Adéquation en dialyse péritonéale : mise au point

The optimal method to assess the adequacy of peritoneal dialysis therapies is controversial. Today, the adequacy must not be considered as a number or a concept assessed only by two parameters (total KT/V urea and total solute clearance) but defined by many more items. In the absence of data, based on theoretical considerations, the reanalysis of the CANUSA study showed that renal kidney function, rather than peritoneal clearance, was associated with improved survival. Residual renal function is considered as a major predictor factor of cardiovascular mortality. Results of this reanalysis were supported by the adequacy data in ADEMEX, EAPOS and ANZDATA studies. Therefore, clinical assessment plays a major role in PD adequacy. The management of fluid balance, the regular monitoring of malnutrition, the control of mineral metabolism and particularly the glucose load, considered as the “corner-stone” of the system, are the main points to be considered in the adequacy of PD patients. The essential goal is to minimize glucose load by glucose-sparing strategies in order to reduce the neoangiogenesis of the peritoneal membrane.     

Hypoxia increases leptin expression in human PAZ6 adipose cells

AIMS/HYPOTHESIS: Leptin, an adipose tissue-derived cytokine involved in the control of body weight, also participates in a variety of biological functions, including angiogenesis. Because reduced oxygen availability is a major inducer of angiogenesis, we hypothesized that low cellular oxygen tension could regulate leptin expression in adipose cells. METHODS: Differentiated PAZ6 adipocytes were cultured for 48 h in the presence of chemical inducers of cellular hypoxia (cobalt chloride or desferrioxamine) or in an atmosphere containing only 6% oxygen. The effect of hypoxia on the expression of leptin and several adipose genes was assessed by semi-quantitative RT-PCR. The effect of hypoxia on leptin promoter activity was tested in PAZ6 cells transiently transfected with a luciferase reporter construct, containing 1.87 kb of the human leptin promoter. Leptin secretion in the culture medium was determined by radioimmunoassay. RESULTS: Hypoxia increased leptin mRNA expression, leptin promoter activity and leptin secretion in the culture medium by two- to threefold ( p<0.05). The expression of the glucose transporter isoform 1 (GLUT-1) mRNA, a well known hypoxia inducible gene, was also increased. In contrast, glucose transporter isoform 4 (GLUT-4), hormone sensitive lipase (HSL), fatty acid binding protein (aP2) and uncoupling protein 2 (UCP2) mRNAs were markedly reduced by hypoxia. In addition, a similar hypoxia-induced increase in leptin mRNA and secretion was observed in primary rat adipose cells. CONCLUSION/INTERPRETATION: Hypoxia markedly and specifically increased leptin gene expression through activation of the leptin gene promoter, and this resulted in an increased leptin production by human PAZ6 adipocytes.     

Severe hemolysis complicated by renal insufficiency in a patient with mitro-aortic bioprostheses and review of the literature

The authors report a very rare case of massive haemolytic anaemia complicated by renal failure in a patient with a double aortic and mitral bioprosthesis. The haemolysis was attributed to degeneration of the aortic bioprosthesis causing turbulent flow, aggravated by associated infectious endocarditis. The essential condition for haemolysis is a change in blood flow through the valve by degeneration or other associated pathology. The haemolytic anaemia completely regressed after aortic valve replacement as did the renal failure.     

Synthesis of Telechelic Oligomers via Atom Transfer Radical Polymerization, 1

Summary: Atom Transfer Radical Polymerization (ATRP) of styrene was carried out at 110 °C using various substituted 2‐bromoisobutyrates as initiators and the homogeneous catalyst CuBr/1,1,4,7,10,10‐hexamethyltriethylenetetramine (HMTETA). Telechelic oligomers were obtained by coupling the bromo terminated polymers using Cu(0)/PMDETA catalyst at 90 °C. The products were characterized by ¹H NMR and MALDI‐TOF and some unsaturated polymer chains were observed. They could originate from either disproportionation reaction or dehydrohalogenation of halogen terminated oligomers during MALDI analysis. Using this method, polymers with hydroxy, acid, or ester end groups were synthesized in a range of molecular weights from 1 000 to 13 000 g · mol^?1. Coupling efficiency was between 79 and 100%, depending on the structure of the initiator.

Coupling reaction of substituted polystyrenes using Cu(0)/PMDETA system at 90 °C.     

Lipid profile,inflammation, and oxidative status in peri- and postmenopausal women

Objective: To evaluate the effect of perimenopause and postmenopause on lipid profile, inflammation, and oxidative stress in women.

Methods: This cross-sectional study included 117 women (47?±?6 years) classified as perimenopausal (n?=?47), postmenopausal (n?=?40), or non-menopausal (n?=?30). In serum, we analyzed lipid profile, tumor necrosis factor-alpha (TNF-α), interleukin-1α (IL-1α), and C-reactive protein (CRP). Pro-oxidant status was assessed by thiobarbituric acid reactive substances (TBARS) and protein carbonyls. Antioxidant defense was performed by analysis of superoxide dismutase (SOD) and catalase activities.

Results: Compared to non-menopausal women, triacylglycerols (TG) were similar, total cholesterol and LDL-C were higher in perimenopausal and postmenopausal women, while HDL-C concentrations were decreased. TNF-α and IL-1α were higher in postmenopausal women, while CRP concentrations were elevated in both peri-and postmenopausal women (p?p?p?Conclusion: Menopausal transition and postmenopause were associated with dyslipidemia, inflammation, and unbalanced oxidative status exposing women to cardiovascular risk.     

Primary ciliary dyskinesia gene contribution in Tunisia: Identification of a major Mediterranean allele

Primary ciliary dyskinesia (PCD) is a genetically heterogeneous disease of motile cilia. Even though PCD is widely studied, North‐African patients have been rarely explored. In this study, we aim at confirming the clinical diagnosis and explore the genetic spectrum of PCD in a cohort of Tunisian patients. Forty clinically diagnosed patients with PCD belonging to 34 families were recruited from Tunisian pediatric departments. In each proband, targeted capture PCD panel sequencing of the 40 PCD genes was performed. PCD panel sequencing identified bi‐allelic mutations in 82% of the families in eight PCD genes. Remarkably, 23.5% of patients carried the same c.2190del CCDC39 mutation. Single nucleotide polymorphism profiling in six unrelated patients carrying this mutation has revealed a founder effect in North‐African patients. This mutation is estimated to date back at least 1,400–1,750 years ago. The identification of this major allele allowed us to suggest a cost‐effective genetic diagnostic strategy in North‐African patients with PCD.     

Intraosseous Lipoma of the Calcaneus: Report of a Case and Review of the Literature

Intraosseous lipoma is a rare, benign primary tumor occurring in bone. In the present report, a case of an intraosseous lipoma of the calcaneus is presented, together with a focused review of published studies. Radiographically, the lesions will appear osteolytic and well delineated, displaying a central area of calcification. Curettage and packing with autogenous bone grafts was our treatment for this rare tumor. In the present case, and 1 previously published case, a central sclerotic mass was observed. The histologic findings were typical, with mature adipose tissue mixed with a few degenerated bone trabeculae.