A comparative study on the effect of argan oil versus fish oil on risk factors for cardio-vascular disease in high-fat-fed rats.

OBJECTIVES: The aim of this study was to investigate the effects of two different sources of polyunsaturated fatty acid-fish oil (FO) and argan oil (AO)-on some risk factors for cardiovascular disease, such as platelet aggregation, dyslipidemia, and oxidative stress. METHODS: To explore this, four groups of six male rats were fed with different diets: The first group received a standard diet (control); the second group received a high-fat diet; the third was fed with a high-fat diet supplemented with 5% FO, and the last group received a high-fat diet supplemented with 5% AO. RESULTS: After 8 wk of the diet, AO showed a decrease in plasma lipids similar to that of FO. However, unlike FO, AO had no significant effect on hepatic lipid levels. On the other hand, supplementation with AO and FO similarly reduced platelet hyperactivity induced by high-fat diet. Concerning the results of oxidative stress, AO showed an antioxidant effect in the tissues and platelets greater than that observed in the high-fat FO group. CONCLUSIONS: For rats, the consumption of FO prevented the development of adiposity, restored insulin sensitivity, decreased plasma and liver lipid levels, and also prevented the prothrombotic effect. Intake of AO as a food supplement did not affect adiposity or liver lipid levels but decreased plasma lipid levels and improved oxidative status and platelet activity. FO and, to a lesser degree, AO thus represent promising nutritional tools in the prevention of cardiovascular disease.

[Shwachman-Diamond syndrome: a case report]. / Le syndrome de Shwachman-Diamond : à propos d'un cas.

Shwachman-Diamond syndrome is a constitutional disorder characterized by exocrine pancreatic failure and neutropenia with dysgranulopoiesis. It is a rare disease, with less than 100 cases reported in France. Here we report the case of a 23-year-old woman with this syndrome. The clinical feature and the diagnostic steps are described, as well as the evolution and management in medical and laboratory medicine practice.

[Lymphoplasmacytic lymphoma or multiple myeloma: immunoglobulins may lead to misdiagnosis]. / Lymphome lymphoplasmocytaire ou myélome multiple : quand les immunoglobulines induisent en erreur.

We report here a case of lymphoplasmacytic lymphoma with IgA paraproteinemia and a case of concomitant Waldenström macroglobulinemia and monoclonal gammapathy of unknown significance. These rare cases show that the isotype of a monoclonal immunoglobulin does not allow to foresee every time the underlying pathology. Clinical data and medical imaging are essential. From a biological point of view, additional analysis such as immunophenotyping, cytogenetics and molecular biology are required in addition to the cytological features in order to make an accurate differential diagnosis between lymphoid and plasma cell malignancy.

[Chronic lymphocytic leukemia with t(14 ;18) and trisomy 12: a case report]. / Leucémie lymphoïde chronique avec t(14;18) et trisomie 12 : un cas clinique.

Chronic lymphocytic leukemia (CLL) is a B-cell neoplasm defined by the presence of at least 5×109 G/L monoclonal B lymphocytes in the peripheral blood. It is the most common type of leukemia in adult patients from Western countries. CLL is characterized by a gradual accumulation of small, longliving, immunologically dysfunctional, morphologically mature-appearing B-lymphocytes in blood, bone marrow and lymphoid tissues. It has also been reported that CLL cells have a proliferation rate higher than previously recognized, particularly in the lymphoid tissues. The flow cytometry analysis of typical CLL identifies a monotypic B-cell population expressing a low level of surface immunoglobulins, light chain being either kappa or lambda-, CD5+, CD19+, CD23+, CD79b (dim), negative for FMC7 and CD10. Clinical presentation, course and outcome are highly variable. Interphase fluorescent in situ hybridization (I-FISH) identifies chromosomal abnormalities in about 80% of cases, most commonly involving 13q14 (55%), 11q22-23 (18%), or 17p13 deletions (7%) and trisomy 12 (16%). Therefore, five prognostic categories have been defined with a statistical model, showing the shortest median survival and treatment-free intervals in patients harboring 17p and 11q deletions, followed by trisomy 12 and a normal karyotype, whereas 13q deletion as the sole abnormality is associated with the best prognosis. We report here a rare case of CLL in a 54 year-old-man.

A case of EDTA-related in vitro platelet degranulation.

A 71 year-old woman is admitted to Le Mans hospital center for management of a chronic skin lesion. She has no personal nor familial bleeding history and does not take any medication. In peripheral blood collected with EDTA (ethylene diamine tetra-acetate), the platelet count is elevated and the blood film shows uniformly grey platelets. In sodium citrate-collected blood, platelets show no abnormality. We describe an EDTA-related artifact that is not to be mistaken for grey platelet syndrome.

Fish Oil and Microalga Omega-3 as Dietary Supplements: A Comparative Study on Cardiovascular Risk Factors in High-Fat Fed Rats.

Dietary supplementation with marine omega-3 polyunsaturated fatty acids (n-3 PUFA) can have beneficial effects on a number of risk factors for cardiovascular disease (CVD). We compared the effects of two n-3 PUFA rich food supplements (freeze-dried Odontella aurita and fish oil) on risk factors for CVD. Male rats were randomly divided into four groups of six animals each and fed with the following diets: control group (C) received a standard diet containing 7 % lipids; second group (HF high fat) was fed with a high-fat diet containing 40 % lipids; third group (HFFO high fat+fish oil) was fed with the high-fat diet supplemented with 0.5 % fish oil; and fourth group (HFOA high fat+O. aurita) received the high-fat diet supplemented with 12 % of freeze-dried O. aurita. After 8 weeks rats fed with the high-fat diet supplemented with O. aurita displayed a significantly lower bodyweight than those in the other groups. Both the microalga and the fish oil significantly reduced insulinemia and serum lipid levels. O. aurita was more effective than the fish oil in reducing hepatic triacyglycerol levels and in preventing high-fat diet-induced steatosis. O. aurita and fish oil also reduced platelet aggregation and oxidative status induced by high fat intake. After an OA supplementation, the adipocytes in the HFOA group were smaller than those in the HF group. Freeze-dried O. aurita showed similar or even greater biological effects than the fish oil. This could be explained by a potential effect of the n-3 PUFA but also other bioactive compounds of the microalgae.

E hepatitis seroprevalence in a population of patients with transaminases increased at Le Mans' hospital (France).

In Europe, infection through the hepatitis E virus presents itself under the form of autochthone, sporadic cases with zoonotic transmission. The diagnosis is more frequent in the case of male subjects above 50, with a generally severe clinical presentation. Moreover, a transition to chronicity is described in the case of immunocompromised patients. In France and in the world, seroprevalence has not clearly been established yet. In the hospital of Le Mans, Sarthe, France, the serologic status regarding the hepatitis E virus was established between October 1(st) 2012 and April 3(rd) 2015 on a population of 299 patients who presented hypertransaminasaemia and negative serology regarding hepatitis A, B and C viruses. According to the Wantai(®) Assays technique, seroprevalence for IgG among this cohort was 26.1%, while 3.7% of patients presented acute hepatitis E and a positive IgM serology. Hepatitis E screening tests are indispensable in the context of acute hepatitis no A, no B, no C.

Rituximab is an effective and safe treatment of relapse in elderly patients with resistant warm AIHA.

We evaluated the efficacy and safety of rituximab for the treatment of 23 elderly patients (median age 78 years) with warm autoimmune haemolytic anaemia (AIHA). The median follow-up was 31 months. Patients had received one to five previous treatments. Rituximab was administered by intravenous infusion at a dose of 375 mg/m(2) once weekly for 4 weeks. The OR rate was 86.9 % (CR = 39.1 %, PR = 47.8 %). Median OS was 87 months. The median OS of patients who reached CR could not be calculated, and that of patients with PR was 67 months. At last follow-up, eight of the 20 responding patients, including one patient in CR and seven in PR, had relapsed after a median of 6 months. Failure to achieve CR was a risk factor for relapse (p = 0.028). We did not identify any pretreatment characteristics predictive of response to rituximab. In conclusion, rituximab is an effective treatment for elderly patients with refractory warm AIHA.

Quadri-lineage disease involving nodal B-cell marginal zone lymphoma, high-grade B-cell lymphoma, Kaposi's syndrome, and acute myeloid leukemia.

A patient with a marginal zone lymphoma received RCHOP and obtained PR. He received RDHAP, autograft, and obtained CR. Three months later, he developed Kaposi's sarcoma with spontaneous regression. Two months later, he developed DLBCL treated with R-MIV with CR. Thereafter, he developed AML and died a few days later.

[Paroxysmal nocturnal hemoglobinuria and myelodysplastic syndrome: a case report]. / Hémoglobinurie paroxystique nocturne et syndrome myélodysplasique : à propos d'un cas.

Paroxysmal nocturnal hemoglobinuria is a rare clonal non-malignant disease, linked to an acquired PIG-A gene mutation. We report the case of 81 years old patient hospitalized for articular ache, swelling and temporal arteries' induration in which we diagnose PNH associated with refractory cytopenia with multilineage dysplasia.

[Blastic plasmacytoid dendritic cell neoplasm: two case reports]. / Leucémie dérivée des cellules dendritiques plasmocytoïdes : à propos de deux cas.

Blastic plasmacytoid dendritic cell neoplasm (LPDC) is a rare and aggressive leukemia entity with cutaneous and extracutaneous involvement, reaching most often lymph, blood and bone marrow. Two cases of LPDC diagnosed in Hospital Center of Le Mans are reported, a 78 year old woman (case 1) and a 82 year old man (case 2), and have been clinically, biologically and histologically documented. The clinical presentation, diagnostic difficulties are reminded, as well as the pathogenesis and therapeutic aspect.

Thrombin time and anti-IIa dabigatran's activity: hypothesis of thrombin time's predictive value.

Dabigatran etexilate (Pradaxa®) is a new oral anticoagulant, competitive inhibitor, selective, fast, direct and reversible of thrombin. Dabigatran has an impact on a large panel of used coagulation tests. There is no relationship between thrombin time's lengthening and anti-IIa activity. This study defines thrombin time's predictive value, when its time is normal. The result of negative value is 97,6%. 255 patients were studied between January 2013 and July 2014. Thrombin time and anti-IIa activity were dosed for each patient. This study can be an assistant for therapeutic decision for laboratories without specialized test.

[ADAMTS13 and thrombotic thrombocytopenic purpura retrospective study at the hospital of Le Mans]. / ADAMTS13 et purpura thrombotique thrombocytopénique Étude rétrospective au Centre hospitalier du Mans.

Thrombotic thrombocytopenic purpura (TTP) is a rare disease with poor prognosis in the absence of treatment. The aim of the study was to compare with the literature, the clinical, biological and therapeutic management of PTT at the hospital of Le Mans (CHM) and to identify sub groups. The criteria for inclusion were all patients hospitalized between 2006 and 2012 at CHM with a number of platelets, level of hemoglobin and ADAMTS13 activity respectively less than 150 G/L, 110 g/L and 10 %. Eleven patients were included, confirming the epidemiological level rarity of this disease and the prevalence in young women, with immune dysfunction, and Afro-Caribbean origin. Consistent with literature, patients had heterogeneous symptoms but mainly neurological symptoms. Biological results were heteregenous and also different from the diagnostic described by Amorosi. Concerning therapy, all patients underwent plasma exchange with fresh frozen plasma substitution, confirming this as a reference treatment of first intention. Sub-group analysis have highlighted three predictive factors of mortality which were: an age over 70 years of age, a renal failure and a haptoglobin level superior to 0.10 g/dL. This study reminded the clinical, biological and therapeutic recommendations about TTP and described predictive factors of mortality.

Blastic plasmacytoid dendritic cell neoplasm: the first report of two cases treated by 5-azacytidine.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy which was first included as an independent cutaneous lymphoma in the 2008 World Health Organisation (WHO) classification (1). BPDCN usually has an extremely poor prognosis, with quick relapses after chemotherapy (2; 3). Here, we report two cases of patients diagnosed in 2011 with BPDCN and myelodysplasia, and who were treated for the first time with 5-azacytidine (5-Aza); a drug approved by the Food and Drug Administration (FDA) and mainly used in the treatment of myelodysplastic syndrome (Kaminskas E, et al. 2005 Clin Cancer Res, 11, 3604-8). The first case was an 81-year-old man who presented with unusual CD10+, CD56- immunohistochemistry and 45X, -Y abnormality using fluorescent in situ hybridization (FISH) analysis. The second case was a 78-year-old woman who manifested monosomy 13 and chromosome instability due to D13S319 locus deletion in 13q14 as determined by FISH. Both patients showed excellent responses of their skin lesions after one cycle of chemotherapy, and their hematological disease was stabilized; however, pulmonary sepsis set in, followed by neutropenia after the fourth and the fifth cycle of treatment, that is, eight and 9 months postdiagnosis, respectively, leading to patient death.

The role of Odontella aurita, a marine diatom rich in EPA, as a dietary supplement in dyslipidemia, platelet function and oxidative stress in high-fat fed rats.

BACKGROUND: Dietary changes are a major factor in determining cardiovascular risk. n-3 polyunsaturated fatty acids modulate the risk factors for metabolic syndrome via multiple mechanisms, including the regulation of the lipid metabolism. We therefore investigated the effect of Odontella aurita, a microalga rich in EPA, which is already used as a food supplement, on the risk factors for high-fat diet induced metabolic syndrome in rats. METHODS: Male Wistar rats were divided into 4 groups and were fed with a standard diet (control); with the standard diet supplemented with 3% freeze-dried O. aurita (COA); with a high-fat diet (HF); or with the high-fat diet supplemented with 3% of freeze-dried O. aurita (HFOA) for 7 weeks. In this study we evaluated the impact of these different diets on the risk factors for metabolic syndrome, such as hyperlipidemia, platelet aggregation, thromboxane B2 production, and oxidative stress. RESULTS: After 7 weeks of treatment, high fat feeding had increased final body weight, glycemia, triacylglycerol, and total cholesterol levels in plasma and liver compared to the control diet. Collagen-induced platelet aggregation and basal platelet thromboxane B2 were also higher in the high-fat fed rats than in those in the control group. In the liver, oxidative stress was greater in the HF group than in the control group. O. aurita intake in HFOA-fed rats resulted in lower glycemia and lipid levels in the plasma and liver relative than in the HF group. Thus, in the HFOA group, n-3 polyunsaturated fatty acid levels in the tissues studied (plasma, liver, and platelets) were higher than in the HF group. Platelet hyper-aggregability tended to decrease in HFOA-fed rats as basal platelet thromboxane B2 production decreased. Finally, O. aurita reduced oxidative stress in the liver, with lower malondialdehyde levels and increased glutathione peroxidase activity. CONCLUSIONS: O. aurita is a marine diatom rich in EPA as well as in other bioactive molecules, such as pigments. The synergistic effect of these microalgal compounds, displayed a beneficial effect in reducing the risk factors for high-fat induced metabolic syndrome: hyperlipidemia, platelet aggregation, and oxidative stress.