Health news sharing is reflected in distributed reward-related brain activity.

Neuroimaging has identified individual brain regions, but not yet whole-brain patterns, that correlate with the population impact of health messaging. We used neuroimaging to measure whole-brain responses to health news articles across two studies. Beyond activity in core reward value-related regions (ventral striatum, ventromedial prefrontal cortex), our approach leveraged whole-brain responses to each article, quantifying expression of a distributed pattern meta-analytically associated with reward valuation. The results indicated that expression of this whole-brain pattern was associated with population-level sharing of these articles beyond previously identified brain regions and self-report variables. Further, the efficacy of the meta-analytic pattern was not reducible to patterns within core reward value-related regions but rather depended on larger-scale patterns. Overall, this work shows that a reward-related pattern of whole-brain activity is related to health information sharing, advancing neuroscience models of the mechanisms underlying the spread of health information through a population.

Brain Activity Tracks Population Information Sharing by Capturing Consensus Judgments of Value.

Information that is shared widely can profoundly shape society. Evidence from neuroimaging suggests that activity in the ventromedial prefrontal cortex (vmPFC), a core region of the brain's valuation system tracks with this sharing. However, the mechanisms linking vmPFC responses in individuals to population behavior are still unclear. We used a multilevel brain-as-predictor approach to address this gap, finding that individual differences in how closely vmPFC activity corresponded with population news article sharing related to how closely its activity tracked with social consensus about article value. Moreover, how closely vmPFC activity corresponded with population behavior was linked to daily life news experience: frequent news readers tended to show high vmPFC across all articles, whereas infrequent readers showed high vmPFC only to articles that were more broadly valued and heavily shared. Using functional connectivity analyses, we found that superior tracking of consensus value was related to decreased connectivity of vmPFC with a dorsolateral PFC region associated with controlled processing. Taken together, our results demonstrate variability in the brain's capacity to track crowd wisdom about information value, and suggest (lower levels of) stimulus experience and vmPFC-dlPFC connectivity as psychological and neural sources of this variability.

[Open versus laparoscopic radical prostatectomy: a French center experience]. / Prostatectomie radicale ouverte versus laparoscopique: expérience d'un centre français.

OBJECTIVE: To compare peri-operative outcomes of open radical prostatectomy (ORP) to laparoscopic radical prostatectomy (LRP) in a single French institution. METHODS: Between 1998 and 2003, 72 patients underwent ORP followed by 279 LRP between 2003 and 2010 for a clinically localized prostate cancer. Demographic, peri-operative and pathological data in the ORP and LRP groups were analyzed and compared. RESULTS: In the ORP group, compared to the LRP group, the following significant differences were found: patients were older (63.1 years versus 65.6), initial PSA was higher (10.2 ng/mL versus 6.7) and the proportion of T1c was higher (62.8 % versus 80.6 %). Operative blood loss (1500 mL versus 500) and length of hospitalization (9.0 days versus 6.3) were higher in the ORP group (P<0.001). Operative time was longer in the LRP group (250 min versus 160; P<0 .001). There was no significant difference regarding length of catheterization (average of 8.5 days). Anastomotic strictures were more frequent following ORP (P<0.001). Positive margins proportion in the ORP group (7.1 %) was lower than that observed in the LRP group (28.7 %) (P=0.001). Patients in the ORP group achieved early continence more frequently (P<0.01) but at 12 months postoperatively there was no significant difference. CONCLUSION: Patients in the LRP group had lower operative blood losses and a shorter length of hospitalization. However, in the ORP group, operative time was shorter and positive margins rate was lower.

[Longitudinal follow-up of the IPSS within the 5 years following treatment of a localized prostate cancer: overall analysis and by type of treatment]. / Suivi longitudinal de l'IPSS dans les cinq ans suivant un traitement d'un cancer de prostate localisé: analyse globale et par type de traitement.

OBJECTIVES: The International Prostate Score Symptom (IPSS) and the question of quality of life (QOL-Q) associated were used in this study for monitoring patients treated for localized prostate cancer (P-Ca). PATIENTS AND METHODS: Three groups treated with radical prostatectomy (RP), external beam radiotherapy (RT) or brachytherapy (BRACHY) completed the self-administered questionnaire IPSS and Q-QOL before treatment (bef-TT), after 3 months and once a year for 5 years. RESULTS: The study included 40 PR, 40 RT and 40 BRACHY. There was no difference between the three groups in bef-TT for the IPSS and Q-QOL or in the patients' characteristics, and P-Ca except for age and a higher PSA in the RT group (70.6 years old and 10.0 ng/mL vs. 66.5/66.2 and 7.1/6.2 for RP and CURIE respectively). The impact, no matter what treatment they received, was significant after the third month and then went back to the pre-AN1 at TT. The analysis by group treatment showed no significant difference between groups at 3months and during the first 4 years of follow-up. In the fifth year the RT group had a greater IPSS than BRACHY and PR groups (P<0.04). CONCLUSION: This study showed no degradation of the IPSS or Q-QOL remote treatment of localized prostate cancer. Urinary incontinence has been partially exploring. His study would have allowed a better urinary quality of life analysis in these patients.

[Management of adult's renal and ureteral stones. Update of the Lithiasis Committee of the French Association of Urology (CLAFU). General considerations]. / Prise en charge urologique des calculs rénaux et urétéraux de l'adulte. Mise au point du Comité Lithiase de l'Association Française d'Urologie (CLAFU). Aspects généraux.

The Lithiasis Committee of the French Association of Urology (CLAFU) aimed to update the current knowledge about urolithiasis. This update will be divided into four parts: 1) general considerations; 2) the management of ureteral stones; 3) the management of kidney stones; 4) metabolic assessment and medical treatment of urolithiasis. Recent technicals advances helped the urologists to improve stones management: new extracorporeal shockwave lithotripsy (ESWL) devices, new flexible ureterorenoscopes, development of laser fragmentation. ESWL, semi-rigid and flexible ureteroscopy and the percutaneous nephrolithotomy (PCNL) remain currently the main therapeutic options. The first part of this update deals with the description and classification of stones, preoperative assessment, post-operative management and clinical follow-up. Main criteria of therapeutic choices are stone location, stone composition and stone size. Stone composition is assessed with infrared spectrophotometry analysis and its hardness is correlated with U.H. density on CT scan assessment. Preoperative assessment consists in urinary cytobacteriological examine, urinary PH, blood creatininemia, hemostasis. Low-dose CT scan is recommended before urological treatment. The result of the treatment must be done 1 or 3 months later with plain abdominal film and ultrasonography. Medical management of urolithiasis will be based on stone composition, metabolic and nutritional evaluation. Treatment success is definited by absence of residual fragments. Annual follow-up is recommended and based either on plain abdominal film and ultrasonography or low-dose CT scan.

[Long-term outcome of renal transplantation: impact of surgical complications on graft survival]. / Impact à long terme des complications chirurgicales sur la survie du transplant rénal.

OBJECTIVE: To determine the incidence of surgical complications of renal transplantation at one institution, relate this to donor and recipient factors and to long-term graft survival. PATIENTS AND METHODS: A consecutive series of 145 renal transplants were audited, and a database of donor and recipient characteristics created for risk-factor analysis. An unstented Barry-Sarramon anastomosis was the most used method of ureteric reimplantation. Lich-Gregoir anastomosis was used in 28.9% of cases. The mean follow-up time was 14.4 ± 6.23 years. RESULTS: There were 67 surgical complications including ten vascular, 39 urological and 18 parietal complications. Among urological complications, 13 were urinary leaks, four distal ureteric necrosis, 13 symptomatic ureteric reflux, six primary ureteric obstructions, and one ureteric stone at some time after transplantation. The overall incidence of urological complications was 26.2%. There was no association with recipient or donor age, cold ischaemic times before organ reimplantation, dialysis duration before transplantation, operating times, or ureteric stenting. Overall surgical complications had a significant pejorative impact on graft survival (Hazard Ratio [HR]=1.805; P=0.32), but as we studied them separately, we highlighted that in fact only vascular complications had an impact on long-term graft survival (HR=17.442, P<5E-10). There was no association between urological (P=0.566) or parietal (P=0.797) complications and long-term graft outcome. CONCLUSION: The onset of a urological or a parietal complication had no impact in this series on long-term graft survival. Vascular complications dramatically increase the rate of graft loss.

[Place of the flexible ureterorenoscopy first choice for the treatment of kidney stones. Survey results practice committee of the AFU lithiasis completed in 2011]. / Place de l'urétérorénoscopie souple en première intention pour le traitement des calculs du rein. Résultats de l'enquête de pratique du comité lithiase de l'AFU réalisée en 2011.

UNLABELLED: The flexible ureterorenoscopy coupled with photovaporisation LASER (USSR-L) for the treatment of kidney kidney is a modern tool whose place is under evaluation. METHODS: Its place has been assessed in France in 2010 by the Committee of urolithiasis of the French Association of Urology (CLAFU). A practice survey among 27 experts concerned the following decision criteria: comorbid patient's supposed nature of the calculation, anatomy of the urinary tract of the patient. This investigation has been proposed to calculate the size not exceeding 20mm, for a calculation of size greater than 20mm and for multiple calculations kidney. RESULTS: Fourteen experts responded. The criteria for the USSR-The first line were: morbid obesity (BMI>30), anticoagulation or anti platelet aggregation, calculations Hard (UH>1000, cystine stones), calculations within diverticular caliceal calculations below, the failure of a first treatment or the wish of the patient. CONCLUSION: The URS-SL was a first-line treatment validated regardless of size and number of kidney stones, when ESWL and PCNL were contraindicated or when their predictable results were poor (hard stones/morbid obesity/lower pole stones) or when stone access is difficult (intradiverticular). It was also the treatment of choice after the failure of a first treatment (ESWL/PCNL).

[Repeat prostate biopsies following a first negative biopsy in a context of an elevated prostate specific antigen]. / Biopsies prostatiques itératives suite à une première biopsie négative dans un contexte d'élévation de l'antigène spécifique de la prostate.

INTRODUCTION: An elevated PSA and a negative prostate biopsy (PB) can be a false negative PB that ignores a prostate cancer (PCa) or a false positive PSA not related to PCa. The objective of this study was to analyze a group of patients who had a negative first BP for a PSA superior to 4 ng/mL and at least one additional PB and to compare these cases with controls who had the diagnosis PCa from the first PB. METHODS: Retrospective single-center study comparing patients with an elevated PSA and repeat biopsy following a first negative PB and patients with PCa diagnosed from the first PB. RESULTS: The 63 cases were younger than the 75 controls and had more often a normal digital rectal examination. Their prostate volume was larger and their number of PSA before the first PB lower: this corresponded to a lower PSA in the second (7/64), third (6/31), fourth (3/9) and sixth (1/1) PB. Among these cases with PCa, the length of core invaded by cancer and the total length of cancer of the entire PB were smaller than controls. In 76% of cases, the Gleason score among cases was 6 or less. CONCLUSION: PCa discovered on repeat biopsy had features of better prognosis than those of controls. We propose an algorithm for management of patients with elevated PSA and negative first PB.

[Open partial nephrectomy: standard of minimal invasive surgery]. / Néphrectomie partielle par chirurgie conventionnelle : définir les critères de la chirurgie mini-invasive.

OBJECTIVE: Partial nephrectomy is now recognized as the standard treatment for tumors less than 7cm. The oncological results are comparable to those obtained by total nephrectomy, while preserving kidney function. Our objective was to describe our experience and research factors associated with complications, recurrence and death. PATIENTS AND METHODS: Partial nephrectomy performed in our center by June 1996 to December 2008 were reviewed retrospectively. Demographic and tumors characteristics, postoperative complications and patient outcomes were identified. Factors associated with complications and survival were investigated by regression tests. RESULTS: Of the 96 patients enrolled (mean age 61.4 years±12.8), 13 had renal insufficiency (serum creatinine 120 to 212µmol/L). The mean tumor size was 32mm (±13.9) and 57 (79.2%) corresponded to clear cell carcinoma. The overall rate of postoperative complications was 26%, including 8.3% of hemorrhagic complications and 3.1% of urinary complications. None of the analyzed variables were associated with the occurrence of complications. With a mean of 2 years and 9 months follow-up (±28months), eight patients (11.1%) had tumor recurrence. Multifocal tumors as well as postoperative complications were associated with risk of recurrence. Three patients with positive tumor margins were monitored with no evidence of progression (with 71, 42 and 12 months of follow-up). CONCLUSION: Our single-center retrospective study of partial nephrectomy for renal tumor showed medium-term oncological results similar to those reported in the total nephrectomy with the advantage of nephron preservation. The results of studies by conventional surgery such as that we report should be a benchmark for laparoscopic surgery.

[Efficiency and tolerance of intermittent self-dilatation after internal urethrotomy for urethral strictures]. / Efficacité et tolérance des dilatations par autosondages après urétrotomie interne pour sténoses urétrales.

OBJECTIVE: To retrospectively evaluate efficiency and tolerance of intermittent self-dilatation (ISD) after unicenter internal urethrotomy (IU) on urethral strictures (US). PATIENTS AND METHODS: From January 2000 to November 2008, ISD have been performed after IU on 54 patients; 44.4% were iatrogenic. ISD median frequency was once a week (0.25-14). ISD was carried out for a median period of 8.4 months (0-97). RESULTS: IPSS was 21 at diagnosis vs 7 during ISD (P=0.018). QoL score of IPSS was 5 at diagnosis vs 2 during ISD (P=0.03). Maximum flow rate was 4.6mL/s at diagnosis vs 16.6mL/s during ISD (P=0.003). Ten patients had recurrence during ISD period. The follow-up from the beginning of ISD was 35 months (range, 0-164). Urologists' evaluation of ISD tolerance was excellent or good for 47 patients (87%). Tolerance self-evaluation was excellent or good for seven patients out of 15. CONCLUSION: ISD was a well-tolerated and useful option after IU. It had a 81.5% efficiency in our cohort.

[Seminal vesicle biopsies: Interest in the prostate cancer staging before radiation therapy or brachytherapy]. / Biopsies des vésicules séminales : intérêt dans le bilan d'extension du cancer de la prostate avant radiothérapie ou curiethérapie.

OBJECTIVE: Seminal vesicle biopsies (SVB) in the staging of prostate cancer are controversial. Our main objective was to assess their contribution before radiation therapy or brachytherapy. Our secondary objective was to compare pathologic findings of the SVB to the magnetic resonance imaging's (MRI) results. PATIENTS AND METHODS: From 2000 to 2008, 135 men (median age: 70 years) with prostate cancer (cT1a to cT3) underwent SVB right and left. The median PSA was 12 ng/ml. The median Gleason score was 7. Forty-one patients had an endorectal MRI. The median follow-up was 47 months. RESULTS: Seminal vesicle involvement was found in 10% of patients. In 9.2% of cases, the biopsy was not contributive. The risk of invasion was significantly associated with the stage T3, the Gleason score up to 7 and the percentage of prostate positive biopsies. A MRI was performed in 41 cases: the correlation between MRI and SVB for the invasion of seminal vesicle was significant but moderate (kappa=0.38). The complications rate of SVB was 10%. CONCLUSION: SVB were a simple and profitable method. They have provided supplementary information that could improve the staging and that could lead to the make use of an appropriate treatment. This information was comparable to the information provided by MRI. Further studies should establish their role in relation to MRI and in particular confirm the best specificity of the SVB.

[Variation of urinary PCA3 following transrectal ultrasound-guided prostate biopsy]. / Variation du PCA3 urinaire après biopsie de prostate transrectale échoguidée.

INTRODUCTION: Serum PSA is known to rise slightly following an attentive digital rectal examination (DRE) and dramatically following prostatic biopsy. The aim of this study was to evaluate the PCA3 response in these situations. PATIENTS AND METHODS: In 15 consecutive men undergoing transrectal ultrasound-guided needle biopsy of the prostate and who gave their informed consent, urinary PCA3 was determined twice: at a first consultation, urine being sampled immediately after an attentive DRE and second within 2 hours after the biopsy. The mean interval between the two samplings was 14 days (median 15). PCA3 measurements were centralized and performed by the same biologist. At least twelve cores were taken using a biopsy gun with an 18-gauge needle. Changes in PCA3 levels were studied. RESULTS: Mean age of the 15 men was 67.3 years (range 50.9-79.1). Mean (median) pre-biopsy total and %free PSA were respectively 6.6 ng/ml (5.7) and 15.8% (15.5). Mean prostate volume was 43.6 cm(3). Seven patients complained of mild LUTS. DRE was suspicious in eight patients. Of the 15 men, 6 (40%) had adenocarcinoma on biopsy (all clinically confined to the prostate). Median (range) Gleason score was 6 (6-7). Median PCA3 score (range) before and after prostatic biopsy were respectively 36 (9-287) and 27 (5-287) with no significant difference between the two groups (sign test for matched series p > 0.05). The median variation between pre- and post-biopsy PCA3 was -18%. When considering a PCA3 cut-off of 35, two patients changed group: one patient had 51 before and 31 after (PSA 4.6; no cancer on prostate biopsy) and the second had 36 before and 27 after (PSA 5.6; low-risk PCa). The figure represents the PCA3 values for each case (squares for the pre-biopsy and diamonds for the post-biopsy). When considering only the six patients with PCA, median (mean) PCA3 score before and after prostatic biopsy were respectively 51.5 (60.8) and 44.5 (54.8) with no significant difference between the two groups (sign test for matched series p > 0.5) and a median variation between pre- and post-biopsy PCA3 of 1.5%. CONCLUSIONS: Prostate biopsy did not alter significantly urinary PCA3 value. This confirms what was theoretically expected.

[Survival is associated with time to reach PSA nadir (DAN) and the ratio DAN/nadir value after androgen deprivation for prostate cancer]. / La survie est associée au délai d'atteinte du PSA nadir (DAN) et au ratio DAN/valeur nadir après suppression androgénique pour cancer de prostate.

OBJECTIVE: The objective of this study was to assess the prognostic decrease rate of PSA in patients treated with androgen suppression (AS) for prostate cancer (PCa). METHODS: We identified in our database CaP patients with histologically documented, treated with SA alone and for whom vital status with a minimum follow-up of 6 months (except death beforehand) was established. Patient characteristics and CaP and PSA at baseline, PSA nadir, time of reaching the nadir PSA (DAN) and the ratio of the DAN/nadir value (ratio DAN/Nadir) were analyzed in relation to progression-free survival, specific and overall survival. RESULTS: One hundred ninety eight patients met the inclusion criteria and the median was 61.5 months (range 4.8 to 233). The median PSA at the start of the SA were 37.1 ng/mL and the median nadir PSA was 0.48 ng/mL. The median time to progression was 23.6 months. The median specific and overall survivals were 94 and 78 months, respectively. In univariate analysis, predictors of progression-free survival were PSA before SA, PSA nadir, DAN, DAN ratio/nadir, Gleason score, the percentage of core positive prostate biopsy and the status of bone scintigraphy. Except for PSA before SA which was no longer significant, predictors of specific and overall survival were similar and added the biochemical response (decrease of more than 50% of PSA) to a second hormonal manipulation during the biological progression. In multivariate analysis, the nadir PSA and the ratio DAN/Nadir remained significant predictors. CONCLUSION: These results have confirmed in one hand the predictive value of survival in patients DAN SA for CaP: achieving faster nadir PSA was associated with shorter survival. They have introduced in the other hand the new concept of DAN/Nadir PSA which provides independent prognostic information.

Management of health risks associated with oysters harvested from a norovirus contaminated area, Ireland, February-March 2010.

Oysters from a harvesting area responsible for outbreaks of gastroenteritis were relaid at a clean seawater site and subsequently depurated in tanks of purified seawater at elevated temperatures. This combined treatment reduced norovirus levels to those detected prior to the outbreak. On the basis of norovirus monitoring the sale of treated oysters was permitted although the harvest area remained closed for direct sale of oysters. No reports of illness have been associated with the consumption of treated oysters.

[Pelvic lymph nodes dissection for prostate cancer: Minilap with speculum vs laparoscopy]. / Curage ilio-obturateur pour cancer de prostate : minilaparotomie au spéculum vs coelioscopie.

INTRODUCTION: The pelvic lymph nodes dissection (PLND) is indicated in case of prostate cancer with high risk of ganglionic metastasis. Criteria admitted for indication of PLND are PSA>or=10ng/ml and/or Gleason score >or=7. Two techniques are available for PLND: minilap and laparoscopy. The purpose of this study was to compare retrospectively minilap and the 2 ways of laparoscopy: intra- and extraperitoneum, in terms of efficiency and complications. MATERIAL AND METHOD: We reviewed 147 cases of men who's had a PLND in our department between 1992 and 2006. The distribution for every technique was: 34 cases of minilap (23%), 39 cases of intraperitoneum laparoscopy (27%) and 74 cases of extraperitoneum laparoscopy (50%). The mean age was of 67.9 years (52-79). The mean PSA was 19.01ng/ml (0.3-93) and the average Body Mass Index (BMI) was 26.75kgm(-2) (17.6-41). RESULTS: Twenty-eight patients (19%) presented a postoperating complication. There was no statistically significant difference according to technique. We did not either find statistical difference concerning the number of analyzed nodes between three groups and the duration of hospitalization. Only the mean operating time and the number of drain of Redon were statistically different. CONCLUSION: This study did not show any difference in terms of result and complications between the laparoscopy and minilap for the PLND in case of prostate cancer. We think each technique could be proposed.

[The French linguistic validation of the Ureteric Stent Symptom Questionnaire (USSQ)]. / Validation en langue française du questionnaire << Ureteric Stent Symptom Questionnaire >> (USSQ).

PURPOSE: Translation and linguistic validation of the French version of the Ureteral Stent Symptom Questionnaire (USSQ). MATERIALS AND METHODS: A double-back translation of the original Ureteral Stent Symptom Questionnaire was performed. First, two urologists translated the English version in French. Then a first consensus meeting between the translators and a group composed with three urologists, one general practitioner and two nurses was achieved. Back-translation of this version was then done by professional translators (Nagpal, Paris) to ensure that no distortion was detected between the two questionnaires. Finally, a pilot test followed by an interview was carried out among two men and two women who had an indwelling ureteral stent. RESULTS: The consensus version is attached to the article. No difficulties were reported by the pilot population to comprehend or to complete this USSQ French version. CONCLUSION: This USSQ version - attached to the article - makes it possible for researchers among a French population to use this validated and internationally recognized tool that provides reproducible and measurable endpoints on tolerance of ureteral stents.