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International audience; Cannabis is the most widely used drug in the world with a prevalence of 2.5%. France and Belgium are no exception. Moreover, pediatric cannabis intoxications are increasing due to the growing use of cannabis in the adult population. In this study, we seek to investigate whether there is a correlation between symptoms and biological data in order to facilitate the diagnosis of pediatric cannabis intoxication. Data were retrospectively collected from 11 French laboratories and 2 Belgian laboratories over 3-year period (2019–2021). This study involved 123 children aged 2 months to 4 years. There was a geographical gradient with an increase in intoxication cases from northern to southern regions. THC, 11-OH-THC and THC-COOH levels were respectively 24.4 ng/mL (range = 0.4–109 ng/mL; median = 17.3 ng/mL), 26.3 ng/mL (range = 0.6–263 ng/mL; median = 18 ng/mL) and 217 ng/mL (range = 0.6–921 ng/mL; median = 163 ng/mL). The most frequently observed symptom was drowsiness in 60.2% of cases. Coma (13.8%, n = 17), convulsions (4.1%, n = 5) and bradypnea (8.1%, n = 10) were the most severe symptoms. The increase of THC content in cannabis products could explain the increase in poisoning severity. However, according to the data collected, it does not seem that the clinical symptoms observed are correlated with plasma or blood THC concentrations. Indeed, cases of coma with Glasgow Coma Scale at 3 have been observed with plasma THC concentrations between 7 and 29 ng/mL.

National audience; The history of ketamine begins in 1962, when Calvin Stevens of the pharmaceutical laboratory Parke-Davis synthesizes it from phencyclidine, a molecule with psychodysleptic, hallucinogenic and dissociative properties. Following the first administration of ketamine to humans in 1964 in Jackson prison (Michigan, USA), its dissociative effects associated with short anaesthesia were reported, and a patent for its human use was filed in 1966. In the 1990s, the discovery of opioid-induced hyperalgesia sparked interest in ketamine as an analgesic. In recent years, the human use of ketamine, and in particular its esketamine enantiomer, has shifted towards the treatment of depression. The first cases of ketamine abuse were reported in 1992 in France, leading to special surveillance by the health authorities, and its inclusion in the list of narcotic drugs in 1997. Today, ketamine has become an attractive substance for recreational use, gradually emerging from alternative techno circles to spread to more commercial party scenes. These elements represent a public health concern, associated with the risk of developing new chemically synthesized analogues, the harmful effects of which are still little known.

National audience; L'α- et la β-amanitine sont de puissantes toxines de champignons supérieurs responsables de cytolyses hépatiques graves pouvant menacer le pronostic vital. En France, les données des centres antipoison rapportent un nombre croissant d'intoxications aux champignons depuis 2016, justifiant le besoin de méthodes de diagnostic biologique robustes. En laboratoire de toxicologie hospitalière, l'objectivation d'une intoxication par les amanitines à partir de prélèvements sanguins ou urinaires constitue ainsi un élément important dans la prise en charge du patient intoxiqué. L'objectif de ce travail consiste à réaliser une mini-revue de la littérature sur le dosage des amanitines dans les fluides biologiques pour le diagnostic des intoxications aux amanitines. Les caractéristiques des amanitines, les méthodes analytiques, les données d'interprétation, les applications pratiques ainsi que les perspectives d'utilisation des techniques de dosage y sont présentées. À travers une comparaison de deux techniques analytiques de chromatographie liquide couplée à de la spectrométrie de masse en tandem utilisées au Centre hospitalier universitaire de Rennes (Waters Xevo TQ XSTM et Thermo Scientific Q ExactiveTM), cet article présente également le retour d'expérience de biologistes médicaux dans l'amélioration continue des méthodes de dosages des amanitines.

National audience; Introduction - Myositis are systemic diseases, in which heart damage is possible. Cardiac troponin T is often found to be defective to detect cardiac involvement. Observation - We report cases of two patients with a myositis. Diagnosis was retained based on muscle pain, increase in serum creatinine kinase, and inflammatory muscle damage on MRI. Histology confirmed the diagnosis for one of the two patients. Cardiac troponin T was measured in both patients, to detect myocardial involvement. Despite a serum elevation of this marker, cardiological assessment remained negative (electrocardiogram, cardiac ultrasound, cardiac MRI). Cardiac troponin I was normal in serum because of the absence of correlation with peripheral muscle involvement. Conclusion - Cardiac troponin T is correlated with muscle involvement in patients with myositis. Cardiac troponin I should be preferred because of a better specificity.

International audience; Introduction: During the last few years, detection of epidermal growth-factor-receptor (EGFR)-activating mutations has become a routine part of clinical practice because of their importance in choosing the optimal treatment strategy for non-small-cell lung cancers (NSCLCs). The emergence of third-generation EGFR-tyrosine-kinase inhibitors required the implementation of sensitive methods to detect the subclonal EGFRT790M mutation. Clinical implications make it essential to rapidly search for the T790M mutation, which is a real challenge for laboratories. The aim of this study was to compare performances of next-generation sequencing (NGS), one of the most frequently used molecular biology methods, and Idylla EGFR-Mutation Assay (henceforth Idylla), a fully automated real-time polymerase chain reaction (PCR) that is increasingly used in pathology laboratories, to detect the EGFRT790M mutation using DNA.Methods: This retrospective study used 47 DNA samples extracted from NSCLC biopsies that previous NGS identified as: 29 harboring EGFR and T790M resistance mutations, 11 EGFR-activating mutation without T790 M and 7 wild-type EGFR. EGFRT790M limit-of-detection (LOD) experiments used a commercial DNA known to harbor that mutation.Results: Idylla detected primary EGFR-activating mutations and the T790 M mutation in 97.5 % and 65.5 % of the cases, respectively. The results of this retrospective analysis and LOD experiments showed that the Idylla should only be used to detect EGFR mutations in samples with > 25 ng of DNA and > 10 % tumor cells.Conclusions: Idylla was able to rapidly detect EGFR-activating mutations but detecting subclone mutations, like T790M, with < 25 ng of good-quality DNA or < 10 % tumor cells (variant allele frequency below the assay's validated LOD) was not always reliable.