[Using cancer case identification algorithms in medico-administrative databases: Literature review and first results from the REDSIAM Tumors group based on breast, colon, and lung cancer]. / Recherche d'algorithmes d'identification des cancers dans les bases médico-administratives : premiers résultats des travaux du groupe REDSIAM Tumeurs sur les cancers du sein, du côlon-rectum et du poumon.

BACKGROUND: The development and use of healthcare databases accentuates the need for dedicated tools, including validated selection algorithms of cancer diseased patients. As part of the development of the French National Health Insurance System data network REDSIAM, the tumor taskforce established an inventory of national and internal published algorithms in the field of cancer. This work aims to facilitate the choice of a best-suited algorithm. METHOD: A non-systematic literature search was conducted for various cancers. Results are presented for lung, breast, colon, and rectum. Medline, Scopus, the French Database in Public Health, Google Scholar, and the summaries of the main French journals in oncology and public health were searched for publications until August 2016. An extraction grid adapted to oncology was constructed and used for the extraction process. RESULTS: A total of 18 publications were selected for lung cancer, 18 for breast cancer, and 12 for colorectal cancer. Validation studies of algorithms are scarce. When information is available, the performance and choice of an algorithm are dependent on the context, purpose, and location of the planned study. Accounting for cancer disease specificity, the proposed extraction chart is more detailed than the generic chart developed for other REDSIAM taskforces, but remains easily usable in practice. CONCLUSIONS: This study illustrates the complexity of cancer detection through sole reliance on healthcare databases and the lack of validated algorithms specifically designed for this purpose. Studies that standardize and facilitate validation of these algorithms should be developed and promoted.

Force normalization in paraplegics.

The principal aim of our study was the determination of the effectiveness of a standardized ratio, allometric scaling model and a gamma function model in normalizing the isometric torque data of spinal cord patients and healthy subjects. For this purpose we studied a sample of 21 healthy males and 23 spinal cord injury males. The experiment consisted of the measurement of the force of the upper limb movement executed by all the subjects. We also determined anthropometric variables with dual-energy x-ray absorptiometry. The experimental data were analyzed with 3 force normalization methods. Our results indicate that the most important confounding variable was the fat free mass of the dominant upper limb (r>0.36, p<0.05). With the standardization by body mass and allometric scaling model, the normalized torque was influenced by body size variables. However, the normalized torque by the gamma function model was independent of body size measures. Paraplegics were weaker (p<0.05) in extension movements when the data were normalized by the gamma function model. In summary, this study shows that the gamma function model with fat free mass of the dominant upper limb was more effective than the standardized ratio in removing the influence of body size variables.

A comparison of elastic tubing and isotonic resistance exercises.

The aim of this study was to assess effects of a short-term resistance program on strength in fit young women using weight machines/free weights or elastic tubing. 42 physically fit women (21.79±0.7 years) were randomly assigned to the following groups: (i) the Thera-Band (®) Exercise Station Group (TBG); (ii) the weight machines/free weights group (MFWG); or (iii) the control group (CG). Each experimental group performed the same periodised training program that lasted for 8 weeks, with 2-4 sessions per week and 3-4 sets of 8-15 submaximal reps. A load cell (Isocontrol; ATEmicro, Madrid, Spain) was used to test the evolution of the Maximum Isometric Voluntary Contraction (MIVC) in 3 different exercises: Vertical Rowing (VR), Squat (S) and Back Extension (BE). A mixed model MANOVA [group (CG, TBG, MFWG) x testing time (pre-test, post-test)] was applied to determine the effect of the different resistance training devices on strength. The only groups to improve their MIVC (p<0.005) were TBG and MFWG, respectively: VR 19.87% and 19.76%; S 14.07 and 28.88; BE 14.41% and 14.00%. These results indicate that resistance training using elastic tubing or weight machines/free weights have equivalent improvements in isometric force in short-term programs applied in fit young women.

Management of goat reproduction and insemination for genetic improvement in France.

Reproductive seasonality observed in all breeds of goats originating from temperate latitudes and in some breeds from subtropical latitudes can now be controlled by artificial changes in photoperiod. Short days stimulate sexual activity, while long days inhibit it. This knowledge has allowed the development of photoperiodic treatments to control sexual activity in goats, for both the buck and doe. In the French intensive milk production system, goat AI plays an important role to control reproduction and, in conjunction with progeny testing, to improve milk production. Most dairy goats are inseminated out of the breeding season with deep frozen semen, after induction of oestrus and ovulation by hormonal treatments. This protocol provides a kidding rate of approximately 65%. New breeding strategies have been developed, based on the buck effect associated with AI, to reduce the use of hormones. With the development of insemination with frozen semen, a classical selection programme was set up, including planned mating, progeny testing and the diffusion of proved sires by inseminations in herds. Functional traits have become important for efficient breeding schemes in the dairy goat industries. Based on knowledge gained over the past decade, the emphasis in selective breeding has been placed on functional traits related to udder morphology and health. New windows have been opened based on new molecular tools, allowing the detection and mapping of genes of economic importance.

Validación psicométrica de la batería UNIPSICO en valenciano/catalán: análisis de las escalas que evalúan las variables psicosociales de demanda / Psychometric validation of the UNIPSICO questionnaire in Valencian/Catalan language: analysis of the scales evaluating psychosocial demand variables

Objetivo: Analizar las propiedades psicométricas de las escalas de demandas de la batería UNIPSICO del contexto de trabajo en valenciano/catalán.Método: La muestra la constituyen 2114 trabajadores de centros públicos de la Generalitat Valenciana, de la provincia de Valencia. La recogida de datos se realizó mediante las esca-las de la batería UNIPSICO que evalúan factores psicosociales de demandas en el trabajo (33 ítems), que se agrupan en 6 escalas: Conflicto de rol (5 ítems), ambigüedad de rol (5 ítems), carga de trabajo (6 ítems), conflictos interpersonales (6 ítems), inequidad en los intercambios sociales (5 ítems), y conflicto trabajo-familia/familia-trabajo (6 ítems). Se rea-lizó un análisis factorial confirmatorio (AFC) y se calcularon los valores alfa de Cronbach y omega de McDonald para las escalas.Resultados: Todos los ítems presentaron valores estadísticos y psicométricos adecuados. El modelo de seis factores que reproduce la estructura original del cuestionario presentó un ajuste adecuado a los datos, con invarianza de sexo. El valor del alfa de Cronbach y omega de McDonald resultó aceptable para las seis escalas del instrumento.Conclusiones: Estos resultados contribuyen a la validación psicométrica del cuestionario, permitiendo concluir que las escalas de demandas de la batería UNIPSICO, en valenciano/catalán resulta un instrumento fiable y con consistencia interna para evaluar los riesgos psicosociales en personal que trabaja en la administración (AU)

Aim: To analyse the psychometric properties of the demand scales of the UNIPSICO ques-tionnaire in in Valencian / Catalan language.Method: The sample consisted of 2114 participants from public administration centres of Generalitat Valenciana in Valencia. Data were collected using the UNIPSICO questionnaire, which is grouped into six scales that measure psychosocial risk factors related to job de-mands (33 items): role conflict (5 items), role ambiguity (5 items), workload (6 items), in-terpersonal conflicts (6 items), inequity in social exchanges (5 items), and work-family and family-work conflict (6 items). We performed confirmatory factor analysis (CFA) and mea-sured Cronbach alpha and McDonald omega coefficients for the scales.Results: All items had adequate statistical and psychometric values. The six-factor model that reproduces the original structure of the questionnaire presented an adequate fit to the data, and gender invariance. The Cronbach alpha and McDonald omega coefficients were acceptable for the six scales of the instrument.Conclusions: These results contribute to the psychometric validation of the questionnaire and allow us to conclude that the demand scales of the UNIPSICO questionnaire translated to Valencian / Catalan language are reliable and possess construct validity for the assess-ment of psychosocial risk factors in government employees (AU)

[Stem cells for the treatment of hearing loss]. / Células madre en el tratamiento de la sordera.

One of the greatest challenges in the treatment of inner ear disorders is to find a cure for the hearing loss caused by the loss of cochlear hair cells or spiral ganglion neurons. The recent discovery of stem cells in the adult inner ear that are capable of differentiating into hair cells, as well as the finding that embryonic stem cells can be converted into hair cells, raise hope for the future development of stem-cell-based treatments.

Impact of density-dependent migration flows on epidemic outbreaks in heterogeneous metapopulations.

We investigate the role of migration patterns on the spread of epidemics in complex networks. We enhance the SIS-diffusion model on metapopulations to a nonlinear diffusion. Specifically, individuals move randomly over the network but at a rate depending on the population of the departure patch. In the absence of epidemics, the migration-driven equilibrium is described by quantifying the total number of individuals living in heavily or lightly populated areas. Our analytical approach reveals that strengthening the migration from populous areas contains the infection at the early stage of the epidemic. Moreover, depending on the exponent of the nonlinear diffusion rate, epidemic outbreaks do not always occur in the most populated areas as one might expect.

Bacterial histidine kinases as novel antibacterial drug targets.

Bacterial histidine kinases (HKs) are promising targets for novel antibacterials. Bacterial HKs are part of bacterial two-component systems (TCSs), the main signal transduction pathways in bacteria, regulating various processes including virulence, secretion systems and antibiotic resistance. In this review, we discuss the biological importance of TCSs and bacterial HKs for the discovery of novel antibacterials, as well as published TCS and HK inhibitors that can be used as a starting point for structure-based approaches to develop novel antibacterials.

[Care for patients with altered states of consciousness in a hospital for chronic and long-stay patients]. / Atencion a pacientes con estados alterados de conciencia en un hospital de pacientes cronicos y larga estancia.

INTRODUCTION: Between 30% and 40% of patients with brain damage present alterations in their level of consciousness and, in some cases, altered states of consciousness: unresponsive wakefulness syndrome (UWS) or minimally conscious state (MCS). Recovery varies and survival is threatened by a number of complications. AIMS: The purpose of this study is to present the working methodology used at the Hospital La Pedrera (HLP) for patients in UWS or MCS and to analyse the clinical characteristics of the patients attended to, their progress, and the functional and cognitive situation at the time of their discharge from hospital. PATIENTS AND METHODS: The work consisted in a prospective descriptive study of patients seen at the HLP over the period 2009-2013, who had been diagnosed with UWS or MCS. RESULTS: The HLP uses the case management method, offering integrated care dispensed by a multidisciplinary team. Patients are classified according to healthcare goals. Patients with UWS or MCS are included in the integrated care and adaptation programme. A total of 23 patients (86.9% males) were attended to, the mean age being 54.9 years. Aetiology: brain haemorrhage, 30.4%; anoxic encephalopathy, 26.6%; metabolic encephalopathy, 17.3%; and other causes, 17.3%. Altogether 73.9% were admitted in UWS and the rest in MCS. COURSE: 43.4% improved their initial cognitive situation and 88.8% presented a situation of total dependence at the time of discharge. The most frequent complications were respiratory and urinary infections (53.6%). Death occurred in 65.2% of cases. CONCLUSIONS: Medical attention in UWS or MCS is complex and requires multidisciplinary care. Almost half of the patients improved their cognitive situation, which justifies a proactive attitude that attempts to improve the quality of life of both patients and their families.

TITLE: Atencion a pacientes con estados alterados de conciencia en un hospital de pacientes cronicos y larga estancia.Introduccion. Un 30-40% de los pacientes con daño cerebral presenta alteraciones del nivel de conciencia, y algunos casos, estados alterados de conciencia: sindrome de vigilia sin respuesta (SVSR) o estado de minima conciencia (EMC). La recuperacion es variable y la supervivencia esta amenazada por multiples complicaciones. Objetivos. Presentar la metodologia de trabajo del Hospital La Pedrera (HLP) para pacientes en SVSR o EMC y analizar las caracteristicas clinicas de los pacientes atendidos, la evolucion, y la situacion funcional y cognitiva en el momento del alta. Pacientes y metodos. Estudio descriptivo prospectivo de pacientes atendidos en el HLP durante el periodo 2009-2013, con diagnostico de SVSR o EMC. Resultados. El HLP trabaja mediante el metodo gestion de caso, ofreciendo una atencion integral por un equipo multidisciplinar. Los pacientes se clasifican segun objetivos asistenciales. Los pacientes con SVSR o EMC se incluyen en el programa de cuidados integrales y adaptacion. Se atendio a 23 pacientes (86,9% varones), con una edad media de 54,9 años. Etiologia: hemorragia cerebral, 30,4%; encefalopatia anoxica, 26,6%; encefalopatia metabolica, 17,3%; y otras causas, 17,3%. El 73,9% ingreso en SVSR y el resto en EMC. Evolucion: el 43,4% mejoro su situacion cognitiva inicial y el 88,8% presentaba una situacion de dependencia total en el momento del alta. Las complicaciones mas frecuentes fueron infecciones respiratorias y urinarias (53,6%). El 65,2% de los casos fueron exitus. Conclusiones. La asistencia en SVSR o EMC es compleja y precisa cuidados multidisciplinares. Casi la mitad de los pacientes mejoro su situacion cognitiva, lo que justifica una actitud proactiva que intente mejorar la calidad de vida de los pacientes y sus familias.

Mobility and the spread of human immunodeficiency virus into rural areas of West Africa.

BACKGROUND: In eastern and southern Africa, the human immunodeficiency virus (HIV) epidemic appeared first in urban centres and then spread to rural areas. Its overall prevalence is lower in West Africa, with the highest levels still found in cities. Rural areas are also threatened, however, because of the population's high mobility. We conducted a study in three different communities with contrasting infection levels to understand the epidemiology of HIV infection in rural West Africa. METHOD: A comparative cross-sectional study using a standardized questionnaire and biological tests was conducted among samples in two rural communities of Senegal (Niakhar and Bandafassi, 866 and 952 adults, respectively) and a rural community of Guinea-Bissau (Caio, 1416 adults). We compared the distribution of population characteristics and analysed risk factors for HIV infection in Caio at the individual level. RESULTS: The level of HIV infection was very low in Niakhar (0.3%) and Bandafassi (0.0%), but 10.5% of the adults in Caio were infected, mostly with HIV type 2 (HIV-2). Mobility was very prevalent in all sites. Short-term mobility was found to be a risk factor for HIV infection among men in Caio (adjusted odds ratio (aOR) = 2.06; 95% CI: 1.06-3.99). Women from Caio who reported casual sex in a city during the past 12 months were much more likely to be infected with HIV (aOR = 5.61 95% CI: 1.56-20.15). Short-term mobility was associated with risk behaviours at all sites. CONCLUSIONS: Mobility appears to be a key factor for HIV spread in rural areas of West Africa, because population movement enables the virus to disseminate and also because of the particularly risky behaviours of those who are mobile. More prevention efforts should be directed at migrants from rural areas who travel to cities with substantial levels of HIV infection.

In vitro fertilization of pig oocytes after different coincubation intervals.

The effects of gamete coincubation time on porcine in vitro fertilization for 4, 6 or 8 hours in Trial 1 or for 1, 2, 3 or 4 hours in Trial 2 were studied. The 876 oocytes were recovered from oviducts of prepubertal gilts. Ovulation was induced. Excessive spermatozoa attached to zona pellucida were removed by pippeting after coincubation (1 to 8 hours). Optimum results were obtained after 3 to 4 hours of coincubation, when 23 to 29% of the oocytes were fertilized by a single spermatozoa. Shorter intervals of coincubation were characterized by reduced percentages of fertilized oocytes and longer intervals of coincubation by increased rates of polyspermic fertilization. The employed sperm concentration was deliberately high (2 x 10(6) sperm/ml). The results show that a coincubation time of 4 hours may be optimal for pig in vitro fertilization. Under these assay conditions, modification of other factors such as sperm concentration, medium volume and physiological environment may increase the percentage of monospermic fertilization.

Balance in children with otitis media with effusion.

To determine the presence of balance disorders in young children who had otitis media with effusion (OME), 25 subjects, aged 13-57 months, diagnosed by pediatric otolaryngologists, were tested on the gross motor subtest of the Peabody Developmental Motor Scales, a standardized test of motor development with established norms. Parents also filled out questionnaires about their children's balance skills. Subjects with unilateral disease did not differ significantly from normals. Subjects with bilateral disease, however, were significantly impaired compared to normals on balance, locomotion and total score and they were significantly impaired compared to unilateral subjects on all scores. Parental perceptions of their children's balance correlated poorly with the test results. These data suggest that young children with bilateral otitis media with effusion are delayed in developing motor skills that require dynamic balance. Therefore, in spite of a negative history for balance problems physicians should consider balance performance when developing a treatment plan. Children with balance impairments might benefit from more aggressive intervention.

Finding of a bullet in the cervical column of a body hit by a train.

This case is about the finding of a body of an unidentified male of approximately 70 years of age who was hit by a train. During the carrying out of the corresponding autopsy and after the radiological tests for posterior odontological identification, a foreign body of a cylindrical-cone shape, identical to that of a bullet, was found lodged between the first and second cervical vertebrae. During dissection of the neck, a bullet was found. When the ballistic test was carried out, it was ascertained that the bullet was from a cartridge of 7.92 by 57-mm Mauser caliber, manufactured in Spain in 1936. This ammunition corresponds to that used during the Civil War in Spain (1936-1939). After the identification of the body, it was proved that the bullet was the result of a war wound. However, the victim had been unaware of the existence of the bullet, which had remained in his body for 50 years.

The use of a CT scan to predict the feasibility of decompression of the first segment of the facial nerve via the transattical approach.

Total surgical decompression of the facial nerve can be offered to patients severely affected by Bell's palsy whether via the transattical or middle fossa approach. We prefer, when feasible, the transattical approach because it does not violate the cranial vault. The purpose of this study was to find the anatomical parameter of the temporal bone, measured by means of computed tomography (CT scan) and to decide which of these approaches should be offered. Sixty temporal bones were studied by CT scan, and then dissected in order to perform total facial nerve decompression via the transattical approach. Correlation between the two studies was established. Results suggest that measurement by CT scan of the attical area in the axial plane (AAA) may determine those patients for whom the transattical approach to facial nerve decompression should be undertaken.

Extramedullary nasal plasmacytoma.

The literature on this rare tumour has been reviewed and three cases of nasal plasmacytoma are described. Immunohistochemistry demonstrated cytoplasmic IgA and Kappa determinants in all cases. Two patients are disease-free at the present time, the third developed an IgG-k multiple myeloma, previously not described in the literature.

[Sensitivity of Salmonella species to four "classical" antibiotics and seven new beta-lactamic antibiotics (author's transl)]. / Sensibilidad de las salmonelas a cuatro antibióticos "clásicos" y a siete nuevos antibióticos beta-lactámicos.

A study of the minimal inhibitory concentration (MIC) for 200 strains of Salmonella sp. has been performed with the following beta-lactamic antibiotics: mezlocillin and azlocillin (penicillins), cephaclor, cephamandole, cephuroxime and cephotaxime (cephalosporins), and cephoxytine (cephamycin). The MIC has been compared with that of chloramphenicol, ampicillin, amoxicillin and cotrimoxazole, all of them widely used antibiotics for the treatment of Salmonella infections in Spain. The different species and serotypes of Salmonella studied were all sensitive to all the beta-lactamic antibiotics tested. Of particular relevance is the fact that cephotaxime (HR 756) MIC was extraordinarily low even for strains resistent to the penicillins. The MIC of cephaclor, and oral cephalosporin, was similar to that of the parenteral cephalosporins.

[Do obstetric causes of death explain the differences in maternal mortality between France and Europe?]. / Les causes obstétricales de décès expliquent-elles les différences de mortalité maternelle entre la France et l'Europe? Groupe Moms.

In view of understanding why the level of maternal mortality is higher in France than in other European countries, a specific study of frequency and causes has been carried out in these 13 countries. Two different sources of data were used: the annual civil death data from national offices which are published by the WHO, and the MOMS data. It was hypothesized that the pattern of causes plays a role in the level of maternal mortality. This hypothesis was checked with results issuing from a European concerted action where deaths were classified by a European group of medical experts using identical criteria. There were apparently more cases of hemorrhage, direct obstetric causes, and indirect obstetric causes in France than in the other European countries. The higher level of indirect obstetric causes may be explained by stronger registration regulations for maternal deaths recently implemented in France. Due to the higher level of hemorrhage as cause of maternal death in France, we suggest in-depth research is needed in the near future to study prevalence and management of obstetrical hemorrhage in France.

Epigenetic alterations in a gastric leiomyoma.

Leiomyomas constitute 2.5% of all resected neoplasms of the stomach. They are usually asymptomatic, but may present mucosal ulceration. Aberrant DNA methylation is a well-defined epigenetic change in human neoplasms; however, gene-acquired methylation may not necessarily be related with a malignant phenotype. In this report we analyzed in a gastric leiomyoma, the methylation status of 84 CpGI in tumor suppressor and DNA repair genes. We analyzed the tumor center (TC) and tumor periphery (TP) separately. We found aberrant methylation in 2/84 CpGI in the TC portion, that is, MLH1 and MSH3, and 5/84 CpGI in the TP, that is, MLH1, MSH3, APC, MSH6, and MGMT. The gene with the highest methylation percentage in the TC and TP was MLH1. Given that MLH1 methylation has been associated with microsatellite instability, we analyzed the status of the microsatellite Bat-26. We found that neither the TC nor the TP presented instability. The methylation of MLH1, MGMT, and APC has been described in GISTs, but to the best of our knowledge this is the first time that the methylation of these genes has been associated with gastric leiomyoma. Further research should be conducted to identify reliable molecular markers that could differentiate between GISTs and gastric leiomyomas.