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Minier T.,University of Pécs | Guiducci S.,University of Florence | Bellando-Randone S.,University of Florence | Bruni C.,University of Florence | And 60 more authors.
Annals of the Rheumatic Diseases | Year: 2013

Objectives: The EULAR (European League Against Rheumatism) Scleroderma Trials and Research Group (EUSTAR) has identified preliminary criteria for very early diagnosis of systemic sclerosis (SSc). Our aim was to assess the prevalence of each proposed diagnostic item in a large observational patient cohort with Raynaud's phenomenon (RP). Methods: Baseline data of 469 RP patients enrolled into the Very Early Diagnosis of Systemic Sclerosis (VEDOSS) cohort are presented. Results: 68% of all RP patients were antinuclear antibody (ANA) positive. ANA+ RP patients more frequently had previous or current puffy fingers (PuFi) (38.5% and 23.3%, p<0.01) and an SSc pattern on nailfold capillaroscopy (NC) (53.6% and 13.4%, p<0.001) than ANA- patients. Telangiectasia, current digital ulcers and digital pitting scars were also commoner in ANA+ RP patients. 38% of ANA+ patients presented with all three features, which should raise suspicion of very early SSc (ANA+RP+PuFi constitutes a 'red flag'). These patients more frequently exhibited an NC SSc pattern, sclerodactyly and telangiectases compared to ANA+ patients without PuFi. Almost 90% of patients with 'red flags' had anti-centromere or anti-topoisomerase I antibodies and/or an NC SSc pattern, and fulfilled the EUSTAR criteria for very early SSc. Previous or current PuFi were present in 23.3% of ANA- RP patients, eight of whom also had an NC SSc pattern. Conclusions: In addition to well-characterised predictive factors, PuFi is an important sign raising suspicion for underlying very early SSc in patients with RP. The relevance of PuFi in ANA- RP patients should be clarified. © 2013 BMJ Publishing Group Ltd & European League Against Rheumatism.

Kone-Paut I.,University Paris - Sud | Shahram F.,Shariati Hospital | Darce-Bello M.,University Paris - Sud | Cimaz R.,A. Meyer Children | And 40 more authors.
Annals of the Rheumatic Diseases | Year: 2015

Background We aimed to describe the main features of Behçet's disease (BD) in children in the largest prospective cohort to date and to propose a classification. Methods An international expert consensus group was formed to define a data set of minimal symptoms for the inclusion of patients. Patients were entered prospectively during 66 months. Experts classified patients on a consensus basis. The concordance of two international classifications was analysed in confirmed patients with BD. Comparisons of subgroups of patients helped define consensus criteria. BD-associated clinical manifestations were also investigated in three control diseases extracted from an independent data set (Eurofever). Findings In total, 42 centres from 12 countries included 230 patients; data for 219 (M/F ratio=1) could be analysed. The experts classified 156 patients (71.2%) as having confirmed BD. Males more often than females showed cutaneous, ocular and vascular symptoms and females more often genital aphthosis. Age at disease onset and skin and vascular involvement were lower for European than non-European children. Oral aphthosis was the presenting sign for 81% (179/219) of patients. The mean delay to the second symptom was 2.9 ±2.2 years. International classifications were not concordant with the expert classification. Our paediatric classification contains six categories, a minimum of three signs (each in a distinct category) defining paediatric BD. Three clinical signs discriminated our cohort from the Eurofever cohorts. Interpretation We present a comprehensive description of a large cohort of patients from both European and non-European countries and propose the first classification of paediatric BD for future therapeutic trials. © 2015 BMJ Publishing Group Ltd & European League Against Rheumatism.

Karadimos D.,University of Ioannina | Karadimos D.,Democritus University of Thrace | Vlastou R.,National Technical University of Athens | Ioannides K.,University of Ioannina | And 10 more authors.
Nuclear Instruments and Methods in Physics Research, Section B: Beam Interactions with Materials and Atoms | Year: 2010

Fission cross-section measurements with the Fast Ionization Chamber (FIC) at the CERN n-TOF facility were challenged by intense signals due to γ-rays and ultra-relativistic particles from the impact of the 20 GeV proton pulses on the neutron spallation target. A method for analyzing the data taken with Flash Analog to Digital Converters (FADC) was developed to treat these problems in an automated way to provide a reliable background subtraction and a fit routine for identifying fission events even at high energies. The analysis is illustrated at the example of the fission cross-section of 238U relative to that of 235U in the energy range from 40 keV to 300 MeV. © 2010 Elsevier B.V. All rights reserved.

PubMed | University Hospital Bichat Claude Bernard, Paris and University Paris Diderot
Type: Journal Article | Journal: PloS one | Year: 2015

Predictors of unscheduled return visits (URV), best time-frame to evaluate URV rate and clinical relationship between both visits have not yet been determined for the elderly following an ED visit.We conducted a prospective-observational study including 11,521 patients aged 75-years and discharged from ED (5,368 patients (53.5%)) or hospitalized after ED visit (6,153 patients). Logistic Regression and time-to-failure analyses including Cox proportional model were performed.Mean time to URV was 17 days; 72-hour, 30-day and 90-day URV rates were 1.8%, 6.1% and 10% respectively. Multivariate analysis indicates that care-pathway and final disposition decisions were significantly associated with a 30-day URV. Thus, we evaluated predictors of 30-day URV rates among non-admitted and hospitalized patient groups. By using the Cox model we found that, for non-admitted patients, triage acuity and diagnostic category and, for hospitalized patients, that visit time (day, night) and diagnostic categories were significant predictors (p<0.001). For URV, we found that 25% were due to closely related-clinical conditions. Time lapses between both visits constituted the strongest predictor of closely related-clinical conditions.Our study shows that a decision of non-admission in emergency departments is linked with an accrued risk of URV, and that some diagnostic categories are also related for non-admitted and hospitalized subjects alike. Our study also demonstrates that the best time frame to evaluate the URV rate after an ED visit is 30 days, because this is the time period during which most URVs and cases with close clinical relationships between two visits are concentrated. Our results suggest that URV can be used as an indicator or quality.

News Article | November 22, 2016

PARIS, 22 de novembro de 2016 /PRNewswire/ -- O charme de Paris, a capital europeia da cultura e da moda, está bem estabelecido. Seus monumentos esplendorosos são testemunhos da história da França e da expertise de seus grandes arquitetos. Suas belas ruas, repletas de lojas sofisticadas e...

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