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IntroductionAlthough aircraft noise is known to impact human health, the biological pathway is still unclear. One of the possible pathway is that aircraft noise exposure may induce a modification o...

Resume Introduction Les recommandations internationales pour l’administration de la vitamine D (25-OH) chez les prematures sont divergentes (800–1000 UI/jour en Europe, 200 UI/kg sans depasser 400 UI/j aux Etats-Unis). Les nouveau-nes prematures de faible poids de naissance sont a risque de carence, mais egalement de surdosage en 25-OH. Methode Entre 2013 et 2015, 16 anciens prematures ( Resultats L’âge gestationnel etait de 27 (24–35) SA pour un poids de 810 (560–2120) grammes. Le signe d’appel du surdosage en 25-OH avait ete une nephrocalcinose (37 %), une hypercalcemie (44 %) ou une hypercalciurie (19 %). L’âge le jour du signe d’appel etait de 36,6 (27,6–47,6) SA. Un dosage de 25-OH avait ete realise 13 (0–281) jours apres le signe d’appel ; la concentration en 25-OH etait alors de 210 (119–350) nmol/L et celle en 1-25(OH), lorsqu’elle avait ete mesuree (n = 10), de 370 (245–718) pmol/L. Apres arret de la supplementation, la 25-OH s’etait normalisee chez 10 patients dans un delai de 10 (3–32) mois. Conclusion Le diagnostic de surdosage en 25-OH chez les anciens prematures doit etre envisage devant l’existence d’une nephrocalcinose, d’une hypercalcemie ou d’une hypercalciurie. Il justifie la realisation d’un dosage de la 25-OH. La supplementation en vitamine D est essentielle pour une formation osseuse optimale mais les objectifs cibles superieurs ne devraient probablement pas exceder 120 nmol/L.

Osteocalcin is a hormone secreted by osteoblasts, which regulates energy metabolism by increasing β-cell proliferation, insulin secretion, insulin sensitivity, and energy expenditure. This has been demonstrated in mice, but to date, the evidence implicating osteocalcin in the regulation of energy metabolism in humans are indirect. To address this question more directly, we asked whether a benign osteoblastic tumor, such as osteoma osteoid in young adults, may secrete osteocalcin. The study was designed to assess the effect of surgical resection of osteoid osteoma on osteocalcin and blood glucose levels in comparison with patients undergoing knee surgery and healthy volunteers. Blood collections were performed the day of surgery and the following morning after overnight fasting. Patients and controls were recruited in the orthopedic surgery department of New York Presbiterian Hospital, NY-USA and Hospices Civils de Lyon, France. Seven young males were included in the study: two had osteoid osteoma, two underwent knee surgery, and three were healthy volunteers. After resection of the osteoid osteomas, we observed a decrease of osteocalcin by 62% and 30% from the initial levels. Simultaneously, blood glucose increased respectively by 32% and 15%. Bone turnover markers were not affected. This case study shows for the first time that osteocalcin in humans affects blood glucose level. This study also suggests that ostoid osteoma may be considered, at least in part, as an osteocalcinoma.

Resume Les tests ELISA et d'inhibition de l'hemagglutination ont ete compares pour la recherche des anticorps Newcastle lors de vaccination par goutte oculaire au moyen de virus type La Sota. Les deux tests sont positifs des le 6eme jour, moment ou seules des IgM specifiques sont observees. Les IgG specifiques apparaissent entre le 7eme et le 8eme jour. On ne trouve pas d'IgA specifiques dans le serum des volailles vaccinees. Une fixation non specifique des IgM sur l'antigene s'observe en methode ELISA. Le test d'inhibition de l'hemagglutination est aussi sensible et plus specifique que le test ELISA pour la recherche des anticorps Newcastle. Zusammenfassung Serologische Diagnostik der Newcastle Disease durch Hamagglutinationshemmungstests und ELISA Kinetik der verschiedenen vakzinalen Antikorperklassen Die ELISA- und Hamagglutinationshemmungstests wurden, um die Newcastle-Antikorper bei der Vakzinierung durch Augentropfen mittels Virus des Types La Sota zu untersuchen, verglichen. Die beiden Tests sind ab dem 6. Tag, wenn nur die spezifischen IgM beobachtet werden, positiv. Die spezifischen IgG erscheinen zwischen dem 7. und 8. Tag. Es gibt keine spezifischen IgA im Serum des vakzinierten Geflugels. Eine unspezifische Verbindung der IgM am Antigen wird mit dem ELISA beobachtet. Um die Newcastle-Antikorper zu untersuchen, ist der Hamagglutinationshemmungstest gleich sensible und spezifischer als der ELISA-Test. Summary Serological diagnosis of Newcastle Disease by haemagglutination inhibition and ELISA tests Kinetics of different classes of vaccinal antibodies The ELISA and HI tests were compared in investigating the antibody response following eyedrop vaccination with La Sota types of Newcastle Disease virus. Both were positive from day 6, when only specific IgM was detected. Specific IgG in the serum of vaccinated fowls appeared between days 7 and 8. No specific IgA was detected in the serum of vaccinated birds. A non-specific binding of IgM to the antigen was revealed by the ELISA test. For the study of ND antibodies the HI test is just as sensitive and more specific than the ELISA test. Resumen El diagnostico de la enfermedad de Newcastle por las pruebas de inhibicion de la hemaglutinacion y ELISA Se compararon las pruebas ELISA y de inhibicion de la hemaglutinacion para examinar los anticuerpos Newcastle en la vacunacion por gota ocular mediante virus tipo La Sota. Ambas pruebas son positivas a partir del dia 6°, si solo se tienen en cuenta las IgM especificas. Las IgG especificas aparecen entre el dia 7° y 8°. No hay ninguna IgA especifica en el suero sanguineo de las aves vacunadas. Se observa con la ELISA una fijacion inespecifica de las IgM als antigeno. Para estudiar los anticuerpos Newcastle, la prueba de inhibicion de la hemaglutinacion es mas sensible y especifica que la prueba ELISA.

International audience; We found for the first time that in maintenance hemodialysis patients, higher sclerostin serum level was associated with severe abdominal aortic calcification (AAC). In addition, cortical bone microarchitecture (density and thickness) assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) at tibia was also independently associated with severe AAC. These results suggest that sclerostin may be involved in the association of mineral and bone disorder with vascular calcification in hemodialysis patients. INTRODUCTION: Severe abdominal aortic calcifications are predictive of high cardiovascular mortality in maintenance hemodialysis (MHD) patients. In patients with end-stage renal disease, a high aortic calcification score was associated with lower bone turnover on bone biopsies. Thus, we hypothesized that sclerostin, a Wnt pathway inhibitor mainly secreted by osteocytes and acting on osteoblasts to reduce bone formation, may be associated with vascular calcifications in MHD patients. METHODS: Fifty-three MHD patients, aged 53 years [35-63] (median [Q1-Q3]) were included. Serum was sampled before the MHD session to assay sclerostin. Framingham score was computed and the abdominal aortic calcification (AAC) score was assessed according to Kauppila method on lateral spine imaging using DEXA. Tibia bone status was evaluated by high-resolution peripheral quantitative computed tomography (HR-pQCT). Patients were distributed into two groups according to their AAC score: patients with mild or without AAC (score below 6) versus patients with severe AAC (score of 6 and above). RESULTS: In multivariate analysis, after adjustment on age, dialysis duration and diabetes, serum sclerostin and cortical thickness were independently associated with severe AAC (odds ratio (OR) = 1.43 for each 0.1 ng/mL increase [95 % confidence interval (CI) 1.10-1.83]; p = 0.006 and 0.16 for 1 SD increase [0.03-0.73]; p = 0.018, respectively). A second cardiovascular model adjusted on Framingham score and the above mentioned confounders showed similar results. CONCLUSIONS: Elevated sclerostin serum level and poorer tibia cortical bone structure by HR-pQCT were positively and independently associated with higher odds of severe AAC in MHD patients. Serum sclerostin may become a biomarker of mineral and bone disorder and vascular risk in MHD patients.

Adrenal insufficiency is a rare but life-threatening disease. Replacement therapy sometimes fails to prevent an acute adrenal crisis and most often does not lead to restoration of well-being. We report here the 1-year outcome of the first simultaneous kidney-adrenal gland-pancreas transplantation in a 33-year-old patient with type 1 diabetes and concomitant autoimmune adrenal insufficiency. En bloc left adrenal gland and kidney grafts were anastomosed on the left iliac vessels in normal vascular conditions and the pancreas graft was anastomosed on the right iliac vessels. The immunosuppressive regimen was not modified by the addition of the adrenal gland. We observed no additional morbidity due to the adrenal gland transplantation, as there were no surgical complications. One-year kidney and pancreas graft functions were satisfactory (estimated glomerular filtration rate: 55 mL/min/1.73 m(2) and HbA1c: 4.8%). The adrenal graft functioned well at 12 months with a normalization of cortisol and aldosterone baseline levels. Functional imaging at 3 months showed good uptake of [(123) I]-metaiodobenzylguanidine by the adrenal graft. Transplantation of the adrenal gland en bloc with the left kidney appears to be a good therapeutic option in patients with adrenal insufficiency awaiting kidney or kidney-pancreas transplantation.

The National Kidney Foundation/Kidney-Dialysis Outcome Quality Initiative guidelines recommend to maintain the serum intact parathyroid hormone (PTH) concentration between 150 and 300 ng/l in chronic kidney disease (CKD) stage 5 patients. As these limits were derived from studies that used the Allegro intact PTH assay, we aimed to evaluate whether they were applicable to other PTH assays. We compared the PTH concentrations measured with 15 commercial immunoassays in 47 serum pools from dialysis patients, using the Allegro intact PTH assay as the reference. We also evaluated the recovery of graded amounts of synthetic 1–84 and 7–84 PTH added separately to a serum pool. Although the assays were highly correlated, the concentrations differed from one assay to another. The median bias between the tested assays and the Allegro intact PTH assay ranged from -44.9 to 123.0%. When the PTH concentrations were 150 or 300 ng/l with the Allegro intact PTH assay, they ranged with other assays from 83 to 323 ng/l and from 160 to 638 ng/l, respectively. The tested assays recognized 7–84 PTH with various cross-reactivities, whereas a given amount of 1–84 PTH was recovered differently by these assays. We found important inter-method variability in PTH results owing to both antibody specificity and standardization reasons. The unacceptable consequence is that opposite therapeutic attitudes may be reached in a single patient depending on the PTH assay used. We propose to use assay-specific decision limits for CKD patients, or to apply a correcting factor to the PTH results obtained with a given assay.

BACKGROUND YKL-40 is a 40 kDa glycoprotein secreted by chondrocytes and synoviocytes. It has been suggested that it is a surrogate marker of synovial inflammation and joint destruction in rheumatoid arthritis (RA) and osteoarthritis (OA) and related to C reactive protein (CRP) serum levels in RA. OBJECTIVE To study serum levels of YKL-40 in patients with hip OA and its relation with CRP. METHODS YKL-40 and CRP were assayed in serum samples from 45 patients (24 women, 21 men, mean age 65) with symptomatic OA of the hip and 33 healthy controls. YKL-40 was assayed by immunoassay and CRP by ultrasensitive immunonephelometry. OA severity was assessed by the measurement of joint space width with a computer analysis system of digitised hip radiographs. Statistical analysis was performed to determine correlations between serum markers and radiological joint space width. RESULTS The mean (standard error) YKL-40 level was 90.3 (8.2) ng/ml in patients with hip OA and 66.9 (8.2) ng/ml in controls (p=0.03). The mean CRP level was 2.93 (3.03) mg/l in OA and 1.40 (1.61) mg/l in controls (p=0.006). The serum levels of YKL-40 and CRP increased with age and were significantly correlated (Spearman test: r s =0.42, p=0.005) in patients but not in controls. Neither YKL-40 nor CRP correlated with radiographic joint space width. CONCLUSIONS Serum YKL-40 was significantly increased in patients with hip OA. The correlation between YKL-40 and CRP suggests that YKL-40 may be a marker of joint inflammation in OA. Longitudinal studies are required to assess the usefulness of YKL-40 in the monitoring of patients with hip OA.

To cover the need in paediatric organ transplantation, every potential donor should be considered as a multi-organ donor. Successful transplantation may be performed with kidneys retrieved from very young infants, even anencephalic neonates if the en-bloc technique using both kidneys is used. Regarding the liver, paediatric donors can be accepted from one month of age while livers harvested from older children and even young adults can be transplanted into small children after ex-vivo reduction of the size of the graft. Multi-organ procurement from the same donor provides valuable organs if the anaesthetic management of the donor is appropriate. Active transplant programs needs international cooperation which is made possible by the organ exchange organizations.