Impact of continuous glucose monitoring on everyday life of young children with type 1 diabetes and their parents: An evaluation of 114 families.

INTRODUCTION: The prevalence of type 1 diabetes is increasing worldwide. The advent of new monitoring devices has enabled tighter glycemic control. AIM: To study the impact of glucose monitoring devices on the everyday life of young children with type 1 diabetes (T1D) and their parents. METHODS: A questionnaire was addressed to parents of children with T1D under the age of 6 years with an insulin pump treated in one of the hospitals of the ADIM network in France between January and July 2020. RESULTS: Among the 114 families included in the study, 53% of parents (26/49) woke up every night to monitor blood glucose levels when their child had flash glucose monitoring (FGM), compared with 23% (13/56) of those whose child had continuous glucose monitoring (CGM). Overall, 81% of parents (86/108) found that glucose monitoring improved their own sleep and parents whose child had CGM were significantly more likely to report improved sleep (86% vs 73%, p = 0.006). Forty-nine percent of parents (55/113) declared that they (in 87% of cases, the mother only) had reduced their working hours or stopped working following their child's T1D diagnosis. Maternal unemployment was significantly associated with the presence of siblings (p = 0.001) but not with glycemic control (p = 0,87). Ninety-eight percent of parents (105/107) think that glucose monitoring improves school integration. CONCLUSION: In these families of children with T1D, new diabetes technologies reduced the burden of care but sleep disruption remained common. Social needs evaluation, particularly of mothers, is important at initial diagnosis of T1D in children.

Distribution of phyllosilicates on the surface of Ceres.

The dwarf planet Ceres is known to host phyllosilicate minerals at its surface, but their distribution and origin have not previously been determined. We used the spectrometer onboard the Dawn spacecraft to map their spatial distribution on the basis of diagnostic absorption features in the visible and near-infrared spectral range (0.25 to 5.0 micrometers). We found that magnesium- and ammonium-bearing minerals are ubiquitous across the surface. Variations in the strength of the absorption features are spatially correlated and indicate considerable variability in the relative abundance of the phyllosilicates, although their composition is fairly uniform. These data, along with the distinctive spectral properties of Ceres relative to other asteroids and carbonaceous meteorites, indicate that the phyllosilicates were formed endogenously by a globally widespread and extensive alteration process.

Dawn arrives at Ceres: Exploration of a small, volatile-rich world.

On 6 March 2015, Dawn arrived at Ceres to find a dark, desiccated surface punctuated by small, bright areas. Parts of Ceres' surface are heavily cratered, but the largest expected craters are absent. Ceres appears gravitationally relaxed at only the longest wavelengths, implying a mechanically strong lithosphere with a weaker deep interior. Ceres' dry exterior displays hydroxylated silicates, including ammoniated clays of endogenous origin. The possibility of abundant volatiles at depth is supported by geomorphologic features such as flat crater floors with pits, lobate flows of materials, and a singular mountain that appears to be an extrusive cryovolcanic dome. On one occasion, Ceres temporarily interacted with the solar wind, producing a bow shock accelerating electrons to energies of tens of kilovolts.

Ammoniated phyllosilicates with a likely outer Solar System origin on (1) Ceres.

Studies of the dwarf planet (1) Ceres using ground-based and orbiting telescopes have concluded that its closest meteoritic analogues are the volatile-rich CI and CM carbonaceous chondrites. Water in clay minerals, ammoniated phyllosilicates, or a mixture of Mg(OH)2 (brucite), Mg2CO3 and iron-rich serpentine have all been proposed to exist on the surface. In particular, brucite has been suggested from analysis of the mid-infrared spectrum of Ceres. But the lack of spectral data across telluric absorption bands in the wavelength region 2.5 to 2.9 micrometres--where the OH stretching vibration and the H2O bending overtone are found--has precluded definitive identifications. In addition, water vapour around Ceres has recently been reported, possibly originating from localized sources. Here we report spectra of Ceres from 0.4 to 5 micrometres acquired at distances from ~82,000 to 4,300 kilometres from the surface. Our measurements indicate widespread ammoniated phyllosilicates across the surface, but no detectable water ice. Ammonia, accreted either as organic matter or as ice, may have reacted with phyllosilicates on Ceres during differentiation. This suggests that material from the outer Solar System was incorporated into Ceres, either during its formation at great heliocentric distance or by incorporation of material transported into the main asteroid belt.

Dark material on Vesta from the infall of carbonaceous volatile-rich material.

Localized dark and bright materials, often with extremely different albedos, were recently found on Vesta's surface. The range of albedos is among the largest observed on Solar System rocky bodies. These dark materials, often associated with craters, appear in ejecta and crater walls, and their pyroxene absorption strengths are correlated with material brightness. It was tentatively suggested that the dark material on Vesta could be either exogenic, from carbon-rich, low-velocity impactors, or endogenic, from freshly exposed mafic material or impact melt, created or exposed by impacts. Here we report Vesta spectra and images and use them to derive and interpret the properties of the 'pure' dark and bright materials. We argue that the dark material is mainly from infall of hydrated carbonaceous material (like that found in a major class of meteorites and some comet surfaces), whereas the bright material is the uncontaminated indigenous Vesta basaltic soil. Dark material from low-albedo impactors is diffused over time through the Vestan regolith by impact mixing, creating broader, diffuse darker regions and finally Vesta's background surface material. This is consistent with howardite-eucrite-diogenite meteorites coming from Vesta.

[Gastric cancer: epidemiologic profile 2001-2007 in Lima, Peru]. / Cancer gastrico: perfil epidemiológico 2001-2007 en Lima, Peru.

OBJECTIVE: To describe and compare the demographic and social characteristics as well as lifestyles of patients with gastric cancer against patients with other important gastric disorders, who attended at main reference health services in Lima, Peru. METHODS: Case control study, matched by sex and age + 2 years, applying a questionnaire to 96 cases with gastric cancer, and to 96 controls from September 2001 to November 2007. RESULTS: There were no significant differences about ethnicity; marital status; exposure to minerals, wood, and metal dusts; tobacco and alcohol; red meat consumption; salt addition; food temperature. 87, 5% of the control group had lesions in the gastric antrum, and 73% of cases group had a tubular adenocarcinoma (56%) in the gastric antrum. There was no family history of cancer in 85% patients of cases group and 59% of controls, (with significant difference). There were significant differences in low scholarship level of cases, as well as for their mothers and fathers (OR 3.75, 3.9, and 3.49 respectively), fruit or vegetables intake, milk or cheese consumption (minus of once a day) (OR 2, 3, 2, 57 and 2, 9 respectively), type of fuel for cooking (firewood, charcoal, and kerosene OR 5, 25), lack of use of refrigerator (OR 8, 4). CONCLUSIONS: The profile of a gastric cancer patient was to proceed from the Andean zone (high altitude +3000 meters over sea level) and jungle, low education level (low socioeconomic level), low consumption of fruits, vegetables and milk, use of firewood, charcoal, or kerosene to cook, and no use of refrigerator. The most frequent histological diagnosis in the case group was tubular adenocarcinoma.

Cancer gástrico: perfil epidemiológico 2001-2007 en lima, Perú / Gastric cancer: epidemiological profile 2001-2007 in lima, Peru

OBJETIVO: Describir y comparar las características socio-demográficas y los estilos de vida de pacientes con cáncer gástrico versus un grupo control con otros desórdenes gástricos importantes, en centros de salud de referencia en Lima, Perú. METODOS: Estudio caso-control pareado por sexo y edad +2 años. Tiempo: Setiembre 2001 a noviembre 2007. Encuesta a 96 casos con cáncer gástrico y a 96 controles. RESULTADOS: No hubo diferencias significativas en raza, estado conyugal, exposición a polvo de minerales, polvo de madera o de metales; consumo de alcohol, tabaco, carnes rojas, agregar sal a los alimentos, o temperatura elevada de los mismos. Se identificó lesión en el antro gástrico en 87,5% de los controles y 73% de los casos, siendo el adenocarcinoma tubular el tipo histológico más frecuente entre los casos (56%). No hubo antecedente familiar de cáncer en 85% de los casos y 59% de los controles, con diferencia significativa. En los casos se encontró baja escolaridad en las madres y padres de los casos en los casos (OR 3,9, 3,49 y 3,75, respectivamente), también en el consumo de frutas o vegetales, leche y queso en menos de una vez por día (OR 2,3, 2,57 y 2, 9 respectivamente), así mismo en el tipo de combustible para cocinar (leña, carbón o kerosene OR 5,25) y no usar refrigerador para la conservación de alimentos (OR 8,4). CONCLUSIONES: El perfil de un paciente con cáncer gástrico fue proceder de la sierra (+ 3000 msnm) y selva; condición socioeconómica baja (baja educación); bajo consumo de frutas, vegetales y leche; así como el uso de leña, carbón o kerosene para cocinar y falta de refrigerador para la conservación de los alimentos. El principal diagnóstico histológico entre los casos fue el adenocarcinoma tubular.

OBJECTIVE: To Describe and compare the demographic and social characteristics as well as lifestyles of patients with gastric cancer against patients with other important gastric disorders, who attended at main reference health services in Lima, Peru. METHODS: Case control study, matched by sex and age + 2 years, applying a questionnaire to 96 cases with gastric cancer, and to 96 controls from September 2001 to November 2007. RESULTS: There were no significant differences about ethnicity; marital status; exposure to minerals, wood, and metal dusts; tobacco and alcohol; red meat consumption; salt addition; food temperature. 87, 5% of the control group had lesions in the gastric antrum, and 73% of cases group had a tubular adenocarcinoma (56%) in the gastric antrum. There was no family history of cancer in 85% patients of cases group and 59% of controls, (with significant difference). There were significant differences in low scholarship level of cases, as well as for their mothers and fathers (OR 3.75, 3.9, and 3.49 respectively), fruit or vegetables intake, milk or cheese consumption (minus of once a day) (OR 2, 3, 2, 57 and 2, 9 respectively), type of fuel for cooking (firewood, charcoal, and kerosene OR 5, 25), lack of use of refrigerator (OR 8, 4). CONCLUSIONS: The profile of a gastric cancer patient was to proceed from the Andean zone (high altitude +3000 meters over sea level) and jungle, low education level (low socioeconomic level), low consumption of fruits, vegetables and milk, use of firewood, charcoal, or kerosene to cook, and no use of refrigerator. The most frequent histological diagnosis in the case group was tubular adenocarcinoma.

Character and spatial distribution of OH/H2O on the surface of the Moon seen by M3 on Chandrayaan-1.

The search for water on the surface of the anhydrous Moon had remained an unfulfilled quest for 40 years. However, the Moon Mineralogy Mapper (M3) on Chandrayaan-1 has recently detected absorption features near 2.8 to 3.0 micrometers on the surface of the Moon. For silicate bodies, such features are typically attributed to hydroxyl- and/or water-bearing materials. On the Moon, the feature is seen as a widely distributed absorption that appears strongest at cooler high latitudes and at several fresh feldspathic craters. The general lack of correlation of this feature in sunlit M3 data with neutron spectrometer hydrogen abundance data suggests that the formation and retention of hydroxyl and water are ongoing surficial processes. Hydroxyl/water production processes may feed polar cold traps and make the lunar regolith a candidate source of volatiles for human exploration.

Flavoenzyme catalysed oxidation of amines: roles for flavin and protein-based radicals.

Amines are a carbon source for the growth of a number of bacterial species and they also play key roles in neurotransmission, cell growth and differentiation, and neoplastic cell proliferation. Enzymes have evolved to catalyse these reactions and these oxidoreductases can be grouped into the flavoprotein and quinoprotein families. The mechanism of amine oxidation catalysed by the quinoprotein amine oxidases is understood reasonably well and occurs through the formation of enzyme-substrate covalent adducts with TPQ (topaquinone), TTQ (tryptophan tryptophylquinone), CTQ (cysteine tryptophylquinone) and LTQ (lysine tyrosyl quinone) redox centres. Oxidation of amines by flavoenzymes is less well understood. The role of protein-based radicals and flavin semiquinone radicals in the oxidation of amines is discussed.

Functional analysis of cis-regulatory elements within the promoter of the tobacco late pollen gene g10.

The tobacco gene g10 is preferentially and maximally expressed in mature pollen, shows homology to pectate lyases, and is the putative homologue of the tomato gene lat56. Analysis of regulatory elements within the g10 promoter was carried out to verify the importance of putative regulatory sequence motifs. Analysis of transgenic plants showed that 1190 bp of g10 5' sequence directed preferential expression of GUS in pollen, with bimodal peaks of expression just before and during pollen mitosis I, and in mature anthers. This was confirmed by northern analysis of native g10 transcripts in isolated spores. Transient expression analysis defined the minimal g10 promoter region capable of directing expression in pollen as -86 to +217. Three upstream regions within -427 bp modulate the expression from g10. Gain-of-function analyses showed that the region from -106 to -53 could enhance pollen-specific expression of a minimal CaMV 35S promoter. These analyses further showed that sequences upstream of -86 modulate expression in pollen, but are not essential for preferential pollen expression. The function of a conserved GTGA motif shared between the tobacco g10 and tomato lat56 promoters was demonstrated in g10. Thus, further functional evidence is provided for the conservation of mechanisms for the regulation of late pollen genes across species.

[Comparison of the histopathological findings among the biopsies of non-cancerous gastric mucosa of patients with gastric cancer and the biopsies of gastric mucosa of dyspeptic patients without gastric cancer]. / Comparación de los hallazgos histopatológicos entre las biopsias de la mucosa gástrica no neoplásica de pacientes con cáncer gástrico y las biopsias de la mucosa gástrica de pacientes dispépticos sin cáncer gástrico.

Gastric biopsies of the non neoplastic area of 46 patients with gastric cancer and 59 gastric biopsies of dyspeptic patients without gastric cancer were reviewed by one pathologist, without knowing from which group they were coming, to determine the histopathologic findings. The results of both groups were compared. Intestinal metaplasia was found to be significantly higher in gastric cancer patients than in patients without neoplasia (54,3 and 25,4% respectively) (p=0,001). Also in patients with cancer and intestinal metaplasia, this was of the complete type in about 80% of the cases. A number of items were assessed using logistic regression, we found that the presence of complete metaplasia, gastric atrophy and hypertrophy of the mucinogenous vacuole correlates with the presence of gastric cancer (p=0,0159 0,0080 y 0,0280 respectively). H.pylori presence was similar in both groups. The study was done between November 1997 and November 1998 at the Cayetano Heredia National Hospital and the National Institute of Neoplastic Diseases.

Comparación de los hallazgos histopatológicos entre las biopsias de la mucosa gástrica no neoplásica de pacientes con cáncer gástrico y las biopsias de la mucosa gástrica de pacientes dispépticos sin cáncer gástrico / Comparison of the histological findings among the biopsies of anon-cancerous gastric mucous of patients with gastric cancer and the biopsies of the gastric mucous of dyspeptic patients without gastric cancer

Las biopsias de la mucosa gástrica no neoplásica de 46 pacientes con cáncer gástrico y las biopsias gástricas de 59 pacientes con dispepsia sin cáncer gástrico fueron evaluadas por un mismo patólogo, sin conocer de que grupo procedían, para establecer los hallazgos histopatológicos. Se compararon los resultados de ambos grupos. Se encontró que la presencia de metaplasia intestinal era significativamente mayor en los pacientes con cáncer gástrico que en los pacientes sin neoplasia (54,3 por ciento y 25,4 por ciento respectivamente) (p=0,001). Además en los pacientes con cáncer gástrico con metaplasia intestinal, ésta era metaplasia completa en un 80 por ciento de los casos. Se evaluó un número de variables usando regresión logística, encontrándose que la presencia de metaplasia completa, atrofia gástrica e hipertrofia de la vacuola mucinógena correlacionan con la presencia de cáncer gástrico (p=0,0159 0,0080 y 0,0280 respectivamente ). La presencia de H. pylori fue similar en ambos grupos. El estudio se realizó entre noviembre de 1997 y noviembre de 1998 en el Hospital Nacional Cayetano Heredia y el Instituto Nacional de enfermedades Neoplásicas.

[Health care in non-insulin dependent diabetics in lower Normandy]. / Etude de la prise en charge de diabétiques non insulinodépendants en Basse-Normandie.

To contribute to better quality health care for patients with type 2 diabetes mellitus living in the French Department Basse-Normandie, the Regional Union of General Practitioners (URML) and the Regional Union of the Nation Health Insurance (URCAM) studied ambulatory practices in this population in 1999. Eight hundred diabetics whose health care reimbursements suggested they were not followed by a specialized center were studied: 400 received a mailed questionnaire and for the 400 others, another questionnaire was filed out by the primary care physician. The physicians' responses demonstrated that they do not feel certain recommended complementary investigations are always necessary for following diabetic patients (microalbuminuria, glycated hemoglobin, search for neuropathy, ophthalmology consultation). Interaction with diabetologists, nutritionists and chiropodists was found to be insufficient. Globally, the responses of the diabetics was coherent with the physicians' statements, providing further precision concerning health care delivery and propositions for improvement. These results can be used to better target education programs for associations, specialists and general practitioners.

[Carotid surgery under loco-regional anesthesia. Early results of 100 recent cases]. / Chirurgie carotidienne sous anesthésie loco-régionale. Résultats précoces de 100 cas récents.

A prospective single-centre study was performed to evaluate the safety and efficacy of carotid revascularisation under local anesthesia. Between November 1, 1996 and March 30, 1998, 92 patients underwent surgery for 100 carotid artery stenoses under local cervical block anesthesia. Fifty-eight stenoses were asymptomatic and 42 were symptomatic. Duplex ultrasound scanning showed a tight (n = 17) or very tight carotid artery stenosis (n = 83); angiography showed 19 contralateral carotid artery stenosis and 30 hemodynamically significant stenosis of vertebral and/or subclavian arteries. Cerebral Magnetic Resonance Imaging (MRI) (N = 87) with circle of Willis Magnetic Resonance Angiogram (MRA) (n = 83) detected 29 ischemic defects (33%). Fifteen ischemic defects were found in 58 asymptomatic patients (26%). Circle of Willis was incomplete in 41%. Anesthesia was performed using superficial cervical block (n = 100). Endarterectomy was the most commonly used revascularisation technique in 86 cases with 5 eversion endarterectomies; carotid vein or prosthetic graft was used in 14%. In this study, there was no mortality, and no cardiac or neurologic complications, during the first postoperative month. Twelve patients experienced neurologic intolerance to carotid clamping. This clamping-related ischemia required 4 shunts. All patients with clamping intolerance had a good clinical outcome after revascularisation with no objective or MRI sequelae. Incomplete circle of Willis on MRA was a significant predictive test of clamping intolerance (p < 0.0001). Carotid artery surgery under local anesthesia reduces the cumulative mortality and morbidity rate (TCMM) to a very low level: 0% in this study. These recent results are the modern reference for current carotid artery surgery evaluation.

[Amyloidosis of a coral reef infrarenal aorta]. / Amylose d'une aorte sous-rénale en pierre de corail.

This case concerns a 37-year-old woman with a cruro-gluteal claudication, from which she had been suffering since the age of 33, and which prevented her from walking more than 50 metres. The arteriographic examination revealed preocclusive coralliform proliferations of the infrarenal aorta, with a 30% stenosis of the right internal carotid artery. After 18 months, a straight aorto-aortic tube yielded excellent results. The results of the pathological examination led to the conclusion that this was a secondary aortic amyloidosis with no specific lesions of the aortic wall. This coral reef aorta is distinguished by its infrarenal location (fourth case worldwide), as well as by the major amylotic infiltrations of the endoaortic proliferations and of the aortic wall. In the absence of generalized amyloidosis, we suspect massive localized amyloidosis subsequent to an old inflammatory aortic process compatible with a juvenile atheroma opened in the aortic lumen or more probably a sequel of Takayasu's disease.

[Carotid-jugular fistula after an attempt at placement of a vena cava filter]. / Fistule carotido-jugulaire après tentative de placement d'un filtre cave.

A carotid-jugular fistula complicated the placement of a Green-field filter via the right internal jugular percutaneous passage: the local signs of an arterio-venous fistula were associated with right parietal infarction neurological symptoms. A crossography showed a carotid-jugular fistula and a limited dissection of the original carotid artery. An elective echo-guided compression failed. The surgical treatment eliminated the fistula, fixed the carotid dissection and placed a vena cava filter with an excellent result 34 months later. Percutaneous placement of vena cava filters can lead to rare vascular complications such as carotid-jugular fistulas which can, in certain cases, be treated with an elective external compression or endovascular procedures. Surgery offers a reliable technical solution that is complete and stable in time, particularly with recent fistulas and associated neurological symptoms.

Endothelial seeding of vascular prostheses: a technique of in situ enzymatic retrieval of endothelial cells without vein sacrifice.

The success of endothelial seeding of vascular prosthetic grafts is largely dependent on endothelial cell retrieval. An in situ cell harvesting technique using enzymatic dissolution in a temporarily excluded segment of the internal jugular vein is described. With this technique the cellular yield is adequate and the internal jugular vein remains patent. This technique allows for high-density seeding in a single stage. In two-stage seeding the excellent yield of cells reduces the duration of in vitro endothelial cell culture and allows for secondary massive and early seeding.

[Chylothorax and chylous ascites following surgery of an inflammatory aortic aneurysm. Case report with review of the literature]. / Chylothorax et chyloperitoine après chirurgie d'un anévrysme aortique inflammatoire. Un cas avec revue de la littérature.

Chylous ascites complicating surgery on the abdominal aorta is infrequent: we report one case associated with right chylothorax, secondary to the surgical cure of an inflammatory aortic aneurysm. Surgery for aneurysms causes 81% of all chylous ascites caused by injuries to the intestinal lymphatics or to their recipients, the left latero-aortic lymph nodes or the cisterna chyli. Upper or extensive dissections of the retroperitoneal space and difficult dissection of ruptured or inflammatory aneurysms are the cisterna chyli. Upper or extensive dissections of the retroperitoneal space and difficult dissection of ruptured or inflammatory aneurysms are the major etiological factors. Stasis and fibrosis, then the rupture of the lymphatics into the aneurysmal wall were described during inflammatory aneurysm: this lymphatic etiology might explain the inflammatory character of these aneurysms and entail a risk of lymphoperitoneal fistula when laying the aneurysmal wall flat. An early diagnosis must be established with paracentesis before any compressive, metabolic, immunological or septic complications occur. Continuous parenteral feeding and selective paracenteses dry out 80% of the postoperative chylous ascites. If the ascites persists after 4 to 6 week's conservative treatment, a peritoneojugular derivation or a direct lymphostasis may be contemplated, according to the patient's condition.