E-learning versus face-to-face training: Comparison of two learning methods for Lyme borreliosis.

OBJECTIVES: To compare two learning methods for Lyme disease (e-learning versus face-to-face training) to assess knowledge and know-how. METHODS: The study population was volunteer general medicine residents and family physicians (FP). Face-to-face training on Lyme disease was offered to each group. E-learning training was then offered to those who had not attended the face-to-face training. Theoretical knowledge was assessed by an identical pre- and post-test questionnaire and know-how by a script concordance test. RESULTS: Seventy learners (47 FPs and 23 general medicine residents) were included in the face-to-face training group and 61 (33 FPs and 28 general medicine residents) in the e-learning group. The pre- and post-test scores were significantly improved in the FP group (difference of 29.3±1.9 [P<0.0001] out of 100) as well as in the general medicine resident group (difference of 38.2±2.7 [P<0.0001] out of 100). E-learning was more effective than face-to-face training, particularly among general medicine residents (progression of mean difference of 44.3±3.4/100 vs. 30.9±4.0/100; P=0.0138) and to a lesser extent among FPs (progression of 25.3±2.3/100 vs. 31.9±2.7/100; P=0.0757). Forty-six script concordance tests were completed by FPs and 20 by general medicine residents. Script concordance test results did not seem significant between the subgroups. CONCLUSIONS: E-learning seems to be a good alternative to face-to-face training for Lyme disease. It seems to be more effective than face-to-face training for the acquisition of theoretical knowledge. The script concordance test evaluation of know-how did not show any difference between the two learning methods.

[Creation of software to help cardiac surgeons: CordaBase].

BACKGROUND: The writing of surgical and hospitalization reports is time-consuming and does not necessarily enable the increment of a statistical database, tool that is indispensable nowadays to evaluate unit activity or to carry out scientific studies. In order to prevent this double data capture, a computer tool, named CordaBase, has been developed by surgeons and set up in a cardiac surgery unit. MATERIALS AND METHODS: CordaBase is an interactive software that stores medical data. Thanks to its intuitive interface, CordaBase stores data which is classified chronologically in the following categories: past medical history, preoperative assessment, operating gesture, stay in intensive care unit, stay in wards and evolution/monitoring after discharge. This date, stored in an Access base, are then used in the creation of personalized surgical and hospitalization reports. All the data is permanently available and can be used for the carrying out of scientific works or for the evaluation of the unit activity. RESULTS: From March 2009 to December 2010, 2617 consecutive patients operated on in a Cardiac Surgery Unit were recorded prospectively in the software. All of this stored data assisted the surgeon in his or her administrative tasks, thanks to personalized surgical and hospitalization reports, immediately at the secretariat's disposal. The database, which is requisitely filled by administrative work, enables the carrying out of any statistical study on all unit activity. CONCLUSION: With a hindsight of almost 2 years, CordaBase has proven its usefulness in an active cardiac surgery unit, both on an administrative and scientific level. The computerized reports have lightened the medical secretariat's workload and statistical studies have now become possible without having to take the paper medical files out again. In the years to come, the accumulation of medical data prospectively or retrospectively stored will surely confirm the potential of the use of such a software.

The genetics of artemisinin content in Artemisia annua L. and the breeding of high yielding cultivars.

Artemisinin, the endoperoxide sesquiterpene lactone produced by the Chinese medicinal herb Artemisia annua, is very difficult to synthesise. Moreover, its production by mean of cell, tissue or organ cultures is very low. Presently, only its extraction from cultivated plants is viable. A large variation in artemisinin content has been observed in the leaves of plants from different origins. The genetic basis of this variation has been assessed and evidence for a quantitative inheritance of the artemisinin concentration presented. Additive genetic components were predominant, resulting in a high narrow-sense heritability estimate. Thus, goods results can be expected from mass selection for the breeding of lines of Artemisia annua rich in artemisinin. Yet, dominance variance is also present in the total genetic variability, indicating that crosses between selected genotypes should generate progenies with particularly high artemisinin content. As a matter of fact, selection and crossing, in wild populations, of genotypes with high artemisinin concentration resulted in hybrid lines containing up to 1.4 % artemisinin (on dry leaves basis).

Complex genetic predisposition to cancer in an extended HNPCC family with an ancestral hMLH1 mutation.

Hereditary non-polyposis colorectal cancer (HNPCC) is characterised by a genetic predisposition to develop colorectal cancer at an early age and, to a lesser degree, cancer of the endometrium, ovaries, urinary tract, and organs of the gastrointestinal tract other than the colon. In the majority of families the disease is linked to mutations in one of the two mismatch repair genes, hMSH2 or hMLH1. We have found a novel hMLH1 nonsense mutation in a Swiss family with Lynch syndrome, which has been transmitted through at least nine generations. A different tumour spectrum of neoplasms of the skin, soft palate, breast, duodenum, and pancreas was observed in three branches of this family, where there was a virtual absence of colonic tumours. The hMLH1 mutation could not be detected in members of these branches suggesting that at least a second genetic defect predisposing to cancer is segregating in part of the kindred.

[Critical review of 243 monoclonal immunoglobulinopathies]. / Revue critique de 243 immunoglobulinopathies monoclonales.

243 cases of monoclonal immunoglobulinopathy were seen at the CHR in Rennes over a period of three years. The authors studied successively the relationship between the monoclonal immunoglobulin and the clinical diagnosis the distribution of the monoclonal compounds according to the heavy chain class and the identification of the light chains, the distribution of the immunoglobulinopathies in terms of the age and the sex of the patients and the correlation between the clinical diagnosis and various laboratory findings (proteins concentration, concentration of normal immunoglobulins, sedimentation rate...). The results obtained are in line with the principal data in the literature concerning monoclonal immunoglobulinopathies. However, the authors demonstrated, in the studied population, a higher percentage of monoclonal IgM than is usually reported. Furthermore, these IgM immunoglobulins, present in Waldenstrom's disease and frequently seen in various other immunoglobulinopathies, were essentially found in men.