Correction: CT-Angiographic Aspects of Pulmonary Embolism on SARS COV-2.

[This corrects the article DOI: 10.5334/jbsr.3021.].

Development of ELIP to Assess Physical Literacy for Emerging Adults: A Methodological and Epistemological Challenge.

Purpose: Following increased interest in physical literacy (PL), development of appropriate tools for assessment has become an important next step for its operationalization. To forward the development of such tools, the objective of this study was to build the foundations of the Évaluation de la Littératie Physique (ELIP), designed to help reduce existing tensions in approaches to PL assessment that may be resulting in a low uptake into applied settings. Methods: We followed two steps: (1) the development of the first version of ELIP by deploying a Delphi method (n = 30); and (2) the modification of items through cognitive interviews with emerging adults (n = 32). Results: The expert consensus highlighted four dimensions of PL to be assessed-physical; affective; cognitive; and social-with new perspectives, including a preference for broad motor tests over fitness. Conclusion: Results offer new insights into the assessment of emerging adults' PL, but ELIP still requires further work concerning validity, reliability, and sensitivity.

Aspects scanographiques de la pneumopathie à COVID-19 à Ouagadougou: Étude multicentrique à propos de 1017 cas.

OBJECTIVE: To study the chest CT profile of SARS-CoV-2 pneumonia in patients in the city of Ouagadougou. PATIENTS AND METHODS: descriptive cross-sectional study with retrospective collection of 1017 patients of both sexes. Included were patients aged 15 and over who had performed a chest CT scan without or with injection of contrast product, suspected or positive for COVID -19. The variables analyzed were: the history, the nature of the examination, the socio-demographic, clinical, CT data including the description of the tomodensitometric lesions and their characteristics, the extent of the parenchymal lesions according to the visual estimate of the French thoracic Imaging Society, complications, other lesions on the chest CT scan and CORADS classification. All parameters (age, sex on the one hand and clinical and CT findings on the other) were subjected to statistical analysis. RESULTS: The mean age of the patients was 56.95 years, predominantly male (1.47). Dyspnea was the most frequent symptomatology, at 46.26% (n = 506). Diabetes was the most common comorbidity with 29.37% (n = 94). Frosted glass opacity accounted for 90.95% of elementary lesions which were predominantly in plaque in 44.35% (n = 451), bilateral in (82.79%) and peripheral subpleural in (81.51%). The lower lobes were the most affected and postero-basal involvement predominant with greater involvement in the right lung. The extent was severe in 28.42% (n = 289). Thirty-nine point twenty-three (39.23)% or 399 of cases presented with complications dominated by pleural effusion at 56.39% (n = 225) and pulmonary embolism at 34.08% (n = 136 ). The lesions were classified as CORADS type in 815 CT reports. CORADS 5 type lesions were found in 47% of patients. Five hundred and ninety-two (592) PCRs of our patients were undetermined, in 58.21%. The PCR was positive in 342 cases or 33.63%. The bi- and multivariate analysis noted: a statistically significant link between the age and the extent of the lesions, between the extent of the lesions and the clinical context, between the extent of the lesions and comorbidities such as diabetes, Hypertension and renal failure. There was also a link between the PCR result and basic lesions such as ground glass and crazy paving and between the occurrence of pulmonary embolism and the presence of hypertension. DISCUSSION: The scanographic profile corresponded to that described in the literature. Frosted glass was the most common elementary lesion. The impairment was severe to critical in patients over 65 with comorbidity. CT angiography was the most requested in front of signs such as dyspnea and desaturation CONCLUSION: A study on CT specificities with precision on the onset of symptoms and the notion of vaccination would complement these results.

A Systematic Review and Meta-analysis of Social Skills Training for Adults with Autism Spectrum Disorder.

This systematic review and meta-analysis is the first to evaluate the effects of group-based social skills training (SST) on parent-report social responsiveness in adults with autism spectrum disorder (ASD). A total of 18 studies were included in the narrative review and among them five randomized-controlled trials (n = 145) were included in the meta-analysis. SST had large positive effects on social responsiveness. The narrative review identified that SST could improve patient's outcomes in adults with ASD. These results should be interpreted with caution due to the moderate quality of the existing evidence, which could have inflated effect sizes. The absence of active comparator control groups makes unclear whether improvements at post-treatment are treatment-specific or are attributable to common factors to all psychotherapies.

Stigma resistance is associated with advanced stages of personal recovery in serious mental illness patients enrolled in psychiatric rehabilitation.

BACKGROUND: Stigma resistance (SR) is defined as one's ability to deflect or challenge stigmatizing beliefs. SR is positively associated with patient's outcomes in serious mental illness (SMI). SR appears as a promising target for psychiatric rehabilitation as it might facilitate personal recovery. OBJECTIVES: The objectives of the present study are: (i) to assess the frequency of SR in a multicentric non-selected psychiatric rehabilitation SMI sample; (ii) to investigate the correlates of high SR. METHODS: A total of 693 outpatients with SMI were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluation included standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, and personal recovery and a large cognitive battery. SR was measured using internalized stigma of mental illness - SR subscale. RESULTS: Elevated SR was associated with a preserved executive functioning, a lower insight into illness and all recovery-related outcomes in the univariate analyses. In the multivariate analysis adjusted by age, gender and self-stigma, elevated SR was best predicted by the later stages of personal recovery [rebuilding; p = 0.004, OR = 2.89 (1.36-4.88); growth; p = 0.005, OR = 2.79 (1.30-4.43)). No moderating effects of age and education were found. CONCLUSION: The present study has indicated the importance of addressing SR in patients enrolled in psychiatric rehabilitation. Recovery-oriented psychoeducation, metacognitive therapies and family interventions might improve SR and protect against insight-related depression. The effectiveness of psychiatric rehabilitation on SR and the potential mediating effects of changes in SR on treatment outcomes should be further investigated in longitudinal studies.

[Status of obstetrical echography at the imaging service of the University Hospital Center of Bogodogo from January 1st, 2016 to December 31st, 2018]. / État des lieux des échographies obstétricales au service d'imagerie du Centre Hospitalier Universitaire Bogodogo du 1er janvier 2016 au 31 décembre 2018.

Obstetric ultrasound performed according to standards from its prescription to the report is a guarantee of quality. The aim of our study was to take stock of obstetrical ultrasounds in order to make rational the ultrasound follow-ups of pregnancy. This was a descriptive cross-sectional study with retrospective data collection through the reports of obstetrical ultrasounds performed from the 1st January 2016 to 31st December 2018. Of the 13,487 ultrasounds in the study period, 2,355 were obstetric ultrasounds, constituting 1746% of the ultrasound activity. The mean gestational age was 27.54 years (± 6.19). The CHU Bogodogo was the requesting structure for 86.88%. Paramedics were prescribers in 66.47%. Third trimester ultrasounds made up 57.06%. Gestational age in 12.99% was greater than 37 weeks while in 66.37% gestational age was greater than 24 weeks. Prenatal follow-up was indicated in 54.48%. Pregnancies were progressive in 97.49%. Twin pregnancies represent 2.72% and ultrasound pathological pregnancies 11.80%. Obstetric Doppler was performed in 2.12% with pre-eclampsia as the main indication (52%). There was 1.18% malformation with nervous system involvement in 60.71%. Through this inventory, the training of prescribers of obstetric ultrasound appears essential. The establishment of an observatory of obstetric ultrasound practices would be an asset for the quality of these medical examinations.

Being parent is associated with suicidal history in people with serious mental illness enrolled in psychiatric rehabilitation.

Parenting is a central life experience that could promote recovery in people with Serious Mental Illness (SMI). It could also be challenging for parents with SMI and result in poor recovery-related outcomes. Parenting is often overlooked in psychiatric rehabilitation. The objectives of the present study were to identify the characteristics and needs for care of mothers and fathers with SMI enrolled in a multicentric non-selected psychiatric rehabilitation SMI sample. We consecutively recruited 1436 outpatients from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). The evaluation included standardized scales for clinical severity, psychosocial function, quality of life and satisfaction with life, wellbeing, personal recovery and a broad cognitive battery. We found that parenting was associated to suicidal history in mothers and fathers with SMI. In the multivariate analysis, being mother was best explained by insight (p < 0.015, adjusted OR = 0.76 [0.59-0.90]), current age (p < 0.001, aOR = 1.13 [1.07-1.21]), education level (p = 0.008; aOR = 0.12 [0.02-0.53]) and family accommodation (p = 0.046, aOR = 0.19 [0.03-0.84]). Being father was best explained by suicidal history (p = 0.005, aOR = 3.85 [1.51-10.10]), marital status (in relationship, p < 0.001; aOR = 7.81 [2.73-23.84]), satisfaction with family relationships (p = 0.032, aOR = 1.22 [1.02-1.47]) and current age (p < 0.001, aOR = 1.16 [1.10-1.23]). In short, parenting was associated to increased history of suicide attempt in mothers and fathers with SMI. Mothers and fathers with SMI may have unique treatment needs relating to parenting and recovery-related outcomes. The implementation of interventions supporting the needs of parents with SMI in psychiatric rehabilitation services could improve parent and children outcomes.

Cognitive remediation and professional insertion of people with schizophrenia: RemedRehab, a randomized controlled trial.

BACKGROUND: People suffering from schizophrenia cannot easily access employment in European countries. Different types of vocational programs coexist in France: supported employment, sheltered employment (ShE), and hybrid vocational programs. It is now acknowledged that the frequent cognitive impairments constitute a major obstacle to employment for people with schizophrenia. However, cognitive remediation (CR) is an evidence-based nonpharmacological treatment for these neurocognitive deficits. METHODS: RemedRehab was a multicentric randomized comparative open trial in parallel groups conducted in eight centers in France between 2013 and 2018. Participants were recruited into ShE firms before their insertion in employment (preparation phase). They were randomly assigned to cognitive training Cognitive Remediation for Schizophrenia (RECOS) or Treatment As Usual (TAU). The aim of the study was to compare with the benefits of the RECOS program on access to employment and work attendance for people with schizophrenia, measured by the ratio: number of hours worked on number of hours stipulated in the contract. RESULTS: Seventy-nine patients were included in the study between October 2018 and September 2019. Fifty-three patients completed the study. Hours worked / planned hours equal to 1 or greater than 1 were significantly higher in the RECOS group than in the TAU group. CONCLUSIONS: Participants benefited from a RECOS individualized CR program allows a better rate of work attendance in ShE, compared to the ones benefited from TAU. Traditional vocational rehabilitation enhanced with individualized CR in a population of patients with schizophrenia is efficient on work attendance during the first months of work integration.

Narrative enhancement and cognitive therapy (NECT) to improve social functioning in people with serious mental illness: study protocol for a stepped-wedge cluster randomized controlled trial.

BACKGROUND: Self-stigma is highly prevalent in serious mental illness (SMI) and is associated with poorer clinical and functional outcomes. Narrative enhancement and cognitive therapy (NECT) is a group-based intervention combining psychoeducation, cognitive restructuring and story-telling exercises to reduce self-stigma and its impact on recovery-related outcomes. Despite evidence of its effectiveness on self-stigma in schizophrenia-related disorders, it is unclear whether NECT can impact social functioning. METHODS: This is a 12-centre stepped-wedge cluster randomized controlled trial of NECT effectiveness on social functioning in SMI, compared to treatment as usual. One hundred and twenty participants diagnosed with schizophrenia, bipolar disorder or borderline personality disorder will be recruited across the 12 sites. The 12 centres participating to the study will be randomized into two groups: one group (group 1) receiving the intervention at the beginning of the study (T0) and one group (group 2) being a control group for the first 6 months and receiving the intervention after (T1). Outcomes will be compared in both groups at T0 and T1, and 6-month and 12-month outcomes for groups 1 and 2 will be measured without a control group at T2 (to evaluate the stability of the effects over time). Evaluations will be conducted by assessors blind to treatment allocation. The primary outcome is personal and social performance compared across randomization groups. Secondary outcomes include self-stigma, self-esteem, wellbeing, quality of life, illness severity, depressive symptoms and personal recovery. DISCUSSION: NECT is a promising intervention for reducing self-stigma and improving recovery-related outcomes in SMI. If shown to be effective in this trial, it is likely that NECT will be implemented in psychiatric rehabilitation services with subsequent implications for routine clinical practice. TRIAL REGISTRATION: ClinicalTrials.gov NCT03972735 . Trial registration date 31 May 2019.

Epidemiological changes in cutaneous lymphomas: an analysis of 8593 patients from the French Cutaneous Lymphoma Registry.

BACKGROUND: Primary cutaneous lymphomas (PCLs) are a heterogeneous group of T-cell (CTCL) and B-cell (CBCL) malignancies. Little is known about their epidemiology at initial presentation in Europe and about potential changes over time. OBJECTIVES: The aim of this retrospective study was to analyse the frequency of PCLs in the French Cutaneous Lymphoma Registry (GFELC) and to describe the demography of patients. METHODS: Patients with a centrally validated diagnosis of primary PCL, diagnosed between 2005 and 2019, were included. RESULTS: The calculated incidence was unprecedently high at 1·06 per 100 000 person-years. The number of included patients increased yearly. Most PCL subtypes were more frequent in male patients, diagnosed at a median age of 60 years. The relative frequency of rare CTCL remained stable, the proportion of classical mycosis fungoides (MF) decreased, and the frequency of its variants (e.g. folliculotropic MF) increased. Similar patterns were observed for CBCL; for example, the proportion of marginal-zone CBCL increased over time. CONCLUSIONS: Changes in PCL frequencies may be explained by the emergence of new diagnostic criteria and better description of the entities in the most recent PCL classification. Moreover, we propose that an algorithm should be developed to confirm the diagnosis of PCL by central validation of the cases.

Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort.

BACKGROUND: Self-stigma is a major issue in serious mental illness (SMI) and is negatively associated with patient outcomes. Most studies have been conducted in schizophrenia (SZ). Less is known about self-stigma in other SMI and autism spectrum disorder (ASD). The objectives of this study are: (i) to assess the frequency of self-stigma in a multicentric nonselected psychiatric rehabilitation SMI and ASD sample; and (ii) to investigate the correlates of elevated self-stigma in different SMI conditions and in ASD. METHODS: A total of 738 SMI or ASD outpatients were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluations included sociodemographic data, illness characteristics, and standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, personal recovery, a large cognitive battery, and daily functioning assessment. RESULTS: 31.2% of the total sample had elevated self-stigma. The highest prevalence (43.8%) was found in borderline personality disorder and the lowest (22.2%) in ASD. In the multivariate analysis, elevated self-stigma was best predicted by early stages of personal recovery (moratorium, p = 0.001, OR = 4.0 [1.78-8.98]; awareness, p = 0.011, OR = 2.87 [1.28-6.44]), history of suicide attempt (p = 0.001, OR = 2.27 [1.37-3.76]), insight (p = 0.002, OR = 1.22 [1.08-1.38]), wellbeing (p = 0.037, OR = 0.77 [0.60-0.98]), and satisfaction with interpersonal relationships (p < 0.001, OR = 0.85 [0.78-0.93]). CONCLUSIONS: The present study has confirmed the importance of addressing self-stigma in SMI and ASD patients enrolled in psychiatric rehabilitation. The effectiveness of psychiatric rehabilitation on self-stigma and the potential mediating effects of changes in self-stigma on treatment outcomes should be further investigated.

[Impact of therapeutic advice on prescription of psychotropics for patients with serious mental illness]. / Impact sur la prescription de psychotropes des conseils thérapeutiques formalisés dans un centre référent de réhabilitation psychosociale.

INTRODUCTION: The improvement of prescription constitutes a major challenge for public health. In France, medication is the third cause of serious adverse reaction. The report of the Parliamentary Commission for Evaluation of Health Policy on adequate use of psychotropics mentions their overconsumption. Promoting practices' dissemination and guidelines' respect is one of the missions of the referral psychosocial rehabilitation centers. Therapeutic advice that is offered consists of suggestions for revision in the patient's treatment with the aim of improving the patient's health. To our knowledge, to date no study has focused on the evaluation of therapeutic advice in psychiatry. The present study aimed at analyzing benefits of therapeutic advice for the patients. To this end: (1) a state of things related to actual practices was carried out: psychotropics prescriptions' problems and therapeutic advice proposed by psychiatrists (quantitative and qualitative assessment); (2) the impact of advice on prescription was assessed; (3) patients' benefits were identified. METHOD: This monocentric trial was carried out at the referral psychosocial rehabilitation center of Lyon. This audit was a retrospective observation of electronic medical records (software CortexteNet V2.6). This project was developed by a multidisciplinary staff (pharmacists and psychiatrists) during summer 2015. All patients treated in this center between September 2010 and December 2014 were included. The collection of data was made by two auditors (pharmacist students) thanks to a collection grid with six parts: identification and epidemiology of patients with therapeutic advice, coding tips, benefits, quantitative and qualitative assessment of prescriptions before and after advice. RESULTS: Of the 601 records explored during this study, 66 advices (8.3% of patients) were identified. Patients concerned by therapeutic advice were mainly men with schizophrenia between 35 and 40 years, living in a town and addressed by public psychiatrists. Advice was taken into account in 81.7%, partially in 8.1%, and was beneficial in 97%. The main benefits were clinical improvement (48.5%) and reduction of adverse drug events (36.4%). There were no statistically significant differences between prescriptions (quantitatively and qualitatively) before and after therapeutic advice. CONCLUSION: In most cases, prescriptions of psychotropics were adequate since only 66 advices (8.3% of patients) were given. Psychosocial rehabilitation centers give medication prescribing advice and promote respect of the guidelines. The collaboration between rehabilitation's psychiatrists and other psychiatrists optimizes patient management. It reduces iatrogenic disorders and improves quality and safety of care. Very few studies deal with the prescription of psychotropics in adult psychiatry. This work highlights the positive effect of therapeutic advice for this population. Further controlled studies should clarify the benefits of therapeutic advice.

T-cell papulosis associated with B-cell malignancy: a distinctive clinicopathologic entity.

BACKGROUND: A distinctive eruption referred to as 'insect bite-like reaction' or 'eosinophilic dermatosis of haematological malignancy' has been described during the course of haematological B-cell malignancies (BCM). However, its clinical evolution, histopathological features and pathogenesis remain unclear. OBJECTIVES: To characterize this eruption and to investigate its pathogenesis and relationship with the underlying BCM. METHODS: In this multicenter retrospective study of the French Study Group on Cutaneous Lymphomas, 37 patients with a BCM and a cutaneous eruption consisting in chronic and/or recurrent papules, papulo-vesicles and/or nodules were included. Clinical, histopathological, immunohistochemical and molecular data were reviewed. RESULTS: No significant insect bite history or seasonal predominance was recorded. Patients had pruritic papules (81%), papulo-vesicles (43%) and nodules (38%), often predominated in the head and neck region (84%), without complete remission periods in most cases (57%). The predominant associated BCM was chronic lymphocytic leukaemia (73%). Histological and immunohistochemical review showed a dense dermal lymphocytic infiltrate predominantly composed of T lymphocytes (100%), with frequent eosinophils (77.6%); a perivascular and periadnexal (most often folliculotropic) pattern (77.6%), sometimes suggestive of a folliculotropic mycosis fungoides; clusters of tumour B cells were identified in 47% of cases using appropriate phenotyping markers. In 10/14 cases (71.4%) tested for B-cell IgH gene rearrangement, a B-cell clone was identified in skin lesions (identical to the blood clone in nine cases), whereas no T-cell clone was present. CONCLUSION: We propose the denomination 'T-cell papulosis associated with B-cell malignancy' (TCP-BCM) for this distinctive eruption. Although resulting in various histopathological pictures, it can be easily recognized by clinicians and may be identified by informed pathologists relying on some key features. An extravasation of tumour B cells with skin-homing properties associated with a secondary, predominant, T-cell immune reaction could explain the clinicopathologic aspect and the prolonged regressive and recurrent course of the disease.

Anaplastic Kaposi's sarcoma: 5 cases of a rare and aggressive type of Kaposi's sarcoma.

BACKGROUND: Anaplastic Kaposi's sarcoma (KS) is a rare form of KS characterized clinically by the development of a tumour mass with unusual local aggressiveness and histologically by a specific architecture and cytological morphology. A very small number of limited series in endemic countries have established characteristics common to these anaplastic forms of KS. We present five patients with an anaplastic form in a context of KS ongoing for several years in a non-endemic country. MATERIALS AND METHODS: We collected 5 cases of anaplastic KS followed in our department over a period of 20years. We describe the main developmental, clinical, virological and histological features. RESULTS: The cases involved 4 men and 1 woman whose mean age at diagnosis of anaplastic KD was 70years, with an average time of 25years between initial diagnosis of KD and anaplastic transformation. Our patients were all treated with chemotherapy and/or radiotherapy (RT) prior to diagnosis of anaplastic transformation. All patients had a tumour mass of the lower limbs developing in classically indolent KS with associated chronic lymphoedema. Progression was very aggressive locally with deep invasion of the soft tissues as well as osteoarticular involvement, without visceral dissemination. At present, three patients are dead, one patient is showing partial response, and one patient is in locoregional progression. Diagnosis of the disease was based on histopathological findings. The tumour cells were undifferentiated, pseudo-cohesive, and chiefly organized in sheets. The mitotic count was high (27 mitoses per 10 fields at high magnification). Necrosis was constant. DISCUSSION: To our knowledge, this is the first series describing anaplastic Kaposi's sarcoma in a non-endemic country. The severity of the prognosis, despite the absence of visceral dissemination, is related to the local aggressiveness of anaplastic KS and to its resistance to radiotherapy and chemotherapy, with amputation being required in certain cases.