[Trimetazidine-induced encephalopathy with choreiform disorders: a case report]. / Encéphalopathie avec mouvements choréiformes induits par la trimétazidine: à propos d'un cas.

Trimetazidine is known to induce parkinsonism but choreiform disorders have not yet been described with this drug. A 88-year-old patient treated with trimetazidine developed choreiform movements, gait disorders, tremor and visual hallucinations. These symptoms disappeared after drug withdrawal. Although this drug contains a piperazinic ring like other anti-dopaminergic drugs which are already known to potentially induce chorea like neuroleptics and some anti-convulsive drugs. When a patient treated with trimetazidine develops or worsens motor disorders (parkinsonism or choreiform disorders), this drug must be stopped.

[Impact of a triage scale in a pediatric emergency department]. / Impact d'une grille de tri à l'accueil d'un service d'urgence pédiatrique.

UNLABELLED: The pediatric nursing staff of the emergency unit has established a list of items for the triage of patients which can be used by the registered nurses. This scale defined 3 stages of severity. OBJECTIVES: 1) to estimate the relevance of this list through the appraisal of the total time necessary to take care of the patients according to their severity stage, and the confrontation of the severity stage determined by the registered nurse and the severity stage determined by the paediatrician; 2) to determine a possible correlation between the severity stage and the rate of hospitalization. METHOD: This prospective study was carried out over a period of 1 month in winter for every child admitted in the pediatric emergency unit for medical reasons (traumatisms excluded). RESULTS: One thousand six hundred and fifty-six children have been included in the study. Among them, 136 have been classified stage I, 1020 stage II and 500 stage III. The children have been taken care of in an average period of 20 min for stage I, 32 min for stage II, 43 min for stage III. The coherence rate between the severity stage determined by the nurse and the severity rate determined by the paediatrician was good. The rate of sub-estimation was low (4,2%). Nevertheless the reception nurses tend to overestimate the stage of severity in 17,6% of the cases. The prediction rate for hospital admittance was good: 68,7% of children classified in stage 1 were admitted, 23,5% of children in stage 2 and only 1,6% of children in stage 3. CONCLUSION: Patients suffering from severe illnesses were taken care without injurious delay which was the main purpose of this list.

Profiling changes in gene expression during differentiation and maturation of monocyte-derived dendritic cells using both oligonucleotide microarrays and proteomics.

Dendritic cells (DCs) are antigen-presenting cells that play a major role in initiating primary immune responses. We have utilized two independent approaches, DNA microarrays and proteomics, to analyze the expression profile of human CD14(+) blood monocytes and their derived DCs. Analysis of gene expression changes at the RNA level using oligonucleotide microarrays complementary to 6300 human genes showed that approximately 40% of the genes were expressed in DCs. A total of 255 genes (4%) were found to be regulated during DC differentiation or maturation. Most of these genes were not previously associated with DCs and included genes encoding secreted proteins as well as genes involved in cell adhesion, signaling, and lipid metabolism. Protein analysis of the same cell populations was done using two-dimensional gel electrophoresis. A total of 900 distinct protein spots were included, and 4% of them exhibited quantitative changes during DC differentiation and maturation. Differentially expressed proteins were identified by mass spectrometry and found to represent proteins with Ca(2+) binding, fatty acid binding, or chaperone activities as well as proteins involved in cell motility. In addition, proteomic analysis provided an assessment of post-translational modifications. The chaperone protein, calreticulin, was found to undergo cleavage, yielding a novel form. The combined oligonucleotide microarray and proteomic approaches have uncovered novel genes associated with DC differentiation and maturation and has allowed analysis of post-translational modifications of specific proteins as part of these processes.