Participation of kallikrein-kinin system in different pathologies

The general description of kinins refers to these peptides as molecules involved in vascular tone regulation and inflammation. Nevertheless, in the last years a series of, evidences has shown that local hormonal systems, such as the kallikrein-kinin system, may be differently regulated and are of pivotal importance to pathophysiological control. The combined interpretations of many recent studies allow us to conclude that the kallikrein-kinin system plays broader and richer roles than those classically described until recently. In this review, we report findings concerning the participation of the kallikrein-kinin system in inflammation, cancer, and in pathologies related to cardiovascular, renal and central nervous systems. (c) 2007 Elsevier B.V. All rights reserved.

Hepatic parasympathetic nerve dysfunction involved in the deregulation of postprandial whole-body insulin sensitivity:a road to diabetes and associated pathologies

FCM: UC Fisiologia - Teses de Doutoramento

Oxidative stress in pregnancy and fertility pathologies

Oxidative stress designates the state of imbalance between reactive oxygen species (ROS) production and antioxidant levels. In a healthy placenta, there is an increase in ROS production, due to formation of new tissues and inherent metabolism, but this is balanced by higher levels of antioxidants. However, this balance is lost in some situations, with a consequent increase in oxidative stress levels. Oxidative stress has been implicated in several placental disorders and pregnancy pathologies. The present review intends to summarize what is known about the relationship between oxidative stress and well-known pregnancy disorders.

Molecular characterization of the fibrinogen-erythrocyte interaction and its influence on cardiovascular pathologies by AFM-based force spectroscopy

Dissertação para obtenção do Grau de Mestre em Engenharia Biomédica

Atlas iconographique tomodensitométrique des pathologies bénignes de l'amiante [Computed tomographic atlas of benign asbestos related pathology].

The demonstration by computed tomography of abnormalities related to asbestos is essential for the recognition of industrial disease, the compensation of which has considerable economic consequences. The use of compute tomography, the most reliable technique for the detection of pleuro-parenchymatous abnormalities related to asbestos exposure, has increased considerably in France since the publication of the results of a consensus conference in Paris in 1999. Since that time, developments in technology have noticeably modified the protocols of investigation and increased the sensitivity of the detection of pleural and interstitial parenchymatous abnormalities and of nodules. The technical recommendations and those for the interpretation of pleural and parenchymatous abnormalities need to be well known. They are presented in the form of an atlas that gives detailed criteria for asbestosis, pleural plaques and pleural fibrosis. The diagnosis of pleural plaques depends on the combination of clear limits at the pleural and pulmonary interface, typical topography and multiple, bilateral localization. In the context of asbestos exposure the plaques are characteristic of this exposure, unlike diffuse pleural thickening, crow's feet images, parenchymatous bands and entrapped atalectasis. The writing of the radiological report would be most appropriate on this basis.

Kyste synovial de l'épaule traité par aspiration et infiltration sous échographie : rapport de 3 cas avec pathologies différentes

Introduction: Les kystes synoviaux localisés à l'épaule sont des conditions rares résultant de tendinopathies rompues de la coiffe des rotateurs, d'une omarthrose sévère, d'arthropathies microcristallines de l'articulation acromio-claviculaire ou gléno-humérale, ou d'une atteinte secondaire à un rhumatisme inflammatoire chronique. Ils se présentent cliniquement le plus souvent sous la forme d'une tuméfaction fluctuante indolore en regard du moignon de l'épaule ou de l'articulation acromio-claviculaire. L'imagerie par échographie permet de caractériser aisément la présence de ces kystes. La prise en charge thérapeutique est généralement non invasive par aspiration-infiltration. Les cas réfractaires sont susceptibles de subir une intervention chirurgicale en fonction de l'âge et de l'état général du patient.Patients et Méthodes: Nous rapportons les cas de 3 patients avec imagerie par échographie et IRM ou Scanner. Le premier cas est celui d'un homme de 47 ans, greffé rénal, présentant une arthrite récidivante des épaules sur arthropathie microcristalline mixte. De multiples kystes synoviaux sont mis en évidence dans la musculature du supra-épineux gauche, communiquant avec l'articulation acromio-claviculaire. Le patient a bénéficié à plusieurs ponctions-infiltrations dirigées par ultrasonographie. Le deuxième cas est celui d'un patient de 32 ans connu pour une arthrite psoriasique évoluant depuis 6 ans. Il présente une importante tuméfaction en regard du biceps à gauche sur un kyste synovial provenant de l'articulation gléno-humérale. Il bénéficie également d'une ponction-infiltration dirigée par ultrason. Le troisième cas est celui d'une femme de 91 ans chez qui au status d'entrée on objective une volumineuse masse polylobée en regard de l'acromio-claviculaire, présente depuis 2002 qui n'a jamais été symptomatique. Un US, puis un CT montrent qu'il s'agit de volumineux kystes articulaires en relation avec une arthropathie sévère dégénérative et à apatite de l'acromio-claviculaire.Résultats: Les trois patients ont bénéficié d'une imagerie diagnostique par échographie complétée par une IRM ou Scanner. Tous les trois ont également subi une aspiration dirigée sous échographie. Dans le premier cas, deux aspiration-infiltration des kystes qui apportaient une évolution favorable avec diminution important des kystes. Dans le deuxième cas nous avons retrouvé un kyste après 2 aspirations et dans ce cas une intervention chirurgicale est considérée. Dans le troisième cas, asymptomatique, une résection à visée esthétique a été refusée par la patiente.Conclusion: Les kystes synoviaux localisés à l'épaule restent des conditions rares, provenant d'entités diverses. Nous rapportons le développement de kystes synoviaux de l'épaule dans une arthropathie microcristalline chez un patient greffé rénal, dans une arthrite psoriasique chez un jeune patient en poussée inflammatoire, et finalement de gros kystes asymptomatiques chroniques sur une atteinte dégénérative et microcristalline chez une patiente âgée. Le diagnostic de ces kystes peut être rapidement obtenu par échographie, permettant l'aspiration guidée avec analyse du liquide. En raison d'un fort taux de récidive malgré un traitement par aspiration-infiltration, une intervention chirurgicale de ces kystes est considérée.

Pathologies mimicking deep venous thrombosis of the legs: pictorial review of US findings : P27

Purpose: Precise diagnosis of DVT of the legs is a challenging problem, not only in front of suspicion of PE, but also in all status of leg pain, warmth and swelling. Clinical diagnosis has a low accuracy and further investigations are mandatory in order to diagnose DVT. Amongst the possible investigations, US has a high specificity and a good NPV. However, many pathologies unrelated to the veins may mimic the signs and symptoms of DVT and have to be recognized in order to make the correct diagnosis. The purpose of this paper is to review the results of the US investigations of the legs performed in our Department during the last three years for a suspicion of DVT and describe alternative diagnoses mimicking DVT. Methods and materials: Through a RIS-based search, we retrospectively reviewed all the cases of US of the legs performed in our Department between January 2006 and December 2008 for a suspicion of DVT. We selected the cases of positive findings unrelated to the veins and illustrated these findings with characteristic images. Results: 419 US of the legs were performed between December 2006 and December 2008 for a suspicion of DVT. Among these, 75 were positive for DVT, and 79 for alternative diagnosis. The most common alternative diagnosis was edema of the legs (31%), followed by hematoma (23%). Other findings were Baker cysts (13%), cellulitis (10%) and lymphoceles (5%). Rare diagnoses were arterio-venous malformations, pseudoaneurysms, pelvic masses, necrosing fasciitis, intramuscular abscesses, subcutaneous seromas, sarcoma and ganglion cysts. Conclusion: A greater knowledge of the US appearance of the pathologies mimicking DVT may help to make the correct diagnosis, avoiding further expensive investigations or inappropriate anticoagulant therapy.

Aptitude à la conduite, pathologies psychiatriques et psychotropes chez la personne âgée [Driving ability, mental illness and psychotropic medication in the elderly].

Fitness to drive in elderly drivers is most commonly discussed with a focus on cognitive impairment. Therefore, this article is focussing on mental illness and the use of psychotropic drugs in elderly drivers, which can both interfere with fitness to drive. Based on a detailed literature review and on clinical judgement, we propose signposts and "red flags" to judge the individual risks. Health professionals dealing with elderly patients should in particular be aware of the dangers related to cumulative risks and need to inform the patients appropriately. For medico-legal reasons the information provided to patients must be written down in the medical record. Individual counselling is important as fitness to drive is a complex topic.

Comparison of fundus autofluorescence between fundus camera (Topcon) and confocal scanning laser ophthalmoscope (HRA) in various pathologies

Purpose: To investigate the differences between Fundus Camera (Topcon TRC-50X) and Confocal Scanning Laser Ophthalmoscope (Heidelberg retina angiogram (HRA)) on the fundus autofluorescence (FAF) imaging (resolution and FAF characteristics). Methods: 105 eyes of 56 patients with various retinal diseases underwent FAF imaging with HRA (488nm exciter/500nm barrier filter) before fluorescein angiography (FFA) and Topcon Fundus Camera (580nm exciter/695nm barrier filter) before and after FFA. The quality of the FAF images was compared for their resolution and analysed for the influence of fixation stability and cataracts. Hypo-and hyper-FAF behaviour was analysed for the healthy disc, healthy fovea, and a variety of pathological features. Results: HRA images were found to be of superior resolution in 18, while Topcon images were estimated superior in 29 eyes. No difference was found in 58 eyes. Both poor fixation (p=0.009) and more advanced cataract (p=0.013) were found associated with better image quality by Topcon. Images acquired by Topcon before and after FFA were identical (100%). The healthy disc was usually dark on HRA (72%), but showed mild autofluorescence on Topcon (85%). The healthy fovea showed in 100% Hypo-FAF on HRA, while Topcon showed in 53% Iso-FAF, in 43% mild Hypo-FAF, and in 4% Hypo-FAF as on HRA. No difference of FAF was found for geographic atrophy, pigment changes, and drusen, although Topcon images were often more detailed. Hyper-FAF due to serous exudation showed better on HRA. Cystic edema was visible only on HRA in a petaloid hyper-FAF pattern in 83%, while only two eyes (17%) showed similar behavior in both HRA- and Topcon images. Hard exudates caused Hypo-FAF only on HRA, hardly visible on Topcon. Blockage phenomenon by blood however was identical. Conclusions: The filter set of Topcon and the single image acquisition appear to be an advantage for patients with cataract and poor fixation respectively. Preceding FFA does not alter the Topcon FAF image. Regarding the FAF behavior, there are differences between the 2 systems which need to be taken into account when interpreting the images.

Pathologies mimicking deep venous thrombosis of the legs : pictorial review of US findings : P27

Purpose: Precise diagnosis of DVT of the legs is a challenging problem, not only in front of suspicion of PE, but also in all status of leg pain, warmth and swelling. Clinical diagnosis has a low accuracy and further investigations are mandatory in order to diagnose DVT. Amongst the possible investigations, US has a high specificity and a good NPV. However, many pathologies unrelated to the veins may mimic the signs and symptoms of DVT and have to be recognized in order to make the correct diagnosis. The purpose of this paper is to review the results of the US investigations of the legs performed in our Department during the last three years for a suspicion of DVT and describe alternative diagnoses mimicking DVT. Methods and materials: Through a RIS-based search, we retrospectively reviewed all the cases of US of the legs performed in our Department between January 2006 and December 2008 for a suspicion of DVT. We selected the cases of positive findings unrelated to the veins and illustrated these findings with characteristic images. Results: 419 US of the legs were performed between December 2006 and December 2008 for a suspicion of DVT. Among these, 75 were positive for DVT, and 79 for alternative diagnosis. The most common alternative diagnosis was edema of the legs (31%), followed by hematoma (23%). Other findings were Baker cysts (13%), cellulitis (10%) and lymphoceles (5%). Rare diagnoses were arterio-venous malformations, pseudoaneurysms, pelvic masses, necrosing fasciitis, intramuscular abscesses, subcutaneous seromas, sarcoma and ganglion cysts. Conclusion: A greater knowledge of the US appearance of the pathologies mimicking DVT may help to make the correct diagnosis, avoiding further expensive investigations or inappropriate anticoagulant therapy.

Approche preventive des pathologies démentietlles [Preventive approaches to dementia].

Prevalence and incidence of dementia increase with demographic aging. Benefits of current antidementia drugs are modest, both in cognitive and functional domains. Therefore, interest is growing to evaluate the effects of interventions aiming at preventing cognitive decline and, ideally, dementia onset. Cognitive training and physical activity seem promising. This paper describes recent studies that assessed the benefits of preventive strategies in the domain of dementia, especially in Alzheimer's disease.