Outcome of transcatheter aortic valve replacement in patients over 85 years of age versus patients aged 85 and younger.

INTRODUCTION: The Dutch general population is aging rapidly. Many of these patient are fit and eligible for TAVR. However, studies on outcome in older versus younger patients are scant. MATERIAL AND METHODS: A single-centre retrospective study comparing patients older and younger than age 85 on outcome. RESULTS: 190 patients underwent TAVR: 136 were aged 85 or younger (U85), 54 were older than 85 (O85). The U85 group had more men (U85: 71 [52.2%] vs O85: 19 [35.2%]; p = 0.034), a higher incidence of diabetes (U85: 36 [26.5%] vs O85: 3 [5.6%]; p = 0.001) and atrial fibrillation (U85: 35 [25.7%] vs O85: 5 [9.3%]; p = 0.03) and a higher body mass index (U85: 27.5 [±â€¯5.24] vs O85: 26 [±â€¯3.78]; p = 0.027). In the O85 group there was a lower estimated glomerular filtration rate (O85: 50.28 [±â€¯15.32] ml/min vs U85: 65.25 [±â€¯29.97] ml/min; p = 0.012). There was no difference in 30-day mortality (U85: 6 [4.4%] vs O85: 3 [5.6%]) and 1­year mortality (U85 9 [6.6%] vs O85 3 [5.6%]) (p = 0.521). There was an equal amount of new onset permanent left bundle branch block (U85: 38 [27.9%] vs O85: 14 [25.9%]; p = 0.896) and permanent pacemaker implantation (U85: 28 [20.6%] vs O85: 28 [20.6%]; p = 0.748). There was no difference in bleeding events (p = 0.469), vascular complications (p = 0.195) or moderate/severe regurgitation (p = 0.972). The U85 group had a slightly longer admission duration (U85 6.29 [±â€¯5.289] days vs O85 5.98 [±â€¯3.328] days (p = 0.037)). CONCLUSION: TAVR in patients over 85 years of age has excellent outcome, comparable to those aged 85 and younger.

Understanding the molecular sensitization for Cypress pollen and peach in the Languedoc-Roussillon area.

BACKGROUND: Cypress allergy is a typical winter pollinosis and the most frequent one in the South of France. Main symptoms are rhinitis, conjunctivitis, and asthma. Peach allergy is common too in Southern Europe. Allergic cross-reactions between cypress and peach have been reported, including an oral allergy syndrome. We wanted to investigate whether a cross-reactive allergen between cypress and peach might be responsible for the observed clinical association. METHODS: We analyzed 127 patients included over a 3-month period, outside the pollen season, and we dosed specific IgE levels, for selected, individual allergens. RESULTS: Patients sensitized to peach were mainly positive for the peach-nonspecific lipid-transfer protein. CONCLUSIONS: Profilins or thaumatins could not explain the observed clinical association between cypress and peach.

[Mesenteric lymph node cavitation disclosing celiac disease in adults]. / Cavitation ganglionnaire mésentérique révélatrice de maladie coeliaque chez l'adulte.

We report a case of cavitation of the mesenteric lymph nodes, an uncommon complication of celiac diseases. Computerized tomography is the method of choice for diagnosis and follow up after gluten free diet.

[Evaluation of Amplicor MTB PCR assay for the detection of Mycobacterium tuberculosis in specimens by means of negative direct microscopic examination]. / Evaluation du test PCR Amplicor MTB pour la détection de Mycobacterium tuberculosis dans des prélèvements à examen microscopique direct négatif.

The reliability of the Roche Amplicor Mycobacterium tuberculosis test (Amplicor MTB) was evaluated by testing smear-negative specimens from patients with clinical and radiological characteristics of tuberculosis. A total of 364 clinical samples including biopsies and fluids from 153 patients was tested using the Amplicor MTB and the results were compared with those of culture. After discrepancy resolution and patients chart review, sensibility, specificity, positive predictive value and negative predictive value were 44.7%, 99.7%, 94.4% and 93.9% respectively. Our study indicates that Amplicor MTB, despite its low sensibility and for its high specificity can bring a valuable complement for improving the laboratory diagnosis of tuberculosis.