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Saint-Denis-d'Oléron, France

Le Garff E.,Lille University Hospital Center | Delannoy Y.,Lille University Hospital Center | Mesli V.,Lille University Hospital Center | Berthezene J.M.,Center Hospitalier Regional Felix Guyon | And 2 more authors.
American Journal of Forensic Medicine and Pathology

Firearm suicides are frequent and well described in the forensic literature, particularly in Europe and the United States. However, the use of homemade and improvised firearms is less well described. The present case reports a suicide with an original improvised gun created using an air-compressed pellet gun and a dumbbell pipe. The aims of this study were to describe the scene, the external examination of the corpse, the body scan, and the autopsy; to understand the mechanism of death; and to compare the results with a review of the forensic literature to highlight the epidemiology of homemade firearm use, the tools used for homemade and improvised firearms in suicides versus homicides, and the manners in which homemade firearms are used (homicide or suicide, particularly in complex suicide cases). © 2015 Wolters Kluwer Health, Inc. All rights reserved. Source

Ravanan P.,University of Reunion Island | Harry G.J.,U.S. National Institutes of Health | Awada R.,University of Reunion Island | Hoareau L.,University of Reunion Island | And 3 more authors.

Objective: White adipose tissue (WAT) is now considered a defined tissue capable of interactions with other organ systems. WAT role in elevating the level of systemic chronic inflammation suggests that alterations in this tissue as the result of disease or environmental factors may influence the development and progression of various obesity-related pathologies. This study investigated WAT cell-specific responses to an organometal compound, trimethyltin (TMT), to determine possible contribution to induced inflammation. Methods: Human primary mature adipocytes and macrophage differentiated THP-1 cells were cultured in TMT presence and relative toxicities and different adipokine levels were determined. The inflammatory response was examined in TMT presence for primary cells from obese ob/ob mice WAT, and after TMT injection in ob/ob mice. Results: Both adipocytes and macrophages were resistant to cell death induced by TMT. However, adipocytes cultured in TMT presence showed increased expression of TNFα and IL-6, and modified leptin levels. In macrophage cultures, TMT also increased TNFα and IL-6, while MCP-1 and MIP-1α were decreased. In vivo, a single injection of TMT in ob/ob mice, elevated TNFα, MIP-1α and adiponectin in WAT. Conclusions: Elevation of the inflammatory related products can be induced by chemical exposure in adipocytes and macrophages, as well as murine WAT. These data suggest that numerous factors, including a systemic chemical exposure, can induce an inflammatory response from the WAT. Furthermore, when characterizing both chemical-induced toxicity and the progression of the chronic inflammation associated with elevated WAT content, such responses in this target tissue should be taken into consideration. © 2010 Elsevier Ltd. Source

Fayeulle S.,Center Hospitalier Regional Felix Guyon | Renou F.,Center Hospitalier Regional Felix Guyon | Protais E.,Center Hospitalier Regional Of Lille | Hedouin V.,Lille University Hospital Center | And 2 more authors.
Presse Medicale

Introduction: Entering prison can feed pre-existent behavior of demands or generate them. Several means of expression are then used. Hunger strike is an average privileged act. It belongs to prison culture. Objective: Estimate how practitioners working in prison take care of the hunger strikers. Methodology: The study, realised in 2008, was led with all the Units of Consultations and Ambulatory Care in France. It is a declarative investigation where a medical testimony by unit was asked. Results: From 174 " maisons d'arrêt" and establishments for punishment in France, 95 answers were obtained. This situation was already seen by 98,8% of the doctors. The motives for hunger strike were mainly judicial for " maisons d'arrêt" (70,1%) and prison motives for detention centers (68,7%). Mainly, doctors opted for a neutral attitude (63% of the cases). The hunger strikes were mostly brief (less than a week in 85% of the cases). Only 5,5% of the doctors proposed written information concerning the risks incurred during a fast. A doctor in 4 approximately (23%) was already witness to complications due to fasting. The fact that a patient may refuse care makes the medical approach difficult. Faced with such a situation, 45% of the doctors privileged their duty of care, 28% respected the patient's wishes, and 27% did not pronounce. From a therapeutic point of view, the place of treatment using vitamins was rarely recognized (32,7%). Discussion: Hunger strike is rarely severe, but it is rather frequent in prison so that every doctor working there will be confronted with it. The refeeding syndrome seems often ignored. The coverage of hunger strike is governed by the law, but ethical questions stay in the appreciation of every doctor. © 2010 Elsevier Masson SAS. Source

Gribouval O.,University of Paris Descartes | Pawtowski A.,AP HP | Arrondel C.,University of Paris Descartes | Sallinen S.-L.,University of Tampere | And 49 more authors.
Human Mutation

Autosomal recessive renal tubular dysgenesis (RTD) is a severe disorder of renal tubular development characterized by early onset and persistent fetal anuria leading to oligohydramnios and the Potter sequence, associated with skull ossification defects. Early death occurs in most cases from anuria, pulmonary hypoplasia, and refractory arterial hypotension. The disease is linked to mutations in the genes encoding several components of the renin-angiotensin system (RAS): AGT (angiotensinogen), REN (renin), ACE (angiotensin-converting enzyme), and AGTR1 (angiotensin II receptor type 1). Here, we review the series of 54 distinct mutations identified in 48 unrelated families. Most of them are novel and ACE mutations are the most frequent, observed in two-thirds of families (64.6%). The severity of the clinical course was similar whatever the mutated gene, which underlines the importance of a functional RAS in the maintenance of blood pressure and renal blood flow during the life of a human fetus. Renal hypoperfusion, whether genetic or secondary to a variety of diseases, precludes the normal development/ differentiation of proximal tubules. The identification of the disease on the basis of precise clinical and histological analyses and the characterization of the genetic defects allow genetic counseling and early prenatal diagnosis. © 2011 Wiley Periodicals, Inc. Source

Leroy S.,Necker Hospital | Leroy S.,University of Paris Descartes | Leroy S.,University of Oxford | Moshous D.,Necker Hospital | And 31 more authors.

Childhood multicentric Castleman disease (MCD) is a rare and unexplained lymphoproliferative disorder. We report a human herpesvirus- 8 (HHV-8)-infected child, born to consanguineous Comorian parents, who displayed isolated MCD in the absence of any known immunodeficiency. We also systematically review the clinical features of the 32 children previously reported with isolated and unexplained MCD. The characteristics of this patient and the geographic areas of origin of most previous cases suggest that pediatric MCD is associated with HHV-8 infection. Moreover, as previously suggested for Kaposi sarcoma, MCD in childhood may result from inborn errors of immunity to HHV-8 infection. Copyright © 2012 by the American Academy of Pediatrics. Source

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