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Introduction Juvenile Idiopathic Arthritis (JIA) is a group of conditions characterized by chronic inflammatory joint disease of unknown aetiology before the age of 16. This joint damage is complicated by joint deformities, amplitude limitations, muscle imbalances causing a reduction in the functional capacities of the child. The delayed diagnosis, the inaccessibility of biotherapies give rise to deformations which hinder the development of the physical capacities and the social, educational and then professional integration of the child. Objective Sensitize practitioners about early diagnosis and multidisciplinary management of JIA, in order to avoid severe deformities. Observation A 17-year-old girl, out of school, was admitted to a rheumatology unit for the evolution of chronic polyarthralgia with transient skin eruption evolving by inflammatory attack with partial remission since the age of 8 years. There was no notable story. On physical examination, the affected joints were painful. Deformities were observed such as valgus of the knees and forefeet, ulnar deviation of the wrists and nonspecific of the fingers (Figs. 1 and 2). The biological inflammatory syndrome was present with (CRP 90 mg/l, VS 48 mm/h) and a blood count (Hb 12.5 g/dl, Plq 205 000/μL, GB 14. 109/l). Serum ferritin was elevated at 197.7 μg/ml. The other assessments in particular (blood cultures, FAN, FR, blood smears) came back negative. The diagnosis of AJI in systemic form was retained. The X-ray showed osteoarticular destruction with fixed exostoses, Larsen's stage 4 (Figs. 3 and 4) and Steinbrocker's stage 3 with minimal functional capacity. The treatment included an NSAID (ibuprofen at 40 mg/kg/day), followed by corticosteroid therapy (Prednisolone at a dose of 1 mg/kg/day) and as background treatment methotrexate (10 mg/week). evolution at 3 months was favorable on the pain. The management of the deformities was the subject of a multidisciplinary consultation meeting (physiotherapists, rheumatologists, orthopedic surgeons and paediatricians) very expensive for the parents. Thus it benefited a physical treatment made up of joint maintenance physiotherapy and equipment for joints that are still mobile. E59 Figures 1 and 2 Open in new tab Download slide E59 Figures 3 and 4 Open in new tab Download slide Discussion In Africa, osteoarticular pathology in children most often evokes diagnoses of sickle cell disease and acute articular rheumatism. From the first symptoms, children are referred to traditional healers, especially in rural areas where there is no specialist, then to pediatrics [1]. These reasons could explain the long delay in diagnosis as in the patient whose delay was 9 years. The diagnostic age of our patient was 17 years, higher than elsewhere [2] but consistent with the results of Diomandé in Abidjan with an average delay of 10 years [3]. Most studies find a female predominance with an age of onset between 4 and 8 years [4, 5]. In our patient, the involvement was polyarticular from the outset and the FRs were negative, as in most studies [1, 3]. The presence of these deformities was a source of significant handicap in our patient, which led to her dropping out of school, as stipulated in the literature. In first intention, we used NSAIDs, however unsatisfactory. Faced with the persistence of pain, she received prednisolone at 1 mg/kg/d favorable. As basic treatment she received methotrexate, biotherapies being inaccessible in our context because of their high cost. The management of deformities was the subject of a multidisciplinary consultation meeting (physiotherapists, rheumatologists, orthopedic surgeons and paediatricians) whose costs were beyond the reach of indigent parents. Conclusion The diagnosis and the multidisciplinary treatment must be early and continuous of the disease in order to avoid the deformations, which once installed are irreversible. References 1. V. Weber, L. Goffin, A. Kolivras, C. Adler and G. Casimir. An atypical case of systemic juvenile idiopathic arthritis: Rev Med Brux 2017; 38: 511–4 2. Diomandé M, Coulibaly AK, Kouakou ESCL, Yao JC. Profile of Juvenile Idiopathic Arthritis Observed in Abidjan (Côte d'Ivoire): A Report about 17 Cases. British Journal of Medicine & Medical Research. 2016; 16 (11): 1–6 3. Chkirate B, Jabouril F, Aïtouamar H, Rouiti A et al. Juvenile idiopathic arthritis (about 70 cases). Medical hope. 2001; 8: 256–260 4. Juvenile idiopathic arthritis—Focus on Disability/Orphanet Disability Encyclopedia www.orpha.net/data/patho/Han/Int/fr/ArthriteJuvenileIdiopathique%5fFR%5ffr%5fHAN%5fORPHA92.pdf | January 2018 5. F. Beltramo, Claude Gavillot, Irène Lemelle, Danièle Sommelet. Physical Medicine and Rehabilitation in Juvenile Idiopathic Arthritis: Rheumatism Review 70 (2003) 507–510 Conflict of interest None [ABSTRACT FROM AUTHOR]

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The study of the coagulation-fragmentation model has provided insights into various engineering and scientific disciplines. However, the characteristics of particle ensembles are determined by multiple parameters in a multidimensional parameter space, including mass, volume, porosity, binder content, enthalpy, mole number, and more. This work focuses on establishing the existence of a continuous solution for the higher dimensional model, subject to certain restrictions on the kernels. Additionally, the conservation of volume of the solution are investigated. The results are derived based on the compactness result of Arzelà-Ascoli and the Banach contraction mapping principle. [ABSTRACT FROM AUTHOR]

The incidence and prevalence of neuroendocrine tumors (NETs) are continually increasing. While it is known that NET symptoms often predate diagnosis, their prevalence and impact on resource utilization and costs are largely unknown. We identified 9,319 elderly patients diagnosed with NETs between 1/2003 and 12/2011 from the Surveillance, Epidemiology and End Results (SEER)-Medicare. We examined the patients’ conditions potentially associated with NET, resource utilization and costs during the year before diagnosis. We found that NET patients were more likely to have diagnoses of hypertension (63.8% vs. 53.3%), abdominal pain (22.2% vs. 7.6%), heart failure (11.7% vs. 8.0%), diarrhea (5.8% vs. 1.8%), peripheral edema (5.4% vs. 3.8%) and irritable bowel syndrome (1.2% vs. 0.5%) compared to the non-cancer control group. They also had much higher resource utilization including number of outpatient visits (mean: 22.1 vs. 17.2), percentage with ER visits (20.9% vs. 11.6%), and hospitalizations (28.4% vs. 17.0%). Similarly, NET patients incurred significantly higher total (mean: $14602 vs. $9464), outpatient (mean: $5987 vs. $4253), and inpatient costs (mean: $8615 vs. $5211). This first population-based study on the pre-diagnosis symptoms and healthcare utilization found that NET patients were more likely to have certain conditions and incur higher resource utilizations and costs. [ABSTRACT FROM AUTHOR]

In this paper, four extragradient-type algorithms are presented for solving bilevel variational inequalities of pseudomonotone and non-Lipschitz continuous operators in real Hilbert spaces. The proposed iterative schemes employ two Armijo-type linesearch methods making them work adaptively. Strong convergence theorems of the suggested algorithms are established under some mild conditions. Finally, some numerical experiments and applications are given to verify the advantages and efficiency of the proposed algorithms over some previously known ones. [ABSTRACT FROM AUTHOR]

In a real Hilbert space, let the GSVI and CFPP represent a general system of variational inclusions and a common fixed point problem of countable nonexpansive mappings and an asymptotically nonexpansive mapping, respectively. In this paper, via a new inertial subgradient extragradient rule we introduce and analyze two iterative algorithms for solving the monotone bilevel equilibrium problem (MBEP) with the GSVI and CFPP as constraints. Some strong convergence theorems for the proposed algorithms are established under some mild assumptions. Our results improve and extend some corresponding results in the earlier and very recent literature. [ABSTRACT FROM AUTHOR]

A new inclusion problem is introduced using generalized Cayley operator and we call it Cayley inclusion problem. We also study its corresponding resolvent equation problem. By using a generalized resolvent operator and generalized Yosida approximation operator, first we establish a fixed point formulation for Cayley inclusion problem. An algorithm is defined to find the solution of Cayley inclusion problem. An existence and convergence result is proved. Secondly, we have shown the equivalence of Cayley inclusion problem with a resolvent equation. We define an iterative algorithm with some of its equivalent forms for solving resolvent equation problem. A numerical example is constructed and a convergence graph is shown by using MATLAB program. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this paper is to introduce and analyze an extragradient method with regularization for finding a common element of the solution set of the split feasibility problem and the set of fixed points of a nonexpansive mapping in the setting of infinite-dimensional Hilbert spaces. Combining the regularization method and the extragradient method due to Nadezhkina and Takahashi [N. Nadezhkina, W. Takahashi, Weak convergence theorem by an extragradient method for nonexpansive mappings and monotone mappings, J. Optim. Theory Appl. 128 (2006) 191–201], we propose an iterative algorithm for finding an element of . We prove that the sequences generated by the proposed algorithm converge weakly to an element of under mild conditions. [Copyright &y& Elsevier]

Abstract: In this paper, we consider the split feasibility problem (SFP) in infinite-dimensional Hilbert spaces, and study the relaxed extragradient methods for finding a common element of the solution set of SFP and the set of fixed points of a nonexpansive mapping . Combining Mann’s iterative method and Korpelevich’s extragradient method, we propose two iterative algorithms for finding an element of . On one hand, for , the identity mapping, we derive the strong convergence of one iterative algorithm to the minimum-norm solution of the SFP under appropriate conditions. On the other hand, we also derive the weak convergence of another iterative algorithm to an element of under mild assumptions. [Copyright &y& Elsevier]

Abstract: The present paper is divided into two parts. In the first part, we introduce implicit and explicit iterative schemes for finding the fixed point of a nonexpansive mapping defined on the closed convex subset of a real Hilbert space. We establish results on the strong convergence of the sequences generated by the proposed schemes to a fixed point of a nonexpansive mapping. Such a fixed point is also a solution of a variational inequality defined on the set of fixed points. In the second part, we propose implicit and explicit iterative schemes for finding the approximate minimizer of a constrained convex minimization problem and prove that the sequences generated by our schemes converge strongly to a solution of the constrained convex minimization problem. Such a solution is also a solution of a variational inequality defined over the set of fixed points of a nonexpansive mapping. The results of this paper extend and improve several results presented in the literature in the recent past. [Copyright &y& Elsevier]

Abstract: In this paper, we introduce the concept of a -function defined on a quasi-metric space which generalizes the notion of a -function and a -distance. We establish Ekeland-type variational principles in the setting of quasi-metric spaces with a -function. We also present an equilibrium version of the Ekeland-type variational principle in the setting of quasi-metric spaces with a -function. We prove some equivalences of our variational principles with Caristi–Kirk type fixed point theorems for multivalued maps, the Takahashi minimization theorem and some other related results. As applications of our results, we derive existence results for solutions of equilibrium problems and fixed point theorems for multivalued maps. We also extend the Nadler’s fixed point theorem for multivalued maps to a -function and in the setting of complete quasi-metric spaces. As a consequence, we prove the Banach contraction theorem for a -function and in the setting of complete quasi-metric spaces. The results of this paper extend and generalize many results appearing recently in the literature. [Copyright &y& Elsevier]

We introduce two new iterative algorithms with line-search process for solving a variational inequality problem with pseudomonotone and Lipschitz continuous mapping and a common fixed-point problem of an asymptotically nonexpansive mapping and a strictly pseudocontractive mapping. The proposed algorithms are based on inertial subgradient extragradient method with line-search process, hybrid steepest-descent method, and viscosity approximation method. Under mild conditions, we prove strong convergence of the proposed algorithms in a real Hilbert space. [ABSTRACT FROM AUTHOR]

Background: Incidence of locoregional neuroendocrine tumors (NETs) is rising. However, after curative resection, the patterns and risk factors associated with recurrence remain unknown. Consensus guidelines recommend surveillance every 6-12 months for up to 10 years after surgery for resected, well-differentiated NETs irrespective of patient demographics, site, grade or stage of tumor with few exceptions. Patients and methods: From the Surveillance, Epidemiology and End Results (SEER)-Medicare database, we identified localized and regional stage NET patients who underwent surgical resection between January 2002 and December 2011. Development of recurrence was identified by capturing at least two claims indicative ofmetastatic disease until 31 December 2013. Results: Of the 2366 identified patients (median age 73 years), 369 (16%) developed metastatic disease within 5 years and only an additional 1% developed metastases between years 5 and 10 with the majority dying due to unrelated causes. The 5-year risk of developing metastases (hazard ratio, HR) varied significantly (log-rank P<0.001) by grade: 9.9% versus 25.9% (2.2) versus 48.1% (4.4) for grades 1, 2 and ⩾3, respectively; stage: 10.3% versus 31.1% (2.8) for localized versus regional; primary tumor size: 7.6% versus 15% (1.3) versus 26.6% (1.5) for<1, 1-2 and>2 cm, respectively and site: ranging from 11.3% for colon to 23.9% for pancreas. Conclusions: Contrary to current guidelines, our study suggests that surveillance recommendations should be tailored according to patient and tumor characteristics. Surveillance past 5 years may be avoided in elderly patients with competing morbidities or low risk of recurrence. Pancreatic, lung, higher grade and regional NETs have a higher risk of recurrence and may be considered for future adjuvant trials. [ABSTRACT FROM AUTHOR]

Background: Several studies have demonstrated the antitumor activity of first-generation somatostatin analogs (SSAs), primarily targeting somatostatin receptor (sstr) subtypes 2 and 5, in neuroendocrine tumors (NET). Pasireotide, a second-generation SSA, targets multiple sstr subtypes. We compared the efficacy and safety of pasireotide plus everolimus to everolimus alone in patients with advanced, well-differentiated, progressive pancreatic NET. Patients and methods: Patients were randomized 1 : 1 to receive a combination of everolimus (10 mg/day, orally) and pasireotide long-acting release (60 mg/28 days, intramuscularly) or everolimus alone (10 mg/day, orally); stratified by prior SSA use, and baseline serum chromogranin A and neuron-specific enolase. The primary end point was progression-free survival (PFS). Secondary end points included overall survival, objective response rate, disease control rate, and safety. Biomarker response was evaluated in an exploratory analysis. Results: Of 160 patients enrolled, 79 were randomized to the combination arm and 81 to the everolimus arm. Baseline demographics and disease characteristics were similar between the treatment arms. No significant difference was observed in PFS: 16.8months in combination arm versus 16.6months in everolimus arm (hazard ratio, 0.99; 95% confidence interval, 0.64-1.54). Partial responses were observed in 20.3% versus 6.2% of patients in combination arm versus everolimus arm; however, overall disease control rate was similar (77.2% versus 82.7%, respectively). No significant improvement was observed inmedian overall survival. Adverse events were consistent with the known safety profile of both the drugs; grade 3 or 4 fasting hyperglycemia was seen in 37% versus 11% of patients, respectively. Conclusions: The addition of pasireotide to everolimus was not associated with the improvement in PFS compared with everolimus alone in this study. Further studies to delineate mechanisms by which SSAs slow tumor growth in NET are warranted. [ABSTRACT FROM AUTHOR]

Background The contribution of induction chemotherapy (IC) before preoperative chemoradiation for esophageal cancer (EC) is not known. We hypothesized that IC would increase the rate of pathologic complete response (pathCR). Methods Trimodality-eligibile patients were randomized to receive no IC (Arm A) or IC (oxaliplatin/FU; Arm B) before oxaliplatin/FU/radiation. Surgery was attempted ∼5–6 weeks after chemoradiation. The pathCR rate, post-surgery 30-day mortality, overall survival (OS), and toxic effects were assessed. Bayesian methods and Fisher's exact test were used. Results One hundred twenty-six patients were randomized dynamically to balance the two arms for histology, baseline stage, gender, race, and age. Fifty-five patients in Arm A and 54 in Arm B underwent surgery. The median actuarial OS for all patients (54 deaths) was 45.62 months [95% confidence interval (CI), 27.63–NA], with median OS 45.62 months (95% CI 25.56–NA) in Arm A and 43.68 months (95% CI 27.63–NA) in Arm B (P = 0.69). The pathCR rate in Arm A was 13% (7 of 55) and 26% (14 of 54) in Arm B (two-sided Fisher's exact test, P = 0.094). Safety was similar in both arms. Conclusions These data suggest that IC produces non-significant increase in the pathCR rate and does not prolong OS. Further development of IC before chemoradiation may not be beneficial. [ABSTRACT FROM PUBLISHER]

Abstract: We introduce a new composite iterative scheme to approximate a zero of an -accretive operator defined on uniform smooth Banach spaces and a reflexive Banach space having a weakly continuous duality map. It is shown that the iterative process in each case converges strongly to a zero of . The results presented in this paper substantially improve and extend the results due to Ceng et al. [L.C. Ceng, H.K. Xu, J.C. Yao, Strong convergence of a hybrid viscosity approximation method with perturbed mappings for nonexpansive and accretive operators, Taiwanese J. Math. (in press)], Kim and Xu [T.H. Kim, H.K. Xu, Strong convergence of modified Mann iterations, Nonlinear Anal. 61 (2005) 51–60] and Xu [H.K. Xu, Strong convergence of an iterative method for nonexpansive and accretive operators, J. Math. Anal. Appl. 314 (2006) 631–643]. Our work provides a new approach for the construction of a zero of -accretive operators. [Copyright &y& Elsevier]

Abstract: In this paper, we propose an iterative scheme for finding a common element of the set of solutions of an equilibrium problem and the set of fixed points of a strict pseudo-contraction mapping in the setting of real Hilbert spaces. We establish some weak and strong convergence theorems of the sequences generated by our proposed scheme. Our results combine the ideas of Marino and Xu’s result [G. Marino, H.K. Xu, Weak and strong convergence theorems for strict pseudo-contractions in Hilbert spaces, J. Math. Anal. Appl. 329 (2007) 336–346], and Takahashi and Takahashi’s result [S. Takahashi, W. Takahashi, Viscosity approximation methods for equilibrium problems and fixed point problems in Hilbert spaces, J. Math. Anal. Appl. 331 (2007) 506–515]. In particular, necessary and sufficient conditions for strong convergence of our iterative scheme are obtained. [Copyright &y& Elsevier]

Objective: To study the differences in cognitive function between patients with laryngeal carcinoma and healthy volunteers. Method: Patients with laryngeal carcinoma who have been first diagnosed with laryngeal carcinoma, but not received treatment at the Department of Otolaryngology in two hospitals in Shanxi Province and healthy volunteers of the same age, gender-matched and similar education were studied for the purpose to evaluate the cognitive status by using the Wechsler memory scale. Result: No significant difference of age, gender and educational level was found between both groups（ P >0.05）.The score of Memory Quotient was significantly lower in the laryngeal carcinoma group than that in healthy control group ( P <0.05). There were significant differences in the results of Wechsler memory scale except for Experience, Orientation and Association test ( P <0.05). Conclusion: The memory, attention and computing power of patients in the laryngeal carcinoma group were not as good as those of patients in the healthy control group. Patients with laryngeal carcinoma have cognitive impairment or lower ability , so we need to pay more attention to the patients during their rehabilitation. The early detection of cancer-related cognitive impairments can help patients improve their cognitive function early, reduce the burden on their families and society, and promote better return of patients to society.

In the RADIANT-2 trial, addition of everolimus to octreotide long-acting repeatable (LAR) exhibited a clinically meaningful 5.1-month improvement in progression-free survival (PFS) in patients with advanced functional neuroendocrine tumors. In this study, we characterized the effects of everolimus co-administration on octreotide LAR pharmacokinetics and its relationship with efficacy and safety. At least one evaluable blood everolimus and plasma octreotide predose minimum concentration (C min ) was available for 182 patients and 294 patients, respectively. Concomitant everolimus administration increased octreotide C min with a geometric mean ratio (everolimus/placebo) of 1.47 (90% confidence interval [CI] = 1.32-1.64). Risk for progression was consistently reduced when everolimus C min was increased twofold, regardless of octreotide exposure (hazard ratio [HR] = 0.74; 95% CI = 0.46-1.18; HR = 0.54; 95% CI = 0.32-0.92 for 6 ng/mL and 4 ng/mL octreotide, respectively). Risk for pulmonary or metabolic events was associated with increased everolimus C min . Co-administration of everolimus plus octreotide LAR increased octreotide C min , which did not impact efficacy., (© 2016 American Society for Clinical Pharmacology and Therapeutics.)

In this study, we report the results of the experience of the Rheumatology Department of Cocody University Hospital in the management of the cervical spinal tuberculosis in Abidjan area. This was a retrospective study of 26 cases collected over a 7 year period (January 2006 to December 2013). The objective of this work was to illustrate the epidemiological, clinical and radiological profile of the cervical localization of tuberculosis in our practice. The prevalence of cervical disease was 4.87%. The average age of our patients was 48.27 years, with a slight male predominance (60.7%). The duration of disease progression was long (8 months on average); symptomatology was dominated by pain associated with stiffness in all patients (100%). One third of patients had already consulted at the stage of neurological complications (1 case of Brown Sequard syndrome, 2 cases of tetraparesis, 5 cases of paraplegia). Computer tomography was performed in all patients, followed by an MRI scan for 6 patients, which revealed the predominance of damage to the C3-C4 floor (34.62%) and 3 cases of sub occipital localization. Spondylodiscitis was the main radiological anatomical lesion (88.46%), lesions were multi-stage in 61.54% of cases, the prevalence of retropharyngeal abscess was high (84.61% of cases), that of the epiduritis was 76.92% and radiological spinal cord compression was recorded in a third of cases. All patients benefited from an antituberculous treatment associated with cervical immobilization., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)