"Hormone-refractory" prostate cancer : a putative new mechanism: the upside-down response to androgens

En aquest article volem revisar la diversitat dels mecanismes moleculars suposadament responsables del creixement independent d'andrògens del càncer de pròstata. Es demostra que alguns càncers de pròstata que escapen de la teràpia endocrinològica estan compostos per cèllules sensibles als andrògens. Ens centraremen els resultats del nostre laboratori i en els d'altres grups de recerca que suggereixen el mateix concepte nou: el comportament del càncer de pròstata refractari als andrògens està associat a una resposta invertida de les cèll. ules als andrògens. Hem observat un alentiment paradoxal en el creixement de diverses línies cell. ulars induït pels andrògens. Aquestes línies cell. ulars provenen de les cèll. ules LNCaP, ja sigui per evolució espontània o per cultiu crònic en un medi sense andrògens. La línia ARCaP (androgen-reverted carcinoma of the prostate) va ser establerta a partir de l'ascitis d'un pacient amb càncer de pròstata avançat. Els tumors que varen créixer a partir d'aquestes cèll. ules reverteixen, encara que transitòriament, en el tractament androgènic. Volem suggerir que la castració podria permetre la proliferació de les cèll. ules que eren paradoxalment alentides pels andrògens i que aquesta reacció invertida als andrògens podria ser el possible mecanisme pel qual el càncer de pròstata deixa de respondre a la teràpia hormonal. Aquests resultats aportarien unes bases racionals per a comprendre el tractament antiandrogènic intermitent.In this paper we survey the diversity of the molecular mechanisms suspected to be responsible for the androgen-independent growth of prostate cancer. It has been shown that some prostate cancers, which escape endocrine therapy, are composed of androgen-sensitive cells. We focus on the results from our laboratory and from a few others that suggest a new concept: that the androgen-refractory behavior of prostate cancer may be associated with an inverted response to androgens by cells. The proliferation of several cell lines was paradoxically slowed by androgens. In the afore-mentioned studies, a series of these cell lines arose from the LNCaP cell line, either spontaneously or after culturing them chronically in androgen-poor culture medium. The ARCaP (androgen-reverted carcinoma of the prostate) was established from the ascites of a patient with advanced prostate cancer. Usually, tumors grown from such cells regress, albeit transiently, under androgen treatment. It has been suggested that castration could allow the proliferation of cells that are paradoxically slowed by androgens and that the inverted response to androgens could possibly be a mechanism, by which prostate cancer escapes from endocrine therapy. These results provide the rationale for intermittent treatment

Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents ( Update 2016)

Background: Because of the changing epidemiology of Helicobacter pylori infection and low efficacy of currently recommended therapies, an update of the European Society for Paediatric Gastroenterology Hepatology and Nutrition/North American Society for Pediatric Gastroenterology, Hepatology and Nutrition recommendations for the diagnosis and management of H pylori infection in children and adolescents is required. Methods: Asystematic review of the literature (time period: 2009-2014) was performed. Representatives of both societies evaluated the quality of evidence using GRADE (Grading of Recommendation Assessment, Development, and Evaluation) to formulate recommendations, which were voted upon and finalized using a Delphi process and face-to-face meeting. Results: The consensus group recommended that invasive diagnostic testing for Hpylori be performed only when treatment will be offered if tests are positive. To reach the aim of a 90% eradication rate with initial therapy, antibiotics should be tailored according to susceptibility testing. Therapy should be administered for 14 days, emphasizing strict adherence. Clarithromycin-containing regimens should be restricted to children infected with susceptible strains. When antibiotic susceptibility profiles are not known, high-dose triple therapy with proton pump inhibitor, amoxicillin, and metronidazole for 14 days or bismuth-based quadruple therapy is recommended. Success of therapy should be monitored after 4 to 8 weeks by reliable noninvasive tests. Conclusions: The primary goal of clinical investigation is to identify the cause of upper gastrointestinal symptoms rather than H pylori infection. Therefore, we recommend against a test and treat strategy. Decreasing eradication rates with previously recommended treatments call for changes to first-line therapies and broader availability of culture or molecular-based testing to tailor treatment to the individual child

Differences in management of eosinophilic esophagitis in Europe : an assessment of current practice

Objectives:The aim of the study was to assess differences in the diagnosis and management of eosinophilic esophagitis (EoE) by European pediatric (PG) and adult gastroenterologists (AG), and their self-reported adherence to guidelines. Methods:A multiple-choice questionnaire gauged the diagnostic and management strategies of gastroenterologists treating children or adults in 14 European countries and the United Arab Emirates (UAE). Results:Questionnaires were completed by 465 PG and 743 AG. PG were significantly more likely to take biopsies in patients with symptoms of esophageal dysfunction (86.2% PG vs 75.4% AG, P<0.001) and to perform endoscopic follow-up (86.3% PG vs 80.6% AG, P<0.001). After failure of proton-pump inhibitors (PPIs), topical steroids were the preferred second-line therapy; however, PG opted more frequently for elimination diets (47.5% PG vs 13.7% AG, P<0.001). More PG than AG indicated having read recent guidelines (89.4% PG vs 58.2% AG, P<0.001). Geographic differences in practice were reported, with respondents from the United Kingdom, Portugal, and Spain more often adhering to recommended biopsy protocols. Physicians in the UAE, France, Lithuania, and Poland tended to opt for steroid therapy or elimination diets as first-line therapy, in contrast to most other countries. Conclusions:Significant differences in general practice between PG and AG were demonstrated with notable divergence from consensus guidelines. International practice variations are also apparent. Among other strategies, educational activities to highlight current recommendations may help harmonize and optimize clinical practice

Genetic and Transmission Analysis of Helicobacter pylori Strains within a Family1

Point mutations, intragenic recombination, and introduction of foreign alleles enhanced strain diversity within the family

Using Macro-Arrays to Study Routes of Infection of Helicobacter pylori in Three Families

allowed tracing the spread of infection through populations on different continents but transmission pathways between individual humans have not been clearly described.To investigate person-to-person transmission, we studied three families each including one child with persistence of symptoms after antibiotic treatment. Ten isolates from the antrum and corpus of stomach of each family member were analyzed both by sequencing of two housekeeping genes and macroarray tests. from outside the family appeared to be probable in the transmission pathways. infection may be acquired by more diverse routes than previously expected

PREVALENCE DE LA RESISTANCE SECONDAIRE AU COURS DE L'INFECTION GASTRIQUE A HELICOBACTER PYLORI CHEZ L'ENFANT

AMIENS-BU Santé (800212102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Activité d'un service d'urgence pédiatrique (résultats d'une étude rétrosceptive [i.e. rétrospective] portant sur 1573 patients)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Evaluation de la tolérance du mélange protoxyde d'azote/oxygène (entonox®) au cours des soins douloureux aux urgences pédiatriques (à propos de 600 observations)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Ulcères et érosions gastro-duodénaux chez l'enfant.

Journal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Evaluation du statut nutritionnel chez tous les enfants hospitalisés dans un service de pédiatrie générale du Nord- Pas-de-Calais

Les troubles nutritionnels, i.e. la dénutrition et l obésité représentent un problème majeur de santé publique de par leur fréquence dans la population pédiatrique générale et plus spécifiquement dans la population hospitalisée. Le dépistage de ces troubles nutritionnels considérés comme un indicateur d amélioration de la qualité des soins. Le but de notre étude est de démontrer que la fréquence de la dénutrition et de l obésité sont élevées chez les enfants hospitalisés induisant une conséquence directe sur leurs complexités de prise en charge. Notre étude révèle que la fréquence de la dénutrition (16.6%) et de l obésité (6.8%) dans la population pédiatrique hospitalisée est non négligeable et que son dépistage doit être systématiquement pris en considération. Enfin notre étude montre que ces deux troubles nutritionnels ont un impact sur la durée d hospitalisation (augmentation de 49.6% pour les patients dénutris et 54.3% pour les patients obèses) et donc un impact médico-économique plus élevé.LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF