Liver, Gastrointestinal, and Cardiac Toxicity in Intermediate Hepatocellular Carcinoma Treated With PRECISION TACE With Drug-Eluting Beads: Results From the PRECISION V Randomized Trial.

OBJECTIVE. The purpose of our study was to evaluate hepatic, gastrointestinal, and cardiac toxicity after PRECISION transarterial chemoembolization (TACE) with drug-eluting beads (DEB) versus conventional TACE with doxorubicin in the treatment of intermediate-stage hepatocellular carcinoma (HCC).SUBJECTS AND METHODS. Two hundred twelve patients (185 men and 27 women; mean age, 67 years) were randomized to TACE with DEB or conventional TACE. The majority of patients (67% in both groups) presented in a more advanced stage. Safety was measured by rate of adverse events (Southwest Oncology Group criteria) and changes in laboratory parameters. Cardiotoxicity was assessed with left ventricular ejection fraction (LVEF) mainly on MRI or echocardiography.RESULTS. The mean maximum postchemoembolization alanine transaminase increase in the DEB group was 50% less than in the conventional TACE group (p < 0.001) and 41% less in respect to aspartate transaminase (p < 0.001). End-of-study values returned to approximately baseline levels but with greater variability in conventional TACE patients. Treatment-emergent adverse events in the hepatobiliary system organ class occurred in 16.1% of DEB group patients compared with 25% of conventional TACE patients. There were fewer liver toxicity events in the DEB group. There was a small but statistically significant difference in mean change from baseline in LVEF between the two groups of 4 percentage points for the conventional TACE group (95% CI, 0.71-7.3; p = 0.018).CONCLUSION. PRECISION TACE with DEB loaded with doxorubicin offers a safe therapy option for intermediate-stage HCC, even in patients with more advanced liver disease.

Santé buccale: déterminants sociaux d'un terrain majeur des inégalités [Oral health: social determinants of a health inequality]

The oral health of disadvantaged social groups is worse at all the ages than that of the favored groups. If tooth decay prevalence decreases, this disease is still unequally distributed: 20% of the children, those with the weakest socio-economic statute (SES), concentrate 60% of the decays. Edentulism strikes significantly more people with weak SES. The inequalities of oral health reflect those of general health. Evidence of the inequalities in oral health is exposed even in the developed countries. Different models of intervention are presented: risk groups identification and targeting by specific programs; oral health community approach which includes socio-economic and public health measures aiming all the population; insurance approach to be combined with the preceding ones.

La construcció de l'església de Sant Feliu de Girona

La construcció de l' església de Sant Feliu de Girona des dels seus orígens (s.IV) fins al segle XVIII

Tradició i llegenda: Sant Narcís i les mosques

Presentació d’un dossier que tracta l’acostament crític a la figura del bisbe Narcís i als prodigis que li han estat atribuïts, així com a la producció historiogràfica i artística que ha generat el mite

Avaluació per capacitat agrològica dels sòls del municipi de Sant Gregori

El projecte consisteix en realitzar l’avaluació dels sòls del municipi de Sant Gregori i la seva posterior classificació per Capacitat Agrològica. Aquest projecte es va portar a terme per pal•liar la manca d’informació sobre sòls que hi ha nivell local

Gènere i identitats en la construcció d'una comunitat colonial a Empúries (segles VI-V a.C.)

El projecte de recerca ha analitzat la complexitat ètnica, social i de gènere de l’assentament colonial d’Empúries a partir d’un exhaustiu estudi contextual dels materials ceràmics d’ús quotidià provinents de diferents sectors excavats als anys vuitanta a la Neàpolis empuritana (N-7000, N-5000 i N-1000). Aquests sectors datats els segles V i IV a.C., corresponen a un moment en el qual s’està construint una identitat colonial diferenciada en l’espai emporità. La comparació dels aixovars domèstics usats quotidianament pels habitants d’aquest tres sectors situats en punts distants de la Neàpolis mostra que estem davant d’un assentament colonial molt heterogeni, on conflueixen materialitats, tradicions tecnològiques i pràctiques quotidianes iberes, gregues i híbrides. Els estudis de materials confirmen que no va existir una segregació espacial entre poblacions d’origen grec i iber en aquest assentament i suggereixen la cohabitació de gent –tant d’homes com de dones- d’origen grec i iber a les diferents àrees estudiades d’aquest assentament portuari. En el registre material ceràmic de totes les zones estudiades s’observa un predomini dels productes ceràmics de tradició grega (colonials o àtics) en els serveis de taula, però no així en els estris utilitzats a la cuina, que són majoritàriament de tradició ibera. També els materials ceràmics relacionats amb l’emmagatzematge domèstic i amb el transport i el comerç (àmfores) són predominantment ibers. Aquest patró suggereix que els ibers que van cohabitar amb els grecs al port emporità no van assumir en tots els casos posicions subalternes, sinó que tingueren un rol rellevant en la gestió econòmica i comercial d’aquest espai portuari.

Testing for potential contextual bias effects during the verification stage of the ACE-V methodology when conducting fingerprint comparisons

This study was conducted to assess if fingerprint specialists could be influenced by extraneous contextual information during a verification process. Participants were separated into three groups: a control group (no contextual information was given), a low bias group (minimal contextual information was given in the form of a report prompting conclusions), and a high bias group (an internationally recognized fingerprint expert provided conclusions and case information to deceive this group into believing that it was his case and conclusions). A similar experiment was later conducted with laypersons. The results showed that fingerprint experts were influenced by contextual information during fingerprint comparisons, but not towards making errors. Instead, fingerprint experts under the biasing conditions provided significantly fewer definitive and erroneous conclusions than the control group. In contrast, the novice participants were more influenced by the bias conditions and did tend to make incorrect judgments, especially when prompted towards an incorrect response by the bias prompt.

Comment faire de la surveillance sanitaire? L'exemple de l'Observatoire Valaisan de la Santé en Suisse [How to conduct public health surveillance? The example of the Observatoire Valaisan de la Santé in Switzerland].

OBJECTIVE: To describe the goals and methods of contemporary public health surveillance and to present the activities of the Observatoire Valaisan de la Santé (OVS), a tool unique in Switzerland to conduct health surveillance for the population of a canton. METHODS: Narrative review and presentation of the OVS. RESULTS: Public health surveillance consists of systematic and continuous collection, analysis, interpretation and dissemination of health data necessary for public health planning. Surveillance is organized according to contemporary public health issues. Switzerland is currently in an era dominated by chronic diseases due to ageing of the population. This "new public health" era is also characterized by the growing importance of health technology, rational risk management, preventive medicine and health promotion, and the central role of the citizen/patient. Information technologies provide access to new health data, but public health surveillance methods need to be adapted. In Switzerland, health surveillance activities are conducted by several public and private bodies, at federal and cantonal levels. The Valais canton has set up the OVS, an integrative, regional, and reactive system to conduct surveillance. CONCLUSION: Public health surveillance provides information useful for public health decisions and actions. It constitutes a key element for public health planning.

Effets du travail de nuit sur la santé

Dans les pays industrialisés, 20% des salariés sont concernés par le travail de nuit. Pourtant, les effets du travail de nuit sur la santé sont peu traités par les revues médicales générales, alors que le travail de nuit a des conséquences non négligeables sur les systèmes cardiovasculaires et digestifs entre autres, comme l'ont démontré de nombreuses études ces dernières décennies. Le travail de nuit a encore récemment attiré l'attention quand il a été déclaré cancérigène probable (catégorie 2A) par le Centre international de recherches sur le cancer. Ainsi dans cet article, seront passés en revue les troubles de la santé qui peuvent être générés ou aggravés par le travail de nuit. Deux cas pratiques illustreront la problématique et permettront d'aborder la conduite à tenir. 20% of employees in industrialized countries are concerned by shift work. Nevertheless, there is very little information in general medical journals about the effects of shift work on health. Shift work can have several major effects on health such as cardiovascular and digestive disorders among others, as demonstrated by several studies in recent decades. Shift work has attracted considerable attention recently when it was declared probable carcinogen by the International Agency for research on cancer. We review the health disorders that may be generated or aggravated by shift work and illustrate the problem by two case studies of occupational medicine and discuss the appropriate attitude to take