92 research outputs found

    Activated protein C increases sensitivity to vasoconstriction in rabbit Escherichia coli endotoxin-induced shock

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    INTRODUCTION: The aim of this study was to investigate the effects of activated protein C (aPC) on vascular function, endothelial injury, and haemostasis in a rabbit endotoxin-induced shock model. METHOD: This study included 22 male New Zealand rabbits weighing 2.5 to 3 kg each. In vitro vascular reactivity, endothelium CD31-PECAM1 immunohistochemistry, plasma coagulation factors and monocyte tissue factor (TF) expression were performed 5 days (D5) after onset of endotoxic shock (initiated by 0.5 mg/kg intravenous bolus of Escherichia coli lipopolysaccharide (LPS)) with or without treatment with aPC injected as an intravenous 2 mg/kg bolus 1 hour after LPS (LPS+aPC group and LPS group, respectively). RESULTS: LPS decreased the sensitivity to phenylephrine (PE) in aortic rings without endothelium (E-) when compared to E- rings from the control group (p < 0.05). This was abolished by N(G)-nitro-L-arginine methyl ester and not observed in E- rings from aPC-treated rabbits. Although aPC failed to decrease monocyte TF expression in endotoxinic animals at D5, aPC treatment restored the endothelium-dependent sensitivity in response to PE (2.0 ± 0.2 μM in rings with endothelium (E+) versus 1.0 ± 0.2 μM in E- rings (p < 0.05) in the LPS+aPC group versus 2.4 ± 0.3 μM in E+ rings versus 2.2 ± 0.2 μM in E- rings (p value not significant), in the LPS group). Endotoxin-induced de-endothelialisation was reduced by aPC at D5 (28.5 ± 2.3% in the LPS+aPC group versus 40.4 ± 2.4% in the LPS group, p < 0.05). CONCLUSION: These data indicate that aPC increased the sensitivity to a vasoconstrictor agent (PE) associated with restoration of endothelial modulation, and protected against endothelial histological injury in endotoxin-induced shock. It failed to inhibit TF expression at D5 after LPS injection

    Laboratoire d’analyse secondaire et des méthodes appliquées à la sociologie – Institut du longitudinal

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    Michel Forsé, directeur de recherche au CNRS avec Yaël Brinbaum, Alain Degenne, Irène Fournier, Marie-Odile Lebeaux, Florence Maillochon, Marion Selz, Louis-André Vallet, chercheurs ou ingénieurs du CNRS au LASMAS-IdL Méthodes quantitatives en sociologie Conduit sous les auspices du LASMAS-IdL et partie prenante du DEA « Sociologie », cet enseignement répond à une demande grandissante de formation en méthodologie quantitative pour les sciences sociales. Il a pour objet de permettre à ceux qui..

    A cross-sectional study to assess job strain of emergency healthcare workers by Karasek questionnaire: The SEEK study

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    BackgroundEmergency healthcare workers (eHCWs) are particularly at risk of stress, but data using the gold standard questionnaire of Karasek are scarce. We assessed the level of stress of eHCWs and aimed to compare it with the general population.MethodsThis is a cross-sectional nationwide study in French Emergency Departments (EDs), using the job-content questionnaire of Karasek, compared with the 25,000 answers in the French general population (controls from the SUMER study). The descriptions of job demand, job control, and social support were described as well as the prevalence of job strain and isostrain. Putative factors were searched using mixed-method analysis.ResultsA total of 166 eHCWs (37.9 ± 10.5 years old, 42% men) from five French EDs were included: 53 emergency physicians and 104 emergency paramedics, compared to 25,000 workers with other occupations. Job demand was highest for physicians (28.3 ± 3.3) and paramedics (25.9 ± 3.8), compared to controls (36.0 ± 7.2; p &lt; 0.001). Job control was the lowest for physicians (61.2 ± 5.8) and paramedics (59.1 ± 6.8), compared to controls (70.4 ± 11.7; p &lt; 0.001). Mean social support did not differ between groups (23.6 ± 3.4 for physicians, 22.6 ± 2.9 for paramedics, and 23.7 ± 3.6 for controls). The prevalence of job strain was massively higher for physicians (95.8%) and paramedics (84.8%), compared to controls (23.9%; p &lt; 0.001), as well as for isostrain (45.1% for physicians, 56.8% for paramedics, and 14.3% for controls, p &lt; 0.001). We did not find any significant impact of sociodemographic characteristics on job control, job demand, or social support.ConclusionEmergency healthcare workers have a dramatic rate of job strain, necessitating urgent promotion of policy to take care of them

    Three-dimensional glass-derived scaffolds for bone tissue engineering: current trends and forecasts for the future

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    Gitelman-Like Syndrome Caused by Pathogenic Variants in mtDNA

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    Background: Gitelman syndrome is the most frequent hereditary salt-losing tubulopathy characterized by hypokalemic alkalosis and hypomagnesemia. Gitelman syndrome is caused by biallelic pathogenic variants in SLC12A3, encoding the Na+-Cl− cotransporter (NCC) expressed in the distal convoluted tubule. Pathogenic variants of CLCNKB, HNF1B, FXYD2, or KCNJ10 may result in the same renal phenotype of Gitelman syndrome, as they can lead to reduced NCC activity. For approximately 10 percent of patients with a Gitelman syndrome phenotype, the genotype is unknown. Methods: We identified mitochondrial DNA (mtDNA) variants in three families with Gitelman-like electrolyte abnormalities, then investigated 156 families for variants in MT-TI and MT-TF, which encode the transfer RNAs for phenylalanine and isoleucine. Mitochondrial respiratory chain function was assessed in patient fibroblasts. Mitochondrial dysfunction was induced in NCC-expressing HEK293 cells to assess the effect on thiazide-sensitive 22Na+ transport. Results: Genetic investigations revealed four mtDNA variants in 13 families: m.591C>T (n=7), m.616T>C (n=1), m.643A>G (n=1) (all in MT-TF), and m.4291T>C (n=4, in MT-TI). Variants were near homoplasmic in affected individuals. All variants were classified as pathogenic, except for m.643A>G, which was classified as a variant of uncertain significance. Importantly, affected members of six families with an MT-TF variant additionally suffered from progressive chronic kidney disease. Dysfunction of oxidative phosphorylation complex IV and reduced maximal mitochondrial respiratory capacity were found in patient fibroblasts. In vitro pharmacological inhibition of complex IV, mimicking the effect of the mtDNA variants, inhibited NCC phosphorylation and NCC-mediated sodium uptake. Conclusion: Pathogenic mtDNA variants in MT-TF and MT-TI can cause a Gitelman-like syndrome. Genetic investigation of mtDNA should be considered in patients with unexplained Gitelman syndrome-like tubulopathies

    Étude diagnostique d’un protocole de dessin d’items évaluant la mémoire sémantique chez des patients suspectés de présenter une maladie neurodégénérative

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    Semantic Memory (SM) consists in overall knowledges that allows us to understand our environment. Semantic Memory Disorders are mostly encounterd in neurodegenerative diseases, mostly in Frontotemporal Lobar Dementia (FTLD) such as the semantic variant of primary progressive aphasia (PPAvs), the comportemental-semantic variant of Frontotemporal Lobar Dementia (FTLDcs) but also in Alzheimer’s Disease (AD). Most of semantic memory tests rely on verbal modality. Thus, semantic memory evaluation can interfere with language skills. The item drawing task has been developed in Rouen to evaluate semantic memory in non-verbal production mode. The main objective of this study was to establish a cut-off value, distinguishing patients with TS from those without, after having set up a rating guide allowing it to be reproducible. A cut-off value of 43/49 (sensitivity rate of 100% and Negative Predictive Value of 100%), enables to detect every patient with semantic memory deficits (True Positive). Concerning interrater reliability, intraclass coefficient reaches 98,9%. Further studies could include more participants in order to improve the test characteristics.La mémoire sémantique (MS) est définie comme l’ensemble des connaissances du monde qui nous entoure et nous permet de mettre du sens sur notre environnement. Les troubles sémantiques (TS) sont majoritairement retrouvés dans le cadre de certaines typologies de dégénérescence lobaire fronto-temporale (DLFT), comme l’aphasie progressive primaire variant sémantique (APPvs), la dégénérescence lobaire fronto temporale variant sémantique-comportemental (DLFTsc) mais également dans le cadre de la maladie d’Alzheimer (MA). Actuellement, les tests proposent principalement une évaluation en modalité de production verbale. L’altération du langage oral chez certains patients peut biaiser l’interprétation de ces tests. Le test de dessin d’items de mémoire a été développé à Rouen pour évaluer la mémoire sémantique en modalité de production non verbale. L’objectif de cette étude était d’établir une valeur seuil, permettant de dépister les patients atteints d’un TS, après avoir mis en place un guide de cotation pour qu’elle puisse être reproductible. La valeur seuil de 43/49 avec un taux de sensibilité à 100% et une Valeur Prédictive Négative (VPN) à 100%, lui permet donc de repérer tous les Vrais Positifs (VP). Concernant la reproductibilité inter-cotateurs, le coefficient intra-classe est de 98,9%. La poursuite de cette étude diagnostique permettra d’augmenter le nombre de participants tout en confirmant les seuils de sévérité des TS
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