Dietary patterns and fatty acids levels of three European populations. Results from the IMMIDIET study.

BACKGROUND AND AIMS: Differences in blood fatty acids (FAs) profile among populations with different lifestyle have partly been attributed to differences in food intake. A holistic approach in dietary guidance through dietary patterns is essential. This study aimed at evaluating the main plasma and red blood cell (RBC) FAs in three European populations and assessing the role of dietary patterns in explaining variation in their levels. METHODS: In the framework of the IMMIDIET Project, 1604 subjects (802 male-female pairs) aged 26-65 years were enrolled in Italy, Belgium and UK. Plasma and RBC FAs were measured. One year recall food frequency questionnaires were used to evaluate dietary habits of each individual. RESULTS: Italian cohort showed lower plasma and RBC n-3 levels than participants of the other two populations (P<0.001). Both plasma and RBC arachidonic acid were higher in Italian cohort as compared to Belgian and English. Reduced rank regression analysis indicated two dietary patterns explaining 35% and 17% of the total variation of the sum of plasma and RBC n-3, respectively. In a holistic dietary analysis, neither fish nor mollusks intake seemed to contribute to n-3 variation as compared to vegetable oils and polyphenol-rich foods. CONCLUSION: The Italian cohort presented significant lower plasma and RBC n-3 FA levels compared to Belgians and English. A holistic approach in dietary analysis seemed to explain a relatively high proportion of plasma and RBC n-3 FAs variability. Dietary pattern analysis may contribute to the study of the association of human diet with FAs levels.

Feasibility and acceptability of HIV screening through the use of rapid tests by general practitioners in a Brussels area with a substantial African community.

OBJECTIVES: To assess:1) if HIV screening with rapid tests in neighbourhoods with a substantial African community is feasible and acceptable among GPs and patients; 2) HIV seroprevalence. METHODS: Multicenter prospective study with 10 trained physicians. Use of HIV standard test and INSTI Ultrarapid test. INCLUSION CRITERIA: MSM, sex worker, multiple sexual partners, having returned or coming from a country with high HIV prevalence, IVDU, Indicator conditions as defined by HIV Indicator Diseases across Europe Study, having an AIDS-defining illness, having had a recent pregnancy or abortion; or presenting other risks. RESULTS: From August 2010 to August 2011, 10 trained GPs offered an HIV test to 224 patients: 51% ♀, 48% ♂, 43% Caucasians, 45% Africans. INCLUSION CRITERIA: 32% "high risk group", 9% returning from an endemic country, 29% with an indicator condition; 12 patients (6%) refused the standard test. The INSTI was offered to 217(97%), 197 performed with 2 reactive rapid tests confirmed. The seroprevalence according to ethnic origin was 0% among Caucasians and 2.2% among Africans and was 1.5% among patients with an indicator condition. 1087 consecutive consultations of the same GPs were recorded: 42% patients had ≥ 1 inclusion criteria among which 41% of offered tests, that is to say 59% of "missed opportunities". The reasons for not offering the test as recorded for 55% of patients:"not indicated" 44.5%, "no time" 33%, "impossible to propose" 15%, test completed previously 11%, known HIV-positive 4%. CONCLUSIONS: Standard and rapid tests are well received by patients but were usually not offered by doctors who have been trained.

Plasma n-6 and n-3 polyunsaturated fatty acids as biomarkers of their dietary intakes: a cross-sectional study within a cohort of middle-aged French men and women.

OBJECTIVE: To measure the correlations between habitual intakes of individual n-6 and n-3 polyunsaturated fatty acids (PUFA) and their percentages in total plasma fatty acids in a population of adult men and women. SUBJECTS/METHODS: Two hundred and seventy-six men and 257 women aged 45-60 (men) or 35-60 (women) at baseline, volunteers of the French SU.VI.MAX cohort. Fifteen 24-h record questionnaires were used to estimate the habitual intake of energy, total fat and linoleic, alpha-linolenic acid, arachidonic, eicosapentaenoic (EPA), n-3 docosapentaenoic (DPA) and docosahexaenoic (DHA) acids. Fatty acid composition of fasting plasma total lipids has been determined at baseline. RESULTS: Dietary intakes of linoleic acid, arachidonic acid, EPA and DHA were weakly but significantly correlated (0.16

Determination of ethephon residues in water by gas chromatography with cubic mass spectrometry after ion-exchange purification and derivatisation with N-(tert-butyldimethylsilyl)-N-methyltrifluoroacetamide.

An analytical method has been developed for the determination of residues of ethephon (2-chloroethyl phosphonic acid) in drinking and surface water. The procedure is based on de-ionisation with an anion/cation-exchange resin, solid phase extraction by means of anion-exchange polystyrene-divinylbenzene extraction disks, elution with a mixture of methanol and 10 M hydrochloric acid (98/2, v/v), redisolution into acetonitrile after evaporation and silylation with N-(tert-butyldimethylsilyl)-N-methyltrifluoroacetamide (MTBSTFA). Quantification is performed by gas chromatography with ion-trap cubic mass spectrometric detection in the electron impact mode (GC-EI-MS3). Method validation was conducted using samples of mineral, tap, and river water that were fortified with ethephon at concentration levels ranging from 0.1 to 1.0 microg/L. The mean recovery from all the fortified samples (n = 36) amounted to 88% with a relative standard deviation of 17%. The method, therefore, was shown to allow accurate determination of ethephon residues in drinking and surface water with a limit of quantification of 0.1 microg/L.

Ratio of triglycerides to HDL cholesterol is an indicator of LDL particle size in patients with type 2 diabetes and normal HDL cholesterol levels.

OBJECTIVE: In patients with type 2 diabetes, a normal HDL cholesterol level does not rule out that LDL particles may be small. Although techniques for analyzing LDL subfractions are not likely to be used in clinical practice, a prediction of LDL size based on a regular lipid profile may be useful for assessment of cardiovascular risk. RESEARCH DESIGN AND METHODS: Sixty patients with type 2 diabetes with acceptable glycemic control and an HDL cholesterol level > or = 1 mmol/l were recruited after cessation of lipid-altering treatments. LDL size was determined by 2-20% PAGE; patients having small LDL (n = 30) were compared with those having intermediate or large LDL (n = 30). RESULTS: Clinical characteristics, pharmacological therapies, lifestyle, and prevalence of diabetes-related complications were similar in both patient groups. LDL size correlated negatively with plasma triglycerides (TGs) (R2 = 0.52) and positively with HDL cholesterol (R2 = 0.14). However, an inverse correlation between the TG-to-HDL cholesterol molar ratio and LDL size was even stronger (R2 = 0.59). The ratio was > 1.33 in 90% of the patients with small LDL particles (95% CI 79.3-100) and 16.5% of those with larger LDL particles. A cutoff point of 1.33 for the TG-to-HDL cholesterol ratio distinguishes between patients having small LDL values better than TG cutoff of 1.70 and 1.45 mmol/l. CONCLUSIONS: The TG-to-HDL cholesterol ratio may be related to the processes involved in LDL size pathophysiology and relevant with regard to the risk of clinical vascular disease. It may be suitable for the selection of patients needing an earlier and aggressive treatment of lipid abnormalities.

Absence of both subunits of cytochrome b558 in the UM384 cell line relative to the inability to generate superoxide anions.

Phagocytic cells are characterized by their ability to generate superoxide anions upon activation by appropriate stimuli. UM384, a myelomonocytic cell line, was shown to be defective in this oxidase activity as measured by nitroblue tetrazolium or cytochrome c reduction. Cytochrome b558, a unique pigment present in phagocytes and implicated in electron transfer from NADPH to O2, was absent in the differentiated UM384 cells. Both subunits of the cytochrome b558 appeared to be absent or present in strongly reduced amounts compared to the mother cell line U937, as indicated by immunocytochemistry or Western blot analysis using monoclonal antibodies (MABs). On the other hand, cytosolic factors also involved in NADPH oxidase activity were shown to be present, either immunologically or by using the capacity of the cytosol to activate the oxidase in a membrane fraction from bovine neutrophils. At the molecular level, the mRNA that encodes the gp91-phox was shown to be absent in the differentiated UM384 cells, whereas the mRNA that encodes the p22-phox was normally expressed. These results suggest that the defect in superoxide production by the UM384 cells is related to the absence of cytochrome b558, a situation mimicking that observed in phagocytes from patients with X-linked chronic granulomatous disease (X-CGD).

Contribution of apolipoprotein(a) size, pentanucleotide TTTTA repeat and C/T(+93) polymorphisms of the apo(a) gene to regulation of lipoprotein(a) plasma levels in a population of young European Caucasians.

Several studies indicate that the inter-individual variation in plasma concentrations of lipoprotein(a) (Lp(a)) is mainly under genetic control. To define the effect of three DNA polymorphisms on apolipoprotein(a) (apo(a)) expression, we have determined plasma Lp(a) concentrations, apo(a) isoform size, KpnI allele size, the TTTTA pentanucleotide repeat number in the 5' control region of the apo(a) gene and the +93 C/T polymorphism in a European Caucasian population. The simultaneous determination of the kringle 4 (K4) number by genotyping and by phenotyping revealed that the size distribution of non-expressed apo(a) alleles was markedly skewed towards alleles with greater than 25 K4 repeats. This is consistent with the inverse relationship frequently described between the kringle 4 number and the plasma Lp(a) level. Apportioning the Lp(a) concentration from the surface of the peaks on apo(a) phenotyping blots, we have observed that the Lp(a) plasma concentration associated with alleles having more than 25 K4 units does not exceed 400 mg/l, whereas the range of Lp(a) concentrations associated with smaller alleles was broad, from 0 to more than 1000 mg/l. It can thus be concluded that the number of K4 repeats is the main determinant of Lp(a) concentration when this number is more than 25, whereas other polymorphisms may be involved in the alleles with fewer than 26 K4. Analyses of the TTTTA repeat number and of the +93 C/T polymorphism were performed in subjects with KpnI alleles of the same length: low Lp(a) concentrations were shown to be preferentially associated with the presence of apo(a) alleles with more than eight pentanucleotide repeats while no association was revealed between Lp(a) plasma levels and the C/T polymorphism. These results demonstrate that the (TTTTA)(n) polymorphism affects the Lp(a) expression independently of apo(a) size polymorphism.

Evaluation of the genotyping and phenotyping approaches in the investigation of apolipoprotein (a) size polymorphism.

Apoprotein (a) size polymorphism was evaluated at the genotypic and phenotypic level in 110 individuals. Both methods were well correlated with respect to size (r = 0.971), providing that the protein size was expressed as a number of kringle 4 repeats. Despite the fact that the immunoblotting method used was sensitive enough to detect less than 1 ng of lipoprotein (a), 62 samples had single-band phenotypes and one sample had no detectable band, whereas only seven samples had single-band genotypes. The mean size of the alleles coding for the undetected isoforms was significantly larger (141 kb) than for the detected isoforms (123 kb), corroborating the earlier finding of an inverse relationship between the size and the plasma expression level of apoprotein (a). Furthermore, increasing detectability was achieved by loading the gel with different amounts of plasma for each sample. Our results indicate that genotyping is more resolving and more sensitive, but requires a more specialized technology. Phenotyping was carried out using commercially available reagents.

Selenium determination in human plasma lipoprotein fractions by mass spectrometry analysis.

Previous observations have suggested that lipoproteins may be involved in the transport of selenium in humans. To further investigate this question, selenium was measured in lipoprotein fractions isolated from plasma of healthy adults. A gas chromatographic-mass spectrometric method using the isotopic dilution technique was developed to ensure a reliable measurement of low amounts of selenium. About 3% of total plasma selenium was bound to lipoproteins, mainly to the LDL fraction. After solvent fractionation of LDL and HDL, the major part of the selenium was recovered in the protein extract, suggesting that it may be incorporated in apolipoproteins. The exact form of Se is not yet clearly established. Considering the different Se compounds found in proteins, it is postulated to be selenomethionine, and/or participating in a selenium-sulphur bond. This could explain why the amount of selenium bound to apolipoprotein B in LDL was about twice that which could be expected from a random substitution of selenomethionine for methionine.

Effect of increased fruit and vegetable intake on the susceptibility of lipoprotein to oxidation in smokers.

OBJECTIVE: To evaluate the effect of an increased dietary intake of fruit and vegetables on susceptibility of LDL to oxidation in smokers and nonsmokers. DESIGN: A descriptive and prospective study. SETTING: Joseph Fourier University, Grenoble. SUBJECTS: Volunteers were age and sex matched in the smoking and nonsmoking groups and were recruited by announcement. INTERVENTIONS: Increased intake of fruits and vegetables for two weeks providing 30 mg/day of carotenoids. MAIN OUTCOME MEASURES: Circulating levels of beta-carotene, lutein, lycopene, alpha-tocopherol; susceptibility of LDL to oxidation. Cu-Zn superoxide dismutase (Cu-Zn SOD), and Se glutathione peroxidase (Se-GSH-Px) activities and reduced (GSH) and oxidized (GSSG) glutathione. RESULTS: At entry (week 0: W0) smokers exhibited a lower plasma carotene level but the plasma parameters of oxidative stress and LDL oxidizability were not different from nonsmokers. After two weeks of increased intake of fruits and vegetables the circulating levels of carotenoids increased in smokers 23% and 11% in nonsmokers. At the same time the resistance of LDL to oxidation increased by 14% in smokers (P < or = 0.05) and by 28% in nonsmokers (P < or = 0.025). The mean whole blood GSH level was higher in smokers at entry but returned to a concentration similar to nonsmokers at the end of the study. CONCLUSION: This pilot study indicates that an increased, carotenoid rich food intake through its inhibitory effect on the susceptibility of LDL to oxidation may be an interesting approach to reduce the risk of atherosclerosis both in smokers and nonsmokers.

Effects of two low-dose oral contraceptives containing ethinylestradiol and either desogestrel or levonorgestrel on serum lipids and lipoproteins with particular regard to LDL size.

This study was designed to determine the effects of two low-dose oral contraceptives, most frequently given in our area, monophasic desogestrel/ethinylestradiol (DG/EE) and triphasic levonorgestrel/ethinylestradiol (LNG/EE), on lipoprotein parameters, especially LDL particle size and HDL subclass distribution (determined by lipid-stained 2%-20% polyacrylamide gradient gel electrophoresis) in 37 healthy normolipidemic women aged 19 to 27 years. Lipid and lipoprotein parameters were measured before the start of treatment and in the third month of oral contraceptive use. Results reflected the estrogen-progestin balance. As compared with baseline values, with both formulations, plasma total cholesterol, phospholipids, and HDL3 cholesterol increased, and LDL-predominant peak size decreased, with a translation of LDL pattern A towards pattern I. With DG/EE, plasma triglycerides, apolipoproteins AI and B increased. With LNG/EE, LDL cholesterol increased, and HDL2 cholesterol decreased. All these modifications were moderate, within threshold limits. Estrogen-dominant monophasic DG/EE appears to be more favorable than progestin-dominant triphasic LNG/EE, since the reduction in LDL-predominant peak size is not associated with an increase in LDL cholesterol or with a decrease in HDL2 cholesterol.

[Apolipoprotein (a) isoform size determination. Value and limits of high resolution phenotyping by agarose gel electrophoresis]. / Détermination de la taille des isoformes de l'apolipoprotéine (a). Intérêts et limites du phénotypage par électrophorèse en gel d'agarose à haute résolution.

High-resolution methods using agarose gel electrophoresis followed by immunoblotting have been recently developed for the measurement of the apolipoprotein (a) size isoforms. Despite the high sensitivity of these methods, a variable proportion of isoforms remain undetected. Four primary antibodies were compared for their ability to detect a large number of isoforms, and were found to express equal reactivity irrespective of the apo (a) size. Comparison of the data obtained both by phenotyping and by genotyping led to the identification of 15 artefactual bands. All these nonspecific bands were of low intensity and occurred when more than 50 ng of Lp (a) were loaded on the gel. The visualization of the isoforms was performed by labelling apo (a) with a peroxidase conjugated antibody coupled to a luminescent substrate, thereby allowing quantification of the relative expression of each isoform by densitometry. There is currently no standardized nomenclature for the apo (a) isoforms: a procedure is proposed using a commercially available standard to express the results in kringle number.

[Plasma apolipoproteins AI and B: reference values in the Isère population and determination of individual values]. / Apolipoprotéines AI et B plasmatiques: valeurs usuelles de la population de l'lsère et détermination de valeurs seuil.

Reference ranges for apolipoprotein AI and B plasma concentrations were established in a population of unrelated apparently healthy volunteers (138 men and 186 women) living in the region of Grenoble. Apolipoproteins were measured using an immunoturbidimetric assay on a Cobas Fara II analyzer, with reagents and IFCC standardized calibrators from Orion. Apolipoprotein AI mean concentration was higher in women than in men and increased with age in both men and women older than 45. Apolipoprotein B mean concentration was higher in men and increased linearly with age in both sexes. Linear regression analysis was used to determine desirable and high risk values for apolipoproteins AI and B from the guidelines developed by the National Cholesterol Education Program for HDL cholesterol and LDL cholesterol, respectively. Our data indicate that an apolipoprotein AI value of 1.05 g/l is comparable to an HDL cholesterol value of 0.35 g/l. The apolipoprotein B cutpoints of 1.15 g/l for men and 1.05 g/l for women correspond to the accepted LDL cholesterol cutpoint of 1.60 g/l.

[Effects of oral contraceptive preparations and smoking on lipoprotein repartition]. / Effets de la contraception orale et du tabac sur la répartition des lipoprotéines.

We studied the effect of oral contraceptives and smoking on the lipid profile of 251 women and 72 men, 20-29-year-old. In women, taking estroprogestatives, cholesterol, triglycerides, apoproteins AI and B were higher than in controls; HDL-cholesterol was not modified. Lipoprotein analyses in polyacrylamide gradient gel exhibited an increase of the HDL3 fraction at the expense of the HDL2 fraction, with a reduced LDL size. Smoking in addition to estroprogestative absorption accentuated these modifications and led to a decreased HDL-cholesterol (HDL2 fraction essentially), with an increased LDL-cholesterol. In men, smoking resulted in higher levels of total cholesterol, apoprotein B and LDL-cholesterol, without any significant change in LDL size, higher levels of triglycerides and lower level of the HDL2 fraction without any change in HDL-cholesterol. In women, smoking led only to an increase in triglycerides. In summary, analysis of the distribution of HDL subclasses and of LDL size showed an evolution towards a supposed more atherogenic lipid profile in women taking oral contraceptives associated or not with smoking, and in male smokers.

[Comparative study of two methods permitting the detection of macroamylases. Application to the evaluation of macroamylasemia in a hospitalized population]. / Etude comparative de deux méthodes permettant la détection de macroamylases. Application à l'évaluation d'une macroamylasémie dans une population hospitalière.

It is of great importance to be able to distinguish hyperamylasemia linked to a pathological condition of the pancreas from one due to the presence of the macroamylase in the serum of the patient. We have evaluated both gel filtration chromatography and precipitation by PEG-6000 for the detection of serum macroamylase. Our study has enabled us to define a simple detection protocol, suitable for routine laboratory use. In this protocol, macroamylasemia is detected initially by precipitation with PEG-6000; if less than 60% of amylase activity is precipitated, there is no macroamylasemia. If more than 60% of amylase activity can be precipitated by PEG-6000, macroamylasemia is confirmed by gel filtration chromatography. The incidence of macroamylasemia in hospitalized patients was studied; it was 1.3% in cases where amylasemia was normal, and 4.5% in hyperamylasemic patients.

[Treatment of a septic patient with acquired haemophilia]. / Traitement d'une hémophilie acquise chez un patient septique.

INTRODUCTION: Acquired haemophilia is a rare bleeding diathesis caused by auto-immune depletion of factor VIII. It is characterised by spontaneous haemorrhagic syndrome, which can be fatal sometimes. EXEGESIS: A 71 year-old man presents in a dysimmunitary context (rheumatoid arthritis complicates by an acquired haemophilia) a septicemia with a methicillin resistant staphylococcus aureus. At the time of the hospitalization, the patient is febrile (39 degrees C). The activated partial thromboplastin time is very much increased, the level of factor VIII is lowered by 7% and the title of the inhibitor to factor VIII amounts to 140 Bethesda unities. An haematoma of the right root thigh is also noted. In that case, the concomitant presence of septicemia makes difficult the use of immunosuppressive therapy usually recommended to decrease auto-antibody's level. For the management of the septicemia, an adapted antibiotherapy (vancomycin then teicoplanin) is organized to J1. To control haemorrhagic risk, immunoglobulins are prescribed from d12 to d16, without immediate results. Then prednisone is introduced. We observe a very fast decrease of the anticoagulant circulating title with a neat improvement of the clinical state, allowing so to realize a draining puncture of the psoas. This invasive investigation required the use of prothrombinic complex concentrates ((Feiba) in the dose of 80 UI/kg two to three times a day). Biopsy does not show infection source. CONCLUSION: The infection delayed the prescription of immunosuppressive therapy and the surgery. Use of corticoids, following 5 days of intravenous polyvalent immunoglobulin, was the good choice. After 7 weeks of hospitalization the patient has recovered a normal haemostasis results, and a good general state.

[Physiopathological and anatomo-clinical study of peritoneal irrigation in generalized acute peritonitis]. / Etude physiopathologique et anatomo-clinique de l'irrigation péritonéale dans les péritonites aiguës généralisées

The objects of peritoneal wash-out and the conditions of its efficacy in acute generalised peritonitis were first defined. The authors then report the results of their physio-pathological research. The rules of intra-peritoneal wash-out then laid down. They suggest a method of wash-out perfectly adapted to the infected peritoneum. Study of the washings provides valuable information. The appearance, bacteriology and rate of wash-out, lead one to define criteria of prognosis which are useful and reliable for later treatment. These criteria may be grouped in a triad which are of value in addition to the clinical signs. The pathological consequences are then discussed. In the immediate post-operative period, there is no noxious effect on intestinal sutures, which can be attributed to the wash-out in this series of 20 cases. In the long-term, the absence of adhesions with restitutio ad integrum of the peritoneal cavity, was noted in 4 patients, and verified later by operation. The physiopathological basis and criteria of efficacy suggest that peritoneal wash-out should be used more often in modern treatment.

Evaluation of LOCI technology-based thyroid blood tests on the Dimension Vista analyzer.

OBJECTIVES: To assess the performance of thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) determinations by luminescent oxygen channeling immunoassay (LOCI) technology on the Dimension Vista analyzer (Siemens Healthcare Diagnostics). DESIGN & METHODS: We assessed 1) functional sensitivity for TSH (FSe-TSH), and intra- and inter-assay variations for TSH, FT4 and FT3 on Vista; 2) comparisons of serum and heparin-treated plasma on Vista; 3) comparisons of a) plasma TSH by Vista versus electrochemiluminescence (ECLIA) on Roche Modular analyzer, and b) plasma FT4 and FT3 by Vista versus Immunotech-Beckman radioimmunoassay (RIA); and 4) association of albumin and prealbumin levels with free thyroid hormone concentrations on Vista. RESULTS: 1) FSe-TSH concentration was below 0.005 mIU/L. Maximum intra-assay CVs (2.1%, 1.4%, 5.2%) and inter-assay CVs (16.5%, 5.1%, 5.8%) were good for TSH, FT4 and FT3 respectively. 2) Heparin-treated plasma samples consistently gave slightly higher values than serum for TSH, FT4 and FT3. 3) Passing-Bablok regression gave: TSH: [LOCI]=0.91[ECLIA]-0.08 (concordance correlation coefficient ρ(c)=0.95); FT4: [LOCI]=1.05[RIA]-1.55 (ρ(c)=0.80); and FT3: [LOCI]=1.05[RIA]-0.06 (ρ(c)=0.81). 4) Both serum albumin and prealbumin concentrations were positively associated with FT3 levels and negatively associated with FT4 levels in patients. CONCLUSION: LOCI is accurate for TSH, FT4 and FT3 analysis. Despite a slight significant bias compared to ECLIA, LOCI is precise for TSH and fulfills the third-generation criteria. However, the poor concordance between LOCI and RIA for FT4 and FT3, and the dependence of these hormones on binding proteins require further investigation.

Sex-related differences in peri- and post-ablation clinical data for patients with atrial flutter.

UNLABELLED: Sex-related differences were not reported for the atrial flutter (AF). The purpose of the study was to look for the influence of gender on indications, clinical data and long-term results of AFl ablation. METHODS: 985 patients, [227 females (23%)] were referred for radiofrequency AFl ablation. Clinical history, echocardiography were collected. Patients were followed from 3 months to 10 years. RESULTS: Age of women and men was similar (65.5 ± 12 vs 64 ± 11.5 years). Underlying heart disease (HD) was as frequent in women as men (77.5 vs 77%), but women had more congenital HD (10 vs 2%;p<0.001), valvular HD (18 vs 10%;p<0.002), hypertensive HD (24 vs 18%;p<0.05), and less chronic lung disease (5 vs 10%;p<0.01), and ischemic HD (5 vs 20%;p<0.001). Atrial fibrillation (AF) history was more frequent in women (36 vs 27%;p<0.001). AFl-related tachycardiomyopathy (4.5 vs 8%;p<0.03) was more frequent, but 1/1 AFl (10 vs 6%;p=NS) as frequent. Failure of ablation (16 vs 10%;p<0.01), ablation-related major complications (3.5 vs 0.9%;p<0.005) were more frequent in women. After 3 ± 3 years, AFl recurrences were as frequent in women and men (10 vs 14%), AF occurrence more frequent in women (34 vs 19.5%; p<0.001). After excluding patients with previous AF, AF risk remained higher in women (19 vs 12%; p<0.004). CONCLUSIONS: In patients admitted for ablation, AFL was less common in women than in men, despite similar age and similarly prevalent HD. More than men, women had frequent AF history, a higher risk of failure of ablation and AFl ablation-related major complications and a higher risk of AF after ablation.

[Pharmacotherapy of children with depressive disorders]. / Traitement psychotrope à long terme dans les dépressions de l'enfant.

Many reviews exist about the use of psychotropic in children with depression (American academy of child and adolescent psychiatry en 2007 [Aacap] 2007, Food and drug administration [FDA] 2004, Afssaps 2008). Antidepressants are the most important long-term treatment: only fluoxetine has been effective and is authorised in France since August 2006. The risk of suicidality and sexual maturation alteration need to be control. Psychotherapy is needed to involve efficacy and tolerability treatment. Other IRS and IRSNA are used, but another study must be conducted in currently practice condition.