Site internet dédié à l'enseignement de l'imagerie en coupes des cardiopathies congénitales

Les cardiopathies congénitales sont des anomalies rares. Les données épidémiologiques actuelles retrouvent une prévalence de 8/1000 naissances toutes cardiopathies confondues. La détection de malformations cardiaques en période anténatale a un impact primordial sur la prise en charge néonatale de ces enfants. Parallèlement, les progrès de la chirurgie cardiaque, l amélioration des techniques de circulation extra-corporelle ainsi que de réanimation pédiatrique, ont permis de traiter des pathologies jusque là létales à plus ou moins court terme. Aujourd hui, beaucoup d enfants nés avec une malformation cardiaque atteignent l âge adulte et ce dans des conditions de vie satisfaisante. Dans les années 80, on a assisté à une révolution radiologique , avec l apparition de scanner multi-barrettes, permettant des acquisitions hélicoïdales et de l IRM. Rapidement, ces techniques sont devenues un moyen robuste d exploration des cardiopathies congénitales. Le radiologue non interventionnel, qui initialement n'était pas directement impliqué dans la prise en charge et le suivi de ces patients, prend alors une place importante au sein de l équipe médico-chirurgicale. Il convient pour cela d être formé, non seulement aux techniques d imagerie cardiaque en coupes mais également d avoir une connaissance précise de l anatomie, de la physiopathologie et des techniques chirurgicales de chaque cardiopathie. Il est admis de tous qu internet est un outil de partage et d enseignement exceptionnel de nos jours. Ce travail a donc consisté en la réalisation d un site internet axé sur l imagerie en coupes des cardiopathies congénitales. Il a pour but de permettre à toutes personnes du corps médical, confronté à ce type de pathologie, d avoir une vision d ensemble de la pathologie ainsi que des différentes modalités d examen utile pour chaque cardiopathie et ce qu ils peuvent en attendre.Congenital heart defects are rare. Current epidemiological data found a prevalence of 8/1000 births, all defects confused. Detection of cardiac malformations in the antenatal period has a crucial impact on neonatal care of these children. Meanwhile, advances in cardiac surgery and improved techniques for both cardiopulmonary bypass and pediatric reanimation, lead to better care for conditions that were letal in a more or less short interval. Today, many children born with heart defects grow to adulthood in satisfactory living conditions. In the 80's, there has been a "radiological revolution " with the advent of both multidetector-row CT-scanner, allowing helical acquisitions, and MRI. Quickly, these techniques have become a robust mean of exploration of congenital heart diseases. The non-interventionist radiologist, who initially was not directly involved in the management and monitoring of these patients, now plays an important role in the medico-surgical team. This requires to be trained, not only to cross sectional cardiac imaging but also to have a precise knowledge of the anatomy, physiology and surgical techniques of each congenital heart disease (CHD). It is admitted by all that the Internet is a fantastic tool for sharing and teaching nowadays. This work consisted in the creation of a website focused on cross sectional imaging of congenital heart diseases. It aims to enable all people in the medical profession, faced with this type of pathology, to have an overview of the disease and the different examination procedures useful for each CHD and what they can obtain from them.AMIENS-BU Santé (800212102) / SudocSudocFranceF

Transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium

Background A persistent anastomosis between the pulmonary veins that connect with the left atrium and the systemic vein that drains into the right atrium has occasionally been reported. We report characteristics and transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium. Methods We retrospectively studied such patients in 5 institutions. Results Ten patients (6 girls) presented at a median age of 8 (0.1 to 54) years with 2 anatomic types: 8 vertical vein types with drainage of the left upper lobe to the innominate vein via a large vertical vein (left superior cardinal vein) and to the left atrium via the left upper pulmonary vein; and 2 scimitar vein (SV) types with drainage of the right middle and lower pulmonary veins into the inferior vena cava and to the left atrium via an anomalous connecting vein. Associated malformations were aortic coarctation (n = 2) and secundum atrial septal defects (n = 3). Two patients of the vertical vein type were operated. Transcatheter occlusion of the abnormal pulmonary venous return was performed in 7 cases, associated with occlusion of systemic arterial supply (n = 2), secundum atrial septal closure (n = 2), left upper pulmonary vein stenosis stenting (n = 1), and coarctation stenting (n = 1). Including previously published cases, 18 patients (13 vertical veins and 5 scimitar veins) underwent transcatheter repair. Patients over 40 years of age tend to be symptomatic at presentation (p = 0.056). Conclusion In partially abnormal pulmonary venous return with dual drainage, transcatheter therapy can be offered in the majority of patients. © 2013 Elsevier Ireland Ltd

Unveiling the Ecological Applications of Ancient DNA From Mollusk Shells

The shells of marine mollusks represent promising metagenomic archives of the past, adding to bones, teeth, hairs, and environmental samples most commonly examined in ancient DNA research. Seminal work has established that DNA recovery from marine mollusk shells depends on their microstructure, preservation and disease state, and that authentic ancient DNA could be retrieved from specimens as old as 7,000 years. Here, we significantly push the temporal limit for shell DNA recovery to >= 100,000 years with the successful genetic characterization of one Portlandia arctica and one Mytilus mussel sample collected within a dated permafrost layer from the Taimyr Peninsula, Russia. We expand the analysis of ancient DNA in carbonate shells to a larger number of genera (Arctica, Cernuella, Crassostrea, Dreissena, Haliotis, Lymnaea, Margaritifera, Pecten, Ruditapes, Venerupis) from marine, freshwater and terrestrial environments. We demonstrate that DNA from ancient shells can provide sufficient resolution for taxonomic, phylogenetic and/or population assignment. Our results confirm mollusk shells as long-term DNA reservoirs, opening new avenues for the investigation of environmental changes, commercial species management, biological invasion, and extinction. This is especially timely in light of modern threats to biodiversity and ecosystems

Transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium

Background A persistent anastomosis between the pulmonary veins that connect with the left atrium and the systemic vein that drains into the right atrium has occasionally been reported. We report characteristics and transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium. Methods We retrospectively studied such patients in 5 institutions. Results Ten patients (6 girls) presented at a median age of 8 (0.1 to 54) years with 2 anatomic types: 8 vertical vein types with drainage of the left upper lobe to the innominate vein via a large vertical vein (left superior cardinal vein) and to the left atrium via the left upper pulmonary vein; and 2 scimitar vein (SV) types with drainage of the right middle and lower pulmonary veins into the inferior vena cava and to the left atrium via an anomalous connecting vein. Associated malformations were aortic coarctation (n = 2) and secundum atrial septal defects (n = 3). Two patients of the vertical vein type were operated. Transcatheter occlusion of the abnormal pulmonary venous return was performed in 7 cases, associated with occlusion of systemic arterial supply (n = 2), secundum atrial septal closure (n = 2), left upper pulmonary vein stenosis stenting (n = 1), and coarctation stenting (n = 1). Including previously published cases, 18 patients (13 vertical veins and 5 scimitar veins) underwent transcatheter repair. Patients over 40 years of age tend to be symptomatic at presentation (p = 0.056). Conclusion In partially abnormal pulmonary venous return with dual drainage, transcatheter therapy can be offered in the majority of patients. © 2013 Elsevier Ireland Ltd