45 research outputs found

    Hepatic Stem-like Phenotype and Interplay of Wnt/β-Catenin and Myc Signaling in Aggressive Childhood Liver Cancer

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    SummaryHepatoblastoma, the most common pediatric liver cancer, is tightly linked to excessive Wnt/β-catenin signaling. Here, we used microarray analysis to identify two tumor subclasses resembling distinct phases of liver development and a discriminating 16-gene signature. β-catenin activated different transcriptional programs in the two tumor types, with distinctive expression of hepatic stem/progenitor markers in immature tumors. This highly proliferating subclass was typified by gains of chromosomes 8q and 2p and upregulated Myc signaling. Myc-induced hepatoblastoma-like tumors in mice strikingly resembled the human immature subtype, and Myc downregulation in hepatoblastoma cells impaired tumorigenesis in vivo. Remarkably, the 16-gene signature discriminated invasive and metastatic hepatoblastomas and predicted prognosis with high accuracy

    Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

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    RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

    Les originalités démographiques d'un bourg artisanal normand au XVIIIe siècle : Villedieu-les-Poëles (1711-1790)

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    Jouan Marie-Hélène. Les originalités démographiques d'un bourg artisanal normand au XVIIIe siècle : Villedieu-les-Poëles (1711-1790). In: Annales de démographie historique, 1969. Villes et villages de l'ancienne France. pp. 87-124

    Réalisation d'un support de communication pour la prévention de la carie dentaire chez le sportif consommateur de boissons énergétiques

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    LILLE2-UFR Odontologie (593502202) / SudocLILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

    Le scanner dentaire, quel prix, quelle irradiation ?

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    Quelle est la cotation d'un examen scanographique ? Est-elle la même quelle que soit la région anatomique étudiée ? Quel est le taux de remboursement appliqué par la Sécurité sociale ? Tels sont les points abordés dans le premier volet de l'exposé. Dans la seconde partie, après un bref rappel sur les notions de dosimétrie, les auteurs décrivent les outils dont disposent le radiologue pour limiter l'irradiation, dans le respect des principes de justification et d'optimisation (conformément à la directive 97/43 Euratom). Des données chiffrées sont fournies, permettant de communiquer au patient une information simple et facilement compréhensible, avec comme élément de comparaison concret l'irradiation naturelle annuelle

    Preoperative Chemerin Level Is Predictive of Inflammatory Status 1 Year After Bariatric Surgery

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    Background Obesity is associated with chronic low-grade inflammation, which has been linked to increased morbidity. However, inflammation variably and unpredictably improves after bariatric surgery. This study aimed at (1) evaluating the relationship between amplitude of weight loss and variation of inflammatory parameters after bariatric surgery, and (2) identifying, among clinical and biological baseline parameters, predictive factors of variation in inflammatory parameters. Methods In a prospective cohort of patients who underwent bariatric surgery, serum concentrations of interleukin (IL)-6, IL-10, resistin, leptin, adiponectin chemerin, and C-reactive protein (CRP) were measured preoperatively and 1 year after surgery, and routine clinical and biochemical parameters were retrieved. Univariate and multivariate analyses (partial least square method) were performed to assess how parameters were associated with weight loss and to predict improvement of inflammatory parameters. Results Eighty-seven patients were included (mean weight +/- SD 136.3 +/- 3.2 kg, 35 gastric bypasses, 52 sleeve gastrectomies). In parallel with weight loss (39.5 +/- 13.8 kg), pro-inflammatory markers (IL-6, CRP, leptin, resistin) significantly decreased, and anti-inflammatory markers (IL-10, adiponectin) increased. Multivariate analysis revealed a significant association between weight loss and improvement in inflammatory parameters. Among all the clinical and biological preoperative parameters, baseline chemerin level was the only parameter that was significantly associated with global improvement of the inflammatory status after surgery. Conclusion The amplitude of weight loss 1 year after bariatric surgery was strongly correlated with improvement of inflammatory profile, which could be predicted by baseline plasma level of chemerin. This suggests a key role of chemerin in obesity-driven inflammation, and a potential use as a biomarker

    À chacun sa tragédie ?

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    Au cœur d’innombrables débats depuis des siècles, la tragédie grecque alimente un flot nourri de publications. Philologues, philosophes, anthropologues, historiens ou encore psychanalystes n’ont de cesse de s’exprimer à son propos. Les uns dissertent sur le genre et sa naissance. D’autres discutent de ses diverses dimensions (politiques, sociales, religieuses, culturelles), quand ils ne commentent pas inlassablement les quelques pièces parvenues in extenso jusqu’à nous. Ces dernières décennies, on doit aux Anglo-Saxons d’avoir, par le biais des « Performance Studies », renouvelé l’interprétation des tragédies en montrant qu’elles étaient avant tout destinées à la scène. Plus récemment, ce sont deux points tenus naguère pour avérés qui ont été fortement remis en cause dans la littérature critique : la liaison tragédie-politique, d’une part ; le lien congénital et exclusif entre la tragédie grecque et la cité d’Athènes, d’autre part. Autres temps, autres perceptions et autres significations ? À chacun donc sa tragédie ? La question ainsi formulée n’a d’autre but que de souligner la richesse des résultats obtenus dès lors que l’on change de perspectives et envisage d’autres angles d’attaque. Ainsi le présent ouvrage montre au lecteur le sens nouveau qui se dégage des Perses d’Eschyle, une fois la pièce replacée dans le contexte commémoratif des années 470. Il met aussi en lumière l’apport de la littérature fragmentaire à notre appréhension du théâtre d’Euripide et la contribution de l’Ancienne et Moyenne Comédie à notre connaissance des tragédies contemporaines. Il présente enfin un bilan raisonné de ce que les tragédies des époques hellénistique puis romaine (sous le nom de « prétextes ») nous apprennent des différents avatars du genre
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