Real world experience of therapeutic monitoring of medically treated prosthetic valve infective endocarditis by 18F-FDG-PET/CT.

INTRODUCTION: 18F-FDG-PET/CT is recommended to improve the diagnosis of prosthetic valve infective endocarditis (PVIE) and is a major criterion in the ESC-2015 classification. However, there is little evidence for its usefulness in the follow-up of medically treated PVIE patients. METHODS: A monocentric retrospective analysis of patients hospitalized for PVIE between January 2013 and December 2019 who were not treated with surgery and who had at least two 18F-FDG-PET/CT examinations during their medical management. RESULTS: Among 170 patients with PVIE, 117 were treated with antibiotic therapy but no surgery. Of these, 36 (31%) had at least two 18F-FDG-PET/CT examinations. At initial imaging, 28 patients had heterogeneous FDG uptake on their prosthetic valve and eight on their associated aortic graft. Hypermetabolism of spleen and bone marrow (HSBM) was observed in 18 and 19 patients, respectively. At the first follow-up 18F-FDG-PET/CT, 21 (58%) patients still had heterogeneous uptake, indicating persistent active endocarditis. HSBM was still present at the last follow-up imaging in four of the six patients with recurrent PVIE. CONCLUSION: 18F-FDG-PET/CT monitoring of medically treated patients with PVIE provides valuable additional information and prospective multicentric study should be conducted to assess its usefulness.

Norms of the Attitudes Toward Intellectual Disability Questionnaire.

BACKGROUND: The Attitudes Toward Intellectual Disability Questionnaire (ATTID) has demonstrated good psychometric qualities for measuring the attitudes of different groups of adults in the general population toward intellectual disability (ID). A significant advantage of the ATTID is that it addresses the concept of attitudes using a three-dimensional model (affective, cognitive and behavioural). To our knowledge, there are no normative data published regarding attitudes toward ID on general population-based samples. METHODS: The sample of 1605 men and women was stratified to be representative of the general adult population of Quebec. The ATTID was administered by phone interview through an independent survey firm. RESULTS: Normative data are presented as percentile scores associated with the raw score of the ATTID by gender and age categories. Analysis of the variance yielded significant differences in attitude by gender and age. The directions and the strength of these associations vary according to each of the five factors used to define attitudes. CONCLUSION: These norms will provide an essential tool to compare different groups and assess the effectiveness of various public campaigns to encourage more positive attitudes towards persons with ID. These norms would also allow international comparisons.

The protein disulfide isomerases PDIA4 and PDIA6 mediate resistance to cisplatin-induced cell death in lung adenocarcinoma.

Intrinsic and acquired chemoresistance are frequent causes of cancer eradication failure. Thus, long-term cis-diaminedichloroplatine(II) (CDDP) or cisplatin treatment is known to promote tumor cell resistance to apoptosis induction via multiple mechanisms involving gene expression modulation of oncogenes, tumor suppressors and blockade of pro-apoptotic mitochondrial membrane permeabilization. Here, we demonstrate that CDDP-resistant non-small lung cancer cells undergo profound remodeling of their endoplasmic reticulum (ER) proteome (>80 proteins identified by proteomics) and exhibit a dramatic overexpression of two protein disulfide isomerases, PDIA4 and PDIA6, without any alteration in ER-cytosol Ca(2+) fluxes. Using pharmacological and genetic inhibition, we show that inactivation of both proteins directly stimulates CDDP-induced cell death by different cellular signaling pathways. PDIA4 inactivation restores a classical mitochondrial apoptosis pathway, while knockdown of PDIA6 favors a non-canonical cell death pathway sharing some necroptosis features. Overexpression of both proteins has also been found in lung adenocarcinoma patients, suggesting a clinical importance of these proteins in chemoresistance.

Public attitudes towards intellectual disability: a multidimensional perspective.

BACKGROUND: Public attitudes towards persons with intellectual disabilities (IDs) have a significant effect on potential community integration. A better understanding of these can help target service provision and public awareness programmes. OBJECTIVE: The objective of the present study is threefold: (1) describe public attitudes towards persons with ID along affective, cognitive and behavioural dimensions; (2) compare and contrast attitudes according to sex, age, education and income, as well as frequency and quality of contacts with persons with ID; and (3) ascertain whether the level of functioning has an effect on attitudes. METHODS: The Attitudes Toward Intellectual Disability Questionnaire (ATTID) was administered by phone to 1605 randomly selected adult men and women, stratified by region in the province of Québec, Canada. The ATTID uses a multidimensional perspective of attitudes that reflect affective, cognitive and behavioural dimensions. RESULTS: The results showed that public attitudes were generally positive regarding all three attitudinal dimensions. Public attitudes towards persons with ID are presented in terms of the five factors measured through the ATTID: (1) discomfort; (2) sensibility or tenderness; (3) knowledge of causes; (4) knowledge of capacity and rights; and (5) interaction. Attitude factor scores vary as a function of participant characteristics (sex, age, education and income) and the degree of knowledge about ID, the number of persons with ID known to the participants, as well as the frequency and quality of their contacts with these persons. Men had greater negative attitudes than women as regards the discomfort factor, while women had more negative attitudes regarding the knowledge of capacity and rights factor. More positive attitudes were revealed among younger and more educated participants. Attitudes were generally not associated with income. Public attitudes tended to be more negative towards people with lower functioning ID. CONCLUSION: These results yield useful information to target public awareness and education.

[Perforation of the nasal septum: a rare complication of bevacizumab]. / Perforation de la cloison nasale : une complication rare du bévacizumab.

INTRODUCTION: Neovascularisation is a hallmark of cancer. Vascular endothelial growth factor (VEGF) is directly involved in the regulation of this tumoural neoangiogenesis, especially in lung cancer. Bevacizumab is a humanized monoclonal antibody targeting VEGF that is commonly used in thoracic oncology. Among the side effects, perforation of the nasal septum is rare. CASE REPORT: We report the case of a 50-year-old woman with adenocarcinoma of the right upper lobe, immediately metastatic, treated with five cycles of chemotherapy (cisplatin, gemcitabine, bevacizumab). She developed a perforation of the nasal septum after the third injection of bevacizumab given as monotherapy during the maintenance phase. CONCLUSIONS: This is, to our knowledge, the first description of this complication in the course of treatment of bronchial carcinoma. Its management is purely symptomatic. The action to be taken in using bevacizumab is not fully codified.

[Retroperitoneal lymphadenectomy and survival of patients treated for an advanced ovarian cancer: the CARACO trial]. / Impact des curages rétropéritonéaux sur la survie des patientes atteintes d'un cancer de l'ovaire à un stade avancé : le protocole CARACO.

The standard management for advanced-stage epithelial ovarian cancer is optimum cytoreductive surgery followed by platinum based chemotherapy. However, retroperitoneal lymph node resection remains controversial. The multiple directions of the lymph drainage pathway in ovarian cancer have been recognized. The incidence and pattern of lymph node involvement depends on the extent of the disease and the histological type. Several published cohorts suggest the survival benefit of pelvic and para-aortic lymphadenectomy. A recent large randomized trial have demonstrated the potential benefit for surgical removal of bulky lymph nodes in term of progression-free survival but failed to show any overall survival benefit because of a critical methodology. Further randomised trials are needed to balance risks and benefits of systematic lymphadenectomy in advanced-stage disease. CARACO is a French ongoing trial, built to bring a reply to this important question. A huge effort for inclusion of the patients, and involving new teams, are mandatory.

Rotational and vibrational relaxation of methane excited to 2nu3 in CH4/H2 and CH4/He mixtures at 296 and 193 K from double-resonance measurements.

A series of time-resolved IR-IR double-resonance experiments have been conducted where methane molecules are excited into a selected rovibrational level of the 2nu3(F2) vibrational substate of the tetradecad and where the time evolution of the population of the various energy levels is probed by a tunable continuous wave laser. The rotational relaxation and vibrational energy transfer processes occurring in methane upon inelastic CH4-H2 and CH4-He collisions have been investigated by this technique at room temperature and at 193 K. By probing transitions in which either the lower or the upper level is the laser-excited level, rotational depopulation rates in the 2nu3(F2) substate were measured. The rate constants for CH4-H2 collisions were found to be 17.7 +/- 2.0 and 18.9 +/- 2.0 micros(-1) Torr(-1) at 296 and 193 K, respectively, and for CH(4)-He collisions they are 12.1 +/- 1.5 and 16.0 +/- 2.0 micros(-1) Torr(-1) at the same temperatures. The vibrational relaxation was investigated by probing other stretching transitions such as 2nu3(F2) - nu3, nu3 + 2nu4 - 2nu4, and nu3 + nu4 - nu4. A kinetic model, taking into account the main collisional processes connecting energy levels up to 6000 cm(-1), that has been developed to describe the various relaxation pathways allowed us to calculate the temporal evolution of populations in these levels and to simulate double-resonance signals. The different rate coefficients of the vibrational relaxation processes involved in these mixtures were determined by fitting simulated signals to the observed signals corresponding to assigned transitions. For vibration to translation energy transfer processes, hydrogen is a much more efficient collision partner than helium, nitrogen, or methane itself at 193 K as well as at room temperature.

[Status of low-vision rehabilitation for age-related macular degeneration by orthoptists in the North of France]. / "Etat des lieux" en rééducation orthoptique Basse Vision dans la région Nord-Pas-de-Calais.

AIM OF THE STUDY: To evaluate the status of low-vision rehabilitation carried out by the orthoptists in the North of France. This study was a preliminary step in setting up a network between different vision professionals for the management of age-related macular degeneration (AMD) the North of France. METHODS: The ASO (Association Septentrionale d'Ophtalmologie) conducted a survey funded by the URCAM (Union Régionale des Caisses d'Assurance Maladie) with the FAQSV (fond d'aide à la qualité des soins de ville). The survey was based on the analysis of two forms sent to orthoptists of the North region of France. RESULTS: The survey analyzed 46 responses (a representative sample with 69% responses) providing a description of the orthoptists of the North of France: 19% males, 81% females whose mean professional experience was 13.3 years. Thirty-four percent of the orthoptists have had training in low-vision rehabilitation. This training was given during the university courses for 21% of responders and during a postgraduate course for 79%. Of the orthoptists surveyed, 64% worked in a private context, 9% in a public context, and 27% in both public and private contexts. Their main activity was in their own private practice for 60%, in an ophthalmologist's office for 20%, in a public institution for 16%, and a private institution for 4%. The mean number of patients treated was 70 per week per orthoptist, with 21% working mostly with children, 36% working mainly with adults between 16 and 60 years of age, and 7% with the elderly, whereas 36% reported no specificity related to patient age. The mean number of patients dealt with for low vision related to AMD was 4.1 per month per orthoptist. The average number of patients dealt with for low vision with no relation to AMD was 1.5 per month. The prescriber of low-vision rehabilitation was an ophthalmologist for 88.9% of the orthoptists and a general practitioner for 11.1%. Questions addressed to AMD patients: at the beginning of the survey, 83.8% of the patients did not have sufficient visual acuity to be able to read a text of current size (Parinaud 4); 40.4% of the patients required help for everyday life, and 59.6% were autonomous. For 7.1% of the patients, low-vision rehabilitation was carried out less than 1 month after the stabilization of retinal lesions, but in 35.3%, rehabilitation was carried out more than 2 years after lesions were stabilized. The main request of the patients involved improvement of near vision (89.9%). CONCLUSION: This survey will be a preliminary step in setting up a regional health network coordinating the ophthalmological and orthoptic management of AMD.

[Olfactory esthesioneuroma manifesting as Schwartz-Bartter syndrome]. / Esthésioneurome olfactif révélé par un syndrome de Schwartz-Bartter.

INTRODUCTION: Olfactory esthesioneuroblastoma is an uncommon neuroectodermal tumor originating from the olfactory epithelium, which is rarely associated with hormone excess syndrome. EXEGESIS: Asymptomatic olfactory esthesioneuroblastoma was diagnosed in a 22-year-old man who presented a syndrome of inappropriate antidiuretic hormone secretion. Following surgery, the immunohistochemical analysis demonstrated the existence of neurophysin hormone in tumoral cells. CONCLUSION: This case provides evidence that olfactory esthesioneuroblastoma can be uncovered by inappropriate antidiuretic hormone secretion.

[Eye medulloepithelioma. Apropos of 2 cases]. / Les médullopithéliomes oculaires. A propos de deux cas.

The authors report two cases of medullo-epithelioma of ciliary body found in two young children. They describe the main clinical symptoms which are often non specific (cataract, glaucoma). Diagnosis is based on histological findings following enucleation: the tumor is developed from the ciliary body cells and has often a local malignancy. Metastasis are rare.