Le développement de l’inventaire de dépistage ERIraos: un outil global d’appréciation du risque d’évolution psychotique

Adequate identification of patients for early intervention programmes requires reliable and valid assessment tools. Within the German Schizophrenia Network (Kompetenznetz Schizophrenie) a set of schedules for early detection of schizophrenia has been proposed: the Early Recognition Inventory ERIraos. ERIraos is a two-step procedure with a 17-item checklist used at step 1 by GPs, psychologists, teachers, while a comprehensive 110-item symptom list is applied at early intervention centres at the expert level. In addition, ERIraos allows the assessment of several risk factors for psychosis such as familial load, childhood deficiencies, alcohol and drug use by special modules. Some preliminary results are presented here. The frequency of the 17 checklist symptoms increases from the early to the late prodrome, and more specific symptoms occur over time. The 17 checklist symptoms are grouped by factor analysis to 5 factors (psychotic, depressive, disorganised, withdrawn, dysphoric). In addition to prodromal symptoms, most patients (86.2%) report at least one additional risk factor (mean: 1.7 risks). 68% demonstrate some schizotypal features, 53% report alcohol and/or drug consumption, 24% demonstrate some deficiency or delay in childhood development, 21% report definite obstetric or birth complications, and 10% have a family history of schizophrenia or some schizophrenia-like diagnosis in first degree relatives. So far, the results are of a preliminary nature, and when sufficient information on psychotic transitions is available, the predictive value of ERIraos will be determined.     

Prevention de l’infertilite d’origine infectieuse chez l’adolescent

Some causes of infertility can be prevented, as is the case for infertility of infectious origin. Genital infections represent a major source of infertility. Prostato-epididymitis consecutive to an urinary infection can be prevented by identifying and treating prostatic localizations at an early stage of urinary infection. The prevention of sexually transmitted diseases (STD), which cause male and female infertility, is, at the moment, accomplished by the prevention of the sexual transmission of the HIV. Teenagers represent a target of choice for the educational campaigns promoting condom use. The role of physicians, especially when teenagers are asking for a contraception, must be complementary to the public health campaign to decrease the spread of HIV and other STDs.     

Les enjeux de l’intégration de l’automate d’immunohématologie AutoVue d’Ortho-Clinical Diagnostics au sein du laboratoire

Evaluation des critères de sécurité, productivité et conformité à la réglementation. L’automatisation de la paillasse d’immuno-hématologie au laboratoire est une démarche dont l’objectif est d’optimiser les contraintes organisationnelles et économiques tout en préservant la qualité des résultats par l’utilisation des techniques analytiques de référence dans un cadre sécuritaire et réglementaire de haut niveau.     

Prevention de l’infertilite d’origine infectieuse chez l’adolescent

Some causes of infertility can be prevented, as is the case for infertility of infectious origin. Genital infections represent a major source of infertility. Prostato-epididymitis consecutive to an urinary infection can be prevented by identifying and treating prostatic localizations at an early stage of urinary infection. The prevention of sexually transmitted diseases (STD), which cause male and female infertility, is, at the moment, accomplished by the prevention of the sexual transmission of the HIV. Teenagers represent a target of choice for the educational campaigns promoting condom use. The role of physicians, especially when teenagers are asking for a contraception, must be complementary to the public health campaign to decrease the spread of HIV and other STDs.     

Validité de la somme angulaire comme technique d’extraction d’images planaires à partir de données tomoscintigraphiques pulmonaires de ventilation-perfusion

The aim of our study was to assess the concordance between the results of angular summed images obtained from lung SPECT data versus true planar images in the diagnosis of pulmonary embolism. One hundred and ten patients suspected of pulmonary embolism included in a prospective study underwent a planar lung scan and a lung SPECT. Planar images were extracted from SPECT data using an angular summing technique. Both modalities were reviewed according to revised Pioped criteria by two nuclear medicine physicians. Concordance between modalities and observers was compared with a weighted kappa test. A good degree of agreement between the two modalities (κ = 0.696) were found. Interobserver degree of agreement was similar in planar images (κ = 0.919) and in angular summed images (κ = 0.903). These results suggest that angular sum images from SPECT data are usable and concordant with ventilation perfusion planar images.     

L’apport de la neuro-imagerie dans la maladie d’Alzheimer

Today, the role of neuroimaging in the diagnosis of Alzheimer’s disease (AD) extends beyond its traditional role of excluding other conditions such as neurosurgical lesions. Modern challenges for neuroimaging techniques aim to contribute to the early diagnosis of AD. Early diagnosis includes recognition of pre-demented conditions, such as people with mild cognitive impairment (MCI) or with high risk of developing AD. In addition, early diagnosis would allow early treatment using currently available therapies or new therapies in the future. In this article, we will present the modern role of neuroimaging in AD. Structural MRI can detect and follow the time course of medial temporal lobe atrophy as a surrogate marker for the pathological process. New MRI techniques and image analysis software can detect subtle brain diffusion, perfusion or metabolic changes thus providing new tools for studying the pathological process. New ligands are also available for studies using tracers and positron emission tomography.     

Conception et suites de la Paléontologie française d’Alcide d’Orbigny

The whole formed by his Paléontologie française, his Prodrome, and his Cours élémentaire, which are closely linked, constitutes one of the major parts of Alcide d’Orbigny’s scientific production, in which he exposed his concept of Palaeontology as a science closely related with Zoology and as an indispensable tool for Stratigraphy. The result was a remarkable impulsion for palaeontological and stratigraphical research, which from that time developed on new scientific foundations. Two annexes complete this communication, the first concerning the ‘Comité de la Paléontologie française’ (1860–1893), the second specifying the publication dates of four volumes of the Paléontologie française.     

Facteurs psychologiques et conjugaux de l’impuissance: Toujours d’actualite

Although many cases of impotence are associated with “hidden” organic lesions undetectable by normal clinical assessment, and only detectable by paraclinical examination, it is obvious that interactions between psychological and factors often prevail in such cases. The paper describes the main psychological factors implicated in impotence, as well as recent data wich start to provide an explanation of the mechanisms by which psychological factors perturb sexuality. At the peripheral level, stress-induced sympathetic hyperactivity probably inhibits erection by causing contraction of the cavernosal smooth muscle. At a central level, animal experimentation and results from the pharmacological treatment of human impotence, suggest that psychological factors might inhibit sexual drive, and perhaps erection, through α 2—adrenergic receptors and the hypersecretion of endogenous opioids. These data open some highly stimulating pharmacological pespectives.     

Contribution a l’etude de la forme des plantes: discussion d’un modele de ramification

The problem of the forms of plants and models of branching are discussed using experimental data on the mistletoe. The number of branches by division, the distribution of divisions with regard to the number of branches per division and to the level of division, the geometrical characters of branches according to the level of division and the host, the stability of model are studied. One gives an interpretation of the model of branching as a model of growth.      

Étude de l’impact d’une correction d’atténuation par tomodensitométrie en scintigraphie myocardique

Myocardial perfusion SPECT is a routine for the assessment of patients with coronary artery disease (CAD). However, attenuation artifacts may decrease the specificity of the test. These artifacts can be corrected with an attenuation correction. We prospectively included 70 patients who underwent myocardial perfusion SPECT with (IRAC) and without (IRNC) attenuation correction using transmission CT imaging integrated in the acquisition system in patients with low prevalence of CAD. Automatic quantitative analysis with summed stress score (SSS) and rest (SRS) and summed difference score (SDS) was used as interpretation criteria. The results showed a specificity of 80% for IRAC and 56% for IRNC, a positive predictive value of 40% for IRAC and 23% for IRNC, without any significant change in sensitivity. An unpaired t-test showed no significant difference between the overall population and one where an artifact was corrected for heart rate and breath rate during the acquisition effort, the body mass index, chest and abdomen circumferences, and the ratio of these two parameters. Attenuation correction significantly improves the specificity of myocardial scintigraphy with no significant difference in sensitivity. The majority of corrections were for artifacts from the inferior wall in men. There is no correlation between the anthropomorphic and physiological parameters and the occurrence of an artifact of attenuation corrected with CT data.     

Interet diagnostique d’une injection intracaverneuse de 20 μg de Prostaglandine E1 dans l’impuissance

Intracavernous injection of 20 μg of prostaglandin E1 (PGE1) was carried out in 130 impotent patients. The erectile response was compared to the results of arteriological investigations including nocturnal penile tumescence and rigidity monitoring (NPTR) in 59 patients. The response of 60 patients positively categorized as exclusively psychogenic or vasculogenic was also compared to the pattern of the response to 80 mg of papaverine observed in a previous study by the same authors. The PGE1 test may not discriminate psychogenic from wholly organic patients since its results are not correlated to those of NPTR. It helps for the screening of vasculogenic impotence. Lack of response or a partly rigid response is consistent with this actiology but is not specific for it. A fully response makes it unlikely. Compared to papaverine, PGE1 induces less non rigid responses in psychogenic patients (15% versus 35% with papaverine) and more fully rigid responses in vasculogenic patients (respectively 12% and 5 %). Consequently the specificity of the PGE1 test is higher but its sensitivity lower than that of papaverine so that there is no clear difference in the effectiveness of the tests. Nevertheless the PGE1 test should be preferred, because it is safer. Prolonged erections occured in only 5 patients, and all ceased spontaneously. However 4 presented severely painful erections.     

Effets de l’Oxygenation du Milieu d’Incubation des Cotyledons de Ricin sur les Flux de Protons et sur l’Absorption du Saccharose

Some of the effects of oxygen concentration in the external medium bathing castor bean cotyledons were investigated. At 700 μM O₂, the sucrose-dependent proton influx was dependent on external pH while sucrose influx was independent of pH between 4,5 and 6; proton influx and sucrose influx were both dependent on external sucrose concentration; both were saturated above 50 mM sucrose. The stoichiometry H+/S decreased with increasing pH and sucrose concentration. These data were consistent with the results obtained in stirred or aerated external medium. Oxygen consumption, acidification of the medium, sucrose-dependent proton influx and sucrose uptake increased with increasing oxygen concentration up to 700 μM where saturation was reached. Bubbling with air (O₂, 160 μM) resulted in the same increase despite lower oxygen concentration. It is suggested that not only O₂ concentration but also CO₂ concentration act on O₂ consumption, and proton and sucrose fluxes.

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Performance de la 18FDG-TEP dans le dépistage de paragangliome chez des patients porteurs d’une mutation SDHx

ObjectiveTo evaluate the performance of ¹⁸FDG-PET/CT for detecting infra-clinic paraganglioma (PGL) in SDHx mutation carriers (relatives).Patients and methodsSixty-six patients, from 13 distinct families underwent a genetic testing on the SHD genes between 2003 and 2012. Among the 45 patients with a mutation, 30 with a ¹⁸FDG-PET performed at initial work-up were included in this retrospective study. A gadolinium-enhanced magnetic resonance angiography of the neck (angio-MR) was performed in all cases, a thoracoabdominal-pelvic contrast-enhanced computed tomography (TAP-CT) in 25 cases, a TAP-MR in 20 cases, a ¹²³I-metaiodo-benzylguanidine scintigraphy (¹²³I-MIBG) in 20 cases and a somatostatin receptor scintigraphy (SRS) in 20 cases. Gold standard was histologic or composite (confirmation by another imaging method and follow-up).ResultsA tumor was found in five subjects: 2 abdominal PGL, 1 pheochromocytoma and 2 PGL of the neck. The sensitivity of ¹⁸FDG-PET was 100 %, of SRS was 80 %, of ¹²³I-MIBG was 60 % and of anatomical imaging (association between angio-MR of the neck and TAP-CT and/or TAP-MR) was 100 %. Three false positive lesions were described: 2 with the ¹⁸FDG-PET imaging and 1 with the TAP-MR technique.Conclusion¹⁸FDG-PET/CT is an excellent tool for screening SDHx relatives and should be completed by an angio-MR of the neck if suspicion of abnormality. Association of angio-MR of the neck and TAP-MR has the advantage of being a non-irradiating imaging method but with limited access in some countries.