B Acad Nat Med Paris
-
Gastrointestinal stromal tumors (GIST) are the most frequent sarcomas but were underdiagnosed until the beginning of this century. GIST derive from interstitial cells of Cajal and may develop all along the digestive tract. GIST are characterized by the expression of KIT (CD117), and also DOG-1, which was recently discovered by transcriptome analysis. ⋯ For example, patients with metastatic GIST and a duplication of KIT exon 9 should receive twice the usual dose of imatinib, while GIST with the PDGFRA p. D842 V mutation are resistant to imatinib. This article presents the main pathologic characteristics of GIST and the important insights that GIST research has provided for oncology in general.
-
B Acad Nat Med Paris · Feb 2012
[Life-threatening behaviors, suicide, attempted suicide and self-inflicted injury].
In France, suicide is the second cause of death among young people. Each year, 550 people under 25 years of age take their own lives, and at least 40,000 attempt suicide. One in three young people who attempt suicide relapse during the following year. ⋯ Better screening of young people at risk is urgently required The author proposes easily recognizable risk factors that he and Marie Choquet (Inserm) identified through a study conducted in schools. These factors are not always recognized by professionals who deal with adolescents. Regarding hospital management, the author advocates a well-defined assessment period to determine the reasons for the crisis, interposed between the initial evaluation and the choice of the most appropriate therapeutic option.
-
B Acad Nat Med Paris · Jan 2012
[Health consequences of environmental temperature and climate variations].
Recent climate change is a consequence of the greenhouse effect and human activity, and is directly responsible for extreme events such as heatwaves (see report of the French Académie des Sciences). Human thermoregulation depends more on behavior than on biology Air conditioning and building structure play an essential role. The 2003 heatwave was not a unique event. ⋯ Climate change plays a important role in allergic diseases, through changes in the diffusion and composition of pollens. These modifications are being monitored by several observatories. Six different veterinary diseases, including several zoonoses, are of particular concern.
-
Percutaneous extracorporeal life support (ECLS) is now widespread for treating acute cardiac failure. ECLS has been used for treating in-hospital and out of hospital cardiac arrests. A systematic review of literature was performed in order to assess the results. ⋯ ECLS was used after out of hospital cardiac arrests in 3 studies published between 2008 and January 31, 2011. They included 110 patients of which only 6 survived (4.4 %) despite strict inclusion criteria. Low flow lasted between 60 and 120 min (mean 98 min.) According to these results the use of ECLS should be encouraged after in-hospital cardiac arrest and training in cardiorespiratory resuscitation should be improved in global population and health professionals.