Revue Fran?aise des Laboratoires最新文献

{"title":"Quelques Pièges Du Diagnostic Biologique En Immunologie","authors":"Gilles Renier ,&nbsp;Alain Chevailler","doi":"10.1016/S0338-9898(05)80163-5","DOIUrl":"10.1016/S0338-9898(05)80163-5","url":null,"abstract":"<div><p>Les possibilités de pièges diagnostiques en immunologie sont très variées comme en témoigne la liste, non exhaustive, suivante : faux pics monoclonaux liés à la présence de fibrinogène, difficulté de typage des chaînes légères des IgA monoclonales ou de mise en évidence des protéines de Bence Jones sériques, ou encore présence d'une cryoglobuline dans l'exploration des immunoglobulines ; absence ou altération de la cible autoantigénique, présence de facteurs rhumatoïdes, fausses négativités liées à une trop grande concentration en autoanticorps ou aspects d'IFI inhabituels dus à leur nature monoclonale, ou encore inadaptation du conjugué utilisé à la situation particulière du patient dans l'exploration de l'autoimmunité.</p><p>Pour le biologiste les moyens de s'en prémunir reposent essentiellement sur son expérience, son regard critique et sur l'indispensable dialogue avec le clinicien.</p></div><div><p>There is a great diversity in the possibilities of diagnostic pitfalls in immunology as shown by the following list, although it is not exhaustive : false monoclonal spikes due to the presence of fibrinogen, difficulties in the typing of the light chains of monoclonal IgA or in the finding of Bence Jones proteinemias, or the presence of a cryoglobuline with regard to the examination of immunoglobulins ; lack or alteration of the autoantigenic target, presence of rheumatoid factors, false negative results due to an excess of antibodies concentration or unusual IFI patterns due to their monoclonal being, or unsuitability of the conjugate for the patient's peculiarity with regard to the examination of autoimmunity.</p><p>The major ways to get out of these diverse pitfalls rest on the biologist expert practice, his critical mind, and on the absolutely necessary dialogue with the clinician.</p></div>","PeriodicalId":101129,"journal":{"name":"Revue Fran?aise des Laboratoires","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0338-9898(05)80163-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126266895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Révocation des derniers brevets sur BRCA 1","authors":"J.-M.M.","doi":"10.1016/S0338-9898(05)80013-7","DOIUrl":"https://doi.org/10.1016/S0338-9898(05)80013-7","url":null,"abstract":"<div><p>Dans l'action en révocation des brevets engagée par la Communauté scientifique européenne contre Myriad Genetics, le second épisode, comme attendu, lui a rendu justice. L'Office européen des brevets (OEB, Munich) a rejeté l'essentiel de ces brevets abusifs sur le gène BRCA 1 de prédisposition au cancer.</p></div>","PeriodicalId":101129,"journal":{"name":"Revue Fran?aise des Laboratoires","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0338-9898(05)80013-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137366934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Les limites du bilan standard d'hémostase","authors":"Denis Massignon","doi":"10.1016/S0338-9898(05)80034-4","DOIUrl":"10.1016/S0338-9898(05)80034-4","url":null,"abstract":"<div><p>Le temps de saignement (TS), le temps de céphaline + activateur (TCA) et le temps de Quick, ou taux de prothrombine (TP) regroupés dans le bilan d'hémostase sont des tests rapides et peu coûteux mais non dénués de reproches. Le TS est assez peu reproductible, n'a pas de valeur prédictive de saignement en préopératoire dans une population non sélectionnée cliniquement ou chez les malades sous anti-agrégants et enfin est normal dans de nombreux cas de Willebrand modérés ou de thrombopathies. Le TP et le TCA sont des tests très artificiels qui n'explorent qu'une partie de la coagulation. Ces deux tests sont sensibles à de nombreux paramètres pré-analytiques, sont très dépendants des réactifs utilisés et des coagulomètres. Ils ont des sensibilités et spécificités assez faibles aux seuils d'alarme habituels. Le TP en particulier reste normal avec de nombreux déficits en facteur VII. Quant au TCA, un même réactif ne saurait parfaitement répondre aux différents buts qui lui sont assignés : dépistage de déficit(s) en facteur(s) de coagulation (facteurs VIII et IX en particulier), recherche d'un anticoagulant circulant et surveillance d'un traitement à l'héparine. La conséquence finalement est un écart parfois important entre ce que l'on observe in vitro et ce qui se produit réellement in vivo. Une bonne communication entre le clinicien et le biologiste permet d'affiner les recherches, de diminuer les erreurs d'interprétation, et peut conduire d'emblée à des examens spécialisés même si le bilan est normal.</p></div><div><p>Bleeding time (BT), activated partial thromboplastin time (APTT) and Quick's time or prothrombin time (PT) are rapid and cheap haemostasis screening tests, but they have some limits. BT has a poor reproducibility, no positive preoperative predictive value for bleeding in a non clinicaly selected population or in patients under antiagregants and at last it is normal with many patients with a moderate Willebrand desease or with a thrombopathy. PT and APTT are very artificial tests what investigate a small part of coagulation. Both tests are sensitive to many pre-analytical factors and are very dependent on reagents and coagulometers. They have limited sensitivities and specificities at the usual thresholds values; PT particularly is normal with many mild factor VII deficiencies. Regarding APTT, a unique reagent cannot perfectly reach the different goals of this test: detection of coagulation factor deficiencies, specially factor VIII and IX deficiencies, detection of circulating anticoagulants, and monitoring of heparin therapy. Consequently there are sometimes great discordances in the coagulation test results and the clinical observations. A good communication between the physician and the biologist are necessary in order to improve the investigations, to minimize the mistakes of interpretation of the results and to undertake rapidly specialised tests, even when coagulation screening tests are normal.</p></div>","PeriodicalId":101129,"journal":{"name":"Revue Fran?aise des Laboratoires","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0338-9898(05)80034-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132574639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L'Académie de médecine et l'anonymat de la prise en charge d'IST","authors":"J.-M.M.","doi":"10.1016/S0338-9898(05)80008-3","DOIUrl":"https://doi.org/10.1016/S0338-9898(05)80008-3","url":null,"abstract":"","PeriodicalId":101129,"journal":{"name":"Revue Fran?aise des Laboratoires","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0338-9898(05)80008-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137436875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Un panel hépatites","authors":"","doi":"10.1016/S0338-9898(05)80044-7","DOIUrl":"https://doi.org/10.1016/S0338-9898(05)80044-7","url":null,"abstract":"","PeriodicalId":101129,"journal":{"name":"Revue Fran?aise des Laboratoires","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0338-9898(05)80044-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136422812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Léflunomide contre rhumatisme psoriasique","authors":"","doi":"10.1016/S0338-9898(05)80001-0","DOIUrl":"https://doi.org/10.1016/S0338-9898(05)80001-0","url":null,"abstract":"","PeriodicalId":101129,"journal":{"name":"Revue Fran?aise des Laboratoires","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0338-9898(05)80001-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92033319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L'autophagie assure la survie dès la naissance","authors":"A. Kuma","doi":"10.1016/S0338-9898(05)80025-3","DOIUrl":"10.1016/S0338-9898(05)80025-3","url":null,"abstract":"","PeriodicalId":101129,"journal":{"name":"Revue Fran?aise des Laboratoires","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0338-9898(05)80025-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113673870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Le génome humain entièrement séquencé, mais…","authors":"L.D. Stein","doi":"10.1016/S0338-9898(05)80019-8","DOIUrl":"10.1016/S0338-9898(05)80019-8","url":null,"abstract":"","PeriodicalId":101129,"journal":{"name":"Revue Fran?aise des Laboratoires","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0338-9898(05)80019-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"108439950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficultés d'interprétation diagnostique (1): La RFL vous aide","authors":"Jean-Claude Nicolas ,&nbsp;Martine Tirouche","doi":"10.1016/S0338-9898(05)80031-9","DOIUrl":"10.1016/S0338-9898(05)80031-9","url":null,"abstract":"","PeriodicalId":101129,"journal":{"name":"Revue Fran?aise des Laboratoires","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0338-9898(05)80031-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115427518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Un facteur de croissance pour traiter les mucites","authors":"R. Spielberger,&nbsp;P. Stiff","doi":"10.1016/S0338-9898(05)80030-7","DOIUrl":"10.1016/S0338-9898(05)80030-7","url":null,"abstract":"","PeriodicalId":101129,"journal":{"name":"Revue Fran?aise des Laboratoires","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0338-9898(05)80030-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107039638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}