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OBJECTIVE: The exceptional health situation related to the SARS-Cov2 coronavirus pandemic (COVID-19) required a deep and very quickly adaptation of management practices in gynecological cancer. The main objective is to estimate the proportion of patients with treatment modifications. METHOD: This is a multicenter prospective study conducted in 3 university gynecological cancer departments (HCLyon, France) during the period of confinement (March 16 to May 11, 2020). All patients with non-metastatic breast cancer or gynecological cancer were included. The planned treatment, postponement, delay and organizational modifications (RCP, teleconsultations) were studied. RESULTS: Two hundred and five consecutive patients were included, average age 60.5±1.0. 7 patients (3.4%) had SARS-Cov-2 infection, 2 patients died. One hundred and twenty-two patients (59.5%) had a treatment maintained, 72 patients (35.1%) postponed, 11 patients (5.4%) cancelled. Of the 115 (56.1%) planned surgeries, 40 (34.8%) postponed, 7 cancelled (6.1%). 9 patients (7.8%) had a surgical modification. Of the 59 (28.8%) radiotherapy treatments scheduled, 24 (40.7%) postponed and 2 (3.4%) cancelled. Of the 56 (27.3%) chemotherapy treatment planned, 8 (14.3%) postponed and 2 (3.6%) cancelled. One hundred and forty-five patients (70.7%) have been discussed in multidisciplinary meeting. One hundred and fifty-eight patients (77%) had a teleconsultation system. CONCLUSION: Our study assessed the impact of the COVID-19 pandemic on therapeutic management of patients with gynecological cancer during the period of confinement. This will probably improve our management of an eventual epidemic rebound or future health crisis.
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Betacoronavirus , Neoplasias de la Mama/terapia , Infecciones por Coronavirus/epidemiología , Neoplasias de los Genitales Femeninos/terapia , Cooperación del Paciente/estadística & datos numéricos , Neumonía Viral/epidemiología , Antineoplásicos , Neoplasias de la Mama/epidemiología , COVID-19 , Femenino , Francia/epidemiología , Neoplasias de los Genitales Femeninos/epidemiología , Procedimientos Quirúrgicos Ginecológicos/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Pandemias , Estudios Prospectivos , Radioterapia/estadística & datos numéricos , Consulta Remota/estadística & datos numéricos , SARS-CoV-2 , Privación de Tratamiento/estadística & datos numéricosRESUMEN
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Neanderthals are often considered as less technologically advanced than modern humans. However, we typically only find faunal remains or stone tools at Paleolithic sites. Perishable materials, comprising the vast majority of material culture items, are typically missing. Individual twisted fibres on stone tools from the Abri du Maras led to the hypothesis of Neanderthal string production in the past, but conclusive evidence was lacking. Here we show direct evidence of fibre technology in the form of a 3-ply cord fragment made from inner bark fibres on a stone tool recovered in situ from the same site. Twisted fibres provide the basis for clothing, rope, bags, nets, mats, boats, etc. which, once discovered, would have become an indispensable part of daily life. Understanding and use of twisted fibres implies the use of complex multi-component technology as well as a mathematical understanding of pairs, sets, and numbers. Added to recent evidence of birch bark tar, art, and shell beads, the idea that Neanderthals were cognitively inferior to modern humans is becoming increasingly untenable.
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Cognición , Fósiles , Hombre de Neandertal/psicología , Tecnología/historia , Textiles/historia , Animales , Arqueología , Celulosa/análisis , Francia , Historia Antigua , Lignina/análisis , Microscopía Electrónica de Rastreo , Suelo/química , Espectroscopía Infrarroja por Transformada de Fourier , Espectrometría Raman , Textiles/análisisAsunto(s)
Estenosis de la Válvula Aórtica/diagnóstico , Estenosis de la Válvula Aórtica/fisiopatología , Estenosis Coronaria/diagnóstico , Estenosis Coronaria/fisiopatología , Reserva del Flujo Fraccional Miocárdico/fisiología , Aorta/fisiopatología , Aneurisma de la Aorta/fisiopatología , Comorbilidad , Angiografía Coronaria , Femenino , Humanos , Hipertrofia Ventricular Izquierda/diagnóstico , Hipertrofia Ventricular Izquierda/fisiopatología , Microcirculación/fisiología , Persona de Mediana Edad , Pronóstico , Medición de RiesgoRESUMEN
A 54-year-old woman was hospitalized for an acute pulmonary oedema revealing a severe aortic stenosis (AS) associated with an aortic aneurysm and a left ventricular hypertrophy (LVH). The coronary angiography found an equivocal left main lesion. Fractional flow reserve (FFR) showed hemodynamic significance (FFR=0.78) and optical coherence tomography confirmed this result with a minimal lumen area of 4.9mm2. FFR-guided percutaneous intervention is reported to improve outcome in patients with stable coronary disease. However, only few data are available in cases of AS. In this condition, secondary LVH is associated with microcirculatory dysfunction, which interferes with optimal hyperemia. An elevated right atrial pressure could also modify FFR measurement. This risk of underestimation of a coronary lesion in patients with severe AS has to be taken into consideration in clinical practice.
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Aneurisma de la Aorta Torácica/fisiopatología , Estenosis de la Válvula Aórtica/fisiopatología , Estenosis Coronaria/fisiopatología , Reserva del Flujo Fraccional Miocárdico/fisiología , Hipertrofia Ventricular Izquierda/fisiopatología , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/cirugía , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Estenosis de la Válvula Aórtica/cirugía , Bioprótesis , Angiografía Coronaria , Estenosis Coronaria/diagnóstico por imagen , Estenosis Coronaria/cirugía , Femenino , Implantación de Prótesis de Válvulas Cardíacas , Hemodinámica/fisiología , Humanos , Hipertrofia Ventricular Izquierda/diagnóstico por imagen , Hipertrofia Ventricular Izquierda/cirugía , Persona de Mediana Edad , Revascularización Miocárdica , Edema Pulmonar/diagnóstico por imagen , Edema Pulmonar/fisiopatología , Edema Pulmonar/cirugía , Factores de Riesgo , Tomografía de Coherencia ÓpticaRESUMEN
Study of prehistoric art is playing a major role in the knowledge of human evolution. Many scientific methods are involved in this investigation including chemical analysis of pigments present on artefacts or applied to cave walls. In the past decades, the characterization of coloured materials was carried on by taking small samples. This procedure had two main disadvantages: slight but existing damage of the paintings and limitation of the number of samples. Thanks to the advanced development of portable systems, in-situ analysis of pigment in cave can be now undertaken without fear for this fragile Cultural Heritage. For the first time, a portable system combining XRD and XRF was used in an underground and archaeological environment for prehistoric rock art studies. In-situ non-destructive analysis of black prehistoric drawings and determination of their composition and crystalline structure were successfully carried out. Original results on pigments used 13,000 years ago in the cave of Rouffignac (France) were obtained showing the use of two main manganese oxides: pyrolusite and romanechite. The capabilities of the portable XRD-XRF system have been demonstrated for the characterization of pigments as well as for the analysis of rock in a cave environment. This first in-situ experiment combining X-ray diffraction and X-ray fluorescence open up new horizons and can fundamentally change our approach of rock art studies.
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Derivative Fourier transform infrared (FTIR) spectroscopy and curve fitting have been used to investigate the effect of a thermal treatment on the nu(1)nu(3) PO(4) domain of modern bones. This method was efficient for identifying mineral matter modifications during heating. In particular, the 961, 1022, 1061, and 1092 cm(-1) components show an important wavenumber shift between 120 and 700 degrees C, attributed to the decrease of the distortions induced by the removal of CO(3)(2-) and HPO(4)(2-) ions from the mineral lattice. The so-called 1030/1020 ratio was used to evaluate crystalline growth above 600 degrees C. The same analytical protocol was applied on Magdalenian fossil bones from the Bize-Tournal Cave (France). Although the band positions seem to have been affected by diagenetic processes, a wavenumber index--established by summing of the 961, 1022, and 1061 cm(-1) peak positions--discriminated heated bones better than the 1030/1020 ratio, and the splitting factor frequently used to identify burnt bones in an archaeological context. This study suggest that the combination of derivative and curve-fitting analysis may afford a sensitive evaluation of the maximum temperature reached, and thus contribute to the fossil-derived knowledge of human activities related to the use of fire.
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Huesos/química , Fósiles , Calor , Espectroscopía Infrarroja por Transformada de Fourier/métodos , Arqueología/métodos , Carbonatos , Francia , FosfatosRESUMEN
Polarized and depolarized Brillouin scattering experiments on molten ZnCl2 were performed between 300 and 600 degrees C in different geometries. VV spectra measured in backscattering and small angle scattering were analyzed with conventional viscoelastic theory using either a Debye or a Cole-Davidson model for the memory function. We also analyzed in the same way the temperature dependence of the transverse Brillouin lines detected in a 90 degrees VH geometry. We show that the Cole-Davidson memory function yields a consistent interpretation of all the spectra. The resulting shear and longitudinal relaxation times are equal within their error bars, and are about 2.5 times smaller than the alpha relaxation time previously determined. The static shear viscosity values deduced from the analysis of the propagating transverse waves agree, at all temperatures, with the measured viscosity values.