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Background To date, there has been no published comprehensive estimation of costs related to Prader-Willi syndrome (PWS). Our objective was therefore to provide data on the economic burden and health-related quality of life associated with PWS in France in order to raise awareness of the repercussions on individuals suffering from this syndrome and on caregivers as well as on the health and social care systems. Method A retrospective cross-sectional study was carried out on 51 individuals recruited through the French PWS patient association. Data on their demographic characteristics and resource use were obtained from an online questionnaire, and costs were estimated by a bottom-up approach. The EQ-5D-5L health questionnaire was used to measure the health-related quality of life of individuals suffering from PWS and their caregivers. Results The average annual cost of PWS was estimated at €58 890 per individual, with direct healthcare accounting for €42 299, direct non-healthcare formal costs €13 865 and direct non-healthcare informal costs €8459. The main contributors to PWS costs were hospitalisations and social services. Indirect costs resulting from loss of productivity in the labour market was €32 542 for adults suffering from PWS. Mean EQ-5D utility scores were 0.4 for individuals with PWS and 0.7 for caregivers. Conclusions Prader-Willi syndrome represents a major economic burden from a societal perspective and has a significant impact on health-related quality of life both for individuals suffering from PWS and for their caregivers in France. These results underscore the need to develop tailored policies targeted at improving care. Likewise, a larger study collecting a broader range of medical characteristics should be undertaken to achieve more precise estimations. [ABSTRACT FROM AUTHOR]

Summary: Epilepsy is a frequent neurological pathology whose effects on affective and cognitive development of the child have long been underestimated. The origin of the cognitive and behavioral disorders of children diagnosed with epilepsy is often multifactorial: the identification and the treatment of these disorders require a multidisciplinary assessment and approach, which would take into consideration neurological, cognitive, as well as psychological factors. Based on the multidisciplinary approach employed by the professionals of the Sessad, the study of a clinical case is presented in this article. The authors stress the importance for each professional concerned to have a knowledge of the different dimensions of the illness, as well as to collaborate with other colleagues, the parents and the school in order to develop a comprehensive therapeutic program tailored to the individual child. [Copyright &y& Elsevier]

Background: Based on the observation of the misuse of ICD-10 to code the diagnoses in the RIM-P (lack of completeness, conformity and diversity), the Technical Agency for information on Hospital Care (ATIH), which provides tools for collecting medical information, conducted two actions in 2016. First, a chapter devoted to the instructions of coding has been written in the methodological guide of production of the RIM-P, second, a variable "type psy" was added to the ICD-10 nomenclature's file framing ICD-10 coding in the RIM-P. The purpose of this study is to describe the quality of diagnosis coding using ICD-10 in the RIM-P in 2015 and 2016., Methods: The quality of diagnosis coding using ICD-10 in the summaries of activity of the RIM-P national databases was described in 2015 and 2016. The study focused on the completeness, the conformity and the diversity of coding., Results: Between 2015 and 2016, the percentage of summaries without primary diagnosis ("DP") decreased slightly for full-time (5.2% vs. 3.8%), part-time (6.3% vs. 4.9%) inpatient stays and outpatient care (9.9% vs. 8.9%). ICD-10 codes used to code DP or associated diagnosis ("DA"), while prohibited, mainly belong to Chapter V Mental and behavioral disorders. Per year, only one-third of the summaries and one-half of patients had two or more ICD-10 codes reported for inpatient stays (one-fifth of the summaries and one-fourth of the patients for outpatient care). In addition, per year and per facility, the average number of distinct ICD-10 codes used to fill "DP" or "DA" was approximately half as important in part-time hospitalization, as in full-time hospitalization or for outpatient care. Moreover, 90% of the health facilities used<550 distinct ICD-10 codes in full-time inpatient stays,<270 in part-time inpatient stays and<950 for outpatient care to code the "DP" or the "DA". The diversity of ICD-10 codes used was low and similar between 2015 and 2016, especially to describe the socio-economic environment, resistance to treatment or non-compliance., Conclusion: This study emphasizes the need for a collective effort to improve the diversity of the diagnoses' coding in the RIM-P., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Background: French post-acute care and rehabilitation facilities describe and code their activity through the Program for Medicalization of Information Systems (PMSI). A new specific catalogue of rehabilitation procedures (CSARR) has been implemented to code rehabilitation acts since 2013. This study aimed to assess the coherence of the coding of the rehabilitation acts using the CSARR two years after its establishment through the analyze of 3 main items regarding patients and therapists., Methods: We analyzed the use of CSARR for coding rehabilitation acts from the PMSI national database for post-acute care and rehabilitation, in 2015. Analyses were made on specific items characterizing rehabilitation acts: "number of patients", "type of therapists" and "number of therapists"., Results: There were 72,014,731 rehabilitation acts coded in 2015 using CSARR nomenclature; 86% were individual rehabilitation acts. All acts of CSARR, except one, were used to describe rehabilitation activities. Physiotherapists coded the majority of rehabilitation acts (47%), then nurses (14%). Coding errors were identified as the "number of patients", coded with more than one patient for individual acts (13% of the acts) or with less than 2 patients for groups (6% of the acts), or the "number of therapists" coded with only one therapist for rehabilitation acts requiring several professionals., Conclusion: This first assessment indicated a good level of appropriation of the CSARR coding rules in the national PMSI database by post-acute care and rehabilitation facilities. However, a simplification of this catalogue and therapist training could increase the quality of the rehabilitation data., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Severe combined immunodeficiencies (SCID) are a group of inherited diseases of the immune system characterized by profound abnormalities of T-cell development. Infants with SCID require prompt clinical intervention to prevent life-threatening infection and studies show significantly improved survival in babies diagnosed at birth based on previous family history. SCID follows the criteria for population-based newborn screening because it is asymptomatic at birth and fatal within the 1st year of life if there is no intervention, the confirmation of the disease is easy, there is a curative treatment, and it is known that early hematopoietic stem cell transplantation significantly improves survival, the quality of immune reconstitution, and quality of life. Quantification of T-cell receptor excision circles (TRECs) in DNA extracted from Guthrie samples is a sensitive and specific screening test for SCID. We conducted a nationwide prospective study of neonatal screening of SCID in a population of 200,000 French newborns over a period of 2 years. The objective was to study the clinical utility and the cost-effectiveness ratio, and to demonstrate that universal SCID screening could result in a substantial benefit to detect individuals, making screening relatively cost-effective in spite of the low incidence of the disease., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

The extent to which ivermectin treatments have an impact on onchocerciasis transmission is a matter of some concern. We investigated this issue in the Mbam valley, a hyperendemic focus located in a forest-savannah mosaic area of Cameroon. Parasitological examinations of 5-9-year-old children, who had never received any antifilarial drug, were conducted before the first distribution of ivermectin in 1991-1993 and again in 2002, after four annual rounds of mass treatments. After matching for gender, age and village of residence, the prevalence and intensity of microfilaridermia corresponded respectively, in 2002, to 66.2 and 42.0% of the initial values. The decrease was more marked among the youngest children who, compared with the older ones, were submitted to the reduced force-of-infection earlier in their life. The results of the present study suggest that the specific vectorial competence of Simulium squamosum cytotype B, the vector of Onchocerca volvulus in the Mbam valley, allows a significant decrease in onchocerciasis transmission after several years of treatment, despite low therapeutic coverage. Though these results are encouraging, efforts should be made to improve the therapeutic coverage in the area.

To meet the needs of a colony, bees collect honey, honey-dew, pollen and water from an environment exposed to various bacterial and chemical contaminants, which might be incorporated in products for human consumption. In addition to this environmental pollution, contamination of bee products may also occur during packing. In France, tests for various pollutants are performed more or less systematically, at the request of the Ministry of Agriculture, merchants or producers. Honey and royal jelly contain very little bacterial or chemical contamination, due to both the ability of colonies to eliminate pathogenic and non-pathogenic micro-organisms present in their environment, and to the physico-chemical properties of these products, as well as the role of bees in filtering chemical pollutants. To create the framework for European legislation on the testing of products, bacterial and chemical standards should be created and should be based on standardised techniques. The testing of imported bee products requires greater attention.

An evolutionary diagram that takes into account the development of personality and its structuring or restructuring was developed thanks to a better understanding of autistic disorders from a psychodynamic point of view through long term psychoanalytic treatment of autistic children. This grid is organised around the major stages of the formation of the bodily ego which autistic children helped us understand better. The construction of space and the capacities of cognitive instrumentation are logically within this line of structuring. These major stages are defined: the first is the "successful" autistic state; the second is the stage where the primary skin is recovered (feeling of a circular envelope); the third is the symbiotic phase which includes vertical splitting then horizontal splitting of the image of the body; finally, the fourth is the phase of individuation/separation into a whole body. At each stage the following are assessed: state of the image of the body, of the gaze, of language, of writing, the autistic symptoms, emotional-relational manifestations, exploration of space and objects, recognition in time, the aggressive behaviours, reactivity to pain and to immune states (somatic and psychosomatic manifestations).

The authors have tried to look at the graphs of ultrasound growth in their population in order to establish a base pattern. The infants were divided into groups according to their frame and a study of each diameter was made for each group. The authors show that all babies that start off from the same point arrive at their final stature which is different from all others because of their own rates of growth. The curve which is suggested fits in with this spread. The way it is built up has been explained as well as the follow-up studies that show that it is valid. The discussion points out that the rates of growth can be measured; and the value of the diameter of the thorax.