Position du problème?: cette étude visait à décrire l’état dentaire, les comportements de santé orale et les facteurs associés au degré d’atteinte carieuse d’une population surveillée par un Service ...de Santé au Travail du Nord de la France. Méthodes?: un échantillon représentatif des salariés a été constitué entre mai et juillet 2006. Les données ont été recueillies par un médecin de santé au travail au moyen d’un questionnaire et d’un examen dentaire. Après une analyse descriptive des variables, les sujets ont été répartis en deux groupes au moyen du Significant Caries Index. Les facteurs associés au degré d’atteinte carieuse ont été recherchés au moyen d’une régression logistique ajustée sur l’âge. Résultats?: 420 sujets ont été inclus avec un âge moyen de 34,6 (± 10,4) ans. L’indice CAOD (Dents Cariées Absentes Obstruées) moyen était de 8,9 (± 6,5) avec en moyenne par sujet 1,3 (± 2,8) dents cariées. Trois facteurs indépendants associés à un haut degré d’atteinte carieuse ont été identifiés?: un niveau d’éducation inférieur au baccalauréat (ORa = 1,85?; p < 0,05), une consommation régulière d’en-cas et/ou de boissons sucrés (ORa = 2,01?; p < 0,05) et le fait d’avoir consulté dernièrement le chirurgien-dentiste pour une douleur ou une demande autre qu’une visite préventive (ORa = 1,89?; p < 0,05). Conclusion?: cette étude a montré un besoin élevé en soins et en actions de prévention dans cette population et confirme la place des services de santé au travail dans la surveillance et la promotion de la santé orale des salariés.
Background: Somatostatin receptor scintigraphy (SRS) has been reported for receptor (SSTR) screening in advanced hepatocarcinoma (aHC) prior to somatostatin analogue treatment. Aims: To evaluate SSTR ...screening with SRS in aHC patients. Methods: SRS was performed prior treatment, with images at 4, 24, 48 hours. For 7 tumors, SSTR2 subtype was detected immunohistochemically. Results: 70 aHC patients (63 men) aged 65±11 years were included, with alcohol, viral or other causes cirrhosis in 35(50%), 23(33%), 12(17%) cases respectively. CLIP score was 2.7±1.7, with more than 3 nodules in 37(53%) cases. Largest nodule measured 7.6±4.5 cm. Median alpha-fetoprotein was 574 UI/mL. SRS was positive in 25/70 (35.7%) livers and 7/17 (41.2%) metastatic sites. Positive SRS patients differed from others for tumor size (9.2±4 vs. 6.7±4.6 cm, p=0.03), prothrombin time (PT) (75.2±15.2 vs. 61.9±19 %, p=0.005), albumin (34.1±5.9 vs. 30.5±7.2 g/L, p=0.04) and Child-Pugh (6.7±1.8 vs. 7.7±2.3, p=0.04). After multivariate analysis, only PT was associated with positive SRS (p=0.028). Immunohistochemistry was positive for SSTR2s in 6/7 tumors (SRS uptake in 5/6 cases). Conclusions: In advanced hepatocarcinoma, we report SRS uptake in 35.7% of livers and 41.2% of metastatic sites. SRS value in sreening patients for somatostatin analogue treatment remains to be assessed.
Background: Few data are available concerning the dental health of adults in France. This study was designed to describe dental status, oral health behaviour and factors associated with caries among ...workers followed by an occupational health service in Northern France. Methods: A representative sample of workers was selected between May and July 2006. Data were collected by occupational health physicians using a questionnaire completed during a face-to-face interview and a dental examination. After descriptive analysis of the variables, two groups were defined according to the degree of caries as assessed by the Significant Caries Index. Factors associated with the degree of caries were investigated using logistic regression adjusted to age. Results: 420 workers with a mean age of 34.6(±10.4) years were included. The mean DMFT (Decayed Missing Filled Teeth) score and the mean number of decayed teeth were 8.9 (± 6.5) and 1.3 (±2.8), respectively. Three independent factors associated with high caries rates were identified: level of education less than Baccalaureate (ORa = 1.85; p < 0.05), regular consumption of sweet snacks and/or sweet drinks (ORa = 2.01; p < 0.05) and a last dental visit motivated by pain or a reason other than preventive care (ORa = 1.89; p < 0.05). Conclusion: This study showed a high need for care and oral health education in this population of workers. More oral health education programmes should be set up in the adult working population by occupational health services. //ABSTRACT IN FRENCH: Position du problème?: cette étude visait à décrire l'état dentaire, les comportements de santé orale et les facteurs associés au degré d'atteinte carieuse d'une population surveillée par un Service de Santé au Travail du Nord de la France. Méthodes: un échantillon représentatif des salariés a été constitué entre mai et juillet 2006. Les données ont été recueillies par un médecin de santé au travail au moyen d'un questionnaire et d'un examen dentaire. Après une analyse descriptive des variables, les sujets ont été répartis en deux groupes au moyen du Significant Caries Index. Les facteurs associés au degré d'atteinte carieuse ont été recherchés au moyen d'une régression logistique ajustée sur l'âge. Résultats: 420 sujets ont été inclus avec un âge moyen de 34,6 (± 10,4) ans. L'indice CAOD (Dents Cariées Absentes Obstruées) moyen était de 8,9 (± 6,5) avec en moyenne par sujet 1,3 (± 2,8) dents cariées. Trois facteurs indépendants associés à un haut degré d'atteinte carieuse ont été identifiés: un niveau d'éducation inférieur au baccalauréat (ORa = 1,85?; p < 0,05), une consommation régulière d'en-cas et/ou de boissons sucrés (ORa = 2,01?; p < 0,05) et le fait d'avoir consulté dernièrement le chirurgien-dentiste pour une douleur ou une demande autre qu'une visite préventive (ORa = 1,89?; p < 0,05). Conclusion: cette étude a montré un besoin élevé en soins et en actions de prévention dans cette population et confirme la place des services de santé au travail dans la surveillance et la promotion de la santé orale des salariés. Reproduced by permission of Bibliothèque de Sciences Po
The purpose of this study was to evaluate the clinical feasibility of coronary artery imaging during routine preoperative 64-slice MDCT scans of the chest. Ninety-nine consecutive patients in sinus ...rhythm underwent a biphasic multidetector-row spiral CT examination of the chest without the administration of beta-blockers, including an ECG-gated acquisition over the cardiac cavities, followed by a non-gated examination of the upper third of the thorax. Data were reconstructed to evaluate coronary arteries and to obtain presurgical staging of the underlying disease. The percentage of assessable segments ranged from 65.4% (972/1,485) when considering all coronary artery segments to 88% (613/693) for the proximal and mid segments, reaching 98% (387/396) for proximal coronary artery segments. The 387 interpretable proximal segments included 97 (97%) LM, 99 (100%) LAD, 96 (97%) LCX and 95 (96%) RCA with a mean attenuation of 280.70+/-52.93 HU. The mean percentage of assessable segments was significantly higher in patients with a heart rate <or=80 bpm (n=48) than in patients with a heart rate greater than 80 bpm (n=35) (80+/-11% vs. 72+/-13%; P=0.0008). Diagnostic image quality was achieved in all patients for preoperative staging of the underlying disorder. The mean estimated effective dose was 12.06+/-3.25 mSv for ECG-gated scans and 13.88+/-3.49 mSv for complete chest examinations. Proximal and mid-coronary artery segments can be adequately evaluated during presurgical CT examinations of the chest obtained with 64-slice MDCT without the administration of beta-blockers.
Somatostatin receptor scintigraphy (SRS) has been reported for receptor (SSTR) screening in advanced hepatocarcinoma (aHC) prior to somatostatin analogue treatment.
To evaluate SSTR screening with ...SRS in aHC patients.
Seventy aHC patients (63 men) aged 65 +/- 11 y were included, with alcohol, viral or other causes cirrhosis in 35 (50%), 23 (33%), 12 (17%) cases respectively. CLIP score was 2.7 +/- 1.7, with more than three nodules in 37 (53%) cases. Largest nodule measured 7.6 +/- 4.5 cm. Median alpha-fetoprotein was 574 UI/mL. SRS was positive in 25/70 (35.7%) livers and 7/17 (41.2%) metastatic sites. Positive SRS patients differed from others for tumor size (9.2 +/- 4 vs. 6.7 +/- 4.6 cm, p = 0.03), prothrombin time (PT) (75.2 +/- 15.2 vs. 61.9 +/- 19%, p = 0.005), albumin (34.1 +/- 5.9 vs. 30.5 +/- 7.2 g/L, p = 0.04) and Child-Pugh (6.7 +/- 1.8 vs. 7.7 +/- 2.3, p = 0.04). After multivariate analysis, only PT was associated with positive SRS (p = 0.028). Immunohistochemistry was positive for SSTR2s in 6/7 tumors (SRS uptake in 5/6 cases).
SRS was performed prior treatment, with images at 4, 24 and 48 h. For seven tumors, SSTR2 subtype was detected immunohistochemically.
In advanced hepatocarcinoma, we report SRS uptake in 35.7% of livers and 41.2% of metastatic sites. SRS value in screening patients for somatostatin analogue treatment remains to be assessed.
This study deals with the application of macrozoobenthos-based biotic indices (BI) within the frame of the implementation of the European Water Framework Directive. More precisely, this study aimed ...at assessing the performance of five recently developed methodologies (BI) for the assessment of ecological quality status (EcoQ) in two semi-enclosed, sheltered coastal ecosystems and in one transitional water body situated along the Western French coast, namely Marennes-Oléron Bay, Arcachon Bay, and the Seine Estuary. This study showed that these five indices rarely agreed with each other, describing very different pictures of the overall EcoQ of the three study sites. This work also clearly underlined the limitations of these approaches, notably the dependency of most of these BI and the resulting EcoQ classifications on habitat characteristics, more particularly to natural levels of sediment silt–clay content and the location of stations in the subtidal or the intertidal. The implication of our observations concerning the use of these BI for implementation of the WFD is discussed in terms of definition of habitat-specific reference conditions and necessity to adjust thresholds to the particular habitat occurring in semi-enclosed ecosystems. Meanwhile, the unmodified use of these BI severely impaired accurate assessment of EcoQ and decision-making on the managers’ point of view.
Aplastic anemia (AA) is a rare hematopoietic stem cell disease, which can be treated with horse antilymphocyte globulin (ALG) for patients not eligible for bone marrow transplantation. ALG gives ...about 60% overall survival rate (OS) after 5 years, a 30% of persistent complete remission and a 20% early death rate related to failure. ALG has been incriminated in the emergence of 10 to 20% therapy-related AML/MDS (t-AML/MDS) with the usual doses. Questions remain whether higher doses of ALG could improve the response and OS rates and whether the combination with androgens is able to protect patients from t-AML/MDS. We have carried out a single institutional retrospective study of 87 AA treated with higher doses of ALG, twice the usual posology (140 mg/kg instead of 75 mg/kg), combined to androgens. The overall response rate was 77% and the OS rate at 5 years was 78%. Androgens in combination with ALG improved response and OS rates. At diagnosis, 6% of AA had an abnormal karyotype using conventional cytogenetic not related to any time-to-event. Two patients displayed a cytogenetic conversion related to the occurrence of secondary malignancies. The incidence of t-AML/MDS was 2.3% with an estimated 10-year cumulative incidence of 3.1. Our results show that higher doses of ALG combined to androgens are feasible and give results close to those recently describe with the immunosuppressive treatments including ALG associated to cyclosporine, with a low SMD/AML incidence rate.
γ-Amino α,β-unsaturated dimethyl acetals are direct precursors of (E)-1-methoxy-2-methylamino-1,3-butadiene and of the corresponding bis-dienes, which are useful partners in cycloadditions.
...γ-Amino-α,β-unsaturated dimethyl acetals are direct precursors to (E)-1-methoxy-2-methylamino-1,3-butadienes and the corresponding bis-dienes which are useful partners for cycloaddition reactions.
Morphological changes of plasma cells (PC) are common in multiple myeloma (MM). Loss of round or oval nuclear shape has been related to cell malignancy in human, and we looked for the occurrence of ...such morphological change on PC from bone marrow (BM) smears in a retrospective series of 169 MM patients at diagnosis. Nuclear shape changes of PC differed according to the patients (notch, dumb-bell, folded or monocytoid appearance), even in the same patient; all subtypes were pooled and defined as PC with irregular nuclear shape (PCIN). A significant number of PCIN (≥5% of all BMPC) was found at diagnosis in 20.7%. Median survival was of 22 months for patients with ≥5% PCIN, and 41 months for others (
p
=
0.0001). Significant relationship was observed with prognostic parameters related intrinsic malignancy of the tumour process but not with beta-2-microglobulin (b2m). A clear-cut relationship was found also between PCIN and hypodiploidy (
p
=
0.0001), but not with deletion of chromosome 13. This study emphasises the relationship between PCIN, an easy-to-ascertain marker of intrinsic malignancy of the tumour process, and adverse prognosis.
