154 resultados para 158-957


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Malignant gliomas, including the most common and fatal form glioblastoma (GBM, WHO grade IV astrocytoma), remain a challenge to treat. In the United States and Europe, more than 30,000 patients per year are newly diagnosed with GBM. Despite ongoing trials, the best currently available multimodal treatment approaches include surgical resection followed by concomitant and adjuvant radiation (RT) and temozolomide (TMZ) therapy, resulting in a low median overall survival (OS) rate ranging from 12.2 - 15.9 months. The important role of genetic and epigenetic changes in DNA, RNA, and protein alteration as well as epigenetic changes secondary to the tumor microenvironment and outside selection pressure (therapeutic interventions), are increasingly being recognized. In GBM treatment, the focus is shifting toward a more patient-centered (personalized) therapy. In this regard, in particular, microRNAs are being increasingly studied. MicroRNAs are non¬protein coding small RNAs that serve as negative gene regulators by binding to a specific sequence in the promoter region of a target gene, thus regulating gene expression. A single microRNA potentially targets hundreds of genes; thus, microRNAs and their cognate target genes have important roles as tumor suppressors and oncogenes as well as regulators of various cancer- specific cellular features, such as proliferation, apoptosis, invasion, and metastasis. The identification of distinct microRNA-gene regulatory networks in GBM patients can be expected to provide novel therapeutic insights by identifying candidate patients for targeted therapies. To this end, in this work we identified and validated clinically relevant and meaningful novel gene- microRNA regulatory networks that correlated with MR tumor phenotypes, histopathology, and patient survival and response rates to therapy. - Le traitement des gliomes malins, y compris sous leur forme la plus commune et meurtrière, le glioblastome (GBM, ou astrocytome de grade IV selon l'OMS), demeure à ce jour un défi. Aux États-Unis et en Europe, un nouveau diagnostic de GBM est prononcé dans plus de 30Ό00 cas par an. En dépit de tests en cours, les meilleures approches thérapeutiques combinées actuellement disponibles comprennent la résection chirurgicale de la tumeur, suivie d'une radiothérapie adjuvante ainsi que d'un traitement au temozolomide (RT/TMZ), thérapies dont résulte une médiane de survie globale basse (overall survival, OS), comprise entre 12.2 et 15.9 mois. On reconnaît de plus en plus le rôle majeur de l'ADN, de l'ARN et de l'altération des protéines ainsi que des modifications épigénétiques, secondaires par rapport au microenvironnement de la tumeur et à la pression de sélection extérieure (les interventions thérapeutiques). Dans le traitement du GBM, le centre d'intérêt se déplace vers une thérapie centrée sur le cas individuel du patient. Dans ce but, en particulier les microARN sont de plus en plus analysés. Les microARN sont de petits ARN non-codants (les protéines) qui servent de régulateurs négatifs de gènes en s'attachant à une séquence spécifique dans la région promotrice d'un gène-cible, régulant ainsi l'expression du gène. Un seul microARN cible potentiellement des centaines de gènes; on a ainsi découvert que les microARN et leurs gènes-cibles apparentés ont une fonction importante en tant que suppresseurs de tumeurs et d'oncogènes, ainsi que comme régulateurs de diverses caractéristiques cellulaires spécifiques du cancer, comme la prolifération, l'apoptose, l'invasion et la métastase. On peut s'attendre à ce que l'identification de réseaux microARN régulateurs de gènes, distincts selon les patients de GBM, fournisse une approche thérapeutique inédite par la détermination des patients susceptibles de réagir favorablement à des thérapies ciblées.

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In this study, we enlarged our previous investigation focusing on the biodiversity of chlamydiae and amoebae in a drinking water treatment plant, by the inclusion of two additional plants and by searching also for the presence of legionellae and mycobacteria. Autochthonous amoebae were recovered onto non-nutritive agar, identified by 18S rRNA gene sequencing, and screened for the presence of bacterial endosymbionts. Bacteria were also searched for by Acanthamoeba co-culture. From a total of 125 samples, we recovered 38 amoebae, among which six harboured endosymbionts (three chlamydiae and three legionellae). In addition, we recovered by amoebal co-culture 11 chlamydiae, 36 legionellae (no L. pneumophila), and 24 mycobacteria (all rapid-growers). Two plants presented a similar percentage of samples positive for chlamydiae (11%), mycobacteria (20%) and amoebae (27%), whereas in the third plant the number of recovered bacteria was almost twice higher. Each plant exhibited a relatively high specific microbiota. Amoebae were mainly represented by various Naegleria species, Acanthamoeba species and Hartmannella vermiformis. Parachlamydiaceae were the most abundant chlamydiae (8 strains in total), and in this study we recovered a new genus-level strain, along with new chlamydiae previously reported. Similarly, about 66% of the recovered legionellae and 47% of the isolated mycobacteria could represent new species. Our work highlighted a high species diversity among legionellae and mycobacteria, dominated by putative new species, and it confirmed the presence of chlamydiae in these artificial water systems.

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In 2006, a medico-legal consultation service devoted to adult victims of interpersonal violence was set up at the Lausanne University Hospital Centre, Switzerland: the Violence Medical Unit. Patients are received by forensic nurses for support, forensic examination (in order to establish medical report) and community orientation. In 2008, a telephone survey was conducted on patients. The objectives of the survey were to estimate the degree of patients' satisfaction and to document the use of the medical report by six questions. Among the 476 patients admitted to the VMU in 2007, 132 were interviewed. Their overall satisfaction was high with an average mark of 8.7/10. The medical report was used extensively by the interviewed victims (81%) for its primary function - to be produced as evidence. As the consultations are financed by public funds, these results were of interest for advocacy of long-lasting financial support.

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In mammals, transcriptional autorepression by Period (PER) and Cryptochrome (CRY) protein complexes is essential for the generation of circadian rhythms. We have identified CAVIN-3 as a new, cytoplasmic PER2-interacting protein influencing circadian clock properties. Thus, CAVIN-3 loss- and gain-of-function shortened and lengthened, respectively, the circadian period in fibroblasts and affected PER:CRY protein abundance and interaction. While depletion of protein kinase Cδ (PKCδ), a known partner of CAVIN-3, had little effect on circadian gene expression, CAVIN-3 required the PKCδ-binding site to exert its effect on period length. This suggests the involvement of yet uncharacterized protein kinases. Finally, CAVIN-3 activity in circadian gene expression was independent of caveolae.

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Hybrid zones between genetically differentiated populations provide material to study evolutionary processes. Since the discovery of chromosomal races in Sorex araneus, contact zones have attracted attention of scientists. So far, studies on genetic markers in Sorex hybrid zones are missing. The acrocentric chromosomal race Cordon and the highly metacentric race Valais meet and hybridize at Les Houches in the Western Alps. On a transect through the hybrid zone, 273 shrews were caught at 15 localities over 4 years. Karyotype as well as the nuclear protein loci Alb and Pg were analyzed. F-st and F-is values were calculated by F-statistics. An analysis on pooled samples revealed the genetical differences between the hybridizing races as the only cause of population structuring. Genetical markers show dines with very strong frequency shifts at a mountain torrent, but behave differently through the zone. The performance of the torrent in maintaining the hybrid zone, selection against hybrids, possible assortative mating and linkage of the Valais Pg allele to a diagnostic chromosome arm, are discussed.

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Inherited metabolic disorders are the cause of a small but significant number of sudden unexpected deaths in infancy. We report a girl who suddenly died at 11 months of age, during an intercurrent illness. Autopsy showed spongiform lesions in the subcortical white matter, in the basal ganglia, and in the dentate nuclei. Investigations in an older sister with developmental delay, ataxia, and tremor revealed L-2-hydroxyglutaric aciduria and subcortical white matter changes with hyperintensity of the basal ganglia and dentate nuclei at brain magnetic resonance imaging. Both children were homozygous for a splice site mutation in the L2HGDH gene. Sudden death has not been reported in association with L-2-hydroxyglutaric aciduria so far, but since this inborn error of metabolism is potentially treatable, early diagnosis may be important.

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Abstract¦This thesis examines through three essays the role of the social context and of people concern for justice in explaining workplace aggressive behaviors.¦In the first essay, I argue that a work group instrumental climate - a climate emphasizing respect of organizational procedures -deters employees to manifest counterproductive work behaviors through informal sanctions (i.e., socio-emotional disapproval) they anticipate from it for misbehaving. A contrario, a work group affective climate - a climate concerned about others' well-being - leads employees to infer less informal sanctions and thus indirectly facilitates counterproductive work behaviors. I additionally expect these indirect effects to be conditional on employees' level of conscientiousness and agreeableness. Cross-level structural equations on cross-sectional data obtained from 158 employees in 26 work groups supported my expectations. By promoting collective responsibility for the respect of organizational rules and by knowing what their work group considers threatening their well-being, leaders may be able to prevent counterproductive work behaviors.¦Adopting an organizational justice perspective, the second essay provides a theoretical explanation of why and how collective deviance can emerge in a collective. In interdependent situations, employees use justice perceptions to infer others' cooperative intent. Even if moral transgressions (e.g., injustice) are ambiguous, their repetition and configuration within a team can lead employees to assign blame and develop collective cynicism toward the transgressor. Over time, collective cynicism - a shared belief about the transgressor's intentional lack of integrity - progressively constrains the diversity of employees' response to blame and leads collective deviance to emerge. This essay contributes to workplace deviance research by offering a theoretical framework for investigations of the phenomenon at the collective level. It organizations effort to manage and prevent deviance should consider.¦In the third essay, I solve an apparent contradiction in the literature showing that justice concerns sometimes lead employees to react aggressively to injustice and sometimes to refrain from it. Drawing from just-world theory, a cross-sectional field study and an experiment provide evidence that retaliatory tendencies following injustice are moderated by personal and general just-world beliefs. Whereas a high personal just-world belief facilitates retaliatory reactions to injustice, a high general just-world belief attenuates such reactions. This essay uncovers a dark side of personal just-world belief and a bright one of general just-world belief, and participates to extend just-world theory to the working context.

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BACKGROUND: Lower ambulatory performance with aging may be related to a reduced oxidative capacity within skeletal muscle. This study examined the associations between skeletal muscle mitochondrial capacity and efficiency with walking performance in a group of older adults. METHODS: Thirty-seven older adults (mean age 78 years; 21 men and 16 women) completed an aerobic capacity (VO peak) test and measurement of preferred walking speed over 400 m. Maximal coupled (State 3; St3) mitochondrial respiration was determined by high-resolution respirometry in saponin-permeabilized myofibers obtained from percutanous biopsies of vastus lateralis (n = 22). Maximal phosphorylation capacity (ATP) of vastus lateralis was determined in vivo by P magnetic resonance spectroscopy (n = 30). Quadriceps contractile volume was determined by magnetic resonance imaging. Mitochondrial efficiency (max ATP production/max O consumption) was characterized using ATP per St3 respiration (ATP/St3). RESULTS: In vitro St3 respiration was significantly correlated with in vivo ATP (r = .47, p = .004). Total oxidative capacity of the quadriceps (St3*quadriceps contractile volume) was a determinant of VO peak (r = .33, p = .006). ATP (r = .158, p = .03) and VO peak (r = .475, p < .0001) were correlated with preferred walking speed. Inclusion of both ATP/St3 and VO peak in a multiple linear regression model improved the prediction of preferred walking speed (r = .647, p < .0001), suggesting that mitochondrial efficiency is an important determinant for preferred walking speed. CONCLUSIONS: Lower mitochondrial capacity and efficiency were both associated with slower walking speed within a group of older participants with a wide range of function. In addition to aerobic capacity, lower mitochondrial capacity and efficiency likely play roles in slowing gait speed with age.

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Bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) is used to diagnose osteoporosis and assess fracture risk. However, DXA cannot evaluate trabecular microarchitecture. This study used a novel software program (TBS iNsight; Med-Imaps, Geneva, Switzerland) to estimate bone texture (trabecular bone score [TBS]) from standard spine DXA images. We hypothesized that TBS assessment would differentiate women with low trauma fracture from those without. In this study, TBS was performed blinded to fracture status on existing research DXA lumbar spine (LS) images from 429 women. Mean participant age was 71.3 yr, and 158 had prior fractures. The correlation between LS BMD and TBS was low (r = 0.28), suggesting these parameters reflect different bone properties. Age- and body mass index-adjusted odds ratios (ORs) ranged from 1.36 to 1.63 for LS or hip BMD in discriminating women with low trauma nonvertebral and vertebral fractures. TBS demonstrated ORs from 2.46 to 2.49 for these respective fractures; these remained significant after lowest BMD T-score adjustment (OR = 2.38 and 2.44). Seventy-three percent of all fractures occurred in women without osteoporosis (BMD T-score > -2.5); 72% of these women had a TBS score below the median, thereby appropriately classified them as being at increased risk. In conclusion, TBS assessment enhances DXA by evaluating trabecular pattern and identifying individuals with vertebral or low trauma fracture. TBS identifies 66-70% of women with fracture who were not classified with osteoporosis by BMD alone.

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Introduction et But de l'étude. - La plupart des études d'évaluation de la nutrition en réanimation concernent les patients ventilés bénéficiant d'un support nutritionnel artificiel. La nutrition per os qui concerne les patients les moins graves ou sortis de la phase critique est peu étudiée. Cette étude observationnelle, menée dans le cadre d'un travail de Bachelor en collaboration avec les Hôpitaux Universitaires de Genève, a pour objectif de réaliser un état des lieux des pratiques nutritionnelles actuelles, tous patients confondus, dans un service de réanimation médico-chirurgicale, et de mesurer la couverture des besoins énergétiques en fonction du type de nutrition administré ou consommé. Matériel et Méthodes. - Inclusion de tous les patients adultes hospitalisés pour plus de 24 h en réanimation durant 6 semaines consécutives, suivis jusqu'à la sortie du service mais pendant 14 jours au maximum. Les apports caloriques entéraux et parentéraux ont été récoltés dans le dossier patient informatisé. Les apports per os ont été estimés sur la base de la composition nutritionnelle standard des repas servis et le report infirmier des quantités consommées. Les suppléments nutritifs oraux ont été inclus dans les apports per os. Les solutés glucosés et les dilutions de médicaments n'ont pas été comptabilisés. La cible calorique a été fixée à 30 kcal/kg pour les hommes et 25 kcal/kg pour les femmes, sur la base du poids mesuré ou anamnestique ou sur le poids correspondant à un BMI de 22,5 en cas d'obésité. Résultats. - Six cent quatre-vingt douze journées-patients ont été analysées, issues de 114 patients dont le score SAPS II moyen est de 43. Toutes journées confondues (sans tenir compte du début ou fin de séjour) : 44 % (n = 307) des journées sont sous NE exclusive, 9 % (n = 64) sous NP exclusive et 7 % (n = 47) combinent ces deux types d'apports. La nutrition per os exclusive représente 17 % (n = 116) des journées et 23 % (n = 158) ne comportent aucun apport nutritionnel. Lorsque l'on s'intéresse au pour centage d'atteinte de la cible calorique selon le type de nutrition, il se répartit comme tel (médiane ± espace interquartile) : NE : 83 ± 44 % ; NP : 84 ± 75 % ; combiné : 95 ± 39 % ; per os : 28 ± 33 %. La nutrition per os se retrouve en fin de séjour mais pas uniquement puisque seules un peu plus de la moitié des journées de nutrition per os ont lieu lors du dernier (35 %) ou de l'avant dernier (28 %) jour du séjour. L'atteinte de la cible calorique par la nutrition per os exclusive évolue peu au long du séjour. Conclusion. - La nutrition per os représente le mode d'alimentation d'un nombre important de journées dans cette observation. La très faible couverture des besoins caloriques lors de ces journées, tout au long du séjour, classe ces patients dans une catégorie à risque nutritionnel important. Une évaluation plus précise des apports protéino-énergétique devrait être réalisée afin de quantifier plus exactement les déficits et un suivi de l'évolution de ces patients apporterait un éclairage important.

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The semi-structured diagnostic interview for genetic studies (DIGS) was developed to assess major mood and psychotic disorders and their spectrum manifestations in genetic studies. Our research group developed a French version of the DIGS and tested its inter-rater and test-retest reliability in psychiatric patients. In this article, we present estimates of the reliability of substance use and antisocial personality disorders. High kappa coefficients for inter-rater reliability were found for drug and alcohol as well as antisocial personality diagnoses and slightly lower kappas for test-retest reliability. Combined with evidence of the reliability of major mood and psychotic disorders, these findings support the suitability of the DIGS for studies of familial aggregation and comorbidity of psychiatric disorders including substance use and antisocial personality disorders.

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OBJECTIVE: Previous studies have shown that premature birth and the immaturity of the child can affect the quality of the parent-child relationship. The present study examines the relationship between maternal and infant interactional behavior over time and infant perinatal risk factors as well as maternal perinatal recollected traumatic experience. Few studies have explored the relationship between maternal stress and the quality of parent-infant interaction. DESIGN: Mother-child interaction was recorded at 6 and 18 months of infant's age, in a population of 47 preterm infants (GA<34 weeks) and 25 full-term infants, born in 1998, during a play interaction. According to the Care Index, sensitivity, control and unresponsiveness have been used to code maternal interactional characteristics, and cooperation, compliance-compulsiveness, difficulty and passivity have been used to code the infant's interactional characteristics. The level of maternal stress was evaluated with the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ), and the infant's perinatal risk factors were assessed with the Perinatal Risk Inventory (PERI). RESULTS: Mothers of high-risk infants, as well as mothers that had experienced traumatic stress in the perinatal period, were less sensitive and more controlling at 6 months. The interactional behavior of the preterm infant was different from that of the full-term infant at 18 months of age, and was correlated with maternal traumatic stress but not with perinatal risk factors. CONCLUSION: These results underline the importance of maternal traumatic experience related to premature birth and its potential long lasting influence on mother-child interactional behavior.

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A painful worsening of known difficulties in walking led us to investigate a man who presented a spastic paraparesis. Radiological investigations had to be repeated three times before making a diagnosis of a right C6 spinal dural arteriovenous fistula after a 22-month follow-up. Knowing the mechanisms leading to spinal venous hypertension may explain the low yield of the early radiological investigations that should be repeated. The efficiency of the treatment depends on the severity of the presurgical neurologic manifestations.