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Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. 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.)

The goal of this study was to assess plasma procalcitonin (PCT) concentrations during infectious events of burns in the ICU. We conducted a prospective, observational study in a 20-bed Burn Intensive Care Unit in Tunisia. A total of 120 septic patients admitted to the Burn ICU were included in our study. Sepsis was assumed according to the French Burn Association criteria for the presence of infection. Serum PCT was measured over the entire septic episode every 48 hours until resolution of infection, based on clinical signs and decrease of PCT of about 80% compared to its initial value. Patients were assigned to two groups depending on clinical course and outcome: Group A = patients with favourable evolution; Group B = patients with unfavourable evolution. Monitoring of kinetics of PCT allowed us to judge the effectiveness of the initial antibiotic therapy, with a threshold of 43.5% decrease at day 3 of treatment, with a better sensitivity and specificity of 79.6% and 87.7% respectively. In addition, PCT monitoring allowed a reduction in the duration of antibiotic therapy of 5±2.8 days versus 8 to 10 days before the use of PCT. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Osteoporosis is characterized by low bone mass and density, as well as change in microarchitecture of bone tissue leading to decreased bone strength. In vitro research shows nicotine can increase osteoblast activity and proliferation, also suppress osteoclast activity. Therefore we explore nicotine anti-resorptive property by in vivo true experimental and randomized posttest only controlled group research that was conducted in 18-20 weeks old Rattus norvegicus. METHODS: twenty-five female rats were divided into five groups, with 5 rats per group. The first group represented normal rats (Sham), while the second to fifth group underwent bilateral ovariectomy. The second group serves as positive control group (ovariectomy-only/OVX). The third to fifth group serve as dose 1 (P1-0.25mg/kg), dose 2 (P2-0.5 mg/kg), and Dose 3 (P3-0.75 mg/kg) treatment group receiving daily per-oral nicotine for 28 days, started 3 weeks post- ovariectomy. After 28 days treatment, the serum was checked. RESULTS: nicotine has dose-dependent manner on serum osteocalcin and serum DPD level. Level of osteocalcin in P2 group was significantly lower (Mann-Whitney, p = 0.008) compared to OVX group (59.4% lower). Level of DPD in all group was not significantly different (ANOVA, p = 0.05) but shows lowest level in P2 group. For serum calcitonin level, there's no significant different between groups. CONCLUSION: nicotine at right low-dose might be able to inhibit osteoclast activity, thus open a possibility of anti-resorptive property of nicotine.

Résumé: Objectif: L’objectif de ce travail est de comparer deux paramètres biologiques, la protéine C-réactive (CRP) et la procalcitonine (PCT) dans la détection des lésions rénales aiguës confirmées par la scintigraphie au DMSA, dans les pyélonéphrites aiguës (PNA) chez l’enfant. Patients et méthodes: Étude prospective menée sur une année, incluant les enfants présentant un premier épisode de PNA. Tous les enfants ont eu un dosage de la PCT, la CRP et l’hémogramme. Résultats: Parmi les 75 patients inclus, 33 avaient des lésions rénales aiguës (groupe A) et 42 enfants avaient une scintigraphie au DMSA normale (groupe B). Dans le groupe A, la valeur moyenne de la PCT était plus élevée que dans le groupe B avec une différence significative (8,81ng/mL versus 1,7ng/mL, p =0,01). Le calcul de l’air sous la courbe ROC de la CRP et de la PCT a trouvé que la PCT à un seuil de 0,76ng/mL était plus performante dans la détection des lésions rénales aiguës par rapport à la CRP à un seuil de 70mg/L avec une meilleure sensibilité, valeur prédictive négative et indice de Youden (82 % versus 70 % ; 84 % versus 70 % et 0,58 versus 0,25). Conclusions: Notre étude a confirmé la bonne sensibilité et la bonne spécificité du dosage de la PCT dans le diagnostic des lésions aiguës du parenchyme rénal des infections urinaires de l’enfant fébrile. [ABSTRACT FROM AUTHOR]

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.)

Summary: Urinary tract infections (UTIs) are one of the most common sources of bacterial infections among young febrile children. Accurate diagnosis of acute pyelonephritis (APN) and vesico-ureteral reflux (VUR) are important because of their association with renal scarring, sometimes leading to long-term complications. However, the gold standard examinations are either a DMSA scan for APN and scarring, or cystography for VUR, but both present limitations (feasibility, pain, cost, etc.). Procalcitonin, a reliable marker of bacterial infections, was demonstrated to be a good predictor of renal parenchymal involvement in the acute phase and in late renal scars, as well as of high-grade VUR. These findings need further broad validations and impact studies before being implemented into daily practice. However, procalcitonin may play a role in the complex and still debated picture of which examination should be performed after UTI in children. [Copyright &y& Elsevier]

Summary: The maternofetale infection (IMF) establishes one of the major concerns of the paediatrician, the main cause of inflammation and the main part of the prescriptions of antibiotics in the neonatal period. In Morocco, the IMF is responsible for mortality important for the neonatal period. The signs of the IMF are fickle and non-specific, making the early diagnosis often difficult. The purpose of our study is to estimate our protocol of coverage of the suspect of IMF in newborn children, to study the performance of the procalcitonin in the early diagnosis of the IMF and to determining its sensitivity, specificity, predictive value during the first six hours of life. Subject and methods: We led a cohort study over a period of 24 months, going from December 1st, 2009 until November 30th, 2011. For every inclusive newborn child, we proceeded to a dosage of the procalcitonin during the first six hours of life (between H1 and H6) and in a dosage of CRP at H24 of life. Two distinct populations were defined based on clinical, biological and bacteriological criteria:group 1 (infected neonates), and group 2 (non infected neonates). We determined the cut-off value correlated with maternofetal infection by analysing the receiver operating characteristics curve (ROC). Results: The study had interested 99 newborns, of lower age or equal to H6 of life. Seventy-one newborns children were symptomatic in the birth with infectious anamnesis. Twenty-eight newborns children were asymptomatic whose moms had infectious risk factors. Fifty-six newborns (56.6%) were classified in group 1 with 48 likely infections and eight confirmed infections with neonatal meningitis case. The PCT threshold value (≤H6 of life) found by the ROC curve with the highest sensibility (89.29%), highest specificity (100%) and the good negative (87.8%) and positive (100%) predictive value was 1.99ng/mL, making it possible to reduce the abusive use of antibiotics, duration of the antibiotic therapy and the average duration of hospitalization with a statistically significant difference (P <0.001) between the group 1 and 2. The mean value of the PCT (≤H6 of life) in group 1 was significantly higher than in group 2 (14.87±23.79ng/mL versus 0.73l±0.61ng/mL; P <0.001). The procalcitonin is an innovative marker of the infection having a cinetic more premature than that of the other proteins of the acute phase of the inflammation. In our experience, the PCT could establish a good marker in the diagnosis of infection. Our results give evidence in the decision-making threshold of 1.99ng/ml, during the first six hours of life, a better sensibility, of an excellent specificity and of a good negative predictive value. [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.)

Summary: Objective: The authors have evaluated the contribution of procalcitonin (PCT) assay to monitor bacterial nosocomial infection (BNI) of premature newborns carrying a venous central catheter during a prolonged hospitalization. Using the quantitative KRYPTOR®-PCT method, they determined the sensitivity (Se) and the specificity (Sp) for PCT and C-reactive protein (CRP). Materials and methods: Newborns with a suspicion of BNI were included. They were divided into two groups: not infected (group 0), infected (group 1). Comparing the two groups, the authors established a threshold value for PCT and CRP using the ROC curves. We also highlighted Se, Sp, positive (VPP) and negative predictive values (VPN) for PCT and CRP. Results: Forty premature newborns of 28.3 weeks gestational age average were included during a 17 months period. The distribution was as follows: 26 patients in group 0 and 14 patients in the group 1. The threshold value was 0.8ng/ml for PCT, 6mg/l for CRP. The Se, Sp, VPP and VPN values were 79, 96, 92 and 89% for PCT, 50, 88, 70 and 77% for CRP. From the ROC curves, the surface under curve was 0.94 for PCT, 0.68 for CRP (p <0.05). Conclusion: This study confirms the interest of PCT assay in the diagnosis of BNI in premature newborns. The PCT is an early marker of bacterial infection in Neonatal Intensive Care Unit. [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.)

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: Purpose: The availability of a sensitive, specific and prognostic marker of bacterial infection is a major issue. More than ten years after the first publication assessing the usefulness of serum procalcitonin dosage (PCT), its exact place in the diagnostic process remained to be defined. The purpose of this review is to point out the indications of PCT measurement in clinical practice in the adult population. Relevant data: PCT is an early, sensitive but above all specific marker of severe bacterial/parasitic infections. After being studied mostly in critically ill patients, the indications of PCT measurement have been extended to medical and emergency medicine practice, generating cut-off points between 0.2 and 0.6 μg/L. The medical area of application of PCT measurement is varied: discrimination between inflammatory disease and infectious complication or between bacterial/parasitic and viral infection, diagnosis of negative result gram staining meningitis or shock, assessment of antibiotic treatment efficiency. Moreover, PCT measurement provides outcome information in that sepsis-related raised PCT levels seem to be closely related to the magnitude of host systemic inflammatory response to microbial invasion. High PCT levels allow the early identification of patients prone to develop severe sepsis or septic shock. Prospects: After the first published study reporting the usefulness of PCT as a screening biological tool in emergency medicine, future studies will probably refined the place of PCT in such practice fields: decision about inpatient or outpatient management or antibiotics dispensation. Finally, PCT measurement could help physician in screening which septic patients should benefit from sepsis innovative therapeutics. [Copyright &y& Elsevier]

Abstract: Propose: Today, calcitonin assay is used for the diagnosis of thyroid medullary cancer in the context of nodular thyroid disease. Calcitonin is an excellent marker of thyroid medullary cancer but some hypercalcitoninemia can also be related to other diseases, such as renal failure, endocrine tumors other than thyroid medullary cancer and sometimes to C cell hyperplasia, which is a not well-defined situation. Recent studies contributed to define calcitoninemia thresholds, which guide decision and avoid excessive invasive treatment. Current knowledge and key points: After a brief reminder of physiological role of calcitonin and assays, the difficulties encountered in interpreting hypercalcitoninemia and its potential causes other than thyroid medullary cancer are addressed. Recent studies, on large series, now allow a better knowledge of specificity and sensitivity of calcitonin measurement in patients with nodular thyroid disease and a well-argued management. Future prospects and projects: In the future, calcitonin dosage will be ordered even more frequently, as some authors recommend it for the diagnosis of thyroid nodule. It is up to us to know how to use this remarkable marker, by considering all possible situations of benign hypercalcitoninemia and reserving aggressive treatments for patients who really need them. [Copyright &y& Elsevier]

Abstract: Bone mass is primarily genetically determined, but exogenous factors also play a major role. The prevention of osteoporosis can start from childhood, and optimal achievement of peak bone mass during childhood and adolescence is important in order to minimise future fracture risks. Chronic inflammatory diseases can have a detrimental effect on bone mass, by means of several mechanisms. Different diagnostic methods for detection and monitoring of osteoporosis are in use or under investigation. The role of calcium and vitamin D supplementation for the prevention and treatment of osteoporosis associated with paediatric rheumatic diseases remains to be established. New treatments such as bisphosphonates and calcitonin are now available, although their use in the paediatric age has been limited. [Copyright &y& Elsevier]

Copyright of EMC-Anesthesie--Reanimation 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: Background. – Appendicitis clinical diagnosis in children is difficult and the acute inflammatory markers hyperleucocytis and CRP do not contribute to it. Objective. – To study the predictive value of procalcitonin (PCT) and to assess variations of its serum level according to inflammatory lesions in paediatric appendicitis. Patients and method. – Among 101 children aged two and 15, hospitalized for painful abdominal syndromes, 70 underwent operation for acute appendicitis and appendiceal peritonitis, 31 had no operation. PCT was evaluated in all children, normal serum concentration was&#60;0,5 ug/L. Every appendicectomy part has been examined through histological analysis to confirm the diagnosis and the histological lesions have been classified into three categories according to their severity. Results. – Out of 70 appendix analysed at histology, 68 (97%) were healthy and 2 (3%)were unhealthy. Among the 68 cases of healthy appendix, 19 had a PCT higher than 0,5 ug/L and among 33 cases of unhealthy appendix 4 had a PCT higher than 0,5 ug/L. The PCT mean of healthy children was not significantly different from unhealthy appendix population, appendicitis prevalence was 0,67, PCT sensitivity 28%: IC 95% [18–40], specificity 88%: IC 95% [72–97], positive predictive value 83%: IC 95% [61–95], and negative predictive value 37%: IC 95% [26–49]. PCT mean increases with the severity of inflammatory lesions of the appendix (P =0,0051). Conclusion. – PCT has not a good predictive value in acute paediatric appendicitis but remains a good indicator of severity in paediatric appendicitis. [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.)

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.)

La prévention et le traitement de l’ostéoporose sont devenus une nécessité compte tenu du vieillissement de la population et du coût socio-économique des complications fracturaires. La publication de recommandations des agences d’enregistrement au cours de la dernière décennie est venue encadrer de façon précise l’évaluation des nouveaux médicaments destinés à la prévention et au traitement de l’ostéoporose post-ménopausique. L’intérêt d’une supplémentation calcique et vitaminique D chez les patients ostéoporotiques est clairement démontré, notamment chez les sujets les plus âgés et ce, surtout s’ils sont institutionnalisés mais les études prospectives visant à mettre en évidence un effet de ce type de traitement dans la réduction du risque fracturaire ont donné des résultats discordants. Dans l’étude FIT (Fracture Intervention Trial), le traitement par alendronate 10 mg/j réduit le risque de fracture vertébrale de 48 % et augmente la densité minérale osseuse (DMO) chez les patientes présentant une fracture vertébrale prévalente. Les études VERT-MN (Vertebral Efficacy with Risedronate Therapy MultiNational) et VERT-NA (North America) ont montré que le traitement par risédronate 5 mg/j réduit le risque de fracture vertébrale à 3 ans de 49 % et de 41 % respectivement. Le traitement par risédronate 5 mg pendant 3 ans induit une augmentation de la DMO par rapport à la valeur initiale. Dans l’étude PROOF (Prevent Recurrence Of Osteoporotic Fractures) et dans le groupe à 200 UI de calcitonine, une réduction significative du risque de survenue de fracture vertébrale est observé mais cette étude fait l’objet de nombreuses critiques dans son déroulement. Les SERM (selective estrogen receptor modulator) agissent soit comme agoniste soit comme antagoniste des estrogènes selon le tissu cible. L’étude MORE (Multiple Outcomes of Raloxifene Evaluation) a démontré l’efficacité du raloxifène sur la réduction du risque de fracture vertébrale (réduction de 50 % en l’absence de fracture vertébrale prévalente et 30 % en cas de fracture vertébrale prévalente). L’hormone parathyroïdienne (PTH) stimule la formation et de façon plus modérée la résorption osseuse et induit une augmentation de la masse osseuse. Le traitement par PTH induit une augmentation de la DMO par rapport à la valeur de base et réduit le risque de fracture vertébrale de 65 %. Le ranelate de strontium, par un mécanisme d’action original (stimulation de la formation osseuse et diminution de la résorption osseuse) a démontré un effet positif à la dose de 2 g/j sur l’augmentation de la masse osseuse chez des femmes ostéoporotiques ; dans l’étude de phase III SOTI (Spinal Osteoporosis Therapeutic Intervention), une réduction significative du risque de survenue de fracture vertébrale de 41 % à 3 ans a été mise en évidence. Nous disposons de moyens thérapeutiques efficaces permettant d’envisager une meilleure prise en charge de l’ostéoporose post-ménopausique. Cette maladie reste encore sous-diagnostiquée et les besoins thérapeutiques ne sont pas couverts. La prévention de la première fracture constitue une des préoccupations majeures. Mots clés : recommandations, ostéoporose, biphosphonates, SERM, vitamine D, calcium, calcitonine, ranelate de strontium, hormone parathyroïdienne Abstract The prevention and treatment of osteoporosis are now a necessary goal because of the aging of the population and the social and economic costs of fracture complications. The publication of guidelines by registration agencies during the last 10 years has provided precise rules for evaluating new drugs designed for the prevention and treatment of postmenopausal osteoporosis. The benefit of combination treatment with calcium and vitamin D in osteoporotic patients has clearly been proven, especially among the oldest patients, but results of prospective studies designed for the prevention of fracture risk are conflicting. In the Fracture Intervention Trial (FIT), treatment with alendronate 10 mg/day reduces the risk of vertebral fracture by 48% and increases bone mineral density (BMD) in patients with vertebral fractures. In the Vertebral Efficacy with Risedronate Therapy MultiNational (VERT-MN) and VERT-NA (North America) studies, treatment with risedronate 5 mg/day reduces the risk of vertebral fracture by 49% and 41%, respectively. Risedronate 5mg daily for 3 years leads to an increase in BMD. The Prevent Recurrence Of Osteoporotic Fractures (PROOF) study has shown a significant decrease in the risk of vertebral fracture in patients treated with calcitonin 200IU. However, numerous criticisms of the methodology of this study design have been identified. Selective estrogen receptor modulators could act as agonists or antagonists of estrogens, depending on the target tissue. In the Multiple Outcomes of Raloxifene Evaluation (MORE) study, treatment with raloxifene reduces the risk of vertebral fracture by 50% in patients without prevalent vertebral fracture and by 30% in patients with prevalent vertebral fracture. PTH treatment leads to an increase in BMD and reduces the risk of vertebral fracture by 65%. Strontium ranelate has a novel mechanism of action (stimulation of bone synthesis and a decrease in bone resorption), and administration of 2g daily has a proven positive effect, leading to an increase in bone mass among women with osteoporosis. This effect was especially evident in the Spinal Osteoporosis Therapeutic Intervention phase III (SOTI) study, in which a significant decrease in the incidence of vertebral fracture of 41% over 3 years has been shown. Thus, effective therapeutic strategies now enable improved treatment of postmenopausal osteoporosis. However, this condition is still poorly diagnosed and not all patients are correctly treated. Preventing the occurrence of the first fracture should remain the prime concern. Keywords: guidelines, osteoporosis, vitamin D, SERM, bisphosphonates, strontium ranelate, calcium, parathyroid hormone, calcitonin Texte reçu le 26 septembre 2003 ; accepté le 26 septembre 2003 [ABSTRACT FROM AUTHOR]

In the situation of persistant hypercalcaemia after cervicotomy for medullary carcinoma of the thyroid (CMT), the concerns are radically different depending on whether the initial operation has been adequate or not. If it has been inadequate, it is necessary to reoperate via cervicotomy and facilitate, in all cases, a total thyroidectomy and a bilateral and central neck dissection. If the cervicotomy has been adequate, it is necessary to have a high index of suspicion for a locoregional recurrence and systemic disease, but the indications for reintervention must be respected. The essential problem is the difficulty in staging residual or recurrent disease. In this situation all the imagery available should be utilised, including laparoscopy to rule out the possibility of miliary metastatic liver disease. There is no hope of cure in the setting of systemic disease, but it is necessary to recall that an extremely elevated calcitonin can be well tolerated and compatible with a survival for several decades. The overall prognosis lies not in the level of elevation of the tumoral marker but the extent of local invasion and systemic disease. There is no hope of cure when the calcitonin level is superior to 1000 pg/ml. There is also no chance of localising recurrent disease when the calcitonin level is inferior to 50 pg/ml. Therefore, one should only utilise the various available localisation techniques when the level of calcitonin is between 50 and 1000 pg/ml. A mediastinal disssection via sternotomy is only indicated in the absence of distal metastases and in the setting of nodal involvement just caudal to the initial cervicotomy, and only after a laparoscopy to exclude hepatic metastases. The future hopes lie with radio-immunoguided surgery in cases of local invasive disease and radiolabelled immunochemotherapy for systemic disease. [Copyright &y& Elsevier]

Objective – To assess the importance of procalcitonin (PCT) in pneumonia, PCT was compared to other blood markers, C-reactive protein (CRP), interleukin 6 (IL6), and interferon-alpha (INFα). This prospective study was performed in the emergency room on 88 children (two months–13 years) hospitalized for severe community-acquired pneumonia.Patients – S. Pneumoniae was isolated in ten patients'' blood culture, 15 patients a probable bacterial pneumonia according to sputum analysis (14 S. Pneumoniae, 1 Haemophilus influenza b), ten patients a Mycoplasma pneumoniae infection, and 37 others were infected with viruses, eight of whom with a bacterial co-infection. In 16 patients, no causal agent was identified.Results – PCT was always > 2 μg/L in the ten patients with blood culture positive for S. pneumoniae and CRP was > 60 mg/L in 8/10. PCT was > 1 μg/L in 86% of all patients with probable bacterial infection (including Mycoplasma). CRP concentrations of 20 mg/L had a similar sensitivity but a much lower specificity than PCT (40% vs. 86%) to discriminate between bacterial and viral causes of pneumonia. Specificity and sensitivity of IL6 were lower in all cases. Interferon-alpha is a good marker of viral pneumonia but biological assessment requires two days or more.Conclusions – PCT concentrations, with a threshold of 1 μg/L provides better sensitivity and specificity in emergency room than CRP, IL6, INFα, or white blood cell count to differentiate bacterial and viral causes of community-acquired pneumonia in hospitalized children. [Copyright &y& Elsevier]

Biomarkers of inflammation such as sedimentation rate, C-reactive protein and procalcitonin are used in daily clinical practice for the diagnosis, prognosis and follow-up of patients with fever or inflammatory syndrome. The purpose of this article is to summarize the current knowledge about these main biological tests and to discuss new biomarkers and new assay approaches such as multiplex technology.

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Résumé: Objectif: Limiter la prescription d’une antibiothérapie dans l’infection néonatale précoce en améliorant le dépistage et le diagnostic de l’infection des nouveau-nés. Patients et méthode: Première partie : dépistage systématique de l’infection anténatale par dosage de la procalcitonine (PCT) au cordon. Quatre-vingt-sept cas. Seuil de PCT à 0,5ng/mL. Dosage de la protéine C-réactive (CRP) à 24heures (H) en cas de PCT élevée. Deuxième partie : diagnostic de l’infection anté- et pernatale par dosage de la PCT entre H4 et H6 en présence de facteurs de risque infectieux. Quarante-sept cas sur 6 mois. Seuil de PCT à 2ng/mL. CRP à H12 ou H24 Résultats: Dix antibiothérapies ont été prescrites pour 1000 naissances pendant la période d’étude versus 30/1000 avant l’étude, soit une diminution des deux-tiers des prescriptions. Conclusion: Combiner dans le temps les marqueurs de l’inflammation tels que la PCT qui possède une bonne spécificité et une bonne valeur prédictive négative (VPN) de 0 à 6 H de vie et la CRP qui possède une bonne sensibilité et bonne la valeur prédictive positive (VPP) de 12 à 24 H de vie. [ABSTRACT FROM AUTHOR]

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Copyright of Zeitschrift Für Zellforschung und Mikroskopische Anatomie is the property of Springer Nature 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 Senegal, reducing neonatal mortality remains a challenge. The management of neonatal infections remains problematic and presents a strong clinical focus. Indeed, like all developing countries, the difficulty of acquiring state-of-the-art infrastructure and the financial cost impact on the routine use of biomarkers. It is in this context that we conducted this study to identify the best biological strategy for making a reliable diagnosis. Ninety-nine newborns were recruited at the pediatric service of the Diamniadio Children's Hospital (Senegal). CRP was assayed by latex immuno-agglutination method, IL-6 and IL-8 using Luminex ® technology, PCT by chemiluminescence, orosomucoid by immunoturbidimetry and SAA by ELISA technique. 20 newborns had probable infection and six established infection. Deaths and complications were significantly greater in these groups. With an optimal decision threshold of 16.3 mg/L, CRP performed better (compared to the other tested blood biomarkers) with AUC, sensitivity and specificity of 94%, 88% and 99%, respectively. With the performance obtained from CRP in the diagnosis of neonatal bacterial infections, the installation of panels with other biomarkers with advanced and expensive technology is not necessary. Thus, optimal care and within a reasonable timeframe can be done in our health facilities, with this accessible marker that is CRP.

The authors describe the cases of two patients from the same family who presented medullary thyroid carcinoma (MTC). Hormone measurement showed a significantly elevated basal calcitonin. The treatment was total thyroidectomy. Histological findings showed multifocal, bilateral MTC. Direct sequencing identified in both patients a heterozygous germline missense mutation TGC-TTC at codon 634 of exon 11 in the RET gene that causes an animosubstitution of cysteine to phenylalanine. The clinical outcome of the cases is considered to be favourable. [ABSTRACT FROM AUTHOR]

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Abstract: Procalcitonin (PCT) is a biological marker of infection. We present the cas of a patient who has presented a high concentration of PCT with PCT-Q® test (Brahms®). At the same time, the concentration of CRP is remained low, which is no physiological. Then, PCT concentration has been determinated with an automatic system (Kryptor®–Brahms®) and finded at low than 0.5 μg/l. Brahms® company has searched an analytical interference: human anti-mouse antibodies (HAMA) were positive. If PCT concentration stay a marker of infection for the most part, this case show that biologists have to keep in mind that immunological assays remain submitted to interferences. [Copyright &y& Elsevier]