Le syndrome de pourfour du petit : une manifestation rare des cellulites cervico-mediastinales

Le syndrome de Pourfour du Petit (SPdP) relève de diverses étiologies. Nous rapportons le premier cas de SPdP secondaire à une cellulite cervico-médiastinale, a travers lequel nous décrivons l’étiopathogénie, la présentation clinique et les aspects évolutifs de cette entité clinique rare. un homme de 37 ans a été hospitalisé pour cellulite cervico-médiatinale. Outre le blindage inflammatoire cervical, l’examen a objectivé une mydriase gauche associée à une exophtalmie et un élargissement de la fente palpébrale d’installation récente. Le reste de l’examen neurologique et ORL a été sans particularité. Nous avons retenu le diagnostic du SPdP d’origine infectieuse. Le patient a été mis sous antibiothérapie et a eu un drainage et nettoyage de toute la loge viscérale cervicale et du médiastin supérieur. L’évolution a été favorable avec régression partielle des signes ophtalmiques. Le syndrome de Pourfour du Petit est une entité rare. Sa connaissance offre au clinicien des pistes diagnostiques notamment dans les pathologies mettant en jeu le pronostic vital.Mots clés : syndrome de Pourfour du Petit, système nerveux sympathique cervical, mydriase.The Pourfour de Petit syndrome (PdPS) is of various etiologies. We report the first case of SPdP secondary to cervicomediastinal cellulitis through which we describe the etiopathogeny, clinical presentation and evolution aspects of this rare clinical entity. A 37 years old male was hospitalized for cervico-mediastinal cellulitis. Besides the cervical inflammation, examination objectified a recent left mydriasis, exophthalmia and a widening of the palpebral fissure. The rest of the neurological examination was unremarkable. We retained the diagnostic of PdPS of an infectious origin. Beside antibiotherapy, the patient had drainage and cleaning of the visceral lodge and upper mediastinum. The evolution was favorable with partial regression of ophthalmic signs. The PdPS is a rare entity. its knowledge provides the clinician with diagnostic tracks including diseases involving lifethreatening.Key words : Pourfour du Petit syndrome, cervical sympathetic system, mydriasi

Towards the creation of a decision support system tool for the preliminary risk assessment of brownfield sites

Brownfield sites always raise concern for the health and safety of site workers involved in site renovations and developments and, subsequently, for the residents or occupants of the sites. As a minimum, a preliminary risk assessment is necessary to determine whether a brownfield site is contaminated and, if so, ensuring any redevelopment is safe and suitable for its proposed use. Despite growing interest in the progression of risk assessment tools, there are limited instruments available for brownfield site assessors to consult when conducting investigations at the preliminary risk assessment stage. This study presents a conceptual framework that ultimately aims to create a web-based decision support system (DSS) for the preliminary risk assessment of brownfield sites. This is based on a pollutant linkage model (Source–Pathway–Receptor). The proposed framework aids the identification of health and safety hazards and, in doing so, it addresses the challenges facing those persons dealing with the decision-making on brownfield site developments. Moreover, the framework enables them to determine the most appropriate remediation strategy(ies) to halt pollutant linkages, promote safer developments and minimise the risks to future occupants of brownfield sites and neighbouring lands

Aerobic exercise training improves the role of high-density lipoprotein antioxidant and reduces plasma lipid peroxidation in type 2 diabetes mellitus

In this study, we analyzed the effect of aerobic exercise training (AET) and of a single bout of exercise on plasma oxidative stress and on antioxidant defenses in type 2 diabetes mellitus (DM) and in healthy control subjects (C). DM and C did not differ regarding triglycerides, high-density lipoprotein cholesterol (HDL-c), insulin, and HOMA index at baseline and after AET. To measure the lag time for low-density lipoprotein (LDL) oxidation (LAG) and the maximal rate of conjugated diene formation (MCD), participants` plasma HDL(2) and HDL(3) were incubated with LDL from pooled healthy donors` plasma. In the presence of HDL(3), both LAG and MCD were similar in C and DM, but only in DM did AET improve LAG and reduce MCD. In the presence of HDL(2), the lower baseline LAG in DM equaled C after AET. MCD was unchanged in DM after AET, but was lower than C only after AET. Furthermore, after AET plasma thiobarbituric acid-reactive substances were reduced only in DM subjects. Despite not modifying the total plasma antioxidant status and serum paraoxonase-1 activity in both groups, AET lowered the plasma lipid peroxides, corrected the HDL(2), and improved the HDL(3) antioxidant efficiency in DM independent of the changes in blood glucose, insulin, and plasma HDL concentration and composition.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo-FAPESP[05/55249-7]Fundacao de Amparo a Pesquisa do Estado de Sao Paulo-FAPESP[03/02266-6

Dietary salt restriction increases plasma lipoprotein and inflammatory marker concentrations in hypertensive patients

Background: Dietary salt restriction has been reported to adversely modify the plasma lipoprotein profile in hypertensive and in normotensive subjects. We investigated the effects of the low sodium intake (LSI) on the plasma lipoprotein profile and on inflammation and thrombosis biomarkers during the fasting and postprandial periods. Methods: Non-obese, non-treated hypertensive adults (n=41) were fed strictly controlled diets. An initial week on a control diet (CID, Na=160 mmol/day) was followed by 3 weeks on LSI (Na=60mmol/day). At admission and on the last day of each period, the 24-h ambulatory blood pressure was monitored and blood was drawn after an overnight fasting period and after a fat-rich test meal. Results: The dietary adherence was confirmed by 24-h urinary sodium excretion. Fasting triglyceride (TG), chylomicron-cholesterol, hsC-reactive protein (CRP), tumor necrosis factor-a (TNF-alpha). interleukin-6 (IL-6) concentrations, renin activity, aldosterone, insulin, and homeostasis model assessment insulin resistance (HOMA-IR) Values were higher, but non-esterified fatty acids (NEFA) were lower on LSI than on CD. For LSI, areas under the curve (AUC) of TG, chylomicron-cholesterol, apoB and the cholesterol/apoB ratio were increased, whereas AUC-NEFA was lowered. LSI did not modify body weight, hematocrit, fasting plasma cholesterol, glucose, adiponectin, leptin, fibrinogen and factor VII (FVII), and AUC of lipoprotein lipase and of lipoprotein remnants. Conclusion: LSI induced alterations in the plasma lipoproteins and in inflammatory markers that are common features of the metabolic syndrome. (C) 2008 Elsevier Ireland Ltd. All rights reserved.FAPESP (Sao Paulo Research Foundation)[00/04249-3]AMC and FCS[01/08302-9]AMC and FCS[00/14918-8]CNPq (Brazilian National Research CouncilECRQ)LIMHC/FMUSP (Medical Investigation Laboratories, Hospital das Clinicas/Faculty of Medical Sciences of University of Sao Paulo