategy, antibiotic resistance profiles need to be closely monitored to ensure treatment guidelines are up to date to limit inappropriate empiric therapy