Synthesis and anti-inflammatory effect of lipoxins in human airway epithelial cells.

In this study, we investigated the synthesis of lipoxins (LXs) and their anti-inflammatory effects in different human airway epithelial cell culture models. After cell incubation with exogenous 5(S),6(R)-dihydroxy-7,9-trans-11,14-cis-eicosatetraenoic acid, LXA(4) was detected in supernatants of differentiated human bronchial epithelial cells by contrast to non-differentiated cells. Exogenous LXA(4) significantly inhibited tumor necrosis factor-alpha (TNF-alpha)-induced interleukin-8 (IL-8) release in the different epithelial cell types and the potency of inhibition was dependent of the accessibility of the specific LXA(4) receptor, formyl-peptide receptor like-1 (FPRL-1) expressed by all these cells. Immunohistochemistry analysis on human bronchial biopsies showed a high expression of FPRL-1 in the epithelium. Finally, an FPRL-1 receptor antagonist, boc-2 peptide reversed LXA(4) effect on IL-8 generation. Together, these findings indicate that differentiated human bronchial epithelium synthesizes LX in vivo which could have autocrine actions through its specific receptor FPRL-1 to promote resolution of airway inflammation.     

Control of laser treatment of 58 cervical condylomas: cyto-colposcopic correlations at 3, 6 and 12 months

Cytologic and colposcopic findings 3, 6 and 12 months after laser treatment of cervical condyloma or intraepithelial neoplasia have been studied. Cytologic features of Papillomavirus infection were evidenced in 28 cases by cytology but only in 12 by colposcopy. The cytologic most frequent feature was parakeratosis without clear koilocytosis. One year after laser treatment, cytology and colposcopy showed features of papillomavirus infection in only seven cases. Thus, spontaneous regression of colposcopically detected lesions occurred in five cases. In 16 cases, the parakeratosis detected on the first smear seem to represent healing and tissue maturation more than the persistence of HPV infection.     

La téléconsultation pour le suivi après radiothérapie du cancer de la prostate : une place à l’innovation numérique en cancérologie

PurposeThe annual follow-up in radiotherapy for prostate cancer consists of an oral interview with a radiation oncologist. The present study aimed at surveying the target population on their knowledge and perceptions of telemedicine.Materials and methodsA prospective study was conducted at the Lucien Neuwirth Cancer Institute (France) that included patients with prostate cancer undergoing treatment or in follow-up, during spring 2019 (n = 158). A specific questionnaire was designed for the study. Patient's self-evaluation of satisfaction and enthusiasm was assessed through visual analog scale (VAS) (0/10 to 10/10).ResultsOne hundred and fifty-eight patients completed the survey. The vast majority of the population commonly used phone for communication and 56% of patients owned internet connexion. Around 56% of patients declared telemedicine knowledge without having ever experienced telemedicine. If 60.8% of patients would not be against telemedicine with a median enthusiasm VAS of 6/10, patients’ opinions were divergent: 48.7% of patients would like to keep a classical follow-up and 48.7% of patients would envision to alternate classical consultation with telemedicine.ConclusionThis feasibility study with an aged cohort showed that telemedicine is a valuable option for long-term radiotherapy follow-up, even if therapeutic education and information will be necessary to supervise this novel approach.     

Functional and echocardiographic improvement following multisite biventricular pacing for congestive heart failure

BACKGROUND: Heart failure remains a major cause of morbidity and mortality despite advances in pharmacological treatment. Recently, multisite biventricular pacing has been used in the treatment of patients with heart failure. OBJECTIVES AND METHODS: The short and medium term effects of this treatment modality were assessed, and the association between baseline clinical characteristics and the positive response to treatment was investigated. Consecutive patients who received this treatment modality were included. They underwent comprehensive clinical and echocardiographic assessment including a 6 min walk at baseline, one month and three months. RESULTS: Between January 1998 and June 1999, 95 patients received multisite biventricular pacing therapy in the three participating hospitals. In 63 patients with complete three-month follow-ups, there were improvements from baseline to three-month follow-up in New York Heart Association heart failure (3.3 +/- 0.5 to 2.2 +/- 0.6, P<0.001) and 6 min walk (305 +/- 120 to 403 +/- 113 m, P<0.001). Significant salutary changes in echocardiographic measurements were also observed in left ventricular (LV) diastolic dimension, ejection fractions (EFs), interventricular contraction delay and severity of mitral regurgitation (MR). The 63 patients were categorized into responders (n=42) and nonresponders (n=21) based on the clinical response. Clinical characteristics were similar between the two groups. The responders had a more pronounced decrease in QRS width. An increase in LVEF and a reduction in LV diastolic dimension, interventricular mechanical delay and severity of MR were observed in the responders but not in the nonresponders. Furthermore, there was a positive association between the reduction in QRS width and the increase in LVEF. CONCLUSIONS: Cardiac resynchronization by means of multisite pacing appears to be a promising therapy in the treatment of heart failure. The salutary clinical response is associated with echocardiographic improvement.     

Inflammatory bowel disease in primary immunodeficiency disorders is a heterogeneous clinical entity requiring an individualized treatment strategy: A systematic review

ObjectiveTo describe the prevalence, clinical presentation and current treatment regimens of inflammatory bowel disease (IBD) in patients with primary immunodeficiency disorders (PIDs).MethodsA systematic review was conducted. The following databases were searched: MEDLINE, Embase, Web of Science, the Cochrane Library and Google Scholar.ResultsA total of 838 articles were identified, of which 36 were included in this review. The prevalence of IBD in PIDs ranges between 3.4% and 61.2%, depending on the underlying PID. Diarrhea and abdominal pain were reported in 64.3% and 52.4% of the patients, respectively. Colon ulceration was the most frequent finding on endoscopic evaluation, while cryptitis, granulomas, ulcerations and neutrophilic/lymphocytic infiltrates were the most frequently reported histopathological abnormalities. Described treatment regimens included oral corticosteroids and other oral immunosuppressive agents, including mesalazine, azathioprine and cyclosporin, leading to clinical improvement in the majority of patients. In case of treatment failure, biological therapies including TNF- α blocking agents, are considered.ConclusionsThe overall prevalence of IBD in patients with PID is high, but varies between different PIDs. Physicians should be aware of these complications and focus on characteristic symptoms to reduce diagnostic delay and delay in initiation of treatment. Treatment of IBD in PIDs depends on severity of symptoms and may differ between various PIDs based on distinct underlying pathogenesis. An individualized diagnostic and therapeutic approach is therefore warranted.     

Multidisciplinary team meeting for complex bone and joint infections diagnosis: The PHICTOS study

Background

In France, the most severe bone and joint infections (BJI), called “complex” (CBJI), are assessed in a multidisciplinary team meeting (MTM) in a reference center. However, the definition of CBJI, drawn up by the Health Ministry, is not consensual between physicians. The objective was to estimate the agreement for CBJI classification.

Incidence and survival rates during a two-year period of intracerebral and subarachnoid haemorrhages, cortical infarcts, lacunes and transient ischaemic attacks. The Stroke Registry of Dijon: 1985-1989.

The age- and sex-specific incidence and survival rates over two years of intracerebral and subarachnoid haemorrhages, cortical infarcts, lacunes and transient ischaemic attacks (TIA) in a town of 140,000 inhabitants, are reported. During the five years, (1985 to 1989), 984 patients suffering from first stroke were registered by the Dijon Stroke Registry. The diagnosis was established by a CT-Scan in 88% of cases. Intracerebral haemorrhages (ICH) account for 8.8% of strokes, subarachnoid haemorrhages (SH) for 1.5%, cortical infarcts (CI) for 45.6%, lacunes for 16.7%, TIA for 15.8%, and 11% were undetermined. The annual average incidence rates per 100,000 are 13.4 for ICH, 2.0 for SH, 69.0 for Cl, 30.0 for lacunes and 25.5 for TIA. The survival rates for the acute stage (up to four weeks) differ between ICH and SH (46% and 67%), and the other types of strokes: 77% for Cl, 90% for lacunes and 98% for TIA. The survival rates of unclassified stroke are similar to ICH rates. At two years, survival rates of lacune and TIA are the highest. The divergences between public hospital based data and population-registry data are discussed. A population registry is necessary for studying the natural history of stroke.