Prevalence of severe cardiovascular disease in patients with schizophrenia

OBJECTIVES

We assessed the prevalence of severe cardiovascular (CV) disease requiring hospitalization among patients with schizophrenia in France.

METHOD

We included patients hospitalized with schizophrenia or psychotic disorder during 2015, in five French psychiatric hospitals. Patients with CV disease were defined as those with a correspondent ICD-10 code during a hospital stay in any general hospital, five years before or three years after the psychiatric hospitalization. CV disease included myocardial infarction (MI), stroke, heart failure (HF), coronary artery disease (CAD) or peripheral artery disease. Risk factors such as hypertension, obesity and diabetes were recorded.

RESULTS

In total, 4424 patients with schizophrenia were included. Overall, 203 (4,6%) patients were diagnosed with CV disease, 93 (2.1%) with CAD, 86 (1.9%) with HF and 49 (1.1%) with stroke. The prevalence of hypertension, obesity and diabetes was 11.3%, 9.7% and 7.8%. The median (interquartile range) age of patients with MI and diabetes was 57 (49-70) and 56 (48-66) years.

CONCLUSION

Patients with schizophrenia develop severe CV disease requiring hospitalization at an early age. These severe events are associated with a high prevalence of risk factors. Early screening and treatment of CV disease and risk factors is important to improve life expectancy and quality of life of these patients.

In vivo setup characterization for pulsed electromagnetic field exposure at 3 GHz

An in vivo setup for pulsed electric field exposure at 3 GHz is proposed and characterized in this work. The exposure system allows far field, whole-body exposure of six animals placed in Plexiglas cages with a circular antenna. Chronic exposures under 18 W incident average power (1-4 kW peak power) and acute exposures under 56 W incident average power (4.7 kW peak power) were considered. Numerical and experimental dosimetry of the setup allowed the accurate calculation of specific absorption rate (SAR) distributions under various exposure conditions. From rat model numerical simulations, the whole-body mean SAR values were 1.3 W kg(-1) under chronic exposures and 4.1 W kg(-1) under acute exposure. The brain-averaged SAR value was 1.8 W kg(-1) and 5.7 W kg(-1) under chronic and acute exposure, respectively. Under acute exposure conditions, a 10 g specific absorption of 1.8  ±  1.1 mJ · kg(-1) value was obtained. With temperature rises below 0.8 °C, as measured or simulated on a gel phantom under typical in vivo exposures, this exposure system provides adequate conditions for in vivo experimental investigations under non-thermal conditions.

[Glance at tropical dermatitis]

We report a case of a French soldier, among more than fifteen others, who looked for dermatitis occurred in Central African Republic revealing a lepidopterism. We detail the Anaphae venata etiologic agent, what to do diagnosis and treatment.

Electron paramagnetic resonance as a sensitive tool to assess the iron oxide content in cells for MRI cell labeling studies

MRI cell tracking is a promising technique to track various cell types (stem cells, tumor cells, etc.) in living animals. Usually, cells are incubated with iron oxides (T(2) contrast agent) in order to take up the particles before being injected in vivo. Iron oxide quantification is important in such studies for validating the labeling protocols and assessing the dilution of the particles with cell proliferation. We here propose to implement electron paramagnetic resonance (EPR) as a very sensitive method to quantify iron oxide concentration in cells. Iron oxide particles exhibit a unique EPR spectrum, which directly reflects the number of particles in a sample. In order to compare EPR with existing methods (Perls's Prussian blue reaction, ICP-MS and fluorimetry), we labeled tumor cells (melanoma and renal adenocarcinoma cell lines) and fibroblasts with fluorescent iron oxide particles, and determined the limits of detection of the different techniques. We show that EPR is a very sensitive technique and is specific for iron oxide quantification as measurements are not affected by endogenous iron. As a consequence, EPR is well adapted to perform ex vivo analysis of tissues after cell tracking experiments in order to confirm MRI results.

[Deafness in adults. Study of practices in general medicine]

INTRODUCTION

Deafness is a sensory disability responsible for communication disorder, sometimes impairing social life. In children, the hearing is an important concern for all stakeholders in early childhood (systematic neonatal screening, etc.). On the other hand, in the adult, it is rarely tested, and patients do consult when their audiometric status is already badly impaired. But their care is all the better if the deafness diagnosis is made early, as for the audio-prosthetic rehabilitation for example. Today, the general practitioner is the first link of the diagnostic and therapeutic management chain. The objective of this study was to evaluate the diagnostic practices of practitioners in front of deafness in adults.

SUBJECTS AND METHODS

This prospective study included 74 practitioners based in "Ile de France" interviewed using a multiple choice questionnaire (MCQ) on otoscopic and audiometric diagnostics and a Script Concordance test (SC) on clinical adult deafness situations validated by a 5 experts panel.

RESULTS

The obtained average score was 66.35% of correct answers to the MCQ and 47.76% to the SC.

CONCLUSIONS

In our study, the surveyed practitioners showed a good level of otoscopic and audiometric diagnosis in the MCQ. However, their answers were not concordant with those of the expert panel in the SC. They have been particularly poorly performing on issues related to functional signs and their use in a given clinical situation, often driving to establish an otoscopic misdiagnosis while their diagnostic recognition of a pathological eardrum in the MCQ was rather good. These results reflect a lack of confidence in their otoscopic diagnosis related to the lack of knowledge of the causes of deafness in adults and their symptoms.

Microwave exposure of neuronal cellsin vitro: Study of apoptosis

PURPOSE

The aim of this study was to investigate microwave (MW) effects on neuronal apoptosis in vitro.

MATERIALS AND METHODS

Human neuroblastoma cells SH-SY5Y were exposed to a 900 MHz global system for mobile communication (GSM) or continuous-wave (CW) radiofrequency fields for 24 h in a wire-patch cell. The specific absorption rates (SAR) used were 2 W/kg for CW and 0.25 W/kg average for GSM. During CW exposure, an increase of 2 degrees C was measured, and controls with cells exposed to 39 degrees C were then performed. Apoptosis rate was assessed immediately or 24 h after exposure using three methods: (i) 4',6-diamino-2-phenylindole (DAPI) staining; (ii) flow cytometry using double staining with TdT-mediated dUTP nick-end labeling (TUNEL) and propidium iodide (PI); and (iii) measurement of caspase-3 activity by fluorimetry.

RESULTS

No statistically significant difference in the apoptosis rate was observed between sham and 24 h MW-exposed cells, either GSM-900 at an average SAR of 0.25 W/kg, or CW 900 MHz at a SAR of 2 W/kg, either 0 h or 24 h post-exposure. Furthermore, for CW-exposure, apoptosis rates were comparable between sham-, CW-, 37 degrees C- and 39 degrees C-exposed cells. All three methods used to assess apoptosis were concordant.

CONCLUSION

These results showed that, under the conditions of the present experiment, MW-exposure (either CW or GSM-900) does not significantly increase the apoptosis rate in the human neuroblastoma cell line SH-SY5Y.

A new in vitro exposure device for the mobile frequency of 900 MHz

A wire patch cell has been designed for exposing cell cultures during in vitro experiments studying possible effects of mobile radio telephone. It is based on the wire patch antenna which works at 900 MHz with a highly homogeneous field inside the antenna cavity. The designed cell structure is symmetric and provides a rather homogeneous field distribution in a large area around its centre. Moreover, the exposure cell can irradiate equally up to eight 35 mm Petri dishes at the same time, which enhances the statistical biological studies. To improve the specific absorption rate (SAR) homogeneity inside each sample, each dish is placed into another 50 mm dish. This way, SAR inhomogeneity is always proper for biological studies (below 30%). The main advantage of this new device is that it can provide SAR levels 20 times higher than those induced by classical Crawford transverse electromagnetic (TEM) cell. Moreover, this small open device is easy to construct and fits into an incubator. However, to be used for in vitro, the wire patch cell is a radiating element with the same radiating pattern as a dipole, and thus some absorbing materials are necessary around the system when used for in vitro experiments. Secondly, because of its narrow bandwidth, it is difficult to maintain its working frequency. To overcome this problem, a matching device is integrated into the test cell. In this paper, we present a detailed explanation of the cell behavior and dosimetric assessments for eight 35 mm Petri dishes exposed. Simulations using the Finite Difference Time Domain technique and experimental investigations have been carried out to design the cell at 900 MHz. The numerical dosimetry was validated by dosimetric measurements. These investigations estimated the dosimetric precision at 11%.

Spontaneous pituitary apoplexy with transient panhypopituitarism and diabetes insipidus

A 40-year-old patient presented with intractable headache, panhypopituitarism and diabetes insipidus 5 months after a severe shock syndrome. The magnetic resonance imaging of the brain confirmed a hemorragic necrosis of the pituitary gland. On follow-up, the patient recovered a normal pituitary function, except for the persistence of a partial ACTH deficiency. The pituitary image also normalized. Pituitary apoplexy is a rare disease of severe prognosis due to its neurological and endocrine consequences. It can now be more easily recognized by the new imaging techniques.

HBs antigen in human plasma fractions

Therapeutic fractions were obtained by fractionating human plasma containing HBs antigen, by the Cohn ethanol technique modified by Nitschmann. Plasmas with various HBs antigen titers were selected. The antigen was sought in each fraction by the techniques of counterelectrophoresis and radioimmunological detection in liquid phase. With the exception of very pure albumins, all fractions were found to contain the HBs antigen, though in variable proportions. A technique for the purification of albumin, applicable on an industrial scale, is proposed. It makes it possible to obtain an albumin fraction in which the HBs antigen cannot be detected by the most sensitive techniques, even starting with a plasma which is very rich in HBs antigen (titer 1/64 by counterelectrophoresis).