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Thoracic radiotherapy is a usual treatment for lung cancer. Early-stages may be treated in stereotactic mode while locally advanced stages are usually treated with conventional radiotherapy mode. Pulmonary function tests show that thoracic irradiation has no impact on lung volume such as forced expiratory volume in one second (FEV1) or forced vital capacity (FCV). However, some studies found that CO (carbon monoxide) diffusing capacity (TLCO) may be altered under thoracic radiotherapy. DLCO alteration is usually symptomatic of either a lesion in the alveolar membrane or a pulmonary capillary alteration. Pulmonary diffusion may be also appreciated by the NO (azote monoxide) diffusion capacity. Moreover, using a double measurement of NO and CO diffusing capacities permit to assess which lung compartment (capillary or membrane) is affected. CONORT is an observational prospective monocentric study, aiming to assess the CO and NO diffusing capacity (as well as other pulmonary function tests) during thoracic radiotherapy. Inclusion criteria are patients with lung cancer, treated by thoracic radiotherapy (conformational or stereotactic), who signed consent. Pulmonary function tests are performed before, during, at the end and six weeks and six months after thoracic irradiation. To estimate a difference of 15% in diffusing capacity test, we have to include 112 patients with a 90% power and a 5% alpha risk. Four months after beginning, 36 patients were included. Preliminary data will be presented at the SFRO meeting., (Copyright © 2014 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.)

We examined 129 patients recruited from two sleep clinics to study the sleep apnea syndrome (SAS), defined by the apnea-hypopnea index (AHI) > or = 10. Information was registered from a self-administered questionnaire, basal physical measurements, and polysomnography. In 68 subjects recorded for two consecutive nights, a high correlation was found between first- and second-night AHIs (r = 0.89). Habitual loud snoring and breathing arrests during sleep were associated with AHI > or = 10. A model including these two variables, sex, age, and body mass index was created in order to predict AHI > or = 10 and with which it was possible to successfully classify almost three of four patients. Among subjective sleep questionnaire items, only daytime sleepiness was related to drops of transcutaneous oxygen tension. These discrepancies in the observed relationship between sleep parameters and subjective sleep items reduce the questionnaire value in epidemiologic settings where it aimed to detect SAS, as defined solely by the AHI value.

Transiently evoked oto-acoustic emissions (TEOAEs) are generated by active contractions of the outer hair cells (OHC) of the organ of Corti. TEOAE are inhibited by the medial efferent olivocochlear system which originates in the brainstem and innervates the OHC. TEOAEs are a rapid non-invasive objective method of auditory screening in infants. Because in infants sleep represents 75% of their time, it was of interest to determine whether sleep stages which are induced in the brainstem could concomitantly affect TEOAEs. Repeated TEOAE recordings during polygraphic recordings of sleep stages were made on seven, 6-week-old infants. Results showed that: (i) TEOAE spectrum frequency components remained stable over sleep stages; (ii) TEOAE amplitude tended to increase during recording sessions; (iii) sleep stages (quiet, active and indeterminate sleep) did not affect TEOAE amplitude. This pilot study reveals that sleep mechanisms seem to have no effect on active OHC micromechanical properties. Therefore, in auditory screening, TEOAEs may serve to study active cochlear mechanisms in infants even during sleep which is the better time to perform recordings because of the quietness required.

The report concerns findings for brainstem auditory evoked potentials (BAEPs) recorded in 116 children, aged between a few days and 7 years, having suffered from bacterial meningitis. 26% of cases occurred between birth and 6 months, 55% between 6 months and 2 years, and 19% after 2 years of age. Hemophilus was the most common bacteria (49%), followed by Pneumococcus (22%) and Meningococcus (15%). Neurological complications were found in 30% of the meningitis cases and accounted for 85% of all complications found. 29% of BAEPs were abnormal, of which 47% revealed transmission, 32% endocochlear and 21% retrocochlear impairment. Transmission impairment mainly occurred before the age of 2 years (88%), most frequently in meningococcus meningitis cases (44%), and independently of neurological complications. Retrocochlear impairment was found in association with neurological complications in 71% of cases. Endocochlear BAEP damage was found in 9.5% of cases, half of which were bilateral and total, representing cophosis: it was found at all ages, and without any particular associated neurological complication. Hemophilus was the commonest bacterial agent in endocochlear cases overall, with Pneumococcus underlying 50% of cophosis cases. The study shows BAEP recording in association with a clinical ear examination is useful following childhood bacterial meningitis, screening for definitive endocochlear and deafness, distinguishing total from partial hearing-loss and indicating suitable treatment.

Tianeptine is a new antidepressant drug reported to enhance serotonin (5-hydroxytryptamine [5-HT]) uptake in rat brain. The effect of tianeptine on 5-HT platelet uptake was studied in 10 depressed patients treated for 28 days. Tianeptine increases Vmax of 5-HT platelet uptake during treatment without inducing any change in Km. As early as 2 hr after the first administration, Vmax increased significantly (+23%, alpha = 0.01). Although of a lesser magnitude, 5-HT platelet uptake remains increased after chronic administration (+14% on day 10 and +13% on day 28). This suggests that tianeptine affects 5-HT platelet uptake sites, either directly or via an action on modulators of 5-HT uptake. These results, in contrast with the action of other tricyclic antidepressants, confirm the original action of tianeptine on 5-HT platelet metabolism.

Transcutaneous carbon dioxide and oxygen tensions (PtcCO2 and PtcO2) were monitored in seven critically ill patients under mechanical ventilation during fiberoptic bronchoscopy. In these conditions, both PtcO2 and PaO2 and PtcCO2 and PaCO2 correlated, with correlation coefficients of 0.964 and 0.793 respectively. Fiberoptic bronchoscopy induced an average fall in PtcO2 of 42 +/- 2.57 mmHg and an average increase in PtcCO2 of 12.1 +/- 1.89 mmHg; these two parameters returned quickly to their initial values after the procedure. Holter monitoring showed an arrhythmia in five of the seven patients. Continuous measurement of PtcO2 and PtcCO2 was a safe and reliable method for monitoring mechanically ventilated patients undergoing fiberoptic bronchoscopy.

An alimentary/thermic conflict of motivation was used to explore the effects of very low doses of dexfenfluramine (dFF), an anorectic serotoninergic agonist, on the parameters of food motivation, drive and incentive (or palatability). Six rats trained to feed 2 hr/day, were given the possibility to feed on chow in a shelter (25 degrees C), and to get a snack of shortcake, a highly palatable bait, from a feeder placed 16 m away in a very cold environment (-15 degrees C). dFF at 0.6 or 1.25 mg/kg decreased neither the chow intake in the shelter, nor the mean duration of the snacks in the cold, which is the parameter believed to be the best indicator of incentive. In contrast, dFF reduced the number of trips to the bait in the cold as well as the total mass of palatable bait ingested and the mean amount ingested by snack. Such an effect was no longer observed after a food restriction had reduced the body weight of the rats to 90% of its initial value. It is concluded that, even at doses too small to reduce the consumption of basic food, dFF decreases the drive to get palatable food.