Five-Year Survivors From Brain Metastases Treated With Stereotactic Radiosurgery: Biology, Improving Treatments, or Just Plain Luck?

BACKGROUND: Improvements in therapies have led to an increasing number of long-term survivors of brain metastases. The present series compares a population of 5-year survivors of brain metastases to a generalized brain metastases population to assess for factors attributable to long-term survival. METHODS: A single institution retrospective review was performed to identify 5-year survivors of brain metastases who received stereotactic radiosurgery (SRS). A historical control population of 737 patients with brain metastases was used to assess similarities and differences between the long-term survivor population and the general population treated with SRS. RESULTS: A total of 98 patients with brain metastases were found to have survived over 60 months. No differences between long-term survivors and controls were identified with regards to the age at first SRS ( CONCLUSION: Five-year survivors of brain metastases represent a diverse histologic population, suggesting a small population of oligometastatic and indolent cancers exist for each cancer type

Evidence for a Role of srGAP3 in the Positioning of Commissural Axons within the Ventrolateral Funiculus of the Mouse Spinal Cord

Slit-Robo signaling guides commissural axons away from the floor-plate of the spinal cord and into the longitudinal axis after crossing the midline. In this study we have evaluated the role of the Slit-Robo GTPase activating protein 3 (srGAP3) in commissural axon guidance using a knockout (KO) mouse model. Co-immunoprecipitation experiments confirmed that srGAP3 interacts with the Slit receptors Robo1 and Robo2 and immunohistochemistry studies showed that srGAP3 co-localises with Robo1 in the ventral and lateral funiculus and with Robo2 in the lateral funiculus. Stalling axons have been reported in the floor-plate of Slit and Robo mutant spinal cords but our axon tracing experiments revealed no dorsal commissural axon stalling in the floor plate of the srGAP3 KO mouse. Interestingly we observed a significant thickening of the ventral funiculus and a thinning of the lateral funiculus in the srGAP3 KO spinal cord, which has also recently been reported in the Robo2 KO. However, axons in the enlarged ventral funiculus of the srGAP3 KO are Robo1 positive but do not express Robo2, indicating that the thickening of the ventral funiculus in the srGAP3 KO is not a Robo2 mediated effect. We suggest a role for srGAP3 in the lateral positioning of post crossing axons within the ventrolateral funiculus

Multimorbidity and clinical reasoning through the eyes of GPs: a qualitative study

Despite the high prevalence of patients suffering from multimorbidity, the clinical reasoning processes involved during the longitudinal management are still sparse. This study aimed to investigate what are the different characteristics of the clinical reasoning process clinicians use with patients suffering from multimorbidity, and to what extent this clinical reasoning differs from diagnostic reasoning

Multimobidité et raisonnement clinique à travers les yeux des médecins généralistes : une étude qualitative exploratoire

Lors de la prise en charge au long cours des patient-e-x-s souffrant de multimorbidité, le raisonnement clinique que fait le médecin généraliste pour prendre des diverses décisions médicales et faire le suivi des différentes maladies est un processus cognitif très peu connu. Pourtant, ces patient-e-x-s représentent un grande partie de la patientèle des médecins généralistes. Nous avons mené une étude qualitative exploratoire au moyen d'entretien individuel auprès de 9 médecins généralistes à Genève en 2018 pour comprend et identifier les processus en jeu lors de la prise en charge au long cours de patients souffrant de multimorbidité. Les résultats montrent qu'un raisonnement clinique "longitudinal" existe et que bien qu'il présente des similitudes avec le raisonnement clinique "diagnostic", il semble plus riche et plus complexe. Les voies analytique et intuitive sont également utilisées dans ce raisonnement clinique "longitudinal" avec possiblement une utilisation plus fréquente de la voie analytique. Bien qu'aucun raisonnement clinique partagé n'ai été clairement mis en évidence, l'implication du/de la patient-e-x est nécessaire et indispensable à tous les niveaux de la prise en charge

Etude sur la scolarisation des élèves allophones nouvellement arrivés (EANA) et des enfants issus de familles itinérantes et de voyageurs (EFIV)

Rapport

Etude sur la scolarisation des élèves allophones nouvellement arrivés (EANA) et des enfants issus de familles itinérantes et de voyageurs (EFIV)

Rapport