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ABSTRACT. Objective. To determine the level of residual inflammation [synovitis, bone marrow edema (BME), tenosynovitis, and total inflammation] quantified by hand magnetic resonance imaging (h-MRI) in patients with rheumatoid arthritis (RA) in remission according to 3 different definitions of clinical remission, and to compare these remission definitions. Methods. A cross-sectional study. To assess the level of residual MRI inflammation in remission, cutoff levels associated to remission and median scores of MRI residual inflammatory lesions were calculated. Data from an MRI register of patients with RA who have various levels of disease activity were used. These were used for the analyses: synovitis, BME according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system, tenosynovitis, total inflammation, and disease activity composite measures recorded at the time of MRI. Receiver-operating characteristic analysis was used to identify the best cutoffs associated with remission for each inflammatory lesion on h-MRI. Median values of each inflammatory lesion for each definition of remission were also calculated. Results. A total of 388 h-MRI sets of patients with RA with different levels of disease activity, 130 in remission, were included. Cutoff values associated with remission according to the Simplified Disease Activity Index (SDAI) ≤ 3.3 and the Boolean American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) definitions for BME and tenosynovitis (1 and 3, respectively) were lower than BME and tenosynovitis (2 and 5, respectively) for the Disease Activity Score on 28 joints (DAS28) ≤ 2.6. Median scores for synovitis, BME, and total inflammation were also lower for the SDAI and Boolean ACR/EULAR remission criteria compared with DAS28. Conclusion. Patients with RA in remission according to the SDAI and Boolean ACR/EULAR definitions showed lower levels of MRI-detected residual inflammation compared with DAS28

Hacia un modelo en la práctica del deporte adaptado (deporte adaptado e integración)

El deporte adaptado ha evolucionado desde su concepción como actividad de ocio, hasta la conceptualización actual de deporte como actividad integradora y socioeducativa. Desde esta perspectiva, los aspectos que intervienen en esta práctica son múltiples. En este artículo se intentan resumir los puntos básicos de esta actividad holística. Así pues, se considera importante este nuevo concepto de integración deportiva, junto con su evolución histórica ¿institucional y profesional. Por otro lado, se han comprobado los efectos beneficiosos de esta práctica sobre las personas con discapacidad, que producen a priori una mejora de la calidad de vida, así como beneficios específicos, como los físicos (mejor movilidad, aumento del dominio del cuerpo, etc.), psicológicos (sentimientos de utilidad que elevan la autoestima, ocio y diversión, etc.) y sociales (establecimiento de relaciones interpersonales, coordinación y cooperación entre personas, etc.). Todo esto da lugar a un mundo que está empezando a implantarse de manera generalizada y que hay que potenciar desde las diferentes disciplinas

Dosimetrie du radiodiagnostic. La fiche individuelle d'irradiation. Application dosimetrique des electrets

Available from CEN Saclay, Service de Documentation, 91191 Gif-sur-Yvette Cedex (France) / INIST-CNRS - Institut de l'Information Scientifique et TechniqueSIGLEFRFranc

Cap a un nou model en la pràctica de l’esport adaptat (esport adaptat i integració)

L’esport adaptat ha evolucionat, des de la seva concepció com a activitat de distracció, fins a la conceptualització actual d’esport com a activitat integradora i socioeducativa.   Des d’aquesta perspectiva, els aspectes que intervenen en aquesta pràctica són múltiples. En aquest article s’intenten resumir els punts bàsics d’aquesta activitat holística. Així doncs, es considera important aquest nou concepte d’integració esportiva, junt amb la seva evolució històrica –institucional i professional–. D’altra banda, s’han comprovat els efectes beneficiosos d’aquesta pràctica sobre els discapacitats, que produeixen a priori una millora de la qualitat de vida, juntament amb beneficis específics, com els físics (millor mobilitat, augment del domini del cos, etc.), psicològics (sentiments d’utilitat que eleven l’autoestima, distraïbilitat i diversió, etc.) i socials (establiment de relacions interpersonals, coordinació i cooperació entre persones, etc.). Tot això dóna lloc a un món que està començant a implantar-se de manera generalitzada i que cal potenciar des de les diferents disciplines

Validation of fast Monte Carlo dose calculation in small animal radiotherapy with EBT3 radiochromic films

International audienceIn preclinical studies, the absorbed dose calculation accuracy in small animalsis fundamental to reliably investigate and understand observed biologicaleffects. This work investigated the use of the split exponential track lengthestimator (seTLE), a new kerma based Monte Carlo dose calculation methodfor preclinical radiotherapy using a small animal precision micro irradiator,the X-RAD 225Cx.Monte Carlo modelling of the irradiator with GATE/GEANT4 wasextensively evaluated by comparing measurements and simulations for halfvaluelayer, percent depth dose, off-axis profiles and output factors in waterand water-equivalent material for seven circular fields, from 20 mm down to1 mm in diameter. Simulated and measured dose distributions in cylinders ofwater obtained for a 360° arc were also compared using dose, distance-toagreementand gamma-index maps.Simulations and measurements agreed within 3% for all static beamconfigurations, with uncertainties estimated to 1% for the simulation and 3% forthe measurements. Distance-to-agreement accuracy was better to 0.14 mm. Forthe arc irradiations, gamma-index maps of 2D dose distributions showed thatthe success rate was higher than 98%, except for the 0.1 cm collimator (92%).Using the seTLE method, MC simulations compute 3D dose distributionswithin minutes for realistic beam configurations with a clinically acceptableaccuracy for beam diameter as small as 1 mm

Is IMAT the ultimate evolution of conformal radiotherapy? Dosimetric comparison of helical tomotherapy and volumetric modulated arc therapy for oropharyngeal cancer in a planning study

International audienc

RTEP7-IFCT-1402 : un exemple de contrôle qualité « de qualité »

International audienc

In Regard to Perrier et al

SCOPUS: le.jinfo:eu-repo/semantics/publishe

Efficacy of extracranial stereotactic body radiation therapy (SBRT) added to standard treatment in patients with solid tumors (breast, prostate and non-small cell lung cancer) with up to 3 bone-only metastases: study protocol for a randomised phase III trial (STEREO-OS)

International audienceAbstract Background Stereotactic Body Radiation Therapy (SBRT) is an innovative modality based on high precision planning and delivery. Cancer with bone metastases and oligometastases are associated with an intermediate or good prognosis. We assume that prolonged survival rates would be achieved if both the primary tumor and metastases are controlled by local treatment. Our purpose is to demonstrate, via a multicenter randomized phase III trial, that local treatment of metastatic sites with curative intent with SBRT associated of systemic standard of care treatment would improve the progression-free survival in patients with solid tumor (breast, prostate and non-small cell lung cancer) with up to 3 bone-only metastases compared to patients who received systemic standard of care treatment alone. Methods This is an open-labeled randomized superiority multicenter phase III trial. Patients with up to 3 bone-only metastases will be randomized in a 1:1 ratio.between Arm A (Experimental group): Standard care of treatment & SBRT to all bone metastases, and Arm B (Control group): standard care of treatment. For patients receiving SBRT, radiotherapy dose and fractionation depends on the site of the bone metastasis and the proximity to critical normal structures. This study aims to accrue a total of 196 patients within 4 years. The primary endpoint is progression-free survival at 1 year, and secondary endpoints include Bone progression-free survival; Local control; Cancer-specific survival; Overall survival; Toxicity; Quality of life; Pain score analysis, Cost-utility analysis; Cost-effectiveness analysis and Budget impact analysis. Discussion The expected benefit for the patient in the experimental arm is a longer expectancy of life without skeletal recurrence and the discomfort, pain and drastic reduction of mobility and handicap that the lack of local control of bone metastases eventually inflicts. Trials registration ClinicalTrials.gov NCT03143322 Registered on May 8th 2017. Ongoing stud