[Impact of Dapagliflozin on echocardiographic parameters in patients with heart failure and reduced ejection fraction: "About a monocentric series of 43 cases"]. / Impact de la Dapagliflozine sur les paramètres échocardiographiques chez les patients présentant une insuffisance cardiaque à fraction d'éjection réduite : « À propos d'une série monocentrique de 43 cas ¼.

INTRODUCTION: The treatment of heart failure with reduced ejection fraction HFrEF (< 40%) uses hygienic-dietary rules combined with beta-blockers, renin-angiotensin system blockers RASB (alone or in combination with Sacubitril) and spironolactone. Dapagliflozin (SGLT2 inhibitor) has proven its effectiveness in reducing morbi-mortality in patients with HF. However, its effects on echocardiographic parameters are less known. OBJECTIVE: To describe the impact of the addition of Dapagliflozin to conventional treatment on echocardiographic parameters in patients with HFrEF < 40%. METHOD: Observational, single-center and non-randomized study involving patients with HFrEF < 40%. This group was compared to a cohort of 50 patients with HfrEF < 40% under conventional treatment without Dapagliflozin (taken from the HF register of our center and whose management dates back to before the adoption of this molecule in the HF ESC-2021 guidelines) to assess the ultrasound impact of Dapagliflozin. RESULTS: 43 patients aged between 40 and 68 years with HfrEF < 40% on Beta-blocker, BSRA, Spironolactone and Dapagliflozin 10 mg/d. The mean EF was 33% ± 3 (30-39%), mean LVd diameter 64 mm ± 6 (55-71 mm) and mean longitudinal strain at -11% ± 4. These patients were compared to a cohort of 50 patients with the same profile without Dapagliflozin. After a follow-up of 7 months (5-8 months): The average EF increased to 37% with 11 patients EF > 40% against 35% and 5 patients EF > 40% for the group without Dapagliflozin (P 0.057), average LVd at 61 mm versus 66 mm in the group without Dapagliflozin (P 0.095), Mean longitudinal strain at -14% (6 patients < -15) versus -12% (1 patient <-15) in the group without Dapagliflozin (P 0.046). CONCLUSION: In a population of patients with HfrEF < 40% under conventional treatment for HF, the prescription of Dapagliflozin is associated with an improvement of echocardiographic parameters (EF and longitudinal strain). MOTS-CLéS: Série;Dapagliflozine;insuffisance cardiaque;strain;ProBNP;dysfonction VG.

[COVID-19 myocarditis : "About a monocentric series of 33 cases"]. / Myocardite à COVID-19 : « à propos d'une série monocentrique de 33 cas ¼.

INTRODUCTION: The world is experiencing a pandemic linked to the respiratory spread of SARS-CoV2 which can affect the heart with elevated troponins, ECG abnormalities and kinetic disturbances in echocardiography, of ischemic or non-ischemic origin (most often fulminant myocarditis). OBJECTIVE: To describe the evolutionary modalities of post-COVID-19 myocarditis and to identify factors of poor ejection fraction (EF) recovery under treatment of heart failure. METHOD: Monocentric observational study including patients with post-COVID-19 non-fulminant myocarditis confirmed by cardiac MRI. These patients were divided into 2 groups according to the evolution of their EF at 3 months (EF > 50% vs EF < 50%). RESULTS: 33 patients (19♂/14♀) aged from 30 to 61 were included, all of whom had repolarization disorder; mean EF at baseline was 44.3% (30-52%) with a troponin level 480 times normal (20-2100). Conventional treatment for heart failure was initiated in all patients with clinical, electrical and echocardiographic monitoring at 1 and 3 months. A significant improvement (EF > 50%) was observed in 29 patients. Gender, congestive signs, electrical and angiographic abnormalities do not seem to influence the evolution of EF (P > 0.10). Age > 60 years, troponins > 1200 times normal, pericardial effusion and a combined criterion of the three seem to be associated with poor evolution of EF (P at 0.07, 0.02, 0.035 and 0.01 respectively). DISCUSSION: Non-fulminant post-COVID-19 myocarditis have a good prognosis (EF recovery in 87.88%). Factors of poor recovery are age > 60 years, elevated troponins, appearance of pericardial effusion and the combined criterion of the three. CONCLUSION: Non-fulminant post-COVID-19 myocarditis seems to have a favorable course. Patients presenting factors of poor evolution had to have a longer follow-up.

Primary desmoplastic small round cell tumor of upper cervical lymph nodes.

Desmoplastic small round cell tumors (DSRCT) are rare malignancies that typically arise in the abdominopelvic cavities. They are very uncommon in the head and neck region. We present a case of an 11-year-old Caucasian male with a primary cervical lymph node tumor in the neck. Fine-needle aspiration cytology, histopathologic examination, immunohistochemical staining, and molecular genetic testing led to the diagnosis of DSRCT. Due to the very limited number of cases reported and the lack of staging criteria, the preferred management approach remains uncertain.

Array comparative genomic hybridization analysis of small supernumerary marker chromosomes in human infertility.

Small supernumerary marker chromosomes (sSMC) are structurally abnormal chromosomes that cannot be unambiguously identified by conventional banding cytogenetics. This study describes four patients with sSMC in relation with infertility. Patient 1 had primary infertility. His brother, fertile, carried the same sSMC (patient 2). Patient 3 presented polycystic ovary syndrome and patient 4 primary ovarian insufficiency. Cytogenetic studies, array comparative genomic hybridization (CGH) and sperm analyses were compared with cases previously reported. sSMC corresponded to the 15q11.2 region (patients 1 and 2), the centromeric chromosome 15 region (patient 3) and the 21p11.2 region (patient 4). Array CGH showed 3.6-Mb gain for patients 1 and 2 and 0.266-Mb gain for patient 4. Sperm fluorescent in-situ hybridization analyses found ratios of 0.37 and 0.30 of sperm nuclei with sSMC(15) for patients 1 and 2, respectively (P < 0.001). An increase of sperm nuclei with disomy X, Y and 18 was noted for patient 1 compared with control and patient 2 (P < 0.001). Among the genes mapped in the unbalanced chromosomal regions, POTE B and BAGE are related to the testis and ovary, respectively. The implication of sSMC in infertility could be due to duplication, but also to mechanical effects perturbing meiosis.

[Self-assessment questionnaire of alcoholic craving (ECCA Questionnaire: Behavior and Cognition in Relation to Alcohol: French translation and validation of the Obsessive-Compulsive Drinking Scale]. / Auto-questionnaire d'appétence alcoolique (questionnaire ECCA: échelle de comportement et de cognitions vis-à-vis de l'alcool: traduction française et validation de l'OCDS (obsessive compulsive drinking scale).

Clinical, neurobiological and neuropsychological hypotheses suggest that the dimension of alcohol craving includes the concept of both obsessive thoughts about alcohol use and compulsive behaviors toward drinking. Anton et al. (1995) developed a 14 items self-rating scale, the Obsessive Compulsive Drinking Scale (OCDS) which includes items for assessing three dimensions: global, and the obsessive and the compulsive subdimensions. In this study, we included 156 patients, 105 men and 51 women, who met DSM IV diagnostic criteria for alcohol dependence. The mean age of our population was 39.1 +/- 11.2 years without difference between sexes. We did not found any correlation between the CAGE score and the OCDS total score or the obsessive and compulsive subscores (respectively, r = .15, r = .10 et r = .18). Moreover, we did not found any correlation between OCDS scores and mean daily alcohol consumption (r = .18, r = .16, r = .19). This could indicate that the dimension measured by the scale was somewhat independent of actual drinking. As such, it might act as an independent measure of the "state of illness" for alcohol-dependent patients. The test-retest correlation for the OCDS total score was .95 and the obsessive and compulsive subscales test-retest correlations were .93 and .89 respectively. The internal consistency of the items of the OCDS was high (alpha = .89). Principal component analysis had identified in the french version of the OCDS, three factors accounting for 63.5% of the total variance. These results indicate that the french version of the OCDS seems to validly measure a dimension of alcohol dependence. The ease of administration, reliability, and concurrent validity of the OCDS makes it particularly useful as an outcome measurement tool for various clinical therapeutic protocols in alcoholism.

[Angioplasty and coronary restoration using the internal mammary artery]. / Angioplastie et remodelage coronaire avec l'artère mammaire interne.

A technique of coronary surgical angioplasty is described. At the level of the stenosis the arteriotomy of the coronary artery is closed with the internal thoracic artery giving an enlargement patch effect. The major surface of the atherome plaque is excluded from the lumen of the anastomosis and put outside the suture line. The origins of the collateral arteries are kept in the vascular lumel. So the new remodeled coronary artery is formed with a small gutter of native coronary artery and the whole surface of the internal thoracic artery wall. In some cases it is useful to associate a limited endarterectomy to the angioplasty. Sixty-six surgical angioplasties have been done in extensive coronary disease. Operative mortality was 5.4% and myocardial infarction 5.4%.

[Complex coronary reconstructions using the internal mammary artery. Technique of surgical angioplasty, preliminary results]. / Reconstructions coronaires complexes avec l'artère mammaire interne. Technique de l'angioplastie chirurgicale, résultats préliminaires.

A technique of coronary surgical angioplasty is described. The long arteriotomy of the coronary artery over the stenosis is closed with the Internal Thoracic Artery (ITA) giving an enlargement patch effect. The majority of the atheromatous plaque is excluded from the lumen of the anastomosis and placed outside the suture line. The origin of the collateral arteries is preserved in the vascular lumen. The remodeled coronary artery is composed of a small gutter of native coronary artery and the whole surface of the ITA wall. In some cases, it is useful to associate a limited endarterectomy with the angioplasty. 66 surgical angioplasties have been performed in extensive coronary disease. Operative mortality was 5.4% with a myocardial infarction rate of 5.4%.