N-terminal pro-B-type natriuretic peptide and the prediction of primary cardiovascular events: results from 15-year follow-up of WOSCOPS

<b>Aims:</b>To test whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) was independently associated with, and improved the prediction of, cardiovascular disease (CVD) in a primary prevention cohort. <b>Methods and results:</b> In the West of Scotland Coronary Prevention Study (WOSCOPS), a cohort of middle-aged men with hypercholesterolaemia at a moderate risk of CVD, we related the baseline NT-proBNP (geometric mean 28 pg/mL) in 4801 men to the risk of CVD over 15 years during which 1690 experienced CVD events. Taking into account the competing risk of non-CVD death, NT-proBNP was associated with an increased risk of all CVD [HR: 1.17 (95% CI: 1.11–1.23) per standard deviation increase in log NT-proBNP] after adjustment for classical and clinical cardiovascular risk factors plus C-reactive protein. N-terminal pro-B-type natriuretic peptide was more strongly related to the risk of fatal [HR: 1.34 (95% CI: 1.19–1.52)] than non-fatal CVD [HR: 1.17 (95% CI: 1.10–1.24)] (P= 0.022). The addition of NT-proBNP to traditional risk factors improved the C-index (+0.013; P < 0.001). The continuous net reclassification index improved with the addition of NT-proBNP by 19.8% (95% CI: 13.6–25.9%) compared with 9.8% (95% CI: 4.2–15.6%) with the addition of C-reactive protein. N-terminal pro-B-type natriuretic peptide correctly reclassified 14.7% of events, whereas C-reactive protein correctly reclassified 3.4% of events. Results were similar in the 4128 men without evidence of angina, nitrate prescription, minor ECG abnormalities, or prior cerebrovascular disease. <b>Conclusion:</b> N-terminal pro-B-type natriuretic peptide predicts CVD events in men without clinical evidence of CHD, angina, or history of stroke, and appears related more strongly to the risk for fatal events. N-terminal pro-B-type natriuretic peptide also provides moderate risk discrimination, in excess of that provided by the measurement of C-reactive protein

Analyse des adhérences organiques de deux couples à socles du site « La Hougue Bie » à Jersey. Rapport d'étude présenté à la DRAC –Bretagne et Pays de la Loire

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Studies on pyrrolidinones. On the carbamoylation of some pyroglutamic derivatives

The carbamoylation of some lactams derivatived from pyroglutamic acid has been studied; better yields were obtained starting from the unsubstitued lactam (toluene, 80°) rather than starting with the N-silyllactam (room temperature), although these latter reaction conditions could be interesting for heat sensitive compounds. Methyl and phenyl isothiocyanate react only with the sodium salt of methyl pyroglutumate, giving 1,5-diaddition products

Transient pseudohypoaldosteronism: a potentially severe condition affecting infants with urinary tract malformation

International audienceBackground Secondary pseudohypoaldosteronism (S-PHA) is a life-threatening condition affecting young children with urinary tract malformation (UTM). Objective The aim of the study was to highlight the diagnosis of S-PHA in children with UTM and propose appropriate management. Study design The authors retrospectively reviewed cases of S-PHA related to UTM observed at the institution and searched the PubMed (R) database to review the literature. Results A total of 116 cases of S-PHA associated with UTM, including the four cases from the institution, were reviewed. One hundred six cases (92.2%) were younger than 6 months, and 95 cases (81.9%) occurred in boys. Urinary tract infection was associated in 105 cases (90.5%). All types of UTM were observed. In the absence of urinary tract infection, S-PHA was related to bilateral UTM or solitary kidney. In 89 cases (76.5%), S-PHA resolved with medical treatment only. In cases of UTM requiring immediate surgery, electrolyte imbalance related to S-PHA also resolved after surgery. Children with associated urinary tract infection and bilateral UTM are at higher risk of developing S-PHA. Discussion The pathogenesis of S-PHA has not been fully elucidated. Renal tubular immaturity may be one of the factors involved, in view of the young age of the population being affected. A high rate of bilateral UTM (or UTM on solitary kidney) was observed (50.9%), suggesting an association with S-PHA. In the absence of urinary tract infection (UTI), S-PHA appeared to occur more frequently in the presence of bilateral UTM. Although the indication for early surgery remains unclear, it may have a role in the prevention of UTI and prevention of recurrence of S-PHA. Serum electrolytes should be checked in children with UTM before urological surgery, and/or presenting urinary tract infection, before the age of 6 months. The results of this study must be interpreted cautiously because of its retrospective nature and the fact that data were derived from various articles. Few articles on S-PHA related to UTM have been published in the literature. To the best of the authors' knowledge, the study constitutes the largest series published to date. Conclusions S-PHA results in potentially severe electrolyte imbalance and affects children younger than 6 months with UTI and/or UTM. Electrolyte abnormalities related to S-PHA often resolve after administration of appropriate intravenous electrolyte solution and treatment of UTI and/or surgery. [GRAPHICS]

Exploitation of the Menshutkin reaction for the controlled assembly of halogen bonded architectures incorporating 1,2-diiodotetrafluorobenzene and 1,3,5-triiodotrifluorobenzene

1,4-Diazabicyclo[2.2.2]octane (DABCO) forms well-defined co-crystals with 1,2-diiodotetrafluorobenzene (1,2-DITFB), [(1,2-DITFB) DABCO], and 1,3,5-triiodotrifluorobenzene, [(1,3,5-TITFB) DABCO]. Both systems exhibited lowerthan-expected supramolecular connectivity, which inspired a search for polymorphs in alternative crystallization solvents. In dichloromethane solution, the Menshutkin reaction was found to occur, generating chloride anions and quaternary ammonium cations through the reaction between the solvent and DABCO. The controlled in situ production of chloride ions facilitated the crystallization of new halogen bonded networks, DABCO-CH Cl[(1,2-DITFB)Cl] (zigzag X-bonded chains) and (DABCO-CH Cl) [(1,3,5-TITFB) Cl ] ·CHCl3 (2D pseudo-trigonal X-bonded nets displaying Borremean entanglement), propagating with charge-Assisted C-I⋯Cl-halogen bonds. The method was found to be versatile, and substitution of DABCO with triethylamine (TEA) gave (TEA-CH Cl) [(1,2-DITFB)Cl ] ·4(H O) (mixed halogen bond hydrogen bond network with 2D supramolecular connectivity) and TEA-CH Cl[(1,3,5-TITFB)Cl] (tightly packed planar trigonal nets). The co-crystals were typically produced in high yield and purity with relatively predictable supramolecular topology, particularly with respect to the connectivity of the iodobenzene molecules. The potential to use this synthetic methodology for crystal engineering of halogen bonded architectures is demonstrated and discussed

Early farming economy in Mediterranean France: fruit and seed remains from the Early to Late Neolithic levels of the site of Taï (ca 5300–3500 cal bc)

International audienceThis article presents the archaeobotanical study of Taï, a Neolithic settlement located in Languedoc, southern France. In the western Mediterranean, the Neolithization process occurred during the 6th millennium BC and is supposed to have induced a fundamental change in the subsistence economy, with the development of agriculture and animal husbandry. Unfortunately, the Neolithic farming economy is still poorly known in southern France, mostly from old archaeobotanical studies. At Taï, soil flotation of 127 samples provided the largest dataset available for the Early Neolithic in southern France, which testifies to the changes occurring in cultivated plants and in the subsistence economy during the Neolithic. Sampling also allowed comparisons between the archaeobotanical record inside the cave and from the outside settlement. Naked barley and naked wheat were the most cultivated plants throughout the Neolithic sequence. The contribution of emmer and the probable use of opium poppy during the Early Neolithic should also be highlighted. This encourages us to reconsider the role of glume wheats during the early stages of agriculture in the area. Einkorn was more common in the Late Neolithic, in agreement with results from other sites in the region. Chaff remains were always underrepresented. Remains of weeds and wild fruits were very abundant in the Early Neolithic samples from the cave. Wild plants were probably brought to the site for the tending of domestic animals or by the animals themselves (dung, fodder and/or litter). Livestock was most probably occasionally kept at the site

Five simultaneous artificial intelligence data challenges on ultrasound, CT, and MRI

International audiencePurposeThe goal of this data challenge was to create a structured dynamic with the following objectives: (1) teach radiologists the new rules of General Data Protection Regulation (GDPR), while building a large multicentric prospective database of ultrasound, computed tomography (CT) and MRI patient images; (2) build a network including radiologists, researchers, start-ups, large companies, and students from engineering schools, and; (3) provide all French stakeholders working together during 5 data challenges with a secured framework, offering a realistic picture of the benefits and concerns in October 2018.Materials and methodsRelevant clinical questions were chosen by the Société Francaise de Radiologie. The challenge was designed to respect all French ethical and data protection constraints. Multidisciplinary teams with at least one radiologist, one engineering student, and a company and/or research lab were gathered using different networks, and clinical databases were created accordingly.ResultsFive challenges were launched: detection of meniscal tears on MRI, segmentation of renal cortex on CT, detection and characterization of liver lesions on ultrasound, detection of breast lesions on MRI, and characterization of thyroid cartilage lesions on CT. A total of 5,170 images within 4 months were provided for the challenge by 46 radiology services. Twenty-six multidisciplinary teams with 181 contestants worked for one month on the challenges. Three challenges, meniscal tears, renal cortex, and liver lesions, resulted in an accuracy > 90%. The fourth challenge (breast) reached 82% and the lastone (thyroid) 70%.ConclusionTheses five challenges were able to gather a large community of radiologists, engineers, researchers, and companies in a very short period of time. The accurate results of three of the five modalities suggest that artificial intelligence is a promising tool in these radiology modalities