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Abstract Background To identify demographic and clinical factors associated with psychological and behavioral functioning (PBF) in people with type 2 diabetes living in France. Methods In March 2002, approximately 10,000 adults, who had been reimbursed for at least one hypoglycemic treatment or insulin dose during the last quarter of 2001, received a questionnaire about their health status and PBF (3,646 responders). For this analysis, the 3,090 persons with type 2 diabetes, aged 18-85 years old were selected. PBF was measured with the adapted version of the Diabetes Health Profile for people with type 2 diabetes. This permitted the calculation of three functional scores - psychological distress (PD), barriers to activity (BA), and disinhibited eating (DE) - from 0 (worst) to 100 (best). Results Major negative associations were observed with PBF for microvascular complications (a difference of 6.7 in the BA score between persons with and without microvascular complications) and severe hypoglycemia (difference of 7.9 in the BA score), insulin treatment (-8.5 & -9.5 in the PD & BA scores respectively, as compared to treatment with oral hypoglycemic agents), non-adherence to treatment (-12.3 in the DE score for persons forgetting their weekly treatment), increasing weight (-8.5 & -9.7 in the PD & DE scores respectively, as compared to stable weight), at least one psychiatrist visit in 2001 (-8.9 in the DE score), and universal medical insurance coverage (-7.9 in the PD score) (due to low income). Conclusion Prevention and management of microvascular complications or adherence to treatment (modifiable factors) could be essential to preserving or improving PBF among people with type 2 diabetes. A specific approach to type 2 diabetes management may be required in groups with a low socioeconomic profile (particularly people with universal medical insurance coverage), or other non modifiable factors.

A thorough questionnaire-based survey of French diabetes networks depicts an accurate description of the services they offer, in particular concerning physical activity. Often considered as less important than medicinal monitoring and dietetics, physical activity is at the core of a new professional dynamic. Practical sessions of adapted physical activity are presently offered in half the networks, as either one-time awareness-raising sessions or a complete series of sessions. Sports medicine educators seem to constitute an emerging professional group within a framework which aims to complement information provided to patients by skills-building through group sessions. Two distinct perspectives emerge as being linked to intervention methods: the first one aims to educate about physical activity, while the second aims to educate through physical activity.

It is debatable whether treatment of thyroid nodules with thyroid hormones is effective, results of clinical trials, even randomized, being inconclusive, none of them showing significant efficacy of this therapy. Two questions remain unanswered: what is the natural history of these nodules and is it possible to identify patients with these heterogeneous lesions who will respond to treatment? Currently available study data show a marked level of spontaneous regression or even total disappearance of the nodules. Further long-term clinical trials appear indicated, including a sufficient number of patients and a large cohort of untreated patients.

The authors report of three cases of medullary carcinoma of the thyroid and, from a review of the literature, study the definition, frequency, embryological and etiological characteristics of this disease. The physiology of thyrocalcitonin, the concept of the APUD system the secretion of active substances by the tumour cells are considered. The macroscopic and microscopic characteristics and its mode of spread are described. The two main clinical forms, the sporadic form and the familial form are described together with the other endocrine involvements. Among the factors in positive diagnosis, accent is placed on per-operative histological examination and on biological tests of familial detection. Among the forms of treatment the essential place of surgery explains partly the relatively favourable course and prognosis of the malignant disease.