[Etiological diagnosis of thyroid nodules†: collaborative approach between the internist and specialists]. / Diagnostic étiologique des nodules thyroïdiens - Approche collaborative entre le médecin de premier recours et les spécialistes.

One or more thyroid nodules, most often asymptomatic, may be found in more than half of the population, and they usually do not require specific therapeutic management, except for cancerous nodules. In order to avoid under-diagnosis and over-treatment, we propose a diagnostic strategy in line with current recommendations, based on the collaboration between general internist, radiologist, and endocrinologist. In addition to clinical information and thyroid function tests, thyroid ultrasound remains the first step in assessing the risk of nodule malignancy and setting the indication for fine needle aspiration. Cytology then makes it possible to define the therapeutic strategy, from an observation of the evolution to interventional, surgical or radiofrequency management.

Un ou plusieurs nodules thyroïdiens, le plus souvent asymptomatiques, peuvent être découverts chez plus de la moitié de la population, et dans la plupart des cas, ils ne nécessitent pas de prise en charge thérapeutique spécifique, sauf pour les nodules cancéreux. Afin d'éviter à la fois le sous-diagnostic et le surtraitement, nous proposons une stratégie diagnostique basée sur les recommandations actuelles, faisant appel à la collaboration entre l'interniste généraliste, le radiologue et l'endocrinologue. En complément aux informations cliniques et aux tests de la fonction thyroïdienne, l'ultrason de la thyroïde est l'examen de premier choix pour évaluer le risque de malignité du nodule et pour poser l'indication à la ponction à l'aiguille fine. La cytologie permet alors de définir la stratégie thérapeutique entre une observation de l'évolution ou une prise en charge interventionnelle, chirurgicale ou par radiofréquence.

[The therapeutic education: an awareness program for health professionals]. / L'education thérapeutique pour tous: programme de sensibilisation pour professionnels de la santé.

The impact of the educational process has been shown to improve the quality of life of patients with chronic disease and their involvement in the management of their daily treatments, particularly in the field of diabetes patients. Usually, several health professionals are involved in the accompaniment of chronic patients. Currently, the health professional has few continuing education training programms that can help to support patients with chronic diseases and to better communicate with colleagues from other disciplines. The purpose of this article is to describe and present a new education program designed for all health care professional working in the filed of the chronic disease.

Effectiveness of a real-life program (DIAfit) to promote physical activity in patients with type 2 diabetes: a pragmatic cluster randomized clinical trial.

Introduction: The aim of this study was to evaluate the effectiveness of a real-life clinical physical activity program (DIAfit) on improving physical fitness, body composition, and cardiometabolic health in an unselected population with type 2 diabetes mellitus, and to compare the effects of two variants a different exercise frequencies on the same outcomes. Research design and methods: This was a cluster randomized-controlled assessor-blind trial conducted in 11 clinical centres in Switzerland. All participants in the clinical program with type 2 diabetes were eligible and were randomized to either standard (3 sessions/week for 12 weeks) or alternative (1 session/week for the first four weeks, then 2 sessions/week for the rest of 16 weeks) physical activity program each consisting of 36 sessions of combined aerobic and resistance exercise. Allocation was concealed by a central office unrelated to the study. The primary outcome was aerobic fitness. Secondary outcome measures included: body composition, BMI, HbA1c, muscle strength, walking speed, balance, flexibility, blood pressure, lipid profile. Results: All 185 patients with type 2 diabetes (mean age 59.7 +-10.2 years, 48% women) agreed to participate and were randomized in two groups: a standard group (n=88) and an alternative group (n=97)). There was an 11% increase in aerobic fitness after the program (12.5 Watts; 95% CI 6.76 to 18.25; p<0.001). Significant improvements in physical fitness, body composition, and cardiometabolic parameters were observed at the end of the DIAfit program (improvements between 2-29%) except for lean body mass, triglycerides and cholesterol. No differences were observed between both programs, except for a larger weight reduction of -0.97kg (95% CI -0.04 to -1.91; p=0.04) in the standard program. Conclusions: Both frequency variants of the nation-wide DIAfit program had beneficial effects on physical fitness, HbA1c, body composition, and blood pressure in type 2 diabetes patients and differences were negligible. Clinical trial registration: clinicaltrials.gov, identifier NCT01289587.

Arbuscular mycorrhizal fungi on growth, nutrient status, and total antioxidant activity of Melilotus albus during phytoremediation of a diesel-contaminated substrate.

This research evaluated the effects of arbuscular mycorrhizal fungi (AMF) on growth, nutritional status, total antioxidant activity (AOX), total soluble phenolics content (TPC), and total nitrate reductase activity (NRA) of leaves and roots of Melilotus albus Medik planted in diesel-contaminated sand (7500 mg kg(-1)). Seedlings of Melilotus either Non inoculated (Non-AMF) or pre-inoculated plants (AMF) with the AMF-inoculum Glomus Zac-19 were transplanted to non-contaminated or contaminated sand. After 60 days, diesel significantly reduced plant growth. AMF- plants had no significant greater (64% and 89%, respectively) shoot and leaf dry weight than Non-AMF plants, but AMF plants had lower specific leaf area. AMF-plants had significantly greater content of microelements than non-AMF plants. Regardless diesel contamination, the total AOX and TPC were significantly higher in leaves when compared to roots; in contrast, NRA was higher in roots than leaves. Diesel increased total AOX of leaves, but AMF-plants had significantly lower AOX than non-AMF plants. In contrast, roots of AMF-plants had significantly higher AOX but lower NRA than non-AMF plants. AMF-colonization in roots detected via the fungal alkaline phosphatase activity was significantly reduced by the presence of diesel. AMF-inoculation alleviated diesel toxicity on M. albus by enhancing plant biomass, nutrient content, and AOX activity. In addition, AMF-plants significantly contributed in higher degradation of total petroleum hydrocarbons when compared to non-AMF-plants.

Cytokinin promotes catalase and ascorbate peroxidase activities and preserves the chloroplast integrity during dark-senescence.

Increased oxidative stress displayed during dark-senescence of wheat leaves (Triticum aestivum L.) is caused not only by the increased levels of radicals but also by a loss of antioxidant capacity. Mature leaves were incubated in 6-benzylaminopurine (BAP 10(-4)M) or water (control) during 6d in the dark. The senescence-delaying effect of BAP was associated with the retention of the chloroplast structure, 60% of the initial content of chlorophyll (Chl) and 77% of the initial content of protein. BAP reduced the degradation of the light-harvesting chlorophyll a/b binding protein (LHCP-2), and the large (LSU) and small subunits (SSU) of Rubisco. Our results indicated that the presence of the NADPH:protochlorophyllide oxidoreductase (POR, EC.1.6.99.1) was not promoted by the cytokinin, leading to the conclusion that BAP maintains the level of Chl, preventing its degradation, rather than inducing Chl biosynthesis. The internal structure of chloroplasts was maintained in BAP-treated leaves for up to 6d, with well-organized grana thylakoids and small plastoglobuli; in contrast, chloroplasts of control leaves deteriorated rapidly from day 4 with disorganized internal membranes, and more and larger plastoglobuli. BAP increased the activities of catalase (CAT, EC 1.11.1.6) and ascorbate peroxidase (APX, EC 1.11.1.11) and reduced the level of H(2)O(2) in the delayed-senescence tissue. The present research indicates that BAP reduces levels of reactive oxygen species (ROS), and enhances the activity of antioxidant enzymes (CAT, APX). Our results suggest that BAP protects the cell membranes and the photosynthetic machinery from oxidative damage during delay of senescence in the dark.

A study of allelic diversity underlying flowering-time adaptation in maize landraces.

Landraces (traditional varieties) of domesticated species preserve useful genetic variation, yet they remain untapped due to the genetic linkage between the few useful alleles and hundreds of undesirable alleles. We integrated two approaches to characterize the diversity of 4,471 maize landraces. First, we mapped genomic regions controlling latitudinal and altitudinal adaptation and identified 1,498 genes. Second, we used F-one association mapping (FOAM) to map the genes that control flowering time, across 22 environments, and identified 1,005 genes. In total, we found that 61.4% of the single-nucleotide polymorphisms (SNPs) associated with altitude were also associated with flowering time. More than half of the SNPs associated with altitude were within large structural variants (inversions, centromeres and pericentromeric regions). The combined mapping results indicate that although floral regulatory network genes contribute substantially to field variation, over 90% of the contributing genes probably have indirect effects. Our dual strategy can be used to harness the landrace diversity of plants and animals.

Stress in callus of hippocratea excelsa: catalase activity, hydrogen peroxide content and canophyllol accumulation

En las células vegetales algunos factores adversos inducen frecuentemente estrés oxidativo, el cual genera síntesis de moléculas que activan una gama de señales en las rutas de transducción y antioxidantes. Una molécula-señal producida bajo estrés es el H2O2, el cual ha sido asociado a la producción de metabolitos secundarios in vitro y a la actividad antioxidante de las células vegetales. En este trabajo se utilizó la producción de canofilol en callos de Hippocratea excelsa como un ejemplo para demostrar el incremento en la producción de metabolitos secundarios bajo estrés. Semillas obtenidas de frutos fueron cultivadas in vitro para la obtención del callo. Dos diferentes tipos de estrés fueron aplicados: nutricional, reduciendo la cantidad de N2 en el medio, y osmótico, usando polietilenglicol. Se midió el contenido de canofilol y de H2O2, así como la actividad de la enzima catalasa. El estrés nutricional causó una respuesta diferente a la del estrés osmótico en la acumulación de canofilol y en la actividad de la catalasa, mientras que el contenido de H2O2 aumentó bajo ambos tipos de estrés. La mayor cantidad de canofilol (8 veces el control) se obtuvo bajo estrés nutricional en el tratamiento de 25 por ciento de N2. Este trabajo muestra que las respuestas en la producción de canofilol y la actividad de catalasa en callos de H. excelsa son señalizadas diferencialmente en los dos diferentes tipos de estrés aplicados.