Influence of Genetic Variations on Levels of Inflammatory Markers of Healthy Subjects at Baseline and One Week after Clopidogrel Therapy; Results of a Preliminary Study

International audienceWe aimed to assess the association between the most common polymorphisms of cytochrome P450 (CYP) epoxygenases on the plasma levels of inflammatory markers in a population of healthy subjects. We also sought to determine whether CYP2C19*2 polymorphism is associated with the anti-inflammatory response to clopidogrel. In a population of 49 healthy young males, the baseline plasma levels of inflammatory markers including C-reactive protein, haptoglobin, orosomucoid acid, CD-40 were compared in carriers vs. non-carriers of the most frequent CYP epoxygenase polymorphisms: CYP2C9*2, CYP2C9*3, CYP2C19*2, CYP2C8*2 and CYP2J2*7. Also, the variation of inflammatory markers from baseline to 7 days after administration of 75 mg per day of clopidogrel were compared in carriers vs. non-carriers of CYP2C19* allele and also in responders vs. hypo-responders to clopidogrel, determined by platelet reactivity tests. There was no significant association between epoxygenase polymorphisms and the baseline levels of inflammatory markers. Likewise, CYP2C19* allele was not associated with anti-inflammatory response to clopidogrel. Our findings did not support the notion that the genetic variations of CYP epoxygenases are associated with the level of inflammatory markers. Moreover, our results did not support the hypothesis that CYP2C19*2 polymorphism is associated with the variability in response to the anti-inflammatory properties of clopidogrel

Curative anticoagulation prevents endothelial lesion in COVID‐19 patients

International audienceBackground: Coronavirus disease-2019 (COVID-19) has been associated with cardiovascular complications and coagulation disorders.Objectives: To explore the coagulopathy and endothelial dysfunction in COVID-19 patients.Methods: The study analyzed clinical and biological profiles of patients with suspected COVID-19 infection at admission, including hemostasis tests and quantification of circulating endothelial cells (CECs).Results: Among 96 consecutive COVID-19-suspected patients fulfilling criteria for hospitalization, 66 were tested positive for SARS-CoV-2. COVID-19-positive patients were more likely to present with fever (P = .02), cough (P = .03), and pneumonia at computed tomography (CT) scan (P = .002) at admission. Prevalence of D-dimer >500 ng/mL was higher in COVID-19-positive patients (74.2% versus 43.3%; P = .007). No sign of disseminated intravascular coagulation were identified. Adding D-dimers >500 ng/mL to gender and pneumonia at CT scan in receiver operating characteristic curve analysis significantly increased area under the curve for COVID-19 diagnosis. COVID-19-positive patients had significantly more CECs at admission (P = .008) than COVID-19-negative ones. COVID-19-positive patients treated with curative anticoagulant prior to admission had fewer CECs (P = .02) than those without. Interestingly, patients treated with curative anticoagulation and angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers had even fewer CECs (P = .007).Conclusion: Curative anticoagulation could prevent COVID-19-associated coagulopathy and endothelial lesion

Apport de la géophysique terrestre (géo-radar, sismique réfraction) pour l’aide à la gestion du trait de côte.

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Evolution of platelet functions in cirrhotic patients undergoing liver transplantation: A prospective exploration over a month.

This prospective observational study was designed to analyze platelet functions across time in 50 patients scheduled for liver transplantation (LT) secondary to decompensated cirrhosis or hepatocellular carcinoma. Platelet functions were assessed before LT (pre-LT), one week (D7) and 1 month (D28) after LT. Platelet count significantly increased from pre-LT time to day 28 as well as circulating CD34+hematopoietic stem cells. To avoid any influence of platelet count on assays, platelet function was evaluated on platelet-rich-plasma adjusted to pre-LT platelet count. Although platelet secretion potential did not differ between time-points, as evaluated by the expression of CD62P upon strong activation, platelet aggregation in response to various agonists significantly increased along time, however with no concomitant increase of circulating markers of platelet activation: platelet microvesicles, platelet-leukocyte complexes, soluble CD40L and soluble CD62P. In the multivariate analysis, hepatic function was associated with platelet count and function. A lower platelet aggregation recovery was correlated with Child C score. History of thrombosis or bleeding was associated with respective higher or lower values of platelet aggregation. This longitudinal analysis of platelet functions in LT patients showed an improvement of platelet functions along time together with platelet count increase, with no evidence of platelet hyperactivation at any time-point

Commentaire romand de la Loi fédérale sur la protection des données

Dans la lignée des commentaires article par article de tradition germanique, mais dans une perspective spécifique à la Suisse francophone, la collection des Commentaires romands propose des ouvrages de référence à l’usage de la pratique, de la magistrature et de la recherche. Trente ans après son entrée en vigueur, la Loi fédérale sur la protection des données (LPD) a fait l’objet d’une révision totale pour la mettre en conformité avec le droit international et garantir aux personnes faisant l’objet d’un traitement de données en Suisse une protection équivalente à celle qui prévaut dans les pays voisins. Ce commentaire article par article de la nouvelle LPD, entrée en vigueur le 1er septembre 2023, tient compte des derniers développements jurisprudentiels et doctrinaux, y compris les nombreuses recommandations des autorités de surveillance européennes lorsque cela est pertinent. Fidèle à l’esprit de la collection, il offre à son lecteur, praticien comme chercheur, des réponses claires et précises

Neura: a specialized large language model solution in neurology

Large language models’ (LLM) ability in natural language processing holds promise for diverse applications, yet their deployment in fields such as neurology faces domain-specific challenges. Hence, we introduce Neura: a scalable, explainable solution to specialize LLM. Blindly evaluated on a select set of five complex clinical cases compared to a cohort of 13 neurologists, Neura achieved normalized scores of 86.17% overall, 85% for differential diagnoses, and 88.24% for final diagnoses (55.11%, 46.15%, and 70.93% for neurologists) with rapid response times of 28.8 and 19 seconds (9 minutes and 37.2 seconds and 8 minutes and 51 seconds for neurologists) while consistently providing relevant, accurately cited information. These findings support the emerging role of LLM-driven applications to articulate human-acquired and integrated data with a vast corpus of knowledge, augmenting human experiential reasoning for clinical and research purposes

Evolution of platelet functions in cirrhotic patients undergoing liver transplantation: A prospective exploration over a month - Fig 2

<p><b>(A) Boxplots for platelet count and (B) CD34+ hematopoietic progenitor stem cells at different time points.</b> Horizontal lines show median values and the 25–75 percentiles. Pre LT: pre liver transplantation.</p

Baseline characteristics of the study population at inclusion and quality of the liver graft.

<p>Baseline characteristics of the study population at inclusion and quality of the liver graft.</p