Institut National de la Santé et de la Recherche Médicale U1016, Institut Cochin, Paris, France
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PROVIDER: EGAC00001000178 | EGA |
REPOSITORIES: EGA
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Project description:The French Institute for Public Health Surveillance monitors health events of potential international importance occurring worldwide to provide timely warning to French health authorities. We reviewed the nature and place of occurrence of the last 200 events. From an individual country's perspective, the need for multiple sources is emphasized.
| S-EPMC2851537 | biostudies-literature
Project description:Monkeypox virus: Genome sequencing by Pathogen Genomic Lab, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| PRJEB89000 | ENA
Project description:Data Access Committee EGAC00001001539
| EGAC00001001539 | EGA
Project description:Data Access Committee EGAC00001000723
| EGAC00001000723 | EGA
Project description:Background The goal of this research project was to identify and suggest means of filling the gaps/needs in Canadian research activity and public policy action on the income and health relationship. Methods The research consisted of an environmental scan and analysis of 321 empirical research pieces from Canada (n=241), the United Kingdom (n=40) and Finland (n=40) followed by a systematic gaps/needs analysis of these studies by members of three advisory committees, consisting of researchers and policy advocates. These data were complemented by key informant interviews with researchers from Canada, the UK and Finland. The gaps/needs were then reviewed and assigned priority rankings by members of the three advisory committees. Findings Numerous gaps/needs in Canadian research on income and health were apparent. They fell into five main areas: (a) training and capacity building in addressing income as a health determinant; (b) developing adequate data and measures; (c) researching specific substantive health issues; (d) researching specific public policy areas; and (e) developing an understanding of the pathways and mechanisms mediating the income and health relationship. Members of the advisory committees achieved a high level of agreement concerning these gaps/needs and means of reducing them. Conclusions The Canadian Institutes of Health Research (CIHR) and the Institute of Population Health should target specific research initiatives to help fill the identified gaps in knowledge. They should also work together with public policy institutes to synthesize findings concerning income, its distribution, and health, and help distribute these findings to the public in general and policy-makers in particular. Electronic Supplementary Material Supplementary material is available for this article at 10.1007/BF03405393 and is accessible for authorized users.
| S-EPMC6976139 | biostudies-literature
Project description:Data Access Committee EGAC00001000224
| EGAC00001000224 | EGA
Project description:Primary lymphedema is a rare chronic pathology associated with constitutional abnormalities of the lymphatic system. The objective of this French National Diagnosis and Care Protocol (Protocole National de Diagnostic et de Soins; PNDS), based on a critical literature review and multidisciplinary expert consensus, is to provide health professionals with an explanation of the optimal management and care of patients with primary lymphedema. This PNDS, written by consultants at the French National Referral Center for Primary Lymphedema, was published in 2019 ( https://has-sante.fr/upload/docs/application/pdf/2019-02/pnds_lymphoedeme_primaire_final_has.pdf ). Primary lymphedema can be isolated or syndromic (whose manifestations are more complex with a group of symptoms) and mainly affects the lower limbs, or, much more rarely, upper limbs or external genitalia. Women are more frequently affected than men, preferentially young. The diagnosis is clinical, associating mild or non-pitting edema and skin thickening, as confirmed by the Stemmer's sign (impossibility to pinch the skin on the dorsal side or the base of the second toe), which is pathognomonic of lymphedema. Limb lymphoscintigraphy is useful to confirm the diagnosis. Other causes of swelling or edema of the lower limbs must be ruled out, such as lipedema. The main acute lymphedema complication is cellulitis (erysipelas). Functional and psychological repercussions can be major, deteriorating the patient's quality of life. Treatment aims to prevent those complications, reduce the volume with low-stretch bandages, then stabilize it over the long term by exercises and wearing a compression garment. Patient education (or parents of a child) is essential to improve observance.
| S-EPMC7789008 | biostudies-literature
Project description:Cystic lymphatic malformations (LMs) are rare chronic conditions which management differs according to the type (macrocystic LMs, microcystic LMs or both). Studies are lacking due to rarity of the pathology. We aimed to establish a French National Diagnosis and Care Protocol (PNDS: Protocole National de Diagnostic et de Soins), to provide health professionals with free open access synthesis on optimal management and care of patients with LMs ( https://www.has-sante.fr/upload/docs/application/pdf/2021-03/malformations_lymphatiques_kystiques_-_pnds.pdf ). The process included a critical review of the literature and multidisciplinary expert consensus. LMs are congenital but are not always discovered at birth. Nearly 75% of them are located in the head and neck because of the highly dense lymphatic system in this region. Physical examination (showing painless masses with normal skin color and depressible consistency, or cutaneous/mucosal lymphangiectasia) and color Doppler ultrasonography, usually allow for diagnosis. MRI (involving T2 sequences with fat saturation in at least two spatial planes) is the tool of choice for evaluating anatomical extension, characterizing lesions (microcystic and macrocystic), and before considering therapeutic management. A biopsy, coupled to a blood sample, can also be used for molecular biology analyses, to search for activating mutations of the PIK3CA gene, particularly with LM integrating in a syndromic form (CLOVES or Klippel-Trenaunay syndrome) but also in certain isolated (or common) LMs. The spontaneous evolution of LMs, in particular microcystic forms, is often toward progressive aggravation, with an increase in the number of vesicles, thickening, increased oozing and bleeding, while pure macrocystic LMs may regress due to "natural sclerosis", i.e. fibrosis secondary to an inflammatory reorganization after common infantile infections. In case of voluminous LMs or syndromic forms, functional and psychological repercussions can be major, deteriorating the patient's quality of life. LMs must be treated by physicians integrated in multidisciplinary teams, and be personalized. Management is a life-long process that involves one or several of these therapies: conservative management, physical therapy (compression), sclerotherapy, surgery, drugs such as mTOR inhibitors (sirolimus), that has shown efficacy in decreasing the volume of LMs, and, more recently, PI3K-inhibitors in syndromic forms. Psychological and social support is necessary, taking into account the patient and his family.
| S-EPMC9837920 | biostudies-literature
Project description:Dunnigan syndrome, or Familial Partial Lipodystrophy type 2 (FPLD2; ORPHA 2348), is a rare autosomal dominant disorder due to pathogenic variants of the LMNA gene. The objective of the French National Diagnosis and Care Protocol (PNDS; Protocole National de Diagnostic et de Soins), is to provide health professionals with a guide to optimal management and care of patients with FPLD2, based on a critical literature review and multidisciplinary expert consensus. The PNDS, written by members of the French National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS), is available on the French Health Authority website (in French). Dunnigan syndrome is characterized by a partial atrophy of the subcutaneous adipose tissue and by an insulin resistance syndrome, associated with a risk of metabolic, cardiovascular and muscular complications. Its prevalence, assessed at 1/100.000 in Europe, is probably considerably underestimated. Thorough clinical examination is key to diagnosis. Biochemical testing frequently shows hyperinsulinemia, abnormal glucose tolerance and hypertriglyceridemia. Elevated hepatic transaminases (hepatic steatosis) and creatine phosphokinase, and hyperandrogenism in women, are common. Molecular analysis of the LMNA gene confirms diagnosis and allows for family investigations. Regular screening and multidisciplinary monitoring of the associated complications are necessary. Diabetes frequently develops from puberty onwards. Hypertriglyceridemia may lead to acute pancreatitis. Early atherosclerosis and cardiomyopathy should be monitored. In women, polycystic ovary syndrome is common. Overall, the management of patients with Dunnigan syndrome requires the collaboration of several health care providers. The attending physician, in conjunction with the national care network, will ensure that the patient receives optimal care through regular follow-up and screening. The various elements of this PNDS are described to provide such a support.
| S-EPMC9019936 | biostudies-literature
Project description:BackgroundFew studies have explored the potential for family dynamics to hinder or promote help-seeking and disclosure behaviours among adolescents who self-harm or experience suicidality. We sought to examine whether family dynamics may influence self-harm-related disclosure to parents or other family members and online help-seeking.MethodsWe identified youths, 14-17 years, in the 2014 Ontario Child Health Study (OCHS) who self-reported past-year suicidal ideation (with or without a suicide plan or past suicide attempt[s]) and/or non-suicidal self-harm. The OCHS is a provincially representative, cross-sectional survey. The person most knowledgeable about the adolescent, usually the mother, reported family dynamics: family dysfunction and positive and negative parenting practices. We used logistic regression to generate adjusted odds ratios.ResultsA total of 359 adolescents positively endorsed past-year suicidal ideation and/or non-suicidal self-harm. Disclosure and help-seeking were common (≥67.3% and ≥25.6%, respectively). Adolescents experiencing suicidal ideation and greater family dysfunction were more likely to share their suicidal thoughts with non-family compared to not telling anyone (OR = 1.09, 95% CI: 1.01 to 1.18) and were less likely to tell their parents or other family members about their suicidal thoughts when compared to non-family such as teachers, partners, or friends (OR = 0.82, 95% CI: 0.71 to 0.94). Positive parenting was not associated with any form of disclosure or online help-seeking for non-suicidal self-harm or suicidal ideation. As adolescent exposure to negative parenting increased, so did the likelihood that they would seek help online for their suicidal thoughts (OR = 1.22, 95% CI: 1.08 to 1.37). Sensitivity analyses replicated or were very similar to findings from the main models.ConclusionWe found that negative family dynamics were related to reduced sharing of suicidal thoughts with parents or other family members and greater online help-seeking. Our findings suggest that the importance of negative family dynamics to disclosure and support-seeking for adolescent suicidality may be under-recognized.
| S-EPMC11795579 | biostudies-literature