Hôpital Fontmaure

IntroductionFLNA pathogenic variants lead to various congenital malformations. Pulmonary manifestations were reported in early age. In adults, few cases of emphysema were published. We aimed to assess the frequency and characteristics of emphysema in adults with a pathogenic or probably pathogenic variant in FLNA.MethodWe conducted a transversal single-center study. Adults with FLNA pathogenic variant followed in Lille University Hospital were identified among the French rare disease database BaMaRa®. They attended medical examination, non-contrast chest CT-scan and pulmonary function tests (PFT). We collected medical history, tobacco smoking status, occupational and domestic exposures. When emphysema was identified, the PTPN6 gene was sequenced and alpha1antitrypsin deficiency searched. The primary objective of the study was to assess the frequency of emphysema. Secondary objectives were to evaluate emphysema type, distribution and extension, lung function in case of emphysema and the frequency of unexplained emphysema.ResultsAmong the 29 patients identified, 10 met non-inclusion criteria, 4 declined, 5 could not be reached and so 10 patients were included. The frequency of emphysema was 70%. It was most often centrilobular and located in upper lobes (n = 4) with a median volume of 8.8% (IQR: 3.0–18.0%) of the total lung volume. The frequency of unexplained emphysema was estimated to be 57.1% of emphysema cases. PFT revealed airflow limitation (n = 3), reduced DLCO (n = 5) and small airway disease on IOS (n = 5).ConclusionThese preliminary results suggest that adults with FLNA pathogenic variant frequently develop emphysema, allowing for a larger study to be considered.Trial registrationClinicalTrials.gov, NCT05550844, Registered 19 September 2022 https://clinicaltrials.gov/study/NCT05550844?cond=FLNA&rank=1.

The resting primate brain is traversed by spontaneous functional connectivity patterns that show striking differences between conscious and unconscious states. Transcranial direct current stimulation (tDCS), a non-invasive neuromodulatory technique, can improve signs of consciousness in disorders of consciousness (DOCs); however, can it influence both conscious and unconscious dynamic functional connectivity? We investigated the modulatory effect of prefrontal cortex (PFC) tDCS on brain dynamics in awake and anesthetized non-human primates using functional MRI. In awake macaques receiving either anodal or cathodal tDCS, we found that cathodal stimulation robustly disrupted the repertoire of functional connectivity patterns, increased structure-function correlation (SFC), decreased Shannon entropy, and favored transitions toward anatomically based patterns. Under deep sedation, anodal tDCS significantly altered brain pattern distribution and reduced SFC. The prefrontal stimulation also modified dynamic connectivity arrangements typically associated with consciousness and unconsciousness. Our findings offer compelling evidence that PFC tDCS induces striking modifications in the fMRI-based dynamic organization of the brain across different states of consciousness. This study contributes to an enhanced understanding of tDCS neuromodulation mechanisms and has important clinical implications for DOCs.

The objective of this study was to examine the evolution of suicides and suicide attempts over the last 10 years in France. We analyzed the number of deaths by suicide and suicide attempts in metropolitan France (2009–2018) from French national databases, on a daily, weekly or monthly basis. Seasonal variation in suicide rates was modeled using a cosinor function. Based on this model, we determined the association of suicides and suicide attempts with geographic characteristics, age, gender, means used and psychiatric disorders. The number of suicides and suicide attempts decreased over the last ten years in France (mean decrease of 14.49% and 11.69% per year). We observed a significant and recurrent seasonal pattern of suicides and suicide attempts in France, with a peak in spring. The suicide and suicide attempt rates were higher in the northern departments of France. Suicides were more frequent for men (75%) and middle-age individuals (45–54 years old), while suicide attempts were more frequent for women (62%) and young adults and middle-age individual (15–19 and 40–49 years old). Nearly two-thirds of the patients who attempted suicide suffered from comorbid psychiatric disorders. Mood disorders was the most frequent comorbid psychiatric disorder (54%). Voluntary drug intoxication was the most common means of suicide attempt (80%), and hanging was the most common means of suicide (54%). The number of suicides and suicide attempts decreased in France over the last 10 years, with large and recurrent seasonal variations. These findings could be used to alert and adjust prevention policies, as well as developing preventive strategies such as chronotherapeutics.

Après les ouvrages dirigés par Marie-Laure Pain (Les groupes cathédraux et complexes monastiques, 2016) et Cécile Treffort et Pascale Brudy (Monastères entre Loire et Charente, 2014), la collection Archéologie et culture des Presses Universitaires de Rennes s’enrichit d’une nouvelle étude consacrée à la dimension monumentale du monachisme médiéval. L’ouvrage de Patrick Bouvard, Les prieurés de Fontevraud dans le diocèse de Poitiers, s’inscrit pleinement dans les intentions de la collection d...

Abstract Introduction: The objective of this study was to examine the evolution of suicides and suicide attempts over the last 10 years in France. Methods: We analyzed the number of deaths by suicide and suicide attempts in metropolitan France (2009-2018) from French national databases, on a daily, weekly or monthly basis. Seasonal variation in suicide rates was modeled using a cosinor function. Based on this model, we determined the association of suicides and suicide attempts with geographic characteristics, age, gender, means used and psychiatric disorders. Results: The number of suicides and suicide attempts decreased over the last ten years in France (mean decrease of 14.49% and 11.69% per year). We observed a significant and recurrent seasonal pattern of suicides and suicide attempts in France, with a peak in spring. The suicide and suicide attempt rates were higher in the northern departments of France. Suicides were more frequent for men (75%) and middle-age individuals (45-54 years old), while suicide attempts were more frequent for women (62%) and young adults and middle-age individual (15-19 and 40-49 years old). Nearly two-thirds of the patients who attempted suicide suffered from comorbid psychiatric disorders. Mood disorders was the most frequent comorbid psychiatric disorder (54%). Voluntary drug intoxication was the most common means of suicide attempt (80%), and hanging was the most common means of suicide (54%).Conclusion: The number of suicides and suicide attempts decreased in France over the last 10 years, with large and recurrent seasonal variations. These findings could be used to alert and adjust prevention policies, as well as developing preventive strategies such as chronotherapeutics.

In 2018 in France, overall mean health-related out-of-pocket (OOP) expenditures were 214.00€/year/patient. To evaluate OOP expenditures for psoriasis patients in France. Observational, cross-sectional, non-comparative, multicentre study in 3000 patients with clinically confirmed psoriasis who responded to a specific digital questionnaire collecting demographic and socio-economic characteristics, assessing the 3 domains (severity, psychosocial impact and past history and interventions) of the patient's Simplified Psoriasis Index (sa-SPI) and expenditures to manage psoriasis, including OOP. Multivariate linear regression was conducted to search for factors associated with higher OOP. In total, 2681 patients completed the questionnaire and, of those, 2562 provided clinically validated data. Overall, 60% were women; the mean age was 49.4±14.8years. 30% of the patients declared that they suffered from psoriatic arthritis. The final mean sa-SPI core was 10.86±9.70. Of these 2562 patients, 243 (9.5%) had severe, 442 (17.3%) moderate and 1877 (73.3%) mild psoriasis. In addition, 932 (36.4%) patients reported facial involvement, 724 (28.25%) genital impairment and 1124 (43.8%) lesions on the limbs. Mean OOP expenditures to manage psoriasis per patient were 531.00€, 439.74€±939.85€ for patients with mild, 791.06€±1367.67€ with moderate and 1077.64€±1680.14€ for patients with severe psoriasis. For patients with psoriasis in the genital area, the median amount of expenditures (251.17€; CI95% [138.35;363.99]) was significantly higher than that for the face (183.85€; CI95% [78.76;288.94]) or limbs (199.96€; CI95% [93.77;306.15); (P<0.001). More than 90% of the patients had OOP expenditures for over-the-counter products (97.5%) and alternative care (92.0%), especially for emollients and/or hydrating products. In France, in 2019, OOP expenditures to manage psoriasis were on average more than twice as high as the overall mean health-related OOP expenditures estimated by the French Health Agency in 2018. These results should lead health authorities to review certain standards of healthcare reimbursement.