Notes

Achievements as well as problems involving talk vocabulary therapy services provision within American Kenya: About three situation studies.
cal recurrence (8·9% [5·2-15·0] vs 3·4% [1·4-7·9]; p=0·050) between the open surgery and laparoscopic surgery groups at 10 years after surgery. The stratified hazard ratios, adjusted for ypT and ypN classification and tumour regression grade, for open surgery versus laparoscopic surgery were 0·94 (95% CI 0·63-1·43) for overall survival, 1·05 (0·74-1·49) for disease-free survival, and 2·22 (0·78-6·34) for local recurrence.

The 10-year follow-up of the COREAN trial confirms the long-term oncological safety of laparoscopic surgery in patients with rectal cancer treated with preoperative chemoradiotherapy. Similar to open surgery, laparoscopic surgery does not compromise long-term survival outcomes in rectal cancer when performed by well trained surgeons.

National Cancer Center, Goyang, South Korea.
National Cancer Center, Goyang, South Korea.The ageing of the population confronts French society with profound changes and has a particular impact on our healthcare system. In the practice of trainer in a nursing training institute, the importance of teaching adapted to these evolutions is measured. Also, we can question ourselves on the awareness of the students to the care of the elderly subject with a pedagogical sequence wishing to meet this objective..Severe forms of Covid-19 infectious disease often affect the frail elderly. They can induce inaugural psychiatric manifestations or aggravate the underlying psychiatric pathologies. Some of these pathologies persist after the acute episode and require specific management. Doctors and caregivers involved in the care of infected patients are themselves exposed to psychological and even psychiatric difficulties and are looking for collaborative help complementing actions in the somatic care sectors.The medication circuit is a complex, transversal and risky process. It involves interdependent clinical and logistical stages. Its automation and computerisation are real levers for securing the patient's medication management and optimising the organisation of care. It allows care staff to free up precious time to provide care, particularly in geriatrics.The living lab is an approach that encourages the design and development of innovative technological solutions in a process of coconstruction involving users and other key players. Its methodology develops the technologies of the Broca living lab, dedicated to the care of elderly people with cognitive disorders and their carers.The Alzheimer's plans have led to significant progress in the care management of elderly people suffering from Alzheimer's disease or other forms of dementia, but the medical and social network remains fragmented in geriatrics. We have proposed to caregivers a monthly videoconference combining expert presentations and discussion of clinical cases. Several health professions were represented. The main positive point was the time saved. The videoconferencing improved multidisciplinary exchanges, especially for patients with complex problems and their families.Dependency care is a real public health issue. The lengthening of life expectancy and the increase in polypathologies require health policies that are as close as possible to the needs of the elderly. The World Health Organisation has set up a program to encourage healthy ageing. Based on this program, the Toulouse gerontopôle has developed digital tools for the prevention, evaluation, monitoring and management of ageing in order to detect and monitor 200,000 elderly people in Occitania within five years.These last ten years, new technologies are more and more used in therapeutic and rehabilitation programms for patients with dementia, and used for the diagnosis of theses diseases, from the signal treatment. A review of litterature shows this growing interest among the scientific communauty for these new technologies.Gerontotechnologies are becoming increasingly important for the elderly, their relatives and the professionals who accompany them. However, this deployment raises a large number of questions, fears and reluctance - or "technoscepticism" - including in the health and medico-social sectors. There are levers that could promote the successful implementation of these technologies.
Syphilis transmission is increasing, and precisely how Treponema pallidum is transmitted sexually from person to person is unclear. We aimed to determine the frequency of T pallidum shedding from potentially asymptomatic sites and the stage of infection at which shedding is most frequent in men who have sex with men (MSM), who have been disproportionately affected by syphilis.

We did a prospective, cross-sectional study in MSM recruited from Melbourne Sexual Health Centre (Melbourne, VIC, Australia). Men were eligible if they were aged 18 years or older, reported sex with men during the past 12 months, and had laboratory confirmed primary, secondary, or early latent syphilis, consistent with Australian definitions. Primary and secondary syphilis lesions were swabbed and non-lesion samples were collected via oral rinse, oral cavity swab, anal canal swab, urine, and semen. Samples were tested for T pallidum using PCR assays targeting polA (lesion and non-lesion samples) and 47 kDa (non-lesion samples only) o ascertain the contribution of shedding of T pallidum from non-lesion sites to transmission of syphilis.

Australian National Health and Medical Research Council.
Australian National Health and Medical Research Council.Cutaneous and renal glomerular vasculopathy (CRGV) is an emerging disease in the UK, but its aetiology remains unclear. It is considered a thrombotic microangiopathy (TMA) in which the kidney and skin are the most commonly affected organs. We now document two cases of CRGV with brain lesions, which may have accounted for neurological signs displayed by these animals. The histopathological brain lesions were similar to TMA lesions in humans with thrombotic thrombocytopaenic purpura (TTP) and complement-mediated haemolytic uraemic syndrome (CM-HUS), in which the neurological signs are more associated with TMA than with any systemic disease or electrolyte imbalance. Fibrinoid necrosis in brain arterioles and associated lesions in these dogs were similar to those in human CM-HUS, indicating that the alternative complement pathway may play an important role in the pathophysiology of CRGV.Congenital tumours and tumour-like lesions represent a group of rare disorders in both veterinary and human medicine that arise from tissue remnants and are detected during pregnancy or within the first 2-3 months of life. Different forms of congenital tumours and congenital tumour-like lesions have been reported in calves and their development is poorly understood. They often pose a diagnostic challenge and the referring nomenclature occasionally may be equivocal. Previous reports regarding tumour-like lesions, soft tissue tumours, vascular tumours, round cell tumours and neoplasms of the nervous, peritoneum and urogenital systems are summarized in this review, and the role of genetic factors in the development of these conditions is discussed.Primary central nervous system (CNS) lymphomas are rare in humans and even more uncommon in animals. We report the clinical, pathological and immunohistochemical features of a presumptive primary cerebral T-cell lymphoma (PCTCL) in an aged female white-tailed deer (Odocoileus virginianus) that had chronic progressive neurological disease characterized by ataxia, claudication and eventual circling. The animal was euthanized due to poor prognosis. Grossly, a 2.5 cm dark red, friable nodule effaced the cortical neuroparenchyma of the left anterior cingulate cortex (LACC). Microscopically, the meningeal vasculature and adjacent grey and white matter cortical neuroparenchyma of the LACC were infiltrated by a poorly demarcated, unencapsulated and densely cellular round cell neoplasm with a consistent angiocentric pattern. The neoplasm was associated with extensive regions of haemorrhage and liquefactive necrosis. Neoplastic cells immunolabelled for CD3 antigen and had high proliferative activity, as indicated by Ki-67 labelling. Based on the cytohistomorphological and immunohistochemical features and absence of metastasis, a diagnosis of PCTCL was determined. This case indicates that PCTCL should be considered in the differential diagnosis of neurological disease and intracranial, intra-axial CNS masses in deer.There are few reports of tumours in bats, despite the fact that members of the Chiroptera order include 22.4% of all currently known mammal species. We now describe a case of malignant peripheral nerve sheath tumour (MPNST) in an adult female Seba's short-tailed bat (Carollia perspicillata) from a private zoo in Switzerland. The macroscopical and histological findings indicated that the MPNST originated from a dorsal spinal nerve root sheath in the lumbar region and metastasized to the spleen. Immunohistochemical labelling for glial fibrillary acid protein, S100 protein, neuron specific enolase and synaptophysin was negative. The cytoplasm of a few neoplastic cells labelled for smooth muscle actin and desmin. To our knowledge, this is the first report of a PNST in a member of the Chiroptera order.We describe the pathology of gastrointestinal tuberculosis in three cows. Gross lesions were found in the jejunum and ileum in all cases, and were characterized by button-shaped ulcers in the mucosa overlying Peyer's patches and adjacent mucosa. CD437 molecular weight One case had similar changes in the pyloric region of the abomasum. In the affected intestinal segments, marked granulomatous inflammation effaced the lymphoid follicles of Peyer's patches and often extended transmurally. Transmural granulomatous inflammation was also found in the abomasum of one cow. Acid-fast bacilli were identified by the Ziehl-Neelsen method and the lesions were immunolabelled by an anti-Mycobacterium tuberculosis complex antibody. M. tuberculosis var. bovis was isolated in one case. Disseminated tuberculosis and marked lung lesions in all cows suggested that the gastrointestinal lesions were most likely secondary to pulmonary infection.The Mediterranean monk seal (Monachus monachus) is the rarest species of pinniped in the world. Necropsy of a Mediterranean monk seal pup that stranded alive on the southern Adriatic Italian coast and died a few hours later revealed co-infection by cetacean morbillivirus (CeMV) and Toxoplasma gondii. Pathological lesions included a multifocal, moderate to severe, necrotizing myocarditis and a diffuse, chronic, moderate interstitial pneumonia with bronchial and bronchiolar epithelial hyperplasia. Lesions of atypical necrotizing arteritis were seen in the aorta and major pulmonary arteries in association with the presence T. gondii organisms. Severe haemorrhagic foci and lesions of non-suppurative meningoencephalitis, together with the presence of protozoal cysts, were seen in the brain. Co-infection of CeMV and T. gondii has not been previously reported in monk seals. The vascular lesions found in this animal can be considered atypical because they have not been reported in other terrestrial or marine mammal species. The disseminated toxoplasmosis associated with the unusual vascular and haemorrhagic brain lesions could be related to the immunosuppressive effects of CeMV infection.
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