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In this study, laminar flow forced convection heat transfer of a non-Newtonian nanofluid flowing inside a Micro conduit that is subjected to a constant wall temperature was investigated. By considering the effect of viscous dissipation. The effects of Brinkman numbers (Br), power low index (n) and nanoparticle concentrations (φ) on the developing temperature fields and the local Nusselt number were examined. The obtained results were validated with available solutions for the special cases of conventional fluids (φ = 0) and non-viscous dissipation effect (Br = 0). Bulk temperature distribution and local Nusselt number are presented graphically for Br = 0, 0.5, 1, -0.5 and 1 for non-Newtonian fluids described by the power-law model with the flow index n = 0.3, 1.0 and 3.0. The Nusselt numbers of nanofluids were obtained for different Al2O3 nanoparticle concentrations as well as various Brinkman numbers. [ABSTRACT FROM AUTHOR]

À ce jour, il existe relativement peu d'études concernant la rééducation cardiaque chez le sujet très âgé, en particulier de 80 ans et plus. La plupart des études de la littérature incluent des patients de plus de 65 ans, mais avec un âge moyen compris entre 70 et 75 ans. Ces dernières montrent que la rééducation cardiaque réduit la mortalité, les réadmissions à l'hôpital, les coûts et améliore la capacité d'exercice, la qualité de vie et le bien-être psychologique. Notre expérience personnelle, à propos de trente-huit patients âgés de plus de 80 ans, va dans le même sens. Elle documente l'intérêt de la rééducation cardiaque en termes d'autonomie, de bien-être, de capacités physiques et de qualité de vie. [ABSTRACT FROM AUTHOR]

Insulin resistance is a pathological condition that arises when insulin signaling is impaired, forcing β-cells to produce more insulin in order to cope with body demands and to maintain glucose homeostasis. When the pancreas is no more able to support an appropriate insulin secretion, insulin resistance becomes decompensated and hyperglycemia is detected. One of the mechanisms leading to insulin resistance is low-grade inflammation that involves a number of protagonists such as inflammatory cytokines, lipids and their metabolites, reactive oxygen species (ROS), hypoxia and endoplasmic reticulum stress, and changes in gut microbiota profiles. We review here the molecular aspects of metabolic inflammation converging to insulin resistance and secondarily to type 2 diabetes. We also discuss the place of high-sensitivity C-reactive protein (hsCRP) in the assessment of metabolic inflammation and potential therapeutic interventions aimed to impede inflammation and therefore prevent insulin resistance.

Background: Immune thrombocytopenia (idiopathic thrombocytopenic purpura [ITP]) frequently occurs in young adults, particularly women in their third or fourth decade. The female predominance suggests that sex hormones may play a role in the different aspects of ITP. In this paper, we report a gender-related analysis of patients with ITP, specifically examining the clinical manifestations, responses to treatment and overall outcomes of the patients., Methods: We included patients with "ITP" attending the departments of onco-hematology or internal medicine B (university hospital of Strasbourg, France) between 1990 and December 2010 The gender-related analysis was retrospective., Results: We studied in 225 consecutive cases of established ITP with a follow-up period of 1.7 to 112 months The mean age of the patients was 44 years; 156 patients were female. The analysis revealed no significant statistical differences regarding patient characteristics between the female and male groups, with the exception of the following characteristics: the bleeding score, which altered in the presence of meno- and/or metrorrhagia and hematuria in female patients (P=0.03); the presence of anemia (P=0.04); and the detection of antinuclear and/or antiphospholipid antibodies (P=0.02). During the follow-up, no statistically significant difference was found regarding outcome or treatment response in relation to gender among these 225 patients (all P>0.05)., Discussion: Gender does not appear to affect the manifestation of immune thrombocytopenia, the outcome or response to treatment. However, further large-scale randomized trials are needed to confirm these findings., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Hypervitaminemia B12 or high serum level of cobalamin B12 is a frequent and clinical underestimated abnormality. Clinically, it can be sometimes paradoxically accompanied by signs of deficiency reflecting a functional deficit in relation to qualitative abnormalities related to defects in tissue uptake and action of vitamin B12. Etiological profile of hypervitaminemias B12 has mostly serious disease entities and for which early diagnosis is crucial to the plan rather than prognostic. These entities are represented mainly by solid malignancies, hematological malignancies and liver diseases. This reflects the potential significance that may have the dosage of vitamin B12 as an early marker of diagnosis of these diseases. Codified approach is needed to determine the potential indications of the search for a hypervitaminemia B12 and practice what to do to pass before the discovery of a high serum level of cobalamin., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Objective: In this article, we report and discuss the clinical presentation and management of idiosyncratic drug-induced agranulocytosis (neutrophil count <0.5 × 10(9)/l)., Results/conclusions: Idiosyncratic drug-induced agranulocytosis remains a potentially serious adverse event owing to the frequency of severe sepsis with severe deep tissue infections (e.g., pneumonia), septicemia and septic shock in approximately two-thirds of all hospitalized patients. However, several prognostic factors have recently been identified that may be helpful in practice to identify 'susceptible' patients. Old age (>65 years), septicemia or shock, metabolic disorders such as renal failure and a neutrophil count below 0.1 × 10(9)/l are currently consensually accepted as poor prognostic factors. In this potentially life-threatening disorder, modern management with broad-spectrum antibiotics and hematopoietic growth factors (particularly granulocyte colony-stimulating factor) is likely to improve prognosis. Thus, with appropriate management, the mortality rate from idiosyncratic drug-induced agranulocytosis is currently approximately 5%.

Objective: The aim of this study is to validate the efficacy and safety of oral cobalamin therapy in the treatment of cobalamin deficiency related to various causes., Patient and Method: It's a retrospective study, including 31 patients with documented cobalamin deficiency related to food-cobalamin malabsorption (n=20) and pernicious anemia (n=11). These patients were treated at least for 3 months with oral cyanocobalamin, between 125 to 1000microg per day. Serum cobalamin levels and hematological parameters were compared before and after the therapy and in relation with the nature of cobalamin deficiency. Safety data were also recorded., Results: After 3 months of therapy, the serum cobalamin levels have significantly increased in all the patients, with a mean of +161.6±79.3pg/mL in the food-cobalamin malabsorption group (P<0,00005) and +136.7±67.4pg/mL in the pernicious anemia group (P<0,0001). Hematological parameters have been normalized in 90 % of the patients, independently of the cause of the cobalamin deficiency. Only 1 patient presented an urticarial reaction., Conclusion: This study confirms the efficacy and safety of oral cobalamin therapy in food-cobalamin malabsorption and also in case of pernicious anemia., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

Importance of the Field: Cobalamin (vitamin B12) deficiency is particularly common in the elderly (> 15%). Management of cobalamin deficiency with cobalamin injections is well codified at present, but new routes of cobalamin administration (oral and nasal) are being studied, especially oral cobalamin therapy for food-cobalamin malabsorption., Areas Covered in This Review: The objective of this review is to evaluate the efficacy of oral cobalamin treatment in elderly patients. To reach this objective, PubMed data were systematically searched for English and French articles published from January 1990 to July 2008. Data from our research group on cobalamin deficiency (Groupe d'Etude des CAREnce vitamine B12 - CARE B12) were also analyzed., What the Reader Will Gain: Three prospective randomized studies, a systematic review by the Cochrane group and five prospective cohort studies were found and provide evidence that oral cobalamin treatment may adequately treat cobalamin deficiency. The efficacy was particularly highlighted when looking at the marked improvement in serum vitamin B12 levels and hematological parameters, for example hemoglobin level, mean erythrocyte cell volume and reticulocyte count. The effect of oral cobalamin treatment in patients presenting with severe neurological manifestations has not yet been adequately documented. Oral cobalamin treatment avoids the discomfort, inconvenience and cost of monthly injections., Take Home Message: Our experience and the present analysis support the use of oral cobalamin therapy in clinical practice.

Food-cobalamin malabsorption is a new well-characterized syndrome. In association with pernicious anemia, it is the leading etiology of cobalamin deficiency in adult, especially in elderly patient. Currently, it is an exclusion diagnosis that requires a well-codified clinical strategy for diagnosis. There are several causes of food-cobalamin malabsorption, mainly gastric disorders and drugs (metformin and anti-acid drugs). Current treatment modality includes oral cobalamin administration with lower doses than in pernicious anemia. Studies are in the way to better characterize the food-cobalamin malabsorption in a clinical practice perspective and to validate the usefulness of oral cobalamin therapy.