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1.
Artigo em Inglês | MEDLINE | ID: mdl-37833136

RESUMO

INTRODUCTION AND AIMS: Celiac disease (CD) is an autoimmune enteropathy that develops in genetically susceptible individuals. The typical gastrointestinal manifestation is diarrhea but symptoms of dyspepsia, such as epigastric pain, nausea, or satiety, can sometimes appear. Previous studies have reported that the prevalence of CD in patients with dyspepsia can be as high as 7%. The aim of the present study was to evaluate CD seroprevalence in subjects with dyspeptic symptoms and a control group in a Mexican population. MATERIAL AND METHODS: A case-control study was conducted on blood donors that answered the PAGI-SYM questionnaire for dyspepsia and in whom IgA antibodies to tissue transglutaminase 2 (IgA anti-tTG2) and IgG antibodies to deamidated gliadin peptide (IgG anti-DGP) were determined. CD seroprevalence in subjects with dyspeptic symptoms and in asymptomatic subjects was compared. RESULTS: A total of 427 subjects (76.3% men), with a mean patient age of 34 years (range of 18-65 years) were included. Of those participants, 87 (20.3%) had symptoms of dyspepsia (group A) and 340 (79.6%) were asymptomatic (group B). Antibodies were positive in one (1.15%) of the group A subjects (1/87, 95% CI 0.2-6 %), whereas they were positive in 4 (1.18%) of the group B subjects (4/340, 95% CI 0.4-2.9%, p = 0.59). CONCLUSIONS: CD seroprevalence in the study population with dyspeptic symptoms (1%) was not different from that of the control population. Thus, CD screening in Mexican patients with dyspepsia is not justified.

3.
Phys Rev E ; 105(5-1): 054902, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35706299

RESUMO

We investigate numerically the impact process of a particle of diameter d and velocity V_{i} onto a cohesive granular packing made of similar particles via two-dimensional discrete element method simulations. The cohesion is ensured by liquid bridges between neighboring particles and described by short range attraction force based on capillary modeling. The outcome of the impact is analyzed through the production of ejected particles from the packing, referred to as the splash process. We quantify this production as a function of the impact velocity for various capillary strength Γ and liquid content Ω. The numerical data indicate that the splash process is modified when the dimensionless cohesion number Co=6Γ/ρ_{p}gd^{2} (where ρ_{p} is the particle density, d its diameter, and g the gravitational acceleration) exceeds a critical value of the order of the unity. Above this value, we highlight that the ejection process is triggered above a threshold impact Froude number, Fr=V_{i}/sqrt[gd], which depends both on Γ and Ω and scales as Γ^{ß}Ω^{δ}, where the values of the exponents are found close to 1/2 and 1/6, respectively, and can be derived from rational physical arguments. Importantly, we show that, above the threshold, the number of splashed particles follows a linear law with the impact Froude number as in the cohesionless case.

4.
EClinicalMedicine ; 28: 100598, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33294813

RESUMO

BACKGROUND: This study applies multimodal MRI to investigate neurodevelopment in nine-year-old children born to cancer-complicated pregnancies. METHODS: In this cohort study, children born after cancer-complicated pregnancies were recruited alongside 1:1 matched controls regarding age, sex and gestational age at birth (GA). Multimodal MRI was used to investigate whole-brain and subcortical volume, cortical structure (using surface-based morphometry), white matter microstructure (using fixel-based analysis) and functional connectivity (using resting-state blood-oxygen-level-dependant signal correlations). Graph theory probed whole-brain structural and functional organization. For each imaging outcome we conducted two group comparisons: 1) children born after cancer-complicated pregnancies versus matched controls, and 2) the subgroup of children with prenatal chemotherapy exposure versus matched controls. In both models, we used the covariate of GA and the group-by-GA interaction, using false-discovery-rate (FDR) or family-wise-error (FWE) correction for multiple comparisons. Exploratory post-hoc analyses investigated the relation between brain structure/function, neuropsychological outcome and maternal oncological/obstetrical history. FINDINGS: Forty-two children born after cancer-complicated pregnancies were included in this study, with 30 prenatally exposed to chemotherapy. Brain organization and functional connectivity were not significantly different between groups. Both cancer and chemotherapy in pregnancy, as compared to matched controls, were associated with a lower travel depth, indicating less pronounced gyrification, in the left superior temporal gyrus (pFDR ≤ 006), with post-hoc analysis indicating platinum derivatives during pregnancy as a potential risk factor (p = .028). Both cancer and chemotherapy in pregnancy were related to a lower fibre cross-section (FCS) and lower fibre density and cross-section (FDC) in the posterior corpus callosum and its tapetal fibres, compared to controls. Higher FDC in the chemotherapy subgroup and higher FCS in the whole study group were observed in the anterior thalamic radiations. None of the psycho-behavioural parameters correlated significantly with any of the brain differences in the study group or chemotherapy subgroup. INTERPRETATION: Prenatal exposure to maternal cancer and its treatment might affect local grey and white matter structure, but not functional connectivity or global organization. While platinum-based therapy was identified as a potential risk factor, this was not the case for chemotherapy in general. FUNDING: This project has received funding from the European Union's Horizon 2020 research and innovation program (European Research council, grant no 647,047), the Foundation against cancer (Stichting tegen kanker, grant no. 2014-152) and the Research Foundation Flanders (FWO, grants no. 11B9919N, 12ZV420N).

5.
Schweiz Arch Tierheilkd ; 162(7): 439-450, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32618567

RESUMO

INTRODUCTION: Dogs with hypercortisolism are predisposed to developing bacteriuria associated either with clinical signs of cystitis or without clinical signs (subclinical bacteriuria). Based on current guidelines, dogs with subclinical bacteriuria should not be treated with antibiotics because there is no evidence that treatment improves outcome and because unnecessary treatments should be avoided. Before these guidelines were published in 2019, dogs with hypercortisolism and bacteriuria were commonly treated with antibiotics irrespective of clinical signs. Comprehensive data on the frequency of bacterial cystitis, subclinical bacteriuria and the outcome of antimicrobial treatment in dogs with hypercortisolism is sparse. The aims of this study were to investigate dogs with hypercortisolism for the presence of bacterial cystitis and subclinical bacteriuria, to address the pathogens involved, and to assess the outcome of antibiotic treatment. Dogs newly diagnosed with hypercortisolism between 2005 and 2015 from which a urine bacterial culture was available were included. Statistical analysis was performed with non-parametric tests. Of the 161 client-owned dogs included, 29 (18%) showed bacteriuria, which was subclinical in 24 (83%) cases. Escherichia coli was the most commonly isolated pathogen (58%). Bacteriuria was not associated with sex or neutering status. In 14 dogs, follow-up data was available, of which 13 (93%) were treated with antimicrobials for 14 to 28 days. Follow-up bacterial culture (1 to 118 days after cessation of therapy) was negative in 10 (77%) treated dogs; a negative follow-up culture was not associated with gender, age or duration of treatment. Bacteriuria persisted in three treated dogs and the one untreated dog. The prevalence of positive bacterial urinary culture in dogs with hypercortisolism was lower than previously reported. In the majority of dogs, bacteriuria was subclinical. Most dogs had a negative bacterial culture result after antimicrobial treatment; however, more resistant bacteria were detected in persistently positive urine.


INTRODUCTION: Les chiens atteints d'hypercortisolisme ont tendance à développer une bactériurie associée avec ou sans signes cliniques de cystite. Selon les recommandations de traitement actuelles, les chiens atteints de bactériurie subclinique ne doivent pas être traités avec des antibiotiques, car il n'y a aucune preuve d'une amélioration du succès du traitement et des traitements inutiles doivent être évités. Avant la publication de ces lignes directrices en 2019, les chiens atteints de hypercortisolisme et de bactériurie étaient traités de façon standard avec des antibiotiques, quels que soient les symptômes cliniques. Les données sur la fréquence de la cystite bactérienne, de la bactériurie subclinique et du résultat du traitement antimicrobien chez les chiens atteints d'hypercortisolisme sont rares. Le but de cette étude était d'examiner des chiens souffrant d'hypercortisolisme quant à la présence d'une cystite bactérienne et d'une bactériurie subclinique, d'identifier les agents pathogènes impliqués et d'évaluer le succès thérapeutique du traitement antibiotique. Cent soixante et un chiens, diagnostiqués avec hypercortisolisme entre 2005 et 2015 et chez qui une culture bactérienne urinaire était disponible, ont été utilisés. L'analyse statistique a été réalisée avec des tests non paramétriques. Une bactériurie a été diagnostiquée chez 29 (18%) des chiens avec hypercortisolisme, de façon subclinique dans 24 (83%) cas. Escherichia coli était le pathogène le plus fréquemment isolé (58%). Il n'y avait aucune association entre la bactériurie et le sexe ou le statut de castration. Des données de suivi étaient disponibles chez 14 chiens, dont 13 (93%) ont été traités avec des antibiotiques pendant 14 à 28 jours. La culture bactérienne (1 à 118 jours après la fin du traitement) a été négative chez 10 chiens (77%) traités. Il n'y avait aucune différence entre le sexe, l'âge ou la durée du traitement. Une bactériurie persistante a été observée chez trois chiens traités et un chien non traité. La prévalence de la culture bactérienne d'urine positive chez les chiens atteints d'hypercortisolisme était moins fréquente que celle publiée précédemment. Chez la majorité des chiens, la bactériurie était subclinique. La plupart des chiens avaient une culture bactérienne négative après un traitement antimicrobien; cependant, les cultures d'urine positives persistantes ont démontré des germes plus résistants aux antibiotiques.


Assuntos
Antibacterianos/uso terapêutico , Bacteriúria/veterinária , Síndrome de Cushing/veterinária , Doenças do Cão/tratamento farmacológico , Infecções Urinárias/veterinária , Animais , Antibacterianos/efeitos adversos , Bactérias/isolamento & purificação , Bacteriúria/complicações , Bacteriúria/tratamento farmacológico , Bacteriúria/microbiologia , Síndrome de Cushing/complicações , Síndrome de Cushing/microbiologia , Doenças do Cão/microbiologia , Cães , Infecções Urinárias/complicações , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia
6.
Phys Rev Lett ; 124(19): 198501, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32469561

RESUMO

We report experiments on windblown sand that highlight a transition from saltation to collisional regime above a critical dimensionless mass flux or Shields number. The transition is first seen through the mass flow rate Q, which deviates from a linear trend with the Shields number and seems to follow a quadratic law. Other physical evidences confirm the change of the transport properties. In particular, the particle velocity and the height of the transport layer increases with increasing Shields number in the collisional regime while the latter are invariant with the wind strength in the saltation regime. Discrete numerical simulations support the experimental findings and ascertain that mid-air collisions are responsible for the change of transport regime.

7.
Lett Appl Microbiol ; 70(1): 29-35, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31631350

RESUMO

The objective of this study was to undertake a microbiological survey of foods, animal faeces and wastewater samples for Clostridium difficile, and determine the genotypes and antimicrobial susceptibilities of isolates. A total of 211 samples were tested for C. difficile using culture methods. Thirteen toxigenic C. difficile isolates were obtained; ten from wastewater samples, one each from pig and duck faeces and another from a raw meat product. Eight PCR-ribotypes (RTs) were identified, including two novel RTs (878 and 879). Single-nucleotide polymorphism analysis using WGS data for all isolates provided greater discrimination between C. difficile isolates within the same RT and multilocus sequence typing (MLST) profiles. All C. difficile isolates were found to be susceptible to the first-line human antimicrobials used to treat C. difficile infection. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study to report the isolation of Clostridium difficile from animals, food and wastewater in New Zealand (NZ) and provides important data with respect to ribotypes and multilocus sequence typing profiles, whole genome sequence and antimicrobial susceptibilities. The results highlight the need for further investigations into the epidemiology of C. difficile in NZ and to elucidate the role of the environmental and food sources as transmission routes of human infection.


Assuntos
Clostridioides difficile/isolamento & purificação , Fezes/microbiologia , Carne/microbiologia , Águas Residuárias/microbiologia , Animais , Antibacterianos/farmacologia , Clostridioides difficile/classificação , Clostridioides difficile/efeitos dos fármacos , Clostridioides difficile/genética , Patos , Contaminação de Alimentos/análise , Genótipo , Humanos , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Nova Zelândia , Suínos
8.
Lett Appl Microbiol ; 69(6): 392-398, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31562639

RESUMO

Four cases of listeriosis in a hospital (A) in New Zealand were identified in 2012. Pulsed-field gel electrophoresis (PFGE) used at the time identified four pulsotypes amongst the clinical isolates. Two of the pulsotypes matched to Listeria monocytogenes isolates obtained from ready-to-eat (RTE) meat samples from a RTE producer tested during a nationwide microbiological survey the month prior. The outbreak investigation confirmed that the RTE producer had supplied product to the hospital and additional testing confirmed the presence of L.  monocytogenes in RTE meats from the hospital kitchen. Two further listeriosis cases presented in another hospital (B) with one clinical isolate identified as the same pulsotype as identified for one case in hospital A, but the epidemiology information concluded that the clinical cases from hospital B were not linked to the outbreak. Retrospective whole-genome sequencing confirmed that epidemiologically linked isolates belonging to three different genotypes for clinical cases from hospital A and RTE meats samples from the hospital kitchen differed by 0-1 core-genome locus or single nucleotide polymorphisms (SNP). The use of core-genome multilocus sequence typing and SNP analysis provided a greater degree of discrimination between isolates compared to PFGE. SIGNIFICANCE AND IMPACT OF THE STUDY: This study describes a listeriosis outbreak associated with a hospital in New Zealand and attributed to contaminated ready-to-eat (RTE) meat supplied to the hospital by a single producer. Retrospective whole-genome sequence analysis of outbreak isolates was found to provide a greater degree of discrimination between isolates compared to pulsed-field gel electrophoresis and supported the conclusions made at the time of the outbreak. The multiple genotypes identified from clinical cases and the RTE meats obtained during the outbreak highlight the importance of epidemiological concordance alongside genotyping.


Assuntos
Infecção Hospitalar/microbiologia , Listeria monocytogenes/genética , Listeriose/epidemiologia , Produtos da Carne/microbiologia , Carne/microbiologia , Surtos de Doenças , Eletroforese em Gel de Campo Pulsado , Microbiologia de Alimentos , Genoma Bacteriano/genética , Genótipo , Humanos , Listeria monocytogenes/classificação , Listeria monocytogenes/isolamento & purificação , Listeriose/microbiologia , Tipagem de Sequências Multilocus , Nova Zelândia/epidemiologia , Polimorfismo de Nucleotídeo Único/genética , Estudos Retrospectivos , Sequenciamento Completo do Genoma
9.
Sci Robot ; 4(29)2019 04 24.
Artigo em Inglês | MEDLINE | ID: mdl-31414071

RESUMO

While all minimally invasive procedures involve navigating from a small incision in the skin to the site of the intervention, it has not been previously demonstrated how this can be done autonomously. To show that autonomous navigation is possible, we investigated it in the hardest place to do it - inside the beating heart. We created a robotic catheter that can navigate through the blood-filled heart using wall-following algorithms inspired by positively thigmotactic animals. The catheter employs haptic vision, a hybrid sense using imaging for both touch-based surface identification and force sensing, to accomplish wall following inside the blood-filled heart. Through in vivo animal experiments, we demonstrate that the performance of an autonomously-controlled robotic catheter rivals that of an experienced clinician. Autonomous navigation is a fundamental capability on which more sophisticated levels of autonomy can be built, e.g., to perform a procedure. Similar to the role of automation in fighter aircraft, such capabilities can free the clinician to focus on the most critical aspects of the procedure while providing precise and repeatable tool motions independent of operator experience and fatigue.

10.
Rev Mal Respir ; 36(7): 752-800, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31285084

RESUMO

Although recognized as less dangerous than conventional cigarettes, the toxicity of the electronic cigarette vapor's toxicity remains to be fully assessed. This review explores vapers' exposition to formaldehyde and acrolein. METHOD: Systematic PubMed search for reports regarding formaldehyde or acrolein or their metabolites in electronic cigarette vapor, in vapers, or in ambient air. RESULTS: Fifty-two publications were selected. Found in almost all studies on vaper, formaldehyde is 8 times out of 11 - and acrolein constantly - in lower amounts than those found in conventional cigarettes. Acrolein's metabolite is found in all studies in vapers. The concentrations of formaldehyde and/or acrolein generated during vapor production may be affected by the characteristics of the E-liquid, voltage, vaping topography, and by the flavor additives. CONCLUSION: In the current state of knowledge, we must continue to support and help smokers to quit smoking, and for those who are engaged in a harm reduction approach, to minimize the duration of their electronic cigarette use.


Assuntos
Acroleína/toxicidade , Sistemas Eletrônicos de Liberação de Nicotina , Formaldeído/toxicidade , Exposição Ocupacional , Vaping/efeitos adversos , Humanos , Exposição Ocupacional/análise , Exposição Ocupacional/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/métodos , Vaping/epidemiologia
12.
J Nanosci Nanotechnol ; 17(1): 846-52, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-29634187

RESUMO

Biodegradables Chitosan-based Nanoparticles (CS NPs) have been extensively studied as delivery system for therapeutic molecules and as efficient carriers or adjuvants in experimental vaccination. Physicochemical association between CS NPs and antigens is a key step for the biological function as carrier devices. However, for the adjuvant CS NPs property, it is not well known if coupling with vaccine antigens is required or not to potentiate the immune response. To address this issue, in this work, we evaluated the potential adjuvant effect of CS NPs by simply mixing with two different antigens such as Bovine Serum Albumin (BSA) or E protein from Dengue Virus serotype 2 (E protein DENV2). Thus the CS NPs were prepared by ionic gelation with sodium tripolyphosphate, resulting particles among 68 and 188 nm of size. Immunization of 6­8 week old female BALB/c mice, were carried out by intraperitoneal route with a simple combination of CS NPs either with BSA (CS NPs-BSA) at 10 µg or with E protein DENV2 (CS NPs-Protein E) at 5 µg. Combinations with the above antigens with CS NPs elicited robust specific primary and secondary humoral responses comparable to alum, a well-known adjuvant. BSA-specific IgG titers were detectable by day 14 after priming with the CS NPs-BSA formulation, with titers that ranged from 102 to 103 EU ml-. After a second immunization, the anti-BSA titers ranged around 104 EU ml-. In contrast, in the group of mice immunized with the protein alone, BSA-specific serum IgG titers were undetectable at day 14 and 28. For the immunizations with the CS NPs-E protein formulation, we observed also a remarkable specific-antibody production in the primary response, with titers reaching 103 EU ml-. After the booster immunization the anti-E protein DENV2 antibodies titers reached peak values around 104 EU ml-. Interestingly, for both antigens, the combination with CS NPs polarized the immune response to a Th2-like profile, which is characterized mainly by the production of the IgG1 Isotype, confirming that CS NPs can enhance and modulate the humoral immune responses against different antigens independently of physicochemical conjugation. This could represent a simplification in the use of CS NPs as adjuvants in vaccination.


Assuntos
Adjuvantes Imunológicos/química , Adjuvantes Imunológicos/farmacologia , Compostos de Alúmen/química , Antígenos/química , Quitosana/química , Imunidade Humoral/efeitos dos fármacos , Nanopartículas/química , Animais , Antígenos/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Soroalbumina Bovina/química , Soroalbumina Bovina/imunologia , Proteínas do Envelope Viral/química , Proteínas do Envelope Viral/imunologia
13.
Clin Exp Immunol ; 188(1): 109-126, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27886660

RESUMO

Listeriolysin O (LLO) has been proposed as a potential carrier or adjuvant molecule in the vaccination field. However, the cytotoxic and pro-apoptotic effects of LLO are the major limitations for this purpose. Here, we have performed a preclinical safety evaluation and characterized a new potential adjuvant application for a non-cytolytic LLO mutant (dtLLO) to enhance and modulate the immune response against the envelope (E) protein from dengue virus. In addition, we have studied the adjuvant effects of dtLLO on human immune cells and the role of membrane cholesterol for the binding and proinflammatory property of the toxoid. Our in-vivo results in the murine model confirmed that dtLLO is a safer molecule than wild-type LLO (wtLLO), with a significantly increased survival rate for mice challenged with dtLLO compared with mice challenged with wtLLO (P < 0·001). Histopathological analysis showed non-toxic effects in key target organs such as brain, heart, liver, spleen, kidney and lung after challenge with dtLLO. In vitro, dtLLO retained the capacity of binding to plasma membrane cholesterol on the surface of murine and human immune cells. Immunization of 6-8-week-old female BALB/c mice with a combination of dtLLO mixed with E protein elicited a robust specific humoral response with isotype diversification of immunoglobulin (Ig)G antibodies (IgG1 and IgG2a). Finally, we demonstrated that cholesterol and lipid raft integrity are required to induce a proinflammatory response by human cells. Taken together, these findings support a potential use of the dtLLO mutant as a safe and effective adjuvant molecule in vaccination.


Assuntos
Adjuvantes Imunológicos , Antígenos Virais/imunologia , Toxinas Bacterianas/imunologia , Vírus da Dengue/imunologia , Proteínas de Choque Térmico/imunologia , Proteínas Hemolisinas/imunologia , Imunidade Humoral , Proteínas Mutantes/imunologia , Animais , Anticorpos Antivirais/imunologia , Especificidade de Anticorpos/imunologia , Toxinas Bacterianas/genética , Colesterol/metabolismo , Citocinas/metabolismo , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Dengue/imunologia , Dengue/patologia , Dengue/prevenção & controle , Modelos Animais de Doenças , Feminino , Proteínas de Choque Térmico/genética , Proteínas Hemolisinas/genética , Hemólise/imunologia , Imunização , Mediadores da Inflamação/metabolismo , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/metabolismo , Lipídeos de Membrana/metabolismo , Camundongos , Proteínas Mutantes/genética , Ligação Proteica/imunologia
14.
Neuroimage ; 146: 883-893, 2017 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-27771348

RESUMO

The neural network and the task-dependence of (local) activity changes involved in bimanual coordination are well documented. However, much less is known about the functional connectivity within this neural network and its modulation according to manipulations of task complexity. Here, we assessed neural activity via high-density electroencephalography, focussing on changes of activity in the beta frequency band (~15-30Hz) across the motor network in 26 young adult participants (19-29 years old). We investigated how network connectivity was modulated with task difficulty and errors of performance during a bimanual visuomotor movement consisting of dial rotation according to three different ratios of speed: an isofrequency movement (1:1), a non-isofrequency movement with the right hand keeping the fast pace (1:3), and the converse ratio with the left hand keeping the fast pace (3:1). To quantify functional coupling, we determined neural synchronization which might be key for the timing of the activity within brain regions during task execution. Individual source activity with realistic head models was reconstructed at seven regions of interest including frontal and parietal areas, among which we estimated phase-based connectivity. Partial least squares analysis revealed a significant modulation of connectivity with task difficulty, and significant correlations between connectivity and errors in performance, in particular between sensorimotor cortices. Our findings suggest that modulation of long-range synchronization is instrumental for coping with increasing task demands in bimanual coordination.


Assuntos
Ritmo beta , Sincronização Cortical , Córtex Motor/fisiologia , Desempenho Psicomotor , Córtex Sensório-Motor/fisiologia , Adulto , Mapeamento Encefálico , Eletroencefalografia , Feminino , Humanos , Masculino , Vias Neurais/fisiologia , Adulto Jovem
15.
Rev Mal Respir ; 33(10): 892-898, 2016 Dec.
Artigo em Francês | MEDLINE | ID: mdl-27242286

RESUMO

INTRODUCTION: Long-term nicotine use has been proposed as a risk-reduction strategy in smokers unwilling or unable to quit. However, its safety remains debated. METHODS: Analysis of publications identified in PubMed, Toxibase, Google Scholar and in the Food and Drug Administration, and French National Authority for Health websites. RESULTS: Nicotine seems to be implicated in the genesis of atherosclerosis. It could be a cancer precursor, could be implicated in cancer proliferation and angiogenesis, in apoptosis reduction, and may be genotoxic. New studies are warranted for more complete assessment of the risk-benefit balance. CONCLUSION: It is difficult to affirm the safety of long term nicotine use. The risk-benefit balance should be assessed in terms of a risk-reduction strategy, as in other domains, notably illicit drug use.


Assuntos
Efeitos Adversos de Longa Duração , Nicotina/efeitos adversos , Abandono do Hábito de Fumar/métodos , Tabagismo/terapia , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/epidemiologia , Humanos , Efeitos Adversos de Longa Duração/epidemiologia , Neoplasias/induzido quimicamente , Neoplasias/epidemiologia , Nicotina/administração & dosagem , Nicotina/metabolismo , Nitrosação/efeitos dos fármacos , Medição de Risco , Abandono do Hábito de Fumar/estatística & dados numéricos , Fatores de Tempo
16.
Neurogastroenterol Motil ; 28(9): 1419-32, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27132547

RESUMO

BACKGROUND: Patients with Crohn's disease (CD) in remission are exposed to chronic psychological distress, due to the constant risk of relapse. This permanent situation of anticipation and uncertainty can lead to anxiety, which may, in turn, trigger relapse. We aimed to investigate the effects of uncertainty on behavioral and brain responses to anticipation of visceral discomfort in quiescent CD patients. METHODS: Barostat-controlled rectal distensions were preceded by cued uncertain or certain anticipation in nine CD patients and nine matched healthy volunteers. Brain responses obtained before distension across the different anticipation conditions in regions of interest (ROI) involved in (anticipation of) pain were measured using functional magnetic resonance imaging and compared between CD and controls. The association between anxiety-related psychological variables and cerebral anticipatory activity was tested. KEY RESULTS: During uncertainty, CD patients had significantly stronger activations than controls in the cingulate cortex, insula, amygdala, and thalamus with trends in the hippocampus, prefrontal, and secondary somatosensory cortex. In patients, brain responses to uncertainty in the majority of ROI correlated positively with gastrointestinal symptom-specific anxiety, trait-anxiety, and intolerance of uncertainty. CONCLUSIONS & INFERENCES: In a context of uncertainty regarding occurrence of uncomfortable visceral sensations, CD is associated with excessive reactivity in brain regions known to be involved in sensory, cognitive and emotional aspects of pain processing and modulation, and threat appraisal. Our findings contribute to a better understanding of the role of emotional and cognitive processes in CD. This may, in turn, lead to the development of new (psycho)therapeutic approaches for management of symptoms and related anxiety.


Assuntos
Antecipação Psicológica/fisiologia , Ansiedade/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Doença de Crohn/diagnóstico por imagem , Estresse Psicológico/diagnóstico por imagem , Adulto , Ansiedade/complicações , Ansiedade/fisiopatologia , Encéfalo/fisiopatologia , Doença de Crohn/complicações , Doença de Crohn/fisiopatologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/complicações , Estresse Psicológico/fisiopatologia , Incerteza , Adulto Jovem
17.
Neurogastroenterol Motil ; 28(7): 994-1000, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26914655

RESUMO

BACKGROUND: The cost-effectiveness for screening for celiac disease (CD) in patients with irritable bowel syndrome (IBS), specifically in the diarrhea (IBS-D) subtype, is beneficial if the prevalence is >1%. However, recent studies have shown controversial results. In this large case-control study, our aim was to determine the prevalence of CD and a panel of related antibodies in patients diagnosed with IBS. MATERIALS AND METHODS: Four hundred IBS patients (Rome III) and 400 asymptomatic healthy controls were prospectively evaluated using antihuman tissue transglutaminase (h-tTG IgA) and deamidated gliadin peptide antibodies (DGP II IgA and DGP II IgG). Duodenal biopsy was performed on the patients that were positive for the h-tTG IgA and/or DGP II IgG antibodies. RESULTS: The mean age of the population was 44.47 ± 18.01 years and 335 (82%) of the subjects were women. Twenty-one patients and six controls had at least one positive test for CD (5.25% VS 1.5%, p = 0.003, OR 3.63 [95% CI 1.4-9.11]). Eighteen patients were positive for h-tTG and/or DGP-II IgG. Histologic confirmation of CD was 2.5% in the IBS patients vs 0.5% in the controls (p = 0.04, OR 5.21). The IBS-D subtype had the highest prevalence for serological positivity (12.7%). CONCLUSIONS: Up to 5.2% of the patients with IBS according to the Rome III criteria were positive for at least one of the CD-related antibodies and 2.5% had biopsy-confirmed CD. Therefore, in our population, screening for CD in subjects with IBS appears to be a reasonable strategy, especially in the IBS-D subgroup.


Assuntos
Autoanticorpos/sangue , Doença Celíaca/sangue , Doença Celíaca/epidemiologia , Síndrome do Intestino Irritável/sangue , Síndrome do Intestino Irritável/epidemiologia , Adulto , Estudos de Casos e Controles , Doença Celíaca/classificação , Feminino , Humanos , Imunoglobulina A/sangue , Síndrome do Intestino Irritável/classificação , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos
18.
Encephale ; 42(3): 226-33, 2016 Jun.
Artigo em Francês | MEDLINE | ID: mdl-26796561

RESUMO

INTRODUCTION: The link between social practices and representations is now well known. But while many studies have focused on the social representation of mental illness, in various populations, few studies have focused on the notion of disease/illness by comparing professionals and non-professionals health workers representations. Indeed, the disease is both a reality described, explained and treated by medicine; for those who are affected by a disease, it is an individual experience with psychological, social and cultural impacts. The social representation is determined by the structure of the social groups in which it develops; therefore, it is a form of knowledge socially shaped and shared by the members of a social group. Several theoretical extensions have been elaborated and particularly, the structural approach and the central core theory. These approaches sustain the arguments of a hierarchical organization of a social representation with a central core surrounded by peripheral zones. The central core is common and shared by the majority of the members of a given group, whereas the peripheral zones provide space for the individualization of the social knowledge. PURPOSE: The main goal of our study is to highlight the social representations of disease in health professionals (HP) and in non-health professionals (NHP). The group of HP has been differentiated into three subgroups: "medical doctors", "nurses" and "pharmacists", while that of NHP in two subgroups: those submitted to a "long period medical treatment" and those "without treatment". Our aim is to show that there are different social and professional Representations of disease. The professional representations are specific social representations related to professional contexts. We formulate the following assumptions (a) that the social representations of HP and NHP will be articulated around a common central core. Nevertheless, we expect to find specific peripheral elements related to professional status, based on different knowledge and a differentiated "practice"; (b) the HP should refer to more descriptive aspects of the disease and monitoring of patients, while (c) NHP should refer more to the experience of illness around emotional aspects. METHOD: Our sample is composed of 270 participants (135 HP and 135 HNP). Representations are measured by a free association task based on the target term: disease. The data have been submitted to prototypical and categorical analyses in agreement with the central core theory. RESULTS AND DISCUSSION: The results confirm that there is a common social representation of disease shared by the two groups, which refers essentially to suffering and pain. The analysis of each group brings to light two different registers: the one of the HP with more descriptive words referring to the nature and the illness's characteristics, and the other ones of the HNP with more words connected to emotions and referring to personal real experience of the illness. As expected, the social representation of the HP is referring to the "professional representations" of the disease, while the one for the HNP is linked to "practices" of an illness. An analysis of intra-group differences shows specificities for each of the questioned subgroups. In the HP, medical doctors focus on the diagnosis and consequences of the disease, pharmacists refer to the treatment of the disease and its management, while nurses focus on the treatment and on the relation while monitoring patients. In the NHP, people submitted to a "long period medical treatment" refer to the emotional aspects and to the consequences of the illness on their live, while those without treatment use more descriptive and formal terms. These results suggest to the PS to expand exchanges related to the disease in order to facilitate communication centered on taking care of the patient, considered in its wholeness and not only as an actual or potential patient. This is an important step in improving the health of the patient.


Assuntos
Comportamento de Doença , Transtornos Mentais/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Dor/psicologia , Pacientes , Farmacêuticos , Médicos , Autoimagem , Percepção Social , Estresse Psicológico/psicologia , Adulto Jovem
19.
Facts Views Vis Obgyn ; 8(4): 237-242, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28210484

RESUMO

The sex life of Arabs is terra incognita for scientists and policy makers. Shereen El Feki's book "Sex and the Citadel" is the first serious attempt to chart sexual intimacy in the rapidly changing Arab world.

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