Cervical Dysplasia and Treatments Barrier in Jail: A Study in Marseille's Detention Center-Les Baumettes, France.

Introduction: The main objective was to estimate the prevalence of cervical dysplasia among incarcerated women. The secondary objective was to identify obstacles to the possible management of a cervical dysplasia in detention by assessing their knowledge of screening for cervical cancer (CC), the existence of vaccination, and the management of precancerous lesions. Materials and Methods: The first part of the study was descriptive and retrospective, studying pap-smear results in women's correctional facility at the Baumettes prison center (PC) in Marseille, France. The second part of the study was qualitative and prospective and took place at the Baumettes PC. Voluntary and French-speaking inmates aged 25-65 years answered an short-form 12 quality-of-life questionnaire and a more targeted questionnaire on CC screening and cervical dysplasia treatments. Results: In total, 201 pap-smear tests were assessed, 135 were normal (66.8%) and 33 unsatisfactory (16.3%). There were 33 abnormal pap-smear tests (16%). The patients were 38.9 years (±9.5 years), had 4.05 pregnancies (±2.7), and 2.29 children (±1.85). Seventy-five percent were smokers. Psychiatric disorders were found in 52.2% inmates. In the second part of the study, among the 35 inmates questioned, the SF-12 questionnaire's analysis shows that the physical health component score was on average 43.6 and the mental health component score (MCS) was 36.5. Analysis demonstrated that the uncertainty of the exact day of hospitalization is an obstacle to treatment for 15 patients presenting significantly a lower MCS score (p = 0.047). Conclusion: Prevalence of pathological pap-smear tests is higher within a prison population, screening is accepted and the inmates are receptive to information about CC prevention, delivered during individual interviews. Mental health's management and care system's reorganization in detention are essentials factors for care acceptance.

Usefulness of polymerase chain reaction for diagnosing Whipple's disease in rheumatology.

OBJECTIVES: To determine when Tropheryma whipplei polymerase chain reaction (PCR) is appropriate in patients evaluated for rheumatological symptoms. METHODS: In a retrospective observational study done in rheumatology units of five hospitals, we assessed the clinical and radiological signs that prompted T. whipplei PCR testing between 2010 and 2014, the proportion of patients diagnosed with Whipple's disease, the number of tests performed and the number of diagnoses according to the number of tests, the patterns of Whipple's disease, and the treatments used. Diagnostic ascertainment was based on 1- Presence of at least one suggestive clinical finding; 2- at least one positive PCR test, and 3- a response to antibiotic therapy described by the physician as dramatic, including normalization of C Reactive Protein. RESULTS: At least one PCR test was performed in each of 267 patients. Rheumatic signs were peripheral arthralgia (n = 239, 89%), peripheral arthritis (n = 173, 65%), and inflammatory back pain (n = 85, 32%). Whipple's disease was diagnosed in 13 patients (4.9%). The more frequently positive tests were saliva and stool. In the centres with no diagnoses of Whipple's disease, arthritis was less common and constitutional symptoms more common. The group with Whipple's disease had a higher proportion of males, older age, and greater frequency of arthritis. The annual incidence ranged across centres from 0 to 3.6/100000 inhabitants. CONCLUSION: Males aged 40-75 years with unexplained intermittent seronegative peripheral polyarthritis, including those without constitutional symptoms, should have T. whipplei PCR tests on saliva, stool and, if possible, joint fluid.

CMT4D (NDRG1 mutation): genotype-phenotype correlations.

Charcot-Marie-Tooth (CMT) disease is a heterogeneous condition with a large number of clinical, electrophysiological and pathological phenotypes. More than 40 genes are involved. We report a child of gypsy origin with an autosomal recessive demyelinating phenotype. Clinical data, familial history, and electrophysiological studies were in favor of a CMT4 sub-type. The characteristic N-Myc downstream-regulated gene 1 (NDRG1) mutation responsible for this CMT4D phenotype was confirmed: p.R148X. The exact molecular function of the NDRG1 protein has yet to be elucidated.