Epidemiology of pneumoconiosis in coalminers of Nord-Pas-de-Calais in France

This is a longitudinal study of 3 167 active or retired pneumoconiotic coalminers from Nord - Pas de Calais collieries (HBNPC) recognised through medico-legal decision over three defined periods: 1942-61, 1952-81 and 1982-87

ECMO for COVID-19 patients in Europe and Israel

Since March 15th, 2020, 177 centres from Europe and Israel have joined the study, routinely reporting on the ECMO support they provide to COVID-19 patients. The mean annual number of cases treated with ECMO in the participating centres before the pandemic (2019) was 55. The number of COVID-19 patients has increased rapidly each week reaching 1531 treated patients as of September 14th. The greatest number of cases has been reported from France (n = 385), UK (n = 193), Germany (n = 176), Spain (n = 166), and Italy (n = 136) .The mean age of treated patients was 52.6 years (range 16–80), 79% were male. The ECMO configuration used was VV in 91% of cases, VA in 5% and other in 4%. The mean PaO2 before ECMO implantation was 65 mmHg. The mean duration of ECMO support thus far has been 18 days and the mean ICU length of stay of these patients was 33 days. As of the 14th September, overall 841 patients have been weaned from ECMO support, 601 died during ECMO support, 71 died after withdrawal of ECMO, 79 are still receiving ECMO support and for 10 patients status n.a. . Our preliminary data suggest that patients placed on ECMO with severe refractory respiratory or cardiac failure secondary to COVID-19 have a reasonable (55%) chance of survival. Further extensive data analysis is expected to provide invaluable information on the demographics, severity of illness, indications and different ECMO management strategies in these patients

A retrospective study on ultra‐wide diameter dental implants for immediate molar replacement

Background Although immediate implant placement for single rooted teeth is well documented, the prognosis of ultra-wide implants in molar sockets lacks data. Purpose To evaluate the outcome of ultra-wide implants, immediately placed in molar sockets. Materials and Methods Patients treated with immediate ultra-wide diameter implants that have been in function for at least 40 months, were invited for a clinical evaluation. A radiograph was taken to measure marginal bone loss. Probing depths as well as plaque and bleeding scores were recorded at the implant and contralateral tooth. Crown and soft tissue dimensions were measured, and patients filled out an OHIP-14 questionnaire. Results Eighty-five out of 230 patients (37%) were evaluated. Twenty-eight implants received a bone graft to fill the residual space. Average bone loss was 0.19 mm after a mean follow-up of 67 months, with no significant changes over time (P = 0.170). There was no significant difference in bone loss between the maxilla and mandible (P = 0.797), male or female (P = 0.128), smoking and nonsmoking (P = 0.219), grafted and nongrafted sites (P = 0.098), or the different bio-types (P = 0.404). The distal papillae were significantly higher if a contact point was present (P = 0.002). Plaque was more frequent at the contralateral tooth (P < 0.001), but more bleeding on probing was observed around the implants (P = 0.021). Overall, 63.5% of the patients experienced no problems at all. Conclusion Ultra-wide diameter implants for immediate molar replacement demonstrate little bone loss and stable soft tissue conditions over a 4 to 7-year period

Epidemiology of pneumoconiosis in coalminers of Nord-Pas-de-Calais in France

International audienceThis was a longitudinal study of 3167 active or retired pneumoconiotic coalminers from Nord-Pas de Calais collieries (HBNPC, acronym in French) recognized through medico-legal decisions over three delined periods: 1942-1961, 1962-1981 and 1982-1987. Periodic medical examinations of pneumoconiotics are provided by the medical services of HBNPC for miners and exminers. Physicians involved in this follow-up programme are concerned with the high incidence of progressive massive fibrosis (PMF). The objectives of this study were to describe pneumoconiosis at time of compensation and examine factors related to the occurrence of PMF. For each subject, two radiological films were extracted from the medical files. They were reinterpreted according to the ILO classification (ILO, 1980) by three independent medical readers. Results indicated that radiological criteria for compensation had changed over time ; a marked predominice of category 212 small opacities was noted for cases compensated before 1962 and a predominice of category 1/1 among those compensated after 1981. Comparison of distribution of small opacity types in the 1942-1961 period with that in 1982-1987 confirmed the progressive fall, reported by other investigators, of proportions of predominant micronodular opacities accompanied by an increase in proportions of small irregular opacities at compensation [COCKCROFT and ANDERSON, Br. J. ind. Med. 44,484-487 (1987)]. When time interval between films was taken into account, profusion of small opacities at compensation greater than 1/1 was associated with a probability of 40% or more of developing PMF. Severity of coalworkers simple pneumoconiosis (CWSP) at compensation in HBNPC has been seen to decline since 1982 and the disease to occur mostly after retirement. The reported changes in small opacity types suggest a reduction in incidence of pure silicosis. Occurrence of PMF was correlated with profusion of small opacities at compensation

Recognition and progression of coal workers' pneumoconiosis in the collieries of northern France

International audienceIn France, both active and retired coal miners take part in medical surveillance programs. Those compensated for pneumoconiosis are registered and receive annual chest X-rays and regular lung function assessments. A longitudinal study was done among 2719 pneumoconiotics from the Nord-Pas de Calais region Compensation Register, who received first compensation between 1942 and 1987 to study Progression of CSWP. Chest radiographs taken at time of compensation and in 1987 were examined by three independent readers. There was a change over time in the characteristics of pneumoconiosis at the time of first compensation toward a low profusion of irregular opacities. In the period from 1982 to 1987, 645 pneumoconiotics developed progressive massive fibrosis (PMF). The occurrence of PMF was related to the date o f compensation and the profusion of small opacities at detection (after controlling for time to follow-up). Two profiles for changes in coal workers' simple pneumoconiosis (CWSP) were observed: the first in the group of subjects with mild pneumoconiosis at compensation, who did not reach category 2 at follow-up and had a low attack rate of PMF; and the second in the group of those compensated for category 1/2 pneumoconiosis or higher, who reached severe CWSP and had a twofold attack rate for PMF at follow-up. The changes observed in the characteristics o f pneumoconiosis at first compensation between 1942 and 1987 suggest a lessening of disease severity

Bone apposition to laminin-1 coated implants: histologic and 3D evaluation

Laminin-1 has been reported as one of the factors responsible for the nucleation of calcium phosphates and, in vitro, has been reported to selectively recruit osteoprogenitors. This article focused on its in vivo effects, and evaluated the effect of laminin-1 local application on osseointegration. Polished cylindrical hydroxyapatite implants were coated with laminin-1 (test) and the bone responses in the rabbit tibiae after 2 and 4 weeks were evaluated and compared to the non-coated implants (control). Before the samples were processed for histological sectioning, they were three-dimensionally analysed with micro computed tomography (mu CT). Both evaluation methods were analysed with regards to bone area around the implant and bone to implant contact. From the histologic observation, new bone formation around the laminin-1 coated implant at 2 weeks seemed to have increased the amount of supporting bone around the implant, however, at 4 weeks, the two groups presented no notable differences. The two-dimensional and three-dimensional morphometric evaluation revealed that both histologic and three-dimensional analysis showed some tendency in favour of the test group implants, however there was no statistical significance between the test and control group results

Quality of life and retrospective perception of the effect of growth hormone treatment in adult patients with childhood growth hormone deficiency.

Divergent findings on the quality of life (QoL) and the psychosocial functioning of adults treated during childhood with growth hormone (GH) because of GH deficiency (GHD) have been reported. In the present study we evaluated the QoL and the perception of the effect of former GH treatment in Belgian young adults with childhood GHD. Thirty-six patients (22 males) were included in the study. They all were treated during childhood with GH for GHD. QoL was evaluated with a standardised questionnaire: the Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA). Psychosocial functioning, sexual experience and schooling were evaluated by semi-structured interviews and questionnaires. The influence of gender, type of hormone deficiency (isolated GHD vs multiple pituitary hormone deficiencies [MPHD]), age at the start of GH therapy (before 12 yr vs after 12 yr) and the height deficit at the start of GH therapy ( -3 SDS) were studied. In addition, the patients' and parents' perception of height and of the effect of GH treatment was retrospectively evaluated by semi-structured interviews. Age (mean ± SD) at the time of evaluation was 20.0 ± 1.3 yr and final height was -0.5 ± 0.9 SDS, comparable to mid-parental height (-0.6 ± 0.8 SDS). The QoL-AGHDA score was 9 ± 6. About half of the patients, especially those in whom GH treatment was started after the age of 12 years, complained of retrospective difficulties with self-confidence and social contact, and about one-quarter of the patients had current difficulties with self-confidence, social contact, contact with the opposite sex and with emotional life. Only 44% of the patients had had sexual intercourse - none of those with MPHD. According to the parents, the patients had and still have more difficulties with self-confidence and social contact than their siblings and/or peers, and they needed and still need more emotional support. In one out of four patients the parents expected difficulties in finding a job, in one out of three patients parents expected difficulties in leaving home or in having a stable relationship. The educational level of patients with a height deficit -3 SDS. According to the parents, about half of the patients, especially those with MPHD, had more study problems compared to siblings. In all patients, satisfaction with final height and GH therapy was obvious. In conclusion, the psychosocial outcome of young adults with childhood GHD was more satisfying than in previous studies. This could be due to a more adequate GH treatment with better final height results. Nevertheless, more difficulties with respect to psychosocial functioning were observed in patients with MPHD, in patients in whom GH treatment was started after 12 years of age and in patients with a height deficit < -3 SDS at the start of GH therapy, underlining the need for early diagnosis and treatment of childhood GHD, and of continuing medical follow-up and psychosocial counselling, particularly in these subgroups of patients with GHD