Influence of the gender on the relationship between heart rate and blood pressure

Blood Pressure (BP) and Heart Rate (HR) provide information on clin-ical condition along 24h. Both signals present circadian changes due to sympa-thetic/parasympathetic control system that influence the relationship between them. Moreover, also the gender could modify this relation, acting on both con-trol systems. Some studies, using office measurements examined the BP/HR re-lation, highlighting a direct association between the two variables, linked to sus-pected coronary heart disease. Nevertheless, till now such relation has not been studied yet using ambulatory technique that is known to lead to additional prog-nostic information about cardiovascular risks. In order to examine in a more ac-curate way this relation, in this work we evaluate the influence of gender on the BP/HR relationship by using hour-to-hour 24h ambulatory measurements. Data coming from 122 female and 50 male normotensive subjects were recorded using a Holter Blood Pressure Monitor and the parameters of the linear regression fit-ting BP/HR were calculated. Results confirmed those obtained in previous stud-ies using punctual office measures in males and underlined a significant relation between Diastolic BP and HR during each hour of the day in females; a different trend in the BP/HR relation between genders was found only during night-time. Moreover, the circadian rhythm of BP/HR is similar in both genders but with different values of HR and BP at different times of the day

Effects of transcutaneous tibial nerve stimulation on anorectal physiology in fecal incontinence: a double-blind placebo-controlled cross-over evaluation.

International audienceBACKGROUND: Transcutaneous electrical tibial nerve stimulation (TENS) is of growing interest for the treatment of fecal incontinence (FI), but its mechanism of action remains uninvestigated. We aimed to further assess the anorectal response to TENS in a dynamic model. METHODS: We performed a placebo-controlled, randomized, double-blinded crossover study in 19 patients suffering from FI to assess the effects of TENS on anorectal function. Anorectal physiology and perception were recorded through two sequences of rectal isobaric distension using an electronic barostat device to measure anal and rectal pressures, rectal volumes, and perception scores. KEY RESULTS: Maximal rectal pressure and volume variation were affected by TENS, with higher mean maximal rectal pressure (5.33 and 4.06 mmHg in the active and sham TENS respectively, p < 0.0001) and lower volume variation (11.45 and 14.7 mL in the active and sham stimulation respectively, p < 0.05). Rectal compliance was not modified by active TENS. Pressure of the upper anal canal was significantly lower with raised isobaric distension in sequences assigned to active TENS. CONCLUSIONS & INFERENCES: Acute TENS modified anorectal physiology by strengthening the myogenic response to distension rather than increasing muscle relaxation and related rectal compliance in patients with FI

O095 : High transferrin saturation during maintenance venesection therapy in HFE hemochromatosis is associated with increased morbidity regardless of serum ferritin levels

International audienceno abstrac

Prospective cohort study of phenotypic variation based on an anal sphincter function in adults with fecal incontinence

International audienceBackground: One-third of patients with fecal incontinence (FI) do not have any anal dysfunction. The aim was to characterize patients with FI with normal anal function compared with patients with anal weakness. Methods: The general characteristics and data of anal manometry, endosonography, and defecography of patients who were evaluated for FI at a single institution from 2005 to 2015 were prospectively assessed. Fecal incontinence was defined by the Cleveland Clinic Incontinence Score (CCIS) >4. Anal weakness was defined by one or more of the three following parameters: 63 years; odds ratio [OR] = 0.29), higher weight (>65 kg; OR = 1.69), fecal urgency (OR = 1.58), less severe FI score (CCIS score >10; OR = 0.52), higher abdominal pressure (>36 mmHg; OR = 2.15), and paradoxical puborectal contraction (OR = 2.07) in a multivariate analysis model. Conclusion & inferences: Fecal incontinence with normal anal function is a specific phenotype that involves distal constipation and may be an early stage of FI with anal weakness. Physicians should adapt their management to focus on the treatment of constipation. © 2016 John Wiley & Sons Lt

A pre-operative scoring system for adnexal mass in children and adolescents to preserve their future fertility

International audienceSTUDY OBJECTIVE: To develop a predictive score for ovarian malignancy to avoid unnecessary adnexectomy in cases of adnexal mass in pediatric and adolescent girls.DESIGN: A population-based retrospective study on girls who underwent surgery for an ovarian mass with normal levels of human chorionic gonadotrophin (hCG) and alpha fœtoprotein (aFP) between 1996 and 2016.SETTING: Rennes University Hospital, Rennes, France.PARTICIPANTS: Eighty-one patients operated on for ovarian tumor.MAIN OUTCOME MEASURES: The main outcome measure was the rate of malignant and borderline tumor. A pre-operative scoring system was constructed after multivariate analysis.RESULTS: The rate of malignant ovarian tumor was 7%, borderline tumor was 9% (i.e., outcome measure: 16%), and benign tumor was 84%. In a univariate analysis, the characteristics significantly associated with malignancy were early puberty, palpable mass, size and content of the tumor, and positive epithelial tumor markers [CA 125, CEA, and CA 19-9]. The predictive malignancy score was based on two variables obtained after multivariate analysis: tumor size and cystic content. The score defined 3 groups at risk for malignancy: low risk, middle-risk and high-risk. The sensitivity for detecting malignancy was 1.3% (95%CI: 0.1–18.4), 26.2% (95%CI: 11.6-49.0) and 53.1% (95%CI: 29.1–75.8), respectively.CONCLUSION: We set up a simple predictive score of malignancy based on objective criteria to help decision making on whether or not ovarian-sparing surgery is feasible in case of children and adolescents with ovarian tumors and normal hCG and aFP levels while ensuring oncologic safety

Contribution of voriconazole phenotyping to patient management

International audienceMeeting Abstract PS-07

Regulation of inhibitory and activating killer-cell Ig-like receptor expression occurs in T cells after termination of TCR rearrangements.

A small fraction of T cells expresses killer-cell Ig-like receptors (KIR), a family of MHC class I-specific receptors that can modulate TCR-dependent activation of effector functions. Although KIR(+) cells are enriched within Ag-experienced T cell subsets, the precise relationships between KIR(+) and KIR(-) T cells and the stage of KIR induction on these lymphocytes remain unclear. In this study, we compared KIR(-) and KIR(+) alphabeta T cell clones, sorted by means of the CD158b (KIR2DL2/KIR2DL3/KIR2DS2) specific mAb GL183. We isolated several pairs of CD158b(+) and CD158b(-) alphabeta T cell clones sharing identical productive and nonproductive TCR transcripts. We showed that expression of functional KIR on T cells is regulated after termination of TCR rearrangements. Transcriptional regulation of KIR genes was documented in multiple T cell clones generated from the same donor, and the presence of KIR transcripts was also detected in KIR(-) T cells. These results document a complex regulation of KIR expression in T cells at both pre and posttranscriptional levels, under the control of yet undefined signals provided in vivo