Relationship between CRP and hypofibrinolysis: Is this a possible mechanism to explain the association between CRP and outcome in critically ill patients?

BACKGROUND-: Endothelial cell dysfunction may be implicated in the development of multiple organ failure (MOF) by a number of mechanisms. Among these, altered fibrinolysis promotes fibrin deposition, which may create microvascular alterations during inflammation. Elevated concentrations of C-reactive protein (CRP), especially when these persist over time, are correlated with an increased risk of MOF and death. CRP may inhibit fibrinolysis by inducing plasminogen activator inhibitor-1 (PAI-1) release from human aortic endothelial cells. Moreover, the administration of recombinant CRP in volunteers may increase circulating PAI-1 levels. In this study, we tested the hypothesis that CRP is associated with hypofibrinolysis in intensive care patients with and without sepsis. METHODS-: We studied the association of inflammation and abnormal fibrinolysis in intensive care unit (ICU) patients with (n = 11) and without (n = 21) sepsis. The inflammatory response was assessed by serum concentration of C-reactive protein (CRP), a marker of the acute phase reaction, which increase rapidly in the inflammatory response, and the plasma fibrinolytic capacity was evaluated by the Euglobulin Clot Lysis Time (ECLT), determined by a new semi-automatic method. RESULTS-: ECLT was significantly higher in septic than non-septic patients (1104 ± 439 vs 665 ± 275 min; p = 0.002) and was significantly correlated with CRP concentration (R(2 )= 0.45; p < 0.001). In a multivariate analysis, CRP was the strongest predictor of ECLT (R(2 )= 0.51, F = 25.6, p < 0.001). In addition, the overall ICU length of stay was significantly correlated with CRP (R(2 )= 0.264, p = 0.003) and ECLT (R(2 )= 0.259, p = 0.003). CONCLUSION-: In critically ill patients a significant correlation thus exists between plasma fibrinolytic capacity and serum CRP levels. Our data were obtained in the first 24 hours of ICU admission or of sepsis, thus, the relation between CRP and hypofibrinolysis appeared very quickly. This finding is compatible with a link between inflammation and abnormal fibrinolysis, and may explain the negative prognostic value of CRP in critically ill patients

Plasma fibrinolysis is related to the degree of organ dysfunction but not to the concentration of von Willebrand Factor in critically ill patients

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

Sleep restriction increases white blood cells, mainly neutrophil count, in young healthy men: A pilot study

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

Exposure of Endothelial Cells to Physiological Levels of Myeloperoxidase-Modified LDL Delays Pericellular Fibrinolysis

Blood fluidity is maintained by a delicate balance between coagulation and fibrinolysis. The endothelial cell surface is a key player in this equilibrium and cell surface disruptions can upset the balance. We investigated the role of pericellular myeloperoxidase oxidized LDLs (Mox-LDLs) in this balance.Journal ArticleResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Temporal Dissociation between Myeloperoxidase (MPO)-Modified LDL and MPO Elevations during Chronic Sleep Restriction and Recovery in Healthy Young Men

OBJECTIVES: Many studies have evaluated the ways in which sleep disturbances may influence inflammation and the possible links of this effect to cardiovascular risk. Our objective was to investigate the effects of chronic sleep restriction and recovery on several blood cardiovascular biomarkers. METHODS AND RESULTS: Nine healthy male non-smokers, aged 22-29 years, were admitted to the Sleep Laboratory for 11 days and nights under continuous electroencephalogram polysomnography. The study consisted of three baseline nights of 8 hours sleep (from 11 pm to 7 am), five sleep-restricted nights, during which sleep was allowed only between 1 am and 6 am, and three recovery nights of 8 hours sleep (11 pm to 7 am). Myeloperoxidase-modified low-density lipoprotein levels increased during the sleep-restricted period indicating an oxidative stress. A significant increase in the quantity of slow-wave sleep was measured during the first recovery night. After this first recovery night, insulin-like growth factor-1 levels increased and myeloperoxidase concentration peaked. CONCLUSIONS: We observed for the first time that sleep restriction and the recovery process are associated with differential changes in blood biomarkers of cardiovascular disease

Ir-LBP, an Ixodes ricinus Tick Salivary LTB4-Binding Lipocalin, Interferes with Host Neutrophil Function

BACKGROUND: During their blood meal, ticks secrete a wide variety of proteins that can interfere with their host's defense mechanisms. Among these proteins, lipocalins play a major role in the modulation of the inflammatory response. METHODOLOGY/PRINCIPAL FINDINGS: We previously identified 14 new lipocalin genes in the tick Ixodes ricinus. One of them codes for a protein that specifically binds leukotriene B4 with a very high affinity (Kd: +/-1 nM), similar to that of the neutrophil transmembrane receptor BLT1. By in silico approaches, we modeled the 3D structure of the protein and the binding of LTB4 into the ligand pocket. This protein, called Ir-LBP, inhibits neutrophil chemotaxis in vitro and delays LTB4-induced apoptosis. Ir-LBP also inhibits the host inflammatory response in vivo by decreasing the number and activation of neutrophils located at the tick bite site. Thus, Ir-LBP participates in the tick's ability to interfere with proper neutrophil function in inflammation. CONCLUSIONS/SIGNIFICANCE: These elements suggest that Ir-LBP is a "scavenger" of LTB4, which, in combination with other factors, such as histamine-binding proteins or proteins inhibiting the classical or alternative complement pathways, permits the tick to properly manage its blood meal. Moreover, with regard to its properties, Ir-LBP could possibly be used as a therapeutic tool for illnesses associated with an increased LTB4 production.Journal ArticleResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe

De la pédagogie universitaire à la pédagogie médicale: quelques réflexions.

Recent studies have shown that an appropriate pedagogic training, characterized by a high specificity, is necessary for teaching in universities. However, the time when it should be initiated and whether it should be a compulsory or a optional formation are still debated. Furthermore, the specificity of medical training is at the origin of a new expending discipline, medical pedagogy, that must take into account the necessity to provide the students with a basic professional competence. Finally, postgraduate continuous medical education has its own methods that also require a preliminary pedagogic training.English AbstractJournal ArticleReviewSCOPUS: re.jinfo:eu-repo/semantics/publishe

Rencontres de Venise: Regards sur l'épistémologie à l'intention des curieux en sciences du vivant

Nous vivons une période d’insécurité intellectuelle dans le domaine scientifique. Non pas par manque de théories ou de calculs, et encore moins par absence de formes explicatives élaborées. C’est essentiellement le temps de la réflexion qui nous fait défaut pour que nous puissions juger à un niveau professionnel les avancées importantes qui sont réalisées. C’est dans ce cadre que l’épistémologie peut s’avérer un outil utile.Dans cet ouvrage, l’accent est délibérément placé sur les sciences de la vie, dans la mesure où celles-ci ont, de tout temps, été présentées à l’avant poste de l’intérêt du grand public. L’un des atouts du présent ouvrage n’est pas de présenter des théories toutes faites ou de servir de manuel offrant un prêt à l’emploi. Il propose plutôt des manières diverses de penser à ceux qui, par leur pratique ou au cours de leurs études, ont des interrogations sur certains aspects du vivant et des sciences qui l’étudient.info:eu-repo/semantics/published

An unusual cause of acute intestinal bleeding in a young woman: Angiodysplasia and Taenia saginata infestation [8]

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