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INTRODUCTION: Dysbaric osteonecrosis is a rare illness in professional divers and compressed-air workers. The correlation between dysbaric osteonecrosis and previous decompression sickness with osteoarthromuscular pain (type 1 decompression sickness) remains a controversial subject. The probability for ischemic lesions detected with MRI to turn into osteonecrosis after decompression sickness is still not established. EXEGESIS: The authors report the case of a military diver declared definitely medically unfit to dive after the occurrence of advanced dysbaric osteonecrosis of the shoulder, eight months after decompression sickness treated with hyperbaric oxygen, in the same area. A close link between those two events and the requirement for monitoring the follow-up of acute type 1 decompression sickness are discussed. CONCLUSION: Every decompression sickness with osteoarthromuscular pain should be early examined with MRI in order to screen osteomedullar damages liable to worse with diving and change subsequently in bone necrosis.

INTRODUCTION: Dysbaric osteonecrosis is a rare illness in professional divers and compressed-air workers. The correlation between dysbaric osteonecrosis and previous decompression sickness with osteoarthromuscular pain (type 1 decompression sickness) remains a controversial subject. The probability for ischemic lesions detected with MRI to turn into osteonecrosis after decompression sickness is still not established. EXEGESIS: The authors report the case of a military diver declared definitely medically unfit to dive after the occurrence of advanced dysbaric osteonecrosis of the shoulder, eight months after decompression sickness treated with hyperbaric oxygen, in the same area. A close link between those two events and the requirement for monitoring the follow-up of acute type 1 decompression sickness are discussed. CONCLUSION: Every decompression sickness with osteoarthromuscular pain should be early examined with MRI in order to screen osteomedullar damages liable to worse with diving and change subsequently in bone necrosis.

OBJECTIVES: The N-terminal pro brain natriuretic peptide (N-BNP) is a promising cardiac natriuretic peptide used as a clinical hormonal marker in cardiac dysfunction. The main stimulus for N-BNP synthesis and secretion is cardiac wall stress, which is recognized as a common denominator of many cardiac diseases. Diving is associated with environmental factors leading to variations in thoracic blood volume and hemodynamic changes. The purpose of the present study was to examine the changes in the concentration of N-BNP in healthy men during and after scuba diving. METHOD: There were 10 healthy military divers (mean age 33 yr) who performed a dive in the sea for 1 h at 10 m depth. Venous blood samples were taken at timed intervals to allow evaluation of plasma levels of N-BNP at different steps, namely at To (before immersion), at T30 min (during the dive, after a short surfacing), at T60 min (right after surfacing), at T300 min (post-dive), and finally at T24 h. Peptide blood concentrations were determined by electrochemoluminiscence immunoassay. Data were analyzed using parametric statistics. RESULTS: When compared with To, the results show a significant increase of N-BNP levels (in % of baseline levels) at T60(128 +/- 5%, p < 0.043) and at T300 (149 +/- 8%, p < 0.001). CONCLUSION: This preliminary study reveals that N-BNP rises with scuba diving. Our findings suggest that diving involves a mechanical strain on the heart with a persistent endocrine myocardial activity post-dive.

OBJECTIVES: The N-terminal pro brain natriuretic peptide (N-BNP) is a promising cardiac natriuretic peptide used as a clinical hormonal marker in cardiac dysfunction. The main stimulus for N-BNP synthesis and secretion is cardiac wall stress, which is recognized as a common denominator of many cardiac diseases. Diving is associated with environmental factors leading to variations in thoracic blood volume and hemodynamic changes. The purpose of the present study was to examine the changes in the concentration of N-BNP in healthy men during and after scuba diving. METHOD: There were 10 healthy military divers (mean age 33 yr) who performed a dive in the sea for 1 h at 10 m depth. Venous blood samples were taken at timed intervals to allow evaluation of plasma levels of N-BNP at different steps, namely at To (before immersion), at T30 min (during the dive, after a short surfacing), at T60 min (right after surfacing), at T300 min (post-dive), and finally at T24 h. Peptide blood concentrations were determined by electrochemoluminiscence immunoassay. Data were analyzed using parametric statistics. RESULTS: When compared with To, the results show a significant increase of N-BNP levels (in % of baseline levels) at T60(128 +/- 5%, p < 0.043) and at T300 (149 +/- 8%, p < 0.001). CONCLUSION: This preliminary study reveals that N-BNP rises with scuba diving. Our findings suggest that diving involves a mechanical strain on the heart with a persistent endocrine myocardial activity post-dive.

International audience ; Refusals to provide care to people with HIV have been reported in the USA, the UK and elsewhere in Europe but their frequency remains poorly documented. In 2015, the French parliament examined a law that includes an article on non-discrimination in access to health care and the possibility of doing tests to determine the extent and nature of the discrimination. During the legislative debates, AIDES did a situation testing survey4 to ascertain the frequency and nature of refusals to provide dental and gynaecological care to people with HIV. The situation testing survey was done by telephone in 440 dental and 116 gynaecology offices randomly selected in 20 French cities, chosen on the basis of their HIV incidence and medical density for these two specialties.

International audience ; Refusals to provide care to people with HIV have been reported in the USA, the UK and elsewhere in Europe but their frequency remains poorly documented. In 2015, the French parliament examined a law that includes an article on non-discrimination in access to health care and the possibility of doing tests to determine the extent and nature of the discrimination. During the legislative debates, AIDES did a situation testing survey4 to ascertain the frequency and nature of refusals to provide dental and gynaecological care to people with HIV. The situation testing survey was done by telephone in 440 dental and 116 gynaecology offices randomly selected in 20 French cities, chosen on the basis of their HIV incidence and medical density for these two specialties.

International audience ; Refusals to provide care to people with HIV have been reported in the USA, the UK and elsewhere in Europe but their frequency remains poorly documented. In 2015, the French parliament examined a law that includes an article on non-discrimination in access to health care and the possibility of doing tests to determine the extent and nature of the discrimination. During the legislative debates, AIDES did a situation testing survey4 to ascertain the frequency and nature of refusals to provide dental and gynaecological care to people with HIV. The situation testing survey was done by telephone in 440 dental and 116 gynaecology offices randomly selected in 20 French cities, chosen on the basis of their HIV incidence and medical density for these two specialties.

International audience ; Refusals to provide care to people with HIV have been reported in the USA, the UK and elsewhere in Europe but their frequency remains poorly documented. In 2015, the French parliament examined a law that includes an article on non-discrimination in access to health care and the possibility of doing tests to determine the extent and nature of the discrimination. During the legislative debates, AIDES did a situation testing survey4 to ascertain the frequency and nature of refusals to provide dental and gynaecological care to people with HIV. The situation testing survey was done by telephone in 440 dental and 116 gynaecology offices randomly selected in 20 French cities, chosen on the basis of their HIV incidence and medical density for these two specialties.

International audience ; Refusals to provide care to people with HIV have been reported in the USA, the UK and elsewhere in Europe but their frequency remains poorly documented. In 2015, the French parliament examined a law that includes an article on non-discrimination in access to health care and the possibility of doing tests to determine the extent and nature of the discrimination. During the legislative debates, AIDES did a situation testing survey4 to ascertain the frequency and nature of refusals to provide dental and gynaecological care to people with HIV. The situation testing survey was done by telephone in 440 dental and 116 gynaecology offices randomly selected in 20 French cities, chosen on the basis of their HIV incidence and medical density for these two specialties.

International audience ; Background: We examined how the relationship between education and latelife cognitive impairment (defined as a Mini Mental State Examination score below 24) is influenced by age, sex, ethnicity, and Apolipoprotein E epsilon 4 (APOE*4).Methods: Participants were 30,785 dementia-free individuals aged 55-103 years, from 18 longitudinal cohort studies, with an average follow-up ranging between 2 and 10 years. Pooled hazard ratios were obtained from multilevel parametric survival analyses predicting cognitive impairment (CI) from education and its interactions with baseline age, sex, APOE*4 and ethnicity. In separate models, education was treated as continuous (years) and categorical, with participants assigned to one of four education completion levels: Incomplete Elementary; Elementary; Middle; and High School.Results: Compared to Elementary, Middle (HR = 0.645, P = 0.004) and High School (HR = 0.472, P < 0.001) education were related to reduced CI risk. The decreased risk of CI associated with Middle education weakened with older baseline age (HR = 1.029, P = 0.056) and was stronger in women than men (HR = 1.309, P = 0.001). The association between High School and lowered CI risk, however, was not moderated by sex or baseline age, but was stronger in Asians than Whites (HR = 1.047, P = 0.044), and significant among Asian (HR = 0.34, P < 0.001) and Black (HR = 0.382, P = 0.016), but not White, APOE*4 carriers.Conclusion: High School completion may reduce risk of CI associated with advancing age and APOE*4. The observed ethnoregional differences in this effect are potentially due to variations in social, economic, and political outcomes associated with educational attainment, in combination with neurobiological and genetic differences, and warrant further study.

International audience ; Background: We examined how the relationship between education and latelife cognitive impairment (defined as a Mini Mental State Examination score below 24) is influenced by age, sex, ethnicity, and Apolipoprotein E epsilon 4 (APOE*4).Methods: Participants were 30,785 dementia-free individuals aged 55-103 years, from 18 longitudinal cohort studies, with an average follow-up ranging between 2 and 10 years. Pooled hazard ratios were obtained from multilevel parametric survival analyses predicting cognitive impairment (CI) from education and its interactions with baseline age, sex, APOE*4 and ethnicity. In separate models, education was treated as continuous (years) and categorical, with participants assigned to one of four education completion levels: Incomplete Elementary; Elementary; Middle; and High School.Results: Compared to Elementary, Middle (HR = 0.645, P = 0.004) and High School (HR = 0.472, P < 0.001) education were related to reduced CI risk. The decreased risk of CI associated with Middle education weakened with older baseline age (HR = 1.029, P = 0.056) and was stronger in women than men (HR = 1.309, P = 0.001). The association between High School and lowered CI risk, however, was not moderated by sex or baseline age, but was stronger in Asians than Whites (HR = 1.047, P = 0.044), and significant among Asian (HR = 0.34, P < 0.001) and Black (HR = 0.382, P = 0.016), but not White, APOE*4 carriers.Conclusion: High School completion may reduce risk of CI associated with advancing age and APOE*4. The observed ethnoregional differences in this effect are potentially due to variations in social, economic, and political outcomes associated with educational attainment, in combination with neurobiological and genetic differences, and warrant further study.

International audience ; Background: We examined how the relationship between education and latelife cognitive impairment (defined as a Mini Mental State Examination score below 24) is influenced by age, sex, ethnicity, and Apolipoprotein E epsilon 4 (APOE*4).Methods: Participants were 30,785 dementia-free individuals aged 55-103 years, from 18 longitudinal cohort studies, with an average follow-up ranging between 2 and 10 years. Pooled hazard ratios were obtained from multilevel parametric survival analyses predicting cognitive impairment (CI) from education and its interactions with baseline age, sex, APOE*4 and ethnicity. In separate models, education was treated as continuous (years) and categorical, with participants assigned to one of four education completion levels: Incomplete Elementary; Elementary; Middle; and High School.Results: Compared to Elementary, Middle (HR = 0.645, P = 0.004) and High School (HR = 0.472, P < 0.001) education were related to reduced CI risk. The decreased risk of CI associated with Middle education weakened with older baseline age (HR = 1.029, P = 0.056) and was stronger in women than men (HR = 1.309, P = 0.001). The association between High School and lowered CI risk, however, was not moderated by sex or baseline age, but was stronger in Asians than Whites (HR = 1.047, P = 0.044), and significant among Asian (HR = 0.34, P < 0.001) and Black (HR = 0.382, P = 0.016), but not White, APOE*4 carriers.Conclusion: High School completion may reduce risk of CI associated with advancing age and APOE*4. The observed ethnoregional differences in this effect are potentially due to variations in social, economic, and political outcomes associated with educational attainment, in combination with neurobiological and genetic differences, and warrant further study.

International audience ; Background: We examined how the relationship between education and latelife cognitive impairment (defined as a Mini Mental State Examination score below 24) is influenced by age, sex, ethnicity, and Apolipoprotein E epsilon 4 (APOE*4).Methods: Participants were 30,785 dementia-free individuals aged 55-103 years, from 18 longitudinal cohort studies, with an average follow-up ranging between 2 and 10 years. Pooled hazard ratios were obtained from multilevel parametric survival analyses predicting cognitive impairment (CI) from education and its interactions with baseline age, sex, APOE*4 and ethnicity. In separate models, education was treated as continuous (years) and categorical, with participants assigned to one of four education completion levels: Incomplete Elementary; Elementary; Middle; and High School.Results: Compared to Elementary, Middle (HR = 0.645, P = 0.004) and High School (HR = 0.472, P < 0.001) education were related to reduced CI risk. The decreased risk of CI associated with Middle education weakened with older baseline age (HR = 1.029, P = 0.056) and was stronger in women than men (HR = 1.309, P = 0.001). The association between High School and lowered CI risk, however, was not moderated by sex or baseline age, but was stronger in Asians than Whites (HR = 1.047, P = 0.044), and significant among Asian (HR = 0.34, P < 0.001) and Black (HR = 0.382, P = 0.016), but not White, APOE*4 carriers.Conclusion: High School completion may reduce risk of CI associated with advancing age and APOE*4. The observed ethnoregional differences in this effect are potentially due to variations in social, economic, and political outcomes associated with educational attainment, in combination with neurobiological and genetic differences, and warrant further study.

International audience ; Background: We examined how the relationship between education and latelife cognitive impairment (defined as a Mini Mental State Examination score below 24) is influenced by age, sex, ethnicity, and Apolipoprotein E epsilon 4 (APOE*4).Methods: Participants were 30,785 dementia-free individuals aged 55-103 years, from 18 longitudinal cohort studies, with an average follow-up ranging between 2 and 10 years. Pooled hazard ratios were obtained from multilevel parametric survival analyses predicting cognitive impairment (CI) from education and its interactions with baseline age, sex, APOE*4 and ethnicity. In separate models, education was treated as continuous (years) and categorical, with participants assigned to one of four education completion levels: Incomplete Elementary; Elementary; Middle; and High School.Results: Compared to Elementary, Middle (HR = 0.645, P = 0.004) and High School (HR = 0.472, P < 0.001) education were related to reduced CI risk. The decreased risk of CI associated with Middle education weakened with older baseline age (HR = 1.029, P = 0.056) and was stronger in women than men (HR = 1.309, P = 0.001). The association between High School and lowered CI risk, however, was not moderated by sex or baseline age, but was stronger in Asians than Whites (HR = 1.047, P = 0.044), and significant among Asian (HR = 0.34, P < 0.001) and Black (HR = 0.382, P = 0.016), but not White, APOE*4 carriers.Conclusion: High School completion may reduce risk of CI associated with advancing age and APOE*4. The observed ethnoregional differences in this effect are potentially due to variations in social, economic, and political outcomes associated with educational attainment, in combination with neurobiological and genetic differences, and warrant further study.