Accordion Phenomenon in the Radial Artery : Should we treat the radial as a coronary artery?

The accordion phenomenon is a well-known finding mechanism in the field of interventional cardiology. It is a benign condition and has mainly been described in tortuous coronary arteries during percutaneous coronary interventions. It is believed to be induced by a stiff guidewire. However, this phenomenon has not been observed previously in the radial artery. We present a case of accordion phenomenon in the radial artery, which was successfully resolved after the catheters and the wire were retrieved, with the pseudolesions found to have completely disappeared in subsequent image findings

Tako-Tsubo Cardiomyopathy Triggered by Misdirection

Tako-Tsubo cardiomyopathy (TTC), also known as transient left ventricular apical ballooning syndrome or stress-induced cardiomyopathy, is a novel reversible cardiomyopathy mimicking acute myocardial infarction without epicardial coronary artery disease. The exact physiopathology of TTC remains unclear. It is usually precipitated by acute physical or emotional stress and it most commonly affects postmenopausal women. The growing number of clinical cases of TTC have demonstrated a wide field of possible etiologies beyond the emotional stress. We report a case of a 67-year-old postmenopausal woman who was being supplemented by enteral feeding via a nasogastric tube and who developed TTC due to misdirection, probably favored by the mechanical blockade by the nasogastric tube, while swallowing the drug pills

European Society of Cardiology: Cardiovascular Disease Statistics 2019

Aims The 2019 report from the European Society of Cardiology (ESC) Atlas provides a contemporary analysis of cardiovascular disease (CVD) statistics across 56 member countries, with particular emphasis on international inequalities in disease burden and healthcare delivery together with estimates of progress towards meeting 2025 World Health Organization (WHO) non-communicable disease targets. Methods and results In this report, contemporary CVD statistics are presented for member countries of the ESC. The statistics are drawn from the ESC Atlas which is a repository of CVD data from a variety of sources including the WHO, the Institute for Health Metrics and Evaluation, and the World Bank. The Atlas also includes novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery obtained by annual survey of the national societies of ESC member countries. Across ESC member countries, the prevalence of obesity (body mass index ≥30 kg/m2) and diabetes has increased two- to three-fold during the last 30 years making the WHO 2025 target to halt rises in these risk factors unlikely to be achieved. More encouraging have been variable declines in hypertension, smoking, and alcohol consumption but on current trends only the reduction in smoking from 28% to 21% during the last 20 years appears sufficient for the WHO target to be achieved. The median age-standardized prevalence of major risk factors was higher in middle-income compared with high-income ESC member countries for hypertension {23.8% [interquartile range (IQR) 22.5–23.1%] vs. 15.7% (IQR 14.5–21.1%)}, diabetes [7.7% (IQR 7.1–10.1%) vs. 5.6% (IQR 4.8–7.0%)], and among males smoking [43.8% (IQR 37.4–48.0%) vs. 26.0% (IQR 20.9–31.7%)] although among females smoking was less common in middle-income countries [8.7% (IQR 3.0–10.8) vs. 16.7% (IQR 13.9–19.7%)]. There were associated inequalities in disease burden with disability-adjusted life years per 100 000 people due to CVD over three times as high in middle-income [7160 (IQR 5655–8115)] compared with high-income [2235 (IQR 1896–3602)] countries. Cardiovascular disease mortality was also higher in middle-income countries where it accounted for a greater proportion of potential years of life lost compared with high-income countries in both females (43% vs. 28%) and males (39% vs. 28%). Despite the inequalities in disease burden across ESC member countries, survey data from the National Cardiac Societies of the ESC showed that middle-income member countries remain severely under-resourced compared with high-income countries in terms of cardiological person-power and technological infrastructure. Under-resourcing in middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, device implantation and cardiac surgical procedures. Conclusion A seemingly inexorable rise in the prevalence of obesity and diabetes currently provides the greatest challenge to achieving further reductions in CVD burden across ESC member countries. Additional challenges are provided by inequalities in disease burden that now require intensification of policy initiatives in order to reduce population risk and prioritize cardiovascular healthcare delivery, particularly in the middle-income countries of the ESC where need is greatest

Les lymphocytes TH17, nouveaux acteurs dans la paraparésie spastique tropicale ou myélopathie associée à HTLV-1 (TSP/HAM)

La paraparésie spastique tropicale ou la myélopathie associée à HTLV-1 (TSP/HAM) est une maladie neurologique chronique caractérisée par le développement de paralysies spastiques des membres inférieurs et de déficits sensoriels divers. Une infiltration périvasculaire souvent observée dans le système nerveux central des patients atteints de TSP/HAM correspondant essentiellement à des lymphocytes T CD4+, cibles préférentielles du HTLV-1 in vivo. Cependant, le facteur déclencheur du processus inflammatoire de la TSP/HAM est toujours méconnu. De ce fait, nous nous sommes intéressés à l'étude de l'implication d'une nouvelle population inflammatoire des T CD4+, les TH17, dans cette pathologie. Une quantification de l'expression de l'ARNm d'IL-17, la cytokine inflammatoire sécrétée par les TH17, a été menée sur les cellules du sang périphérique issues de patients infectés ainsi que sur des lignées cellulaires chroniquement infectées par HTLV-1. L'expression élevée de l'IL-17 détectée dans les lignées cellulaires est corrélée avec celle de la protéine transactivatrice du HTLV-1, Tax. Par ailleurs, Tax induit l'expression du régulateur transcriptionnel clé des TH17, RORg, par l'intermédiaire de la cytokine pro-inflammatoire Ostéopontine. Finalement, nous avons pu montrer l'existence d'une relation dynamique entre l'expression de l'ARNm de Tax, OPN, RORg, IL-17 et IL-22 chez les patients asymptomatiques et TSP/HAM avec une expression d'IL-17 et d'IL-22 plus élevée chez le groupe des TSP/HAM. Nos résultats suggèrent que l'infection par HTLV-1 in vivo induirait une réponse TH17 qui pourrait avoir un rôle majeur dans la pathogenèse de la TSP/HAM.HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a neurological inflammatory disease of the central nervous system characterized by a chronic, progressive inflammatory demyelinating myelopathy. It is thought that the pathogenesis of this disease involves a predominant infiltration of CD4+ T cells which are the main subset of in vivo infected cells with HTLV-1. However, until now, the identity of the triggering factor which promotes the inflammatory process in HAM/TSP remains unclear. Therefore, we investigated the implication of the new CD4+ T cells inflammatory lineage TH17 in this disease. We quantified the mRNA expression levels of IL-17, a cytokine associated with the TH17 response, in peripheral blood from 10 HAM/TSP patients, 6 healthy asymotomatic carriers (HCs) and 4 normal uninfected controls as well as in HTLV-1-infected T-cell lines. Elevated production of IL-17 observed in HTLV-1-infected T-cell lines was correlated with the expression of Tax, the major HTLV-1 regulatory protein. Thus, we established that Tax increases the expression of RORg, the TH17-lineage specific transactivator, by inducing Osteopontin expression, an inflammatory cytokine known to promote TH17 response. Finally, we demonstrated a dynamic relationship between the expression of Tax, Osteopontin, RORg, IL-17 and IL-22 mRNAs in HCs and HAM/TSP patients, where higher expression of IL-17 and IL-22 were observed in HAM/TSP cases. These findings suggest that in vivo infection by HTLV-1 may lead to a deleterious deviation of CD4+ T Helper response to TH17, that could play a major role in HAM/TSP pathogenesis.MONTPELLIER-BU Sciences (341722106) / SudocSudocFranceF

Catalytic Tubular Microjet Propulsion Model for Endovascular Navigation

International audienceThis paper describes the propulsion of the catalytic tubular microjet using Navier-Stokes equations. Especially , the thrust capability of the microjet is outstanding compared with the other microsystems, but remains only partially understood. Studies have identified the internal precursory mechanisms of the propulsion of the microjet: its inner wall catalyzes the dismutation of aqueous hydrogen peroxide, and an oxygen bubble is then formed and migrates towards its widest opening. This impulses the propulsion of the microjet towards the opposite direction. However, the precise propellant role of the liquid surrounding the jet remains misunderstood. The same goes for the inner wall of the vessel in which the jet navigates, especially in narrowed environment. This article discusses these aspects in a simplified theoretical framework. Calculations are performed by explicit computation of Navier-Stokes equations. The obtained theoretical outcome are in good agreement with experimental results in the literature

Increased osteopontin expression in HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) patient cells is associated with IL-17 expression

International audienc

Freud, les femmes, l'amour / Azar & Sarkis ; préface de Gérard Mendel

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