1. Gynecol Obstet Fertil. 2010 Sep 21. [Epub ahead of print]
[Perils for the term infant born by elective caesarean section!]
[Article in French]
Marret S, Marpeau L.
Service de pédiatrie néonatale et réanimation, hôpital Charles-Nicolle, CHU de
Rouen,1, rue de Germont, 76031 Rouen cedex, France; Clinique de
gynécologie-obstétrique, hôpital Charles-Nicolle, CHU de Rouen,1, rue de Germont,
76031 Rouen cedex, France.
PMID: 20864376 [PubMed - as supplied by publisher]
2. Int J Comput Assist Radiol Surg. 2010 Sep 17. [Epub ahead of print]
Automatic cardiac ventricle segmentation in MR images: a validation study.
Grosgeorge D, Petitjean C, Caudron J, Fares J, Dacher JN.
Université de Rouen, LITIS EA 4108, BP 12, 76801, Saint-Etienne-du-Rouvray,
France.
PURPOSE: Segmenting the cardiac ventricles in magnetic resonance (MR) images is
required for cardiac function assessment. Numerous segmentation methods have been
developed and applied to MR ventriculography. Quantitative validation of these
segmentation methods with ground truth is needed prior to clinical use, but
requires manual delineation of hundreds of images. We applied a well-established
method to this problem and rigorously validated the results. METHODS: An
automatic method based on active contours without edges was used for left and the
right ventricle cavity segmentation. A large database of 1,920 MR images obtained
from 59 patients who gave informed consent was evaluated. Two standard metrics
were used for quantitative error measurement. RESULTS: Segmentation results are
comparable to previously reported values in the literature. Since different
points in the cardiac cycle and different slice levels were used in this study, a
detailed error analysis is possible. Better performance was obtained at end
diastole than at end systole, and on mid-ventricular slices than apical slices.
Localization of segmentation errors were highlighted through a study of their
spatial distribution. CONCLUSIONS: Ventricular segmentation based on
region-driven active contours provided satisfactory results in MRI, without the
use of a priori knowledge. The study of error distribution allows identification
of potential improvements in algorithm performance.
PMID: 20848320 [PubMed - as supplied by publisher]
3. Arterioscler Thromb Vasc Biol. 2010 Sep 16. [Epub ahead of print]
Endothelial Estrogen Receptor {alpha} Plays an Essential Role in the Coronary and
Myocardial Protective Effects of Estradiol in Ischemia/Reperfusion.
Favre J, Gao J, Henry JP, Remy-Jouet I, Fourquaux I, Billon-Gales A, Thuillez C,
Arnal JF, Lenfant F, Richard V.
Institut National de la Santé et de la Recherche Médicale U644 and Rouen
University Hospital, Institute for Biomedical Research IUHRBM and IFRMP 23,
University of Rouen, France; INSERM U858, Institut de Médecine Moléculaire de
Rangueil, University of Toulouse III, Toulouse, France; Centre de Microscopie
Electronique Appliquée à la Biologie, Faculty of Medicine, University Paul
Sabatier Toulouse, Toulouse, France.
OBJECTIVE: To assess the coronary endothelial protective effects of 17β-estradiol
(E2) and the role of estrogen receptor (ER) α in ischemia/reperfusion (I/R).
METHODS AND RESULTS: E2 exerts protective effects in cardiac I/R. However, the
implication in vivo of the endothelium and the cellular targets of the
anti-ischemic effects of E2 are unknown. Mice were subjected to I/R (30 minutes
of I and 1 hour of R) in vivo, after which acetylcholine-induced relaxation of
isolated coronary segments was assessed ex vivo. I/R induced a coronary
endothelial dysfunction in untreated ovariectomized mice that was prevented by
long-term treatment with E2 in wild-type, but not in ERα(-/-), mice. Chimeric
mice inactivated for ERα in the hematopoietic compartment remained protected by
E2. Further inactivation of endothelial ERα abolished the protective action of E2
on coronary endothelial function in Tie2-Cre(+) ERα(f/f) mice. More importantly,
E2 significantly limited infarct size in wild-type mice but not in mice deficient
in endothelial ERα, even in the presence of hematopoietic ERα. CONCLUSIONS:
Endothelial ERα plays a crucial role in the E2-induced prevention of endothelial
dysfunction after I/R. To our knowledge, we demonstrate for the first time, by
using unique genetically modified mice, that targeting endothelial protection per
se can confer cardiomyocyte protection in I/R.
PMID: 20847304 [PubMed - as supplied by publisher]
4. Eur Heart J. 2010 Sep 15. [Epub ahead of print]
Transcatheter aortic valve implantation: early results of the FRANCE (FRench
Aortic National CoreValve and Edwards) registry.
Eltchaninoff H, Prat A, Gilard M, Leguerrier A, Blanchard D, Fournial G, Iung B,
Donzeau-Gouge P, Tribouilloy C, Debrux JL, Pavie A, Gueret P; on behalf of the
FRANCE Registry Investigators.
Cardiology Department, Charles Nicolle Hospital, University of Rouen-INSERM U
644, 1, rue de Germont, Rouen Cedex 76031, France.
Aims Transcatheter aortic valve implantation is a therapeutic alternative for
high-surgical-risk patients with severe symptomatic aortic stenosis. Two models
of prosthesis are currently commercialized in France, which can be implanted
either via a transarterial or a transapical approach. The aim of the study was to
evaluate in a national French registry the early safety and efficacy of
transcatheter aortic valve replacement (AVR) using either the Edwards SAPIEN™ or
CoreValve™ in high-surgical-risk patients with severe aortic stenosis. Methods
and results The multicentre national registry was conducted in 16 centres between
February 2009 and June 2009, under the authority of the French Societies of
Cardiology and Thoracic and Cardio-Vascular Surgery. The primary endpoint was
mortality at 1 month. Two hundred and forty-four high-surgical-risk patients
(logistic EuroSCORE ≥20%, STS ≥10%, or contra-indication to AVR) were enrolled.
Mean age was 82 ± 7 years and 43.9% were female. Edwards SAPIEN and CoreValve
were implanted in 68 and 32% of patients, respectively. The approaches used were
transarterial (transfemoral: 66%; subclavian: 5%) or transapical in 29%. Device
success rate was 98.3% and 30-day mortality was 12.7%. Severe complications
included stroke (3.6%), tamponade (2%), acute coronary occlusion (1.2%), and
vascular complications (7.3%). Pacemaker was required in 11.8%. At 1 month, 88%
of patients were in NYHA class II or less. Conclusion This prospective registry
reflects the real-life experience of transcatheter aortic valve implantation in
high-risk elderly patients in France. The early results are satisfactory in terms
of feasibility, short-term haemodynamic and functional improvement, and safety.
Longer term follow-up will be further assessed.
PMID: 20843959 [PubMed - as supplied by publisher]
5. Ann Fr Anesth Reanim. 2010 Sep 13. [Epub ahead of print]
[Temporomandibular joint dislocation occurring by removing an LMA.]
[Article in French]
Michot JB, Compère V, Hardy H, Dureuil B.
Service d'anesthésie-réanimation chirurgicale Samu, CHU de Rouen, 1, rue de
Germont, 76031 Rouen, France.
PMID: 20843645 [PubMed - as supplied by publisher]
6. Prog Urol. 2010 Sep;20(8):584-9. Epub 2010 Mar 29.
[Input from a specialized nurse consultation in the management of detrusor
overactivity treated with intradetrusor injections of botulinum toxin in urology
department. Pilot study]
[Article in French]
Le Gal S, Safsaf A, Galliot I, Catovic B, Grise P.
Service d'urologie, CHU Charles-Nicolle-Rouen, 1, rue Germont, 76031 Rouen cedex,
France. sophie.legal@netcourrier.com
OBJECTIVES: To adapt in daily practice, in a urology department, recommendations
for good clinical practice for follow-up of neurological patients with neurogenic
detrusor overactivity treated with injections of botulinum toxin type A by
involving a referent nurse in neuro-urology. METHOD: A nurse consultation in
neuro-urology has been created in June 2007 to intervene at each follow-up
consultation at D0, D8, D45, then by phone until reappearance of functional signs
to organize a new injection of botulinum toxin. This pilot study evaluated the
faisability, the input on clinical workload, and the benefit on relationship
between the patient and the caregiver. RESULTS: An improvement of the quality of
care has been given to the patient since first contact to follow-up. The number
of neurological patient transfers and waiting time between the recurrence of
functional signs and new therapeutic care were reduced. The number of medical
consultations has been reduced saving time to redistribute on other activities.
Knowledge improvement and privileged relationship with the patient and the doctor
were reported by the referent nurse. CONCLUSION: The participation of a referent
nurse in neuro-urology has improved the quality of care of these patients from
first contact to follow-up and has allowed adaptation of the recommendations in
the practice of caring of an urology department.
PMID: 20832036 [PubMed - in process]
7. Digestion. 2010 Sep 9;83(1-2):1-2. [Epub ahead of print]
Temporary Percutaneous Gastric Electrical Stimulation: Significant Progress in
the Treatment of Drug-Refractory Vomiting and Nausea.
Ducrotté P, Gourcerol G.
Rouen University Hospital and EA 4311, Rouen, France.
No abstract available.
PMID: 20829593 [PubMed - as supplied by publisher]
8. Eur J Surg Oncol. 2010 Sep 7. [Epub ahead of print]
Transposed right colon segment for vaginal reconstruction after pelvic
exenteration.
Bridoux V, Kianifard B, Michot F, Resch B, Sibert L, Tuech JJ.
Department of Digestive Surgery, Rouen University Hospital, 1 rue Germont, 76031
Rouen cedex, France.
Vaginal reconstruction following pelvic exenteration surgery for malignant
disease is an important step in the physical and psychological rehabilitation of
such patients. Planning of such procedures must include a strategy for
reconstruction of the vagina and the oncological surgical team must be aware of
the surgical techniques available in order to optimally plan and execute such
procedures. We described a procedure which involves supralevator exenteration of
the pelvis along with primary colorectal anastomosis. A transposed right colon
segment is used to reconstruct the vagina and an omental flap is interpositioned
between the reconstructed vagina and the colorectal anastomosis. The procedure is
described in the text and in a didactic video.
PMID: 20828978 [PubMed - as supplied by publisher]
9. J Clin Endocrinol Metab. 2010 Sep;95(9):4173-4.
Image in endocrinology. Marginal-zone lymphoma mimicking adrenal myelolipoma on
computed tomography scan.
Moreau L, Gobet F, Grise P, Perraudin V, Lefebvre H.
Department of Endocrinology, Institut National de Santé et de Recherche Médicale
Unité 982, 76031 Rouen, France.
PMID: 20823468 [PubMed - indexed for MEDLINE]
10. Gastroenterol Clin Biol. 2010 Sep 3. [Epub ahead of print]
Outcome of patients with obscure gastrointestinal bleeding after negative capsule
endoscopy: Results of a one-year follow-up study.
Lorenceau-Savale C, Ben-Soussan E, Ramirez S, Antonietti M, Lerebours E, Ducrotté
P.
Service d'hépatogastroentérologie et nutrition, centre hospitalier universitaire
de Rouen, 76031 Rouen cedex, France; Service d'hépatogastroentérologie, hôpital
européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
BACKGROUND: Capsule endoscopy (CE) is an effective method for investigating the
small bowel, especially in cases of obscure gastrointestinal bleeding (OGIB),
although the long-term outcome of patients with a negative CE is generally not
known. PATIENTS AND METHODS: For 49 patients with OGIB and a negative CE, their
referring physicians filled out a follow-up questionnaire to assess bleeding
recurrence and any repeat investigations after negative video capsule endoscopy
(VCE). RESULTS: A minimum follow-up duration of one year (median: 15.9 months)
was available for 35 patients with an overall rebleeding rate of 23% (n=8). Of
these eight patients, four women presented with recurrence prior to new
investigations. In the four remaining patients, repeat endoscopy work-ups after
negative CE were performed and revealed previously missed lesions with bleeding
potential, mainly in the stomach. Overall, 13 patients, with or without
rebleeding, had repeat endoscopy work-ups after a negative CE, leading to a
definitive diagnosis in nine patients, with lesions located in the stomach and
colon in eight of them. CONCLUSION: Patients with OGIB and a negative CE had a
low rate of rebleeding. This study highlights the importance of the initial
endoscopy work-up, and suggests that CE be proposed after a minimum of two
gastroscopies and one complete colonoscopy.
PMID: 20822872 [PubMed - as supplied by publisher]
11. Presse Med. 2010 Sep 2. [Epub ahead of print]
[Pemphigus.]
[Article in French]
Lapeyre-Liénard H, Joly P.
Hôpital Charles-Nicolle, clinique dermatologique, Inserm U 905, centre de
référence maladies bulleuses autoimmunes, 76031 Rouen cedex, France.
Pemphigus is a rare autoimmune blistering disorder involving the skin and
mucosae. Three types of pemphigus have been described, including pemphigus
vulgaris, pemphigus foliaceus and paraneoplastic pemphigus. Diagnosis of the type
of pemphigus is made by the combination of clinical features, histological and
direct immunofluorescence findings, and serum analysis by indirect
immunofluorescence, immunoblot analysis and enzyme-linked-immunosorbent-assay
(Elisa). Most patients are treated with oral corticosteroids, sometimes
associated with immunosuppressants. Patients with treatment failure or with
contraindications to systemic corticosteroids and/or immunosuppressants may be
treated with intravenous immunoglobulins or rituximab, an anti-CD20 monoclonal
antibody.
PMID: 20817387 [PubMed - as supplied by publisher]
12. J Radiol. 2010 Sep;91(9 Pt 1):917-20.
[Multiple ovarian fibromas in a patient with Gorlin syndrome: US and MR imaging
features with pathological correlation.]
[Article in French]
Berment H, Genevois A, Dacher J, Sabourin J.
Service de Radiologie, CHU Charles Nicolle, 1, rue de Germont, 76000 Rouen.
We report a case of multiple ovarian fibromas in a 23 year old woman with Gorlin
syndrome. We describe the US and MR imaging features with pathological
correlation. The fibrous component of the tumors were hypoechoic and attenuating
on US with corresponding T2W hypointensity whereas myxoid components were
hypoechoic with increased through transmission on US with corresponding T2W
hyperintensity.
PMID: 20814383 [PubMed - in process]
13. Am J Surg. 2010 Sep;200(3):406-12.
Biomechanical analysis of polypropylene prosthetic implants for hernia repair: an
experimental study.
Sergent F, Desilles N, Lacoume Y, Tuech JJ, Marie JP, Bunel C.
Rouen University, UPRES EA GRHV, France. Fabrice.Sergent@chu-rouen.fr
BACKGROUND: Although polypropylene (PP) is the most common biomaterial used for
ventral and inguinal hernia repairs, its mechanical properties remain obscure.
METHODS: Retraction, solidity, and elasticity of 3 large pore-size monofilament
PP prostheses, 1 heavy-weight PP (HWPP), a second low-weight PP, and a third
coated with atelocollagen were evaluated in a rabbit incisional hernia model. A
small pore-size multifilament PP implant (MPP) also was tested. RESULTS: Unlike
pore size, the weight of the prosthesis was not an influencing factor for
retraction. Atelocollagen coating reduced retraction (P < .05). HWPP and MPP were
less likely to rupture (P < .05). HWPP had comparatively better elasticity (P <
.05), whereas MPP supported the greatest elastic force (P < .05). Nevertheless,
the amount of shrinkage of MPP (30% of the original size) made this prosthesis
unusable. CONCLUSIONS: In this study, HWPP presented the most advantageous
biomechanical compromise for hernia surgery.
PMID: 20800718 [PubMed - indexed for MEDLINE]
14. Rev Stomatol Chir Maxillofac. 2010 Sep;111(4):213-5. Epub 2010 Aug 24.
[Upper aerodigestive tract erythroplakia]
[Article in French]
Hardy H, Persac S, Péron JM.
Service de chirurgie maxillo-faciale et stomatologie, CHRU Charles-Nicolle, 1,
rue de Germont, 76031 Rouen cedex, France. hubhrd@gmail.com
Erythroplakia is a red mucosal macule with a chronic evolution. It is diagnosed
after excluding traumatic, vascular, or inflammatory etiologies. Erythroplakia is
rare in the upper aerodigestive tract. It affects middle-aged adults. The main
predisposing factors are those of in situ carcinoma. Lesions are mainly located
on lips or mucosa. Erythroleukoplakia may also occur. Ninety-one percent of
erythroplakia are severe dysplasia, in situ carcinoma, or invasive carcinoma.
Excision and histopathological examination are mandatory.
PMID: 20739037 [PubMed - in process]
15. Am J Cardiol. 2010 Sep 1;106(5):707-12. Epub 2010 Jul 23.
Frequency of conduction disturbances after transcatheter implantation of an
Edwards Sapien aortic valve prosthesis.
Godin M, Eltchaninoff H, Furuta A, Tron C, Anselme F, Bejar K, Sanchez-Giron C,
Bauer F, Litzler PY, Bessou JP, Cribier A.
Department of Cardiology, Rouen University Hospital and INSERM U, University of
Rouen, France.
We evaluated the incidence of conduction abnormalities and requirement for
permanent pacemaker in patients undergoing transcatheter aortic valve
implantation (TAVI) with the Edwards Sapien prosthesis. In 2009, >8,000 patients
were treated with TAVI using 1 of the 2 commercialized models of bioprosthesis
(Edwards Sapien, Edwards Lifesciences, Irvine, California; and CoreValve,
Medtronic, Irvine, California). Occurrence of conduction abnormalities including
complete atrioventricular block requiring permanent pacemaker has been reported
after TAVI with the 2 models of valve, more frequently with the CoreValve. We
analyzed standard 12-lead electrocardiograms of 69 consecutive patients in whom
an Edwards Sapien prosthesis was successfully implanted. Electrocardiograms were
examined before treatment, at day 1, and at 1-month follow-up. Heart rate, PR and
QT intervals and QRS duration were measured and the presence of a first-,
second-, or third-degree atrioventricular block was documented. There was a
slight increase in heart rate and a discrete decrease in QT interval at day 1.
These values had returned to baseline values at 1 month. There was no change in
PR interval but a transitory increase in QRS duration was noted. Frequency of
left bundle branch block increased from 14.5% at baseline to 27.5% at day 1 with
a decreased incidence at day 30 (21.3%). Permanent pacemaker was required in only
3 patients (4.3%). In conclusion, in our experience, conductive disorders and
requirement of a definitive pacemaker after implantation of an Edwards Sapien
aortic bioprosthesis are infrequent. The physical properties of this prosthesis
may explain this observation.
PMID: 20723650 [PubMed - indexed for MEDLINE]
16. Ann Fr Anesth Reanim. 2010 Sep;29(9):629-34. Epub 2010 Aug 1.
[Albumin in sepsis]
[Article in French]
Tamion F.
Service de réanimation médicale, CHU de Rouen, 1 rue de Germont, Rouen, France.
fabienne.tamion@chu-rouen.fr
Human serum albumin is a small (66kD) globular protein representing over 60 % of
the total plasma protein content. It is made up of 585 amino 6 acids and contains
35 cysteine residues forming disulfide bridges that contribute to its overall
tertiary structure. It has a free cysteine-derived thiol group at Cys-34, which
accounts for 80 % of its redox activity. Physiologically, serum albumin exists in
a reduced form with a free thiol contributing to its antioxidant properties. It
is synthesized primarily in the liver and is an acute-phase protein. It is a
multifunctional plasma protein ascribed ligand-binding and transport properties
as well as antioxidants and enzymatic functions. It maintains colloid osmotic
pressure, modulates inflammatory response and may influence oxidative damage.
Hypoalbuminemia is common in the intensive care unit and may be due to decreased
synthesis by the liver and/or to increased losses or increased proteolysis and
clearance. Although albumin was long used to control vascular collapse in
critically ill patients, the evidence suggests that it does not offer a benefit
over crystalloid solutions in vascular collapse. However, human serum albumin is
an important circulating antioxidant and it may be beneficial in critically ill
patients to limit oxidative damage. A number of studies suggest that in specific
groups of hypoalbuminemic critically ill patients, albumin administration may
have beneficial effects on organ function, although the exact mechanisms remain
undefined. Further trials are needed to confirm theses observations and to
clearly demonstrate whether albumin should be administered in critically ill
patients with hypoalbuminemia.
PMID: 20675098 [PubMed - in process]
17. Am J Drug Alcohol Abuse. 2010 Sep;36(5):254-60.
Sexual addictions.
Garcia FD, Thibaut F.
Rouen University Hospital and Biomedical Research Institute, France.
The potential adverse consequences, personal distress, shame and guilt presented
by patients who suffer from sexual addiction require a more in-depth
understanding of the phenomenology and psychobiology of this disorder. Methods: A
bibliographic review was conducted using MEDLINE and EBSCO databases with the
following keywords: "sexual addiction," "hypersexuality," "compulsive sexual
behavior," "behavioural addiction," "treatment," and "addiction." Results:
Several conceptualizations of excessive nonparaphilic sexual disorder have been
proposed based on the models of, respectively, obsessive compulsive disorder,
impulse control disorder, out of control excessive sexual disorder, and addictive
disorder. Despite the lack of robust scientific data, a number of clinical
elements, such as the frequent preoccupation with this type of behavior, the time
spent in sexual activities, the continuation of this behavior despite its
negative consequences, the repeated and unsuccessful efforts made to reduce the
behavior, are in favor of an addictive disorder. In addition there is a high
comorbidity between excessive sexual behavior and other addictive behaviors.
Conclusion: The phenomenology of excessive nonparaphilic sexual disorder favors
its conceptualization as an addictive behavior, rather than an
obsessive-compulsive, or an impulse control disorder. Moreover, the criteria that
are quite close to those of addictive disorders were recently proposed for the
future DSM-V in order to improve the characterization of this condition. Finally,
controlled studies are warranted in order to establish clear guidelines for
treatment of sexual addiction.
PMID: 20666699 [PubMed - in process]
18. Rev Med Interne. 2010 Sep;31(9):600-5. Epub 2010 Jun 3.
[Usefulness of magnetic resonance imaging in Churg-Strauss syndrome related
cardiac involvement. A case series of three patients and literature review]
[Article in French]
Sauvetre G, Fares J, Caudron J, Dacher JN, Girszyn N, Daragon A, Levesque H,
Marie I.
Département de médecine interne, CHU de Rouen, 1, rue de Germont, 76031 Rouen
cedex, France.
PURPOSE: The reported prevalence of cardiac complications is variable in patients
with Churg-Strauss syndrome (15-92%) and depends on diagnostic tools. Diagnosis
at early stage of heart involvement is crucial, resulting in appropriate
management. METHODS: We report three patients who developed cardiac
manifestations, revealing Churg-Strauss syndrome. The diagnosis of cardiac
involvement was obtained using cardiac magnetic resonance imaging (MRI). RESULTS:
Two patients were males and the remaining one was a female. Presenting clinical
manifestations were: cardiac failure (n=1) and retrosternal pain (n=2).
Laboratory findings disclosed: high blood count of eosinophils (range:
6000-11,000/mm(3)); antineutrophil cytoplasmic antibodies were positive in a
single patient. Cardiac MRI demonstrated: (1) late gadolinium enhancement (n=3),
involving mainly the apical and mid-cavity left ventricular segments; (2)
impaired left ventricular function (n=2), mean left ventricular ejection fraction
being: 51%; and (3) pericardial effusion (n=3). Outcome was favourable after
institution of combined therapy with prednisone and cyclophosphamide (n=2); one
patient also underwent plasma exchanges. CONCLUSION: Our case series underlines
that MRI is a helpful tool in the diagnosis of Churg-Strauss syndrome-related
cardiac complications. We further suggest that clinical assessment of patients
with Churg-Strauss syndrome should include cardiac MRI, in order to detect
cardiac involvement at an early stage; indeed, because cardiac manifestations are
predictive factors of poor prognosis, diagnosis at early stages of cardiac
involvement may result in improvement of patients management.
PMID: 20605285 [PubMed - in process]
19. Rev Med Interne. 2010 Sep;31(9):637-9. Epub 2010 Jun 23.
[TRAPS: clinical significance of genotype. A report of two cases]
[Article in French]
Lahaxe L, Josse S, Grateau G, Levesque H, Marie I.
Département de médecine interne, CHU de Rouen, 1 rue de Germont, 76031 Rouen
cedex, France.
INTRODUCTION: Tumor necrosis factor receptor associated periodic fever syndrome
(TRAPS) is defined as recurrent attacks of generalized inflammation for which no
infectious or auto-immune cause can be identified; it is caused by dominantly
inherited mutations in the gene encoding the first TNF receptor. We report two
additional cases of patients with TRAPS, suggesting that mutation pattern of
TNFRSF 1A gene may influence the TRAPS phenotype. CASE REPORTS: The first
patient, with a C30S mutation, exhibited severe digestive clinical
manifestations; because the patient required high-dose corticosteroids regimen to
improve TRAPS manifestations, he was further given successfully etanercept. The
second patient, with a R92Q mutation of TNFRSF 1A gene, presented with moderate
symptoms; TRAPS outcome was favourable after corticosteroid therapy initiation.
CONCLUSION: Therefore, R92Q may be associated with a mild disease phenotype. On
the other hand, C30S mutation appears to be associated with a severe phenotype,
leading to an increased risk of amyloidosis. These findings suggest that these
latter patients may require a closer follow-up.
PMID: 20576331 [PubMed - in process]
20. Free Radic Biol Med. 2010 Sep 1;49(5):748-56. Epub 2010 Jun 4.
Mitochondrial impairment contributes to cocaine-induced cardiac dysfunction:
Prevention by the targeted antioxidant MitoQ.
Vergeade A, Mulder P, Vendeville-Dehaudt C, Estour F, Fortin D, Ventura-Clapier
R, Thuillez C, Monteil C.
INSERM U644, University of Rouen, Rouen F-76183, France.
The goal of this study was to assess mitochondrial function and ROS production in
an experimental model of cocaine-induced cardiac dysfunction. We hypothesized
that cocaine abuse may lead to altered mitochondrial function that in turn may
cause left ventricular dysfunction. Seven days of cocaine administration to rats
led to an increased oxygen consumption detected in cardiac fibers, specifically
through complex I and complex III. ROS levels were increased, specifically in
interfibrillar mitochondria. In parallel there was a decrease in ATP synthesis,
whereas no difference was observed in subsarcolemmal mitochondria. This
uncoupling effect on oxidative phosphorylation was not detectable after
short-term exposure to cocaine, suggesting that these mitochondrial abnormalities
were a late rather than a primary event in the pathological response to cocaine.
MitoQ, a mitochondrial-targeted antioxidant, was shown to completely prevent
these mitochondrial abnormalities as well as cardiac dysfunction characterized
here by a diastolic dysfunction studied with a conductance catheter to obtain
pressure-volume data. Taken together, these results extend previous studies and
demonstrate that cocaine-induced cardiac dysfunction may be due to a
mitochondrial defect.
PMID: 20566328 [PubMed - in process]
21. Antimicrob Agents Chemother. 2010 Sep;54(9):4016-9. Epub 2010 Jun 14.
Baseline genotypic and phenotypic susceptibilities of HIV-1 group O to
enfuvirtide.
Depatureaux A, Charpentier C, Collin G, Leoz M, Descamps D, Vessière A, Damond F,
Rousset D, Brun-Vézinet F, Plantier JC.
Laboratoire associé au Centre National de Référence du VIH, EA2656, CHU Charles
Nicolle, Rouen, France.
We assessed the natural genotypic and phenotypic susceptibilities to enfuvirtide
of 171 HIV group O (HIV-O) samples and 29 strains, respectively. The N42D
resistance-associated mutation in the gp41 region was detected in 98% of cases.
The phenotypic assay showed a wide range of baseline susceptibilities, with 50%
inhibitory concentrations (IC(50)s) from 4 to 5,000 nM, a range similar to that
reported for HIV-1 group M. Thus, despite the natural genotypic resistance
conferred by the N42D signature mutation, HIV-O variants appear to be
phenotypically susceptible. Enfuvirtide could therefore potentially be used in
antiretroviral treatments for HIV-O-infected patients.
PMCID: PMC2935004 [Available on 2011/3/1]
PMID: 20547806 [PubMed - in process]
22. Gastroenterol Clin Biol. 2010 Sep;34(8-9):502-4. Epub 2010 May 27.
Pneumatosis cystoides intestinalis: An unusual cause of distal constipation.
Chaput U, Ducrotté P, Denis P, Nouveau J.
Department of Gastroenterology - ADEN EA 4311 - Rouen University Hospital and
Rouen University, 1, rue de Germont, 76031 Rouen cedex, France.
PMID: 20537481 [PubMed - in process]
23. Interact Cardiovasc Thorac Surg. 2010 Sep;11(3):357-9. Epub 2010 Jun 1.
Acute aortic syndrome: a 'last glance' before incision.
Lebreton G, Litzler PY, Bessou JP, Doguet F.
Department of Thoracic and Cardiovascular Surgery, Rouen University Hospital, 1,
rue de Germont, 76000 Rouen, France. guillaumelebreton@live.fr
Comment in:
Interact Cardiovasc Thorac Surg. 2010 Sep;11(3):359.
Interact Cardiovasc Thorac Surg. 2010 Sep;11(3):359.
Acute aortic syndrome (AAS) (aortic dissection, intramural aortic haematoma, or
penetrating atherosclerotic ulcer) is a surgical emergency. Computed tomography
(CT) is the reference technique for the diagnosis of this critical situation.
However, a few reports of false-positive images leading to unnecessary
interventions have been published. It is important to recognize and understand
the pitfalls in the CT diagnosis of AAS. We describe the case of a 76-year-old
man with clinical signs of AAS and a CT-scan compatible with a diagnosis of
aortic intra-mural haematoma, leading to emergency surgery. The peroperative
findings revealed a normal aortic wall with the presence of an unusual
pericardial recess at the right side of the aorta.
PMID: 20515919 [PubMed - in process]
24. Nephrol Dial Transplant. 2010 Sep;25(9):3096-106. Epub 2010 Mar 17.
A 50% reduction in cyclosporine exposure in stable renal transplant recipients:
renal function benefits.
Etienne I, Toupance O, Bénichou J, Thierry A, Al Najjar A, Hurault de Ligny B, Le
Meur Y, Westeel PF, Marquet P, François A, Hellot MF, Godin M.
Department of Nephrology, Rouen University Hospital, and Inserm CIC 0204,
Institute of Biomedical Research, University of Rouen, Rouen, France.
Isabelle.Etienne@chu-rouen.fr
BACKGROUND: Although cyclosporine maintenance therapy reduces the risk of acute
rejection and increases short-term graft survival in renal transplant recipients,
its associated nephrotoxicity increases the risk of chronic graft dysfunction.
The dose that allows an optimal risk-to-benefit ratio has not been established.
METHODS: This multicentre study enrolled stable renal allograft recipients
receiving cyclosporine and mycophenolate mofetil without corticosteroids in their
second year post-transplant. Patients were randomized to a cyclosporine dose
targeted to a standard area under the concentration-time curve (AUC)(0-12 h)
(usual exposure, n = 104) or 50% of the study standard AUC(0-12 h) (low exposure,
n = 108) using a three-point pharmacokinetic sampling. The primary endpoint was
the percentage of patients with treatment failure at 24 months (graft loss/acute
rejection/nephrotoxicity/>15% serum creatinine level increase). RESULTS:
Treatment failure was reported in 37 out of 101 (37%) patients in the
usual-exposure and 19 out of 106 (18%) patients in the low-exposure groups (P =
0.003). Mean estimated glomerular filtration rate decreased from baseline to 2
years with usual exposure and increased with low exposure (P < 0.001). Mean
systolic and diastolic blood pressures were lower with low exposure (P = 0.03 and
P = 0.008, respectively). CONCLUSION: In renal transplant recipients receiving
maintenance therapy without corticosteroids, a minimization strategy using
three-point pharmacokinetic sampling to reduce and maintain cyclosporine exposure
to 50% of the usual levels is safe and reduces the risk of graft dysfunction.
PMID: 20299336 [PubMed - in process]
25. QJM. 2010 Sep;103(9):703-4. Epub 2009 Oct 20.
Palmar fasciitis and polyarthritis syndrome.
Marie I, Cailleux N, Roca F, Benhamou Y, Scotte M, Levesque H.
Département de Médecine Interne, CHU de Rouen, 76031 Rouen Cedex, France.
isabelle.marie@chu-rouen.fr
PMID: 19843603 [PubMed - in process]
