MRI and Neuropsychological Correlates of Carbon Monoxide Exposure: A Case Report

A 45-year-old woman experienced long-term, chronic exposure to carbon monoxide in the restaurant kitchen where she was employed as a cook. After returning to the restaurant after 5 days off work, she noticed that her symptoms returned immediately; she then aired out the room and called the gas company. Approximately 6 hr after a leak was detected, the patient went to the hospital, where her carboxyhemoglobin was found to be within normal limits and results of a neurologic examination were described as normal. Based on her symptoms, the patient believed she had been exposed to CO for at least 1 year before the leak was discovered. Initially, she experienced flu-like symptoms, which eventually resolved. At the time of her first neuropsychological evaluation (17 months after the exposure was identified), her persisting complaints included difficulties in reading, writing, speaking and word retrieval. The test results were consistent with secondary frontal lobe dysfunction associated with subcortical disorders such as those seen after CO exposure. Results of a subsequent neuropsychological examination (29 months postexposure) showed slight improvement in performance, but her performance was still consistent with mild frontal/subcortical dysfunction. Although the initial screening of a brain magnetic resonance image (MRI) performed 15 months after the exposure was interpreted as being within normal limits, two subsequent blind reviews of the same scans identified multiple bilateral lesions in the basal ganglia, which were consistent with chronic CO exposure. We present this case as an example of the utility of MRI and neuropsychological examinations in detecting central nervous system dysfunction secondary to CO exposure

Thiazolidine derivatives as potent and selective inhibitors of the PIM kinase family

The PIM family of serine/threonine kinases have become an attractive target for anti-cancer drug development, particularly for certain hematological malignancies. Here, we describe the discovery of a series of inhibitors of the PIM kinase family using a high throughput screening strategy. Through a combination of molecular modeling and optimization studies, the intrinsic potencies and molecular properties of this series of compounds was significantly improved. An excellent pan-PIM isoform inhibition profile was observed across the series, while optimized examples show good selectivity over other kinases. Two PIM-expressing leukemic cancer cell lines, MV4-11 and K562, were employed to evaluate the in vitro anti-proliferative effects of selected inhibitors. Encouraging activities were observed for many examples, with the best example (44) giving an IC50 of 0.75μM against the K562 cell line. These data provide a promising starting point for further development of this series as a new cancer therapy through PIM kinase inhibition

Indigo, outil multimédia d éducation thérapeutique destiné à des patients diabétiques de type 1 adultes (évaluation du point de vue des patients utilisateurs)

Introduction : En 2013, en France, de nombreux patients diabétiques de type 1 n ont pas accès à une offre d éducation thérapeutique. La démocratisation d Internet permet d envisager ce média comme support éducatif. INDIGO est outil multimédia d éducation thérapeutique du patient (ETP) accessible par Internet et sur CD-Rom. L objectif principal de cette étude est d évaluer la qualité du site INDIGO du point de vue des patients utilisateurs selon les critères de qualité d un outil d intervention en éducation pour la santé de l Institut National de Prévention et d Education pour la Santé (INPES). Matériel et méthodes : Enquête qualitative par entretiens dirigés et semi-dirigés menée auprès de 11 patients diabétiques de type 1 adultes, diagnostiqués depuis moins de 3 ans, suivis au Centre Hospitalier Universitaire de Grenoble, ayant ou non déjà bénéficié d ETP. De plus, une patiente diagnostiquée depuis 27 ans a été incluse afin de comparer ses réponses. Résultats : La qualité du contenu et la qualité pédagogique sont appréciées. L identification est permise par les vidéos de témoignages. Son caractère modulable le rend adaptable aux besoins de chacun. Malgré quelques problèmes d ordre technique, le choix du support Internet est approuvé. Il en facilite l accès et le rend interactif. Conclusion : Pour les patients interrogés, le site répond aux critères de qualité d un outil d intervention en éducation pour la santé de l INPES. Des propositions d amélioration ont été formulées qu il conviendrait d envisager. Une étude complémentaire pourrait être menée auprès de professionnels de santé. Après une diffusion à grande échelle, une évaluation d impact devrait être envisagée.GRENOBLE1-BU Médecine pharm. (385162101) / SudocSudocFranceF

Transmission ecosystems of Echinococcus multilocularis in Eurasia, with particular reference to the Alay Valley

International audienceFrom continental to regional scales, the zoonosis alveolar echinococcosis (AE) (caused by Echinococcus multilocularis) forms discrete patches of endemicity within which transmission hotspots of much larger prevalence may occur. Since the late 80s, a number of hotspots have been identified in Europe and continental Asia, mostly in China, wherein the ecology of intermediate host communities has been described. Here we present a comparative natural history and characteristics of transmission ecosystems, with a particular focus on the Alay Valley hotspot, recently studied