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1.
Rev Med Brux ; 38(6): 490-493, 2017.
Article in French | MEDLINE | ID: mdl-29318805

ABSTRACT

The number of transplantations is mainly limited by the shortage of organs, thereby leading to potentially lethal delays for patients registered on waiting lists. Among the causes of refusals of organ donation, religious reasons are often advocated. In order to make the point, we organized a debate between representatives of secularism ( " laïcité ") and of the most represented religions in Belgium, i.e. catholic, Islamic and Judaic. Even though the representation of death was variable, organ donation is authorized and even encouraged by the fundamental texts. Refusals of organ donation result more often from personal interpretations by local preachers. Therefore, the gathering of political and religious authorities in order to promote organ donation is desirable instead of sowing doubt for pseudo-religious reasons.


En médecine de transplantation, la pénurie d'organes représente le principal obstacle et cause de retard aux greffes vitales pour les receveurs inscrits sur liste d'attente. Parmi les causes de refus de don d'organes, des raisons d'ordre religieux sont souvent invoquées. Afin de faire le point sur cette problématique, nous avons organisé un débat rassemblant des représentants de la laïcité et des religions monothéistes les plus représentées en Belgique : catholicisme, islam, judaïsme. Il est apparu que, si la représentation de la mort varie selon les courants, le don d'organes est en fait autorisé, voire encouragé par les textes fondateurs des trois religions. Les refus sont plutôt le fait d'une interprétation personnelle par des prédicateurs. Dès lors, il serait judicieux de rassembler les forces politiques et spirituelles afin de promouvoir le don d'organes plutôt que de semer le doute à son sujet sous des prétextes pseudo-religieux.

2.
Eur J Neurol ; 18(12): 1432-4, 2011 Dec.
Article in English | MEDLINE | ID: mdl-21771202

ABSTRACT

BACKGROUND AND PURPOSE: To evaluate in disorders of consciousness (DOC) circadian variations in motor patterns and their possible synchronization with physiologically regulated light variations and/or a social environmental factor, i.e. presence and actions of other persons. METHODS: Actimetric and ambient light levels recordings were obtained during 4-9 days in two patients with traumatic brain injury (TB1 and TB2) in a minimally conscious state (MCS), one MCS (AI1) and one comatose (AI2) anoxic-ischaemic patients. Environmental changes were automatically recorded using a video system. RESULTS: Minute light variations correlated with motor activity in all patients. However, motor activity was significantly higher during day than nighttime and correlated with social environmental changes, in patients TB1 and TB2 only. CONCLUSIONS: Night-day circadian variations in motor activity patterns and influence of social stimulations were observed in traumatic MCS patients only. Nonetheless, rapid light variations may temporarily promote increased arousal, and consequently motor activity, in all DOCs.


Subject(s)
Arousal/physiology , Brain Injuries/complications , Circadian Rhythm , Consciousness/physiology , Hypoxia-Ischemia, Brain/complications , Light , Motor Activity , Persistent Vegetative State/physiopathology , Social Behavior , Acceleration , Adult , Arousal/radiation effects , Awareness/physiology , Humans , Microcomputers , Middle Aged , Motor Activity/radiation effects , Persistent Vegetative State/etiology , Photography , Social Isolation , Young Adult
3.
Rev Med Brux ; 32(1): 14-7, 2011.
Article in French | MEDLINE | ID: mdl-21485459

ABSTRACT

In the framework of implementation of his national program for control and prevention of cardiovascular diseases, Cameroonian government has set up a cardiac surgery project. We report in this manuscript results of one year follow up of the patients operated during the pilot phase. From September 22 till 26, 2008, 11 patients have been operated in Cameroun. Surgical procedures were 5 mitral mechanic valve replacement, 2 aortic mechanic valve replacement, 1 atrial septal defect closure, 2 pace maker implantation. No intrahospital death was observed. One patient died at 11th month after the operation due to mitral valve thrombosis and attributed to lack of compliance. One patient presented low cardiac output, pneumonia and a pleural effusion. 2 patients presented 2 minor complications consisting of pericarditis and superficial wound infection. The results of the pilot phase of cardiac surgery in Cameroon are effective. However, the sustainability of the program require human, material capacity building, and funding mechanism as well.


Subject(s)
Cardiac Surgical Procedures/statistics & numerical data , Adult , Cameroon , Female , Heart Diseases/surgery , Humans , Male , Pilot Projects , Postoperative Complications/epidemiology
5.
Pathol Biol (Paris) ; 59(6): 336-8, 2011 Dec.
Article in French | MEDLINE | ID: mdl-19896293

ABSTRACT

Intoxication by glycyrrhizin is a rare cause of hypokalemia. We describe a patient with severe hypokalemia caused by long-term consumption of syrup containing liquorice. The physiopathological mechanism of the intoxication and the differential diagnosis are presented.


Subject(s)
Glycyrrhiza/adverse effects , Hypokalemia/chemically induced , Hypokalemia/diagnosis , Aged , Diagnosis, Differential , Glycyrrhetinic Acid/adverse effects , Glycyrrhetinic Acid/metabolism , Humans , Hypokalemia/etiology , Male , Models, Biological , Signal Transduction/physiology
8.
Rev Med Interne ; 31(8): e1-2, 2010 Aug.
Article in French | MEDLINE | ID: mdl-20627475

ABSTRACT

Pituitary apoplexy is well known as the first manifestation of pituitary tumour. Conversely, haemorrhage of a pituitary adenoma, revealed by anticoagulant therapy, is very uncommon. Two weeks after initiation of anticoagulant therapy for a deep venous thrombosis, an 83-year-old woman presented with intracranial hypertension and blindness. CT-scan revealed pituitary hematoma within a large adenoma. Three months after surgery, partial visual defect persisted in association with panhypopituitarism. When pituitary disorder is known, hemorrhage risk should be taken into account in the prescription of anticoagulant therapy.


Subject(s)
Adenoma/complications , Anticoagulants/adverse effects , Hemorrhage/chemically induced , Pituitary Diseases/chemically induced , Pituitary Neoplasms/complications , Aged, 80 and over , Female , Humans
9.
Rev Med Interne ; 31(6): e5-6, 2010 Jun.
Article in French | MEDLINE | ID: mdl-20206420

ABSTRACT

A 55-year-old woman presented with a recent diabetes mellitus associated with pancreatic and renal malformations. This atypical diabetes raised the possibility of maturity onset diabetes of the young (MODY) and a genetic research was performed. These malformations led to MODY5 diagnosis that was confirmed by the presence of HNF1beta gene mutation.


Subject(s)
Diabetes Mellitus, Type 2/genetics , Hepatocyte Nuclear Factor 1-beta/genetics , Kidney/abnormalities , Pancreas/abnormalities , Biomarkers/metabolism , Female , Genetic Counseling , Humans , Middle Aged , Mutation , Phenotype
10.
New Phytol ; 185(1): 248-57, 2010 Jan.
Article in English | MEDLINE | ID: mdl-19807870

ABSTRACT

Data on plant pathogenic oomycetes are scarce and little is known about the early events leading to the onset of infection. The aim of this work was to analyze the penetration process of the soil-borne plant pathogen Phytophthora parasitica, which has a wide host range. Here, we performed a cytological analysis of the colonization of the first plant cell and developed an inoculation assay for characterizing the entire penetration process through cellular and molecular analyses. We showed that P. parasitica infects roots by producing a specialized structure, the appressorium. We produced the first cDNA library for the penetrating stage of a Phytophthora species and showed it to be highly enriched in pathogenicity-related sequences. These included coding sequences for many cell-degrading enzymes, effectors such as RXLR-containing proteins and proteins involved in protection against plant defense responses. Characterization of the appressorium cDNA library and identification of genes overrepresented early in P. parasitica infection provided us with an unprecedented opportunity to decipher the molecular mechanisms involved in penetration of the plant cells during the initiation of infection by a soil-borne oomycete.


Subject(s)
Algal Proteins/genetics , DNA, Algal , Phytophthora/pathogenicity , Plant Diseases , Plant Roots/physiology , Plants/parasitology , Algal Proteins/metabolism , Gene Library , Phytophthora/genetics , Phytophthora/physiology , Plant Cells , Plant Roots/cytology , Plant Roots/parasitology
12.
Rev Med Interne ; 30(2): 179-80, 2009 Feb.
Article in French | MEDLINE | ID: mdl-18539363

ABSTRACT

Bourneville tuberous sclerosis is a phacomatosis characterized by skin, neurological and ophthalmological lesions. At first, seizure can reveal cerebral lesions, but other causes may be suspected. We report a case of a Bourneville tuberous sclerosis in a 41-year-old-man with hypoglycemia leading to seizures, resulting from an insulinoma.


Subject(s)
Insulinoma/diagnosis , Pancreatic Neoplasms/diagnosis , Seizures/etiology , Tuberous Sclerosis/complications , Adult , Humans , Hypoglycemia/complications , Hypoglycemia/etiology , Male
13.
Scanning ; 29(6): 270-9, 2007.
Article in English | MEDLINE | ID: mdl-17957745

ABSTRACT

The performance of X-ray microanalysis in the variable pressure or environmental scanning electron microscope (VP-SEM or ESEM) is limited by skirting. Under certain conditions, charging effects can occur and change the X-ray emission, which affects the X-ray microanalysis. The conventional way to evaluate charging is to calculate the Duane-Hunt limit by fitting the X-ray intensity region located below the energy cut-off. Nevertheless, this method appears to have serious limitations for instance in the case of strong insulators. A perfect example of this limitation is to study the evolution of composition of an alkali glass with time. This paper reports on the evolution of the sodium X-ray intensity with time depending on accelerating voltage, pressure and presence of a surface coating. For certain conditions, a decrease of sodium X-ray intensity with time was observed but for other conditions the reverse behavior was noticed. The increase of sodium X-ray intensity with time was obtained when the force created by the surface electrons was stronger than the force generated by electrons trapped in the interaction volume, whereas the decrease of sodium X-ray intensity occurred when the force generated by electrons trapped in the interaction volume was the stronger. The variations of sodium X-ray intensity were also compared to the variation of the Duane-Hunt limit, the determination of which is studied in detail in this article.

14.
Arch Mal Coeur Vaiss ; 100(8): 605-8, 2007 Aug.
Article in French | MEDLINE | ID: mdl-17928760

ABSTRACT

UNLABELLED: The new recommendations of the French national authority for health (or Haute Autorité de Santé: HAS) concerning management of high blood pressure (HBP) deserve to be compared with real clinical practices in a large population. MATERIAL AND METHODS: [corrected] EPIMIL is a prospective epidemiological study designed to assess the prevalence of the metabolic syndrome and the risk factors in a 2045 French male military personnel coming from Paris area. The different recommendations of the HAS have been applied to these subjects, and the aim of this work is to compare these theoretical objectives to what is done in real practice. RESULTS: Among these 2045 subjects aged of mean 38,6 +/- 8,8 years, 78 (4%) are known and treated for HPB. Although half of them present more than two associated risk factors, the means of systolic blood pressure and diastolic blood pressure stay at high levels. The blood pressure (BP) targets established at 140/90 mmHg are only reached by 33 patients (42%). Among the 1967 subjects considered to have normal BP, the BP considered as optimal (120/80 mmHg) is only found in 695 subjects (35.3%) and 428 (21.7%) do present ignored or neglected HBP, in spite of the presence of important associated risk factors. Then, the cardiovascular risk stratification into levels, as recommended by the HAS, shows that for these subjects considered to have normal BP, risk is finally low for 6%, moderate for 12%, and high for 3.5%. COMMENTS: In a selected and in theory regularly followed population, the recommendations of the HAS are insufficiently applied, as well for detection or treatment of HBP. Then, information of both medical personnel and also the interested parties should be necessary, in order to see these recommendations applied in real practice.


Subject(s)
Hypertension/epidemiology , National Health Programs , Practice Guidelines as Topic , Adult , Antihypertensive Agents/therapeutic use , Cardiovascular Diseases/prevention & control , France/epidemiology , Humans , Hypertension/drug therapy , Male , Military Personnel , Prospective Studies , Risk Assessment , Risk Factors
15.
Arch Mal Coeur Vaiss ; 100(8): 668-72, 2007 Aug.
Article in French | MEDLINE | ID: mdl-17928773

ABSTRACT

UNLABELLED: The aim of this study was to assess the responsibility of night-time blood pressure in the onset of nephropathy in diabetic patients. PATIENTS AND METHODS: This study included 98 diabetic patients (mean age: 54 +/- 15 years, diabetes duration: 15 +/- 10 years). An evaluation of diabetes and a 24-h ambulatory blood pressure were performed at the initial evaluation (Y0) and about five years later (Y5). At Y0, all patients had normal urinary albumin excretion (UAE) (<30 mg/24h). They were separated into two groups according to urinary albumin excretion at Y5: group (N +): UAE>30 mg/24h and group (N-): UAE<30 mg/24h. Twenty four hours ambulatory blood pressure, clinical and biological parameters recorded at Y0 were compared in both. RESULTS: At Y5, there was 18 patients in group (N +) and 78 in group (N-). Patients of group (N +) were older than those of group (N-): 62.9 +/- 9.5 vs. 52.6 +/- 15.7 years, p<0.01, and their BMI was higher (28 +/- 5 vs. 25 +/- 4 kg/m2, p<0.03). Diabetes duration and Hb A1c levels did not differ from significant manner in both. At Y0, UAE was significantly higher in group (N +) than in group (N-): 13 +/- 7 vs. 8 +/- 6 mg/24h, p<0.01. At the initial evaluation, daytime systolic and diastolic blood pressures did not differ from significant manner in both. Systolic and diastolic BP night-time were higher in diabetic patients who developed microalbuminuria (SBP: 122 +/- 19 vs. 113 +/- 13 mmHg, p<0.05 and DBP: 70 +/- 6 vs. 65 +/- 10 mmHg, p<0.03). UAE collected at Y5 was correlated to night-time BP recorded at Y0 (SBP: r=0.381, p=0.001 and PAD: r=0.294, p=0.004) and night-time systolic BP explained 12.3% of the UAE variance. Progression of UAE between the two evaluations was found to be correlated to the night-time systolic BP recorded at Y0 (r=0.335, p=0.0008) and night-time systolic BP explained 11.7% of the progression variance. There was a negative correlation between UAE at A5 and the difference between daytime and night-time BP recorded during the same evaluation (r=- 0.230, p=0.024 with SBP and r=- 0.243, p=0.017 with DBP). CONCLUSION: The results underlign the resposability of night-time blood pressure, and more especially of nighttime systolic blood pressure, for the onset of nephropathy in diabetic patients.


Subject(s)
Blood Pressure/physiology , Circadian Rhythm/physiology , Diabetic Nephropathies/physiopathology , Albuminuria/physiopathology , Female , Humans , Longitudinal Studies , Male , Middle Aged
16.
Arch Mal Coeur Vaiss ; 100(8): 699-703, 2007 Aug.
Article in French | MEDLINE | ID: mdl-17928780

ABSTRACT

UNLABELLED: The purpose of this study was to assess the blood pressure modifications in type 1 diabetic patients who present reduction of heart rate variability. PATIENTS AND METHODS: This study included 70 type 1 diabetic patients (mean age: 42 +/- 13 years, diabetes duration: 13.2 +/- 9 years. They were free for complications and did not receive other treatment than insulin. Heart rate variability was evaluated using 24-h continuous ECG record spectral analysis. Patients were divided into two groups according to whether log high frequency power was lower (group 1, N=36) or higher (group 2, N=3 4) than 70 patients'mean. Clinical and biological features and 24-h ambulatory blood pressure measurement were compared in both groups. RESULTS: Patients of group 1 were older than group 2 (47.8 +/- 11.2 vs. 35.7 +/- 12.2 years, p<0.0001) and diabetes duration was higher (16.9 +/- 8.4 vs. 9.4 +/- 8 years, p<0.001). BMI and Hb A1c did not differ from significant in both. Night-time blood pressure was upper in group 1 (SBP: 112 +/- 13 vs. 103 +/- 11 mmHg, p<0.01 and DBP: 66 +/- 8 vs. 60 +/- 7 mmHg, p<0.001). The difference between blood pressures during day and night (DeltaBP) were lower in group 1 than in group 2 (DeltaSBP: 10 +/- 9 vs. 15 +/- 7 mmHg, p<0.02 and DeltaDeltaBP: 9 +/- 7 vs. 12 +/- 5 mmHg, p<0.04). DSBP and DDBP were found to be correlated with log HF power (r=0.356, p<0.003), which could explain 11.8% and 12% of their variance. Urinary albumin excretion rate was higher in group 1 (8 +/- 4 vs. 5 +/- 3 mg/24h, p<0.01). CONCLUSION: In type 1 diabetic patients free for complications, reduction in heart rate variability linked to age and diabetes duration is associated with a reduction in nighttime BP fall. These two parameters of autonomic neuropathy could have a pathogenic role in the development of incipient nephropathy.


Subject(s)
Blood Pressure/physiology , Diabetes Mellitus, Type 1/physiopathology , Heart Rate/physiology , Adult , Age Factors , Blood Pressure Monitoring, Ambulatory , Circadian Rhythm/physiology , Electrocardiography , Female , Humans , Male , Middle Aged , Time Factors
17.
Rev Med Interne ; 28(12): 888-9, 2007 Dec.
Article in French | MEDLINE | ID: mdl-17624638

ABSTRACT

We reported a 92-year-old woman with hyponatremia (117 mmol/l) occurring three days after the introduction of tramadol. Diagnosis of inappropriate antidiuretic hormone secretion was based on blood and urinary analysis and dosage of antidiuretic hormone. Natremia became normal after tramadol cessation and fluid restriction. Natremia must be measured when neurological abnormality occurs with tramadol treatment.


Subject(s)
Hyponatremia/chemically induced , Tramadol/adverse effects , Aged, 80 and over , Analgesics, Opioid/adverse effects , Female , Humans , Muscle, Skeletal , Pain/drug therapy , Vasopressins/metabolism
18.
Scanning ; 29(3): 114-22, 2007.
Article in English | MEDLINE | ID: mdl-17455262

ABSTRACT

The variable pressure or environmental scanning electron microscope (VP-SEM; ESEM) has become the microscope of choice for many scientists and technologists. Hence, the development of robust methods for X-ray microanalysis, limited by skirting, has become critical. In this paper, two pressure variation correction methods (Doehne and Gauvin) are compared. Both of these methods appear to be effective; the results were found to be well within 10% of the values obtained at 0 Pa. The Doehne method is dependent on an empirical factor (D), therefore the accuracy of the results will depend on the accuracy of this value. Also the Doehne method is compromised by the nonlinearity of the response with pressure. The Gauvin method is more user-friendly and more precise when considering the total range of pressure.

19.
Rev Med Interne ; 28(3): 183-5, 2007 Mar.
Article in French | MEDLINE | ID: mdl-17166633

ABSTRACT

INTRODUCTION: Septic arthritis caused by Neisseria gonorrhoeae is mono or pauciarticular. They represent a nonrare cause of arthritis in sexually active adults. He is necessary to think of it even in the absence of urethritis. EXEGESIS: We report the case of gonococcal arthritis without urethritis in a young man associated with positive synovial fluid culture and negative blood cultures. CONCLUSION: Prompt recognition and treatment of this disease results in cure without aftereffects. The finding of penicillin-resistant organisms reinforces recent recommendations that advanced-generation cephalosporin must be used as initial therapy.


Subject(s)
Arthritis, Infectious/diagnosis , Gonorrhea/diagnosis , Adult , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/drug therapy , Arthritis, Infectious/microbiology , Ceftriaxone/therapeutic use , Gonorrhea/complications , Gonorrhea/drug therapy , Humans , Male , Synovial Fluid/microbiology
20.
Rev Med Interne ; 28(1): 46-7, 2007 Jan.
Article in French | MEDLINE | ID: mdl-17166635

ABSTRACT

While hypothyroidism secondary to treatments by lithium are well known, cases of hyperthyroidism are less common. A 48 years old patient under lithium carbonate from about 10 years ago presents hyperthyroidism without any auto-immunity biological markers, associated with a very low thyroid tracer uptake on scintigraphy. Treatments by anti thyroid agents will be necessary during months in order to normalize the hormone level, whereas lithium is maintained. Only few tens of cases of hyperthyroidism related to lithium have been reported in the literature. This observation shows the importance of the thyroid hormonal follow up for patients under lithium, in order to treat them before the outbreak of a thyroid dysfunction. The causal toxic mechanism is still unclear, and may be related with a direct damage of lithium to follicular cells.


Subject(s)
Antimanic Agents/adverse effects , Hypothyroidism/chemically induced , Lithium Carbonate/adverse effects , Humans , Male , Middle Aged
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