Novel Insights into the Bovine Polled Phenotype and Horn Ontogenesis in Bovidae

Despite massive research efforts, the molecular etiology of bovine polledness and the developmental pathways involved in horn ontogenesis are still poorly understood. In a recent article, we provided evidence for the existence of at least two different alleles at the Polled locus and identified candidate mutations for each of them. None of these mutations was located in known coding or regulatory regions, thus adding to the complexity of understanding the molecular basis of polledness. We confirm previous results here and exhaustively identify the causative mutation for the Celtic allele (PC) and four candidate mutations for the Friesian allele (PF). We describe a previously unreported eyelash-and-eyelid phenotype associated with regular polledness, and present unique histological and gene expression data on bovine horn bud differentiation in fetuses affected by three different horn defect syndromes, as well as in wild-type controls. We propose the ectopic expression of a lincRNA in PC/p horn buds as a probable cause of horn bud agenesis. In addition, we provide evidence for an involvement of OLIG2, FOXL2 and RXFP2 in horn bud differentiation, and draw a first link between bovine, ovine and caprine Polled loci. Our results represent a first and important step in understanding the genetic pathways and key process involved in horn bud differentiation in Bovidae

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Évaluation rétrospective de la prise en charge des luxations gléno-humérales antérieures au SAMU de Lyon et aux urgences traumatologiques de l'hôpital Édouard Herriot en 2012

Introduction : À ce jour, il n'existe pas de protocole clairement défini pour la réduction des luxations gléna-humérales antérieures (LGHA). L'objectif de cette étude était d'effectuer un état des lieux sur les pratiques hospitalières et préhospitalières à Lyon en 2012. Méthode: Nous avons réalisé une étude rétrospective observationnelle comparative de la prise en charge des LGHA, du 1er janvier au 31 décembre 2012, au SAMU de Lyon et aux urgences traumatologiques du SMA de l' hôpital Edouard Herriot. Résultats: Nous avons retenu 53 LGHA prises en charge par le SAMU et 167 par le SMA. Les luxations prises en charge par le SAMU étaient principalement des luxations récidivantes (60%) et non traumatiques (66%) par opposition à celles du SMA qui étaient des luxations premières (56%) et traumatiques (61 %). Les médecins du SAMU ont tenté de réduire 87% des LGHA en l'absence de radiographie préalable, dont 26% de traumatiques, avec un taux de succès total de 83%. Un seul de ces patients présentait une urgence nerveuse. Aucune erreur diagnostique n'a été commise. Les médecins du SMA ont tenté de réduire 96% de leurs luxations avec un taux de succès de 92%. 3% des patients n'ont pas eu de radiographie. Aucun patient n'a présenté de complication au décours de ces prises en charge d'après les renseignements contenus dans les dossiers. Les médecins du SMA ont principalement utilisé du MEOP A seul ou en association avec un antalgique de palier 1 ou sans aucune médication, dans 74% des dossiers alors que le SAMU a utilisé de la morphine ou une association d'un analgésique et d'un sédatif pour 65% de ses patients. Moins de 3% des patients comportaient un examen clinique, noté dans le dossier, satisfaisant sur le plan médico-légal. La durée d'immobilisation était adaptée dans seulement 46% des 80 dossiers renseignés. Conclusion : L'établissement d'un protocole clair de prise en charge semble indispensable pour améliorer nos pratiques et le pronostic fonctionnel des patients (durées d'immobilisation, techniques de réduction plus adaptées et le dépistage des lésions vasculo-nerveuses), limitant ainsi les récidives et les séquelles ultérieures. Notre travail confirme le bon diagnostic clinique des médecins urgentistes, à travers l'examen sémiologique des luxations et des fractures du col de l'humérus, et l'absence de tentative de réduction en cas d'incertitudeLYON1-BU Santé (693882101) / SudocSudocFranceF

Registre "ESTIM Rhône" des syndromes coronaires aigus avec sus décalage persistant du segment ST (analyse et perspectives après 2 ans d'inclusion)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

A Phase-Contrast MRI Study to Investigate the Interaction of the CSF Dynamic with the Intracranial CSF Distribution

PURPOSES: Cine PC-MRI has shown that CSF oscillations increase with age, while the ratio between the CSF Oscillation in the aqueduct and the spinal canal is constant. Our aim was to test whether the CSF hydrodynamic can bring complementary information to study pediatric population with an increase of the CSF volume. Material and Method: Forty three patients, newborns and children (mean age: 31 ± 32 months; 5 days - 111 months) with an intracranial CSF volume increase (ventricular or/and subarachnoid spaces) underwent a morphological MRI along with cine PC-MRI to quantify CSF oscillations. We defined a ratio of the ventricular area to that of the intracranial subarachnoid spaces (CSFratio). We also determined an index called CSFdynamic, which equals the CSF aqueduct stroke volume (SVAq) divided by the cervical stroke volume (SVC2C3) at the level C2C3 in the spine. RESULTS: Twenty-three patients presented only ventricular dilatation: CSFdynamic = 20 ± 25; CSFratio: 120 ± 151; with no significant correlation, (rs = 0.152, p = 0.48). Sixteen patients presented both ventricular and subarachnoid space dilations: CSFdynamic = 18 ± 17; CSFratio = 1.67 ± 0.81; with significant positive correlation (rs = 0.5911 p = 0.016). CONCLUSIONS: In pediatric population, the absence of correlation between the dynamic of the CSF and its volume shows that the CSF oscillation does not result only of the size of the ventricles and/or the subarachnoid spaces. The CSF oscillations bring complementary information concerning the active aspect of the CSF

Cerebral arterial flow dynamics during systole and diastole phases in young and older healthy adults

Abstract Background Since arterial flow is the leading actor in neuro-fluids flow dynamics, it might be interesting to assess whether it is meaningful to study the arterial flow waveform in more detail and whether this provides new important information. Few studies have focused on determining the influence of heart rate variation over time on the arterial flow curve. Therefore, this study aimed to evaluate cerebral arterial flow waveforms at extracranial and intracranial compartments in young and elderly healthy adults, also considering systole and diastole phases. Methods Cine phase-contrast magnetic resonance imaging (CINE-PC MRI) was performed on twenty-eight healthy young volunteers (HYV) and twenty healthy elderly volunteers (HEV) to measure arterial blood flows at the extracranial and intracranial planes. A semi-automated protocol using MATLAB scripts was implemented to identify the main representative points in the arterial flow waveforms. Representative arterial profiles were estimated for each group. Moreover, the effects of age and sex on flow times, amplitude-related parameters, and parameters related to systole and diastole phases were evaluated at the extracranial and intracranial compartments. Student’s t-test or Wilcoxon’s test (depending on the normality of the distribution) was used to detect significant differences. Results In HYVs, significant differences were observed between extracranial and intracranial levels in parameters related to the AP1 amplitude. Besides the detected differences in pulsatility index (extracranial: 0.92 ± 0.20 vs. 1.28 ± 0.33; intracranial: 0.79 ± 0.15 vs. 1.14 ± 0.18, p < .001) and average flow (715 ± 136 vs. 607 ± 125 ml/min, p = .008) between HYV and HEV, differences in the amplitude value of the arterial flow profile feature points were also noted. Contrary to systole duration (HYV: 360 ± 29 ms; HEV: 364 ± 47 ms), diastole duration presented higher inter-individual variability in both populations (HYV: 472 ± 145 ms; HEV: 456 ± 106 ms). Our results also showed that, with age, it is mainly the diastolic phase that changes. Although no significant differences in duration were observed between the two populations, the mean flow value in the diastolic phase was significantly lower in HEV (extracranial: 628 ± 128 vs. 457 ± 111 ml/min; intracranial: 599 ± 121 vs. 473 ± 100 ml/min, p < .001). No significant differences were observed in the arterial flow parameters evaluated between females and males in either HYV or HEV. Conclusion Our study provides a novel contribution on the influence of the cardiac cycle phases on cerebral arterial flow. The main contribution in this study concerns the identification of age-related alterations in cerebral blood flow, which occur mainly during the diastolic phase. Specifically, we observed that mean flow significantly decreases with age during diastole, whereas mean flow during systole is consistent

Hydrodynamic and Hemodynamic Interactions in Chronic Hydrocephalus

Background: During a cardiac cycle, intracranial pressure is related to arterial entry into the cranium and its interaction with intracranial compliance. The arterial inflow is compensated by intracranial compliance and, initially, the flushing of cerebrospinal fluid (CSF) into the cervical subarachnoid spaces. Our objective is to analyze the interactions between intracranial arteriovenous exchange and cerebrospinal fluid oscillations. Method: A total of 23 patients (73 ± 8 years) with suspected chronic hydrocephalus (CH) underwent an infusion test and phase-contrast MRI. Rout is an important factor in the diagnosis of CH. Patients were divided into 2 populations: probableCH (Rout: resistance to CSF outflow) (Rout > 12 mmHg/mL/min, 13 patients) and unlikelyCH (Rout vasc) and CSF (CSF stroke volume at upper cervical level: SVCSF) volume variations during the cardiac cycle. Results: In the whole population, we observed a significant correlation between SVvasc and SVCSF (R2 = 0.43; p = 0.0007). In the population unlikelyCH, this correlation was significant (R2 = 0.76; p = 0.001). In the population probableCH, this correlation was not significant (R2 = 0.17, p = 0.16). Conclusions: These results show that the link between the compliance of the oscillating CSF and the abrupt arterial inflow seems to be altered in CH. CSF oscillations between intracranial and cervical fluid spaces limit the impact of the abrupt arterial inflow

Procoagulant properties of OKT3 at the monocyte level: Inhibition by pentoxifylline

SCOPUS: cp.jinfo:eu-repo/semantics/publishe

Hemodynamic and Hydrodynamic Pathophysiology in Chiari Type 1 Malformations: Towards Understanding the Genesis of Syrinx

Background: The pathophysiology of this association of type 1 Chiari malformation (CM1) and syrinxes is still unknown. There is an alteration in the dynamics of neurofluids (cerebrospinal fluid, arterial and venous blood) during the cardiac cycle in CM1. Our objective is to quantify CSF or arterial blood or venous blood flow in patients with Chiari syndrome (CS) with and without syrinxes using phase-contrast MRI (PCMRI). Methods: We included 28 patients with CM1 (9 with syrinxes, 19 without). Morphological MRI with complementary PCMRI sequences was performed. We analyzed intraventricular CSF, subarachnoid spaces CSF, blood, and tonsillar pulsatility. Results: There is a highly significant correlation (p < 0.001) between cerebral blood flow, cerebral vascular expansion volume and venous drainage distribution. Venous drainage distribution is significantly inversely correlated with oscillatory CSF volume at the level of the foramen magnum plane [−0.37 (0.04)] and not significantly correlated at the C2C3 level [−0.37 (0.05)] over our entire population. This correlation maintained the same trend in patients with syrinxes [−0.80 (<0.01)] and disappeared in patients without a syrinx [−0.05 (0.81)]. Conclusion: The distribution of venous drainage is an important factor in intracranial homeostasis. Impaired venous drainage would lead to greater involvement of the CSF in compensating for arterial blood influx, thus contributing to syrinx genesis