Des tumeurs surrénaliennes bilatérales Esnault, H.; Lahaye, C.; Girard, L. ...
La revue de medecine interne,
January 2020, 2020-01-00, Letnik:
41, Številka:
1
Journal Article
Abstract Objective By proposing a new terminology (acquired deforming hypertonia or ADH) and a new definition for contractures, the main objective of this study was to establish their prevalence ...among institutionalized elderly patients. Secondary objectives were to analyze the negative impact of ADH and collect the opinions of clinicians on the possible treatments available. Methodology A multicenter cross-sectional study was conducted among residents of 39 geriatric institutions (29 EHPAD and 10 USLD). All subjects presenting at least one ADH were surveyed over a one-week period. Results Among 3145 observed patients (mean age 88.9 ± 9.7 years) 22% ( n = 692) presented at least one ADH. In average, each patient presented 4.4 ± 3.2 ADHs. Negative consequences on self-care, nursing and difficulties in getting dressed were most frequently observed. Only 25.4% of clinicians considered the ADH to be potentially reversible. Physical therapy was the therapeutic option most frequently chosen over medication and surgery. Conclusion This study confirms the important prevalence of ADH among elderly institutionalized patients. Consequences on the level of dependence were significant. It seems relevant to elaborate hierarchical therapeutic strategies in order to counter these disorders and the fatalism that ensues.
The ionization of a series of benzyltriflones ArCH2SO2CF3 (Ar = C6H5, 4-CNC6H4, 4-NO2C6H4, 2,4-(NO2)2C6H3, 2,4,6-(NO2)3C6H2) has been studied kinetically and thermodynamically as well as by 1H, 13C, ...and 19F NMR in H2O−Me2SO mixtures and/or Me2SO. The findings that the acidity of the triflones is enhanced on going from hydroxylic solvents to Me2SO and that their deprotonation is associated with high Marcus intrinsic reactivities are two major results indicating the presence of a large polarizable charge density at Cα of the carbanionic species. Comparison of the results obtained with those for related arylnitromethane and arylacetonitrile compounds strongly supports this conclusion. NMR data add to the evidence that polarization rather than d−p π-resonance or negative hyperconjugation is the dominant factor in accounting for the capability of the strongly electron withdrawing SO2CF3 group to stabilize negative charge. Altogether, our results lead to a structural picture of the triflone carbanions in solution which does not totally fit the conclusions reached on the basis of solid-state or computed gas-phase studies.
To evaluate the safety and performance of MedicelTulle Dressing (MTD) in subjects with chronic or acute wounds left to heal by secondary intention.
This 28-day, multi-centre, single-arm clinical ...study was conducted at seven sites in France. Thirty patients with a chronic (n = 20) or acute wound (n = 10) were treated with MTD and gauze as a secondary dressing. Study treatment lasted 28 days or until healing.
Mean baseline wound area was 14.8cm2. There were 103 clinic dressing changes and 220 home dressing changes. Seven adverse events were reported in five subjects, including one treatment-related adverse event of dry scab. No adherence was reported for 66% of clinic dressing changes and 53% of home dressing changes. No trauma was reported for 96% of clinic dressing changes. Mean reduction in wound size was 7.0cm2.
In this study, MTD demonstrated good safety results. Additional study is warranted to confirm the clinical utility of MTD in the management of chronic or acute wounds left to heal by secondary intention.
Research in France on concurrent medical problems predisposing to the development of pressure ulcers of the heel. Patients with heel ulcers were matched to an ulcer-free control group to examine the ...implications of underlying arterial disease. (BNI unique abstract) 5 references
The catalytic hydrodehalogenation reaction using molecular hydrogen and Pd/C has been revisited. It is shown that the speed of removal of halogen increases with increasing electronegativity I < Br < ...Cl. Nevertheless, selective dehydrohalogenation in compounds containing other reducible functions can be achieved only with iodine and not with bromine or chlorine. Selective deiodination of iodobenzophenone could be accomplished without reducing the carbonyl group. Hydrogenolysis of azidoiodoaromatic compounds to the corresponding azido compounds is high yielding. This selectivity was exploited for the labeling of benzophenone- and azido-containing compounds by deuterium and tritium.
(N-CHDT)-(α)-isosparteinium ditosylamide can be used in conjunction with tritium NMR spectroscopy to assign the configuration of an intact stereogenic (chiral) methyl group. The S-CHDT group has a 3H ...chemical shift that is 49 ppb downfield of the R-CHDT resonance. The sign and magnitude of this chemical shift difference of these diastereotopic tritium nuclei are found to be in agreement with predictions made via a purely ab initio computational approach. The chemical shift difference is due to an equilibrium isotope effect originating from a novel CH3 ...N hydrogen bond. Despite the improved tritium chemical shift dispersion, this method is not useful for determining the enantiopurity of CHDTN(Tos)2 due to partial racemization that occurs during the derivatization step. Milder methylation conditions are described for reactions using methyl p-toluenesulfonate or methyl-d 3 triflate. These studies suggest that (−)-(α)-isosparteine is a potential new reagent for chirality analysis of methyl groups originating from suitably reactive electrophiles.
We have investigated the effects of granulocyte-macrophage (GM) CSF on two biochemical responses thought to play internal signaling roles in the neutrophils, namely the increase in the concentration ...of free calcium and the changes in the internal pH. The changes in the right-angle light scatter of the cell suspensions were also examined. GM-CSF was found not to affect the resting levels of calcium or the internal pH of the cells. However, pre-incubation of the neutrophils with the growth factor resulted in an increase in the magnitude of the calcium transients that follow the stimulation of the cells with chemotactic factors as well as a profound depression of the cell alkalinization that is induced by fMet-Leu-Phe, leukotriene B4, and platelet-activating factor, as well as by phorbol esters. The rapid cytoplasmic acidification elicited by these agents was apparently magnified. GM-CSF did not directly affect the Na+/H+ antiport as GM-CSF-treated cells were as capable as untreated cells of recovering from an acid load. The right-angle light scatter responses of the cells to the chemotactic factors were found not to be affected by GM-CSF. These results provide an initial description of the effects of GM-CSF on the cellular physiology of the neutrophils and insights into the mechanism of action of this factor as well as into the excitation-response coupling sequence activated by chemotactic factors.
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