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Biomedical subjects

Pierre Mercier

Publications and source records attributed to Pierre Mercier.

10 recordsLinked to original sources

HLA-DRB1 polymorphism is associated with Kell immunisation.

K immunisation is observed in some polytransfused patients and pregnant women but does not occur in all cases of K incompatibility. This study analysed the role of genetic background in this selective response to K antigen by investigating HLA-DRB1 alleles associated with K immunisation in a southern European population. HLA-DRB1 genotyping was performed by polymerase chain reaction sequence-specific oligonucleotide/sequence-specific primer procedures in 54 K immunised patients and 200 healthy controls. The frequency of HLA-DRB1*11 was significantly higher in K immunised patients than healthy controls: 31 of 54 (57%) vs. 56 of 200 (28%) (P(c) < 0.001). In the remaining K immunised HLA-DRB1*11-negative patients, the frequency of HLA-DRB1*13 was increased: 14 of 23 (61%) vs. 49 of 144 in healthy controls (34%) (P < 0.02). The combined frequency of the two HLA-DRB1 alleles (HLA-DRB1*11 and HLA-DRB1*13) was 83% in K immunised patients when compared with 52% in healthy controls (P(c) < 0.001). K and k differ by a single amino acid T193 (M). The DRB1*11 and DRB1*13 alleles share a HLA-DRB1 gene sequence containing S in position 13, D in 70 and A in 74, and coding for the P4 pocket within the HLA-DR binding groove. This feature of the HLA-DRB1 gene could be involved in the K peptide presentation through a polymorphism ligand specific for the T193 (M) of K. In conclusion, this study demonstrated a high frequency of HLA-DRB1*11 or HLA-DRB1*13 alleles in K immunised patients, which could be due to specific K peptide presentation by HLA-DR molecules.

Alleles↗

Sensory deprivation and balance control in idiopathic scoliosis adolescent.

Balance control is influenced by the availability and integrity of sensory inputs as well as the ability of the balance control mechanisms to tailor the corrective action to the gravitational torque. In this study, to challenge balance control, visual and ankle proprioceptive information were perturbed (eyes closed and/or tendon vibration). We masked sensory inputs in order: (1) to test the hypothesis that adolescent idiopathic scoliosis (AIS), compared to healthy adolescent, relies more on ankle proprioception and/or visual inputs to regulate balance and (2) to determine whether it is the variation or the amplitude of the balance control commands of AIS that leads to greater body sway oscillations during sensory deprivation. By manipulating the availability of the sensory inputs and measuring the outcomes, center of pressure (CP) range and velocity variability, we could objectively determine the cost of visual and/or ankle proprioception deprivation on balance control. The CP range was larger and the root mean square (RMS) of the CP velocity was more variable for AIS than for control participants when ankle proprioception was perturbed. This was observed regardless of whether vision was available or not. The analysis of the sway density curves revealed that the amplitude rather than the variation of the balance control commands was related to a larger CP range and greater RMS CP velocity for AIS. The present results suggest that AIS, compared to control participants, relies much more on ankle proprioception to control the amplitude of the balance control commands.

Adolescent↗

HLA-DRB1 alleles and Jk(a) immunization.

BACKGROUND: In transfusion medicine, anti-Jk(a) has been implicated in hemolytic transfusion reactions. Development of anti-Jk(a) after transfusion does not always occur after Jk(a-) patients receive at least 1 unit of Jk(a+) blood unit. This study was designed to identify HLA-DRB1 alleles associated with predisposition to Jk(a) immunization after blood transfusion or pregnancy. STUDY DESIGN AND METHODS: Genotyping by polymerase chain reaction and sequence-specific oligonucleotide probe nonradioactive hybridization/sequence-specific primers was performed in 20 Jk(a)-immunized patients and 200 controls from the same southern European population. RESULTS: Genotyping showed that HLA-DRB1*01 was significantly more frequent in Jk(a)-immunized patients than controls: 55 percent versus 17 percent (odds ratio [OR], 5.9; confidence interval [CI], 2.3-15.5; corrected p value<0.05). Because HLA-DRB1*0101, DRB1*0102, and DRB1*1001 share a common sequence in their B1 chain, that is, F in 13, R in 71, and A in 74, HLA genetic predisposition was analyzed by comparing patients and controls with respect to the distribution of F13/R71/A74-positive and -negative alleles. Results demonstrated greater positivity of the F13/R71/A74 sequence (DRB1*0101, *0102, or *1001) in patients than in controls: 65 percent versus 19.5 percent (OR, 7.7; CI, 2.9-20.5; p<0.001). CONCLUSION: In conclusion, HLA-DRB1*0101, DRB1*0102, and DRB1*1001, which share a common DRB1 sequence, appeared to be overrepresented in Jk(a)-immunized patients.

Alleles↗

Temporal references in dreams and autobiographical memory.

In an attempt to determine whether temporal references identified in dreams follow the same temporal distributions as those documented for autobiographical memories, 28 younger women (18-35 years of age) and 30 older women (60-77 years of age) kept a home dream diary for 1 week and then slept 1 night in the laboratory for rapid eye movement sleep dream collection. The following morning, they identified temporal references in their dreams and produced a sample of autobiographical memories using the semantic cuing method. For both groups, there was a linear decrease in temporal references identified in dreams and autobiographical memories with increased remoteness for the last 30 years. As predicted, for the older group, there were similar cubic trends reflecting a disproportionately higher number of both temporal references identified in dreams and autobiographical memories from adolescence/early adulthood compared with adulthood and childhood. The results support the notion of continuity between waking and dreaming memory processes.

Adolescent↗

Cartography of emergency department visits for asthma - targeting high-morbidity populations.

BACKGROUND: Asthma education should be offered with priority to populations with the highest asthma-related morbidity. In the present study, the aim was to identify populations with high-morbidity for asthma from the Quebec Health Insurance Board Registry, a large administrative database, to help the Quebec Asthma and Chronic Obstructive Pulmonary Disease Network target its interventions. METHODS: All emergency department (ED) visits for asthma were analyzed over a one-year period, considering individual and medical variables. Age- and sex-adjusted rates, as well as standardized rate ratios related to the overall Quebec rate, among persons zero to four years of age and five to 44 years of age were determined for 15 regions and 163 areas served by Centres Locaux de Services Communautaires (CLSC). The areas with rates 50% to 300% higher (P<0.01) than the provincial rate were defined as high-morbidity areas. Maps of all CLSC areas were generated for the above parameters. RESULTS: There were 102,551 ED visits recorded for asthma, of which more than 40% were revisits. Twenty-one CLSCs and 32 CLSCs were high-morbidity areas for the zero to four years age group and five to 44 years age group, respectively. For the most part, the high-morbidity areas were located in the south-central region of Quebec. Only 47% of asthmatic patients seen in ED had also seen a physician in ambulatory care. CONCLUSION: The data suggest that a significant portion of the population seeking care at the ED is undiagnosed and undertreated. A map of high-morbidity areas that could help target interventions to improve asthma care and outcomes is proposed.

Adolescent↗

Genetic characterization of the population of Grande Comore Island (Njazidja) according to major blood groups.

The Comorian population is historically considered a blend of influences from African Bantus, Arabs, and possibly Austronesians. In this study we present the first genetic data on the current Comorian population. Serologic analysis of the six major blood group systems (ABO, RH, KEL, FY, JK, and MNS) was performed on 164 individuals from Grande Comore Island (Njazidja). In addition, Duffy genotypes were determined by polymerase chain reaction using allele-specific primers. Our findings establish a high frequency of the Fy(a- b-) phenotype (86%), presenting the same genetic background as in sub-Saharan Africa. Analysis of genetic frequencies, distances, and admixture with other populations indicates that African Bantus made the main contribution to the gene pool (73.2%+/-15.5%). The Arab contribution from the Arabian peninsula was smaller (24.2%+/-7%) and the Indonesian contribution was minor (2.6%+/-9%). The major Bantu contribution was commensurate with the Bantu cultural influence. The contribution from the Arabian peninsula seemed in relation to its permeating religious and linguistic influence. As with the language, the Indonesian contribution to the Comorian gene pool was small. These results are in agreement with historical, sociological, and linguistic data.

Alleles↗

Trait anxiety and sleep-onset insomnia: evaluation of treatment using anxiety management training.

OBJECTIVES: This study was initially designed to test the notion that generalized anxiety is a predominant factor in the maintenance of psychologically determined sleep-onset insomnia and that a trait anxiety reducing technique can provide significant therapeutic gains. METHODS: Twenty participants (age 19-63) with moderate to severe sleep-onset chronic insomnia were first asked to monitor their sleep-onset latency (SOL) for a 3-week baseline period at home using a SOL clock device. Then, 10 received anxiety management training (AMT) for 9 weeks, while the remaining 10 were trained in the use of progressive relaxation (PR). All participants were measured before and after therapy using sleep laboratory recordings (three nights each), the Spielberger Trait Anxiety Inventory and the Beck Depression Inventory. Daily home sleep-onset measures with the SOL clock device were also taken during therapy. RESULTS: There was no change in SOL over the 3-week baseline period. However, both groups experienced a significant improvement in SOL from pretreatment (end of baseline) to posttreatment periods. In the laboratory, both groups experienced a reduction in Stage 1 sleep as well as an increase in slow wave sleep (SWS) and sleep satisfaction. On the personality measures, both groups experienced a significant reduction in trait anxiety and a decrease in depression. Overall, there was no indication that one of the therapies was significantly better than the other in effecting changes. CONCLUSION: These results suggest that both PR and AMT are efficient therapies for sleep onset insomnia and overall sleep quality. Improvements in the application of the AMT technique are proposed to maximize its usefulness.

Adult↗

Functional categorization of HLA-DRB1 alleles in rheumatoid arthritis: the protective effect.

Because of past recombination event, human leukocyte antigen (HLA) alleles that are not closely related in overall sequence may come to resemble each other in areas coding for peptide binding regions (PBR) of HLA molecules. Peptide binding is likely to be important for the role of HLA molecules in autoimmune disease. As a result, it has been suggested that a strategy of searching for HLA disease associations that groups alleles in functional categories based on PBR motifs may be more successful than conventional strategies based on studying different alleles. Using such functional categorization, we examined the possibility of discriminating subcategories of HLA-DRB1 alleles associated with rheumatoid arthritis (RA) in a Southern French population. HLA-DRB1 genotyping was performed by polymerase chain reaction with sequence-specific oligonucleotide hybridization or sequence-specific primers. HLA-DRB1 alleles were classified according to a functional categorization that defined seven similar subregion structures or restrictive supertype patterns (RSPs) within pocket 4 of HLA-DR peptide binding groove as the molecular basis for grouping these alleles. HLA-DRB1* RSPs "A," "De," "Q," "Dr," "E," " R," and "a" association with susceptibility or resistance to disease was then studied in 200 RA patients versus 200 controls. DRB1* RSP "A" containing the shared epitope alleles (DRB1*0101, *0102, *0401, *0404, *0405, *0408, *1001, *1402; odds ratio [OR] = 4.35; pc < 0.001) had a predisposing effect, with double-dose effect as expected, OR 6.68 (pc < 0.001). Among the six remaining RSPs, two had significantly protective effect: DRB1* RSP "De" (DRB1*0103, *0402, *1102, *1103, *1301, *1302, *1304; OR = 0.33; p(c) < 0.001), and DRB1* RSP "Q" (DRB1*0701; OR = 0.40; pc < 0.001). One had non-significantly protective effect: DRB1* RSP "Dr" (DRB1*08, *1101, *1104, *1106, *12, *1303, *16; OR = 0.68; p < 0.05, pc = not significant [NS]). Three had neutral effect: HLA-DRB1* RSPs "E" (DRB1*0403, *0407, *0901, *1401; OR = 0.71; p = NS), " R" (DRB1*0301, *0302; OR = 0.76; p = NS), and "a" (DRB1*1501, *1502; OR = 0.94; p = NS). The functional categorization allowed us to discriminate among the HLA-DRB1 alleles those that confer a predisposing effect, a neutral effect, and a protective effect in RA.

Alleles↗

Sample size, confidence, and contingency judgement.

According to statistical models, the acquisition function of contingency judgement is due to confidence increasing with sample size. According to associative models, the function reflects the accumulation of associative strength on which the judgement is based. Which view is right? Thirty university students assessed the relation between a fictitious medication and a symptom of skin discoloration in conditions that varied sample size (4, 6, 8 or 40 trials) and contingency (delta P = .20, .40, .60 or .80). Confidence was also collected. Contingency judgement was lower for smaller samples, while confidence level correlated inversely with sample size. This dissociation between contingency judgement and confidence contradicts the statistical perspective.

Adult↗

Perception of the social support for adolescents who undergo corrective back surgery for scoliosis.

The objective of this study is to compare the perception of social support upon admission and 6 weeks postoperation of adolescents aged 13 to 19 years (M = 14.7 years), who underwent corrective back surgery for scoliosis. Twenty-two French-speaking participants were found from three different hospital centers located in two large cities in the Quebec province. Data were collected using the French version of Interpersonal Relationships Inventory (IPRI). No significant difference was observed between the results obtained on admission and those obtained 6 weeks later for the global measures of social support available. Nevertheless, analysis of data at the two time points showed a significant difference with regard to intimacy of adolescents. Adolescents reported feeling more invaded in the postoperative period (6 weeks after the surgery) than on admission at the hospital. These results serve to point out the nursing care involvement as well as the surgical techniques and ambulatory care that reduce hospitalization time. The results raise questions about the nurse's role in the adequate support for adolescents as well as the impact of reduced length of hospitalization.

Adolescent↗