Glycaemic status during pregnancy and longitudinal measures of fetal growth in a multi-racial US population: a prospective cohort study. Lancet Diabetes Endocrinol 2020; 8: 292-300. 4 Italian Ministry of Health. Linee guida gravidanza fisiologica aggiornamento 2011: sistema nazionale per le linee guida dell'Istituto Superiore di Sanità. 2011. http://www.salute.gov.it/imgs/C_17_ pubblicazioni_1436_allegato.pdf (accessed April 20, 2020). 5 Sovio U, Murphy HR, Smith GC. Accelerated foetal growth prior to diagnosis of gestational diabetes mellitus: a prospective cohort study of nulliparous women. Diabetes Care 2016; 39: 982-87.

No abstract

No abstract

Geriatric factors (MMSE and IADL) are predictive of severe toxicity or unexpected hospitalization (MMSE) in a randomized prospective phase III study in mCRC. These results suggest that cognitive function and autonomy impairment should be taken into account when choosing a regimen for chemotherapy.

BackgroundLongitudinal data are data in which each variable is measured repeatedly over time. One possibility for the analysis of such data is to cluster them. The majority of clustering methods group together individual that have close trajectories at given time points. These methods group trajectories that are locally close but not necessarily those that have similar shapes. However, in several circumstances, the progress of a phenomenon may be more important than the moment at which it occurs. One would thus like to achieve a partitioning where each group gathers individuals whose trajectories have similar shapes whatever the time lag between them.MethodIn this article, we present a longitudinal data partitioning algorithm based on the shapes of the trajectories rather than on classical distances. Because this algorithm is time consuming, we propose as well two data simplification procedures that make it applicable to high dimensional datasets.ResultsIn an application to Alzheimer disease, this algorithm revealed a “rapid decline” patient group that was not found by the classical methods. In another application to the feminine menstrual cycle, the algorithm showed, contrarily to the current literature, that the luteinizing hormone presents two peaks in an important proportion of women (22%).

Background Gastric hyperplastic polyps (GHPs) have a risk of neoplastic transformation reaching 5 %. Current endoscopic resection techniques appear suboptimal with a high risk of local recurrence. This study assessed the outcomes of endoscopic resection for GHPs and identified risk factors for recurrence and neoplastic transformation. Methods This retrospective, multicenter, European study included adult patients with at least one GHP ≥ 10 mm who underwent endoscopic resection and at least one follow-up endoscopy. Patients with recurrent GHPs or hereditary gastric polyposis were excluded. All data were retrieved from the endoscopy, pathology, and hospitalization reports. Results From June 2007 to August 2018, 145 GHPs in 108 patients were included. Recurrence after endoscopic resection was 51.0 % (74 /145) in 55 patients. R0 resection or en bloc resection did not impact the risk of polyp recurrence. In multivariate analysis, cirrhosis was the only risk factor for recurrence (odds ratio [OR] 4.82, 95 % confidence interval [CI] 1.33 – 17.46; P = 0.02). Overall, 15 GHPs (10.4 %) showed neoplastic transformation, with size > 25 mm (OR 10.24, 95 %CI 2.71 – 38.69; P < 0.001) and presence of intestinal metaplasia (OR 5.93, 95 %CI 1.56 – 22.47; P = 0.01) being associated with an increased risk of neoplastic transformation in multivariate analysis. Conclusions Results confirmed the risk of recurrence and neoplastic transformation of large GHPs. The risk of neoplastic change was significantly increased for lesions > 25 mm, with a risk of high grade dysplasia appearing in polyps ≥ 50 mm. The risk of recurrence was high, particularly in cirrhosis patients, and long-term follow-up is recommended in such patients.

BackgroundIn sub-Saharan Africa, men living with HIV often start ART at more advanced stages of disease and have higher early mortality than women. We investigated gender difference in long-term immune reconstitution.Methods/Principal FindingsAntiretroviral-naïve adults who received ART for at least 9 months in four HIV programs in sub-Saharan Africa were included. Multivariate mixed linear models were used to examine gender differences in immune reconstitution on first line ART.A total of 21,708 patients (68% women) contributed to 61,912 person-years of follow-up. At ART start,. Median CD4 at ART were 149 [IQR 85–206] for women and 125 cells/µL [IQR 63–187] for men. After the first year on ART, immune recovery was higher in women than in men, and gender-based differences increased by 20 CD4 cells/µL per year on average (95% CI 16–23; P<0.001). Up to 6 years after ART start, patients with low initial CD4 levels experienced similar gains compared to patients with high initial levels, including those with CD4>250cells/µL (difference between patients with <50 cells/µL and those with >250 was 284 cells/µL; 95% CI 272–296; LR test for interaction with time p = 0.63). Among patients with initial CD4 count of 150–200 cells/µL, women reached 500 CD4 cells after 2.4 years on ART (95% CI 2.4–2.5) and men after 4.5 years (95% CI 4.1–4.8) of ART use.ConclusionWomen achieved better long-term immune response to ART, reaching CD4 level associated with lower risks of AIDS related morbidity and mortality quicker than men.

Background With the increasing frequency and impact of Ebola virus disease (EVD) outbreaks illustrated by recent epidemics, good knowledge on extent of viral persistance or RNA detection in body fluids from survivors is urgently needed. Methods Ebola viral RNA shedding was studied with molecular assays in semen (n=1,368), urine (n=1,875), cervico-vaginal fluid (n=549), saliva (n=900), breast milk (n=168) and feces (n=558) from EVD survivors in Guinea (POSTEBOGUI cohort, n=802) at a regular base until 40 months after inclusion. Results 27/277 (9.8%) male survivors tested positive for Ebola RNA in at least one semen sample. The probability of remaining positive for Ebola RNA in semen was estimated at 93.02% and 60.12% after three and six months. Viral RNA in semen was more frequent in patients with eye pain (p=0.036), joint pain (p=0.047), and higher antibody levels to Ebola virus antigens (NP (p=0.001), GP (p=0.05) and VP40 (p=0.05)). Ebola RNA was only rarely detected in other body fluids from EVD survivors : saliva (1/454) urine (2/593), breast milk (2/168), cervico-vaginal secretions (0/273), feces (0/330). RNA was detected in breast milk one month after delivery but 500 days after discharge of Ebola treatment unit (ETU) in a women who became pregnant seven months after discharge from the ETU. Conclusions The frequency and potential long term presence of viral RNA in semen confirm that systematic prevention measures in male survivors are required. Our observation in breast milk suggest that our knowledge on viral reservoir in immune priveledged sites and its impact are still incomplete.