Modified cued recall test in the French population with Down syndrome: A retrospective medical records analysis.

BACKGROUND: Adults with Down syndrome (DS) are at increased risk of developing Alzheimer's disease (AD) due to genetic predisposition. Identification of patients with AD is difficult since intellectual disabilities (ID) may confound diagnosis. The objective of this study was to evaluate the ability of the French version of the modified cued recall test (mCRT) to distinguish between subjects with and without AD in the adult DS population. METHODS: This was a retrospective, single-centre, medical records study including data between March 2014 and July 2020. Adults aged ≥30 years with DS who had at least one mCRT record available were eligible. Age, sex and ID level were extracted, and subjects were attributed to three groups: patients with AD, patients with co-occurring conditions that may impact cognitive function and subjects without AD. mCRT scores, adjusted by sex, age and ID level, were compared between groups. The optimal cut-off value to distinguish between patients with and without AD was determined using the receiver operating characteristic curve. The impact of age and ID level on mCRT scores was assessed. RESULTS: Overall, 194 patients with DS were included: 12 patients with AD, 94 patients with co-occurring conditions and 88 healthy subjects. Total recall scores were significantly lower (P < 0.0001) in patients with AD compared with healthy subjects. The optimal cut-off value to discriminate between patients with AD and healthy subjects was 22, which compares well with the cut-off value of 23 originally reported for the English version of the mCRT. Patients aged 30-44 years had higher mCRT total recall scores compared with patients aged ≥45 years (P = 0.0221). Similarly, patients with mild ID had higher mCRT scores compared with patients with severe ID (P < 0.0001). INTERPRETATION: The mCRT is a sensitive tool that may help in the clinical diagnosis of AD in subjects with DS. Early recognition of AD is paramount to deliver appropriate interventions to this vulnerable population.

[Interventional computed tomography in thoracic oncology. Apropos of 170 cases]. / Tomodensitométrie interventionnelle en oncologie thoracique. A propos de 170 cas.

The authors report their experience with follow-up cytohistological examination of subclinical thoracic lesions in oncology by transparietal puncture with CAT-scanning localization in 170 patients. They detail a few special points concerning the material used and their techniques, in view of reducing the most common incidents and of managing the most severe complications. They analyze their results in two groups of patients, one investigated in a context of known malignancy and the other, with no history of malignancy in whom bronchoscopy, bronchial lavage and brushing were negative. They found an overall sensitivity and specificity of 86% and 100%, respectively, in the diagnosis of malignant disease. The method showed an efficacy of 83.5%. For the two populations, sensitivity was 84% and 87% respectively, and efficacy was 82 and 85% respectively. Thus, the results were better in the patients who had never received anticancer therapy. They also observed significant differences depending on whether the targets were mediastinal, pleuropulmonary or parietal. While the rapid diagnostic information appears invaluable in both groups of patients, in contrast, the small volume of the specimens, which may be hemorrhagic, necrotic, with more or less extensive fibrosis of the stroma, and the immaturity of certain tumors, sometimes make it impossible for the pathologist to give a precise diagnosis of the tumor other than the benign or malignant structural character of the lesion. This represents a significant obstacle in hematology for affections which, although non surgical, nevertheless require precise identification of the lesion for effective therapy. The elaboration of more effective sampling material, repeated punctures and immunohistoenzymatic analysis techniques would probably further improve the results of the method.

[Atypical prostatic leiomyoma: a new case with cytodensitometric analysis]. / Léiomyome à cellules bizarres de la prostate: un nouveau cas avec étude cytométrique.

Atypical prostatic leiomyoma is a very rare benign tumor. We report here a new case with a cytodensitometric analysis. The result of cytodensitometry is a polyploid tumor that is well correlated with the morphology of nuclear multilobulated cells of this tumor. The differential diagnosis is essentially the leiomyosarcoma which is characterized by the absence of mitotic activity.

A comparison between distal and proximal port device insertion in head and neck cancer.

AIM: To compare technical feasibility and complications of radiologically arm port device implantation using arm venography exclusively (API-Group B) with chest port placement using cephalic vein cutdown (CVC-Group A), in advanced consecutive head and neck cancer patients (HNP). METHODS: Port device placement was attempted in 225 consecutive HNP. Decision for inclusion in Group A or B was made first by the availability of the surgeon/radiologist to perform the procedure, second by contraindications of each technique. Patient transfer from one group to the other was recorded as well as technical feasibility, complications and device specific duration in this retrospective study. RESULTS: Technical success was statistically higher in Arm Port Group (99.1%) compared to Chest Port Group (75.2%). Device specific duration rate of the whole population was 53% (95%CI) [0.47-0.60] at 6 months, 44.1% (95%CI) [24.4-37.8] at 12 months and 8% (95%CI) [4.4-14.5] at 24 months. Median follow-up was 5.55 months (range: 0.032-9.6] in Group A versus 5.90 months [range: 0.06-27.6] (p=ns) in Group B. Complication rate was 15.9% in Group A versus 8.9% in Group B corresponding to a complication rate per patient-implantation-days of 0.66/1000 patient-days (A) versus 0.42/1000 patient-days (B). Premature port device explantation rate was 4.4% (A) versus 5.4% (B). Axillary and subclavian venous thrombosis was the main complication and occurred in 12 Group A patients and three Group B patients. Venous thrombosis rate was 0.37/1000 patient-days (A) and 0.13/1000 patient-days (B) (p=0.03). CONCLUSIONS: A few data exist about device insertion in HNP in whom venous cervical access is contraindicated. This comparative study demonstrates that both implantation techniques are safe and effective. The higher technical success rate with 0% heavy sedation, the lower venous thrombosis rate in the API group, and the 5.3% (A-B) patient transfer rate argue in favour of arm port placement in HNP. Indications for API include patients with an ipsilateral major pectoralis-myocutaneous flap, with radiodermatitis, tumour recurrence in the neck and upper chest, or with respiratory impairment.

Radiological and surgical placement of port devices: a 4-year institutional analysis of procedure performance, quality of life and cost in breast cancer patients.

PURPOSE: The present study is designed to evaluate and compare percutaneous radiologic arm port (R) and surgical subclavian port (S) devices in two homogeneous sets of breast cancer patients in terms of safety, efficacy, quality of life (QoL) and cost analysis. MATERIAL AND METHODS: This study involved a retrospective review of a prospective databank including 200 consecutive port device implantation attempted procedures performed over a 4-year period, in two similar groups of 100 breast cancer women who underwent either the surgical cephalic vein cutdown approach or the percutaneous basilic vein catheterization for intravenous adjuvant chemotherapy. Parameters analyzed included technical success, procedure duration, complications, QoL and cost evaluation for both techniques. RESULTS: The success rate for port implantation was higher for R than for S placement (96% versus 91%). Mean implant duration time was 5.6 and 7.6 months for R and S, respectively. The overall complication rate was 10 and 16% for R and S, respectively. Mean implant duration time, without any complication or death, was 6.4 and 7.8 months for R and S, respectively. Six and seven percent for R and S, respectively, had to be removed prematurely. Both techniques exhibited very good QoL. Direct costs were respectively euro 230.8 and 219.1 for R and S, respectively. CONCLUSION: The significant advantages of R over S include higher success rate, higher cosmetic results despite a 15% relative overcost for R placement. Both are indicated for breast cancer chemotherapy treatment, nevertheless R placement is mandatory in anxious patients who fear surgery, in case of previous cervico-thoracic irradiation or upper extremity venous thrombosis, or in patients at risk of respiratory insufficiency.

Use of BOP-Cl in the presence of Boc-amino monothioacids for the thioacylation of imino acid residues.

BOP-Cl was found to be an efficient coupling reagent for the introduction of thiopeptide bonds on imino acid residues (Pro, Sar). Boc-amino monothioacids were coupled at moderate temperature (0 degree C-RT) with fair yields and with retained optical purity. The mechanism of the coupling reaction is discussed.

Six triterpenoid saponins from Mmaesa laxiflora.

Six new triterpenoid saponins, maelaxins A-F (1-6), were isolated from a n-BuOH extract of the leaves of Maesa laxiflora. They possess 22-O-angeloyl-camelliagenin A, 16-O-acetyl, 22-O-angeloyl-camelliagenin A, or 22-O-(2Z)-hexenoyl-camelliagenin A as the aglycon. The pentasaccharide moiety linked to C-3 of the aglycon consists of D-glucuronic acid, L-rhamnose, D-glucose, and/or D-galactose. Their structures were elucidated by extensive NMR experiments including 1H-1H (COSY, 2D HOHAHA, NOESY) and 1H-13C (HMQC and HMBC) spectroscopy and chemical evidence.

Oxidation, nitrosation, and nitration of serotonin by nitric oxide-derived nitrogen oxides: biological implications in the rat vascular system.

Because NO is not very reactive in an oxygen-free buffer, a significant part of serotonin (5-HT) is transformed by NO in nondeaerated phosphate buffer, at pH 7.4, into (4-serotonyl)-4-serotonin, 4-nitrososerotonin, and 4-nitroserotonin. Dimerization and above all nitrosation occur through the HNO2 reaction in the pH 4-6 range, possibly via radical mechanism involving N2O3. 5-HT is readily a substrate for nitrosation by HNO2 or N2O3, whereas tyrosine was described as not very reactive under the same conditions. Peroxynitrite converts 5-HT to the (4-serotonyl)-4-serotonin and to the 4-nitro derivative. In order to evaluate whether such structural modifications could modulate the biological properties of 5-HT, arterial pressure was measured after i.v. bolus injection of these derivatives to anesthetized rats. Injections of the 4-nitroso- and 4-nitro-5-HT resulted in first a brief hypotensive response and did not give the subsequent hypertensive and hypotensive phases observed with 5-HT. Finally, when tested on some cloned rat 5-HT receptors stably transfected into LMTK- cells, both 4-nitroso and 4-nitro derivatives behaved as agonists and antagonists toward 5-HT1B and 5-HT2B receptors, respectively.