[MIRA study: epidemiology of microalbuminuria in type 2 diabetes patients and associated comorbidities]. / Enquête mira: épidémiologie de la microalbuminurie et des comorbidités associées chez le diabétique de type 2.

UNLABELLED: This is an observational survey screening for microalbuminuria in diabetes patients type 2. This survey takes place during the general practioner (GP) consultation in Rhône-Alpes area. It is preliminary survey. Five hundred and sixty three patients were included, consecutively, during the same week, by 185 GP. They were aged from 18 to 80 years and previously research for microalbuminuria was carried out at least one year ago. A questionnaire collecting data concerning age, weight, height, diabetic vintage and HbA1c, arterial pressure, renal function, associated risk factors as (lipids, tabacco, cardiovascular history personal and family, antihypertensive diabetic and lipid treatments. Microalbuminuria as well as urine creatinine was detected with a dipstick to calculate albumin-creatinine ratio. Patients aged 64.66 +/- 11.23, 55% were male; 51% had a microalbumuniria between 30 mL/L and 300 mL/L, but if one consider the albumin-creatinine ratio 59% had a microalbuminuria. In these patients, the diabetes history is longer and body mass index >30 is more frequent 35 vs 27%. HbA1c is similar in the two groups of patients, but patients with microalbuminuria had more often two treatments. Regarding hypertension, there are no difference between the two groups in term of blood pressure control and there is no correlation between blood pressure and albuminuria level. Nevertheless 68% of the patients were uncontrolled for blood pressure. Renal impairment (creatinine clearance <60 mL/min) was present in 26% of the whole group but more frequent in microalbuminuria patients 30 vs 23%. IN CONCLUSION: prevalence of microalbuminuria seems to be higher in this population compared to data previously reported and linked to the vintage of the diabetes mellitus. Comorbidities as well as risk factors were more frequent in patients with microalbuminuria.

[Evaluation of post transfusion hypertransaminasemia]. / Evaluation des hypertransaminasémies lors du bilan post-transfusionnel.

UNLABELLED: Dosage of post transfusion ALT has been performed since a government recommendation was issued in 1996. Yet, the advantage of this analysis during the post transfusion tests has not been determined. The aims of this study were to estimate: a) the incidence of hypertransaminasemia, b) the causes of hypertransaminasemia and c) the advantage of an etiologic investigation. PATIENTS AND METHODS: At the University Hospital of Brest, follow-up of the labile blood products recipients was initiated in June 1993. Since 1997, a visit in the hepatogastroenterology unit was systematically proposed to patients having post transfusion hypertransaminasemia. RESULTS: Since November 1997 to July 2003, ALT increase was detected in 235 patients (4%). Among them, 108 patients consulted a hepatologist. Diagnosis was certain for 46 patients (46%). A drug reaction or alcoholic disease was the cause of ALT elevation in the majority of cases (80%). The diagnosis was probable for 42 patients (39%) due to medications in 81% of cases. The diagnosis remained undetermined in 20 patients (18%). CONCLUSION: Our study shows that alcohol or drug hepatotoxicity explained the majority of post transfusion hypertransaminasemia. We could not demonstrate a viral cause. We have decided to continue the follow-up of post transfusion hypertransaminasemia during two more years and to reevaluate the usefulness of the etiologic investigation.

[Diagnosis of mediastinal neuro-endocrine tumor using endosonography guided transesophageal puncture biopsy]. / Diagnostic de tumeur neuro-endocrine médiastinale par ponction-biopsie transoesophagienne guidée sous échoendoscopie.

Histologic diagnosis of tumors of the mediastinum is mandatory for therapeutic management. The location and the variety of tumors are responsible for diagnostic difficulties. Endosonography guided fine-needle biopsy is an efficient and safe procedure for the diagnosis of peridigestive masses. We report the case of a patient with a neuroendocrine tumor of the mediastinum revealed by a mass syndrome. The diagnosis was performed by endosonography guided needle biopsy.