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Estimer de manière précise la prévalence et les facteurs associés à l'uvéite dans une population de patients ayant une spondyloarthrite traitée par biothérapie dans le CHU de Saint-Étienne. Étude rétrospective monocentrique réalisée chez tous les patients suivis pour une spondyloarthrite dans le service de rhumatologie du CHU de Saint-Étienne entre le 1er janvier 2008 et le 1er juillet 2022. Les informations ont été collectées concernant les antécédents d'uvéite, de même que les caractéristiques de la spondyloarthrite. Les facteurs associés de manière indépendant à l'uvéite ont été déterminés. Les informations concernant les traitements ont été collectées, de même que la temporalité des survenues d'uvéites selon leur date de mise en place. Nous avons également défini dans notre étude les spondyloarthrites difficiles à traiter (SpA D2T) et les facteurs qui y sont associés. Au total, 1709 patients ont été inclus, 138 patients ont été exclus, les données de 1571 patients ont été analysées. La population analysée a un âge moyen de 50,6 ans ± 14,7 (52,7 % d'hommes), une moyenne d'évolution de 13,6 ans ± 10,6. Le pourcentage de spondylarthrites ankylosante est de 46,7 %. Le portage du HLAB27 est de 59,5 % dans l'ensemble de la population. La prévalence d'uvéite est de 12,3 % IC95 % [10 ;14 %], et de 20,7 % en présence de l'antigène HLAB27. Les facteurs associés de manière indépendant aux uvéites sont l'atteinte axiale (OR = 3,34 ; IC [1,46 – 7,65]), la présence du HLA B27 (OR 3,65 IC [2,3–5,82] p < 0,01) et la durée d'évolution de la SpA (OR = 1,03 ; IC [1,01–1,05] ; p < 0,001). Concernant les survenues d'uvéite selon les traitements reçus, une récidive plus importante d'uvéites sous antiIL17 a été remarquée, en comparaison aux anti-TNF à 33,3 % contre 10,4 %, à 0,02 au χ2. Concernant les SpA D2T, la présence de MICI (OR = 3,51 ; IC [1,91 ; 6,44]), le BASDAI (OR = 1,29 ; IC [1,2 ; 1,4]), l'ASDAS CRP (OR = 1,22 ; IC [1,04 ; 1,43]), la durée d'évolution (OR = 1,04 ; IC [1,03 ; 1,06]) et le tabac (OR = 1,6 ; IC [1,18 ; 2,17]) y sont associés de manière indépendante. Notre étude indique que l'uvéite est l'atteinte extra-articulaire dans la spondyloarthrite, survenant de manière préférentielle chez les patients ayant une atteinte axiale, un portage de HLA-B27 et ayant une durée plus longue d'évolution de la maladie. Dans notre étude, les anti-IL17 et anti-IL23 semblent plus associés à une récidive d'uvéite, en comparaison aux anti-TNF. [ABSTRACT FROM AUTHOR]

Lectin-like oxidized LDL (oxLDL) receptor-1 (LOX-1), a novel scavenger receptor highly expressed in human and experimental atherosclerotic lesions, is responsible for the uptake of oxLDL in vascular cells. We demonstrated previously that Tanshinone II-A (Tan), a pharmacologically active compound extracted from the rhizome of the Chinese herb Salvia miltiorrhiza Bunge, inhibits atherogenesis in hypercholesterolemic rats, rabbits, and apolipoprotein-E deficient (ApoE(-/-)) mice. However, the precise mechanism by which Tan protects against atherogenesis remains to be elucidated. Therefore, we hypothesized that Tan can suppress the uptake of oxLDL by diminishing the expression of LOX-1 via suppression of NF-[kappa]B signaling pathway, thereby contributing to reduced macrophage foam cell formation. In cultured murine macrophages, oxLDL induced LOX-1 expression at the mRNA and protein levels, was abrogated by addition of Tan or pyrrolidinedithiocarbamic acid ammonium salt (PDTC), a widely used inhibitor of NF-[kappa]B, suggesting the involvement of NF-[kappa]B. Tan also reduced LOX-1 expression in atherosclerotic lesions of ApoE(-/-) mice fed a high cholesterol diet. Mechanistically, Tan suppressed the nuclear translocation of NF-[kappa]B P65 subunit and phosphorylation of I[kappa]B-[alpha] induced by oxLDL. Electrophoretic mobility shift assay (EMSA) demonstrated that Tan inhibited the nuclear protein binding to NF-[kappa]B consensus sequence. Functionally, we observed that Tan inhibited DiI-oxLDL uptake by macrophages in a fashion similar to that produced by LOX-1 neutralizing antibody. Our current findings reveal a novel mechanism by which Tan protects against atherogenesis and shed new light on the potential therapeutic application of Tan to the treatment and prevention of atherosclerotic cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Abstract: We investigated the incidence of the trigeminocardiac reflex (TCR) during ethylene vinyl alcohol copolymer (Onyx Liquid Embolic System, ev3 Neurovascular, Irvine, CA, USA) embolisation of intracranial dural arteriovenous fistulas (DAVFs) and evaluated the post-procedural recovery of these patients. Between June 2006 and July 2009, 21 patients (11 females, 10 males) with a mean age of 61years (range: 25–85years) underwent 28 Onyx embolisations of intracranial DAVFs at our institution. The case histories of these patients were reviewed retrospectively. A TCR occurred in three (10.7%) of the embolisations, with bradycardia lower than 60 beats/minute and a drop in mean arterial blood pressure of 20% or more. The reflex was blunted promptly with intravenous atropine, and follow-up of these patients showed no complications that might have been directly related to it. The TCR may occur during Onyx embolisation of intracranial DAVFs. Recognition of this phenomenon allows for early detection and appropriate intraoperative management. [ABSTRACT FROM AUTHOR]

The 2020 coronavirus pandemic and the following quarantine measures have led to significant changes in daily life worldwide. Preliminary research indicates that air quality has improved in many urban areas as a result of these measures. This study takes a neighborhood-scale approach to quantifying this change in pollution. Using data from a network of citizen-hosted, low-cost particulate matter (PM) sensors, called Air Quality & yoU (AQ&U), we obtained high-spatial resolution measurements compared to the relatively sparse state monitoring stations. We compared monthly average estimated PM 2.5 concentrations from February 11 to May 11, 2019 at 71 unique locations in Salt Lake County, UT, USA with the same (71) sensors' measurements during the same timeframe in 2020. A paired t -test showed significant reductions (71.1% and 21.3%) in estimated monthly PM 2.5 concentrations from 2019 to 2020 for the periods from March 11-April 10 and April 11-May 10, respectively. The March time period corresponded to the most stringent COVID-19 related restrictions in this region. Significant decreases in PM 2.5 were also reported by state monitoring sites during March (p < 0.001 compared to the previous 5-year average). While we observed decreases in PM 2.5 concentrations across the valley in 2020, it is important to note that the PM 2.5 concentrations did not improve equally in all locations. We observed the greatest reductions at lower elevation, more urbanized areas, likely because of the already low levels of PM 2.5 at the higher elevation, more residential areas, which were generally below 2 μg/m3 in both 2019 and 2020. Although many of measurements during March and April were near or below the estimated detection limit of the low-cost PM sensors and the federal equivalent measurements, every low-cost sensor (51) showed a reduction in PM 2.5 concentration in March of 2020 compared to 2019. These results suggest that the air quality improvement seen after March 11, 2020 is due to quarantine measures reducing traffic and decreasing pollutant emissions in the region. • Significant reductions in PM concentration corresponded to COVID-related restrictions and traffic reductions. • Networked low-cost PM measurements identified decreases in PM levels at 50+ locations. • The low-cost PM measurements supported findings from sparse state monitors. • The greatest percent reductions occurred in locations with the most urban activity. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Intraoperative haemodynamic optimization based on fluid management and stroke volume optimization (Goal Directed Fluid Therapy [GDFT]) can improve patients’ postoperative outcome. We have described a closed-loop fluid management system based on stroke volume variation and stroke volume monitoring. The goal of this system is to apply GDFT protocols automatically. After conducting simulation, engineering, and animal studies the present report describes the first use of this system in the clinical setting. Study design: Prospective pilot study. Patients: Patients undergoing major surgery. Methods: Twelve patients at two institutions had intraoperative GDFT delivered by closed-loop controller under the direction of an anaesthesiologist. Compliance with GDFT management was defined as acceptable when a patient spent more than 85% of the surgery time in a preload independent state (defined as stroke volume variation<13%), or when average cardiac index during the case was superior or equal to 2.5l/min/m2. Results: Closed-loop GDFT was completed in 12 patients. Median surgery time was 447 [309–483] min and blood loss was 200 [100–1000] ml. Average cardiac index was 3.2±0.8l/min/m2 and on average patients spent 91% (76 to 100%) of the surgery time in a preload independent state. Twelve of 12 patients met the criteria for compliance with intraoperative GDFT management. Conclusion: Intraoperative GDFT delivered by closed-loop system under anaesthesiologist guidance allowed to obtain targeted objectives in 91% of surgery time. This approach may provide a way to ensure consistent high-quality delivery of fluid administration and compliance with perioperative goal directed therapy. [Copyright &y& Elsevier]