43 research outputs found
Ătude comparative tensiomĂštre automatique versus doppler Ă ultrasons dans la mesure de lâindex de pression systolique Ă la cheville (Ipsc)
ObjectifLâĂ©valuation de lâindex de pression systolique Ă la cheville (IPSC) est la mĂ©thode non invasive la plus simple de dĂ©pistage de lâartĂ©riopathie des membres infĂ©rieurs (AOMI) mais reste peu usitĂ©e en pratique courante, car elle est chronophage, implique un Ă©quipement et une formation appropriĂ©s. Le but de notre Ă©tude est dâĂ©valuer la validitĂ© et la fiabilitĂ© de la mesure de lâIPSC Ă lâaide dâun tensiomĂštre automatique par comparaison avec les rĂ©sultats obtenus par doppler continu, mĂ©thode de rĂ©fĂ©rence. MĂ©thodes Les patients de 65 ans et plus hospitalisĂ©s au CHU dâAngers de juillet 2008 à mars 2009 en mĂ©decine interne et nâayant pas dâAOMI documentĂ©e au moment de lâinclusion ont participĂ© Ă lâĂ©tude. Les critĂšres dâexclusion Ă©taient la prĂ©sence dâune fibrillation auriculaire et une incompressibilitĂ© des artĂšres distales des membres infĂ©rieurs. Pour chaque patient, lâIPSC a Ă©tĂ© Ă©valuĂ© par tensiomĂštre automatique et par la mĂ©thode Doppler de rĂ©fĂ©rence ; ces mesures Ă©tant faites par le mĂȘme examinateur. La concordance entre les deux mesures Ă©tait apprĂ©ciĂ©e par la mĂ©thode de Bland et Altman et le coefficient de corrĂ©lation intraclasse (ICC). RĂ©sultats Sur 287 patients participant Ă lâĂ©tude, 221 ont Ă©tĂ©s inclus. Cinquante-six (25 %) de ces patients avaient un IPSC < 0,90. La concordance entre les deux mĂ©thodes Ă©tait mĂ©diocre : ICC Ă 0,35 ± 0,08 et moyenne Ă 0,08 ± 0,26 selon la mĂ©thode de Bland et Altman. Conclusion La mĂ©thode de dĂ©pistage de lâAOMI par mesure de lâIPSC par tensiomĂštre automatique ne peut ĂȘtre retenue comme une alternative Ă la mĂ©thode Doppler
Roughness at the depinning threshold for a long-range elastic string
In this paper, we compute the roughness exponent zeta of a long-range elastic
string, at the depinning threshold, in a random medium with high precision,
using a numerical method which exploits the analytic structure of the problem
(`no-passing' theorem), but avoids direct simulation of the evolution
equations. This roughness exponent has recently been studied by simulations,
functional renormalization group calculations, and by experiments (fracture of
solids, liquid meniscus in 4He). Our result zeta = 0.390 +/- 0.002 is
significantly larger than what was stated in previous simulations, which were
consistent with a one-loop renormalization group calculation. The data are
furthermore incompatible with the experimental results for crack propagation in
solids and for a 4He contact line on a rough substrate. This implies that the
experiments cannot be described by pure harmonic long-range elasticity in the
quasi-static limit.Comment: 4 pages, 3 figure
Width distribution of contact lines on a disordered substrate
We have studied the roughness of a contact line of a liquid meniscus on a
disordered substrate by measuring its width distribution. The comparison
between the measured width distribution and the width distribution calculated
in previous works, extended here to the case of open boundary conditions,
confirms that the Joanny-de Gennes model is not sufficient to describe the
dynamics of contact lines at the depinning threshold. This conclusion is in
agreement with recent measurements which determine the roughness exponent by
extrapolation to large system sizes.Comment: 4 pages, 3 figure
Antithrombotic effects of hydroxychloroquine in primary antiphospholipid syndrome patients
International audienc
Impact of front line relative dose intensity for methotrexate and comorbidities in immunocompetent elderly patients with primary central nervous system lymphoma
Primary central nervous system lymphomas (PCNSL) are non-Hodgkin lymphomas strictly localized to the CNS, occurring mainly in elderly patients with comorbidities. Current treatment in fit patients relies on high-dose methotrexate and high-dose cytarabine. The aim of this study was to evaluate the efficacy and feasibility of this treatment in elderly patients and to assess potential prognostic factors associated with survival. We conducted a retrospective study in two centers between January 2008 and September 2015 including 35 elderly immunocompetent patients who received first-line treatment with high-dose methotrexate. With a median follow-up of 19.8Â months (range: 1.7-73.4Â months), median overall survival (OS) was 39.5Â months (95% confidence interval (95% CI): 18.3-60.7) and median progression-free survival (PFS) was 25.8Â months (95% CI: 5.2-46.4). In univariate analysis, administration of high-dose cytarabine and achieving a relative dose intensity for methotrexate >â75% were associated with increased OS (pâ=â0.006 and pâ=â0.003, respectively) and PFS (pâ=â0.003 and pâ=â0.04, respectively) whereas comorbidities, defined by a CIRS-G score â„â8, were associated with decreased OS and PFS (pâ=â0.02 and pâ=â0.04, respectively). A high MSKCC score was associated with decreased OS (pâ=â0.02). In multivariate analysis, administration of high-dose cytarabine was associated with increased OS and PFS (pâ=â0.02 and pâ=â0.007, respectively). Comorbidities and relative dose intensity for methotrexate are important for the prognosis of elderly patients with PCNSL. These results must be confirmed in prospective trials
Splenectomy and/or cyclophosphamide as salvage therapies in thrombotic thrombocytopenic purpura: the French TMA Reference Center experience: SALVAGE THERAPIES IN SEVERE TTP
BACKGROUND: The objective was to assess the efficacy and safety of splenectomy and cyclophosphamide as salvage therapies in severe thrombotic thrombocytopenic purpura (TTP).STUDY DESIGN AND METHODS: During a 10-year period, patients who did not improve with plasma exchanges, steroids, vincristine, and/or rituximab were considered for splenectomy or cyclophosphamide. Patients with a documented severe (<10% of normal value) acquired ADAMTS13 deficiency are reported here. RESULTS: Eighteen patients with a severe acquired ADAMTS13 deficiency required a salvage therapy. Thirteen patients had a splenectomy 19 (interquartile range [IQR], 10-51) days after TTP diagnosis. One patient died the day after splenectomy. The remaining patients improved platelets (PLTs) until Day 6, along with a rapid and major lactate dehydrogenase improvement. Six patients, however, subsequently experienced a transient worsening. Durable PLT count recovery in survivors was observed within 13 (IQR, 11.5-25.5) days. Postoperative complications included thromboembolic events (two cases) and infections (five cases). Five patients received pulses of cyclophosphamide 12 (IQR, 12-15) days after TTP diagnosis. All patients recovered PLTs 10 (IQR, 9-24) days after the first pulse and two experienced a transient worsening. Three patients experienced infections. Three relapses occurred 5 months, 2.5 years, and 4.5 years after splenectomy and one relapse occurred 3.5 years after cyclophosphamide. After a 2.5 (IQR, 0.75-6.2)-year follow-up, the overall survival was 94%. CONCLUSION: Cyclophosphamide and splenectomy provide comparable high remission rates in severe TTP with acceptable side effects and should be considered in the more severe patients who do not improve with other therapies
Genome-wide meta-analysis of common variant differences between men and women
The male-to-female sex ratio at birth is constant across world populations with an average of 1.06 (106 male to 100 female live births) for populations of European descent. The sex ratio is considered to be affected by numerous biological and environmental factors and to have a heritable component. The aim of this study was to investigate the presence of common allele modest effects at autosomal and chromosome X variants that could explain the observed sex ratio at birth. We conducted a large-scale genome-wide association scan (GWAS) meta-analysis across 51 studies, comprising overall 114 863 individuals (61 094 women and 53 769 men) of European ancestry and 2 623 828 common (minor allele frequency >0.05) single-nucleotide polymorphisms (SNPs). Allele frequencies were compared between men and women for directly-typed and imputed variants within each study. Forward-time simulations for unlinked, neutral, autosomal, common loci were performed under the demographic model for European populations with a fixed sex ratio and a random mating scheme to assess the probability of detecting significant allele frequency differences. We do not detect any genome-wide significant (P < 5 Ă 10â8) common SNP differences between men and women in this well-powered meta-analysis. The simulated data provided results entirely consistent with these findings. This large-scale investigation across âŒ115 000 individuals shows no detectable contribution from common genetic variants to the observed skew in the sex ratio. The absence of sex-specific differences is useful in guiding genetic association study design, for example when using mixed controls for sex-biased trait