Association between timing of intensive care unit admission and outcomes for emergency department patients with community-acquired pneumonia.

Objective: To compare the 28-day mortality and hospital length of stay of patients with community-acquired pneumonia who were transferred to an intensive care unit on the same day of emergency department presentation (direct-transfer patients) with those subsequently transferred within 3 days of presentation (delayed-transfer patients).

Design: Secondary analysis of the original data from two North American and two European prospective, multicenter, cohort studies of adult patients with community-acquired pneumonia.

Patients: In all, 453 non-institutionalized patients transferred within 3 days of emergency department presentation to an intensive care unit were included in the analysis.

Prediction of myocardial infarction risk in older patients with acute coronary syndrome.

Purposes: To identify bedside variables that aid in diagnosis of acute coronary syndrome (ACS) and might facilitate rapid triage of patients aged > or = 65 years.

Basic Procedures: Prospective, observational study of consecutive patients aged > or = 65 years with suspicion of ACS presenting to our emergency department (ED). Patients' medical characteristics were collected at baseline and during a 1-month follow-up period.

Reduced 3-O-methyl-dopa levels in OCD patients and their unaffected parents is associated with the low activity M158 COMT allele.

The catechol-O-methyltransferase (COMT) gene is considered as a candidate gene in obsessive-compulsive disorder (OCD). Specifically, the COMT low-activity M158 allele has been suggested to be associated with OCD. However, there is no study reporting that COMT activity is decreased in OCD patients and that the decrease is mediated by the V158M polymorphism.

[Liver fibrosis: from pathophysiology to therapeutic openings].

Understanding of liver fibrosis pathogenesis has undergone tremendous advances over the past twenty years. In this respect, demonstration of the reversibility of fibrosis was a major turnpoint. The panel of therapeutic targets is continuously expanding.

Prevalence of sleep-disordered breathing in a 316-patient French cohort of stable congestive heart failure.

Background: Heart failure with systolic dysfunction occurs frequently. Studies in North America and Germany have shown a high prevalence of sleep-disordered breathing in patients with heart failure.

Aims: To assess the prevalence of sleep-disordered breathing and its associated risk factors in French patients with heart failure.

Risk stratification of early admission to the intensive care unit of patients with no major criteria of severe community-acquired pneumonia: development of an international prediction rule.

Introduction: To identify risk factors for early (< three days) intensive care unit (ICU) admission of patients hospitalised with community-acquired pneumonia (CAP) and not requiring immediate ICU admission, and to stratify the risk of ICU admission on days 1 to 3.

Methods: Using the original data from four North American and European prospective multicentre cohort studies of patients with CAP, we derived and validated a prediction rule for ICU admission on days 1 to 3 of emergency department (ED) presentation, for patients presenting with no obvious reason for immediate ICU admission (not requiring immediate respiratory or circulatory support).

Results: A total of 6560 patients were included (4593 and 1967 in the derivation and validation cohort, respectively), 303 (4.

Glutathione deficiency in cardiac patients is related to the functional status and structural cardiac abnormalities.

Background: The tripeptide glutathione (L-gamma-glutamyl-cysteinyl-glycine) is essential to cell survival, and deficiency in cardiac and systemic glutathione relates to heart failure progression and cardiac remodelling in animal models. Accordingly, we investigated cardiac and blood glutathione levels in patients of different functional classes and with different structural heart diseases.

Methods: Glutathione was measured using standard enzymatic recycling method in venous blood samples obtained from 91 individuals, including 15 healthy volunteers and 76 patients of New York Heart Association (NYHA) functional class I to IV, undergoing cardiac surgery for coronary artery disease, aortic stenosis or terminal cardiomyopathy.

Endoscopic resection of osteoma of the forehead.

We report the one-year follow-up of a series of endoscopic removal of osteomas of the forehead to assess the feasibility of the technique, its functional results, and the satisfaction of the patients. Osteomas were resected in five patients (two women, three men, mean age 40 years, range 30 to 55) using an endoscopic technique. All operations were successful and did not require conversion to open operation.

[Helicobacter pylori infection: what to do after first intent treatment failure?].

First intent therapy of H. pylori infection is triple therapy combining PPI, amoxicillin and clarithromycin for 7 to 10 days. Due to the increasing rate of primary resistance to clarithromycin, expected eradication rates are below 70%.

Multiplex allele-specific fluorescent PCR for haplotyping the IVS8 (TG)m(T)n locus in the CFTR gene.

Background: Precise genotyping of the intron 8 poly(TG) and poly(T) tracts of the cystic fibrosis transmembrane conductance regulator (CFTR) gene is of clinical relevance in CFTR pathology. The (TG)(m) locus influences the penetrance of the (T)(5) allele, which may be associated with male infertility by congenital bilateral absence of the vas deferens (CBAVD) or other CFTR-related disorders (CFTR-RD), in particular in the context of (TG)(12) and (TG)(13). Simple and accurate genotyping of both loci should thus be routinely offered in laboratories.

Expression of matrix metalloproteinase-2 and -9 and of tissue inhibitor of matrix metalloproteinase-1 in liver regeneration from oval cells in rat.

Oval cells participate in liver regeneration when hepatocyte replication is impaired. These precursor cells proliferate in periportal regions and organize in ductules. They are surrounded by a basement membrane, the degradation of which by matrix metalloproteinases (MMP) might trigger their terminal differentiation into hepatocytes.

Sleep quality in mechanically ventilated patients: comparison of three ventilatory modes.

Objectives: To compare the influence of three ventilatory modes on sleep.

Design: Prospective, comparative, crossover study.

Setting: Medical intensive care unit in a university hospital.

Environmental factors as disease accelerators during chronic hepatitis C.

Progression of chronic hepatitis is highly variable among individuals, as the result of several host, viral and environmental factors. The latter have been extensively investigated in order to ameliorate hepatitis C outcome, particularly in difficult-to-treat patients. Over the last decade, several studies have shown that a combination of HCV infection and high levels of alcohol abuse results in synergistic acceleration of liver fibrogenesis.

Cystic fibrosis carrier frequency and estimated prevalence of the disease in Morocco.

Background: The epidemiology of cystic fibrosis (CF) is poorly known in North African populations, in particular in Morocco and the CF carrier frequency in the general Moroccan population has never been evaluated.

Methods: To estimate the prevalence of CF mutations in Morocco, blood samples from 150 healthy Moroccans were tested for frequent CFTR mutations and the intron 8 polyT variant.

Results: Two subjects were heterozygous for F508del and eight others for the (T)5 variant.

Daily cannabis use: a novel risk factor of steatosis severity in patients with chronic hepatitis C.

Background & Aims: Steatosis is highly prevalent in patients with chronic hepatitis C (CHC) and has been reported to increase fibrosis and reduce the rate of viral eradication. Two recent studies indicate that endocannabinoids promote experimental steatosis via activation of hepatic CB1 receptors. We therefore investigated the impact of cannabis smoking on steatosis severity during CHC.

CD158K/KIR3DL2 transcript detection in lesional skin of patients with erythroderma is a tool for the diagnosis of Sézary syndrome.

The distinction between Sézary syndrome (SS) and benign erythrodermic inflammatory diseases (EID) is difficult to make both clinically and on skin biopsies, since histomorphology can provide nonspecific results. New markers of circulating malignant Sézary cells have been recently described, especially CD158k/KIR3DL2 and T-plastin, but it has not been yet determined whether they could help in the diagnosis of erythroderma in skin samples. In this study, 13 frozen skin specimens from 10 SS patients and 26 from EID were analyzed for CD158k/KIR3DL2 expression using immunohistochemistry with AZ158 mAb, which also recognizes the monomeric CD158e/KIR3DL1 receptor.

ZFHX1B mutations in patients with Mowat-Wilson syndrome.

Mowat-Wilson syndrome (MWS) is a recently delineated mental retardation (MR)-multiple congenital anomaly syndrome, characterized by typical facies, severe MR, epilepsy, and variable congenital malformations, including Hirschsprung disease (HSCR), genital anomalies, congenital heart disease (CHD), and agenesis of the corpus callosum (ACC). It is caused by de novo heterozygous mutations or deletions of the ZFHX1B gene located at 2q22. ZFHX1B encodes Smad-interacting protein-1 (SMADIP1 or SIP1), a transcriptional corepressor involved in the transforming growth factor-beta signaling pathway.