Optimizing PO during peripheral veno-arterial ECMO: a narrative review.

During refractory cardiogenic shock and cardiac arrest, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is used to restore a circulatory output. However, it also impacts significantly arterial oxygenation. Recent guidelines of the Extracorporeal Life Support Organization (ELSO) recommend targeting postoxygenator partial pressure of oxygen (PO) around 150 mmHg.

Vericiguat for the treatment of heart failure: mechanism of action and pharmacological properties compared with other emerging therapeutic options.

Introduction: The significant morbidity and mortality in patients with heart failure (HF), notably in the most advanced forms of the disease, justify the need for novel therapeutic options. In the last year, the soluble guanylate cyclase (sGC) stimulator, vericiguat, has drawn the attention of the medical community following the report of reduced clinical outcomes in patients with worsening chronic HF (WCHF).

Areas Covered: The authors review the available data on the mechanism of action of vericiguat (cyclic guanosine monophosphate (cGMP) pathway), its clinical development program, its role in HF management, and its future positioning in the therapeutic recommendations.

Tubular Reconstruction with Bovine Pericardium Xenografts to Treat Native Aortic Infections.

Background: The treatment of aortic infections is complex, and the material of reconstruction remains discussed. Several alternatives were suggested in the literature. The current consensus is the use of biological material.

Changes in cardiac arrest patients' temperature management after the 2013 "TTM" trial: results from an international survey.

Background: Therapeutic hypothermia (TH between 32 and 34 °C) was recommended until recently in unconscious successfully resuscitated cardiac arrest (CA) patients, especially after initial shockable rhythm. A randomized controlled trial published in 2013 observed similar outcome between a 36 °C-targeted temperature management (TTM) and a 33 °C-TTM. The main aim of our study was to assess the impact of this publication on physicians regarding their TTM practical changes.

Rationale and design of the Cyclosporine to ImpRove Clinical oUtcome in ST-elevation myocardial infarction patients (the CIRCUS trial).

Background: Both acute myocardial ischemia and reperfusion contribute to cardiomyocyte death in ST-elevation myocardial infarction (STEMI). The final infarct size is the principal determinant of subsequent clinical outcome in STEMI patients. In a proof-of-concept phase II trial, the administration of cyclosporine prior to primary percutaneous coronary intervention (PPCI) has been associated with a reduction of infarct size in STEMI patients.

Human developmental anatomy: microscopic magnetic resonance imaging (μMRI) of four human embryos (from Carnegie Stage 10 to 20).

Background And Aim: Technological advances in the field of biological imaging now allow multi-modal studies of human embryo anatomy. The aim of this study was to assess the high magnetic field μMRI feasibility in the study of small human embryos (less than 21mm crown-rump) as a new tool for the study of human descriptive embryology and to determine better sequence characteristics to obtain higher spatial resolution and higher signal/noise ratio.

Methods: Morphological study of four human embryos belonging to the historical collection of the Department of Anatomy in the Faculty of Medicine of Reims was undertaken by μMRI.

[Aggressive and resistant-to-treatment pituitary tumors].

Pituitary adenomas define slow growing tumors developing from anterior pituitary. Most often benign, their treatment and subsequent management are based on transphenoidal surgery and/or medical therapy, generally without difficulties in clinical practice. However, 2 clinicopathological situations, more or less intricated, may considerably complicate the management of these tumors and the patient health condition.

Control of a regional outbreak of vanA glycopeptide-resistant Enterococcus faecium, Eastern France, 2004-2009.

At the end of 2004, an outbreak of glycopeptide-resistant enterococci (GRE) spread from the Nancy Teaching Hospital to more than 40 facilities in the Lorraine region. Because this outbreak appeared to be uninhibited, a regional task force was set up to organize and co-ordinate the management of the outbreak, visiting the affected facilities to publicize the existing recommendations and take stock of the problems encountered in the field. The task force then proposed control measures specific to the region.

Efficacy of melphalan and prednisone plus thalidomide in patients older than 75 years with newly diagnosed multiple myeloma: IFM 01/01 trial.

Purpose: Until recently, melphalan and prednisone were the standards of care in elderly patients with multiple myeloma. The addition of thalidomide to this combination demonstrated a survival benefit for patients age 65 to 75 years. This randomized, placebo-controlled, phase III trial investigated the efficacy of melphalan and prednisone plus thalidomide in patients older than 75 years with newly diagnosed myeloma.

Cryptic 7q21 and 9p23 deletions in a patient with apparently balanced de novo reciprocal translocation t(7;9)(q21;p23) associated with a dystonia-plus syndrome: paternal deletion of the epsilon-sarcoglycan (SGCE) gene.

We report on a boy with myoclonus-dystonia (M-D), language delay, and malformative anomalies. Genetic investigations allowed the identification of an apparently balanced de novo reciprocal translocation, t(7;9)(q21;p23). Breakpoint-region mapping using fluorescent in situ hybridization (FISH) analysis of bacterial artificial chromosome (BAC) clone probes identified microdeletions of 3.

Clinical phenotype of germline RUNX1 haploinsufficiency: from point mutations to large genomic deletions.

Germline RUNX1 mutations result in a rare autosomal dominant condition characterized by qualitative and quantitative platelet defects and predisposition to the development of myeloid malignancies (familial platelet disorder with propensity to acute myeloid leukaemia, FPD/AML). Only 13 pedigrees have previously been described so far. We report on two novel germline RUNX1 mutations: (1) an out-of-frame 8 bp heterozygous deletion (c.

[Surgical treatment of ureteropyelic junction stenosis using robotic-assisted laparoscopy].

Since the introduction of mini-invasive surgery approximately thirty years ago, Laparoscopic surgery has significantly evolved both in terms of its extended field of application and of the tools used which were diversified and improved. More recently, the development of robotic-assisted laparoscopy has brought, among other improvements, three-dimensional vision, dexterity, and a comfortable working position, which have reduced the surgeon's fatigability, the difficulties related to the operations and the learning curves of standard laparoscopy. Urology, which makes slightly less use of standard laparoscopy than general or gynaecological surgery, largely benefits from robotics concerning the precision of movements, and has much increased the operating indications of laparoscopy, including the treatment of pyeloureteral junction, kidney tumourectomy, living donor nephrectomy and radical prostactectomy.

[Robotic-assisted laparoscopy: general principles].

Born in the late 90s, robotic-assisted laparoscopy has today an exponential growth. It presents some disadvantages, the first of them being a very high cost, similarly to all new medical technologies. On the other hand, its advantages are very important and allow the open surgeon to apply his natural skills to the endoscopic approach, while recovering the 3-dimensional vision.

[Residual neuromuscular blockades. Clinical consequences, frequency and avoidance strategies].

Even after administration in routine clinical dosages, muscle relaxants can lead to long-lasting residual blockades which increase the risk of severe postoperative pulmonary complications. Even without the additional effects from analgetics, sedatives or anaesthetics, a partial neuromuscular blockade, which cannot reliably be avoided either by the anaesthetist alone or by the additional use of nerve stimulators (train-of-four [TOF] ratio 0.5-0.

[Medical treatment of chronic congestive heart failure].

Medical treatment in congestive heart failure has been largely improved during the last 15 years. Treatment of left ventricular systolic dysfunction using angiotensin-converting-enzyme inhibitor is now confirmed in all NYHA classes, due to the important reduction in morbi-mortality. Betablockers have to be systematically associated in symptomatic classes.

[The CASS-CHOU study of mesenteric angina. The comparative effects of cassoulet and sauerkraut with sausages].

The goal of study was evaluate in 1,837 consecutive patients the comparative effects of French cassoulet (CASS) and international sauerkraut (CHOU). After procedures of exclusion classical, 8 patients could be evaluated and received in a randomised, doubleblind, crossover protocol an mouth dose of 22.5 g/kg of CASS or CHOU.

Comparison between serum alpha-glutathione S-transferase and aminotransaminases in detecting cytolysis in hepatitis C-infected children.

Background: alpha-Glutathione S-transferase (alphaGST) has been proposed as a more sensitive indicator than serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in detecting hepatocellular damage due to chronic hepatitis C virus (HCV) infection.

Methods: The accuracy of alpha-GST was compared with that of ALT and AST in detecting cytolysis in 103 blood samples issued from 31 children positive for HCV RNA.

Results: alpha-GST had a lower sensitivity than ALT or AST (32% vs.

[Treatment of ischemic myocardiopathy].

Ischaemic myocardiopathy mandates the control of coronary risk factors and the administration of antiplatelet therapy. If myocardial ischaemia exists, an antianginal treatment will be prescribed. In case of heart failure, the association of an angiotensin-converting enzyme inhibitor and diuretics is required.

A theoretical model for the noninvasive assessment of the transmitral pressure-flow relation.

The purpose of this paper is to formulate from the equations of fluid mechanics an equation which describes the transmitral pressure-flow relationship. According to the linear momentum equation applied to the atrioventricular coupling, the left-atrium-left-ventricle pressure difference (Pa-Pv) can be written as Pa-P v = A delta v/delta t + B v 2 + C v, where v is the transmitral blood velocity and A, B, and C are variables related to the geometry of the atrium, ventricle and mitral orifice, respectively. Based on this theory, Pa-Pv is calculated noninvasively in a patient with a nonobstructive mitral valve.