Reversible atransferrinemia in a patient with chronic enteropathy: is transferrin mandatory for iron transport?

Herein, we report the case of a 42-year-old woman, hospitalized in a French tertiary hospital for a relapse of a chronic enteropathy, who was found on admission to have no detectable serum transferrin. Surprisingly, she only exhibited mild anaemia. This atransferrinemia persisted for two months throughout her hospitalization, during which her haemoglobin concentration remained broadly stable. Based on her clinical history and evolution, we concluded to an acquired atransferrinemia secondary to chronic undernutrition, inflammation and liver failure. We discuss the investigations performed in this patient, and hypotheses regarding the relative stability of her haemoglobin concentration despite the absence of detectable transferrin

Prolonged Plasmodium falciparum Infection in Immigrants, Paris

Few immigrant travelers have Plasmodium falciparum infections >2 months after leaving malaria-endemic areas. We conducted a case–control study to identify factors associated with prolonged P. falciparum infection in immigrant travelers. Results suggest that P. falciparum infection should be systematically suspected, even months after travel, especially in pregnant women and first-arrival immigrants

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Etude protéomique des cellules endothéliales et identification de protéines impliquées dans leur apoptose induite par l'étoposide

PARIS-BIUP (751062107) / SudocSudocFranceF

Identification de cibles antigéniques des anticorps anti-soluble liver antigen (anti-sla) par éléctrophorèse bi-dimensionnelle couplée à la spectrométrie de masse

CHATENAY M.-PARIS 11-BU Pharma. (920192101) / SudocSudocFranceF

Integrating mass spectrometry-based plasma (or serum) protein N-glycan profiling into the clinical practice?

International audienc

Neuropathie héréditaire associée au gène SORD

International audienceMutations in the SORD gene have recently been identified as a cause of autosomal Charcot-Marie-Tooth disease as well as the underlying defect in some cases of hereditary distal motoneuronopathies. Patients may be amenable to therapies in a near future

Approximations for the performance evaluation of a discrete-time two-class queue with an alternating service discipline

We consider a discrete-time queueing system with two queues and one server. The server is allocated in each slot to the first queue with probability alpha and to the second queue with probability 1-alpha. The service times are equal to one time slot. The queues have exponentially bounded, but general, arrival distributions. The mathematical description of this system leads to a single functional equation for the joint probability generating function of the stationary system contents. As the joint stochastic process of the system contents is not amenable for exact analysis, we focus on an efficient approximation of the joint probability generating function. In particular, first we prove that the partial probability generating functions, present in the functional equation, have a unique dominant pole. Secondly, we use this information to approximate these partial probability generating functions by truncating an infinite sum. The remaining finite number of unknowns are estimated from a noise perturbed linear system. We illustrate our approach by various numerical examples and verify the accuracy by means of simulation

Analysis of a discrete-time two-class randomly alternating service model with Bernoulli arrivals

We analyze a discrete-time two-class queueing system with a single server which is alternately available for only one customer class. The server is each time allocated to a customer class for a geometrically distributed amount of time. Service times of the customers are deterministically equal to 1 time slot each. During each time slot, both classes can have at most one arrival. The bivariate process of the number of customers of both classes can be considered as a two-dimensional nearest-neighbor random walk. The generating function of this random walk has to be obtained from a functional equation. This type of functional equation is known to be difficult to solve. In this paper, we obtain closed-form expressions for the joint probability distribution for the number of customers of both classes, in steady state

Heavy-traffic comparison of a discrete-time generalized processor sharing queue and a pure randomly alternating service queue

This paper compares two discrete-time single-server queueing models with two queues. In both models, the server is available to a queue with probability 1/2 at each service opportunity. Since obtaining easy-to-evaluate expressions for the joint moments is not feasible, we rely on a heavy-traffic limit approach. The correlation coefficient of the queue-contents is computed via the solution of a two-dimensional functional equation obtained by reducing it to a boundary value problem on a hyperbola. In most server-sharing models, it is assumed that the system is work-conserving in the sense that if one of the queues is empty, a customer of the other queue is served with probability 1. In our second model, we omit this work-conserving rule such that the server can be idle in case of a non-empty queue. Contrary to what we would expect, the resulting heavy-traffic approximations reveal that both models remain different for critically loaded queues