Rationale and design of the PACIFIC-PRESERVED (PhenomApping, ClassIFication and Innovation for Cardiac dysfunction in patients with heart failure and PRESERVED left ventricular ejection fraction) study.

Background: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome that is poorly defined, reflecting an incomplete understanding of its pathophysiology.

Aim: To redefine the phenotypic spectrum of HFpEF.

Methods: The PACIFIC-PRESERVED study is a prospective multicentre cohort study designed to perform multidimensional deep phenotyping of patients diagnosed with HFpEF (left ventricular ejection fraction≥50%), patients with heart failure with reduced ejection fraction (left ventricular ejection fraction≤40%) and subjects without overt heart failure (3:2:1 ratio).

The PACIFIC ontology for heterogeneous data management in cardiology.

With the emergence of health data warehouses and major initiatives to collect and analyze multi-modal and multisource data, data organization becomes central. In the PACIFIC-PRESERVED (PhenomApping, ClassIFication, and Innovation for Cardiac Dysfunction - Heart Failure with PRESERVED LVEF Study, NCT04189029) study, a data driven research project aiming at redefining and profiling the Heart Failure with preserved Ejection Fraction (HFpEF), an ontology was developed by different data experts in cardiology to enable better data management in a complex study context (multisource, multiformat, multimodality, multipartners). The PACIFIC ontology provides a cardiac data management framework for the phenomapping of patients.

Tracking of Blood Vessels Motion from 4D-flow MRI Data.

This paper presents a novel approach to track objects from 4D-flow MRI data. A salient feature of the proposed method is that it fully exploits the geometrical and dynamical nature of the information provided by this imaging modality. The underlying idea consists in formulating the tracking problem as a data assimilation problem, in which both position and velocity observations are extracted from the 4D-flow MRI data series.

Segmentation of 4D Flow MRI: Comparison between 3D Deep Learning and Velocity-Based Level Sets.

A thoracic aortic aneurysm is an abnormal dilatation of the aorta that can progress and lead to rupture. The decision to conduct surgery is made by considering the maximum diameter, but it is now well known that this metric alone is not completely reliable. The advent of 4D flow magnetic resonance imaging has allowed for the calculation of new biomarkers for the study of aortic diseases, such as wall shear stress.

Patients with meniscus posterolateral root tears repair during ACL reconstruction achieve comparable post-operative outcome than patients with isolated ACL reconstruction.

Purpose: Lateral posterior meniscal root tear (LPMRT) repair, at the time of anterior cruciate ligament (ACL) reconstruction are increasingly being performed. The aim of this study was to compare the clinical and functional outcomes, as well as the complication rates at a minimum of 2 years follow-up, between an isolated ACL reconstruction group with intact menisci and a combined ACL reconstruction and LPMRT repair group.

Methods: All patients who underwent combined ACL reconstruction and LPMRT repair between 2016 and 2020 were included in the study.

Clinical Assessment of a Nocardia PCR-Based Assay for Diagnosis of Nocardiosis.

The diagnosis of nocardiosis, a severe opportunistic infection, is challenging. We assessed the specificity and sensitivity of a 16S rRNA PCR-based assay performed on clinical samples. In this multicenter study (January 2014 to April 2015), patients who were admitted to three hospitals and had an underlying condition favoring nocardiosis, clinical and radiological signs consistent with nocardiosis, and a PCR assay result for a clinical sample were included.

Ultrasound guidance of needle tip position for femoral nerve blockade: an observational study.

Background: The femoral nerve lies in the ilio-fascial space in a groove formed by the iliac and psoas muscles (GIPM) posteriorly, and overlaid by the iliac fascia. Recommendations for needle insertion for femoral blockade using ultrasound imaging are to insert the needle tip behind the iliac fascia at the lateral side of the femoral nerve, but this part of the nerve is poorly visualised in some patients. A more accurate location of the lateral part of the femoral nerve might be achieved by identifying the GIPM and its lateral segment.

[Virus-induced cancers: interplay between genetics and environment].

Among cancers diagnosed worldwide on a yearly basis, 20% are thought to be associated with a viral infection. The viruses involved are, by order of decreasing incidence, the hepatitis viruses, the papillomaviruses and the Epstein-Barr virus. These virus-induced cancers generate a high level of interest not only for the study of mechanisms involved in the neoplastic transformation, but also for the set-up of specific immunotherapies including prophylactic and therapeutic antitumor vaccination.

Hemodynamics in the pulmonary artery of a patient with pneumothorax.

Pneumothorax is characterized by lung collapse and an alteration of lung geometry, resulting in alterations of the pulmonary artery blood flow. Though many clinical studies and animal experiments have investigated the effects of pneumothorax on the hemodynamics of pulmonary arteries, its precise effects remain unclear. In this patient-specific study, we investigated the effects of lung deformation and vascular resistance increases due to pneumothorax on the pulmonary blood flow during the acute phase and after recovery.

Assessment of topographic brachial plexus nerves variations at the axilla using ultrasonography.

Background: The aim of this study was to describe topographic variations in the arrangement of the four main brachial plexus nerves at the junction of the axilla and the upper part of the arm.

Methods: In 153 patients undergoing upper arm surgery using axillary block, we studied nerve arrangements with a three-step approach, combining: (A) cross-sectional ultrasound imaging using a 12 MHz linear ultrasound probe; (B) distal shift of the ultrasound scanhead from the axilla to the elbow joint following the paths of individual nerves; and (C) identifying the distal motor response to electrical nerve stimulation of each nerve. These results were then converted into a 12-section pie chart with the axillary artery (AA) as the axis.

Anatomical basis for ultrasound-guided regional anaesthesia at the junction of the axilla and the upper arm.

Purpose: Ultrasound (US) has emerged in the field of regional anaesthesia in the past few years, as it allows physicians to simultaneously see the needle, the targeted nerves, and the vessels to avoid. Nevertheless, anatomical knowledge is essential for identifying all of the structures seen on the US screen. US also allows an in vivo approach to the variations of nerves and vessels.

Glycaemic dysregulation in nondiabetic patients after major lower limb prosthetic surgery.

Aim: Blood glucose (BG) dysregulation is common after cardiac surgery, but remains poorly described after major noncardiac surgery. The aim of this prospective observational study was to analyze perioperative changes in BG levels in nondiabetic patients undergoing major arthroplasty.

Methods: Nondiabetic consenting patients scheduled for hip or knee arthroplasty were eligible.

Vancomycin and ciprofloxacin: systemic antibiotic administration for peritoneal dialysis-associated peritonitis.

Objectives: Peritonitis due to peritoneal dialysis (PD) is best treated empirically while waiting for the results of the dialysate culture. Thus, antibiotic therapy must cover both gram-positive and gram-negative micro-organisms. First, over a period of 9 years in a multicenter study we evaluated the efficiency of a vancomycin and ciprofloxacin combination given as the first-line treatment protocol for PD peritonitis.

[Inflammatory leiomyosarcoma: a case report].

We report an additional case of inflammatory leiomyosarcoma, arising in the shoulder of a 31-year-old male. The rare inflammatory variant of leiomyosarcoma tends to affect young adults. Histologically it is characterized by a prominent lymphohistiocytic infiltrate often masking fascicles of spindle cells, as well as the presence of clusters of xanthoma cells and psammoma bodies.

Is there appetite after GLP-1 and PACAP?

Anitobesity drugs must increase the sensitivity of the hypothalamic satiety center towards leptin and antagonize the synthesis and action of NPY. The array of pharmacologic tools available is vast and presently ineffective. Among peptide analogs considered for evaluation [NPY-5 antagonists and CCK-A, bombesin, amylin and melanocyte-stimulating hormone-4 (or melanin-concentrating hormone?) agonists], is there a place for GLP-1 and PACAP? GLP-1 receptors present in ARC, PVN, VMN, and SON are the target for both central and blood-borne GLP-1 in those hypothalamic neurons endowed with GLUT-2 and glucokinase.

Severe exacerbation of liver disease during pregnancy in a thalassemic GBV-C/HGV-positive patient and neonatal hepatitis in offspring.

The case of a young woman with GB virus C/hepatitis G virus (GBV-C/HGV) infection and with a severe exacerbation of chronic hepatitis of unknown etiology during pregnancy is described. In the offspring, severe neonatal hepatitis with subsequent mild chronic liver disease of at least 16-month duration was followed by the development of antibodies to the envelope protein (E2) of GBV-C/HGV, suggesting that the child was recovering from GBV-C/HGV infection. There was an improvement in clinical and biochemical parameters in the mother following delivery and alpha-interferon therapy was associated with a transient biochemical response.

[Molecular endocrinology of hereditary obesity].

The hypothalamic disorders of obesity include hyperphagia, a low central orthosympathetic tone (with reduced thermogenesis), vagal hyperinsulinism, low serotonin efficacy, a hyperactive hypothalamo-hypophyseal-adrenal axis, a hypoactive GHRH-GH-IGF axis and hypogonadism of central origin. Hyperlipogenesis, glucose intolerance and excessive gluconeogenesis are secondary features. Most frequently the hypothalamic ARC reacts poorly to the leptin hypersecreted by adipose tissue, so that the local synthesis of NPY is unchecked.

Complications of autosomal dominant polycystic kidney disease in 50 haemodialysed patients. A case-control study. The U.C.L. Collaborative Group.

Background: The impact of renal and extrarenal manifestations of autosomal dominant polycystic kidney disease (ADPKD) during chronic haemodialysis (HD) has never been assessed in a paired case-control study.

Methods: Comparison of the course of 50 ADPKD patients with 50 matched control (C) patients who started chronic HD at the same time.

Results: Follow-up averaged 48 and 39 months in the ADPKD and C groups respectively.

Outcome of renal replacement therapy in autosomal dominant polycystic kidney disease.

We review our own experience as well as pertinent literature on the outcome of renal replacement therapy (RRT) in autosomal dominant polycystic kidney disease (ADPKD). Due to the virtual absence of data on peritoneal dialysis in ADPKD, we deal only with haemodialysis (HD) and renal transplantation (TP). Special attention is paid to the renal and extrarenal complications of ADPKD.

Factors influencing progression of renal failure in autosomal dominant polycystic kidney disease.

Autosomal dominant polycystic kidney disease (ADPKD) frequently leads to end-stage renal failure (ESRF) in the sixth decade of life, but considerable heterogeneity exists in the rate of progression of renal failure. The respective contribution of genetic factors and of potentially amendable factors, such as blood pressure control or protein intake limitation, on the rate of progression in ADPKD patients is still debated. To evaluate the role of factors influencing the rate of progression of renal failure in ADPKD, we retrospectively analyzed the annual rate of decline of creatinine clearance (Ccr) in 109 ADPKD patients followed from the time a Ccr value of 30 to 50 mL per min/1.