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IntroductionLinks have been established between SARS-CoV-2 and endoplasmic reticulum stress (ERS). However, the relationships between inflammation, ERS, and the volume of organ damage are not well known in humans. The aim of this study was to explore whether ERS explains lung damage volume (LDV) among COVID-19 patients admitted to the intensive care unit (ICU).Materials and methodsWe conducted a single-center retrospective study (ancillary analysis of a prospective cohort) including severe COVID-19 ICU patients who had a chest computed tomography (CT) scan 24 h before/after admission to assess LDV. We performed two multivariate linear regression models to identify factors associated with plasma levels of 78 kDa-Glucose-Regulated Protein (GRP78; ERS marker) and Interleukin-6 (IL-6; inflammation marker) at admission.ResultsAmong 63 patients analyzed, GRP78 plasma level was associated with LDV in both multivariate models (β = 22.23 [4.08;40.38]; p = 0.0179, β = 20.47 [0.74;40.20]; p = 0.0423) but not with organ failure (Sequential Organ Failure Assessment (SOFA) score) at admission (r = 0.03 [−0.22;0.28]; p = 0.2559). GRP78 plasma level was lower among ICU survivors (1539.4 [1139.2;1941.1] vs. 1714.2 [1555.2;2579.1] pg./mL. respectively; p = 0.0297). IL-6 plasma level was associated with SOFA score at admission in both multivariate models (β = 136.60 [65.50;207.70]; p = 0.0003, β = 193.70 [116.60;270.90]; p

Abstract Background Crohn’s disease (CD) is a chronic disorder with frequent complications. The objective of this study was to assess the predictive factors of finding a complication of CD using abdominopelvic CT-scan in patients with a visit to the emergency department. Methods Patients with at least one visit to the gastroenterology department of our University hospital during the year with a CD were retrospectively included. All visits to the emergency department of the hospital during the follow-up of these patients were identified. Results A total of 638 patients were included and 318 (49.8%) had at least one visit to the emergency department since the beginning of their follow-up. Abdominopelvic CT-scan was performed in 141 (23.7%) of the 595 visits for digestive symptoms. Only 4.3% of these CT-scans were considered as normal; there was luminal inflammation without complication in 24.8%, abscess, fistula or perforation in 22.7%, mechanical bowel obstruction in 36.9% and diagnosis unrelated to CD in 11.3%. In univariate analysis, stricturing phenotype (OR, 2.48; 95% CI, 1.16–5.29; p = 0.02) and previous surgery (OR, 2.90; 95% CI, 1.37–6.14; p = 0.005) were predictive factors of finding a complication of CD using abdominopelvic CT-scan, whereas no independent predictive factor was statistically significant in multivariate analysis. Conclusion In CD patients consulting in emergency department, CT-scan examination was performed in 24% of visits for digestive symptoms and complications of CD were found in 60%. Complications were more frequent in patients with stricturing phenotype and previous surgery.

Extrapulmonary tuberculosis (EPT) can affect all organs. Its diagnosis is often challenging, especially when the lung is not involved. Some EPT locations, such as when the central nervous system is involved, are a medical emergency, and some have implications for treatment options and length. This review describes clinical features of EPT, diagnostic tests and treatment regimens.

The paper addresses the issue of relational networks in two artistic worlds: movie production and the performing arts. It mobilizes the notion of “coupled careers”, in line with the analyses that H. Becker and A. Strauss devoted to the “important others” in their study of medical careers (Becker and Strauss, 1956). The lasting relationships that develop during project work between film directors and their producers on the one hand, stage directors and their production administrators on the other, are studied on the basis of these professionals’ career prospects. The article focuses on the contexts in which the working relationships emerge. It then examines how the fact they are long-term propositions is an important stake for the professionals involved. A long-term relationship with a film-maker and stage director gives producers and administrators access to two types of resources that are decisive for the development of their own activities, i.e. film and theater ventures and funding opportunities. The article also examines the factors that may threaten these lasting relationships and cut short the dynamics of a coupled career.

Body composition, currently evaluated by computed tomography scan, is related to poor evolution and severity of Crohn's disease (CD). Few MRI studies have been performed, yet it is the most commonly used imaging modality for the surveillance of the disease. Evaluate the feasibility of MRI body composition measurement and compare the variation according to the activity of the disease. A cohort of 132 consecutive patients was studied. The visceral adiposity index (VAI), subcutaneous adiposity index (SAI) and skeletal muscle index (SMI) were measured. Patients were divided into 2 groups according to disease activity. Sarcopenic status was defined according to the cut off value (SMI < 38.9 cm2/m2 in women and < 54.4 cm2/m2 in men). MRI measurements of body composition parameters were feasible and reproducible. After adjustment, sarcopenia was more common (2.07 [1.02; 4.27], p = 0.046), and the SMI (−4.90 [−9.36; −0.431], p = 0.032) was lower in active disease. The SAI was lower (−14.7 [−29.8; 0.258], p = 0.054) in active disease. The VAI tended to be higher with active disease (3.91 [−3.50; 11.9], p = 0.34), and the VAI/SAI+VAI ratio was higher (9.40 [4.72; 14.1], p <0.001). Assessment of body composition is feasible and reproducible in routine MR and parameters are related to disease activity. [ABSTRACT FROM AUTHOR]

Abstract Background The long-term management of perianal Crohn's disease for patients on anti-TNF-α therapy remains challenging. Aim To evaluate the long-term course and complications of patients with perianal fistulas treated with anti-TNF-α based on their clinical remission and healing on MRI. Methods Patients were evaluated clinically and by MRI. Deep remission was defined as clinical remission associated with the absence of contrast enhancement and T2 hyperintensity on MRI. Flare-free survival, surgery and hospitalizations were compared based on the presence or not of deep remission. Results Forty-eight consecutive patients were included with a median follow-up of 62 months after anti-TNF-α first administration. Deep remission was observed in 16 patients (33.4%). For patients in deep remission, the median time to any perianal event was 116 months (95–130) versus 42 months (8–72) in patients with pathological MRI (p < 0.001). Sixteen patients (50%) with pathological MRI had perianal surgery versus 2 (12.5%) in the deep remission group (p < 0.05). The mean duration of cumulative hospital stays was 0.75 ± 0.52 days in the deep remission group versus 19.7 ± 7.4 in the pathological group (p < 0.05). Conclusions Higher flare-free survival and lower rates of surgery and hospitalization were found in patients achieving deep remission. [ABSTRACT FROM AUTHOR]

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Introduction: Onset of cochleovestibular symptoms (hearing loss, dizziness or instability, tinnitus) after a dive (scuba or breath-hold diving) warrants emergency transfer to an otology department. One priority is to investigate the possibility of the development of decompression sickness with a view to hyperbaric oxygen treatment of bubble-induced inner-ear damage. If this injury is ruled out, inner-ear barotrauma should be considered together with its underlying specific injury pattern, perilymphatic fistula. Methods: We report on a series of 11 cases of perilymphatic fistula following ear barotrauma between 2003 and 2015, eight after scuba diving and three after free diving. All patients underwent a series of laboratory investigations and first-line medical treatment. Results: Seven patients had a perilymphatic fistula in the left ear and four in the right. Eight cases underwent endaural surgical exploration. A fistula of the cochlear fenestra was visualised in seven cases with active perilymph leakage seen in six cases. After temporal fascia grafting, prompt resolution of dizziness occurred, with early, stable, subtotal recovery of hearing in seven. Of six patients in whom tinnitus occurred, this disappeared in two and improved in a further two. Two patients were not operated on because medical treatment had been successful, and one patient refused surgery despite the failure of medical treatment. Median follow-up time was 7.4 years (range 0.3 to 12). Conclusion: The diagnosis of perilymphatic fistula is based on clinical assessments and various laboratory findings. When there was strong evidence of this condition, surgery yielded excellent functional outcomes in all patients treated early. [ABSTRACT FROM AUTHOR]

Résumé Depuis les années 1990, la nomenclature française des professions et catégories socioprofessionnelles (PCS), outil historique de description quantitative des inégalités entre les groupes sociaux, apparaît fragilisée par un ensemble de critiques. Parmi celles-ci, l’hypothèse d’une baisse de la pertinence du statut est avancée. L’objet de ce texte est donc de mettre le statut à l’épreuve, en tant qu’il constitue un élément de catégorisation du monde social. Inspirée d’une expérience méthodologique conduite par Luc Boltanski et Laurent Thévenot au début des années 1980, notre démarche s’intéresse aux catégorisations ordinaires du monde social. Elle a consisté à soumettre à 547 enquêtés un jeu de 33 cartes représentant des salariés (sur contrats de durée déterminée ou indéterminée), des travailleurs indépendants (à leur compte ou employeurs), ainsi que des fonctionnaires ou assimilés, et à leur demander de constituer des groupes de cartes. Les classements effectués confirment la centralité du statut en montrant que l’indépendance et la fonction publique constituent en France deux pôles incontournables de représentation de l’espace social. Since the 1990s, the French classification of professions and socio-professional categories, the quantitative tool historically used to describe the inequalities between social groups, has come under criticism from numerous quarters. One critique suggests that status has become less relevant. The aim of this paper, therefore, is to test the concept of status, insofar as it constitutes one way of categorising the social world. Inspired by a methodological experiment conducted by Luc Boltanski and Laurent Thévenot in the early 1980s, our approach looks at the ordinary categorisations of the social world. It entailed submitting to 547 survey subjects a set of 33 cards representing employees (on permanent and temporary contracts), self-employed workers (either freelancers or employers), as well as civil servants or equivalent employees, and asking them to assemble the cards into groups. The classifications formed confirm the centrality of status by showing that self-employment and public service in France constitute two fundamental polarities in the representation of social space. [ABSTRACT FROM AUTHOR]

Extrapulmonary tuberculosis (EPT) can affect all organs. Its diagnosis is often challenging, especially when the lung is not involved. Some EPT locations, such as when the central nervous system is involved, are a medical emergency, and some have implications for treatment options and length. This review describes clinical features of EPT, diagnostic tests and treatment regimens., Competing Interests: Conflict of interest: D. Natali has nothing to disclose. Conflict of interest: G. Cloatre has nothing to disclose. Conflict of interest: C. Brosset has nothing to disclose. Conflict of interest: P. Verdalle has nothing to disclose. Conflict of interest: A. Fauvy has nothing to disclose. Conflict of interest: J-P. Massart has nothing to disclose. Conflict of interest: Q. Vo Van has nothing to disclose. Conflict of interest: N. Gerard has nothing to disclose. Conflict of interest: C.C. Dobler has nothing to disclose. Conflict of interest: P. Hovette has nothing to disclose., (Copyright ©ERS 2021.)

Competing Interests: Les auteurs déclarent n’avoir aucun lien d’intérêts.

Aim: To describe 18 cases of patients treated for advanced cutaneous squamous cell carcinoma (CSCC) of the head metastasing to cervical lymph nodes and parotid gland. To estimate their survival and the risk factors of metastases., Patients and Methods: 18 cases of patients affected by CSCC of the head, metastatic to parotid and cervical lymph nodes were afterward analyzed. Two populations were differentiated: the patients already treated for their CSCC, with secondary appearance of metastases in the Population A, the patients by whom the metastase is concomitantly discovered to the CSCC in the Population B., Results: The treatment consisted of a parotidectomy and neck dissection, possibly associated with excision of the primary tumour. Adjuvant radiotherapy was systematic. Metastatic progression was on lungs most of the time (57%), in patients of the population B (80%), or of whom primitive CSCC was of bad forecast (group 2) (78%). The mortality was bound to the complications induced by distant metastases (63%), at 5 years it was superior in the population B (100%) than in the population A (77%)., Conclusion: CSCC of the head, metastatic to parotid and cervical lymph nodes have a severe prognosis for survival in spite of an optimal curative treatment applied to fragile old patients.

Introduction: The schwannoma of the glossopharyngeal nerve is a rare etiology among the tumor masses developed in the parapharyngeal space., Case Report: We report the case of a 33 years old woman in whom a large schwannoma of the left glossopharyngeal nerve was discovered incidentally on a brain MRI. Respiratory evolutionary prognosis imposed trans-oral surgical treatment., Discussion: We discuss the diagnostic and therapeutic strategy for the benign tumors of the parapharyngeal space., Conclusion: The schwannoma of the glossopharyngeal nerve is a benign rare lesion. The difficulty lies on the surgical strategy and the choice of the approach. The functional suites are marked by difficulty swallowing and require intensive speech therapy.