1. Gynecol Obstet Fertil. 2010 Jan 28. [Epub ahead of print]
[Magnesium sulphate: An improvement in the field of preterm infant
neuroprotection.]
[Article in French]
Marret S.
Service pédiatrie néonatale et réanimation, EA 4309, Neovasc, institut
hospitalo-universitaire de recherche biomédicale et d'innovation, faculté de
médecine, CHU de Rouen, université de Rouen, 1, rue de Germont, 76031 Rouen,
France.
PMID: 20117034 [PubMed - as supplied by publisher]
2. Biol Psychiatry. 2010 Jan 26. [Epub ahead of print]
Impaired Smooth Pursuit in Schizophrenia Results from Prediction Impairment Only.
Nkam I, Bocca ML, Denise P, Paoletti X, Dollfus S, Levillain D, Thibaut F.
Rouen University Hospital-Charles Nicolle and Le Rouvray Hospital, Rouen School
of Medicine, Rouen, France; Roger Prevot Hospital, Moisselles, France.
BACKGROUND: Oculomotor abnormality is one of the endophenotypes in schizophrenia.
The predictive component of smooth pursuit can be studied by comparing the gain,
i.e., the ratio of smooth eye position to target position, during predictable
(pure sinusoidal) and unpredictable (pseudorandom) target motions. The aim of
this experiment was to study predictive and nonpredictive components of smooth
pursuit in two groups of schizophrenia patients compared with control subjects.
METHODS: Fifty-one schizophrenia patients (40 nondeficit and 11 deficit) and 21
control subjects were studied. During a predictable task, subjects were asked to
track a sinusoidal target (.4 Hz). For the unpredictable task, the pseudorandom
target motion consisted of five superimposed sinusoidal waveforms (.1, .2, .4,
.6, and .8 Hz). The smooth eye position (eye position without saccades) gain, and
phase were calculated for each frequency in each participant and for both tasks.
RESULTS: The mean sinusoidal smooth eye position gain was significantly lower in
patients than in control subjects with no significant difference between deficit
and nondeficit patients. During the pseudorandom task, all groups had a similar
gain at .4 Hz. CONCLUSIONS: Our study reveals that patients have a normal
nonpredictive component of smooth pursuit, regardless of their level of negative
symptoms. In contrast, the predictive mechanisms involved in eye pursuit were
impaired in schizophrenia patients. These results indicate that poor pursuit
performance during smooth pursuit is primarily a consequence of a predictive
problem and is not related to the ability to generate an accurate pursuit
maintenance response. Copyright © 2010 Society of Biological Psychiatry.
Published by Elsevier Inc. All rights reserved.
PMID: 20110087 [PubMed - as supplied by publisher]
3. Hum Reprod. 2010 Jan 26. [Epub ahead of print]
Delayed functional outcomes associated with surgical management of deep
rectovaginal endometriosis with rectal involvement: giving patients an informed
choice.
Roman H, Loisel C, Resch B, Tuech JJ, Hochain P, Leroi AM, Marpeau L.
Department of Gynecology and Obstetrics, Rouen University Hospital, Rouen,
France.
BACKGROUND The aim of this study was to compare delayed functional digestive and
urinary outcomes following two different surgical procedures used in the
management of rectal endometriosis. METHODS Women who had undergone surgical
management of rectal endometriosis with at least 1 year of post-operative
follow-up were included in a retrospective study. Post-operative symptoms were
evaluated using specific questionnaires which focused on pelvic pain and
functional outcomes. RESULTS There were 41 women who underwent surgical treatment
of symptomatic rectal endometriosis. Post-operative follow-up was completed over
26 +/- 13 months (range 12-53). Colorectal segmental resection was performed in
25 women (61%) and nodule excision in 16 (39%). An increase in the number of
daily stools >/=3 was observed in 13 (52%) and 3 (19%) patients managed,
respectively, by segmental resection and nodule excision (P = 0.02). Severe
constipation (<1 stool/5 days) was recorded in three women having undergone
segmental resection. The probabilities of being free of dysmenorrhea, dyspareunia
and non-cyclic pain at 24 months in women managed by segmental resection and
nodule excision were, respectively, 80% (95% CI: 55-92%), 65% (95% CI: 42-81%),
43% (95% CI: 23-62%) and 62% (95% CI: 34-81%), 81% (95% CI: 52-94), 69% (95% CI:
40-86%). When pain recurrences occurred, a significantly lower post-operative
score for pain was observed in both groups. No significant difference in pain
improvement was found between surgical procedures. CONCLUSION Colorectal
segmental resection appears to be associated with several unpleasant functional
symptoms when compared with nodule excision. Information about functional
outcomes should be provided to patients managed for rectal endometriosis, and
should be considered when deciding on the most appropriate treatment of this
disease.
PMID: 20106836 [PubMed - as supplied by publisher]
4. World J Gastroenterol. 2010 Jan 28;16(4):462-6.
Gender influence on defecographic abnormalities in patients with posterior pelvic
floor disorders.
Savoye-Collet C, Savoye G, Koning E, Leroi AM, Dacher JN.
Radiology Department, Rouen University Hospital Charles Nicolle, 1 rue de
Germont, F-76031 Rouen, France. savoyecel@hotmail.com
AIM: To compare defecographic abnormalities in symptomatic men and women and to
analyze differences between men and age- and symptom-matched women. METHODS:
Sixty-six men (mean age: 55.4 years, range: 20-81 years) who complained of
constipation and/or fecal incontinence and/or pelvic pain underwent defecography
after intake of a barium meal. Radiographs were analyzed for the diagnosis of
rectocele, enterocele, intussusception and perineal descent. They were compared
with age- and symptom-matched women (n = 198) who underwent defecography during
the same period. RESULTS: Normal defecography was observed in 22.7% of men vs
5.5% of women (P < 0.001). Defecography in men compared with women showed 4.5% vs
44.4% (P < 0.001) rectocele, and 10.6% vs 29.8% (P < 0.001) enterocele,
respectively. No difference was observed for the diagnosis of intussusception
(57.6% vs 44.9%). Perineal descent at rest was more frequent in women (P <
0.005). CONCLUSION: For the same complaint, diagnosis of defecographic
abnormalities was different in men than in women: rectocele, enterocele and
perineal descent at rest were observed less frequently in men than in women.
PMCID: PMC2811799
PMID: 20101772 [PubMed - in process]
5. Int J Gynaecol Obstet. 2010 Jan 21. [Epub ahead of print]
Perioperative course and medium-term outcome of the transobturator and
infracoccygeal hammock for posthysterectomy vaginal vault prolapse.
Sergent F, Zanati J, Bisson V, Desilles N, Resch B, Marpeau L.
Department of Obstetrics and Gynecology, Rouen University Hospital and University
of Rouen, Rouen, France; CNRS FRE 3101, Polymers, Biopolymers, Surfaces, Rouen
National Institute of Applied Sciences, Mont-Saint-Aignan Cedex, France.
OBJECTIVE: To describe the perioperative course and medium-term anatomic and
functional outcomes of the transobturator-infracoccygeal hammock for
posthysterectomy vaginal vault prolapse repair. METHODS: A prospective
consecutive series of 52 women with a stage 2 vaginal vault prolapse or higher
that occurred after total hysterectomy who underwent surgery between 2003 and
2007. Principal outcome measures were anatomic cure (stage 1 or lower) and impact
on quality of life measured using the pelvic floor distress inventory (PFDI) and
pelvic floor impact self-reported questionnaire (PFIQ). Anatomical results were
analyzed using chi(2) and Fisher exact tests, and PFDI and PFIQ scores were
analyzed using the Wilcoxon test. RESULTS: With a median follow-up of 36months,
the anatomic cure rate was 96%. Significant improvements were noted in POPQ-S
scores after surgery (P<0.05). Stress urinary incontinence was cured in 73% of
patients and improved in 15% of patients. The PFDI and PFIQ scores were improved
(P<0.05). One mesh extrusion was observed. The rates of mesh contraction and new
cases of dyspareunia were 31% and 13%, respectively. CONCLUSION: The transvaginal
mesh hammock represents a useful treatment for recurrent and major vaginal vault
prolapse, and has few complications. Copyright © 2009 International Federation of
Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights
reserved.
PMID: 20096834 [PubMed - as supplied by publisher]
6. J Fr Ophtalmol. 2010 Jan 20. [Epub ahead of print]
[Bilateral torpedo maculopathy.]
[Article in French]
Richez F, Gueudry J, Brasseur G, Muraine M.
Service d'Ophtalmologie, CHU Charles Nicolle, Rouen.
PMID: 20096477 [PubMed - as supplied by publisher]
7. Gynecol Obstet Fertil. 2010 Jan 18. [Epub ahead of print]
[Capacity for debate or capacity for change?]
[Article in French]
Marpeau L.
Service de gynécologie-obstétrique, clinique Charles-Nicolle, CHU de Rouen, 1,
rue de Germont, 76031 Rouen cedex, France.
PMID: 20089435 [PubMed - as supplied by publisher]
8. Hypertension. 2010 Jan 18. [Epub ahead of print]
Arterial Stiffness Is Regulated by Nitric Oxide and Endothelium-Derived
Hyperpolarizing Factor During Changes in Blood Flow in Humans.
Bellien J, Favre J, Iacob M, Gao J, Thuillez C, Richard V, Joannidès R.
Department of Pharmacology, Rouen University Hospital and Institut National de la
Sante et de la Recherche Medicale U644, Rouen Medical School, Institut Federatif
de Recherche Multidisciplinaire sur les Peptides 23, Institute for Biomedical
Research, University of Rouen, Rouen, France.
Cytochrome-derived epoxyeicosatrienoic acids may be important endothelium-derived
hyperpolarizing factors, opening calcium-activated potassium channels, but their
involvement in the regulation of arterial stiffness during changes in blood flow
in humans is unknown. In healthy volunteers, we measured arterial pressure,
radial artery diameter, wall thickness, and flow (NIUS02) during hand skin
heating in the presence of saline or inhibitors of NO synthase
(N(G)-monomethyl-L-arginine), calcium-activated potassium channels
(tetraethylammonium), and cytochrome epoxygenases (fluconazole). Arterial
compliance and elastic modulus were calculated and fitted as functions of midwall
stress to suppress the confounding influence of geometric changes. Under saline
infusion, heating induced an upward shift of the compliance-midwall stress curve
and a downward shift of the modulus-midwall stress curve demonstrating a decrease
in arterial tone and stiffness when blood flow increases. These shifts were
reduced by N(G)-monomethyl-L-arginine and abolished by the combinations of
N(G)-monomethyl-L-arginine+tetraethylammonium and N(G)-monomethyl
arginine+fluconazole. In parallel, in isolated mice coronary arteries,
fluconazole and tetraethylammonium reduced the relaxations to acetylcholine.
However, fluconazole did not affect the relaxations to the openers of
calcium-activated potassium channels of small- and intermediate-conductance NS309
and of large-conductance NS1619 excluding a direct effect on these channels.
Moreover, tetraethylammonium reduced the relaxations to NS1619 but not to NS309,
suggesting that the endothelium-derived hyperpolarizing factor involved mainly
acts on large-conductance calcium-activated potassium channels. These results
show in humans that, during flow variations, arterial stiffness is regulated by
the endothelium through the release of both NO and cytochrome-related
endothelium-derived hyperpolarizing factor.
PMID: 20083732 [PubMed - as supplied by publisher]
9. Rev Neurol (Paris). 2010 Jan 11. [Epub ahead of print]
Tangier disease phenotype diversity in dizygous twin sisters.
Pichit P, Quillard M, Couvert P, Sénant J, Carrié A, Bittar R, Hannequin D,
Guyant-Maréchal L.
Service de neurologie, Inserm U614, CHU de Rouen, 1, rue de Germont, 76031 Rouen
cedex, France.
INTRODUCTION: Tangier disease (TD) is a rare autosomal recessive disorder
characterized by a deficiency or absence of high-density lipoprotein (HDL) caused
by mutations in the adenotriphosphate-binding cassette transporter-1 gene
(ABCA1). Mutations of ABCA1 lead to a defect in cellular cholesterol removal and
to deposition of cholesterol esters throughout the body. OBSERVATION: We report
here on the case of a 53-year-old woman with a severe phenotype of TD. The
patient had a dizygous twin sister who had only asymptomatic corneal opacities
and thrombopenia. CONCLUSION: This family demonstrates the wide intrafamilial
phenotype diversity of TD. Copyright © 2009 Elsevier Masson SAS. All rights
reserved.
PMID: 20070997 [PubMed - as supplied by publisher]
10. Neurochirurgie. 2010 Jan 7. [Epub ahead of print]
[Aneurismal subarachnoid hemorrhage in the elderly subject. Should this patient
participate in a randomized clinical trial?]
[Article in French]
Proust F, Bracard S, Thines L, Leclerc X, Penchet G, Bergé J, Vignes JR, Irthum
B, Gabrillargues J, Chazal J, Bataille B, Drouinau J, Mourier K, Ricolfi F, Gay
E, Bessou P, Lonjon M, Sedat J, David P, Lajaunias P, Morandi X, Gauvrit JY,
Pelissou I, Turjman F, Roche PH, Dufour H, Levrier O, Emery E, Courthéoux P,
Laguarrigue J, Cognard C, Civit T, Lejeune JP.
Department of Neurosurgery, Rouen University Hospital, 1, avenue de Germont,
76031 Rouen cedex, France.
PMID: 20060549 [PubMed - as supplied by publisher]
11. Acta Obstet Gynecol Scand. 2010 Jan 11. [Epub ahead of print]
Treatment of concomitant prolapse and stress urinary incontinence via a
transobturator subvesical mesh without independent suburethral tape.
Sergent F, Sentilhes L, Resch B, Verspyck E, Medeiros R, Descamps P, Marpeau L.
Department of Obstetrics and Gynecology, Rouen University Hospital, 1, rue de
Germont-76031 Rouen Cedex, France.
Abstract Objective. Evaluate the efficacy of a transobturator subvesical mesh for
cystocele in concomitant stress urinary incontinence (SUI). Design. Longitudinal
observational study. Setting. Tertiary referral urogynecology center. Population.
One hundred and five women with at least an anterior vaginal wall prolapse and
concomitant SUI who underwent surgery. Methods. After reduction of prolapse
elements, the intervention consisted of a non-absorbable monoprosthesis placement
with two transobturator expansions and, if necessary, associated hysterectomy or
infraccocygeal sacropexy. No specific procedure was performed for SUI. Main
outcome measures. All patients had a physical examination and a subjective
symptoms assessment via questionnaire in the preoperative period and at one-year
or more after surgery. The pelvic organ prolapse quantification system was used
for anatomical results. For SUI, Ingelman-Sundberg classification and cough test
were used. Loss of urine was measured by a one-hour pad test. Functional results
were evaluated by visual analog scale, quality-of-life questionnaires, including
the pelvic floor distress inventory and the pelvic floor impact questionnaire.
Results. Median follow-up was 45 months (range: 12-72). A total of 102 women
(97%) were cured of their prolapse, of whom 72 (69%) were cured of their SUI and
13 (12%) showed improvement. Pad test, visual analogic scale and quality-of-life
questionnaires were all improved (p < 0.05). Complications consisted of one
rectal injury, one transitory urinary retention, and two hematomas. Of the
erosions 6% was observed for monofilament polypropylene prostheses. Conclusion.
Transvaginal monoprosthesis for the simultaneous correction of prolapse and SUI
represents an effective treatment for bulky or recurrent prolapse as well as
posthysterectomy vaginal vault prolapse.
PMID: 20059448 [PubMed - as supplied by publisher]
12. Antimicrob Agents Chemother. 2010 Jan 4. [Epub ahead of print]
Evaluation of new thiazolide/thiadiazolide derivatives reveals nitro
group-independent efficacy against Cryptosporidium parvum in vitro development.
Gargala G, Le Goff L, Ballet JJ, Favennec L, Stachulski AV, Rossignol JF.
Parasitology Department, Rouen University Hospital & UPRES-EA 4311-IFRMP 23,
University of Rouen, France; Immunology Department, Caen University Hospital &
UPRES-EA 2128, University of Caen, France; Romark Center for Drug Discovery at
the University of Liverpool, Liverpool, United Kingdom; Division of
Gastroenterology & Hepatology, Department of Medicine, Stanford University School
of Medicine, Palo Alto, California, USA.
Thirty-nine new thiazolide/thiadiazolide compounds were compared with the
nitro-thiazole nitazoxanide for activity against Cryptosporidium parvum
development in HCT-8 cells. Twenty seven agents exerted a >/=90 % inhibition.
Agents with a lower IC50 than nitazoxanide were either NO2 or halogen
5-substituted on the thiazole moiety. Other 5-substitutions such as methyl, C3H7
C6H11, H, SO2CH3, and SCH3 negatively impacted activity. Five-substituted
deacetylated analogues exhibited higher IC50 than their acetylated counterparts.
Halogeno-thiazolide/thiadiazolides may provide valuable nitro-free alternatives
to nitazoxanide.
PMID: 20047919 [PubMed - as supplied by publisher]
13. Pediatrics. 2010 Jan;125(1):e29-34. Epub 2009 Dec 21.
Prenatal low-dose aspirin and neurobehavioral outcomes of children born very
preterm.
Marret S, Marchand L, Kaminski M, Larroque B, Arnaud C, Truffert P, Thirez G,
Fresson J, Rozé JC, Ancel PY; EPIPAGE Study Group.
Collaborators: Ancel PY, Blondel B, Bréart G, Dehan M, Garel M, Kaminski M,
Maillard F, du Mazaubrun C, Missy P, Sehili F, Supernant K, Marchand L, Durant
AM, Matis J, Messer J, Treisser A, Burguet A, Abraham-Lerat L, Menget A, Roth P,
Schaal JP, Thiriez G, Lévêque C, Marret S, Marpeau L, Boulot P, Picaud JC,
Donadio AM, Ledésert B, André M, Fresson J, Hascoët JM, Arnaud C, Bourdet-Loubère
S, Grandjean H, Rolland M, Leignel C, Lequien P, Pierrat V, Puech F, Subtil D,
Truffert P, de la Loire P, Boog G, Rouger-Bureau V, Rozé JC, Ancel PY, Bréart G,
Kaminski M, duMazaubrun C, Dehan M, Zupan-Simunek V, Vodovar M, Voyer M.
Department of Neonatal Medicine, Rouen University Hospital, Rouen, France.
stephane.marret@chu-rouen.fr
OBJECTIVE: Low-dose aspirin (LDA) given during pregnancy may alter brain
development in very preterm infants. We report the short- and long-term outcomes
of very preterm infants according to LDA treatment. PATIENTS AND METHODS: Data
were from the Etude Epidemiologique des Petites Ages Gestationnels (EPIPAGE)
cohort study, which included all infants born before 33 weeks of gestation in 9
French regions in 1997. This study was restricted to 656 children who were born
to 584 women with an obstetric history of placental vascular disease or with
chronic hypertension or renal or autoimmune diseases. The main outcome measures
were mortality, cerebral lesions, and outcome at 5 years of age, which were
measured by a diagnosis of cerebral palsy; behavioral difficulties, which were
assessed with the Strength and Difficulties Questionnaire; and cognitive
impairment, which was measured by the mental processing composite scale of the
Kaufman Assessment Battery for Children (an IQ-equivalent measure of cognitive
ability in 2 dimensions: sequential and simultaneous processing scores). RESULTS:
LDA treatment was administered to 125 of 584 (21%) mothers and was not
significantly associated with mortality, cerebral lesions, cerebral palsy, or
global cognitive impairment of the children at 5 years of age. The proportion of
low simultaneous processing scores (<70) was lower in the group with LDA (7% vs
19% without LDA; P = .04). This association was not significant after adjustment
for propensity score, prognostic factors, and social class (adjusted odds ratio
[aOR]: 0.59 [95% confidence interval (CI): 0.17-2.06]). LDA treatment was
associated with a reduction, at the limit of significance, in total behavioral
difficulties (aOR: 0.44 [95% CI: 0.19-1.02]) and hyperactivity (aOR: 0.43 [95%
CI: 0.17-1.05]). CONCLUSIONS: LDA was not associated with adverse neonatal or
long-term outcomes. Moreover, the results suggest that LDA may be associated with
a reduction in neurobehavioral difficulties. More research is needed to assess
the effects of aspirin alone or combined with other neuroprotective agents.
PMID: 20026499 [PubMed - in process]
14. Neurosci Lett. 2010 Jan 29;469(3):400-404. Epub 2009 Dec 22.
Influence of sensory inputs and motor demands on the control of the centre of
mass velocity during gait initiation in humans.
Chastan N, Westby GW, Montcel ST, Do MC, Chong RK, Agid Y, Welter ML.
Centre d'Investigation Clinique, Fédération des Maladies du Système Nerveux,
Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière,
Paris F-75013, France; Service de Neurophysiologie, Centre Hospitalier
Universitaire de Rouen, F-76000, France.
Human gait requires the simultaneous generation of goal-directed continuous
movement (locomotion) and the maintenance of balance (postural control). In
adults, the centre of mass (CoM) oscillates in the vertical plane while walking.
During the single support phase of gait initiation, its vertical (vCoM) velocity
increases as the CoM falls and is actively reversed prior to foot-contact. In
this study we investigated whether this active control, which is thought to
reflect balance control during gait initiation, is controlled by visual and
somatosensory inputs (Experiment 1) and whether it is modified by a change in
motor demands, two steps versus one step (Experiment 2). In all healthy adults,
the vCoM velocity was braked, or controlled, by contraction of the soleus muscle
of the stance leg. The elimination of visual input alone had no effect on
braking, although its amplitude decreased when somatosensory inputs were
disrupted (-47%), and further decreased when both visual and somatosensory inputs
were disrupted (-83%). When subjects performed only one step, with no trailing of
the stance foot, the vCoM velocity braking also decreased (-42%). These results
suggest that active braking of the CoM fall during the transition to double
support, an indicator of balance control, is influenced by both multisensory
integration and the demands of the current motor program. The neural structures
involved in this mechanism remain to be elucidated. Copyright © 2009 Elsevier
Ireland Ltd. All rights reserved.
PMID: 20026383 [PubMed - as supplied by publisher]
15. Hum Mutat. 2010 Jan;31(1):E1110-25.
A rare SMN2 variant in a previously unrecognized composite splicing regulatory
element induces exon 7 inclusion and reduces the clinical severity of spinal
muscular atrophy.
Vezain M, Saugier-Veber P, Goina E, Touraine R, Manel V, Toutain A, Fehrenbach S,
Frébourg T, Pagani F, Tosi M, Martins A.
Inserm U614, IFRMP, Institute for Biomedical Research, University of Rouen, 76183
Rouen, France.
Spinal muscular atrophy (SMA) is a common neuromuscular disorder caused by
homozygous inactivation of the SMN1 (Survival Motor Neuron 1) gene. The disease
severity is mainly influenced by the copy number of SMN2, a nearly identical gene
from which only low amounts of full-length mRNA are produced. This correlation is
not absolute, suggesting the existence of yet unknown factors modulating disease
progression. We identified and characterized the rare variant c.859G>C
(p.Gly287Arg) in exon 7 in both SMN2 copies of a male patient affected with type
III SMA, a milder form of the disease rarely associated with only two SMN2
copies. We demonstrated in vivo, in this patient and in a second unrelated
patient, and ex vivo, using SMN splicing assays, that the variant induces
inclusion of exon 7 into SMN2 mRNA. Moreover, we show that the c.859G>C variation
is located in a composite splicing regulatory element in the centre of exon 7.
The variation does not affect binding of HTra2â nor creates a novel SF2/ASF
enhancer, but disrupts an hnRNP A1 binding site. The natural occurrence of
enhanced inclusion of SMN2 exon 7 in milder SMA cases supports the current
therapeutic strategies based on splicing modulation in SMA patients.
PMID: 19953646 [PubMed - in process]
16. J Clin Endocrinol Metab. 2010 Jan;95(1):18-24. Epub 2009 Nov 13.
ACTH-independent Cushing's syndrome with bilateral micronodular adrenal
hyperplasia and ectopic adrenocortical adenoma.
Louiset E, Gobet F, Libé R, Horvath A, Renouf S, Cariou J, Rothenbuhler A,
Bertherat J, Clauser E, Grise P, Stratakis CA, Kuhn JM, Lefebvre H.
Institut National de la Santé et de la Recherche Médicale, Unité 982/Equipe
Associée 4310, Laboratory of Neuronal and Neuroendocrine Differentiation and
Communication, Institut Fédératif de Recherches Multidisciplinaires sur les
Peptides 23, University of Rouen, 76821 Mont-Saint-Aignan, France.
CONTEXT: Bilateral micronodular adrenal hyperplasia and ectopic adrenocortical
adenoma are two rare causes of ACTH-independent Cushing's syndrome. OBJECTIVE:
The aim of the study was to evaluate a 35-yr-old woman with ACTH-independent
hypercortisolism associated with both micronodular adrenal hyperplasia and
ectopic pararenal adrenocortical adenoma. DESIGN AND SETTING: In vivo and in
vitro studies were performed in a University Hospital Department and academic
research laboratories. INTERVENTION: Mutations of the PRKAR1A, PDE8B, and PDE11A
genes were searched for in leukocytes and adrenocortical tissues. The ability of
adrenal and adenoma tissues to synthesize cortisol was investigated by
immunohistochemistry, quantitative PCR, and/or cell culture studies. MAIN OUTCOME
MEASURE: Detection of 17alpha-hydroxylase and 21-hydroxylase immunoreactivities,
quantification of CYP11B1 mRNA in adrenal and adenoma tissues, and measurement of
cortisol levels in supernatants by radioimmunological assays were the main
outcomes. RESULTS: Histological examination of the adrenals revealed nonpigmented
micronodular cortical hyperplasia associated with relative atrophy of
internodular cortex. No genomic and/or somatic adrenal mutations of the PRKAR1A,
PDE8B, and PDE11A genes were detected. 17alpha-Hydroxylase and 21-hydroxylase
immunoreactivities as well as CYP11B1 mRNA were detected in adrenal and adenoma
tissues. ACTH and dexamethasone activated cortisol secretion from adenoma cells.
The stimulatory action of dexamethasone was mediated by a nongenomic effect
involving the protein kinase A pathway. CONCLUSION: This case suggests that
unknown molecular defects can favor both micronodular adrenal hyperplasia and
ectopic adrenocortical adenoma associated with Cushing's syndrome.
PMCID: PMC2805485 [Available on 2011/1/1]
PMID: 19915020 [PubMed - indexed for MEDLINE]
17. Curr Opin Clin Nutr Metab Care. 2010 Jan;13(1):70-4.
Combined infusion of glutamine and arginine: does it make sense?
Coëffier M, Déchelotte P.
Department of Nutrition, Rouen University Hospital and ADEN EA4311, Institute for
Biomedical Research, Institute for Peptides Research (IFRMP23), Medical School,
Rouen University, Rouen, France.
PURPOSE OF REVIEW: Glutamine and arginine are conditionally essential amino acids
because depletion occurs in stressed conditions. Intravenous glutamine
supplementation reduces morbidity and mortality in critically ill patients fed
parenterally. In surgical patients, arginine-enriched diets have beneficial
effects, but the use of supplemental arginine in critically ill patients should
be avoided in most cases. RECENT FINDINGS: In addition to its role as a fuel,
glutamine regulates gut barrier function, immuno-inflammatory response and
antioxidant status. Arginine metabolism leads to nitric oxide and/or polyamines
and thus modulates the immuno-inflammatory response and wound healing. Glutamine
and arginine metabolism are closely related, and therefore may give additive or
antagonist effects on several pathways. The effects of combined arginine and
glutamine are still poorly documented. Combined administration of arginine and
glutamine resulted in additive or synergistic effects on gut barrier function and
inflammatory response but arginine reduced glutamine protection against oxidative
stress. Preliminary data indicate that the combination may be beneficial during
intestinal inflammation, whereas data in surgical or critically ill patients are
still lacking. SUMMARY: Mostly speculative effects of combined infusion of
arginine and glutamine are discussed. Future studies are needed in specific
pathophysiological conditions to assess whether this combination is beneficial or
detrimental.
PMID: 19904200 [PubMed - in process]
18. BJOG. 2010 Jan;117(1):84-93.
Fertility and pregnancy following pelvic arterial embolisation for postpartum
haemorrhage.
Sentilhes L, Gromez A, Clavier E, Resch B, Verspyck E, Marpeau L.
Department of Obstetrics and Gynaecology, Rouen University Hospital, Charles
Nicolle, Rouen, France. loicsentilhes@hotmail.com
OBJECTIVES: To determine and compare the fertility and pregnancy outcomes
following embolisation with or without uterine-sparing surgery for postpartum
haemorrhage, and to attempt to identify specific risk factors associated with an
increased likelihood of intrauterine synechia. DESIGN: Retrospective study.
SETTING: University-affiliated tertiary referral centre. POPULATION: All
consecutive women who had an embolisation with or without uterine-sparing surgery
(vessel ligation and/or uterine compression) for postpartum haemorrhage between
1994 and 2007 were included. METHODS: Data were retrieved from medical files and
telephone interviews. MAIN OUTCOME MEASURE(S): Fertility and pregnancy outcomes,
synechia. RESULTS: Data were available for 68 of the 85 women (80%) included in
the study. Among the 15 women who complained of amenorrhoea or decreased flow of
menstruation, synechia was found in all those who decided to undergo an
ambulatory hysteroscopy (n = 8). Seventeen women had 26 pregnancies with 19 term
deliveries, one ectopic pregnancy, two abortions and four miscarriages. The
clinical courses of the 19 complete gestations were uneventful, but postpartum
haemorrhage recurred in six women (31.6%) (caused by placenta accreta in two
women). Fertility and pregnancy outcomes did not differ between women who had
undergone embolisation versus both embolisation and a uterine-sparing surgical
procedure. The occurrence of synechia was significantly associated with a higher
rate of placenta accreta/percreta (P < 0.001) and postpartum fever above 38.5
degrees C (P = 0.04). CONCLUSIONS: Embolisation, whether or not associated with a
uterine-sparing surgical procedure, for postpartum haemorrhage does not appear to
compromise a woman's subsequent fertility and obstetric outcome. Nevertheless,
these women should be considered at high risk for postpartum haemorrhage during
future deliveries.
PMID: 19832826 [PubMed - in process]
19. Rev Med Interne. 2010 Jan;31(1):23-28. Epub 2009 Oct 13.
[Stiff-person syndrome and other neurological disorders associated with anti-GAD
antibodies.]
[Article in French]
Hijazi J, Bedat-Millet AL, Hannequin D.
Service de neurologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France.
Autoantibodies to glutamic acid decarboxylase (GAD), originally identified in the
stiff-person syndrome, are also associated with rare cases of therapy-resistant
epilepsy and sporadic cerebellar ataxia. The association of GAD antibodies with
these three syndromes and other auto-immune diseases, particularly type 1
diabetes mellitus, argues for their auto-immune origin. Anti-GAD antibodies
inhibit GABAergic circuits inducing a neuronal hyper-excitability that seems to
be responsible for these three syndromes. However, an additional mechanism seems
to be involved in the degenerative component of the cerebellar ataxia associated
with anti-GAD antibodies. A more accurate diagnosis and the study of
neuropathological cases are necessary to document the different mechanisms
implicated in these neurological disorders. Copyright © 2009 Société nationale
française de médecine interne (SNFMI). Published by Elsevier SAS. All rights
reserved.
PMID: 19828214 [PubMed - as supplied by publisher]
20. J Gastrointest Surg. 2010 Jan;14(1):156-65. Epub 2009 Oct 14.
Reporting on quality of life in randomised controlled trials in gastrointestinal
surgery.
Bridoux V, Moutel G, Lefebure B, Scotte M, Michot F, Herve C, Tuech JJ.
Department of Digestive Surgery, Rouen University Hospital, 76031 Rouen Cedex,
France.
BACKGROUND: Although health-related quality of life (HRQOL) has become an
important outcome measure in surgical trials, questions still remain about the
quality of its reporting. The aim of this study was to evaluate HRQOL assessment
methodology of randomised clinical trials concerning gastrointestinal surgery.
METHODS: All articles published in the calendar years 2006 and 2007 that
purported to assess quality of life as end points or make some conclusion about
quality of life were chosen for review from eight general surgical journals and
four medical journals. Identified eligible studies were selected and then
evaluated on a broad set of predetermined criteria. RESULTS: Twenty-four
published randomised controlled clinical trials (RCTs)s with an HRQOL component
were identified. Although most trials exhibited good-quality research, some
methodological limitations were identified: Only 21% of the studies gave a
rationale for selecting a specific HRQOL measure, 46% of the studies failed to
report information about the administration of the HRQOL measure, and 37% did not
give details on missing data. CONCLUSIONS: Although it is clear that HRQOL is an
important end point in surgical RCTs because the information helps to influence
treatment recommendations, a number of methodological shortcomings have to be
further addressed in future studies.
PMID: 19826884 [PubMed - in process]
21. Am J Obstet Gynecol. 2010 Jan;202(1):54.e1-5. Epub 2009 Sep 26.
Hereditary thrombophilia and recurrence of ischemic placental disease.
Verspyck E, Borg JY, Roman H, Thobois B, Pia P, Marpeau L.
Department of Obstetrics and Gynecology, Rouen University Hospital, France.
eric.verspyck@chu-rouen.fr
OBJECTIVE: We sought to evaluate whether testing for hereditary thrombophilia
alone or in combination with second-trimester uterine artery Doppler (UAD) is
useful in predicting recurrent complications in patients with previous
preeclampsia, placental abruption, or stillbirth. STUDY DESIGN: Between 2001 and
2005, 110 consecutive women were included in the study and received 100 mg of
aspirin daily. Adjustment was made for several maternal confounding factors using
a logistic regression model. RESULTS: After multivariable logistic regression
analyses, only abnormal UAD assessment was significantly associated with
recurrent complications (odds ratio, 11.2; 95% confidence interval, 3.8-32.6)
Combining the results of UAD and the presence of laboratory markers of
thrombophilia failed to improve the accuracy of UAD to predict recurrent
complications. CONCLUSION: Hereditary thrombophilia testing is not useful in
predicting recurrent complications in subsequent pregnancy. 2010 Mosby, Inc.
PMID: 19782960 [PubMed - in process]
22. Leuk Res. 2010 Jan;34(1):24-31. Epub 2009 Sep 12.
In vitro secretion of matrix metalloprotease 9 is a prognostic marker in
childhood acute lymphoblastic leukemia.
Schneider P, Costa O, Legrand E, Bigot D, Lecleire S, Grassi V, Vannier JP, Vasse
M.
Pediatric Hematology, Oncology and IHU, Rouen University Hospital, Rouen, France.
pascale.schneider@chu-rouen.fr
Matrix metalloproteases (MMPs) are endopeptidases involved in tumor cell
invasion. Childhood acute lymphoblastic leukemia (ALL) is characterized by its
capacity to infiltrate different organs. We analyzed the expression of MMP-2, -9,
-14 and TIMP-1 and -2 in a prospective study on 86 children with newly diagnosed
ALL (73 B- and 13 T-lineage) and 9 children at relapse with B-ALL. Membrane-bound
and intracytoplasmic MMPs and TIMPs were analyzed by flow cytometry, and secreted
MMPs were quantified by ELISA. In patients at relapse, MMP-14 was present in a
greater proportion of the B-ALL cell population than at diagnosis. In patients
with peripheral infiltration, intracytoplasmic MMP-9 was significantly higher
than in patients without infiltration. ROC curve and Kaplan-Meier curve analysis
showed that a high secretion of MMP-9 (>2450 pg/ml/10(6) cells) was associated
with a lower overall survival rate, suggesting that the secretion of MMP-9 is an
independent prognostic factor in childhood B-ALL. 2009 Elsevier Ltd. All rights
reserved.
PMID: 19748669 [PubMed - in process]
23. Surg Radiol Anat. 2010 Jan;32(1):69-73. Epub 2009 Aug 20.
Contribution of the anatomy laboratory to the practical training of residents in
regional anesthesia.
Demars N, Compère V, Duparc F, Fourdrinier V, Dureuil B.
Department of Anesthesia and Intensive Care, Rouen University Hospital, 1 rue de
Germont, Rouen, France.
INTRODUCTION: Dissection workshop has never been assessed in the initial training
of resident medical students in anesthesia. This work aimed at assessing the
impact of this educational tool on the rates of success of the main blocks the
resident in anesthesia achieved during their training. MATERIALS AND METHODS: The
primary outcome measure studied in this work was the self-assessment by the
resident of the rate of success of every block before and after the complementary
training in regional anesthesia included dissection workshop, determined by a
questionnaire sent by post at least 6 months after the teaching. Besides, the
seminar was estimated at once by a questionnaire evaluating the quality as well
as the interest of the education on a scale ranging from 0 to 10. RESULTS:
Forty-two anesthesia residents went through the training. Thirty-four (77%)
handed back the questionnaire assessing the global interest an average of 8.9
(1.4). Theoretical training received an average score of 7.7 (1.4) and dissection
workshop in anatomy laboratory, a score of 7.8 (1.6). The quality of teaching
methods used was marked nine (0.8). Twenty-seven residents (61.36%) mailed the
questionnaire. The rate of success concerning each block in their clinical
practice before and after the training is not different, only concerning the
humeral canal block. CONCLUSION: Although the educational quality of the training
was acknowledged as responding to the expectancies of the anesthesia residents,
the dissection workshop do not meet with the expected requirements of rates
improval of the different blocks part from the humeral canal one's, within this
medical sample in initial training.
PMID: 19693429 [PubMed - in process]
24. Fertil Steril. 2010 Jan;93(1):307-10. Epub 2009 Aug 14.
Ovarian tissue thawing: a comparison of two conditions.
Perdrix A, Macé B, Milazzo JP, Liard-Zmuda A, Baron M, Rives N.
Reproductive Biology Laboratory-Centre D, Etude et de Conservation des Deufs et
du Sperde, Rouen University Hospital, Institute for Biomedical Research,
University of Rouen, Rouen, France.
Two different protocols to thaw cryopreserved human ovarian cortex have been
evaluated using a histological analysis. The slower one, based on a progressive
dilution of cryoprotectants, seems to maintain an optimal follicle morphology.
Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier
Inc. All rights reserved.
PMID: 19683233 [PubMed - in process]
25. Presse Med. 2010 Jan;39(1):42-48. Epub 2009 Aug 7.
[Diagnosis and treatment of community-acquired urinary tract infections in
adults: what has changed. Comments on the 2008 guidelines of the French Health
Products Safety Agency (AFSSAPS).]
[Article in French]
Caron F.
Expert auprès de l'Afssaps, président du groupe de travail "Recommandations de
bonne pratique : diagnostic et antibiothérapie des infections urinaires
bactériennes communautaires chez l'adulte" ; Groupe de recherche sur les
antimicrobiens et les micro-organismes (GRAM, EA2656), Université de Rouen ;
Service des maladies infectieuses et tropicales, CHU de Rouen, F-76031 Rouen
Cedex, France.
This article comments on the new recommendations for the diagnosis and treatment
of adult patients with community-acquired urinary tract infections (UTIs), issued
in 2008 by the French Health Products Safety Agency (AFSSAPS). The terms
uncomplicated and complicated UTIs have been retained ; complicated UTIs are
those with risk factor for complication (rather than with established
complications). In women, age (>/= 65 years) is no longer considered itself a
risk factor for complications. In men, cystitis must be treated as prostatitis.
The bacterial levels defining UTIs have been revised, but levels below the
threshold cannot be used to rule out UTI in the presence of symptoms. For
uncomplicated cystitis, only fosfomycin-trometamol is recommended as a first-line
treatment, essentially because of its ecological advantages (resistance uncommon,
no cross resistance with other antibiotic classes, specific class, sparing
others). For recurrent cystitis, prophylactic antibiotic treatment must be
limited to cases when other preventive measures are impossible. For complicated
cystitis, the principle is to delay antibiotic therapy until the resistance
profile results are available, when possible (because of the high risk of
resistance). Delay must be avoided during pregnancy, however, because of
maternal-fetal risks. The strategy for uncomplicated pyelonephritis has been
simplified : no plain abdominal radiography, antibiotic therapy shortened to
10-14 days (even 7 days for regimen or relay including fluoroquinolone), and no
routine verification by urine culture. For prostatitis, PSA testing is not
recommended during the acute phase of prostatitis, and a 14-day antibiotic
regimen is enough for the easiest-to-treat infections. Copyright © 2009 Elsevier
Masson SAS. All rights reserved.
PMID: 19665343 [PubMed - as supplied by publisher]
26. J Med Genet. 2010 Jan;47(1):22-9. Epub 2009 Jul 9.
MEF2C haploinsufficiency caused by either microdeletion of the 5q14.3 region or
mutation is responsible for severe mental retardation with stereotypic movements,
epilepsy and/or cerebral malformations.
Le Meur N, Holder-Espinasse M, Jaillard S, Goldenberg A, Joriot S, Amati-Bonneau
P, Guichet A, Barth M, Charollais A, Journel H, Auvin S, Boucher C, Kerckaert JP,
David V, Manouvrier-Hanu S, Saugier-Veber P, Frébourg T, Dubourg C, Andrieux J,
Bonneau D.
Service de Génétique, CHU de Rouen, France. nathalie.lemeur@efs.sante.fr
BACKGROUND: Over the last few years, array-comparative genomic hybridisation
(CGH) has considerably improved our ability to detect cryptic unbalanced
rearrangements in patients with syndromic mental retardation. METHOD: Molecular
karyotyping of six patients with syndromic mental retardation was carried out
using whole-genome oligonucleotide array-CGH. RESULTS: 5q14.3 microdeletions
ranging from 216 kb to 8.8 Mb were detected in five unrelated patients with the
following phenotypic similarities: severe mental retardation with absent speech,
hypotonia and stereotypic movements. Facial dysmorphic features, epilepsy and/or
cerebral malformations were also present in most of these patients. The minimal
common deleted region of these 5q14 microdeletions encompassed only MEF2C, the
gene for a protein known to act in brain as a neurogenesis effector, which
regulates excitatory synapse number. In a patient with a similar phenotype, an
MEF2C nonsense mutation was subsequently identified. CONCLUSION: Taken together,
these results strongly suggest that haploinsufficiency of MEF2C is responsible
for severe mental retardation with stereotypic movements, seizures and/or
cerebral malformations.
PMID: 19592390 [PubMed - in process]
27. J Surg Res. 2010 Jan;158(1):94-103.
Myocardial dysfunction in early state of endotoxemia role of heme-oxygenase-1.
Tamion F, Bauer F, Richard V, Laude K, Renet S, Slama M, Thuillez C.
Inserm (Institut National de la Santé et de la Recherche Médicale) Rouen
University Medical School, Rouen, France. fabienne.tamion@chu-rouen.fr
BACKGROUND: The triggers and cellular mechanisms of cardiac dysfunction have not
been clearly established during the early period following challenge with
lipopolysaccharides (LPS) (<1 h post-LPS). The aim of the study was to evaluate
the myocardial depression during early stage of endotoxemia, the relationship
between oxidative stress production and cardiac dysfunction in a rat model of
endotoxic shock, and its inhibition by heme-oxygenase-1 (HO-1) overexpression.
MATERIALS AND METHODS: LPS-induced myocardial deformation was assessed by tissue
Doppler imaging and invasive hemodynamic measurements in rats 2 h after LPS
challenge. Myocardial samples were processed for the measurements of tumor
necrosis factor alpha (TNFalpha), nitric oxidase synthase II (NOSII), HO-1 gene
expression, reactive oxygen species (ROS) production, and reduced
glutathione/oxidized glutathione (GSH/GSSH) ratio. RESULTS: Myocardial systolic
and diastolic deformation was evident as determined by tissue Doppler imaging but
left ventricular conventional echocardiographic parameters did not show
significant alterations. Myocardial deformation was significantly associated with
reactive oxygen species and TNFalpha overproduction. Pretreatment with hemin to
induce HO-1 resulted in decreased oxidative stress and TNFalpha production, and
prevented LPS-induced alterations in myocardium. CONCLUSIONS: These preliminary
results suggest myocardial alteration at a very early stage after LPS challenge
associated with oxidative stress response. Manipulation of the HO-1 pathway may
represent a future therapeutic strategy to counteract oxidative stress of
endotoxemia and perhaps may limit future myocardial deformation.
PMID: 19515387 [PubMed - indexed for MEDLINE]
