[State of addiction care by general practitioners in north Paris]. / État de la prise en charge addictologique par les généralistes dans le nord de Paris.

BACKGROUND: General practitioners (GPs) are fully concerned with the care of patients suffering from addiction and must have the support of a specialized network. The aim of the study was to evaluate the prevalence of the addict follow-up care by GPs, their use of addictological care facilities and their needs in communicating with specialists. METHODS: Private and salaried GPs working in the 9th, 10th, 18th and 19th districts of Paris were contacted by phone, and a questionnaire was sent to those who agreed to respond. RESULTS: One hundred and thirty-eight GPs responded (median age 57 years, 38.4% women, 54% in private practice). In total, 78.9% received at least one patient weekly for alcohol dependence, 38.1% received at least one patient monthly for opiates and 40.2% for cannabis. They managed ambulatory alcohol (46.8%) and tobacco (65.0%) withdrawal schemes. Among GPs, 86.1% worked with the support of an addictological care facility structure, 69.6% reported lack of specialists for at least one product and 75.4% for at least one specific situation. CONCLUSION: The majority of GPs in north Paris providing care for patients with substance use disorder, worked with addictological care facilities structures. However, they noticed a lack of specialists with whom to communicate. Optimizations are proposed to facilitate interaction.

Prevalence of urinary decoy cells and associated risk factors in a Brazilian kidney, pancreas, and kidney-pancreas transplant population.

BACKGROUND: Polyomavirus BK (BKV) is currently considered one of the most important infectious diseases in kidney transplants recipients. The prevalence of decoy cells (viral containing shed urothelial cells) in these patients varies between 20% and 60%. Of decoy-positive patients, 1%-8% develop BKV nephropathy, a finding that may be associated with graft failure in up to 80% of affected individuals. METHODS: Decoy cells cytology is an easily performed and inexpensive assay useful for poliomavirus infection screening. Data on the prevalence of decoy cells in simultaneous pancreas-kidney or isolated pancreas recipients remains largely unreported. In the present study, we evaluated 221 patients ≥18 years old with >1 month follow-up after transplantation who had attended the outpatient clinic between September and December 2006. RESULTS: The total prevalence of decoy cells was 16% (16.9% in kidney recipients, 5.9% in simultaneous kidney-pancreas recipients and 20% in pancreas alone recipients). There were no differences between patients with either positive or negative urinary cytology for decoy cells, regarding demographic (gender, age, race) or clinical (time posttransplantation, donor type [deceased vs living donation], and presence of delayed graft function or rejection, other associated viral infections and type of immunosuppressive drugs variables.

Screening of SLC26A4 (PDS) gene in Pendred's syndrome: a large spectrum of mutations in France and phenotypic heterogeneity.

Sensorineural hearing defect and goiter are common features of Pendred's syndrome. The clinical diagnosis of Pendred's syndrome remains difficult because of the lack of sensitivity and specificity of the thyroid signs. The identification of PDS as the causative gene allowed molecular screening and enabled a re-evaluation of the syndrome to identify potential diagnostic characteristics. This report presents the clinical and genotypic findings of 30 French families, for whom a diagnosis of Pendred's syndrome had been made. Twenty-seven families had at least one mutated allele. Twenty-eight different mutations were identified, 11 of which had never been previously reported. The main clinical characteristics were: early hearing loss, fluctuation in terms of during deafness evolution, and the presence of an enlarged vestibular aqueduct.