Inter-population variation in the intensity of host manipulation by the fish acanthocephalan Pomphorhynchus tereticollis: are differences driven by predation risk?

Many trophically-transmitted parasites induce behavioural alteration in their intermediate hosts that tend to increase host vulnerability to predation. Inter-population variability in parasite-induced alterations is expected to arise from variable local opportunities for trophic transmission. Yet, this hypothesis has not been investigated so far. We addressed the issue in four populations of the fish parasite Pomphorhynchus tereticollis (Acanthocephala), using variable fish biomass density as a proxy for transmission opportunities. We found variation in the intensity of parasite-induced changes in phototaxis and refuge use among populations. Two of the populations with the lowest predator biomass exhibited the highest levels of behavioural manipulation and prevalence, as expected at low transmission opportunities. They also exhibited micro-habitat segregation between infected and uninfected gammarids in the field. In addition, infection had variable effects on two physiological defence systems, immunity and antioxidant capacity, and on total protein content. Overall, our study brings partial support to the prediction that host manipulation and prevalence should be higher at low predator biomass. Although stronger evidence should be sought by increasing population replicates, our study points to the importance of the ecological context, specifically transmission opportunities brought about by predation pressure, for the evolution of parasite manipulation in trophically-transmitted parasites.

[Impact of the angles and the age of the thrombus on efficacity of thromboaspiration device. A bench study]. / Impact du diamètre et de l'âge du thrombus sur la thromboaspiration. Étude expérimentale.

INTRODUCTION: Coronary thrombectomy is usually used to treat acute coronary syndrome. Many studies evaluated its benefit in this context however, it is still unknown if coronary characteristics are predictive of success or failure. The aim of our laboratory bench study was to evaluate the impact of angiographic characteristics on the thromboaspiration efficiency. METHODS: Glass tubes of 150 mm in the length were used, with five diameters: 2; 2.6; 3; 3.6 and 4 mm; and for each diameter, three angulations: no angulation; 90° and 120°. Blood sample were taken from healthy subject and thrombi of 3 and 6 hours old were performed, with a constant volume for each test. Thromboaspirations were performed with an Export(®) catheter (Medtronic). The primary endpoint was total thrombectomy. A total of 240 thromboaspirations were performed. RESULTS: A total thrombectomy was obtained for 71.2% of the tests. It was achieved more frequently with the smaller diameter, respectively: 100% for 2 mm, 81.3% for 2.6 mm, 89.6% for 3 mm vs 54.2% for 3.6 mm and 31.3% for 4 mm (P<0.001). No differences were observed between the 2 thrombi ages (73.3% for the 3 hours old thrombi and 69.2% for the 6 hours old thrombi, P = 0.476), nor between the three tube's angulations (77.5% for no angle, 66.3% for 90° and 70.0% for 120°, P = 0.278). RESULTS AND CONCLUSION: This study shows an impact of the coronary diameters on the rate of thromboaspiration success with an Export(®) catheter. Beyond 3 mm of diameter, the rate of success is divided by 2: for diameters less or equal to 3 mm, 90.3% of success vs 42.7% for diameters greater than 3 mm (P<0.001). There is no difference of efficiency between the 3 and 6 hours old thrombi, neither between the tube's angulations. However, this is a preliminary and further works are needed to clarify how to optimize the aspiration and the impact of other catheters.

[Risk profile in acute myocardial infarction: a necessary assessment for the population's comparisons]. / Le profil de risque dans l'infarctus du myocarde: une évaluation indispensable pour la comparaison des populations.

OBJECTIVE: The aim of this study is to show that differences of mortality, in acute myocardial infarction, observed between hospitals are not necessarily linked to a bad application of guidelines but can be linked to differences in the risk profile of the populations. METHODS: Two populations admitted for ST and non-ST elevation myocardial infarction in the same region in 2006 were compared: the population of Chalon-sur-Saône's hospital with a standard population from the observatoire des Infarctus de Côte d'Or (RICO). The risk profile of the two populations has been realised with the risk scores GRACE, EMMACE and the Simple Risk Index (SRI). RESULTS: The three scores are applicable for our populations according to the "C statistic". Moreover, there is a significant difference of in-hospital mortality between Chalon-sur-Saône and RICO. But, the population of Chalon-sur-Saône presents a higher risk. Finally, in-hospital rate mortality expected by the three scores is not different from the actual mortality. CONCLUSION: GRACE, EMMACE and SRI are valid scores for the comparison of risk profile of populations in acute myocardial infarction. Comparisons between hospitals are only possible after risk adjustment of the populations.

[Severe drug rash with eosinophilia and systemic symptoms after treatment with minocycline]. / Syndrome d'hypersensibilité médicamenteuse avec manifestations systémiques sévères après traitement par minocycline.

INTRODUCTION: Lung involvement is rarely observed in the DRESS syndrome (Drug rash with eosinophilia and systemic symptoms). We report here a severe minocycline induced hypersensitivity syndrome with initial respiratory distress. CASE REPORT: A 19 year old man was admitted to the intensive care unit for acute respiratory distress with fever (400C), lymph node enlargement, hepatomegaly, splenomegaly and eosinophilia (1640/mm3). Bilateral alveolar opacities were observed on the chest x-ray. Sedation and mechanical ventilation rapidly became necessary because of severe hypoxaemia (47 mm Hg) and the sudden onset of severe aggressive behaviour. The diagnosis of DRESS was immediately suspected as the patient had been treated for acne with minocycline for 28 days, and IV corticosteroids (2 mmg/kg/day) were initiated. Skin lesions were delayed and appeared 3 days later. The outcome was uncertain for the following 6 weeks with serious disturbance of hepatic and renal function. Serology for human herpes virus (HHV6) was initially negative but became positive. One year later, after progressive withdrawal of corticosteroid therapy, the patient had made a complete recovery with no sequelae. CONCLUSION: The DRESS syndrome can cause considerable morbidity with multiple, severe visceral functional disturbances. Respiratory physicians should be aware of this syndrome as lung involvement can be serious and may precede cutaneous symptoms.

[Heart and freezer: about one case of hypereosinophilia and coronary spasm]. / Coeur et congélateur: a propos d'un cas d'hyperéosinophilie et de spasme coronaire.

We report the case of a 41-year-old woman, non-smoker, without cardiovascular risk, hospitalised for acute ST elevation myocardial infarction. The coronarography showed no significant coronary stenosis and a methylergometrine test performed was positive. After the discovery of a moderate chronic hypereosinophilia, a review of the literature about eosinophile and coronary pathology was realised in order to make a link between hypereosinophilia and coronary spasm.

[Prevalence of obesity amount elementary school children in Grenoble]. / Prévalence de l'obésité chez les enfants scolarisés en école primaire à Grenoble.

Facing the growing increase of childhood obesity in France, the Grenoble Municipal School Health Service wanted to evaluate the importance of this phenomenon present among elementary school children in the area. A descriptive, cross-sectional and retrospective survey was conducted during the 2000/2001 academic year among a group of 1361 children born in 1990. The Quetelet Index was utilized to measure the level of being overweight, and the breaking point levels for being overweight and obese were defined according to new international standards. The prevalence of obesity is approximately 3% (2.7% in girls and 2.9% in boys) and remains constant from nursery school to elementary school. Nearly 35% of obese children in nursery school remain obese at the end of elementary school. Overweight prevalence is at its highest and increases significantly from nursery school (8.3%) through elementary school (14%). The study further revealed that girls aged 10-12 who did not pass and were held back from the next grade are five times more at risk of obesity than those who pass. The Municipal School Health Service has a critical role to play in the prevention of childhood obesity and its early screening and detection.

[A complication of peritoneojugular shunt for ascites: peritoneal migration of the shunt tubing]. / Une complication de la dérivation péritonéo-jugulaire pour ascite: la migration intrapéritonéale de la prothèse.

A peritoneojugular shunt operation was done in a cirrhotic patient with ascites. The Le Veen valve functioned correctly for six months. The patient then experienced recurrence of ascites following an uncommon complication: migration of the shunt tubing into the peritoneal cavity. The tubing could no longer be felt in the cervical or thoracic regions. Plain roentgenograms of the abdomen showed that the shunt tubing was in the peritoneal cavity.