Northern European retired residents in nine southern European areas: characteristics, motivations and adjustment

During the last two decades, northern European retirement residence in the southern European sunbelt has grown strongly and its forms have rapidly changed, but standard demographic and social statistical sources provide no information about the flows, the migrants or their increasingly mobile and complex residential patterns. Considerable primary research has however recently been undertaken into the causes, conditions, experiences and consequences of international retirement migration (IRM) by investigators from Germany, Spain, Switzerland and the United Kingdom. Many collaborated when designing their studies and instruments, and all have subsequently worked together in a European Science Foundation Scientific Network. This paper compares the findings of six systematic social surveys in (to be more precise than the title) eight regions of southern Europe and the Canary Islands: all that have tackled similar research questions with similar methods and instruments. It presents interpretations of several comparative tables compiled from their original data, with a focus on the socio-economic backgrounds, motivations and behaviour of the various migrant groups and their relationship with the host and home countries. The paper presents new findings about the typical and variant forms of IRM, and additional understanding of the heterogeneity of the retirees of different nations and in the several regions

Los jubilados franceses en España en el movimiento de inmigración de la Unión Europea : un enfoque geográfico

Ce livre regroupe les résultats de plusieurs recherches sur les retraités européens dans les régions espagnoles, menées par des chercheurs espagnols et étrangers, unis par deux liens, leur participation au réseau scientifique de la Fondation européenne de la science (ESF) sur "La migration internationale dans Europes "et son intérêt pour la migration des retraités en Europe, qui a son expression maximale en Espagne comme principale destination européenne. Les chapitres de ce livre ont été choisis en fonction de leur intérêt scientifique et de leur complémentarité thématique, afin de couvrir autant que possible les pays d’origine et les régions de destination

Chromosome fragility in Fanconi anemia patients: diagnostic implications and clinical impact

International audienceFanconi anemia (FA) is a rare syndrome characterized by bone marrow failure, malformations, and cancer predisposition. Chromosome fragility induced by DNA interstrand crosslink (ICL)-inducing agents such as DEB or MMC is the gold standard test for the diagnosis of FA. In this study we present data from 198 DEB-induced chromosome fragility tests in non-FA and in FA patients where information on genetic subtype, cell sensitivity to MMC and clinical data were available. This large series allowed us to quantify the variability and the level of overlap in ICL-sensitivity among FA patients and normal population. In this article we propose a new chromosome fragility index that provides a cut-off diagnostic level to unambiguously distinguish FA patients, including mosaics, from non-FA individuals. Spontaneous chromosome fragility and its correlation with DEB-induced fragility was also analyzed, indicating that, while both variables are correlated, 54% of FA patients do not have spontaneous fragility. Our data reveal a correlation between malformations and sensitivity to ICLs, This correlation is also statistically significant when the analysis is restricted to the patients from the FA-A complementation group and suggests that genome instability during embryo development may be related to malformations in FA. Finally, chromosome fragility does not correlate with the age of onset of hematological disease, indicating that DEB-induced chromosome breaks in T-cells has no prognostic value in FA

Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Background: Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial. Methods: NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy. Findings: Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity. Interpretation: Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted. Funding: Bayer and Janssen