Evaluation clinique et instrumentale de patients hémiplégiques après chirurgie neuro-orthopédique de pied varus equin spastique

Objectifs:Evaluer les résultats de la correction chirugicale d'un pied équin spastique dans une population de patients hémiplégiques.Population: 10 patients hémiplégiques ont été évalués en moyenne 3.8 ans après une chirurgie neuro-orthopédique de pied: 3 après triple arthrodèse et 7 après un transfert du muscle tibial antérieur associé à des gestes osseux et tendineux.Méthode:Les patients ont été évalués par le même examinateur.Les paramètres étudiés sont: satisfaction,examen articulaire et musculaire,test de marche sur 10 mètres,test des 6 minutes,classification fonctionnelle de la déambulation FAC modifiée,besoin d'aides techniques et paramètres spatio-temporaux de la marche sur tapis électronique GAITRITE.Résultats: le taux de satisfaction globale est de 80% avec allégement de chaussage pour la majorité des patients.Les complications consistent en 3 pseudarthrodèses.Il n'ya eu aucune désinsertion du muscle transféré.la vitesse de marche confortable est plus basse après triple arthrodèse que transfert du tibial antérieur (0.23+/-0.07 m/s versus 0.58+/-0.18 M/s).Sur les paramètres spation-temporaux de la marche,nous retrouvons l'asymétrie entre les deux menbres inférieurs décrites par d'autres auteurs.Discussion: Malgré la faiblesse de notre échantillon,les résultats des patients ayant bénéficié d'une triple arthrodèse semblent moins satisfaisants.La fréquence des complications et l'intérêt de l'analyse instrumentale de la marche sont discutés à la lumière de la littérature.Conclusion: La chirurgie du pied varus équin apporte un bénéfice fonctionnel.L'évaluation précise de ce bénéfice nécessite des études complémentaires afin de dégager des facteurs pronostiques permettant d'affiner nos indications.MONTPELLIER-BU Médecine UPM (341722108) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Measurement of urinary F(2)-isoprostanes by gas chromatographymass spectrometry is confounded by interfering substances

International audienceAnalysis of F2-isoprostanes in urine using gas chromatography-mass spectrometry is confounded by the presence of endogenous compounds interfering with the internal standard, 15-F2t-IsoP-d4 (m/z 573). Previous efforts to resolve the 15-F2t-IsoP-d4 from co-eluting peaks with different solid phase extractions were unsuccessful. This study has now used a highly-deuterated, d9-analogue of the derivatization agent N,O-Bis(trimethyl-d9-silyl) trifl uoroacetamide (BSTFA-d9) yielding trimethylsilyl ethers, but this was not successful in resolving the 15-F2t-IsoP-d4 from co-eluting peaks. It was hypothesized that interfering peaks at m/z 573 could be the tetrahydro analogue of 15-F2t-IsoP. However, using an authentic standard showed the interfering peaks are not due to this metabolite. In subsequent experiments good resolution was shown of the 15-F2t-IsoP peak using 8-F2t-IsoP-d4 (m/z 573) as the internal standard. These data show that care must be taken when using GC-MS for quantitation of F2-IsoPs to prevent interfering substances affecting the results

The effects of oxidation products of arachidonic acid and n3 fatty acids on vascular and platelet function

International audience15-F 2t -isoprostane (15-F 2t -IsoP), an oxidation product of arachidonic acid (AA), affects vascular and platelet function; however, the bioactivity of other fatty acids oxidation products is unknown. This paper studied rat aortic vascular reactivity and human platelet aggregation in response to 14 oxidation products of AA, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and Éø -linolenic acid (ALA) compared with 15-F 2t -IsoP. It also compared the F 2t -IsoPs profi le in human platelets. EPA-derived 15-F 3t -IsoP constricted rat aorta less than 15-F 2t -IsoP, but none of the other oxidation products affected vascular reactivity. Only 15-F 2t -IsoP (10 - 4 M) directly affected platelet aggregation. 15-F 3t -IsoP, ent-16-F 1 -phytoprostane (from ALA) and isofurans A and B (from AA) inhibited reversible aggregation to U46619. Unlike plasma, the platelet profi le of F 2 -IsoP showed that 8-F 2t -IsoP were higher than 15-F 2t -IsoP. Unlike 15-F 2t -IsoP, the test compounds derived from fatty acids oxidation did not affect vascular or platelet function. Elevated platelet 8-F 2t -IsoP could limit 15-F 2t -IsoP-induced aggregation under conditions of oxidant stres

Are Isofurans and Neuroprostanes Increased After Subarachnoid Hemorrhage and Traumatic Brain Injury?

International audienceCurrent diagnostic tools to assess neurological injury after aneurysmal subarachnoid hemorrhage (aSAH) and traumatic brain injury (TBI) have poor discriminatory abilities. Free radicals are associated with the pathophysiology of secondary damage after brain trauma. We examined cerebrospinal fluid (CSF) lipid markers of oxidative stress, isofurans (IsoFs), F4-neuroprostanes (F4-NeuroPs), and F2-isoprostanes (F2-IsoPs), in two casecontrolled studies in patients with aSAH or severe TBI. Patients with aSAH (n = 18) or TBI (n = 18) were age and gender matched with separate control groups. CSF samples were collected from patients within 24 h of the injury. CSF IsoFs and F4-NeuroPs were increased in aSAH patients compared with their controls. In TBI patients, IsoFs and F4-NeuroPs were increased compared with their controls. F2-IsoPs were increased in aSAH patients, but not in TBI patients, compared with their respective controls. CSF IsoFs and F4-NeuroPs are consistently increased after a catastrophic central nervous system injury. These results suggest their measurement may enhance the management of unconscious patients in neurological care

Is There a Role for Isofurans and Neuroprostanes in Pre-Eclampsia and Normal Pregnancy?

International audiencePre-eclampsia is a complex disorder of pregnancy that adversely affects the mother and baby. Arachidonic acid and docosahexaenoic acid are essential for fetal development and can undergo free radical oxidation to F2- isoprostanes (F2-IsoPs) and isofurans (IsoFs); and F4-neuroprostanes (F4-NeuroPs), respectively. These metabolites may be relevant to pre-eclampsia and fetal development. We examined IsoFs, F4-NeuroPs, and F2-IsoPs in maternal plasma and cord blood plasma of 23 women with pre-eclampsia and 21 normal pregnancies. Women with pre-eclampsia had significantly elevated maternal IsoFs and F4-NeuroPs, but not F2-IsoPs. Cord blood F4- NeuroPs were elevated among neonates of women with pre-eclampsia. In women with pre-eclampsia, birth weight was predicted by gestation at delivery. The latter was also true in normal pregnancy, but birth weight was negatively related to maternal F2-IsoPs, IsoFs, and F4-NeuroPs. We have shown that in women with preeclampsia, IsoFs and F4-NeuroPs are elevated, and cord blood F4-NeuroPs are increased. The inverse relationship between maternal F2-IsoPs, IsoFs, and F4-NeuroPs and birth weight may be relevant as predictors of low birth weight in normal pregnancy. Future studies should examine whether these markers in maternal blood at early stages of pregnancy relate to subsequent maternal, fetal, and neonatal complications

Isoprostanes and neuroprostanes: Total synthesis, biological activity and biomarkers of oxidative stress in humans.

International audienceIsoprostanes (IsoPs) and neuroprostanes (NeuroPs) are formed in vivo by a free radical non-enzymatic mechanism involving peroxidation of arachidonic acid (AA, C20:4 n-6) and docosahexaenoic acid (DHA, C22:6 n-3) respectively. This review summarises our research in the total synthesis of these lipid metabolites, as well as their biological activities and their utility as biomarkers of oxidative stress in humans

Le site de référence du Partenariat européen d’innovation pour un vieillissement actif et en bonne santé MACVIA-LR (contre les maladies chroniques pour un vieillissement en bonne santé en Languedoc-Roussillon)

International audienceLe site de référence du Partenariat européen d'innovation pour un vieillissement actif et en bonne santé MACVIA-LR (contre les maladies chroniques pour un vieillissement en bonne santé en Languedoc-Roussillon