155 research outputs found
Prise en charge de lâhyperparathyroidie primaire : a propos de 25 cas et revue de la littĂ©rature
Objectif : Les auteurs rapportent leur expĂ©rience dans la prise en charge de lâhyperparathyroĂŻdie primaire (HPTP) et comparent leurs rĂ©sultats par rapport aux donnĂ©es de la littĂ©rature en discutant les avantages potentiels des diffĂ©rentes techniques chirurgicales. MatĂ©riel et mĂ©thodes : Il sâagit dâune Ă©tude rĂ©trospective Ă propos de 25 patients colligĂ©s sur 8 ans (1998-2005). Tous les patients ont bĂ©nĂ©ficiĂ© dâune Ă©chographie cervicale, dâun bilan rĂ©nal et dâun dosage de la calcĂ©mie et de la parathormonĂ©mie (PTH). Une TDM cervicale a Ă©tĂ© pratiquĂ©e dans 8 cas et une IRM dans 3 cas. Une scintigraphie Ă la tĂ©trofosmine a Ă©tĂ© rĂ©alisĂ©e dans 10 cas, et Ă double isotope (thallium 201-technĂ©tium 99) dans 2 cas. Une cervicotomie avec exploration bilatĂ©rale systĂ©matique des 2 loges thyroĂŻdiennes a Ă©tĂ© pratiquĂ©e dans tous les cas. En postopĂ©ratoire, la surveillance a Ă©tĂ© clinique et biologique avec un recul moyen de 22 mois. RĂ©sultats : La calcĂ©mie Ă©tait Ă©levĂ©e chez 23 patients et la PTH dans tous les cas. LâĂ©chographie a dĂ©tectĂ© une hypertrophie dâune glande parathyroĂŻde chez 14 patients (56%) et de 2 glandes chez 1 seul patient. La TDM cervicale a permis de localiser la lĂ©sion dans 5 cas. LâIRM Ă©tait normale dans les 3 cas oĂč elle a Ă©tĂ© pratiquĂ©e. La scintigraphie a montrĂ© une hyperfixation dans 8 cas. Une exĂ©rĂšse dâadĂ©nomes a Ă©tĂ© pratiquĂ©e dans 92% et une parathyroĂŻdectomie subtotale dans 8% des cas. Le taux de guĂ©rison Ă©tait de 88% aprĂšs premiĂšre intervention. Une reprise chirurgicale avec exĂ©rĂšse dâadĂ©nome a Ă©tĂ© pratiquĂ©e chez 2 patients (8%). Par ailleurs aucune complication nâa Ă©tĂ© notĂ©e en postopĂ©ratoire. Conclusion : La chirurgie parathyroĂŻdienne classique donne de bons rĂ©sultats avec des taux de guĂ©rison Ă©levĂ©s et un taux de morbiditĂ© global faible. Ces rĂ©sultats sont comparables avec ceux de la littĂ©rature. La chirurgie mini-invasive donne des rĂ©sultats semblables mais impose des impĂ©ratifs techniques, une imagerie performante et des patients rigoureusement sĂ©lectionnĂ©s.Mots-clĂ©s : hypercalcĂ©mie, hyperparathyroĂŻdie primaire, hyperparathormonĂ©mie, chirurgie parathyroĂŻdienn
Myopericarditis diagnosed by a 64-slice coronary CT angiography "triple rule out" protocol
We report a case of myopericarditis in a 30-year-old male complaining of shortness of breath. In an emergency department (ED) setting, the symptoms of myopericarditis may overlap with many disease entities and can be a challenging diagnosis to make. However, with the use of a 64-section coronary CT angiography in a âtriple rule outâ (TRO) protocol, we were able to detect a large pericardial effusion surrounding the heart and moderate global hypokinesis in the setting of normal-sized heart chambers and normal coronary arteries. We were further able to exclude pulmonary embolism and thoracic dissection. This is the first reported case of diagnosing myopericarditis using a TRO protocol. It demonstrates the usefulness of TRO in making an emergent diagnosis of myopericarditis while excluding other life-threatening diseases that can lead to earlier appropriate ED disposition and care
Recent advances in cardio-oncology:a report from the 'Heart Failure Association 2019 and World Congress on Acute Heart Failure 2019'
While anti-cancer therapies, including chemotherapy, immunotherapy, radiotherapy, and targeted therapy, are constantly advancing, cardiovascular toxicity has become a major challenge for cardiologists and oncologists. This has led to an increasing demand of cardio-oncology units in Europe and a growing interest of clinicians and researchers. The Heart Failure 2019 meeting of the Heart Failure Association of the European Society of Cardiology in Athens has therefore created a scientific programme that included four dedicated sessions on the topic along with several additional lectures. The major points that were discussed at the congress included the implementation and delivery of a cardio-oncology service, the collaboration among cardio-oncology experts, and the risk stratification, prevention, and early recognition of cardiotoxicity. Furthermore, sessions addressed the numerous different anti-cancer therapies associated with cardiotoxic effects and provided guidance on how to treat cancer patients who develop cardiovascular disease before, during, and after treatment
Analysis of two larval-pupal parasitoids (Hymenoptera, Braconidae) in the biological control of Ceratitis capitata (Wiedemann) in Spanish Mediterranean areas
The Mediterranean fruit fly, Ceratitis capitata (Diptera: Tephritidae), is
considered a key pest in fresh fruit and citrus production in the Mediterranean
Bassin. Nowadays, it is being studied the use of several ecological methods
against this pest in some Mediterranean countries (Spain, Morocco and Tunisia),
like the Sterile Insect Technique (SIT), the classical biological control (CBC) and
the search for native parasitoids. Two exotic larval-pupal parasitoids of fruit-flies
have been imported by the IVIA to Spain: Diachasmimorpha tryoni and D.
longicaudata. As it occurs in other countries, in Spain it is being studied the
combined use of the SIT and overflooding releases of parasitoids to combat Medfiy
populations. To achieve this, only one parasitoid species is usually mass reared
and released. Over the last two years we have been analyzing the competitiveness
of D. longicaudata and D. tryoni in order to choose the species to be used together
with the SIT for the integrated control of the Medfl
Treatments targeting inotropy
Acute heart failure (HF) and in particular, cardiogenic shock are associated with high morbidity and mortality. A therapeutic dilemma is that the use of positive inotropic agents, such as catecholamines or phosphodiesterase-inhibitors, is associated with increased mortality. Newer drugs, such as levosimendan or omecamtiv mecarbil, target sarcomeres to improve systolic function putatively without elevating intracellular Ca2+. Although meta-analyses of smaller trials suggested that levosimendan is associated with a better outcome than dobutamine, larger comparative trials failed to confirm this observation. For omecamtiv mecarbil, Phase II clinical trials suggest a favourable haemodynamic profile in patients with acute and chronic HF, and a Phase III morbidity/mortality trial in patients with chronic HF has recently begun. Here, we review the pathophysiological basis of systolic dysfunction in patients with HF and the mechanisms through which different inotropic agents improve cardiac function. Since adenosine triphosphate and reactive oxygen species production in mitochondria are intimately linked to the processes of excitation-contraction coupling, we also discuss the impact of inotropic agents on mitochondrial bioenergetics and redox regulation. Therefore, this position paper should help identify novel targets for treatments that could not only safely improve systolic and diastolic function acutely, but potentially also myocardial structure and function over a longer-term
Biomineralization of amorphous Fe-, Mn- and Si-rich mineral phases by cyanobacteria under oxic and alkaline conditions
Iron and manganese are poorly soluble elements in oxic and alkaline solutions, whereas they are much more soluble under anoxic conditions. As a
result, the formation of authigenic mineral phases rich in Fe and/or Mn has traditionally been viewed as diagnostic of global or local
anoxic conditions. Here we reveal that some specific cyanobacteria of very small size (<â2â”m, i.e., picocyanobacteria) can
biomineralize abundant, authigenic Fe(III)-, Mn(IV)- and Si-rich amorphous phases under oxic conditions in an alkaline lake in
Mexico. The resulting biominerals cluster as small globules arranged as rings around the division septum of cyanobacterial cells. These rings are
enveloped within an organic, likely polysaccharidic envelope and are partially preserved, at least morphologically, upon sedimentation. Based on
their 16S rDNA sequence, these cyanobacteria were affiliated with the Synechococcales order. The high Fe and Mn enrichment of the
biominerals questions the systematic inference of anoxic conditions based on their detection. Moreover, this process scavenges iron from the water
column, an overlooked biological contribution to the Fe cycle. Finally, it reveals a new case of controlled biomineralization of
Si-rich phases by bacteria.</p
The effect of intravenous ferric carboxymaltose on health-related quality of life in iron-deficient patients with acute heart failure: the results of the AFFIRM-AHF study
Aims: Patients with heart failure (HF) and iron deficiency experience poor health-related quality of life (HRQoL). We evaluated the impact of intravenous (IV) ferric carboxymaltose (FCM) vs. placebo on HRQoL for the AFFIRM-AHF population. Methods and results: The baseline 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ-12), which was completed for 1058 (535 and 523) patients in the FCM and placebo groups, respectively, was administered prior to randomization and at Weeks 2, 4, 6, 12, 24, 36, and 52. The baseline KCCQ-12 overall summary score (OSS) mean ± standard error was 38.7 ± 0.9 (FCM group) and 37.1 ± 0.8 (placebo group); corresponding values for the clinical summary score (CSS) were 40.9 ± 0.9 and 40.1 ± 0.9. At Week 2, changes in OSS and CSS were similar for FCM and placebo. From Week 4 to Week 24, patients assigned to FCM had significantly greater improvements in OSS and CSS scores vs. placebo [adjusted mean difference (95% confidence interval, CI) at Week 4: 2.9 (0.5-5.3, P = 0.018) for OSS and 2.8 (0.3-5.3, P = 0.029) for CSS; adjusted mean difference (95% CI) at Week 24: 3.0 (0.3-5.6, P = 0.028) for OSS and 2.9 (0.2-5.6, P = 0.035) for CSS]. At Week 52, the treatment effect had attenuated but remained in favour of FCM. Conclusion: In iron-deficient patients with HF and left ventricular ejection fraction â€50% who had stabilized after an episode of acute HF, treatment with IV FCM, compared with placebo, results in clinically meaningful beneficial effects on HRQoL as early as 4 weeks after treatment initiation, lasting up to Week 24
Ferric carboxymaltose for iron deficiency at discharge after acute heart failure:a multicentre, double-blind, randomised, controlled trial
Background Intravenous ferric carboxymaltose has been shown to improve symptoms and quality of life in patients with chronic heart failure and iron deficiency. We aimed to evaluate the effect of ferric carboxymaltose, compared with placebo, on outcomes in patients who were stabilised after an episode of acute heart failure. Methods AFFIRM-AHF was a multicentre, double-blind, randomised trial done at 121 sites in Europe, South America, and Singapore. Eligible patients were aged 18 years or older, were hospitalised for acute heart failure with concomitant iron deficiency (defined as ferritin Findings Between March 21, 2017, and July 30, 2019, 1525 patients were screened, of whom 1132 patients were randomly assigned to study groups. Study treatment was started in 1110 patients, and 1108 (558 in the carboxymaltose group and 550 in the placebo group) had at least one post-randomisation value. 293 primary events (57.2 per 100 patient-years) occurred in the ferric carboxymaltose group and 372 (72.5 per 100 patient-years) occurred in the placebo group (rate ratio [RR] 0.79, 95% CI 0.62-1.01, p=0.059). 370 total cardiovascular hospitalisations and cardiovascular deaths occurred in the ferric carboxymaltose group and 451 occurred in the placebo group (RR 0.80, 95% CI 0.64-1.00, p=0.050). There was no difference in cardiovascular death between the two groups (77 [14%] of 558 in the ferric carboxymaltose group vs 78 [14%] in the placebo group; hazard ratio [HR] 0.96, 95% CI 0.70-1.32, p=0.81). 217 total heart failure hospitalisations occurred in the ferric carboxymaltose group and 294 occurred in the placebo group (RR 0.74; 95% CI 0.58-0.94, p=0.013). The composite of first heart failure hospitalisation or cardiovascular death occurred in 181 (32%) patients in the ferric carboxymaltose group and 209 (38%) in the placebo group (HR 0.80, 95% CI 0.66-0.98, p=0.030). Fewer days were lost due to heart failure hospitalisations and cardiovascular death for patients assigned to ferric carboxymaltose compared with placebo (369 days per 100 patient-years vs 548 days per 100 patient-years; RR 0.67, 95% CI 0.47-0.97, p=0.035). Serious adverse events occurred in 250 (45%) of 559 patients in the ferric carboxymaltose group and 282 (51%) of 551 patients in the placebo group. Interpretation In patients with iron deficiency, a left ventricular ejection fraction of less than 50%, and who were stabilised after an episode of acute heart failure, treatment with ferric carboxymaltose was safe and reduced the risk of heart failure hospitalisations, with no apparent effect on the risk of cardiovascular death
Tracking Membrane Protein Association in Model Membranes
Membrane proteins are essential in the exchange processes of cells. In spite of great breakthrough in soluble proteins studies, membrane proteins structures, functions and interactions are still a challenge because of the difficulties related to their hydrophobic properties. Most of the experiments are performed with detergent-solubilized membrane proteins. However widely used micellar systems are far from the biological two-dimensions membrane. The development of new biomimetic membrane systems is fundamental to tackle this issue
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