Anémie du sujet âgé

Anaemia is common in patients older than 75 years. Patho-physiologic mechanisms of anaemia are similar to that involved in younger patients even though certain mechanisms are more common in the elderly. Practical decisional algorithms have to be used for the diagnosis of anaemia. Risk factors for anaemia have been identified in this age group: institutionalization, bad socio-economic conditions, co-morbid conditions. Particular emphasis is given to several points:

1. The clinical tolerance of anaemia is the most important feature to take into account in older patients, rather than the decline of the haemoglobin level. Even if the haemoglobin level is only slightly decreased, evaluation of anaemia should be performed by the geriatrician, including, if needed, the achievement of a bone-marrow aspiration.
2. Causes of anaemia are often multiple, due to frequent comorbid conditions and acute illnesses, associated with nutritional deficiencies, inflammation… Chronic kidney disease and dysthyroidia are also common.
3. Nutritional deficiencies (iron, folate and/or B12 deficiency) are frequent and their cause has to be identified.
4. The prevalence of myelodysplastic syndromes, which are clonal diseases, is probably underestimated in this age group.

     

Dérivés Monotritylés du D-xylose

Monotritylation of O-acetyl derivatives of D-xylopyranose and D-xylofuranose with trityl chloride in acetonitrile-pyridine gave the tri-O-acetyl derivatives of 1-,2-, 3-, and 5-O-trityl-D-xylofuranose and of 1-, 2-, 3-, and 4-O-trityl-D-xylopyranose which were required for the identification of the various monotrityl derivatives obtained in the tritylation at 50° of D-xylose with trityl chloride in pyridine or hexamethylphosphoric triamide-silver acetate.     

Les sépultures italiennes du Paléolithique supérieur. Reconstitutions du régime alimentaire

The identification of dietary habits is increasingly seen as a fundamental aspect for studying the ancient human populations. Accordingly, several projects aiming to identify Paleolithic individuals’ dietary patterns were developed to analyze the organic component of bone tissue and identify isotopic markers to reconstruct the food typology. Bone fragments from six individuals were selected for carbon and nitrogen stable isotopes analysis. The interpretation of human isotopic data was framed through a dataset of twenty-one Italian Paleolithic individuals. The isotopic data generated for the Paleolithic individuals agree with the information already provided by the archaeological record concerning the Italian hunter and gatherer communities. Their subsistence economy was essentially grounded upon the exploitation of high protein foods, either from terrestrial fauna resources or inland lacustrine or riverine species.     

Études du Paléolithique du Japon à partir des téphras

Many studies and discussions have been made on the problem of when the earliest human beings appeared in Japan. In general, hominid fossils in the latest Pleistocene are not preserved except for coralline limestone sequence in Ryukyu islands, but earlier Paleolithic tools were excavated from volcanic ash soil with a ¹⁴C age of about 30,000–35,000 yr. BP or younger at several archeological sites in almost all Japan. Recent studies, however, show a need for revision and refinement of these ages because calibration techniques have progressed from conventional to calendar ages and high-resolution oxygen isotope chronology has given a global standard sequence. Aïra-Tn tephra (AT), the most important time-marker of the Paleolithic age in Japan, was formerly dated at 21,000–22,000 yr ¹⁴C BP by conventional radiocarbon methods but was dated again at ca. 24,500 yr ¹⁴C BP by accelerated mass spectrometry radiocarbon methods. However, it has been further calibrated to a high-resolution calendar age of 30,000 cal yr. by varve chronology of lake sediments of Suigetsu of central Japan, well matched with combined date between oxygen isotope dates based and calibration from AMS radiocarbon dates. As the earliest Paleolithic tools in south Kanto are found in volcanic ash soil significantly below AT ash and above Sambe-Ikeda ash (SI, ca.46 ka), just above the oxygen isotopic stage 3.3, they are estimated to be dated slightly older than 40 ka. Palaeo-environment at that time is estimated mild to cool climate and relatively low sea level after the oxygen isotope stage 3.3. Sill land bridges between Japan islands and continents have not been formed at major straits. We have not yet obtained useful data for calibration older than ca. 45 ka. Also, correlation of oxygen isotopic fluctuation with the terrestrial sequences is incomplete in Stage 3.     

Impact du délai diagnostique sur la survie du cancer du testicule

Objectives

Testicular cancer is the leading cancer of young adults and its incidence is increasing in almost all industrialized countries. The survival rate after testicular cancer is 95%, all stages combined, but a group of patients with poor prognosis still fails to respond to treatment. The time to diagnosis is defined as the time in months between perception of the first symptoms of testicular cancer by the patient and the diagnosis of the disease by the doctor. The objective of this study is to determine whether the time to diagnosis has a prognostic value, particularly whether it is correlated with the stage of the disease and survival.

Material and Methods

The time to diagnosis was studied in 542 patients with a diagnosis of testicular cancer between 1983 and 2002 in the Midi-Pyrenées region. Information concerning the disease and treatments contained in medical files was collected on a summary document. The time to diagnosis was correlated with prognostic parameters, including stage and survival.

Results

The mean time to diagnosis was 3.7±5.1 months and was longer for seminomas (4.9±6.1 months) than for non-seminomatous germ cell tumours (NSGCT) (2.8 ±4.0 months). The time to diagnosis was correlated with the stage of the disease and the 5-year survival on the overall population and in the NSGCT group, but not in the seminoma group.

Conclusions

Early diagnosis has a prognostic value (correlation with stage of the disease and 5-year survival rate). Testicular cancer information campaigns should therefore be envisaged.     

Epidémiologie du risque cardio-vasculaire

L’épidémiologie des maladies cardio-vasculaires est étonnante, et apparemment contradictoire.     

Les responsabilités du biologistes

The responsabilities of the professionals are numerous and various. As an exemple, we discuss the french law (29 july 1994) about the practice of reproductive biology. There are three levels of responsabilities:

? civil liability concern the damage to somebody, the means, information, confidentiality.

? penal code concern the integrity of somebody, the safety of the staff and of the patients.

? administrative.

All the professionals must be aware of the legislation and the penalties they might incur.     

Isorthid AE (Brachiopoda) du dévonien inférieur du massif armoricain

Three species of Isorthidae are described in the Lower Devonian of the Armorican Massif. Two of them were hitherto badly known, being never adequately described nor figured: Isorthis (Protocortezorthis) miloni from the Gahard Formation (Gedinnian) and Isorthis (Protocortezorthis) trigeri from the Saint-Céneré Formation (Gedinnian-Siegenian). Isorthis oehlertiSolle, 1976 is considered as a synonym of Isorthis (Protocortezorthis) trigeri. The geographic distribution of these species allows to corroborate that until the top of the Lower Devonian (top of Le Faou Formation), two provinces with different faunal associations exist in the Armorican Massif.     

La découverte d’un galet gravé du Paléolithique final dans la région du Haut Iénisséï (Sibérie du Sud)

The paper deals with the artifact found during the realization of a salvage archaeological project connected with the construction of the railway from Kyzyl to Kuragino (the Krasnoyarsk Region, South Siberia) in 2012. During the exploration of the multicomponent habitation site of Irba 2 below the Holocene cultural strata the Pleistocene remains have been unearthed. These include bones of bison, reindeer, red deer, giant deer, wild horse, brown bear and hare, lithics, and pieces of worked antler. Radiocarbon dates indicate the Final Pleistocene age (ca. 13 to 11 kyr BP). The assemblage belongs to the Afontova culture dominated in the upper reaches of Yenisei during the Final Upper Paleolithic. The rare finding, an unique engraved oval-shaped flat pebble of white marble is worth to mention. It has 37 lateral grooves, cross-shaped engravings in the central parts of both lateral surfaces and traces of unfinished hollows. The nearest analogs are agalmatolite discs from the sites of Afontova Gora II and III located at Krasnoyarsk. These findings are rare in the Paleolithic and could be considered as amulets.     

Réactivité du plasmalemme végétal Etude cytochimique

Résumé Plusieurs méthodes cytochimiques utilisées convergent pour indiquer l'existence d'une réactivité du plasmalemme, qui le distingue des autres cytomembranes. 1. Des résultats positifs constants ont été obtenus avec deux sortes de méthodes. Certaines sont effectues sur pièces, utilisant la capture de métaux colloïdaux par les groupements électronégatifs. D'autres sont réalisées sur coupes ultrafines: technique dérivant de l'APS et méthode utilisant l'acide phosphotungstique à bas pH, dans différents milieux d'inclusion. 2. D'autres méthodes fournissent des résultats plus sporadiques, en particulier les techniques de détection d'ions inorganiques.Ces données cytochimiques tendent à indiquer l'existence d'une sorte de glycocalyx au niveau du plasmalemme végétal, évoquant celui des cellules animales. Il s'en distingue toutefois par certains caractères (absence d'action de la neuraminidase). La confrontation de ces résultats avec ceux obtenus après les tests d'activité enzymatique ou après des études histoautoradiographiques, confirme l'idée d'une organisation du plasmalemme, liée à son activité.Ces résultats fournissent des précisions sur les modalités de différenciation des membranes et sur leurs relations dans les phénomènes d'échange entre la cellule et le milieu extérieur (pinocytose, émission de vésicules sécrétrices).

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Reactivity of the plasmalemma. Cytochemical study

Summary Several cytochemical methods converge to indicate a reactivity of the plasmalemma, which makes it different from others cytomembranes. 1. Positive and constant results are obtained with two kinds of methods. Some are performed on specimen blocks, using the binding of colloidal metals with electronegative groups; some are performed on ultrathin sections: procedure derivating from PAS reaction, and method using phosphotungstic acid at a low pH in different embedding resins (epon, araldite, methacrylate, glycol-methacrylate). 2. Rather sporadic results are obtained with other procedures, specially those which demonstrate inorganic ions.These cytochemical data tend to indicate the existence, at the level of the plasmalemma, of a kind of glycocalyx similar to that described in animal cells. It is however different in some characteristics (neuraminidase has no effect on its reactivity).After a comparison of the results with those obtained from enzymatic tests or autoradiographic studies, the idea of a special activity of the plasmalemma is enhanced.These results give some informations on the ways the differenciation of cytomembranes occurs, and on their relations during exchanges between the cell and the exterior (pinocytosis and emission of secretory vesicles).

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Abréviations f fossette sécrétrice (anfractuosité du plasmalemme contenant des polysaccharides) - G dictyosome (appareil de Golgi) - ls lomasome - m mitochondrie - mn membrane nucléaire - mt méat - n noyau - P paroi - pe plasmalemme (pellicule ectoplasmique) - pl plaste - ps plasmodesme - re reticulum endoplasmique - sl slime body (corps muqueux de tube criblé) - t tractus polysaccharidique reliant cytoplasme et paroi - v vésicule cytoplasmique - va vacuole - Grossissement sur chaque cliché, le trait représente 0,5 micron     

Altérations environnementales du développement du testicule foetal: zoom sur les phtalates

There are great concerns about the increasing incidence of abnormalities in male reproductive function. Human sperm counts have markedly dropped, and the rate of testicular cancer has clearly increased over the past four decades. Moreover, the prevalence rates of cryptorchidism and hypospadias are also probably increasing. It has been hypothesized that all these adverse trends in male reproduction result from abnormalities in the development of the testis during foetal and neonatal life. Furthermore, many recent epidemiological, clinical and experimental data suggest that these male reproductive disorders could be due to xenobiotics termed endocrine disruptors, which are becoming more and more concentrated and prevalent in our environment. Among these endocrine disruptors, we chose to focus this review on phthalates for different reasons: 1) they are widespread in the environment; 2) their concentrations in many human biological fluids have been measured; 3) the experimental data using rodent models suggesting a reprotoxicity are numerous and are the most convincing; 4) their deleterious effects on the development and function of the rat foetal testis have been largely studied; 5) some epidemiological data in humans suggest a reprotoxic effect at environmental concentrations at least during neonatal life. However, the direct effects of phthalates on human foetal testis have never been explored. Thus, as we did for the rat in the 1990s, we recently developed and validated an organotypic culture system, which allows maintenance of the development of the different cell types of human foetal testis. In this system, the addition of 10^?4 M MEHP (mono-2-ethylhexyl phthalate), the most produced phthalate, had no effect on basal or LH-stimulated production of testosterone, but it reduced the number of germ cells by increasing their apoptosis, without modifying their proliferation. This is the first experimental demonstration that phthalates alter the development of the foetal testis in humans. Using our organotypic culture system, it is interesting to compare these results obtained in humans with the response to MEHP in the mouse and the rat testes to analyse the relevance of toxicological tests based on rodent models.