Practical considerations for the evaluation and management of Attention Deficit Hyperactivity Disorder (ADHD) in adults.

Attention deficit with or without hyperactivity disorder (ADHD) is one of the most frequent neuropsychiatric disorders, and affects 2-4% of adults. In contrast with many European countries, the identification and management of adult ADHD remains underdeveloped in France, and a subject of controversy. This review provides a practical update on current knowledge about ADHD in adults for French-speaking professionals who have to detect or manage adult patients with ADHD.

Intra-test and test-retest reliability of exercise oximetry in arterial claudication.

Background: Transcutaneous oxygen pressure (tcpO2) reliability is blunted by an unpredictable transcutaneous gradient through the skin. We hypothesized that the "Decrease from Rest of Oxygen pressure (DROP: subtraction of limb-changes from chest-changes from the respective starting values) would show a good to excellent reliability during Exercise -tcpO2 investigations.

Methods: In three different experiments we tested: The intra-test variability at the peripheral level (Experiment A: 32 patients, 16 at each location), at the chest level (Experiment B: 45 patients) and the test-retest reproducibility within 3 months (Experiment C: 67 patients).

Carotid-Femoral Pulse Wave Velocity Assessed by Ultrasound: A Study with Echotracking Technology.

Described here is a new method for determination of carotid-femoral pulse wave velocity (PWV) based on arterial diameter waveform recording by an ultrasound system. The study was carried out on 120 consecutive patients. Carotid-femoral PWV was determined using a tonometric technique (PWVpp, PulsePen, DiaTecne, Milan, Italy) and an echotracking ultrasound system (PWVet, E-Track, Aloka, Tokyo, Japan).

Bidimensional unconstrained optimization approach to EMD: An algorithm revealing skin perfusion alterations in pseudoxanthoma elasticum patients.

Background And Objective: Pseudoxanthoma elasticum (PXE) is an inherited and systemic metabolic disorder that affects the skin, leading among other things to a peau d'orange appearance. Unfortunately, PXE is still poorly understood and there is no existing therapy to treat the disease. Because the skin is the first organ to be affected in PXE, we propose herein a study of skin microvascular perfusion.

Personalized thromboprophylaxis using a risk score for the management of pregnancies with high risk of thrombosis: a prospective clinical study.

Unlabelled: Essentials Pregnancy is a risk factor for thrombosis. Management of thrombosis risk in pregnancy remains a challenge. Prophylaxis needs to be personalized.

Aging effect on microcirculation: A multiscale entropy approach on laser speckle contrast images.

Purpose: It has long been known that age plays a crucial role in the deterioration of microvessels. The assessment of such deteriorations can be achieved by monitoring microvascular blood flow. Laser speckle contrast imaging (LSCI) is a powerful optical imaging tool that provides two-dimensional information on microvascular blood flow.

Evaluation of the Vascular Surgical Complications of Renal Transplantation.

Background: Renal transplantation is the treatment of choice of end-stage renal failure. However, vascular surgical complications can compromise the functional prognosis of the transplant or even be life threatening in the short term. Since few data are available in the literature, the objective of this study was to evaluate the vascular surgical complications of renal transplantation.

Modified multiscale sample entropy computation of laser speckle contrast images and comparison with the original multiscale entropy algorithm.

Laser speckle contrast imaging (LSCI) enables a noninvasive monitoring of microvascular perfusion. Some studies have proposed to extract information from LSCI data through their multiscale entropy (MSE). However, for reaching a large range of scales, the original MSE algorithm may require long recordings for reliability.

[Acute finger ischemia: A retrospective study of 13 patients].

Background: Acute ischemia of the upper limbs is rare in comparison with ischemia of the lower limbs. The origins of this condition are varied.

Goals: We retrospectively analyzed cases of acute finger ischemia (Raynaud's phenomena was excluded) in a dermatology department between 2008 and 2013 in order to evaluate the etiology and management of this phenomenon.

Microvascular blood flow monitoring with laser speckle contrast imaging using the generalized differences algorithm.

Laser speckle contrast imaging (LSCI) is a full-field optical technique to monitor microvascular blood flow with high spatial and temporal resolutions. It is used in many medical fields such as dermatology, vascular medicine, or neurosciences. However, LSCI leads to a large amount of data: image sampling frequency is often of several Hz and recordings usually last several minutes.

[Phlegmasia cerulea dolens].

Background: Herein we report a case of phlegmasia cerulea dolens, a form of venous thrombosis complicated by arterial ischaemia.

Patients And Methods: A 69-year-old man presented a bilateral trophic condition of the lower limbs that had appeared 3 weeks earlier. The patient had a history of metastatic urothelial bladder carcinoma and arteritis.

Laser speckle contrast imaging: age-related changes in microvascular blood flow and correlation with pulse-wave velocity in healthy subjects.

In the cardiovascular system, the macrocirculation and microcirculation—two subsystems—can be affected by aging. Laser speckle contrast imaging (LSCI) is an emerging noninvasive optical technique that allows the monitoring of microvascular function and can help, using specific data processing, to understand the relationship between the subsystems. Using LSCI, the goals of this study are: (i) to assess the aging effect over microvascular parameters (perfusion and moving blood cells velocity, MBCV) and macrocirculation parameters (pulse-wave velocity, PWV) and (ii) to study the relationship between these parameters.

Response to statin therapy in obstructive sleep apnea syndrome: a multicenter randomized controlled trial.

Rationale: Accumulated evidence implicates sympathetic activation as inducing oxidative stress and systemic inflammation, which in turn lead to hypertension, endothelial dysfunction, and atherosclerosis in obstructive sleep apnea (OSA). Statins through their pleiotropic properties may modify inflammation, lipid profile, and cardiovascular outcomes in OSA.

Methods: This multicenter, randomized, double-blind study compared the effects of atorvastatin 40 mg/day versus placebo over 12 weeks on endothelial function (the primary endpoint) measured by peripheral arterial tone (PAT).

Can we identify response markers to antihypertensive drugs? First results from the IDEAL Trial.

Current antihypertensive strategies do not take into account that individual characteristics may influence the magnitude of blood pressure (BP) reduction. Guidelines promote trial-and-error approaches with many different drugs. We conducted the Identification of the Determinants of the Efficacy of Arterial blood pressure Lowering drugs (IDEAL) Trial to identify factors associated with BP responses to perindopril and indapamide.

[Heterogeneity in the handling of vitamin-K-antagonists and of INR: the example of Quercy-Rouergue].

Using a questionnaire, we have evaluated how VKA and INR are handled by medical doctors in Quercy-Rouergue. This evaluation is part of an international post-analytical quality assessment survey in laboratory medicine supervised by Noklus (http://www.noklus.

Excellent inter- and intra-observer reproducibility of microvascular tests using laser speckle contrast imaging.

Post-occlusive reactive hyperaemia (PORH) and vasodilation induced by acetylcholine (ACh) iontophoresis are tests of endothelial function that can be studied with laser speckle contrast imaging (LSCI). LSCI has the advantage of having good temporal and spatial resolutions but can lead to a high amount of data when several minutes of recordings are needed. Parameters of PORH and ACh iontophoresis vasodilation are therefore often determined by several observers or by the same observer on different days.

Impact of experimental conditions on noncontact laser recordings in microvascular studies.

Microcirculation, especially skin microcirculation, is a window toward systemic vascular function in magnitude and underlying mechanisms. Different techniques have been developed to assess the microcirculation. Among these techniques, laser technology is used to perform noninvasive microvascular assessments.

Dietary pattern, a modifiable risk factor that can be easily assessed for atherosclerosis vascular disease prevention in clinical practice.

Objectives: Nutrition is one of the modifiable risk factors of atherosclerosis vascular diseases (VD). We aimed to (i) evaluate the dietary patterns associated with VD in clinical practice using a validated FFQ; and (ii) determine potential independent sociodemographic and behavioural factors that are involved in such dietary patterns. The FFQ determined the vascular dietary score (VDS; ranges from -17 to 19) for each subject.

Near-infrared spectroscopy and transcutaneous oxygen pressure during exercise to detect arterial ischemia at the buttock level: comparison with arteriography.

Background: Noninvasive tests are required to detect (in both male and female subjects and side by side) arteries toward the hypogastric circulation that are likely to present significant lesions as a cause of buttock claudication.

Methods: We compared the accuracy of near-infrared spectroscopy (NIRS) and transcutaneous oxygen pressure (TCP o 2 ) on both buttocks during walking tests to detect lesions on the arteries toward the hypogastric circulation. NIRS was considered abnormal if recovery time to pre-exercise values was greater than 240 seconds for tissue oxygen saturation (absent data being coded 0), and TCP o 2 was coded abnormal if the minimal value of buttock changes minus chest changes was lower than -15 mm Hg.

Pain description in patients with isolated proximal (without distal) exercise-related lower limb arterial ischemia.

Among the last 250 claudicants referred to the laboratory for transcutaneous oxygen pressure recording at exercise, we analyzed the symptoms reported by the 36 patients who showed isolated proximal (without distal) ischemia. Among the symptomatic proximal sites cited by these patients, the hip and thigh represent 60%, whereas the buttock is cited in fewer than 25% of cases. Buttock symptoms are reported in only 31% of symptomatic patients.

Reflex control of the cutaneous circulation after acute and chronic local capsaicin.

To investigate whether local activity of capsaicin-sensitive sensory afferents in the skin has a modulatory role in the reflex cutaneous vasodilator response to hyperthermia in humans, experiments were conducted in two parts. First, low-dose topical capsaicin (0.025%) was administered acutely to stimulate local activity of these afferents.

Pressure measurements at rest and after heavy exercise to detect moderate arterial lesions in athletes.

Purpose: This study defined how ankle arterial blood pressure measurements should be analyzed for the detection of moderate arterial disease (asymptomatic while walking). We used external iliac artery endofibrosis as a unique model of an isolated moderate arterial lesion, the role of which in exercise-related pain can be surgically proven.

Methods: Patients who were ambulatory in our institutional referral center were studied.

Dynamics of local pressure-induced cutaneous vasodilation in the human hand.

We recently demonstrated that a pressure-induced vasodilation results from local nonnociceptive stimulation of the skin of the human hand. We aimed to test the hypothesis that this vasodilation was not a short-lived response to a single type of pressure strain, but could be a widely activated and prolonged protective cutaneous response. We studied the dynamics of pressure-induced vasodilation during various ramp changes in local externally applied pressure using laser Doppler flowmetry.