Surgical site infection after surgery to repair femoral neck fracture: a French multicenter retrospective study.

Objective: Femoral neck fracture is the most frequent orthopedic emergency among elderly persons. Despite a high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage in this population, no multicenter study of antibiotic prophylaxis practices and the rate and microbiological characteristics of surgical site infection (SSI) has been performed in France.

Design: Retrospective, multicenter cohort study.

Increased achondroplasia mutation frequency with advanced age and evidence for G1138A mosaicism in human testis biopsies.

Objective: To evaluate the influence of aging on the achondroplasia mutation rate in the male germline.

Design: Studies in sperm and testis biopsy DNA according to donor's age.

Setting: University teaching hospital.

In vitro effects of chorionic gonadotropin hormone on human adipose development.

It is well known that pregnancy is associated with fat weight gain. However, the mechanisms whereby fat mass accumulation is controlled during this period are poorly understood. Therefore, we attempted to determine whether human chorionic gonadotropin (HCG), in vitro, influences human adipose tissue development and/or metabolism.

[Temporal artery biopsy may remain positive even after long-term corticosteroid treatment: report of two cases].

Introduction: Temporal arteritis is the most common systemic vasculitis of the elderly. It is diagnosed with the combination of a clinico-biological syndrome and typical histologic features recognized on temporal artery biopsy (TAB). Cortisteroid therapy is quickly recommended, before the TAB is performed or before the histologic results confirm the diagnosis.

[Jean-Charles Sournia and Berry].

A previous Eloge has been pronounced on June 30, 2001 during the work session of the French and the International Societies of History of Medicine. It was devoted to the various aspects of the medical, historical and public career of Prof Jean-Charles Sournia (November 24, 1917-June 8, 2000). The present session of the French Society of History of Medicine hold in Bourges, on June, 18, 2005 is an accomplishment of the wish of this child of Bourges, the capital of Berry.

Failure to achieve glycemic control despite intensive insulin therapy in a medical ICU: incidence and influence on ICU mortality.

Objective: Intensive insulin therapy reduces mortality in subgroups of intensive care unit (ICU) patients, and awareness of the importance of blood glucose level (BGL) control has increased among ICU physicians and nurses. The impact of insulin treatment strategies on mortality may be influenced by their efficacy in achieving the target BGL range. We assessed the efficacy of an insulin treatment strategy in maintaining BGL within the target range, and we compared ICU mortality in patients who did and did not reach the BGL target.

Critical illness neuromuscular syndromes.

Critical illness neuromyopathy (CINM) is the most common peripheral neuromuscular disorder encountered in the ICU. Bilateral diffuse weakness predominant in the proximal part of the limbs after improvement of the acute phase of the critical illness is highly suggestive of CINM. Although muscle and peripheral nerve often are involved in combination, muscle involvement alone increasingly is identified on electrophysiological investigation, including direct muscle stimulation.

[Late paternity: spermatogenetic aspects].

The effect of maternal age on the risk of meiotic abnormality is well documented. In contrast little is known about the effect of the paternal age. The question of the risk related to paternal age is raised because of the increased demand of Assisted Reproduction Techniques for older men.

Downregulation of human endometrial IL-18 by exogenous ovarian steroids.

Problem: To evaluate the influence of ovarian steroids on IL-18, IL-15 and angiopoietin-2 mRNA expression in the endometrium in the mid luteal phase.

Method Of Study: We quantified IL-18/GAPDH, IL-18 BP/GAPDH, IL-15/GAPDH and angiopoietin-2/GAPDH in the endometrium by quantitative polymerase chain reaction on day 21 of the cycle. We first compared cytokines expression over two natural cycles (n = 15) then between natural and oestrogen-progestin replacement treatment (n = 18).

[Arousal disorders].

Altered states of consciousness are a common reason for visits to the emergency room and admission to intensive care unit. Management of unconscious patient can be difficult because the potential causes of an altered mental status are considerable and the time for diagnosis and effective intervention is short. First, the patient must airway, breathing, and circulation protected.

Adiponectin mediates antiproliferative and apoptotic responses in human MCF7 breast cancer cells.

It is well established that obesity is a risk factor for breast cancer and that blood levels of adiponectin, a hormone mainly secreted by white adipocytes, are inversely correlated with the body fat mass. As adiponectin elicits anti-proliferative effects in some cell types, we tested the hypothesis that adiponectin could influence human breast cancer MCF-7 cell growth. Here we show that MCF-7 cells express adiponectin receptors and respond to human recombinant adiponectin by reducing their growth, AMPkinase activation, and p42/p44 MAPkinase inactivation.

Sex steroids and leptin regulate 11beta-hydroxysteroid dehydrogenase I and P450 aromatase expressions in human preadipocytes: Sex specificities.

Adipose tissue is an important site of steroid hormone biosynthesis, as type I 11beta-hydroxysteroid dehydrogenase (HSD1), the enzyme responsible for the conversion of cortisone into cortisol and the P450 aromatase, the enzyme catalysing androgens aromatization into estrogens, are both expressed in human adipose tissue. In the present report, we have investigated the possibility that sex steroids and leptin could regulate these two enzymes in cultured preadipocytes from men and women intra-abdominal fat depots. In women preadipocytes, human recombinant leptin down-regulates HSD1 mRNA expression (-58%) and P450 aromatase activity (-26%).

Foetal kidney maldevelopment in maternal use of angiotensin II type I receptor antagonists.

We report renal lesions observed in a foetus exposed throughout pregnancy to angiotensin II type I (AT 1) receptor antagonists. The mother suffered from essential hypertension and was treated with Cozaar (losartan 50 mg). Autopsy examination of the foetus revealed severe renal lesions, including tubular dysgenesis, hypertrophy of the endothelial and medial cells lining the arterial and arteriolar walls, hyperplasia of the juxtaglomerular apparatus and poorly developed vasa recta.

[The counselling of patient with prior C-section].

A trial of labor after prior cesarean delivery is associated with a greater perinatal risk than is elective repeated cesarean delivery without labor, although absolute risks are low. Information and counselling aim to estimate specific risks and to balance these risks according to individual factors. Therefore, the physician has to answer two questions: (i) which would be the probability of successful vaginal delivery? (ii) which would be the risk of uterine rupture with a trial of labor? The risk factors for failure of trial of labor are: increased maternal age, obesity, and fetal macrosomia.

Should electronic faucets be used in intensive care and hematology units?

Objective: To compare bacterial contamination associated with electronic faucets and manual faucets in wards admitting patients highly susceptible to infection.

Design: Water samples from electronic faucets and manual faucets were taken according to the French recommendations on water surveillance in healthcare settings.

Setting: Hematology and intensive care units (ICUs) of a 900-bed university hospital and a 500-bed general hospital.

[How to improve central venous catheter use in intensive care unit?].

Objective: Central venous catheter (CVC) insertion is routinely performed in critically ill patients but causes mechanical, thrombotic, or infectious adverse events in 15% of cases. It should be possible to improve the benefit/risk ratio of central venous catheterization in intensive care unit.

Data Source: We searched Pubmed using the terms: "catheterization, central venous, peripheral, adverse effects"; then "thrombosis, phlebitis, thrombophlebitis, jugular vein, femoral vein, subclavian vein, pneumothorax, haemothorax, extravasation of diagnostic and therapeutic materials".

[Epidemiology of catheter-related infections in intensive care unit].

Catheter-related infections remain an important cause of nosocomial infection in the ICU. They include colonization of the device, exit-site infection and catheter-related bloodstream infection with or without bacteraemia. Data from clinical studies and surveillance networks should be compared cautiously due to important methodological differences and wide variations of device-utilization ratio between units or countries.

Paresis following mechanical ventilation.

Purpose Of Review: To review the medical literature on neuromuscular abnormalities acquired in the intensive care unit (ICU), particularly after mechanical ventilation, focusing on the most recent advances in this field.

Recent Finding: Using a simple bedside muscle strength score, significant clinical weakness is detected in one fourth of patients awakening in ICU after more than 1 week of mechanical ventilation. Weakness is associated with a longer time on mechanical ventilation, although the exact relationship between limb and respiratory neuromuscular involvement remains unclear.

[First trimester Down syndrome screening program using nuchal translucency and maternal serum markers: the Echo PAPP-A.78 study].

Successive development of different methods to screen down syndrome (DS) have had unexpected effects, leading to an inflation in the number of karyotypes ordered and the number of induced abortions. In our district (Yvelines, France), DS screening leads to perform 16% karyotypes rate. Rapid progress in biology and ultrasonography has enabled us to correct this overprescription by conducting an early screening program using a combination of ultrasound graphic and new biochemical markers (Pregnancy-associated plasma protein A and the free fraction of ss-hCG) which allow an overall evaluation of risk.

Does ICU-acquired paresis lengthen weaning from mechanical ventilation?

Objective: To determine whether ICU-acquired paresis (ICUAP) is an independent risk factor of prolonged weaning.

Design: Second study of a prospective cohort of 95 patients who were enrolled in an incidence and risk factor study of ICUAP.

Setting: Three medical and two surgical ICUs in four hospitals.