[Cannabis: Similarities and differences with tobacco]. / Le cannabis : similitudes et différences avec le tabac.

Nicotine is the specific psychoactive substance of tobacco while tetrahydrocannabinol (THC) is the specific component of cannabis. The inhalation technique of cannabis is different from that of tobacco smoking: the volume of puffs is larger, inhalation is deeper, and pulmonary retention time is longer. Cannabis addiction is difficult to evaluate, both products often being smoked concomitantly. The principle physical side effects of cannabis affect organs and functions in a similar way to tobacco: pulmonary, cardiovascular, endocrine and stomatological. Gastrointestinal complications such as cannabinoid hyperemesis are specific to cannabis. Some psychological effects of THC may be acute (altered time and space perception, sensory disability, decreased vigilance, mood and dissociative disorders, hallucinations and delirium, impaired learning and memory, impaired cognitive and motor performance, panic attacks and anxiety) or chronic (lack of motivation, disorganisation of thoughts, increase in frequency and severity of schizophrenic crises). Cannabis can also be implicated in traffic and workplace accidents. Synthetic cannabinoids have increased psychotropic and somatic effects due to a greater affinity for brain cannabinoid receptors.

Report from the 20th annual Western Canadian Gastrointestinal Cancer Consensus Conference; Saskatoon, Saskatchewan; 28-29 September 2018.

The 20th annual Western Canadian Gastrointestinal Cancer Consensus Conference was held in Saskatoon, Saskatchewan, 28-29 September 2018. This interactive multidisciplinary conference is attended by health care professionals from across Western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) who are involved in the care of patients with gastrointestinal cancers. In addition, invited speakers from other provinces participate. Surgical, medical, and radiation oncologists, and allied health care professionals participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses current issues in the management of colorectal cancers.

Report from the 19th annual Western Canadian Gastrointestinal Cancer Consensus Conference; Winnipeg, Manitoba; 29-30 September 2017.

The 19th annual Western Canadian Gastrointestinal Cancer Consensus Conference (wcgccc) was held in Winnipeg, Manitoba, 29-30 September 2017. The wcgccc is an interactive multidisciplinary conference attended by health care professionals from across Western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) who are involved in the care of patients with gastrointestinal cancer. Surgical, medical, and radiation oncologists; pathologists; radiologists; and allied health care professionals participated in presentation and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses current issues in the management of colorectal cancer.

Genome-wide SNPs resolve phylogenetic relationships in the North American spruce budworm (Choristoneura fumiferana) species complex.

High throughput sequencing technologies have revolutionized the potential to reconcile incongruence between gene and species trees, and numerous approaches have been developed to take advantage of these advances. Genotyping-by-sequencing is becoming a regular tool for gathering phylogenetic data, yet comprehensive evaluations of phylogenetic methods using these data are sparse. Here we use multiple phylogenetic and population genetic methods for genotyping-by-sequencing data to assess species relationships in a group of forest insect pests, the spruce budworm (Choristoneura fumiferana) species complex. With few exceptions, all methods agree on the same relationships, most notably placing C. pinus as basal to the remainder of the group, rather than C. fumiferana as previously suggested. We found strong support for the monophyly of C. pinus, C. fumiferana, and C. retiniana, but more ambiguous relationships and signatures of introgression in a clade of western lineages, including C. carnana, C. lambertiana, C. occidentalis occidentalis, C. occidentalis biennis, and C. orae. This represents the most taxonomically comprehensive genomic treatment of the spruce budworm species group, which is further supported by the broad agreement among multiple methodologies.

Reliable quantification of bisphenol A and its chlorinated derivatives in human urine using UPLC-MS/MS method.

Bisphenol A (BPA), a widespread man-made chemical classified as an endocrine disruptor, is increasingly considered as a major cause of concern for human health. Chlorine present in drinking water may react with BPA to form chlorinated derivatives (ClxBPA), which have demonstrated a heightened level of estrogenic activity. If many epidemiological studies report that more than 90% of people have detectable BPA levels in their urine, then no such study has been undertaken regarding ClxBPA. The purpose of this work is to propose a highly sensitive and accurate analytical method adapted to large-scale biomonitoring studies aimed at assessing exposure to BPA and ClxBPA through the use of human urine. To achieve this, we have comprehensively validated a method using salting-out assisted liquid/liquid extraction (SALLE) coupled to UPLC-MS/MS and isotope dilution quantification, to measure unconjugated BPA and ClxBPA in human urine according to the accepted guidelines. Deutered BPA as well as deutered 2,2'-DCBPA was used as internal standards. The matrix calibration curve ranged from 0.05 to 1.60 ng mL(-1) and from 0.5 to 16.0 ng mL(-1) for ClxBPA and BPA respectively, and provided good linearity (r²>0.99). This method was precise (the intra- and inter-day coefficients of variation were <20% at three different concentrations: 0.05 ng mL(-1), 0.2 ng mL(-1), 0.8 ng mL(-1) and 0.5 ng mL(-1), 2 ng mL(-1), 8 ng mL(-1) for ClxBPA and BPA, respectively) and accurate (bias ranged from -13% to +12%). The limit of quantification, validated at 0.05 ng mL(-1) and 0.5 ng mL(-1) for ClxBPA and BPA respectively when using 300 µL of urine, was found to be suitable for the concentration existing in real samples. The matrix effect and the BPA cross-contamination were also investigated in this study. The analytical method developed in this study is in accordance with the requirements applicable to biomonitoring of BPA and ClxBPA in human urine.

[Workplace testing of drugs of abuse and psychotropic drugs]. / Exploration biologique des drogues illicites et des médicaments psychotropes en milieu professionnel.

In France, workplace testing of drugs of abuse and psychotropic drugs is rarely performed; meanwhile it is a major public health problem. Furthermore, France is the European country that has been associated with the highest increase of the use of drugs of abuse, particularly cannabis. So workplace biological screening of drugs of abuse and of psychotropic drugs exposure is of major concern. New analytical techniques have been developed during the last years. The authors will consider analytical screening of drugs of abuse and particularly the comparison of analytical techniques applied to urine and saliva. The advantages and the disadvantages of these two matrices will be considered. Urinary and blood quantification will be reviewed, but also the interest of hair testing to explore chronic exposure. The research of psychotropic drugs in biological fluids is also a part of this paper. New analytical trends are promising and complete analysis of these substances will be soon routinely possible in blood using a single spot test.

[Evaluation of the pertinence of international courses on human African trypanosomiasis]. / Evaluation de la pertinence du cours international sur les trypanosomoses humaines africaines.

The goal of this study was to evaluate the adequacy and relevance of a training course on Human African Trypanosomiasis, targeted to reach support and coordination staff in charge of activities being carried out in related prevention and control programmes. A questionnaire was emailed to the four course organisers and the 65 participants. The response rate among the participants was 41%. The training needs expressed covered issues such as treatment, diagnostic and epidemiological techniques, improved knowledge of the disease, and control planning. The lectures given were adapted for participants' professional activities. At the time of the evaluation (one to three years after the course) 67% of the participants had begun implementing the knowledge they had acquired and applying it to their practice, particularly in the area of programme planning. The analysis of the questionnaire's results pointed to the sections of the course that would benefit from modifications, such as the need for the development of lessons and modules in the areas of patient management and planning for future training sessions.

[Requests for residency permits due to medical reasons from foreigners in the Val-d'Oise county between 1999 and 2003]. / Demandes de séjour pour raison médicale des malades étrangers dans le département du Val-d'Oise de 1999 à 2003.

The requests for residence permits from foreigners who wish to remain in France for health reasons are submitted for review to the county public health medical officer. This article reports on the quantitative and qualitative evolution and progression of these requests in a county located near Paris. The number of requests has drastically increased, from 152 in 1999 to 1,823 in the year 2003. The majority of the applicants were women and individuals from sub-Saharan Africa. HIV infection was the most frequent reason cited for the submission of requests, but its relative proportion has decreased over time from 25% in 1999 to 15% of overall requests made in the year 2003, which is then followed by diabetes (8% of all requests), hypertension (5%), and tuberculosis (4%). The decision handed down from the authorities was favourable for residence based on the need for healthcare in 74% of the cases. The health status of the illegal immigrants remains difficult to determine and systematically track; therefore, the applications for residency granted on medical grounds serve as a practical and efficient means to assess and map the existing situation.

[Cannabis and road crashes: a survey of recent French studies]. / Cannabis et accidents de la voie publique: résultats des dernières études françaises.

The clarification of the mechanisms of action of cannabis and its effects on motor and cognitive functions, the results of previous studies performed on driving simulators and closed or open-road driving trials, are important criteria for highlighting the increased risk of road crashes for drivers after a recent use of cannabis. In addition epidemiological studies allow to measure the magnitude of the problem. A survey of French epidemiological studies performed from 1999 to 2004, as well as the data of THC distribution in tissues studies performed on man and animal allowed us to draw a number of conclusions. The risk of road crash after a recent use of cannabis is increased by more than 2.4 in all studies. The prevalence of cannabis use in drivers involved in a road crash has dramatically increased during the last years. For methodological reasons (a too high threshold for THC positivity, a too long time delay between accident and blood sampling), the annual number of fatal cases induced by a cannabis use was likely underestimated. This assessment is consistent with recent data which indicate that THC could be still present in brain while absent in blood. A positivity threshold for THC in blood of 0.5 ng/mL would be more appropriated. So, all recent French studies highlighted that a recent use of cannabis impairs driving ability and that it would be advisable to intensify roadside testing for drugs of abuse.

[Residence permit for foreigners for healthcare in France: survey on the advice of the public health medical officers]. / Autorisation de séjour pour soins des malades étrangers en France: enquête sur les avis des médecins inspecteurs de santé publique.

BACKGROUND: Public health medical officers of the different French administrative districts are called in to advise the public authorities (Préfet) on requests for a residence permit from foreigners seeking healthcare asylum in France. Using a medical report chart, the medical officer specifies whether the foreigner requires treatment, whether lack of medical care can have exceptionally serious consequences and whether the patient can obtain a suitable treatment in his/her own country. Considering the marked increase in the number of requests for healthcare asylum and the potential subjective aspect of the medical officer's advice, a survey was conducted to assess medical officers'practices. METHODS: In March 2002, a questionnaire was addressed by email to the medical officers practising in the 94 administrative districts of metropolitan France. They were to give their advice about two fictional requests for healthcare asylum; the fictional requests closely mimicked real situations which frequently raise difficult issues. The two seekers were a 57-year-old man from Comoros treated for hypertension and noninsulin-dependent diabetes mellitus (case 1) and a 33-year-old woman from the Ivory Coast followed after treatment for tuberculosis (case 2). RESULTS: Among the 94 district medical officers contacted, 42 (45%) responded. Respectively 88% (case 1) and 67% (case 2) of the medical officers considered that the patient required medical care because lack of care would have serious consequences, but for 26% (cases 1 and 2), treatment could be delivered in the country of origin. Finally, the advise proposed by the different officers varied: for 33% (case 1) and 53% (case 2) of the medical officers, asylum in France for healthcare was unjustified. CONCLUSIONS: In spite of a low response rate, this survey shows the subjectivity of the advice provided by medical officers, raising the question of its fairness. Our study suggests that this subjectivity is related to the vagueness of the questions asked to the medical officers and the lack of a frame of reference on which to base their advice.

[Rotavirus laboratory network: results after one year of observation]. / Red de laboratorios de Rotavirus: resultados del primer año de vigilancia.

Rotavirus is the most common cause of severe diarrhea in children and it has been estimated that in Argentina Rotavirus is responsible for 21,000 hospitalizations, 85,000 medical attentions and an annual medical cost of US$ 27 millions. Given that a Rotavirus vaccine is about to be approved, a laboratory network based surveillance system was organized. Herein, we present the results after one year of study. Severe diarrhea was responsible for 9% of pediatric hospitalizations and rotavirus was detected in 42.1% of the diarrhea cases. We estimated that Rotavirus causes 3.8% of pediatric hospitalizations. The number of diarrhea and Rotavirus diarrhea hospitalizations was greater during the first year of life (62% and 71.3%, respectively). The number of diarrhea hospitalizations during the December-May semester was significantly higher than the rest of the year. A Rotavirus diarrhea peak was detected between April and June. These results indicate that Rotavirus is the most important etiological agent of severe diarrhea in Argentine children and show the importance of performing Rotavirus diagnosis in every pediatric hospital. The additional costs will be compensated by many benefits such as better use of antibiotics, improved nosocomial spread control, better handling of hospital beds and of laboratory resources and of the hospitalized patient.

Red de laboratorios de Rotavirus: resultados del primer año de vigilancia / Rotavirus laboratory network: results after one year experience

Rotavirus es el principal agente productor de diarrea infantil y se ha estimado que provoca en Argentina 21.000 hospitalizaciones, 85.000 atenciones ambulatorias, y un costo mayor a los 27 millones de dolares anuales. Ante la inminente aprobación de una vacuna contra este patógeno se organizó un Sistema de Vigilancia Epidemiológica en base a una Red de laboratorios. Se presentan los resultados obtenidos luego del primer año de funcionamiento de esta Red. Se encontró que el 9 por ciento de la internación pediátrica es debido a diarrea aguda, y rotavirus se halló en el 42,1 por ciento de los casos estudiados. Se estimó que rotavirus provoca el 3,8 por ciento de las internaciones pediátricas. La internación por diarrea y la internación asociada a diarrea por rotavirus fue mayor en el primer año de vida (62 por ciento y 71,3 por ciento respectivamente). En el semestre de diciembre a mayo el número de internaciones por diarrea fue significativamente mayor que en el semestre restante. Se detectó un pico de diarreas por rotavirus entre abril y junio en las distintas Unidades centinelas. Estos resultados señalan a los rotavirus como el principal agente etiológico de la gastroenteritis infantil aguda en nuestro país y avalan la necesidad de incorporar su diagnóstico en todos los hospitales pediátricos. Los costos adicionales serán ampliamente superados por los beneficios relacionados con elmejor manejo de las camas hospitalarias, los recursos del laboratorio, y el paciente internado por diarrea, el uso correcto de antibióticos, y el control de la diseminación intrahospitalaria de rotavirus

[Epiphysis-metaphysis bone ischemia in hemorrhagic rectocolitis and Crohn's disease]. / Ischémie osseuse épiphyso-métaphysaire au cours de la rectocolite hémorragique et de la maladie de Crohn.

Aseptic osteonecrosis is a rare extraintestinal manifestation in patients with inflammatory bowel disease; its true prevalence is not precisely known. Steroid treatment undoubtedly participates in the pathophysiology of avascular osteonecrosis, however, other factors like hypercoagulability may be involved. Two cases of bilateral osteonecrosis of the knees--the first occurring during the course of ulcerative colitis, the second in a patient presenting with Crohn's disease--are described. Specific location of the lesions and regression of symptoms, as well as the importance of magnetic resonance imaging for early recognition of osteonecrosis, are noteworthy.

Recurrent cytogenetic abnormalities observed in complete remission of acute myeloid leukemia do not necessarily mark preleukemic cells.

We have undertaken the cytogenetic monitoring of 39 adult patients treated for de novo acute myeloid leukemia (AML) by intensive chemotherapy. We describe this monitoring in seven patients in continuous complete clinical and morphologic remission (CR) of AML. Although in CR, these patients exhibit the emergence of cytogenetically abnormal clones. Abnormalities observed include monosomy 7, del(20)(q11), partial trisomy 1q, and 6p12-22 rearrangements. They correspond to well-known chromosomal rearrangements commonly found in myelodysplasia (MDS), and myeloproliferative syndromes (MPS), as well as AML. Present as the sole detected chromosomal change, they preceded by months the onset of overt leukemia or MDS. In some cases, the abnormal clone showed a proliferative advantage (some patients exhibited up to 100% of abnormal bone marrow metaphases in subsequent analyses). AML relapse, when it occurred, was associated with a different chromosomal modification. Altogether the question arises, whether the abnormalities pointed out in our study (monosomy 7, del(20)(q11), partial trisomy for the long arm of chromosome 1 (q21qter), 6p12-22 rearrangements), and seen after chemotherapy, mark preleukemic cells or not, and whether they participate indirectly, or not at all in the leukemic process.

Detection of tetracycline-resistant strains of Ureaplasma urealyticum by hybridization assays.

Five wild-type strains of tetracycline-resistant Ureaplasma Ureaplasma urealyticum and one tetracycline-sensitive Ureaplasma urealyticum strain were tested for presence of the tetM sequence by hybridization assays. Two sorts of probes were used, a plasmid containing the tetM fragment and the tetM fragment alone. Two sorts of label were used for each, digoxigenin and radio-labelling. Both purified DNA at various concentrations and non-purified DNA in the pellet from a 10 ml culture were used as targets. The digoxigenin-labelled whole plasmid probe was as specific as the insert alone when hybridized with non-purified DNA, and was more sensitive than radio-labelled probes.

Alimentación de recién nacidos de muy bajo peso con leche de su propia madre / Feeding very low birth weight neonates with their own mother's milk

Con el objeto de evaluar el crecimiento de recién nacidos menores de 1.500g alimentados con leche de su propia madre (L.M.) se estudiaron 10 niños con peso promedio de 1,315 ñ 128g y edad gestacional de 31,1 ñ 1,5 semanas, adecuados para la edad gestacional y sin malformaciones congénitas mayores y se compararon con un grupo control de características similares alimentado con fórmula artificial (NAN 13%). La pérdida inicial de peso fue de 10,9% para el grupo L.M. y de 9,8% para el control (p = N.S.). La recuperación del peso de nacimiento ocurrió a los 16,0 días en el grupo L.M. y a los 20,8 en el control (p<0,05). La ganancia ponderal posterior fue de 23,7g x día versus 17,5 en el control (p<0,005). El tiempo empleado en alcanzar los 2.000g fue de 46 ñ 10 días en el grupo L.M. y de 63 ñ 17 en el control (p<0,01). En recién nacidos de muy bajo de peso la leche de su propia madre promueve crecimiento ponderal mejor que la fórmula de uso habitual, disminuye el período de hospitalización y favorece la relación madre-hijo