Biomarker counseling, disclosure of diagnosis and follow-up in patients with mild cognitive impairment:A European Alzheimer's Disease Consortium survey

Objectives: Mild cognitive impairment (MCI) is associated with an increased risk of further cognitive decline, partly depending on demographics and biomarker status. The aim of the present study was to survey the clinical practices of physicians in terms of biomarker counseling, management, and follow-up in European expert centers diagnosing patients with MCI. Methods: An online email survey was distributed to physicians affiliated with European Alzheimer's disease Consortium centers (Northern Europe: 10 centers; Eastern and Central Europe: 9 centers; and Southern Europe: 15 centers) with questions on attitudes toward biomarkers and biomarker counseling in MCI and dementia. This included postbiomarker counseling and the process of diagnostic disclosure of MCI, as well as treatment and follow-up in MCI. Results: The response rate for the survey was 80.9% (34 of 42 centers) across 20 countries. A large majority of physicians had access to biomarkers and found them useful. Pre- and postbiomarker counseling varied across centers, as did practices for referral to support groups and advice on preventive strategies. Less than half reported discussing driving and advance care planning with patients with MCI. Conclusions: The variability in clinical practices across centers calls for better biomarker counseling and better training to improve communication skills. Future initiatives should address the importance of communicating preventive strategies and advance planning

Conception d'un criblage d'inhibiteurs des méthyltransférases d'ADN (vers de nouveaux modulateurs épigénétiques)

L épigénétique étudie les flux d information cellulaires réversibles et transmissibles, qui ne sont pas directement codés par la séquence de l ADN. Les principales régulations épigénétiques sont la méthylation de l ADN, les modifications des histones, la dynamique de la chromatine et les ARN non codant. Elles sont impliquées depuis la gamétogénèse jusqu à la cognition, en passant par l empreinte parentale, la différenciation, etc. La dérégulation épigénétique est un trait commun à tous les cancers. On observe dans les tumeurs une hypométhylation globale du génome induisant une instabilité et une hyperméthylation spécifique des gènes suppresseurs de tumeurs qui favorise la progression de la maladie. Les inhibiteurs des méthyltransférases d ADN (DNMTi) forment une nouvelle classe de grand intérêt, pour leur capacité à reprogrammer les cellules tumorales. Mais leur instabilité chimique et leur toxicité limitent leur usage clinique. Afin de développer des modulateurs épigénétiques plus puissants et plus spécifiques, nous avons conçu un test de criblage innovant de DNMTi à moyen/haut-débit, basé sur la détection d un signal de fluorescence. Après validation de la méthode sur une collection orientée de dérivés de flavones et flavanones qui se sont révélés plus actifs que les molécules de la littérature sur le complexe catalytique Dnmt3A/3L et ont présenté une activité spécifique sur le développement du poisson-zèbre, nous avons réalisé un criblage manuel (1200 molécules, 5,3% de hits) et un criblage automatisé (4600 molécules, 4% de hits). De nouvelles familles de DNMTi prometteuses ont pu être ainsi découvertes, pour lesquelles des relations structure-activité ont été menéesPARIS-BIUSJ-Biologie recherche (751052107) / SudocSudocFranceF

Le diagnostic cristallographique des silicoses pulmonaires

Étude d'un cas de pneumoconiose à quartz pur, mettant en évidence la nocivité toute spéciale du quartz à brisure fraîche. Examen aux rayons X des cendres d'un nodule scléreux et au microscope électronique avec le contrôle de la nature des particules par diffraction électronique. Pathogénie et discussion. Mise en évidence d'une «quartzose » à évolution rapide.Rimsky Alexandre, Oberlin Mathieu-Sicaud Agnès, Ceccaldi Pierre-Fernand. Le diagnostic cristallographique des silicoses pulmonaires. In: Bulletin de la Société française de Minéralogie et de Cristallographie, volume 78, 7-9, 1955. pp. 418-424

DNA methyltransferase assays

DNA methyltransferases are important enzymes and their inhibition has many potential applications. The investigation of DNA methyltransferases as well as screening for potential inhibitors requires specialized enzyme assays. In this chapter, we describe three DNA methyltransferase assays, each of them based on a different method: (1) An assay using radioactively labeled AdoMet and biotinylated DNA substrates that is ideal for enzymatic characterization of these enzymes. (2) An assay using bisulfite conversion of in vitro methylated DNA that is ideal to determine details of the methylation pattern introduced by DNA-(cytosine C5)-methyltransferases. (3) A novel fluorescence-coupled, restriction-based assay suitable for high-throughput screening of DNA methyltransferase inhibitors

Training for breech deliveries with the mother in an upright position: An innovative adaptation of a simulation model

Delivery of a breech baby with the mother in an upright position or on all fours has gained a renewed interest. In these positions, the obstetrician or midwife needs to learn new landmarks and maneuvers. A realistic simulation model would be a valuable adjunct for breech on all fours teaching programs. This article describes the simulation model and training program we have developed to train an interprofessional team to assist breech births when the mother is on all fours. A questionnaire was used to evaluate the realism of the adapted mannequin and the impact of training on the confidence level of the participants. On a Likert scale of 1 to 5, 92% of participants agreed or strongly agreed that the adapted mannequin used was realistic for training obstetric maneuvers for complicated breech births. After training, their confidence level supporting a breech birth in an upright position rose from an average of 2.5 to 5.7 on a scale of 1 to 10. Learning the skills for breech deliveries on all fours is made possible by targeted training with this adapted simulation model

Clinical Phenotypes in Corticobasal Syndrome with or without Amyloidosis Biomarkers

International audienc

Delivering the power of nanomedicine to patients today

The situation of the COVID-19 pandemic reminds us that we permanently need high-value flexible solutions to urgent clinical needs including simplified diagnostic technologies suitable for use in the field and for delivering targeted therapeutics. From our perspective nanotechnology is revealed as a vital resource for this, as a generic platform of technical solutions to tackle complex medical challenges. It is towards this perspective and focusing on nanomedicine that we take issue with Prof Park's recent editorial published in the Journal of Controlled Release. Prof. Park argued that in the last 15 years nanomedicine failed to deliver the promised innovative clinical solutions to the patients (Park, K. The beginning of the end of the nanomedicine hype. Journal of Controlled Release, 2019; 305, 221–222 [1]. We, the ETPN (European Technology Platform on Nanomedicine) [2], respectfully disagree. In fact, the more than 50 formulations currently in the market, and the recent approval of 3 key nanomedicine products (e. g. Onpattro, Hensify and Vyxeos), have demonstrated that the nanomedicine field is concretely able to design products that overcome critical barriers in conventional medicine in a unique manner, but also to deliver within the cells new drug-free therapeutic effects by using pure physical modes of action, and therefore make a difference in patients lives. Furthermore, the > 400 nanomedicine formulations currently in clinical trials are expecting to bring novel clinical solutions (e.g. platforms for nucleic acid delivery), alone or in combination with other key enabling technologies to the market, including biotechnologies, microfluidics, advanced materials, biomaterials, smart systems, photonics, robotics, textiles, Big Data and ICT (information & communication technologies) more generally. However, we agree with Prof. Park that “ it is time to examine the sources of difficulty in clinical translation of nanomedicine and move forward “. But for reaching this goal, the investments to support clinical translation of promising nanomedicine formulations should increase, not decrease. As recently encouraged by EMA in its roadmap to 2025, we should create more unity through a common knowledge hub linking academia, industry, healthcare providers and hopefully policy makers to reduce the current fragmentation of the standardization and regulatory body landscape. We should also promote a strategy of cross-technology innovation, support nanomedicine development as a high value and low-cost solution to answer unmet medical needs and help the most promising innovative projects of the field to get better and faster to the clinic. This global vision is the one that the ETPN chose to encourage for the last fifteen years. All actions should be taken with a clear clinical view in mind, “ without any fanfare”, to focus “on what matters in real life”, which is the patient and his/her quality of life. This ETPN overview of achievements in nanomedicine serves to reinforce our drive towards further expanding and growing the maturity of nanomedicine for global healthcare, accelerating the pace of transformation of its great potential into tangible medical breakthrough

DNA methylation associated with polycomb repression in retinoic acid receptor β silencing

International audienceRetinoic acid receptor β 2 (RARβ2) is a tumor suppressor gene whose loss of expression is recurrent in prostate cancers. Here we studied the epigenetic mechanisms leading to its stable silencing. First, we characterized all RARβ isoforms in 6 human tumor cell lines (prostate DU145, LNCaP, PC3, lung A549, breast Hs578T, and colon HCT116) by RT-PCR and Western blot. We excluded loss of heterozygosity (2D-FISH) and loss of RARa expression, an upstream regulator, as origin of RARβ2 silencing. All data concluded to an epigenetic silencing. In agreement, a DNA methylation inhibitor restored its expression. Second RARβ2 loss of expression was found associated with different epigenetic profiles in LNCaP and DU145 cells. According to bisulfite sequencing and ChIP analysis, we observed heavy methylation (97%) of the RARβ2 promoter with repressive histone mark H3K9me3 in LNCaP. While DNA methylation and polycomb repression are described to be mutually exclusive at CpG-rich promoters, we observed that in DU145, moderate DNA methylation (36%) and H3K9me3 mark were present concomitantly with H3K27me3, a signature of polycomb repression. In summary, we provide new insights on how the RARβ2 promoter is silenced, reveal the existence of two distinct repressive chromatin profiles at the same locus, and support a polycomb-mediated epigenetic repression process in prostate cancer

From face processing to face recognition: Comparing three different processing levels

International audienc

Impact of negative inotropic drugs on accuracy of diastolic stress echocardiography for evaluation of left ventricular filling pressure

Abstract The ratio of early diastolic trans-mitral flow velocity to tissue-Doppler mitral annular early diastolic velocity (E/e′), and left ventricular end-diastolic pressure(LVEDP) have been shown to be correlated at rest, provided that patients are not on positive inotropic drugs. Data concerning the latter correlation during exercise stress are conflicting. Therefore, we investigated if use of negative inotropic drugs (NID), impacts the accuracy of E/e′ as a surrogate for LVEDP during low-level exercise. An exercise(50 watts) during cardiac invasive hemodynamic monitoring and an exercise echocardiography were performed prospectively within 24 hours in 54 patients (81%male, 62 ± 9years) with preserved LV Ejection-Fraction. Before exercise, the patients had scattered LVEDP (13.8 ± 5.8 mmHg) and septal E/e′ (8.7 ± 2.7). Half of them were on NID, mainly betablockers(n = 26). The correlation between septal-E/e′ and LVEDP was low for examinations performed at rest (r = 0.35,p = 0.01) with no significant impact of NID. For measurements performed at 50 Watts, NID had a significant impact on the association between septal-E/e′50 watts and LVEDP50 watts (β = −0.28,p = 0.03). Correlation between septal-E/e′50 watts and LVEDP50 watts persisted in patients on NID (r = 0.61,p = 0.001) while it disappeared in the group of patients with no NID (r = 0.15,p = 0.47). NID use is an important confounding factor to take into consideration when assessing exercise LVFP using stress E/e′ in patients with preserved LVEF