CHRU Brest

Brest, France

CHRU Brest

Brest, France
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PubMed | University of Nantes, EA 938 LSOL, Chru Brest, EA 4324 ORPHY and LIMATB
Type: | Journal: Atherosclerosis | Year: 2016

Statins are prescribed for their preventative effects within atherosclerosis development. To our knowledge, no study focusing on very low-dose (non-hypolipidemic effect) and long-term atorvastatin treatment invivo was available. Our aim was to assess the effect of such atorvastatin treatment on the mechanical and functional characteristics of arteries in the context of primary prevention.An atorvastatin treatment (2.5mg/kg/day) was tested against controls on 34 male 3 to 12 month-old WHHL rabbits. No effect on total cholesterol, triglycerides, HDL or LDL was observed. The arterial stiffness was evaluated on vigil animals by pulse wave velocity (PWV) measurement. Then, invitro measurements were made to evaluate (1) the endothelial and vascular smooth muscle function, (2) the elasticity of the arterial wall and (3) the composition in collagen and elastin in the aorta.The PWV increasing observed with age in control group was canceled by treatment, creating a significance difference between groups at 12 months (5.170.50 vs 2.140.34ms(-1) in control and treated groups respectively). Vasoreactivity modifications cant explain this result but maintain of elasticity with treatment in large arteries was confirm by a static tensile test. A first possible explanation is the change of wall composition with treatment, validated by the percentage of elastin at 12 months, 4.4% lower in the control group compared to the treated group (p<0.05).This study shows that a non-hypocholesterolemic statin treatment could improve vessel elasticity in the atherosclerotic WHHL model. The great novelty of this work is the vessel wall composition changing associated. This first approach in animal opens the reflection on the use of these low doses in humans. This could be interesting in the context of arterial stiffening with aging, non-hyperlipidemic atherosclerosis or with cholesterol reduce by another therapy or lifestyle modification.

Boisrame-Gastrin S.,University of Western Brittany | Boisrame-Gastrin S.,Brest University Hospital Center | Tande D.,University of Western Brittany | Munck M.,CHRU Brest | And 3 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2011

Objectives: Salmonella spp. are among the most frequently encountered bacterial pathogens in children adopted abroad, especially from developing countries. The aim of this study was to investigate the carriage of Salmonella in international adoptees over an 84 month period. This screening programme was initiated after serious infections occurred in adopted children. Material and methods: Stool samples taken at the first visit to the outpatient adoption practice and subsequently every month from children adopted from an orphanage in Bamako (Mali) and from all members of their adoptive families were screened for Salmonella. Bacteria were characterized by standard biochemical methods, serotyping, disc diffusion antibiograms and PFGE. β-Lactamase genes were sought by PCR. Results: Over the study period, 55 families that adopted 61 children from the state orphanage of Bamako were surveyed. Ninety-two Salmonella spp. were isolated from faecal samples from 30 families that had adopted a child. The isolates were all identified as Salmonella enterica of different serovars, Babelsberg and Enteritidis being the most prevalent. PFGE classified the Salmonella isolates into nine genotypic profiles matching with their serovar. Of the 41 non-duplicate isolates, 8 were susceptible to all tested antibiotics and 26 Salmonella isolates produced an extended-spectrum β-lactamase (ESBL). PCR and DNA sequencing revealed that all the ESBL-producing isolates harboured the bla TEM-1 gene, 21 isolates harboured in addition the bla SHV-12 gene and the 5 remaining isolates harboured the bla CTX-M-15 gene. Conclusions: International adoption may contribute to the global emergence and spread of multidrug-resistant Salmonella. © The Author 2011. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

Menn B.,Neurokin S.A. | Bach S.,French National Center for Scientific Research | Blevins T.L.,Efficacy Pharmacology MDS Pharma Services | Campbell M.,Efficacy Pharmacology MDS Pharma Services | And 2 more authors.
PLoS ONE | Year: 2010

Background: Although quite challenging, neuroprotective therapies in ischemic stroke remain an interesting strategy to counter mechanisms of ischemic injury and reduce brain tissue damage. Among potential neuroprotective drug, cyclin-dependent kinases (CDK) inhibitors represent interesting therapeutic candidates. Increasing evidence indisputably links cell cycle CDKs and CDK5 to the pathogenesis of stroke. Although recent studies have demonstrated promising neuroprotective efficacies of pharmacological CDK inhibitors in related animal models, none of them were however clinically relevant to human treatment. Methodology/Principal Findings: In the present study, we report that systemic delivery of (S)-roscovitine, a well known inhibitor of mitotic CDKs and CDK5, was neuroprotective in a dose-dependent manner in two models of focal ischemia, as recommended by STAIR guidelines. We show that (S)-roscovitine was able to cross the blood brain barrier. (S)-roscovitine significant in vivo positive effect remained when the compound was systemically administered 2 hrs after the insult. Moreover, we validate one of (S)-roscovitine in vivo target after ischemia. Cerebral increase of CDK5/p25 activity was observed 3 hrs after the insult and prevented by systemic (S)-roscovitine administration. Our results show therefore that roscovitine protects in vivo neurons possibly through CDK5 dependent mechanisms. Conclusions/Significance: Altogether, our data bring new evidences for the further development of pharmacological CDK inhibitors in stroke therapy. © 2010 Menn et al.

PubMed | University Pompeu Fabra, CHRU Brest, University of Granada, French Institute of Health and Medical Research and French National Center for Scientific Research
Type: | Journal: Physics in medicine and biology | Year: 2017

Prostate volume changes due to edema occurrence during transperineal permanent brachytherapy should be taken under consideration to ensure optimal dose delivery. Available edema models, based on prostate volume observations, face several limitations. Therefore, patient-specific models need to be developed to accurately account for the impact of edema. In this study we present a biomechanical model developed to reproduce edema resolution patterns documented in the literature. Using the biphasic mixture theory and Finite Element analysis, the proposed model takes into consideration the mechanical properties of the pubic area tissues in the evolution of prostate edema. The models computed deformations are incorporated in a Monte Carlo simulation to investigate their effect on post-operative dosimetry. The comparison of Day1 and Day30 dosimetry results demonstrates the capability of the proposed model for patient-specific dosimetry improvements, considering the edema dynamics. The proposed model shows excellent ability to reproduce previously described edema resolution patterns and was validated based on previous findings. According to our results, for a prostate volume increase of 10-20% the Day30 urethra D10 dose metric is higher by 4.2%-10.5% compared to the Day1 value. The introduction of the edema dynamics in Day30 dosimetry shows a significant global dose overestimation identified on the conventional static Day30 dosimetry. In conclusion, the proposed edema biomechanical model can improve the treatment planning of transperineal permanent brachytherapy accounting for post-implant dose alterations during the planning procedure.

Fangous M.-S.,CHRU Brest | Mougari F.,Laboratoire Associe | Mougari F.,University of Paris Pantheon Sorbonne | Gouriou S.,University of Western Brittany | And 8 more authors.
Journal of Clinical Microbiology | Year: 2014

Mycobacterium abscessus, as a species, has been increasingly implicated in respiratory infections, notably in cystic fibrosis patients. The species comprises 3 subspecies, which can be difficult to identify. Since they differ in antibiotic susceptibility and clinical relevance, developing a routine diagnostic tool discriminating Mycobacterium abscessus at the subspecies level is a real challenge. Forty-three Mycobacterium abscessus species isolates, previously identified by multilocus sequence typing, were analyzed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). A subspecies identification algorithm, based on five discriminating peaks, was drawn up and validated by blind identification of a further 49 strains, 94% of which (n = 46) were correctly identified. Two M. abscessus subsp. massiliense strains were misidentified as M. abscessus subsp. abscessus, and for 1 other strain identification failed. Inter- and intralaboratory reproducibility tests were conclusive. This study presents, for the first time, a classification algorithm for MALDI-TOF MS identification of the 3 M. abscessus subspecies. MALDI-TOF MS proved effective in discriminating within the M. abscessus species and might be easily integrated into the workflow of microbiology labs. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Quellec G.,French Institute of Health and Medical Research | Charriere K.,French Institute of Health and Medical Research | Lamard M.,Telecom Bretagne | Cochener B.,University of Western Brittany | Cazuguel G.,CHRU Brest
2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2014 | Year: 2014

Anterior eye segment surgeries are usually video-recorded. If we are able to efficiently analyze surgical videos in real-time, new decision support tools will emerge. The main anatomical landmarks in these videos are the pupil boundaries and the limbus, but segmenting them is challenging due to the variety of colors and textures in the pupil, the iris, the sclera and the lids. In this paper, we present a solution to reliably normalize the center and the scale in videos, without explicitly segmenting these landmarks. First, a robust solution to track the pupil center is presented: it uses the fact that the pupil boundaries, the limbus and the sclera / lid interface are concentric. Second, a solution to estimate the zoom level is presented: it relies on the illumination pattern reflected on the cornea. The proposed solution was assessed in a dataset of 186 real-live cataract surgery videos. The distance between the true and estimated pupil centers was equal to 8.0 ± 6.9% of the limbus radius. The correlation between the estimated zoom level and the true limbus size in images was high: R = 0.834. © 2014 IEEE.

Scotet V.,French Institute of Health and Medical Research | Dugueperoux I.,French Institute of Health and Medical Research | Audrezet M.-P.,French Institute of Health and Medical Research | Audrezet M.-P.,Laboratoire Of Genetique Moleculaire Drs Audrezet And Ferec | And 5 more authors.
American Journal of Obstetrics and Gynecology | Year: 2010

OBJECTIVE: Pregnancies medical follow-up and ultrasonography development have enabled detection of fetal echogenic bowel, a sign associated with various pathologies, including cystic fibrosis. Based on the long experience of a region where cystic fibrosis is frequent (Brittany, France), we describe disorders diagnosed in fetal echogenic bowel fetuses and assess ultrasonography ability in detecting cystic ibrosis in utero. STUDY DESIGN: We reviewed the cases of fetal echogenic bowel iagnosed in pregnant women living in Brittany and referred for CFTR gene analysis over the 1992-2007 period (n = 289). RESULTS: A disorder was diagnosed in 32.2% of the fetuses, cystic fibrosis being the most commonly identified (7.6%). We also found digestive malformations (7.0%), chromosomal abnormalities (3.7%), and maternofetal infections (3.7%). Combining these data with our ongoing newborn screening program since 1989 showed that ultrasonography enabled diagnosis of 10.7% of the cystic fibrosis cases. CONCLUSION: This study highlights the importance of regnancy ultrasound examinations and their efficiency in detecting cystic fibrosis. © 2010 Mosby, Inc. All rights reserved.

Le Calloch R.,Chru Brest
BMJ case reports | Year: 2013

Aplastic anaemia is a rare and serious disease characterised by severe immunosuppression due to prolonged neutropenia and the use of immunosuppressants such as corticosteroids, cyclosporine and antithymocyte globulin. Candida species are pathogens of low virulence colonising the skin and the digestive tract of many healthy individuals. Nonetheless, the incidence of invasive candidal infection is increasing. The widespread use of central intravascular catheters, invasive procedures, broad-spectrum antibiotics and immunosuppresion predisposes patients to these infections. Eye, skin, cardiac, liver, spleen and brain infection are the most common sites of invasive candidiasis. Bone and joint infections are less frequent and Candida hip septic arthritis is extremely rare. We present here a patient treated for aplastic anaemia, who developed fungal arthritis of the hip and systemic candidaemia.

Le Clech L.,CHRU Brest
BMJ case reports | Year: 2014

Opportunistic infections cause a significant morbidity and mortality in immunocompromised patients. We describe the case of a patient with skin fusariosis and a probable cerebral toxoplasmosis after UCB stem cell transplantation for B-cell acute lymphoblastic leukaemia. Fusarium species (spp) infections are difficult to treat. To date, there has been no consensus on the treatment of fusariosis and the management of its side effects. Given the negative pretransplant Toxoplasma serology in this case, identifying the origin of the Toxoplasma infection was challenging. All usual transmission routes were screened for and ruled out. The patient's positive outcome was not consistent with that of the literature reporting 60% mortality due to each infection.

The law gives patients the right to name a healthcare proxy to support them, guide them and communicate their needs and wishes. Healthcare professionals as well as the patients themselves must be familiar with and use this right in order to ensure the provision of high-quality medical and human support. © 2013 Elsevier Masson SAS. All rights reserved.

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