Le phéochromocytome surrénalien bilatéral: à propos d'un cas

Les phéochromocytomes de localisation bilatérale sont rares. Ils s'intègrent le plus souvent dans le cadre d'une maladie familiale. Néanmoins des formes bilatérales sporadiques peuvent être observées. Ainsi, chez tout patient présentant des masses surrénaliennes bilatérales, un phéochromocytome bilatéral doit être suspecté et son caractère familial ou sporadique doit être déterminé devant le risque de récidive tumorale. A ce propos, nous rapportons l'observation d'une patiente âgée de 22 ans qui a été hospitalisée pour exploration d'une hypertension artérielle de découverte récente. L'association à des céphalées, sueurs et palpitations a orienté vers le diagnostic de phéochromocytome. Les taux urinaires des dérivés méthoxylés étaient très élevés. L'échographie et l'IRM abdominales ont noté la présence de deux masses surrénaliennes bilatérales. La scintigraphie au MIBG a montré une hyperfixation au niveau des deux surrénales, sans autres localisations. L'enquête à la recherche d'une néoplasie endocrinienne multiple ou d'une phacomatose était négative. Le traitement a consisté en une surrénalectomie bilatérale par   voie coelioscopique. L'évolution sous traitement substitutif par hydrocortisone était favorable avec une normalisation des chiffres tensionnels

Assessing the presence of Wuchereria bancrofti in vector and human populations from urban communities in Conakry, Guinea

The Global Programme to Eliminate Lymphatic Filariasis was launched in 2000 with the goal of interrupting transmission of lymphatic filariasis (LF) through multiple rounds of mass drug administration (MDA). In Guinea, there is evidence of ongoing LF transmission, but little is known about the most densely populated parts of the country, including the capital Conakry. In order to guide the LF control and elimination efforts, serological and entomological surveys were carried out to determine whether or not LF transmission occurs in Conakry.; The prevalence of circulating filarial antigen (CFA) of Wuchereria bancrofti was assessed by an immuno-chromatography test (ICT) in people recruited from all five districts of Conakry. Mosquitoes were collected over a 1-year period, in 195 households in 15 communities. A proportion of mosquitoes were analysed for W. bancrofti, using dissection, loop-mediated isothermal amplification (LAMP) assay and conventional polymerase chain reaction (PCR).; CFA test revealed no infection in the 611 individuals examined. A total of 14,334 mosquitoes were collected; 14,135 Culex (98.6 %), 161 Anopheles (1.1 %) and a few other species. Out of 1,312 Culex spp. (9.3 %) and 51 An. gambiae (31.7 %) dissected, none was infected with any stage of the W. bancrofti parasite. However, the LAMP assay revealed that 1.8 % of An. gambiae and 0.31 % of Culex spp. were positive, while PCR determined respective prevalences of 0 % and 0.19 %.; This study revealed the presence of W. bancrofti DNA in mosquitoes, despite the apparent absence of infection in the human population. Although MDA interventions are not recommended where the prevalence of ICT is below 1 %, the entomological results are suggestive of the circulation of the parasite in the population of Conakry. Therefore, rigorous surveillance is still warranted so that LF transmission in Conakry would be identified rapidly and adequate responses being implemented

An intrinsic circadian clock of the pancreas is required for normal insulin release and glucose homeostasis in mice

AIMS/HYPOTHESIS: Loss of circadian clocks from all tissues causes defective glucose homeostasis as well as loss of feeding and activity rhythms. Little is known about peripheral tissue clocks, so we tested the hypothesis that an intrinsic circadian clock of the pancreas is important for glucose homeostasis. METHODS: We monitored real-time bioluminescence of pancreas explants from circadian reporter mice and examined clock gene expression in beta cells by immunohistochemistry and in situ hybridisation. We generated mice selectively lacking the essential clock gene Bmal1 (also known as Arntl) in the pancreas and tested mutant mice and littermate controls for glucose and insulin tolerance, insulin production and behaviour. We examined islets isolated from mutants and littermate controls for glucose-stimulated insulin secretion and total insulin content. RESULTS: Pancreas explants exhibited robust circadian rhythms. Clock genes Bmal1 and Per1 were expressed in beta cells. Despite normal activity and feeding behaviour, mutant mice lacking clock function in the pancreas had severe glucose intolerance and defective insulin production; their isolated pancreatic islets had defective glucose-stimulated insulin secretion, but normal total insulin content. CONCLUSIONS/INTERPRETATION: The mouse pancreas has an autonomous clock function and beta cells are very likely to be one of the pancreatic cell types possessing an intrinsic clock. The Bmal1 circadian clock gene is required in the pancreas, probably in beta cells, for normal insulin secretion and glucose homeostasis. Our results provide evidence for a previously unrecognised molecular regulator of pancreatic glucose-sensing and/or insulin secretion

Renal cell carcinoma in children: Case report and literature review

Renal cell carcinoma is infrequent in children; consequently it is important to communicate its diagnosis and follow up. The behaviour of this type of tumor is better characterized in adults and in this setting the treatment of choice is surgical resection. However, the place of chemo- and radiotherapy has not been well defined. Here, we present a 9-year-old boy with renal cell carcinoma demonstrating only hematuria without any pathological physical examination findings. The mass was described by abdominal ultrasonography and computed tomography in the left kidney. After the left nephroureterectomy, the patient was given no adjuvant therapy

Strong resonances at high excitation energy in 17O+alpha resonance scattering

The Thick Target Inverse Kinematic (TTIK) approach was used to measure excitation functions for the elastic 17O ({\alpha}, {\alpha}) scattering at the initial 17O beam energy of 54.4 MeV. We observed strong peaks corresponding to highly excited {\alpha}-cluster states in the 21Ne excitation energy region of 8-16 MeV, which have never been investigated before. Additional tests were done at a 17O beam energy of 56.4 MeV to estimate a possible contribution of resonance inelastic scattering.Comment: 6 pages,3 figures, conference pape

Indirect techniques in nuclear astrophysics. Asymptotic Normalization Coefficient and Trojan Horse

Owing to the presence of the Coulomb barrier at astrophysically relevant kinetic energies it is very difficult, or sometimes impossible, to measure astrophysical reaction rates in the laboratory. That is why different indirect techniques are being used along with direct measurements. Here we address two important indirect techniques, the asymptotic normalization coefficient (ANC) and the Trojan Horse (TH) methods. We discuss the application of the ANC technique for calculation of the astrophysical processes in the presence of subthreshold bound states, in particular, two different mechanisms are discussed: direct capture to the subthreshold state and capture to the low-lying bound states through the subthreshold state, which plays the role of the subthreshold resonance. The ANC technique can also be used to determine the interference sign of the resonant and nonresonant (direct) terms of the reaction amplitude. The TH method is unique indirect technique allowing one to measure astrophysical rearrangement reactions down to astrophysically relevant energies. We explain why there is no Coulomb barrier in the sub-process amplitudes extracted from the TH reaction. The expressions for the TH amplitude for direct and resonant cases are presented.Comment: Invited talk on the Conference "Nuclear Physics in Astrophysics II", Debrecen, Hungary, 16-20 May, 200

Relation of tricuspid annular displacement and tissue Doppler imaging velocities with duration of weaning in mechanically ventilated patients with acute pulmonary edema

<p>Abstract</p> <p>Background</p> <p>Liberation from the ventilator is a difficult task, whereas early echocardiographic indices of weaning readiness are still lacking. The aim of this study was to test whether tricuspid annular plane systolic excursion (TAPSE) and right ventricular (RV) systolic (Sm) and diastolic (Em & Am) tissue Doppler imaging (TDI) velocities are related with duration of weaning in mechanically ventilated patients with acute respiratory failure due to acute pulmonary edema (APE).</p> <p>Methods</p> <p>Detailed quantification of left and right ventricular systolic and diastolic function was performed at admission to the Intensive Care Unit by Doppler echocardiography, in a cohort of 32 mechanically ventilated patients with APE. TAPSE and RV TDI velocities were compared between patients with and without prolonged weaning (≥ or < 7 days from the first weaning trial respectively), whereas their association with duration of ventilation and left ventricular (LV) echo-derived indices was tested with multivariate linear and logistic regression analysis.</p> <p>Results</p> <p>Patients with prolonged weaning (n = 12) had decreased TAPSE (14.59 ± 1.56 vs 19.13 ± 2.59 mm), Sm (8.68 ± 0.94 vs 11.62 ± 1.77 cm/sec) and Em/Am ratio (0.98 ± 0.80 vs 2.62 ± 0.67, p <0.001 for all comparisons) and increased Ε/e' (11.31 ± 1.02 vs 8.98 ± 1.70, p <0.001) compared with subjects without prolonged weaning (n = 20). Logistic regression analysis revealed that TAPSE (R²= 0.53, beta slope = 0.76, p < 0.001), Sm (R²= 0.52, beta = 0.75, p < 0.001) and Em/Am (R²= 0.57, beta = 0.32, p < 0.001) can predict length of weaning ≥ 7 days. The above measures were also proven to correlate significantly with Ε/e' (r = -0.83 for TAPSE, r = -0.87 for Sm and r = -0.79 for Em/Am, p < 0.001 for all comparisons).</p> <p>Conclusions</p> <p>We suggest that in mechanically ventilated patients with APE, low TAPSE and RV TDI velocities upon admission are associated with delayed liberation from mechanical ventilation, probably due to more severe LV heart failure.</p

Diversity, distribution, and density of marine mammals along the Saudi waters of the Arabian Gulf: update from a multi-method approach

Despite the important role of marine mammals in marine ecosystems and the imperative for their conservation, there is still a great lack of information on the diversity, distribution, and density of these animals in the Saudi waters of the Arabian Gulf. To fill this gap, an integrative data-collection approach including fishermen’s questionnaires, opportunistic sighting reports, and directed boat-based surveys, was undertaken between 2016 and 2020, leading to the first scientific report of marine mammal diversity, distribution, and density in the region. The results of the different approaches carried out during the study confirmed a high diversity of cetaceans on the west coast of the study area, with bottlenose dolphins (Tursiops aduncus), humpback dolphins (Sousa plumbea) and dugongs (Dugong dugon) as the most common species. While the two dolphin species were found to be widely distributed in both coastal and offshore waters, D. dugon appears to occur exclusively in coastal waters in the southern part of the study area, mainly in the Gulf of Salwah. The presence of both species of dolphins increased during the summer months and in the vicinity of the numerous oil and gas facilities in this region. The distribution of the observed dolphins was found mostly within a 10–20 km radius around each facility. Other cetacean species observed less frequently in the area include Bryde’s whale (Balaenoptera edeni), killer whale (Orcinus orca), common dolphin (Delphinus delphis) and finless porpoise (Neophocaena phocaenoides). Regarding the density of marine mammals in the region, boat-based surveys confirmed the results of fishermen’s questionnaires and reports of opportunistic sightings, with bottlenose and humpback dolphins being the most abundant species. These results provide a baseline for policies oriented to the conservation of mammals in the Saudi waters of the Arabian Gulf.info:eu-repo/semantics/publishedVersio

Serotonin and corticosterone rhythms in mice exposed to cigarette smoke and in patients with COPD:implication for COPD-associated neuropathogenesis

The circadian timing system controls daily rhythms of physiology and behavior, and disruption of clock function can trigger stressful life events. Daily exposure to cigarette smoke (CS) can lead to alteration in diverse biological and physiological processes. Smoking is associated with mood disorders, including depression and anxiety. Patients with chronic obstructive pulmonary disease (COPD) have abnormal circadian rhythms, reflected by daily changes in respiratory symptoms and lung function. Corticosterone (CORT) is an adrenal steroid that plays a considerable role in stress and anti-inflammatory responses. Serotonin (5-hydroxytryptamine; 5HT) is a neurohormone, which plays a role in sleep/wake regulation and affective disorders. Secretion of stress hormones (CORT and 5HT) is under the control of the circadian clock in the suprachiasmatic nucleus. Since smoking is a contributing factor in the development of COPD, we hypothesize that CS can affect circadian rhythms of CORT and 5HT secretion leading to sleep and mood disorders in smokers and patients with COPD. We measured the daily rhythms of plasma CORT and 5HT in mice following acute (3 d), sub-chronic (10 d) or chronic (6 mo) CS exposure and in plasma from non-smokers, smokers and patients with COPD. Acute and chronic CS exposure affected both the timing (peak phase) and amplitude of the daily rhythm of plasma CORT and 5HT in mice. Acute CS appeared to have subtle time-dependent effects on CORT levels but more pronounced effects on 5HT. As compared with CORT, plasma 5HT was slightly elevated in smokers but was reduced in patients with COPD. Thus, the effects of CS on plasma 5HT were consistent between mice and patients with COPD. Together, these data reveal a significant impact of CS exposure on rhythms of stress hormone secretion and subsequent detrimental effects on cognitive function, depression-like behavior, mood/anxiety and sleep quality in smokers and patients with COPD