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Biomedical subjects

M Merlin

Publications and source records attributed to M Merlin.

At least 19 recordsLinked to original sources

Procalcitonin, interleukin 6 and systemic inflammatory response syndrome (SIRS): early markers of postoperative sepsis after major surgery.

BACKGROUND: Patients who undergo major surgery for cancer are at high risk of postoperative sepsis. Early markers of septic complications would be useful for diagnosis and therapeutic management in patients with postoperative sepsis. The aim of this study was to investigate the association between early (first postoperative day) changes in interleukin 6 (IL-6), procalcitonin (PCT) and C-reactive protein (CRP) serum concentrations and the occurrence of subsequent septic complications after major surgery. METHODS: Serial blood samples were collected from 50 consecutive patients for determination of IL-6, PCT and CRP serum levels. Blood samples were obtained on the morning of surgery and on the morning of the first postoperative day. RESULTS: Sixteen patients developed septic complications during the first five postoperative days (group 1), and 34 patients developed no septic complications (group 2). On day 1, PCT and IL-6 levels were significantly higher in group 1 (P-values of 0.003 and 0.006, respectively) but CRP levels were similar. An IL-6 cut-off point set at 310 pg ml(-1) yielded a sensitivity of 90% and a specificity of 58% to differentiate group 1 patients from group 2 patients. When associated with the occurrence of SIRS on day 1 these values reached 100% and 79%, respectively. A PCT cut-off point set at 1.1 ng ml(-1) yielded a sensitivity of 81% and a specificity of 72%. When associated with the occurrence of SIRS on day 1, these values reached 100% and 86%, respectively. CONCLUSIONS: PCT and IL-6 appear to be early markers of subsequent postoperative sepsis in patients undergoing major surgery for cancer. These findings could allow identification of postoperative septic complications.

Adult↗

[Humanitarian action: its requirements, its stakes].

Humanitarian action is developing in an increasingly changing and troubled world context. Organizations are subject to more and more complex requirements due to ethical, legal, technical, financial, media-related, and political considerations. They must deal with higher and higher stakes such as the emergency-development trade-off, the need for professionalization, and the revival of governmental humanitarian action. The articles in this special issue deal with all these topics and more. In most cases the authors are players in the field of humanitarian action from non-governmental, intergovernmental, international and national organizations. There are also academics, politicians, and civilians.

Altruism↗

Severe hypertriglyceridaemia in Type II diabetes: involvement of apoC-III Sst-I polymorphism, LPL mutations and apo E3 deficiency.

AIMS/HYPOTHESIS: Hypertriglyceridaemia is common in Type II (non-insulin-dependent) diabetes mellitus. Only subgroups of patient however have type V hyperlipidaemia. To investigate the coordination between genetic factors in the modulation of hypertriglyceridaemia in Type II diabetes, we studied three major modifier loci: apoC-III (both Sst-I and insulin-responsive element polymorphisms), apolipoprotein E genotypes and lipoprotein-lipase mutations. METHODS: We studied apoCIII gene polymorphisms, apolipoprotein E genotypes and lipoprotein-lipase gene mutations in 176 patients with Type II (non-insulin-dependent) diabetes mellitus, either normolipaemic (group N, n = 116), mildly hypertriglyceridaemic (group T, n = 28) or with a history of severe hypertriglyceridaemia (triglyceride > 15 g/l) (group H, n = 32). RESULTS: Mild hypertriglyceridaemia in Type II diabetes did not associate with any gene variants in this study. Severe hypertriglyceridaemia was, however, associated with the presence of the apoC-III S2 allele (50% of the patients in group H compared with 15.5 % in group N, p < 0.0001). Additionally this particular phenotype was associated with a low prevalence of the apo E3 allele (35.9% in group H vs 18.1 % in group N, p < 0.005) and a statistically significant over-representation of the E2E4 genotypes. Inactivating lipoprotein-lipase mutations were found in four patients (three heterozygotes, one homozygote), none was found in group N or T. Thus 68.7 % of group H patients (22/32) (vs 21.4 % in group T, p < 0.0005) were carriers of either S2 allele, lipoprotein-lipase mutants or E2E4 genotype with most lipoprotein-lipase mutants or E2E4 genotypes or both in the non-carriers for the S2 allele (6/7). CONCLUSION/INTERPRETATION: Our results strongly support the hypothesis that severe hyperlipaemia in Type II diabetes crucially depends on genetic factors which impair the clearance of triglyceride-rich lipoproteins.

Adult↗

Morphological, histochemical, immunohistochemical, and ultrastructural characterization of tumors and dysplastic and non-neoplastic lesions arising in BK virus/tat transgenic mice.

To study the role in AIDS pathogenesis of the human immunodeficiency virus type 1 (HIV-1) Tat protein, a transactivator of viral and cellular genes, we generated transgenic mice with a recombinant DNA containing BK virus (BKV) early region and the HIV-1 tat gene, directed by its own promoter-enhancer. DNA hybridization revealed that the transgene is stably maintained in all organs of transgenic mice as a tandem insertion in a number of copies ranging from 5 to 20 per cell. In addition, tat and BKV RNA were expressed in all tissues. Transgenic mice developed three types of lesions: 1) tumors, 2) hyperplastic and dysplastic lesions, and 3) non-neoplastic lesions. Tumors of different histotypes, such as lymphomas, adenocarcinomas of skin glands, leiomyosarcomas, skin squamous cell carcinomas, hepatomas, hepatocarcinomas, and cavernous liver hemangiomas, developed in 29% of transgenic animals. The majority of tumors were malignant, invasive, and producing metastases. Conversely, tumors of only two histotypes (lymphomas and adenocarcinomas of skin glands) appeared in control mice. Hyperplastic and dysplastic lesions were more frequent in transgenic than in control mice and involved the skin or its adnexes, the liver and the rectum, indicating multiple targets for the activity of the transgene. Pyelonephritis, frequently complicated with hydronephrosis, inflammatory eye lesions, and amyloid depositions represented the most frequent non-neoplastic lesions detected in transgenic mice. Many of the pathological findings observed in this animal model are comparable to similar lesions appearing in AIDS patients, suggesting a relevant role for Tat in the pathogenesis of such lesions during the course of AIDS.

Adenocarcinoma↗

[Evidence of risk factors for condom breakage among French military personnel stationed overseas].

The French Army Medical Service has been distributing free condoms to overseas personnel since 1989. An epidemiologic study conducted in Cambodia showed that the rate of condom failure during protected sex was 16.3 p. 100. In view this high failure rate, a study to evaluate safety guidelines for condom use was deemed necessary. This report describes the results of an inquiry designed to identify risk factors for condom breakage. The study population included 124 servicemen stationed overseas who consulted an army physician following condom failure. An anonymous questionnaire was completed by the physician with the informed consent of the patient. Data was analyzed by multiple correspondence analysis. Anogenital intercourse and alcohol abuse were the main risk factors for condom failure. Oral sex before penetration, carrying the condom in the pocket, and improper application by the sex partner were also risk factors for failure. The major finding of this study was that 64 of the 124 (51.6 p. 100) denied any sexual activity or improper handling that might have led to condom breakage. Although condoms are still indispensable for prevention sexually transmitted diseases, the results of this study show that they do not provide absolute protection. Health care officials should inform the public as to the risk factors for breakage of latex condoms.

Africa↗

[Anti-plague vaccination: past and future perspectives].

The impact of the three historic plague pandemics will remain engraved forever in the collective memory. During the first half of the XXth century, the development of vaccines inducing protection against bubonic plague, the first production of antibiotics, insecticides and raticides, could have lead some people to think that eradication was possible. But according to the data of epidemiological surveillance, far from disappearing, plague is remaining or so increasing that it is considered, in some places, as a reemerging disease. Yersinia pestis is highly variable, and a multidrug resistant strain has been isolated in 1995 in the Ambalavo district of Madagascar. This high-level of resistance includes the drugs recommended for plague prophylaxis and therapy, and this observation pointed the fact that Yersinia pestis is able to acquire the plasmid carrying the resistance genes, under natural conditions. Consequently, it is not unreasonable to think that clinically ominous events could occur again. Moreover, currently available vaccines do not induce protection against the pneumonic form of plague, and are reactogenic. Lastly, according to some accurate sources, one cannot turn down the assumption of a genetically engineered strain of Yersinia pestis used as a biological weapon by a terrorist organization. So, the surveillance of plague remains a topical activity, as the development of none reactogenic live and/or inactivated new vaccines, inducing protection against the pneumonic form of the disease.

Drug Resistance, Microbial↗

Chromosomal aberrations induced by BK virus T antigen in human fibroblasts.

Human fibroblasts, transfected with a recombinant DNA containing the neo gene and BK virus (BKV) early region, which expresses BPV large T antigen (TAg), show cytogenetic alterations characterized by dicentric chromosomes and other structural aberrations such as deletions, duplications, translocations, and ring chromosomes. Such alterations were absent or significantly less frequent in human fibroblasts transfected with a plasmid expressing only the neo gene. The chromosome damage in BKV-transfected cells was evident before the appearance of the morphologically transformed phenotype and therefore seems to be a primary effect of TAg expression in human cells. The specific pattern of chromosome aberrations suggests the prevalence of an indirect clastogenic effect, determined by the inhibition of p53 regulatory functions on genome stability by BKV TAg. Due to the widespread distribution of BKV in the human population and to the latent state of BKV DNA in many human organs, the clastogenic activity of BKV TAg may potentially participate in an oncogenic process involving BKV latently infected cells.

Antigens, Polyomavirus Transforming↗

Amyotrophic lateral sclerosis after long-term exposure to drinking water with high selenium content.

We examined 9 years' incidence of amyotrophic lateral sclerosis, a disease previously associated with a high-selenium environment, in a cohort of 5,182 residents of Reggio Emilia, Italy. This cohort had accidentally been exposed to drinking water with high selenium content. Four cases were diagnosed during the follow-up. Using the remainder of the municipal population as the reference group, the standardized incidence ratio was 4.22 (95% confidence interval = 1.15-10.80). The standardized incidence ratio was higher after limiting the analysis to the subcohort with the longest ascertainable exposure period. The findings appear to confirm a causal association between overexposure to environmental selenium and amyotrophic lateral sclerosis.

Amyotrophic Lateral Sclerosis↗

Characteristics of serogroup A Neisseria meningitidis strains isolated in the Central African Republic in February 1992.

A severe epidemic of serogroup A meningococcus meningitis occurred in the northwest Central African Republic from January to March 1992. Strains from 24 patients were characterized using serotyping, testing of susceptibility to antibiotics, and multilocus enzyme electrophoresis. In 23 of the 24 patients the causal strain was found to be 4:P1.9/clone III-1. These results indicate that such strains continue to spread in Africa and have taken hold in areas outside the "meningitis belt." This may be a consequence of changing climatic conditions.

Adolescent↗