RANK/OPG ratio of expression in primary clear-cell renal cell carcinoma is associated with bone metastasis and prognosis in patients treated with anti-VEGFR-TKIs.

BACKGROUND: Bone metastases (BMs) are associated with poor outcome in metastatic clear-cell renal carcinoma (m-ccRCC) treated with anti-vascular endothelial growth factor tyrosine kinase inhibitors (anti-VEGFR-TKIs). We aimed to investigate whether expression in the primary tumour of genes involved in the development of BM is associated with outcome in m-ccRCC patients treated with anti-VEGFR-TKIs. METHODS: Metastatic clear-cell renal cell carcinoma patients with available fresh-frozen tumour and treated with anti-VEGFR-TKIs. Quantitative real-time PCR (qRT-PCR) for receptor activator of NF-kB (RANK), RANK-ligand (RANKL), osteoprotegerin (OPG), the proto-oncogene SRC and DKK1 (Dickkopf WNT signalling pathway inhibitor-1). Time-to-event analysis by Kaplan-Meier estimates and Cox regression. RESULTS: We included 129 m-ccRCC patients treated between 2005 and 2013. An elevated RANK/OPG ratio was associated with shorter median time to metastasis (HR 0.50 (95% CI 0.29-0.87); P=0.014), shorter time to BM (HR 0.54 (95% CI 0.31-0.97); P=0.037), shorter median overall survival (mOS) since initial diagnosis (HR 2.27 (95% CI 1.44-3.60); P=0.0001), shorter median progression-free survival (HR 0.44 (95% CI 0.28-0.71); P=0.001) and mOS (HR 0.31 (95% CI 0.19-0.52); P<0.0001) on first-line anti-VEGFR-TKIs in the metastatic setting. Higher RANK expression was associated with shorter mOS on first-line anti-VEGFR-TKIs (HR 0.46 (95% CI 0.29-0.73); P=0.001). CONCLUSIONS: RANK/OPG ratio of expression in primary ccRCC is associated with BM and prognosis in patients treated with anti-VEGFR-TKIs. Prospective validation is warranted.

[Sport and urinary incontinence in women]. / Incontinence urinaire chez la femme sportive.

Women are more attentive to their physical appearance and a quarter of French women use to practice a regular physical activity. Benefits of sport on general health are recognized. However, sport may be the cause of various diseases when it is poorly chosen or improperly performed. In literature, intensive exercise is a risk factor for urinary incontinence, defined as "the complaint of any involuntary leakage of urine". It is essentially stress urinary incontinence, occurring because of the phenomenon of intrabdominal hyperpressure, inherent with certain activities, and excess capacity of sphincters. Some sports are more risky than others, and high-level sportswomen are the most exposed. Health professionals must invest in information, screening, prevention, counseling and treatment track athletes So, the general practitioner and the doctor of sports play a vital role in informing, screening, prevention, therapeutic and monitoring of sportswomen. Better information is needed because according to the severity of incontinence and its impact, there are simple, effective, more or less invasive treatment options. The aim of this study was to establish an inventory of scientific knowledge and to improve the management of these patients.

[Sport and urinary incontinence in women]. / Fuites urinaires et sport chez la femme.

A quarter of French women over 25 years old are regular sportswomen. The practice of sport is synonymous with youth and good health. The current health policy also aims at promoting the sport. However, sport may be the cause of various diseases when it is poorly chosen or improperly performed. The High Authority of Health identifies the intensive exercise as a risk factor for urinary incontinence, defined as "the complaint of any involuntary leakage of urine". It is essentially stress urinary incontinence, occurring because of the phenomenon of intrabdominal hypertension, inherent with certain activities, and excess capacity of sphincters. Some sports are more risk than others, and high-level sportswomen are the most exposed. So, the general practitioner and the doctor of sports play a vital role in informing, screening, prevention, therapeutic orientation and monitoring of sportswomen. Better information is needed for this public health problem because according to the severity of incontinence and its impact, there are simple, effective, more or less invasive treatment options. The aim of this study was to establish an inventory of scientific knowledge on the subject and to assist the practitioner in the care of these patients.

Innervation of the uvea by galanin and somatostatin immunoreactive axons in macaques and baboons.

The neuropeptide galanin has not been localized previously in the primate uvea, and the neuropeptide somatostatin has not been localized in the uvea of any mammal. Here, the distribution of galanin-like and somatostatin-like immunoreactive axons in the iris, ciliary body and choroid of macaques and baboons using double and triple immunofluorescence labeling techniques and confocal microscopy was reported. In the ciliary body, galanin-like immunoreactive axons innervated blood vessels and the ciliary processes, particularly at their bases. In the iris, the majority of these axons was associated with the loose connective tissue in the stroma. Somatostatin-like immunoreactive axons were found in many of the same areas of the uvea supplied by cholinergic nerves. In the ciliary body, there were labelled axons within the ciliary processes and ciliary muscle. They were also found alongside blood vessels in the ciliary stroma. In the iris, somatostatin-like immunoreactive axons were abundant in the sphincter muscle and less so in the dilator muscle. A unilateral sympathectomy had no effect on the distribution of somatostatin-like or galanin-like immunoreactive axons, and these axons did not contain the sympathetic marker tyrosine hydroxylase. They did not contain the parasympathetic marker choline acetyltransferase, either. The galanin-like immunoreactive axons contained other neuropeptides found in sensory nerves, including calcitonin gene-related peptide, substance P and cholecystokinin. Somatostatin-like immunoreactive axons did not contain any of these sensory neuropeptides or galanin-like immunoreactivity, and they were neither labelled with an antibody to 200kDa neurofilament protein, nor did they bind isolectin-IB(4). Nevertheless, they are likely to be of sensory origin because somatostatin-like immunoreactive perikarya have previously been localized in the trigeminal ganglion of primates. Taken together, these findings indicate galanin and somatostatin are present in two different subsets of sensory axons in primate uvea.

Effect of consumption of food cooked in iron pots on iron status and growth of young children: a randomised trial.

BACKGROUND: In less-developed countries, novel strategies are needed to control iron-deficiency anaemia, the most common form of malnutrition. METHODS: We undertook a community-based randomised controlled trial to assess the effects of iron or aluminium cooking pots in young Ethiopian children. Analysis was by intention-to-treat. The primary outcomes were change in children's haemoglobin concentration, weight, or length over the study period. We also did a laboratory study of total and available iron in traditional Ethiopian foods cooked in iron, aluminium, and clay pots. FINDINGS: 407 children, one per household, entered the study. The change in haemoglobin concentration was greater in the iron-pot group than in the aluminium-pot group (mean change to 12 months 1.7 [SD 1.5] vs 0.4 [1.0] g/dL; mean difference between groups 1.3 g/dL [95% Cl 1.1-1.6]). The mean differences between the groups in weight and length gain to 12 months (adjusted for baseline weight or length) were 0.6 cm (95% CI 0.1-1.0) and 0.1 kg (-0.1 to 0.3). The laboratory study showed that total and available iron was greatest in foods cooked in iron pots, except for available iron in legumes for which there was no difference between types of pot. INTERPRETATION: Ethiopian children fed food from iron pots had lower rates of anaemia and better growth than children whose food was cooked in aluminium pots. Provision of iron cooking pots for households in less-developed countries may be a useful method to prevent iron-deficiency anaemia.