57 research outputs found

    Intérêt du toucher vaginal systématique lors de la surveillance des grossesses normales‎ : enquête auprès de 229 professionnels haut-normands

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    Le toucher vaginal (TV) est pratiqué en consultation prénatale (CPN) depuis les années 1970 essentiellement dans le but de dépister des menaces d'accouchement prématuré (MAP). Sa pratique systématique est remise en question depuis une dizaine d'années. En effet, en 2005, sont parues les recommandations de la Haute Autorité de Santé suivantes : "En l'état actuel des connaissances, il n'y a pas d'argument pour la réalisation en routine du TV. Le TV systématique chez une femme asymptomatique comparé à un examen réalisé sur indication médicale ne diminue pas le risque d'accouchement prématuré". Celles-ci sont-elles connues et suivies des professionnels de la grossesse ? Quels sont les arguments avancés par les professionnels pour pratiquer systématiquement ou non le TV à chaque CPN ? Nous avons interrogé 229 professionnels haut-normands pour répondre à ces questions. En ce début 2010, une légère majorité de professionnels pratique encore un TV systématiquement à chaque CPN dans le principal but de dépister des MAP. Mais la plupart d'entre eux serait favorable à l'abandon de cet examen en systématique

    Ischemia/reperfusion-associated tubular cells injury in renal transplantation: Can metabolomics inform about mechanisms and help identify new therapeutic targets?

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    International audienceTubular cells are central targets of ischemia-reperfusion (I/R) injury in kidney transplantation. Inflammation and metabolic disturbances occurring within these cells are deleterious by themselves but also favor secondary events, such as activation of immune response. It is critical to have an in depth understanding of the mechanisms governing tubular cells response to I/R if one wants to define pertinent biomarkers or to elaborate targeted therapeutic interventions. As oxidative damage was shown to be central in the patho-physiological mechanisms, the impact of I/R on proximal tubular cells metabolism has been widely studied, contrary to its effects on expression and activity of membrane transporters of the proximal tubular cells. Yet, temporal modulation of transporters over ischemia and reperfusion periods appears to play a central role, not only in the induction of cells injury but also in graft function recovery. Metabolomics in cell models or diverse biofluids has the potential to provide large pictures of biochemical consequences of I/R. Metabolomic studies conducted in experimental models of I/R or in transplanted patients indeed retrieved metabolites belonging to the pathways known to be particularly affected. Interestingly, they also revealed that metabolic disturbances and transporters activities are in very close mutual interplay. As well as helping to select diagnostic biomarkers, such analyses could also contribute to identify new pharmacological targets and to set up innovative nephroprotective strategies for the future. Even if various therapeutic approaches have been evaluated for a long time to prevent or treat I/R injuries, metabolomics has helped identifying new ones, those related to membrane transporters seeming to be of particular interest. However, considering the very complex and multifactorial effects of I/R in the context of kidney transplantation, all tracks must be followed if one wants to prevent or limit its deleterious consequence

    L’ischémie reperfusion

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    L’ischémie reperfusion est une séquence incontournable en transplantation d’organe. Elle est à l’origine de processus physiopathologiques qui vont finalement agir de manière synergique et contribuer aux lésions du greffon. Ces lésions sont responsables de dysfonctionnements précoces et tardifs pouvant réduire la durée de vie du greffon. Les progrès engendrés par les traitements immunosuppresseurs expliquent, qu’aujourd’hui, l’ischémie reperfusion est une cible thérapeutique majeure. Cette revue développe les différentes étapes du processus physiopathologique et leurs conséquences sur la fonction du greffon rénal, en soulignant l’intérêt grandissant des stratégies visant à limiter ces dysfonctionnements

    Does machine perfusion decrease ischemia reperfusion injury?

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    International audienceIn 1990's, use of machine perfusion for organ preservation has been abandoned because of improvement of preservation solutions, efficient without perfusion, easy to use and cheaper. Since the last 15 years, a renewed interest for machine perfusion emerged based on studies performed on preclinical model and seems to make consensus in case of expanded criteria donors or deceased after cardiac death donations. We present relevant studies highlighted the efficiency of preservation with hypothermic machine perfusion compared to static cold storage. Machines for organ preservation being in constant evolution, we also summarized recent developments included direct oxygenation of the perfusat. Machine perfusion technology also enables organ reconditioning during the last hours of preservation through a short period of perfusion on hypothermia, subnormothermia or normothermia. We present significant or low advantages for machine perfusion against ischemia reperfusion injuries regarding at least one primary parameter: risk of DFG, organ function or graft survival

    Concentration and chain length of polyethylene glycol in islet isolation solution: evaluation in a pancreatic islet transplantation model.

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    International audienceTo improve graft preservation and consequently reduce conservation injuries, the composition of preservation solution is of outmost importance. It was demonstrated that the colloid polyethylene glycol (PEG), used in SCOT solution, has protective effects on cell membranes and immunocamouflage properties. The aim of this study was to optimize the concentration and chain length of PEG to improve pancreatic islet preservation and outcome. In a model of murine islet allotransplantation, islets were isolated with SCOT containing various concentrations of PEG 20 kDa or 35 kDa. Better islet yield (IEQ) was obtained with SCO +PEG at 15-30 g/L versus other PEG concentrations and control CMRL-1066 + 1% BSA solution (p < 0.05). Allograft survival was better prolonged (up to 20 days) in the groups SCOT + PEG 20 kDa 10-30 g/L compared to PEG 35 kDa (less than 17.8 days) and to control solutions (less than 17.5 days). In terms of graft function recovery, the use of PEG 20 kDa 15-30 g/L induced no primary nonfunction and delayed graft function contrary to CMRL-1066 and other PEG solutions. The use of the extracellular-type solution SCOT containing PEG 20 kDa 15 g/L as colloid could be a new way to optimize graft integrity preservation and allograft outcome

    Label-free single nanoparticle identification and characterization including infectious emergent virus

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    Le criblage de particules inconnues, y compris les virus et les nanoparticules, est essentiel dans la médecine, l'industrie et la détermination des polluants. Cependant, les techniques existantes nécessitent une connaissance ou une modification a priori de l'échantillon (par exemple, la fluorescence). Nous présentons ici RYtov MIcroscopy for Nanoparticles Identification (RYMINI), une approche optique non invasive et non destructive qui combine le suivi 3D holographique sans marquage et l'imagerie de phase quantitative à haute sensibilité dans une configuration optique compacte. Dédié à la caractérisation de nano-objets en solution, il est compatible avec des environnements très exigeants tels que les laboratoires biologiques de niveau 3. La caractérisation métrologique a été réalisée au niveau de chaque objet sur des particules absorbantes et transparentes ainsi que sur des particules infectieuses (VIH-1, SARS-CoV-2) et des vésicules extracellulaires en solution. Nous démontrons la capacité de RYMINI à déterminer la nature, la concentration, la taille, l'indice de réfraction complexe et la masse de chaque particule. Nous discutons de l'application de la méthode en solution inconnue sans nécessiter connaissance ou modèle a priori de la réponse des particules. Cela ouvre la voie à une identification sans étiquette des nano-objets en terra incognita.Screening of unknown particles, including viruses and nanoparticles, is key in medicine, industry and pollutant determination. However, existing techniques require sample a priori knowledge or modification (e.g. fluorescence). Here we introduce RYtov MIcroscopy for Nanoparticles Identification (RYMINI), a noninvasive and non-destructive optical approach that is combining holographic labelfree 3D tracking and high-sensitivity quantitative phase imaging into a compact optical setup. Dedicated to the characterization of nano-objects in solution, it is compatible with highly demanding environments such as level-3 biological laboratories. Metrological characterization has been performed at the level of each single object on both absorbing and transparent particles as well as on infectious HIV-1, SARS-CoV-2 and extracellular vesicles in solution. We demonstrate the capability of RYMINI to determine the nature, concentration, size, complex refractive index and mass of each single particle. We discuss the application of the method in unknown solution without requiring any knowledge or model of the particles’ response. It paves the way to label-free nano-object identification in terra incognita
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