Histoire du transport néonatal : progrès dans l’organisation au cours des 30 dernières années

Since the end of the seventies neonatal transfers in France and in most of the europeans countries are organized and realized by specialized teams often with the survey of pediatricians. The teams are « dedicated » for a region or « on call » for a neonatal intensive care unit in a perinatal network. In France, the law has changed following the « Perinatal Plan ». Neonatal transport is now defined in two levels: medical team or teamswith paramedics. In our country, the neonatal emergency transfer systems (Smur pédiatrique) have taken an important part to the diffusion of technical progress and care protocols during the last fifteen years, to improve results and for perinatal regionalisation. They also have played a role in the evaluation of the perinatal policies and in the education of pediatricians, midwifes and nurses.     

Effects of pretreatment with a urea-containing emollient on nickel allergic skin reactions

The aim of this study was to evaluate the effect of a moisturizer containing urea on allergic contact dermatitis. Twenty-five nickel-sensitized patients and five controls (non-sensitized volunteers) applied such a moisturizer on the volar side of one forearm twice daily for 20 days, while the other forearm served as the control. After treatment with the moisturizer, patch tests with 0%, 0.5% and 2% NiSO4 in petrolatum were applied in a randomized manner on each arm. After 72 h, the skin reactions were blindly evaluated by clinical scoring and by measuring transepidermal water loss and electrical impedance. After treatment, the baseline transepidermal water loss values were lower and the baseline magnitude impedance index values were higher on the pretreated forearm. According to clinical scoring and measurements with the two physical measurement techniques, the degree of the patch test reactions was equal. All control subjects had negative nickel tests. We concluded that the skin reactivity to nickel in nickel-sensitized patients is not significantly affected by use of the urea-containing moisturizer.     

Whole-genome views of chromatin structure

DNA in eukaryotes is packed into chromatin. The basic component of chromatin is the nucleosome consisting of DNA wrapped around a histone octamer. Inside the cell nucleus, chromatin is folded into higher-order structures through various mechanisms, including repositioning of nucleosomes along the DNA, packing of nucleosomes into more condensed 3-dimensional configurations, looping of chromatin fibres, and tethering of chromosomal regions to nuclear structures. Over the past few years, new microarray-based methods have been developed for the genome-wide mapping of various aspects of chromatin structure. These methods are beginning to provide insights into the different types of chromatin and the architectural principles that govern the 3-dimensional organisation of the genome inside the nucleus.     

G1‐S transition defects occur in most breast cancers and predict outcome

Cell cycle deregulation is frequently observed in tumors and has moreover been proposed to be a requirement for tumor development. By analyzing the expression of p27 by immunohistochemistry in 100 primary breast tumors and combining the analyses with our earlier characterization of cyclin E, D1, p16, and the retinoblastoma protein (pRB), we have been able to cover the majority of potential G1–S transition defects and observed that 90% of the tumors had alterations in one or several cell cycle regulatory proteins. Considerable variations in protein levels were found among tumors, with low p16 expression as the most common alteration followed by cyclin E or cyclin D1 overexpression, low p27 expression or pRB inactivation in decreasing prevalence. Tumors were grouped according to observed combinations of defects and the proliferative capacity was determined for each group by analyzing Ki–67 labeling index. Low proliferation was observed in tumors with: low p16; high cyclin Dl with normal or high p16 expression; and in tumors without cell cycle defects. Tumors with high cyclin E/low p27 or pRB defects showed higher proliferation. The survival differed noticeably for patients with various combinations of cell cycle defects, and four distinctive clusters were identified showing significantly different breast cancer specific survival (p<0.0001) for both node-positive (p=0.0006) and node-negative patients (p<0.0001). In summary, we have shown that G1-S transition defects are nearly obligatory in breast tumors and that the specific type of cell cycle defect influences the clinical behavior of the tumor.     

Long-term treatment with moisturizers affects the mRNA levels of genes involved in keratinocyte differentiation and desquamation

In a recent study, we showed that long-term treatment with two different moisturizers affected TEWL in opposite directions. Therefore, we decided to examine the effect of these moisturizers on the cellular and molecular level. In a randomized controlled study on 20 volunteers, epidermal mRNA expression of genes essential for keratinocyte differentiation and desquamation after a 7-week treatment with two moisturizers was analyzed. Treatment with one test moisturizer increased gene expression of involucrin, transglutaminase 1, kallikrein 5, and kallikrein 7, while the other moisturizer affected only expression of cyclin-dependent kinase inhibitor 1A. Thus, moisturizers are able to modify the skin barrier function and change the mRNA expression of certain epidermal genes. Since the type of influence depends on the composition of the moisturizer, these should be tailored in accordance with the requirement of the barrier of each individual patient, which merits further investigations.     

Content of fragrance mix ingredients and customer complaints of cosmetic products.

BACKGROUND: In relation to the wide use of cosmetics, serious adverse effects are rare. Occasionally, unwanted effects such as contact dermatitis are reported. Allergic reactions to cosmetics are often caused by fragrances. OBJECTIVE: The aim was to investigate the content of fragrance mix (FM) ingredients in cosmetic products of the brand ACO HUD (Stockholm, Sweden) and the frequency of customer skin complaints about fragranced and unfragranced products over 4.5 years. METHOD: Content of FM ingredients in the fragrances used was both analyzed and requested from the suppliers. Customer complaints were those reported to the company. RESULTS: Between 1 and 7 of FM ingredients were present in levels of less than 0.1 to 770 ppm. The ingredients, in order of frequency, were geraniol, eugenol, hydroxycitronellal, alpha-amyl cinnamic aldehyde, isoeugenol, cinnamic alcohol, and oak moss. Cinnamic aldehyde was not found. No significant difference was found either between the frequency of complaints about products with and without fragrance (P = .21) or in a paired comparison of 17 formulas marketed with and without fragrance (P = .24). CONCLUSION: The study suggests that the investigated fragranced products had a low content of FM ingredients, which might explain the absence of a higher frequency of adversities. Furthermore, it appears that under such circumstances fragrances may be used without introducing an increased rate of spontaneous complaints of skin reactions.     

The effect of a corticosteroid cream and a barrier‐strengthening moisturizer in hand eczema. A double‐blind,randomized, prospective,parallel group clinical trial

Background Hand eczema is a common and persistent disease with a relapsing course. Clinical data suggest that once daily treatment with corticosteroids is just as effective as twice daily treatment. Objectives The aim of this study was to compare once and twice daily applications of a strong corticosteroid cream in addition to maintenance therapy with a moisturizer in patients with a recent relapse of hand eczema. Methods The study was a parallel, double‐blind, randomized, clinical trial on 44 patients. Twice daily application of a strong corticosteroid cream (betamethasone valerate 0.1%) was compared with once daily application, where a urea‐containing moisturizer was substituted for the corticosteroid cream in the morning. The investigator scored the presence of eczema and the patients judged the health‐related quality of life (HRQoL) using the Dermatology Life Quality Index (DLQI), which measures how much the patient’s skin problem has affected his/her life over the past week. The patients also judged the severity of their eczema daily on a visual analogue scale. Results Both groups improved in terms of eczema and DLQI. However, the clinical scoring demonstrated that once daily application of corticosteroid was superior to twice daily application in diminishing eczema, especially in the group of patients with lower eczema scores at inclusion. Conclusions Twice daily use of corticosteroids was not superior to once daily use in treating eczema. On the contrary, the clinical assessment showed a larger benefit from once daily treatment compared with twice daily, especially in the group of patients with a moderate eczema at inclusion.     

No skin reactions to mineral powders in nickel-sensitive subjects

Background. Cosmetic products are known to be able to induce contact dermatitis. Contact dermatitis may also be induced by nickel, and it is estimated that up to 17% of women are allergic to nickel. Objectives. The aim of the present study was to investigate whether nickel sensitized individuals react to make‐up products containing pigments with nickel as an impurity. Patients/Materials/Methods. Twenty‐three individuals with a clinical history of nickel allergy and/or with positive patch test reactions to nickel were exposed to mineral make‐up products and individual pigments dispersed in alkylbenzoate (50%) in small Finn Chambers^® for 48 hr. The skin reactions were evaluated visually and with a non‐invasive instrument that quantifies skin erythema. Results. The results showed that 74% of the included individuals showed a visible reaction to the positive control nickel sulfate, and a significant correlation was found between the visual and instrumental readings. However, none of the nickel sensitive individuals reacted to the test products. A subgroup analysis of the 50% most sensitive individuals also confirmed the absence of skin reactions to the powders. Conclusions. The bioavailability of the trace amounts of nickel in the particles was below the level needed to elicit an eczematous reaction in any of the nickel‐sensitized individuals.