Introduction : Le but de cette étude est d’évaluer l’efficacité, la tolérance et la compliance des patients au protocole du service pour la prévention des saignements après extractions dentaires chez ...des patients hémophiles, porteurs d’une maladie de Willebrand (vWD) ou thrombopéniques. Patients et méthodes : Nous avons inclus, prospectivement, entre février 2013 et février 2014, dans le centre hospitalier régional de Lille, tous les patients ayant besoin d’avulsions dentaires et atteints d’une pathologie de l’hémostase. Un traitement substitutif comme la desmopressine, les concentrés de facteurs ou concentrés plaquettaires et des méthodes d’hémostase locales ont été utilisés. À la consultation postopératoire, les patients ont été interrogés à propos de la survenue de douleur, de saignement, de complication et sur l’évaluation du confort. Résultats : Trente-sept patients ont été inclus. Des saignements se sont produits chez treize patients (35,1 %) et 7 d’entre eux (18,9 %) ont dû consulter aux Urgences pour contrôler le saignement. Les patients ont évalué à 8,77/10 le confort hospitalier et à 8,40/10 le confort au domicile. Discussion : Ce protocole paraît au moins aussi efficace que ceux retrouvés dans la littérature. Les principaux types de complication ont été des douleurs, des réactions allergiques, des infections. Globalement, les patients sont satisfaits de cette prise en charge. Une collaboration pluridisciplinaire reste l’élément le plus important pour une bonne prise en charge.
Introduction: This study evaluated the effectiveness, tolerance and compliance of patients with the protocol of the service for the prevention of bleeding after dental extraction in patients with hemophilia, von Willebrand's disease (VWD) or platelet disorders. Patients and Methods: This study prospectively included all patients needing dental extractions and who had blood hemostasis diseases from February 2013 to February 2014, in the regional hospital center of Lille. Replacement therapy such as desmopressin, clotting factor or platelet concentrates as well as local hemostatic methods were used. At the post-operative consultation, patients were asked about the onset of pain, bleeding, complications and the assessment of comfort. Results: Thirty-seven patients were included. Bleeding occurred in thirteen patients (35.14%). Patients evaluated their comfort at 8.77/10 at the hospital and 8.40/10 at home. Discussion: This protocol appears at least as effective as those found in the literature. The main types of complications were pain, allergic reactions and infections. Overall, patients are satisfied with this support. Pluridisciplinary collaboration remains the most important thing for good management.
This study was undertaken to determine the frequency, and the clinicopathologic and genetic features, of colon cancers driven by neurotrophic receptor tyrosine kinase (NTRK) gene fusions. Of the 7008 ...tumors screened for NTRK expression using a pan-Trk antibody, 16 (0.23%) had Trk immunoreactivity. ArcherDx assay detected TPM3-NTRK1 (n=9), LMNA-NTRK1 (n=3), TPR-NTRK1 (n=2) and EML4-NTRK3 (n=1) fusion transcripts in 15 cases with sufficient RNA quality. Patients were predominantly women (median age: 63 y). The tumors involved the right (n=12) and left colon unequally and were either stage T3 (n=12) or T4. Local lymph node and distant metastases were seen at presentation in 6 and 1 patients, respectively. Lymphovascular invasion was present in all cases. Histologically, tumors showed moderate to poor (n=11) differentiation with a partly or entirely solid pattern (n=5) and mucinous component (n=10), including 1 case with sheets of signet ring cells. DNA mismatch repair-deficient phenotype was seen in 13 cases. Tumor-infiltrating CD4/CD8 lymphocytes were prominent in 9 cases. Programmed death-ligand 1 positive tumor-infiltrating immune cells and focal tumor cell positivity were seen in the majority of cases. CDX2 expression and loss of CK20 and MUC2 expression were frequent. CK7 was expressed in 5 cases. No mutations in BRAF, RAS, and PIK3CA were identified. However, other genes of the PI3K-AKT/MTOR pathway were mutated. In several cases, components of Wnt/β-catenin (APC, AMER1, CTNNB1), p53, and TGFβ (ACVR2A, TGFBR2) pathways were mutated. However, no SMAD4 mutations were found. Two tumors harbored FBXW7 tumor suppressor gene mutations. NTRK fusion tumors constitute a distinct but rare subgroup of colorectal carcinomas.
This study determined the frequency and the clinicopathologic and genetic features of colorectal carcinomas driven by oncogenic fusions of the anaplastic lymphoma kinase gene (ALK). Of the 8150 ...screened tumors, 12 (0.15%) were immunohistochemically ALK-positive with D5F3 antibody. These cancers harbored CAD-ALK (n=1), DIAPH2-ALK (n=2), EML4-ALK (n=2), LOC101929227-ALK (n=1), SLMAP-ALK (n=1), SPTBN1-ALK (n=4), and STRN-ALK (n=1) fusions, as detected by an RNA-based next-generation sequencing assay. ALK fusion carcinomas were diagnosed mostly in older patients with a 9:3 female predominance (median age: 72 y). All tumors, except a rectal one, occurred in the right colon. Most tumors were stage T3 (n=7) or T4 (n=3). Local lymph node and distant metastases were seen at presentation in 9 and 2 patients. These tumors showed moderate (n=6) or poor (n=3) glandular differentiation, solid medullary growth pattern (n=2), and pure mucinous morphology (n=1). DNA mismatch repair-deficient phenotype was identified in 10 cases. Tumor-infiltrating lymphocytes were prominent in 9 carcinomas. In 4 carcinomas, tumor cells showed strong, focal (n=3), or diffuse programmed death-ligand 1 immunoreactivity. CDX2 expression and loss of CK20 and MUC2 expression were frequent. CK7 was expressed in 5 tumors. Four patients died of disease within 3 years, and 7 were alive with follow-up ranging from 1 to 8 years. No mutations in BRAF, RAS, and in genes encoding components of PI3K-AKT/MTOR pathway were identified. However, 1 tumor had a loss-of-function PTEN mutation. Aberration of p53 signaling, TP53 mutations, and/or nuclear accumulation of p53 protein was seen in 9 cases. ALK fusion colorectal carcinomas are a distinct and rare subtype of colorectal cancers displaying some features of mismatch repair-deficient tumors.
Two studies tested the hypothesis that rules of trait inference may differ depending on trait stereotypicality and the social group membership of the target being judged. Specifically, traits that ...are stereotypic of a group were expected to instantiate lower evidentiary standards (require fewer behaviors to confirm), but only in members of that group. Study 1 focused on race and found that across 180 traits, trait stereotypicality was associated with fewer behaviors required to confirm and more to disconfirm in outgroup targets (in Black actors for White judges and in White actors for Black judges). Study 2 focused on gender and again found that stereotypic traits were tied to low evidentiary standards only when judging outgroup targets. The findings are discussed with reference to the literatures on trait inference, stereotyping, and shifting judgment standards.
Two studies tested the hypothesis that rules of trait inference may differ depending on trait stereotypicality & the social group membership of the target being judged. Specifically, traits that are ...stereotypic of a group were expected to instantiate lower evidentiary standards (require fewer behaviors to confirm), but only in members of that group. Study 1 focused on race & found that across 180 traits, trait stereotypicality was associated with fewer behaviors required to confirm & more to disconfirm in outgroup targets (in Black actors for White judges & in White actors for Black judges). Study 2 focused on gender & again found that stereotypic traits were tied to low evidentiary standards only when judging outgroup targets. The findings are discussed with reference to the literatures on trait inference, stereotyping, & shifting judgment standards. Tables, References. Reprinted by permission of Sage Publications Inc., copyright 2005 the Society for Personality and Social Psychology, Inc.
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