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Fat-soluble vitamins, including vitamins A, D, E and K, are molecules with no energy value that are essential to the body's functioning and to life. Their intake is almost exclusively exogenous, i.e. dietary. Deficiency or excess of fat-soluble vitamins is responsible for a variety of more or less specific clinical symptoms. The fact that the functions performed by these vitamins are both ubiquitous and vital explains the wide variety of clinical manifestations and their potential seriousness. Some syndromes are typical of a deficiency in fat-soluble vitamins, such as: the combination of ophthalmological and immunity impairment in the case of vitamin A; a haemorrhagic syndrome and osteopenia in the case of vitamin E; and osteomalacia, muscular weakness, even falls, and rickets in the case of vitamin D. Diagnosis of a deficiency in one of the fat-soluble vitamins is based on blood tests, which are not always essential for routine use. In this case, a therapeutic test may be suggested. [ABSTRACT FROM AUTHOR]

Résumé: En cas d'anomalies récentes des tests hépatiques, le diagnostic repose essentiellement sur l'anamnèse et le bilan biologique. La ponction biopsie hépatique est rarement indiquée. En cas d'anomalies persistantes des tests hépatiques, l'enjeu est de diagnostiquer une cirrhose. Pour cela, la ponction-biopsie hépatique est le plus souvent inutile. En revanche, elle reste indiquée lorsqu'on suspecte une cause rare, surtout en l'absence de cause de cirrhose. In patients with recent liver blood tests abnormalities, the diagnosis is mainly based on the analysis of medical history and the biological work-up. Liver biopsy is rarely indicated. In case of persistent liver blood tests abnormalities, the challenge is to diagnose cirrhosis. For this purpose, liver biopsy is usually unnecessary. By contrast, liver biopsy remains indicated when a rare cause is suspected, especially in the absence of causal factor for cirrhosis. [ABSTRACT FROM AUTHOR]

During a blood test, the discovery of thrombocytosis is a frequent phenomenon with multiple origins. False thrombocytosis linked to analytical interferences is rare but must be eliminated before confirming the anomaly. The reaction origin, often very easily demonstrated by the context and/or the presence of a biological inflammatory syndrome, is the most frequent. More rarely, the diagnosis is oriented towards a clonal hematological pathology not limited to essential thrombocythemia. Currently, many biological tools, which have largely contributed to the recommendations of the latest WHO classification of chronic myeloid neoplasms, are available to classify these pathologies as precisely as possible, allowing optimal management. [ABSTRACT FROM AUTHOR]

Résumé: S’il apparaît qu’en France, trois types de plasma thérapeutique sont actuellement préparés, distribués et délivrés, bien davantage de plasmas thérapeutiques ayant le statut de produits sanguins labiles ou de médicaments dérivés du sang sont disponibles au niveau mondial. Pour un produit type – une même appellation – plusieurs procédés de production ainsi qu’une variété de machines ou de DMU concourant à sa production font qu’il y a en fait un grand nombre de produits finis différents qui peuvent de ce fait soit avoir des propriétés sensiblement distinctes (ou non) et/ou générer des effets indésirables différents (ou non également). Cette revue entend faire le point sur ces questions, de sorte à attirer l’attention sur les difficultés qu’il y a à comparer des données obtenues de façon différente dans des systèmes transfusionnels particuliers ; elle a pour objectif secondaire de dégager des pistes de réflexion pour la préparation future des plasmas thérapeutiques. [ABSTRACT FROM AUTHOR]

Objective: Ten years after determining the normal concentrations in whole blood and plasma of approximately thirty elements by inductively coupled plasma mass spectrometry, it seemed useful to assess the impact of any changes in our environment on these values. Methods: One hundred and six healthy hospital staff volunteers of both sexes, without professional exposure to metals, not treated with lithium or strontium, taking no trace element or vitamin supplements, and without metallic prostheses, were included. Tobacco consumption and the number of dental amalgams were reported. A multi-elementary quantification of 26 metals (Li, Be, V, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Rb, Sr, Mo, Ag, Cd, Sn, Te, Ba, W, Pt, Hg, TI, Pb, Bi and U) in whole blood and plasma was carried out by ICP-MS. Results: The median blood lead level is halved, while the assays were performed under the same conditions (12.5 µg/L versus 26.3 µg/L - p < 0.0001). The whole blood cadmium concentration is significantly higher in smokers compared with non-smokers (1.18 µg/L versus 0.27 µg/L - p < 0.0001). No metal, and in particular whole blood or plasma mercury, is significantly increased in subjects with amalgams. Conclusion: During this ten-year period, the median blood lead level was halved. Due to the significant blood lead decrease, and being the metal which is the most frequently tested, it is mandatory to perform this analysis by ICP-MS. [ABSTRACT FROM AUTHOR]

Résumé: Le don de sang représente un acte solidaire. Il est le plus souvent bénévole et, selon les pays et les circonstances, non rémunéré. Les éléments de la réflexion éthique sont, entre autres, l’augmentation des besoins, les critères d’exclusion de plus en plus nombreux, l’exigence sécuritaire et les modifications des structures de nos sociétés. Compte tenu de cela, les acteurs de la chaîne transfusionnelle doivent s’interroger sur certains paramètres : la valeur du don, le sens du bénévolat, l’opportunité de rémunérer l’acte de livrer une partie de soi, non plus comme un don et comme une expression d’altruisme et de solidarité, mais comme une prestation commerciale définie par des règles économiques. [ABSTRACT FROM AUTHOR]

Résumé: Nous rapportons le cas d’un garçon de 3ans admis au service des urgences pédiatriques après une ingestion accidentelle d’un produit à base d’éthylène glycol (EG). Au cours de l’hospitalisation, l’apparition de brûlures mictionnelles associées à des cristaux dans les urines avait été notée. Le bilan sanguin avait mis en évidence une acidose métabolique à trou anionique élevé. Une échographie-doppler rénale réalisée quelques semaines après avait montré de fines images hyperéchogènes bilatérales au sein de la médullaire rénale. L’examen des urines avait révélé la présence de cristaux de weddellite conduisant au diagnostic de néphrocalcinose secondaire à l’intoxication à l’EG. Une hyperhydratation et un traitement inhibiteur de la cristallisation par citrate de magnésium avaient été instaurés. Malgré cette prise en charge, une cristallurie de weddellite et des signes de néphrocalcinose ont persisté plus de 2ans après l’intoxication. L’EG est métabolisé au niveau du foie par des étapes d’oxydations successives menant à son métabolite final, l’acide oxalique, expliquant l’acidose métabolique à trou anionique élevé observée lors d’une intoxication. Des cristaux d’oxalate de calcium se déposent dans divers tissues notamment les reins. Leur précipitation dans les tubules rénaux peut entraîner une insuffisance rénale aiguë. Le pronostic rénal à long terme est lié aux lésions tubulo-interstitielles chroniques associées à la néphrocalcinose. Le traitement de l’intoxication à l’EG doit être rapide et efficace. Il repose sur les inhibiteurs spécifiques de l’alcool-déshydrogénase et l’hémodialyse dans les formes les plus graves. [ABSTRACT FROM AUTHOR]

Résumé: Objectif: Nous avons évalué l’efficacité et la tolérance de l’hormone adrénocorticotrope (ACTH) dans le traitement de la crise de goutte chez des patients hospitalisés. Méthodes: Nous avons revu rétrospectivement nos données de consultation externe et avons identifié 181 cas de crises de goutte traitées par l’ACTH en première intention. Les données des dossiers d’hospitalisations ont été revues et analysées. Un total de 181 patients était traité par 1mg d’ACTH synthétique en intramusculaire. Résultats: Une réponse favorable a été notée chez 77,9 % des patients et a été évidente dès le jour suivant l’injection d’ACTH. La majorité des non-répondeurs (87,5 %) était traitée par une dose ultérieure d’ACTH le jour suivant la première injection ; 82,8 % de ces patients avaient répondu. Un petit pourcentage de répondeurs (11,3 %) avait souffert d’une seconde crise après la crise initiale, avec une médiane de survenue de quatre jours. La pression artérielle et les taux sanguins de potassium étaient stables à 24 et 48heures suivant l’injection d’ACTH. Les patients diabétiques avaient une augmentation de leur glycémie, 24heures après l’injection comparée à leur glycémie avant l’injection, mais à 48heures il n’y avait plus d’évidence d’augmentation de celle-ci. Conclusions: Nos données indiquent que l’ACTH est efficace et bien tolérée dans le traitement de la goutte chez des patients hospitalisés. L’ACTH est une modalité intéressante pour les patients hospitalisés puisque l’utilisation des anti-inflammatoires non stéroïdiens (AINS), des corticoïdes et de la colchicine pourrait être problématique dans cette catégorie de la population. [ABSTRACT FROM AUTHOR]

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Copyright of IBS, Immuno-analyse & Biologie Specialisee is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of IBS, Immuno-analyse & Biologie Specialisee is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of IBS, Immuno-analyse & Biologie Specialisee is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: One of the main goals of haemovigilance is to gather and analyze adverse events in recipients of blood products in order to improve blood safety. The French National Blood Service has a specific role in the management of immediate adverse events: to alert to quarantine the potentially dangerous blood products from the same donation(s), to provide blood testing for the etiologic assessment and to give transfusion advice to patients. The updating of the recipient''s computer file allows a better monitoring for both immediate and delayed adverse events. Finally, the French National Blood Service''s correspondent of haemovigilance is responsible for donor''s inquiries, especially in cases of transfusion related to bacterial contamination, severe allergy, suspicion of transfusion acute related lung injury and viral seroconversion. The management effectiveness for adverse events requires a strong collaboration between all members of the haemovigilance network. [Copyright &y& Elsevier]

Abstract: Objective: The specificities of military medicine have led to the maintenance of fresh whole blood (FWB) transfusion. Study design: The aim of our study was to evaluate this practice at the French military hospital in Kabul between 2006–2009. Patients and methods: During our study period, 19 FWB transfusions were performed and the data from 15 FWB transfusions could be analyzed. We studied the number of units by recipient, the characteristics of recipients, the results of blood tests performed after transfusion, the incidents in donors and recipients, the period for obtaining a unit of FWB and mortality of recipients. Results: A total of 66 units of FWB were transfused in 15 patients. The median number of FWB units transfused was three per patient. Thirteen out of 15 (87%) were combat-related casualties. All units were tested before transfusion for HIV with rapid diagnostic tests. Every blood samples of donors were negative for pathogens screened at the French Blood Service. No incident in donors and in recipients was reported. The average time between collection and transfusion was 140±197minutes (median 43min). Mortality in recipients was 27% (n =4). Conclusion: In our study, the FWB transfusion was not associated with incidents. Nonetheless, this practice should be used only for exceptional situations like military conflicts where risks of FWB are lower than the absence of transfusion. [Copyright &y& Elsevier]

Copyright of Canadian Oncology Nursing Journal is the property of Pappin Communications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In these last years of revolutionary tyrosine kinase inhibitor treatments, patients with chronic myeloid leukemia are most commonly monitored by regular examination of bone marrow and peripheral blood in order to assess the quality of the response to treatment. Biological criteria and adapted methodologies in cytogenetics and molecular biology have been established from clinical trials. To date, it is essential to know these criteria for an optimal therapeutic management of these patients, in order to guarantee a better overall survival and an event-free survival. [ABSTRACT FROM AUTHOR]

Summary: Sarcoidosis, a chronic multisystem inflammatory granulomatous disorder of unknown origin, is a rare disease in children. Two distinct clinical presentations of sarcoidosis in childhood are known. Older children usually show multisystem disease, close to the adult manifestation, with lung infiltration and frequent hilar lymphadenopathy. Prior to the age of 5, sarcoidosis reveals more frequently with the classical triad of rash, arthritis, and uveitis. Due to non-specific clinical features and the lack of a specific test, recognizing sarcoidosis can be difficult in the pediatric population. Moreover, unlike in adults, lung involvement is rare in pediatric sarcoidosis. Given the lack of a definitive blood test, the World Association of Sarcoidosis and Other Granulomatous disorders (WASOG) only recommends dosing the serum angiotensin-converting enzyme (ACE). Its level is usually higher in children than in adults, but an increased ACE may help in the diagnosis. The gold standard is a biopsy specimen with typical epithelioid gigantocellular granuloma without caseating necrosis granuloma, after other disorders known to cause granulomatous disease have been reasonably excluded. We report here the case of a 4.5-year-old male with the history of polyarthritis and uveitis, considered first as juvenile rheumatoid arthritis, followed 5 years later by cutaneous involvement, which led to reconsidering the diagnosis. There were no pulmonary clinical findings. Histology provided the diagnosis of sarcoidosis. He then developed dependence on steroids. The lack of the classical triad delayed the diagnosis several years. This case shows the pediatric singularity of sarcoidosis, which needs to be known so that early and appropriate follow-up can be conducted. [ABSTRACT FROM AUTHOR]

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Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Since 1999, gamma-hydroxybutyric acid (GHB) is a prescription drug only for hospital use for intra-venous injection. It is classified as a narcotic if used orally. Scheduling GHB led the users to use mainly one of its chemical precursors, the gamma-butyrolactone (GBL) which is not classified. The use of GHB/GBL in a purpose of drug facilitated sexual assault remains rare. The main diverted usage is for entertaining purpose, but as the therapeutic range is narrow, thus its consumption may be life-threatening, particularly if alcohol is taken concurrently. Cases and methods: The toxicological investigations of the presented cases were performed on preserved peripheral blood, and when available, urine by GC-MS. When hair was available; analysis were performed by GC-MS/MS. In three cases analyses were undertaken on seized products. In seven cases of mono-intoxication by GHB/GBL, the blood concentrations ranged from 285 to 815 mg/L for fatal cases (n=4), and from 74 to 158 mg/L for non-fatal cases (n=3). In four non-fatal cases of GHB/GBL intoxication together with alcohol, MDMA, cannabis and/or methadone taken concurrently, the blood concentrations of GHB ranged from 86 to 184 mg/L. In two cases, hair analysis showed a GHB peak on the segment corresponding to the events at respectively 9.8 ng/mg and 9.6 ng/mg, typical of a single intake, in correlation with the presence of exogenous GHB in the blood and the urine at the time of the event. In one case GHB concentration was 62 ng/g in pubic hair and 105 ng/mg in nails, corresponding to a chronic use of GHB/GBL. Conclusion: GHB/GBL use can be lethal. An erratic consumption may be detected by segmental analysis of hair, but should be evidence among other proofs (urine concentration, seized products). A chronic consumption is easily detected in hair and nails. The use of GBL has been proved by the concurrent analysis of seized products. [ABSTRACT FROM AUTHOR]

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Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BLOOD MONITORING OF ANTIDEPRESSANTS CAN BE VERY USEFUL IN CASE OF ANTIDEPRESSANT OVERDOSE BUT ALSO IN ORDER TO ADAPT THE DRUG CONCENTRATION TO THE METABOLIC PATTERN OF THE TREATED PATIENTS. AFTER ACUTE INTOXICATION, THE BLOOD ANALYSIS IS USEFUL TO IDENTIFY THE ANTIDEPRESSANT RESPONSIBLE OF POISONING AND ASSESS THE SEVERITY. THE PRESENCE OF SOME ANTIDEPRESSANTS TOGETHER WITH OTHER TOXIC DRUGS, WITH ALCOHOL OR WITH DRUGS OF ABUSE IS INTERESTING FOR THE CLINICAL SURVEY OF THE PATIENT. HOWEVER, THE DETERMINATION OF THE BLOOD CONCENTRATION OF THE ANTIDEPRESSANTS DURING THE TREATMENT HAS PROVEN ITS EFFICACY TO OPTIMIZE THE TREATMENT WITH A REDUCTION OF COST AND TIME. INDEED, ANTIDEPRESSANTS ARE SUBJECT TO LARGE INTERINDIVIDUAL VARIABILITY SOMETIMES RESPONSIBLE FOR INEFFECTIVE TREATMENT OR ADVERSE EFFECTS IN PATIENTS TREATED WITH RECOMMENDED THERAPEUTIC DOSE. THIS VARIABILITY CAN BE EXPLAINED BY PHYSIOLOGICAL FACTORS (SEX, AGE, LIVER FAILURE,...) OR ENVIRONMENTAL FACTORS (SMOKING, DRUG INTERACTIONS,...), BUT ALSO BY GENETIC FACTORS (POLYMORPHISMS OF METABOLIC ENZYMES AND TRANSPORTERS TO THE SITE OF ACTION) OR BY A LACK OF PATIENT COMPLIANCE. BLOOD MONITORING OF THE DRUG CONCENTRATION IS THE ANSWER TO ALL THESE QUESTIONS. [ABSTRACT FROM AUTHOR]

Abstract: Purpose of the study: To evaluate the needs in staff training in transfusion centres of Sub-Saharan Africa. Material and methods: This preliminary study analyzed the training level of each personnel of four blood banks of Sub-Saharan Africa, their training fields, duration and training structures. Results: The needs remain high in all the fields and are critical regarding the administration of blood transfusion services, equipment maintenance and clinical use of blood. [Copyright &y& Elsevier]

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Copyright of IBS, Immuno-analyse & Biologie Specialisee is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Lemierre''s syndrome is a classical presentation of human necrobacillosis. It is characterized by a primary infection in the face including a septic thrombophlebitis of the internal jugular vein and disseminated metastatic abcesses. Fusobacterium necrophorum is the main pathogen found in that syndrome. The diagnosis is based on clinical features, then on the microbiology with positive anaerobic blood cultures as key role and finally on the computed tomography. Most of the time a well-chosen antibiotic treatment against anaerobic pathogens and Gram negative bacilli is efficient but surgery can be useful. We report a case of a 73years old man, which seems to be unique because it is the first case reported of a Lemierre''s syndrome characterized by a parotitis infected by F. necrophorum. [Copyright &y& Elsevier]

Copyright of IBS, Immuno-analyse & Biologie Specialisee is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Aim: Anticoagulants (AVK) are frequently responsible for iatrogenic accidents leading to hospitalisation. Antibiotics (ATB) are likely to interact with AVK. The aim of this study was to assess if Loire region practitioners complied with the French agency for the safety of health products (AFSSAPS) recommendations for AVK/ATB association. Method: Two strategies were implemented: a retrospective study of the 2007 Loire region General health insurance data on a population exposed to a single AVK split in two groups, exposed or not to antibiotics; a focus-group of practitioners from the Maine et Loire subdivision. Results: Blood tests were not always performed. The proportion of blood tests per month was significantly more frequent in the AVK/ATB group than in the group “not exposed” to antibiotics. GPs did not implement this recommendation, which doesn’t correspond to their behaviour, as analysed by a focus-group, and to the low incidence of hospitalisations due to AVK/ATB interaction. Conclusion: Loire region practitioners do not follow AFSSAPS recommendations. AVK/ATB interaction must be a GP''s constant concern whether responsible or not for initiating AVK. [Copyright &y& Elsevier]

Abstract: Every neonatal jaundice lasting more than 2 weeks needs urgent investigations, beginning with examination of stools colour, and blood tests with total and conjugated serum bilirubin. If neonatal cholestasis (NC) is confirmed, vitamin K should be immediately injected, and the child should be referred to a specialised centre for investigations and treatment. Biliary atresia (BA) is the first cause of NC. Its diagnosis is urgent, since the chance of success of the conservative surgical treatment (Kasai operation or variants) decreases rapidly as the age at surgery increases. Normal ultrasound scans cannot rule out BA. After prompt work-up looking for the main other causes of NC, BA can often be strongly suspected before surgery, and is confirmed by operative findings and cholangiogram if needed. In case of failure to restore the biliary drainage, biliary cirrhosis progresses and leads to liver transplantation, generally in the first years of life. Currently, more than 90 % of children with BA can live, with a close to normal quality of life for most of them. Early diagnosis and treatment of BA contribute to decrease the needs for liver transplantation in infancy and childhood. [Copyright &y& Elsevier]

Abstract: Introduction: Typhoid fever is a food- and water-borne disease, caused by Salmonella enterica serovar Typhi, responsible for high rates of morbidity and mortality in developing countries. Typhoid is also a public health problem in Algeria. Antimicrobial susceptibility surveillance must be applied to prevent the emergence of multidrug resistant strains. Patients and methods: We studied the incidence of S. enterica serovar Typhi isolated from blood cultures in the Ain M’lila public hospital (Algeria), between 2005 and 2008. Blood cultures were performed in the febrile stage of infection and positive samples were identified by biochemical and antigenic tests. Susceptibility to ampicillin, cotrimoxazole, chloramphenicol and nalidixic acid was tested by antibiogram. Results: One hundred and seventy-eight strains were isolated from blood cultures between 2005 and 2008. They were all susceptible to the antibiotics tested. Discussion: Typhoid fever incidence has decreased in Algeria. In our region, it comes by outbreaks during the summer season, with no sporadic cases between the peaks. In our study, S. enterica serovar Typhi was still susceptible to antimicrobials despite the worldwide emergence of multidrug resistant strains. Conclusion: A regular surveillance of Salmonella typhi antibiotic susceptibility is mandatory. [Copyright &y& Elsevier]

Abstract: Since 1994, the French haemovigilance network has not stopped evolving. Based initially on the reporting of informations and incidents related to recipients, it quickly became interested in the procedures and other activities related to blood component transfusion, in order to improve blood safety. Despite some failures (under reporting, heavy declarative management), the French haemovigilance network is going to continue working on improving blood safety, both at the level of the recipients and the donors, and participate to the global improvement of quality of care. [Copyright &y& Elsevier]

Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Purpose: Hypo-uricemia is still considered as a hallmark of the syndrome of inappropriate secretion of antidiuretic hormone. Methods: We analyzed prospectively 98 hospitalized patients with hyponatremia (≤135 mmol/L), excluding those receiving diuretic treatment. Gold standard for the syndrome of inappropriate secretion of antidiuretic hormone combined plasma hypoosmolality, inappropriately concentrated urine, and normal volemia. Results: A final diagnosis of inappropriate secretion of antidiuretic hormone was obtained in 55 patients. They were significantly hypo-uricemic (188 μmol/L [153–245], median [interquartile range]) versus 241 μmol/L, [179–333]; p <0,02) but hypo-uricemia (≤240 μmol/L) performed poorly as a diagnostic test: 71 % sensitivity, 53 % specificity. Positive and negative likelihood ratios were 1,67 and 0,49, respectively. Conclusions: The syndrome of inappropriate secretion of antidiuretic hormone is associated with a lower plasma uric acid concentration, but in routine clinical practice, contrary to what has been previously published, this difference is insufficient for hypouricemia to discriminate reliably between the syndrome of inappropriate secretion of antidiuretic hormone and other causes of hyponatremia. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Introduction: The hemophagocytic syndrome is rare and sometimes associated with tuberculosis. Observation: We report the case of a 30-year-old migrant from Congo presenting with a recurrent right pleuropneumonia, cachexia and night sweat. Blood tests revealed bicytopenia with a normal myelogram. Thorax CT-scan showed large mediastinal lymph nodes and pleuritis. Mediastinal lymph node biopsy concluded to granulomatosis lymphadenopathy with necrosis and bone marrow biopsy suggested hemophagocytic syndrome. The outcome was favorable with antibiotics and corticosteroids. [ABSTRACT FROM AUTHOR]

Abstract: More than ten years ago, the hypothesis that foetal microchimerism (Mc), arising from pregnancy, may have a reaction against the host, or “auto/allo”-immune reaction, has been proposed. More frequent and quantitatively larger foetal Mc found in blood from women with systemic sclerosis (SSc), compared to matched healthy women, argued this hypothesis. Since, Mc has been investigated in SSc and many diseases; however, results were often contradictory. Several explanations are discussed in the current review to understand the controversy and reveal interesting points. Ten years of research allowed to understand that a microchimeric cell is capable of the worst as well as the best depending upon specific factors (environmental, genetics…). Reversion to a non-aggressive phenotype seems possible and gives therapeutic hope. [Copyright &y& Elsevier]

Abstract: Objective: The Roche LightCycler® 480 (LC480) system was evaluated for quantitative molecular diagnosis of opportunistic viral infections caused by human cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), and BK virus (BKV), in comparison with “in-house” real-time PCR assays. Patients and methods: A total of 253 whole blood specimens obtained from transplant recipients were tested. Results: Both the “in-house” and the LC480 methods were highly correlated (Spearman correlation coefficient Rho≥0.85; p <0.0001) with an excellent overall qualitative agreement (90.5 %) and no significant quantitative difference between both techniques for the four viruses tested. The accuracy of the LC480 protocols were confirmed further by the results obtained with the 44 samples from the Quality Control for Molecular Diagnosis (QCMD) 2008 proficiency panel. Conclusion: The LC480 system constitutes a suitable and versatile real-time PCR platform in a routine laboratory setting for the diagnosis and monitoring of opportunistic viral infections in transplant recipients, by measuring HCMV, EBV, HHV-6, and BKV loads in whole blood samples. [Copyright &y& Elsevier]

Abstract: Aim of the study: Diagnosing the presence of cytomegalovirus (CMV) in the blood of immunodepressed patients is often done by quantitative polymerase chain reaction (Q-PCR) even though the reference method remains the antigenemia pp65 (Ag-pp65) test. Objectives: To define the predictive value of the Q-PCR in the diagnosis of CMV disease and assess treatment efficacy using the CMV R-gene® test. To compare the Q-PCR results and feasibility with those of the Ag-pp65 test. Patients and methods: The Q-PCR was performed in 34 whole blood samples (frozen at −80°C until use) from five patients diagnosed with CMV disease, defined as the presence of clinical signs and Ag-pp65 in the nuclei of more than two cells. After extraction, viral DNA was quantified in each sample using the Q-PCR CMV R-gene® kit according to the manufacturer''s instructions. Immediately after blood was drawn, the Ag-pp65 test had been performed in 32 samples using CINAkit® (Argene). Results: The 16 samples positive by the Ag-pp65 test were also positive by PCR; six samples negative by the Ag-pp65 test were positive by PCR; and the remaining 10 samples were negative by both techniques. During treatment, the two markers’ kinetics were similar. Conclusion: The CMV R-gene® test has a predictive value as good as that of the Ag-pp65 test but is fast and easier to use. A prospective study with a greater number of patients is needed to define the prediction threshold for CMV disease. [Copyright &y& Elsevier]

Abstract: The broad use of cytomegalovirus (CMV) viral load quantification in blood to follow immunosuppressed patients need standardized assays. Choice of whole blood allows follow-up for several viruses and simplifies pretreatment and storage of samples. Methods: We therefore evaluated the LightCycler® CMV Quant Kit (Roche Diagnostics) assay on whole blood after a manual extraction (High Pure viral nucleic acid kit, Roche Diagnostics), using as a reference an in-house Taqman assay (LC1UL83) which has been validated in various clinical situations. A panel obtained by serial dilutions of a virion stock in CMV whole blood, a commercial plasma quality control (VQC, Argène, France) crude or diluted in whole blood, infected cells extracts and 46 clinical samples from transplanted patients were tested simultaneously by both techniques. Results: For plasma quality controls, both PCR assays are correlated VQC (R2 =0.93). On whole blood or infected cells dilutions, correlation shows an overestimation by the LC1UL83 assay (mean 1.2 log copies/ml) over 3 log though R2 =0.94. Results with CMV Quant Kit are closer to expected values. Results on clinical samples are close to quality controls with a lower variation of quantification (0.76 log copies/ml). Conclusion: CMV Quant Kit performs well when compared with a clinically validated PCR. Quality control results showed discrepancies between plasma and whole blood, demonstrating the need for whole blood standardized panels to compare the methods. This underlines the need to follow a patient with the same technique during his follow-up. [Copyright &y& Elsevier]

Abstract: Objectives: To describe clinical, biological characteristics and virological aspects of patients with hepatocellular carcinoma (HCC). Patients and methods: Sera obtained from consent patients with clinical suspicion of HCC. Routine biochemical tests and serological markers of hepatitis B virus (HBV), hepatitis D virus (HDV) and hepatitis C virus (HCV) were searched. A hepatic ultrasound scan was realized and, when a suspected mass lesion was observed, ultrasonographic-guided fine needle aspiration of the hepatic mass lesion was made to ascertain the diagnosis of HCC. Results: One hundred and seventy-five sera were collected from 99 men and 76 women. Approximately 96.6% (169/175) of them had previous contact with HBV. HBs surface antigen was positive in 41% (69/169) of whom 53.6% (37/69) were co-infected by the HDV. Three patients (1.71%=3/175) were positive for anti-HCV antibodies. The other three patients (1.71%=3/175) did not present any markers for HBV or HCV. At the time of diagnosis, right upper quadrant pain, hepatomegaly, cachexia, were present in all patients. An increase in serum transaminases (70%), high bilirubin concentrations (40%), high AFP levels (40%) and low prothrombin levels (52%) were the most frequent biological abnormalities. Only 17 guided fine needle aspirations of mass lesions were realized. The diagnosis of HCC was confirmed by cytopathological examination for 14 of them. Conclusions: HCC is a frequent pathology in the Central African Republic (CAR). According to the ultrasound imaging data, patients consult at terminal stage of the disease. This study confirms also the association between HBV and HCC in CAR. Moreover, in 26.5% of patients HDV is associated with severe forms of the disease. [Copyright &y& Elsevier]

Abstract: The monitoring of antimicrobial agents is a routine in our unit. We reviewed the results either of peak-and-through concentrations (peak and through is one sample) or concentrations at steady state (Css) of all antimicrobials given over five years (2001 to 2005) and studied the antimicrobials with at least 20 samples. We found 706 samples in 122 patients, the antimicrobials being amikacin, amoxicillin, ceftazidime, ciprofloxacin, cloxacillin, gentamicin, imipenem, ofloxacin, tobramycin and vancomycin. When comparing samples in witch the concentrations were above a value thought to be predictive of efficacy to those were not, we could notice: that no parameter about patients or burn surface was predictable for achieving targeted blood concentration; that usual regimen could not achieve targeted concentrations, excepted with ceftazidime, provided it was used in continuous infusion; that, with the other β-lactams, continuous infusion was more likely to achieve targeted blood concentrations; that, with fluoroquinolones, both higher and more frequent injections were needed; that, with aminoglycosides used once a day, the dosage had to be higher than usually recommended. We conclude that antimicrobial regimen should be altered in burns and that a monitoring of blood concentrations should be performed in these patients. [Copyright &y& Elsevier]

Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: The purpose of this study was to compare the differences in lactate parameters and maximal aerobic speed (MAS) adaptations to intermittent, mixed and continuous training. Methods: Thirty-six subjects were equally divided into continuous (CT) or intermittent (IT) or mixed (MT) training groups. The trained participants practiced six d/wk for six weeks. Before and after training, all participants completed an incremental exercise test to assess their MAS, and a 30-second supramaximal exercise followed by active recovery. Results: Blood lactate recovery curves from the supramaximal exercise were fitted to a biexponential time function. Following the training period, there was a significant increase in MAS, a significant increase in lactate exchange (γ1) and removal (γ2) abilities, a significantly faster time to peak lactate (t-[La] peak), a significant decrease in lactate half time (t-1/2-[La]). The improvement in MAS and γ 1 were significantly higher in IT and MT-group compared to CT-group. The lactate removal ability (γ 2 ) was significantly higher for IT than for CT and MT-group (p <0.05). However, no significant differences were observed in peak blood lactate concentration ([La] peak) and in t-[La] peak between the three physically-trained groups. We conclude that both IT and MT were more efficient in elevating MAS. However, this two methods were equally effective on all others parameters except γ 2 . IT was more beneficial in raising the lactate removal (γ 2 ) ability. [Copyright &y& Elsevier]

Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Faecal occult blood tests (FOBT) have been established as the most relevant procedure for colorectal cancer screening in the general average risk population. Immunochemical FOBT consists in monoclonal antibodies reacting with the globin of the haemoglobin. These tests provide higher performances than traditional guaiac tests. They do not need any diet restriction and their analytic sensitivity is higher. An increasing number of papers suggest that their acceptance and clinical performances in the general population are more satisfactory than the guaiac test. The use of automated reading allowed to cut the process price making it similar to the guaiac test. The providing of quantitative measure of haemoglobin allows to choose the positivity threshold associated with the best balance between sensitivity, specificity and positivity rate. Comparative studies conducted in France suggest the use of a positivity threshold allowing an increase in both sensitivity and specificity compared to the guaiac tests. [Copyright &y& Elsevier]