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Distribution of atrial cardiomyopathy markers and association with atrial fibrillation detected after ischaemic stroke in the SAFAS study

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Stroke & Vascular Neurology 2024年第2期9卷 165-173,I0426,I0427页

作者： Romain Didier Lucie Garnier Gauthier Duloquin Alexandre Meloux Audrey Sagnard Mathilde Graber Geoffrey Dogon Karim Benali Thibaut Pommier Gabriel Laurent Catherine Vergely Yannick Bejot Charles Guenancia Cardiology CHU Dijon BourgogneDijonFrance dijon Stroke Registry Department of NeurologyUniversity Hospital Centre DijonDijonFrance PEC 2 Universitéde BourgogneDijonFrance Cardiology CHU Saint EtienneSaint EtienneFrance

Background Atrial cardiomyopathy(AC)is an emerging concept explaining the pathophysiology of cardioembolic strokes in absence of atrial fibrillation(AF).A definition based on the presence of electrical abnormality(P-wave terminal force in lead V1(PTFV1)>5000µV×ms),N-Terminal pro-B-type natriuretic peptide(NT pro BNP)>250pg/mL and/or indexed left atrial diameter(LADI)>3cm/m^(2)is currently tested in the ARCADIA(AtRial Cardiopathy and Antithrombotic Drugs In prevention After cryptogenic stroke)*** set out to estimate the prevalence of AC as defined in the ARCADIA trial,its determinants and its association with AF detected after stroke(AFDAS).Methods Stepwise screening for silent Atrial Fibrillation After Stroke(SAFAS)study prospectively included 240 ischaemic stroke *** markers were complete for 192 of them and 9 were not included in this analysis because AF had been diagnosed on *** A total of 183 patients were analysed,of whom 57%(104 patients)met the AC criteria(79 NT-proBNP,47 PTFV1,4 LADI).In the multivariate logistic regression,C reactive protein>3mg/L(OR(95%CI)2.60(1.30 to 5.21),p=0.007)and age(OR(95%CI)1.07(1.04 to 1.10),p34mL/m^(2),OR 2.35(CI 1.09 to 5.06)p=0029).Conclusion AC as defined in ARCADIA is mostly based on NT pro BNP elevation(76%of patients)and is associated with age and ***,AC was not independently associated with AFDAS at *** ARCADIA trial,which compares aspirin to apixaban in patients with embolic strokes of undetermined source with AC markers and must,therefore be analysed in the light of these limitations.

关键词： atrial cardiomyopathy prevention

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Trends in incidence and management of cancer of the ampulla of Vater

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World Journal of Gastroenterology 2014年第29期20卷 10144-10150页

作者： Florian Rostain Samia Hamza Antoine Drouillard Jean Faivre Anne-Marie Bouvier C?me Lepage Registre Bourguignon des Cancers Digestifs INSERM U866CHU de DijonFaculté de Médecine21079 Dijon CedexFrance

AIM: To provide trends in incidence, management and survival of cancer of the ampulla of Vater in a well-defined French population.

关键词： Cancer of the ampulla of Vater Incidence Survival Treatment Epidemiology

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Evaluation and Relevance of Indications for Primary Caesarean Section: A Five-Year Experience Report from Nevers Hospital Center

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 183-191页

作者： Aliou Diouf Remy Kosi Thérèse Mikoka Emilie Serre Philippe Kadhel Centre Hospitalier de Nevers Nevers France chu de dijon Dijon France

Context: The caesarean section rate continues to increase in our different health structures specially for women who have not had a scar in the uterus. Objectives: The aim of this study was to analyze the key factors and main indications for primary caesarean sections and to find ways to reduce the increasing rates. Patients and Method: This is a longitudinal and retrospective study carried out from June 1, 2018 to July 31, 2022. The study included all patients who had a cesarean-section for the first time (primary caesarean). An anterior uterine scar was a non-inclusion criterion. Data were collected prospectively using Synfonievre and Agopra software via patients’ files and information collection sheet. Data were analyzed with SPSS 21 software, Mac version. Averages were calculated for quantitative data and percentages for qualitative data. The statistical tests used were the Pearson Chi2 test. The observed differences were considered significant when the p-value was less than 0.05. Results: During the study period, we recorded 8832 deliveries and 3148 caesarean sections (35.6%). Primary CS concerned 70% of overall C-section rate. The main indications were FHR Fetal Heart Rate abnormalities (FHRA) (27%), followed by the other indications (including preterm delivery, umbilical cord dystocia, malpresentation of fetus, foetal abnormalities, elective CS, triple gestation, mother abnormalities);dystocia or prolonged labor (18.7%), breech presentation in a twin pregnancy with 11.3% and 9.6% respectively. We recorded more vaginal deliveries with labor induction: 81.4% against 75.2%. An obstetrical audit led to better labor management and a reduction in the cesarean section rate. Conclusion: We need to focus on diagnosis of fetal distress, management of breech presentation during of a twin birth and a singleton. Induction of labor can be an effective alternative in certain indications. An obstetrical audit is needed to reverse the caesarean section rate.

关键词： Caesarean Section Rate Indications Apgar Score Obstetrical Audit

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Plasma phospholipid transfer protein （PLTP） modulates adaptive immune functions through alternation of T helper cell polarization

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Cellular & Molecular Immunology 2016年第6期13卷 795-804页

作者： Catherine Desrumau Stephanie Lemaire-Ewing Nicolas Ogier Akadiri Yessoufou Arlette Hammann Anabelle Sequeira-Le Grand Valerie Deckert Jean-Paul Pais de Barros Naig Le Guern Julien Guy Naim A Khan Laurent Lagrost INSERM UMR866 - F21079 dijon France Univ. Bourgogne Franche-Comte F-21000 Dijon France LipSTIC LabEx Fondation de Cooperation Scientifique Bourgogne-Franche Comte F-21000 Dijon France chu Hopital du Bocage Dijon France plateforme de Cytometrie en Flux Universite de Bourgogne Dijon France

Objective： Plasma phospholipid transfer protein （PLTP） is a key determinant of lipoprotein metabolism, and both animal and human studies converge to indicate that PLTP promotes atherogenesis and its thromboembolic complications. Moreover, it has recently been reported that PLTP modulates inflammation and immune responses. Although earlier studies from our group demonstrated that PLTP can modify macrophage activation, the implication of PLTP in the modulation of T-cell-mediated immune responses has never been investigated and was therefore addressed in the present study. Approach and results： In the present study, we demonstrated that PLTP deficiency in mice has a profound effect on CD4＋ ThO cell polarization, with a shift towards the anti-inflammatory Th2 phenotype under both normal and pathological conditions. In a model of contact hypersensitivity, a significantly impaired response to skin sensitization with the hapten-2,4-dinitrofluorobenzene （DNFB） was observed in PLTP-deficient mice compared to wild-type （WT） mice. Interestingly, PLTP deficiency in mice exerted no effect on the counts of total white blood cells, lymphocytes, granulocytes, or monocytes in the peripheral blood. Moreover, PLTP deficiency did not modify the amounts of CD4＋ and CD8＋ T lymphocyte subsets. However, PLTP-deficiency, associated with upregulation of the Th2 phenotype, was accompanied by a significant decrease in the production of the pro-Thl cytokine interleukin 18 by accessory cells. Conclusions： For the first time, this work reports a physiological role for PLTP in the polarization of CD4＋ T cells toward the pro-inflammatory Th I phenotype.

关键词： lipid transfer protein lymphocyte polarization T cell

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Update on Anti-Saccharomyces cerevisiae antibodies, anti-nuclear associated anti-neutrophil antibodies and antibodies to exocrine pancreas detected by indirect immunofluorescence as biomarkers in chronic inflammatory bowel diseases: Results of a multicent

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World Journal of Gastroenterology 2007年第16期13卷 2312-2318页

作者： S Desplat-Jégo C Johanet A Escande J Goetz N Fabien N Olsson E Ballot J Sarles JJ Baudon JC Grimaud M Veyrac P Chamouard RL Humbel chu de la Conception Marseille 13005 France chu Saint-Antoine Paris France chu Saint-Eloi Montpellier France chu Hautepierre Strasbourg France chu Lyon-Sud Pierre-Bénite France chu dijon France chu Timone Marseille France Hpital Trousseau Paris France chu Nord Marseille 13005 France Laboratoire Luxembourgeois d’Immunopathologie Esch-sur-Alzette Luxembourg. Services de gastro-entérologie et pédiatrie France

AIM： Anti-Saccharomyces anti-nuclear associated cerevisiae antibodies （ASCA）, anti-neutrophil antibodies （NANA） and antibodies to exocrine pancreas （PAB）, are serological tools for discriminating Crohn＇s disease （CrD） and ulcerative colitis （UC）. Like CrD, coeliac disease （COD） is an inflammatory bowel disease （IBD） associated with （auto） antibodies. Performing a multicenter study we primarily aimed to determine the performance of ASCA, NANA and PAB tests for IBD diagnosis in children and adults, and secondarily to evaluate the prevalence of these markers in CoD. METHODS： Sera of 109 patients with CrD, 78 with UC, 45 with CoD and 50 healthy blood donors were retrospectively included. ASCA, NANA and PAB were detected by indirect immunofluorescence （IIF）. RESULTS： ASCA＋/NANA- profile displayed a positive predictive value of 94.2% for CrD. Detection of ASCA was correlated with a more severe clinical profile of CrD and treatment of the disease did not influence their serum levels. ASCA positivity was found in 37.9% of active *** were found in 36.7% CrD and 13.3% CoD patients and were not correlated with clinical features of CrD, except with an early onset of the disease. Fifteen CrD patients were ASCA negative and PAB positive. CONCLUSION： ASCA and PAB detected by IIF are specific markers for CrD although their presence does not rule out a possible active CoD. The combination of ASCA, NANA and PAB tests improves the sensitivity of immunological markers for CrD. Repeating ASCA, NANA, and PAB testing during the course of CrD has no clinical value.

关键词： Inflammatory bowel disease Coeliac disease Anti-Saccharomyces cerevisiae antibodies Anti-neutrophil cytoplasmic antibodies Anti-pancreatic antibodies

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Management of renal replacement therapy among adults in French intensive care units: A bedside practice evaluation

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Journal of Intensive Medicine 2023年第2期3卷 147-154页

作者： Florian Jolly Marine Jacquier Delphine Pecqueur Marie Labruyère Christophe Vinsonneau Isabelle Fournel Jean-Pierre Quenot The READIAL Study group Service de Médecine Intensive-Réanimation CHU Dijon-BourgogneDijon 21000France Equipe Lipness Centre de recherche INSERM UMR1231 et LabEx LipSTICUniversitéde Bourgogne-Franche ComtéDijon 21000France INSERM CIC 1432Module Epidémiologie CliniqueDijon 21000France chu dijon-Bourgogne Centre d’Investigation CliniqueModule Epidémiologie Clinique/Essais CliniquesDijon 21000France Service de Médecine Intensive Réanimation-Unitéde Sevrage Ventilatoire et Réhabilitation CH de BethuneBethune 62408France 不详

Background:This study aimed to investigate renal replacement therapy (RRT) practices in a representative nationwide sample of French intensive care units (ICUs).Methods:From July 1 to October 5 2021, 67 French ICUs provided data regarding their ICU and RRT implementation. We used an online questionnaire to record general data about each participating ICU, including the type of hospital, number of beds, staff ratios, and RRT implementation. Each center then prospectively recorded RRT parameters from 5 consecutive acute kidney injury (AKI) patients, namely the indication, type of dialysis catheter used, type of catheter lock used, type of RRT (continuous or intermittent), the RRT parameters initially prescribed (dose, blood flow, and duration), and the anticoagulant agent used for the ***:A total of 303 patients from 67 ICUs were analyzed. Main indications for RRT were oligo-anuria (57.4%), metabolic acidosis (52.1%), and increased plasma urea levels (47.9%). The commonest insertion site was the right internal jugular (45.2%). In 71.0% of cases, the dialysis catheter was inserted by a resident. Ultrasound guidance was used in 97.0% and isovolumic connection in 90.1%. Citrate, unfractionated heparin, and saline were used as catheter locks in 46.9%, 24.1%, and 21.1% of cases, ***:Practices in French ICUs are largely compliant with current national guidelines and international literature. The findings should be interpreted in light of the limitations inherent to this type of study.

关键词： Renal replacement therapy Acute kidney injury Intensive care unit Practice evaluation Bedside

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比较免疫固定和等电聚焦在检测多发性硬化症患者脑脊液中寡克隆带的作用(法)

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世界核心医学期刊文摘(神经病学分册) 2006年第4期 60-61页

作者： Fromont A. Couvreur G. Guiguet M. T. Moreau 许刚 Service de Neurologie CHU de Dijon 3 rue du Faubourg- Raines 21000 Dijon

Introduction. Intrathecal immunoglobulins (Ig) synthesis, reflected by oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is observed in up to 90 percent of patients with clinically definite Multiple Sclerosis (MS). The gold standard laboratory test to establish the presence of OCBs in CSF of MS patients is isoelectric focusing (IEF). However, a quicker and less expensive method has been developed: immunofixation (IF). Methods. The aim of this study was to compare these two methods carried out 74 CSF/serum pairs of MS, 103 CSF/serum pairs of subject controls and to determine their sensitivity and specificity. Results. The agreement between results from IEF and IF was excellent (Kappa=0.84). IEF sensitivity (78 percent) was not significantly different from that of IF (74 percent) (p=0.3). Similarly, the specificity of IEF (93 percent) was not significantly different from that of IF (95 percent) (p=0.2). Conclusion. IF is a semi automated method which is easier to perform than IEF and which appears to be as efficient as IEF.

关键词：多发性硬化症免疫固定寡克隆带等电聚焦脑脊液患者

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对卒中急性期护士护理的评估(法国)

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世界核心医学期刊文摘（神经病学分册） 2005年第5期1卷 49-50页

作者： Minier D. Milan C. Woimant F. M. Giroud 雷翀 Service de Neurologie CHU 3 rue du Faubourg-Raines 21000 Dijon France

Introduction. We report the results of a one-day survey of nursing care loa d in University Hospitals (UH), General Hospitals (GH) and Stroke Units (SU) reg arding the acute stage of stroke. Methods. The type of care and the time devoted to care were compared by type of stroke (transient ischemic attack, ischemic st roke, hemorrhagic stroke, cerebral thrombophlebitis, sub-arachnoid hemorrhage) , and degree of handicap (Barthel score). Results. Twenty-two hospitals (13 UH and 9 GH) participated in the study and provided care for 328 stroke victims (3 0 transient ischemic attacks, 247 ischemic strokes, 36 hemorrhagic strokes, 3 ce rebral thrombophlebitis events and 11 strokes of unknown mechanism). Care was gi ven in UHs for 63 percent of the patients and in GHs for 37 percent; in SUs for 40 percent (132 patients) and general neurology units for 60 percent (196 patien ts). Care involved physiotherapy for 70 percent, speech therapy for 42 percent, and care for cognitive decline for 36 percent. Mean time spent by nurses and nur sing assistants peaked in the morning with a significant time not devoted to car e. More than 3 hours of nurse care per day of care was significantly more freque nt in SUs (p < 0.001) and in GHs (p = 0.02) for patients with Barthel score < 40 or hemorrhagic stroke, irrespective of age. Patients older than 80 years, with a Barthel score < 40, with hemorrhagic stroke, and who were admitted more than 1 5 days before the survey required more than two hours per day of nursing assista nt care significantly more often. The probability of more than three hours per d ay of nurse care for stroke increased 2.8-fold for hemorrhagic stroke, 6.0-f old for Barthel Score < 40, and 2.0-fold for care in a GH. The probability of more than two hours per day of nurse assistant care for stroke increased 3.0- fold for hemorrhagic stroke, 6.1-fold for Barthel score < 40, 2.0-fold for patient s older than 70 years, and 1.5-fold for stroke onset more than 14 days before t

关键词：卒中急性期出血性卒中缺血性卒中卒中类型护理时间血栓性静脉炎残疾程度蛛网膜下腔出血护理人员大学医院

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Criteria deemed important by ICU patients when designating a reference person

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Journal of Intensive Medicine 2022年第4期2卷 268-273页

作者： Jean-Pierre Quenot Nicolas Meunier-Beillard Eléa Ksiazek Caroline Abdulmalak Fiona Ecarnot Jean-Baptiste Roudaut Pascal Andreu François Aptel Marie Labruyère Marine Jacquier Jean-Philippe Rigaud Department of Intensive Care University Hospital François MitterrandDijon 21000France Lipness Team INSERM Research Centre LNC-UMR1231 and LabEx LipSTICUniversity of BurgundyDijon 21000France INSERM CIC 1432 Clinical EpidemiologyUniversity of BurgundyDijon 21000France Espace de RéflexionÉthique Bourgogne Franche-Comté(EREBFC) Dijon 21000France DRCI USMRCHU Dijon BourgogneDijon 21000France Department of Intensive Care Centre Hospitalier William MoreyChâlon sur Saône 71000France Department of Cardiology EA3920University of Franche-ComtéUniversity Hospital BesanconBesancon 25000France Department of Intensive Care Centre Hospitalier de DieppeDieppe 76202France Espace de RéflexionÉthique de Normandie University Hospital CaenCaen 14000France

Background:We investigated the criteria that hospitalized patients in intensive care units(ICUs)deem important when designating relatives who are best qualified to interact with the caregiving ***:We conducted an exploratory,observational,prospective,multicenter study between March 1,2018,and October 31,2018,within two ICUs.A 12-item questionnaire was distributed to patients in the ICUs by the investigating *** were considered eligible if they had a good understanding of the French language and if they had not officially designated surrogates before ICU ***:Seventy-one patients whose average age was 63.9±17.3 years,of whom 21(29.5%)were females,completed the *** average Charlson comorbidity score was 2.5±2.4,and the average Simplified Acute Physiology Score(SAPS II)was 39.8±*** main etiology was respiratory infection(40.8%),followed by sepsis(23.9%).The most important criteria identified by patients when selecting reference persons were a good knowledge of the patient’s wishes and values,an emotional attachment to the patient,and being a family ***:Our findings reveal that ICU patients considered the following criteria to be critical when designating reference persons:knowledge of their wishes and the existence of emotional and family attachments.

关键词： Reference person Intensive care unit Questionnaire

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Respiratory protein-driven selectivity during the Permian-Triassic mass extinction

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The Innovation 2024年第3期5卷 122-128页

作者： Haijun Song Yuyang Wu Xu Dai Jacopo Dal Corso Fengyu Wang Yan Feng Daoliang chu Li Tian Huyue Song William JFoster State Key Laboratory of Biogeology and Environmental Geology School of Earth SciencesChina University of GeosciencesWuhan 430074China Biogéosciences UMR 6282CNRSUniversitéde Bourgogne21000 DijonFrance Universitat Hamburg Institute for Geology20148 HamburgGermany

Extinction selectivity determines the direction of macroevolution,especially during mass extinction;however,its driving mechanisms remain poorly *** investigating the physiological selectivity of marine animals during the Permian-Triassic mass extinction,we found that marine clades with lower O2-carrying capacity hemerythrin proteins and those relying on O2 diffusion experienced significantly greater extinction intensity and body-size reduction than those with higher O2-carrying capacity hemoglobin or hemocyanin *** findings suggest that animals with high O2-carrying capacity obtained the necessary O2 even under hypoxia and compensated for the increased energy requirements caused by ocean acidification,which enabled their survival during the Permian-Triassic mass ***,high O2-carrying capacity may have been crucial for the transition from the Paleozoic to the Modern Evolutionary Fauna.

关键词： extinction selectivity finding

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