OBJECTIVE: Our aims were to assess cognitive impairment in bipolar patients in remission compared with healthy controls, and to study its connection to clinical and therapeutic factors.
METHODS: This was a case-control study of patients with bipolar disorder (BD) in remission and matched healthy controls. It was carried out at the Hédi Chaker University Hospital in Sfax, Tunisia. The Screen for Cognitive Impairment in Psychiatry (SCIP) scale was used to assess cognitive function in patients and controls. This scale comprises subtests for verbal learning with immediate (VLT-I) and delayed (VLT-D) recall, working memory (WMT), verbal fluency (VFT) and information processing speed (PST).
RESULTS: We recruited 61 patients and 40 controls. Compared with controls, patients had significantly lower scores on the overall SCIP scale and on all SCIP subtests (p < 0.001 throughout) with moderate to high effects. In multivariate analysis, the presence of psychotic characteristics correlated with lower scores on the overall SCIP (p = 0.001), VLT-I (p = 0.001) and VLT-D (p = 0.007), WMT (p = 0.002) and PST (p = 0.008). Bipolar II correlated with lower LTV-I scores (p = 0.023). Age of onset and duration of the disorder were negatively correlated with PST scores (p < 10-3 and p = 0.007, respectively). Predominantly manic polarity correlated with lower VFT scores (p = 0.007).
CONCLUSIONS: Our study showed that bipolar patients in remission presented significantly more marked cognitive impairments, affecting various cognitive domains, than the controls. These cognitive impairments appear to be linked to clinical and therapeutic factors that are themselves considered to be factors of poor prognosis in BD.
OBJECTIVE: Nos objectifs étaient d’évaluer les troubles cognitifs chez des patients bipolaires en rémission comparativement à des témoins sains et d’étudier leur rapport avec les facteurs cliniques et thérapeutiques.
UNASSIGNED: Il s’agissait d’une étude cas-témoins, menée auprès de patients atteints de trouble bipolaire (TBP) en rémission et de témoins sains appariés. Elle a été réalisée au centre hospitalo-universitaire (CHU) Hédi Chaker de Sfax (Tunisie). L’échelle the Screen for cognitive impairment in psychiatry (SCIP) a été utilisée pour l’évaluation des fonctions cognitives chez les patients et les témoins. Cette échelle se compose des sous-échelles d’apprentissage verbal avec rappel immédiat (VLT-I) et différé (VLT-D), de la mémoire de travail (WMT), de la fluence verbale (VFT) et de la vitesse de traitement de l’information (PST).
UNASSIGNED: Nous avons recruté 61 patients et 40 témoins. Comparés aux témoins, les cas avaient des scores totaux du SCIP et de toutes les sous-échelles du SCIP significativement plus bas (p < 0,001 partout) avec des tailles d’effet modérées à élevées. Dans l’analyse multivariée, la présence de caractéristiques psychotiques était corrélée à l’abaissement des scores du SCIP total (p = 0,001), du VLT-I (p = 0,001) et VLT-D (p = 0,007), du WMT (p = 0,002), et du PST (p = 0,008). Le TBP de type 2 était corrélé à l’abaissement du score de VLT-I (p = 0,023). L’âge de début et la durée d’évolution du trouble étaient corrélés négativement au score PST (p < 10−3 et p = 0,007 respectivement). La polarité maniaque prédominante était corrélée à l’abaissement du score VFT (p = 0,007).
CONCLUSIONS: Notre étude a montré que les patients bipolaires en rémission présentaient des troubles cognitifs touchant différents domaines cognitifs, significativement plus marqués que chez les témoins. Ces troubles cognitifs semblent être liés à des facteurs cliniques et thérapeutiques considérés eux-mêmes comme des facteurs de mauvais pronostic de la maladie bipolaire.

UNASSIGNED: AFTER-EFFECTS. RETURN TO WORK AND THE RIGHT TO FORGET. The ten-year strategy 2021-2030 against cancers makes staying at work or returning to work after cancer a major priority. A growing number of patients are on the job market at the time of their cancer diagnosis, with a potentially long career future. The after-effects of the disease, and the gap between them and the professional world, present them with numerous difficulties. French national cancer institute (INCa) has launched several initiatives to help people stay in work and return to work, in particular to complement the measures developed by the League against Cancer. INCa has set up the «Cancer and Employment» Business Club, a forum for the exchange of best practices and experiences between employers and researchers in the human and social sciences. The «Cancer aide info réseau entrepreneur» (CAIRE) scheme supports self-employed patients in their professional careers, and gives them a voice in their professional ecosystem. Research initiatives are also undertaken. The social repercussions of the disease also include its impact on borrowing capacity, for both personal and business loans. The \"right to be forgotten\" for cancer sufferers applies 5 years after the end of the therapeutic protocol. A grid completes the system, and in certain cases enables insurances for a loan can be obtained on standard or similar terms, even before this period has elapsed. It also includes other pathologies such as HIV, hepatitis C and cystic fibrosis. Last but not least, health questionnaires have been abolished for loans under €200,000. The role of the health professional is paramount, providing advice and facilitating the completion of documents requested by insurers.
APRÈS UN CANCER : SÉQUELLES, RETOUR À L’EMPLOI ET DROIT À L’OUBLI. La stratégie décennale de lutte contre les cancers 2021-2030 fait du maintien et/ou retour au travail ou en activité après un cancer une de ses priorités. Un nombre croissant de malades sont sur le marché du travail au moment de la survenue du cancer, avec un horizon de carrière potentiel assez long. Ces malades doivent faire face à de nombreuses difficultés du fait des séquelles de la maladie mais souvent également du décalage qui s’installe entre eux et le monde professionnel. Les entreprises se sentent fréquemment démunies. L’Institut national de cancer (INCa) a lancé plusieurs actions pour favoriser le maintien et le retour à l’emploi, notamment en complément de dispositifs développés par la Ligue contre le cancer ; l’INCa a ainsi créé un club d’entreprises « Cancer et emploi », espace d’échanges de bonnes pratiques et d’expériences entre employeurs et chercheurs en sciences humaines et sociales. Le dispositif « Cancer Aide Info Réseau Entrepreneur » (CAIRE) accompagne les travailleurs indépendants malades dans leur parcours professionnel et porte leur voix auprès des acteurs de leur écosystème professionnel. Des actions de recherche sont également entreprises. Le retentissement social de la maladie concerne aussi la capacité d’emprunt, pour des prêts à caractère personnel ou professionnel. Le droit à l’oubli pour les personnes atteintes de cancer s’applique cinq ans après la fin du protocole thérapeutique. Une grille vient compléter ce dispositif et permet dans certains cas, avant même la survenue de ce délai, l’obtention d’une assurance pour un prêt aux conditions standard ou s’en rapprochant. Cette grille inclut également d’autres pathologies, comme le VIH, l’hépatite C ou la mucoviscidose. Enfin, les questionnaires de santé sont supprimés pour les assurances de prêts inférieurs à 200 000 €. La place du professionnel de santé est prépondérante, en apportant des conseils et en facilitant la complétion des documents demandés par les assureurs.

UNASSIGNED: INCIDENCE AND SURVIVAL IN METROPOLITAN France. Incidence and survival rates are key indicators for cancer surveillance. They also help to drive cancer control programs and public health policies. Focusing on the main cancer localisations, this paper describes the latest incidence (2023) and survival (2018) rates, as well as their evolutions since 1990 in metropolitan France. In 2023, the number of new cases of cancer was estimated to be 433 136, of which 57% occurring in men. Both gender considered, the most frequent cancers are: breast cancer (61 214 new cases), prostate cancer (59 885 new cases) and lung cancer (52 777 new cases). Although the « all cancer » incidence rate as remained quite stable for 33 years in men, it has been raising by almost 1% per year in women. Regarding survival, the standardized net survival (SNS) at 5 years shows great disparities among tumor sites, and it is overall higher in women. Cancers with the best prognosis are thyroid cancer (SNS at 5 years: 96%), prostate cancer (93%), skin melanoma (93%) and uterine cancer (74%). On the contrary, a few tumor locations, including the pancreas (SNS at 5 years of 11%), the liver (18%) and the lung (20%) are still associated with a poor prognosis, even if survival rates have increased in most of cancer locations since 1990.
UNASSIGNED: INCIDENCE ET SURVIE EN FRANCE MÉTROPOLITAINE. Les données d’incidence et de survie constituent des indicateurs essentiels à la surveillance des cancers et à l’orientation des politiques publiques en matière de lutte contre le cancer. Cet article résume les données les plus récentes d’incidence (2023) et de survie (2018) des principaux cancers, ainsi que leur évolution depuis 1990. En 2023, en France, le nombre total de nouveaux cas de cancers est estimé à 433 136 cas, dont 57 % chez l’homme. Tous sexes confondus, les cancers les plus fréquents sont le cancer du sein (61 214 nouveaux cas), le cancer de la prostate (59 885 nouveaux cas) et le cancer du poumon (52 777 nouveaux cas). Si le taux d’incidence « tous cancers » est plutôt stable chez l’homme depuis 1990 (+0,3 % par an), il a augmenté de presque 1 % par an chez la femme. La survie nette standardisée (SNS) à cinq ans varie, quant à elle, considérablement selon les localisations, meilleure chez les femmes pour les cancers qui concernent les deux sexes. Les cancers de meilleur pronostic sont notamment ceux de la thyroïde (96 %), de la prostate (93 %), le mélanome de la peau (93 %) et le cancer du corps de l’utérus (74 %). À l’inverse, certains cancers fréquents, dont celui du pancréas (SNS à cinq ans de 11 %), du foie (18 %) ou encore du poumon (20 %), ont une survie qui reste défavorable, malgré une évolution encourageante de la survie dans la plupart des localisations depuis 1990.

OBJECTIVE: Although lifestyle interventions are first-line treatment for individuals living with prediabetes and type 2 diabetes (T2D), they are rarely implemented effectively in routine clinical care.
METHODS: We present a retrospective analysis of a 12-month, single-centre, structured multidomain lifestyle intervention clinic offered to individuals living with prediabetes and type 2 diabetes. The intervention consisted of expert-guided educational and nutritional counselling combined with a personalized physical exercise prescription, with the main goal of improving metabolic health and reaching remission. Anthropometric parameters, glucose, basal insulin, glycated hemoglobin (A1C), and lipid levels were measured at baseline and at 3, 6, and 12 months after the lifestyle intervention initiation. Remission of prediabetes and T2D were defined as a return of A1C at 6 months to <6.5% (or <5.7% for prediabetes) and persisting for at least 3 months in the absence of glucose-lowering pharmacotherapy.
RESULTS: After a multidomain, expert-guided lifestyle intervention, 117 individuals living with prediabetes and T2D had significantly improved metabolic profiles: Mean weight change at 12 months was -4.9 kg (95% confidence interval [CI], -4.0 to -5.7; p<0.001), and mean change in A1C at 12 months was -0.6% (95% CI, -0.4 to -0.7; p<0.001). A substantial proportion of individuals reached the criteria for remission (20% among participants with prediabetes and 12% among those with T2D).
CONCLUSIONS: The results of this study suggest that prioritizing lifestyle changes in a multifaceted, progressive, 12-month intervention in this population improves anthropometric and insulin resistance measures, and has the potential to normalize metabolic values, even to the point of reaching the criteria of remission.

The association À Chacun Son Everest ! created in 1994 by Christine Janin, offers stays in the Chamonix valley (74) to children who have been through the ordeal of cancer. Accompanied by volunteer carers and the team at Chalet Vallot, they discover the mountains, their magnificence and their strength. The activities planned by the association, in contact with this grandiose environment, allow them to regain their self-confidence and to rebuild their lives after the harshness of the disease.

More than one in two people recover from cancer after five years. But before claiming victory, they go through a period of remission, a time of uncertainty and convalescence during which they will have to learn to reinvest their body and their identity in order to fully take charge of their life by integrating the awareness of their fragility.

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BACKGROUND: Since the last cancer plan 2014-2019, the assessment of the impact of the disease on caregivers became essential. The quality of caregiving represents an important part of the patient\'s quality of life. The main objective was to describe the evolution of caregiver\'s attachment style during the first three years of the disease support.
METHODS: Caregivers have been included through the ICE study (Informal Carers of Elderly). They were taking care for one near parent at least 60 years of age with a diagnosis of cancer (breast, prostate, colorectal). Caregivers were interviewed at home within three months of inclusion in the ICE study. This longitudinal research based on recorded semi-structured interviews and used one scale (RSQ) to evaluate the attachment style: secure attachment, detached-type insecure, preoccupied-type insecure or fearful-type insecure.
RESULTS: The evolution of attachment styles reflect different relational strategies among the 33 caregivers included. The three first times of the disease are differently lived by the caregivers and are impacted by an insecurity form. The attachment style is different depending on the stage of the disease and the impact of the assistance provided shows that caregivers use more detachment relational strategy in the first year. Then, between 3 and 15 months, the attachment style is evolving towards more preoccupied style.
CONCLUSIONS: Detached-type insecure caregiver tend to minimize their signs of distress in the first time of disease. By contrast, preoccupied-type insecure adults tend to maximize distress signals. It\'s important to consider the specificity of each step of the process to better support caregivers.

Childhood cancer causes immense upheaval for the child and his or her family. The end of the treatments constitutes a transition period which brings with it numerous other problems. It is essential to take into account the difficulties expressed by families and to envisage areas of action to help and support them.

Bariatric surgery has now emerged as an effective means of glycemic control in individuals with diabetes and obesity. However, long-term data show recurrence of hyperglycemia years after the procedure. Although the exact prevalence of diabetes relapse is unknown because of attrition and limited data on long-term follow up after the surgery, a significant percentage of patients experience relapse of diabetes. The mechanism of diabetes relapse is not completely understood and is not always linked to weight regain. The clinical implications of hyperglycemia after bariatric surgery for patients and healthcare providers is reviewed.