RESUMEN
OBJECTIVES: A survey was conducted in the maternity hospitals of French Guiana in 2017-2018 centered on uses of tobacco, alcohol and pemba (clay) during pregnancy, including questions about violence and the perception of adverse situations during pregnancy. The data used here allow an analysis of lifetime violence and the experience of the last pregnancy. METHODS: An ad hoc questionnaire was designed including some questions to identify at risk situations and T-Ace items for measuring problematic alcohol use. It was adapted to specificities of the local population groups, migrants or from borders, and asking for the maternal tongue. It was administered to women following childbirth. The questionnaire was strictly anonymous. The ethics committee had validated the questionnaire and the collection procedures (Decision 2017-25). In addition, to the issue of violence, seven questions were asked about women's experiences with pregnancy. A bivariate analysis identified significantly associated variables that were used for a multicomponent analysis to identify a typology of women based on their pregnancy experience (Modalisa8 and SPSS19). The very small number of women who smoked tobacco or cannabis during pregnancy (16 and 7 women respectively) led us to ignore these variables. RESULTS: The survey interviewed 789 women throughout Guyana. They were on average 28.9 years old at this pregnancy and had an average of 3.24 living children comprised this newborn. The questioned women were younger than in metropolitan France, less often married, with a low level of education, often foreigners, especially Haitian or Surinamese. Overall, 174 women, or 22% of the total reported having experienced violence in their lifetime, with four women refusing to answer the question. The profiles of the concerned women were not very different according to their ages or levels of education, but differed significantly from the average on several characteristics, such as their mother tongue, marital status, nationalities, whether living on state aid not related to employment or family allowances, or having no resources, living around Cayenne or Kourou and having been on the territory for less than two years. Three groups of women were distinguished by the multicomponent analysis. The first group comprised essentially foreign women living around Cayenne, alone with children, having a low educational level, and having experienced difficulties to cope with this pregnancy. They reported no use of psychoactive substances. They experienced violence more often than in the other groups (almost one in two). One in five had migrated during the last pregnancy. The second group was composed more often of French women, born in Guyana or in metropolitan France. They more often lived with a partner, had a good educational level, personal or marital incomes. They expressed more often worry, with sleep problems but with an entourage to rely on. Before pregnancy they drank alcohol at events but one in three had a T-Ace scoring at two or more. They had a good pregnancy follow-up. The last group was composed of women living around Saint-Laurent-du-Maroni or in remote communities, with a low educational level, living alone with numerous children. They didn't feel worry and had good sleep. They didn't experience violence. They differed by their use of pemba and beer and late or inadequate pregnancy follow-up. CONCLUSIONS: Data on violence in French Guyana show that young people and women declare more often having experienced physical violence, in or out of family life. Young women are overrepresented thus a survey in childbearing women must reveal a high frequency of these events. Our data allow us to go further, by associating this experience of violence and the experience of pregnancy with socio-demographic variables. We can thus see that the overall average obtained on a large number of indicators is smoothed by extremely contrasting situations, of women feeling safe or not, well followed or not for this pregnancy, etc. The groups distinguished by the MCA reveal the contrast between women of Haitian nationality in the Cayenne region and Surinamese or Nengee-speaking women, who are grouped around Saint-Laurent-du-Maroni or in the isolated municipalities of western Guyana. One sub-group stands out in particular for the combination of lifetime violence and very unfavorable conditions during the last pregnancy, both of precariousness, isolation and recent migration. The experience of violence and pregnancy in poor conditions require close actions to take charge of these women, especially since they are at risk for sexually transmitted diseases, including HIV.
Asunto(s)
Consumo de Bebidas Alcohólicas , Migrantes , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Niño , Preescolar , Femenino , Guyana Francesa/epidemiología , Haití , Humanos , Recién Nacido , Embarazo , ViolenciaRESUMEN
We report the generation and characterization of mice lacking adenosine deaminase (ADA). In humans, absence of ADA causes severe combined immunodeficiency. In contrast, ADA-deficient mice die perinatally with marked liver-cell degeneration, but lack abnormalities in the thymus. The ADA substrates, adenosine and deoxyadenosine, are increased in ADA-deficient mice. Adenine deoxyribonucleotides are only modestly elevated, whereas S-adenosylhomocysteine hydrolase activity is reduced more than 85%. Consequently, the ratio of S-adenosylhomocysteine (AdoMet) to S-adenosyl homocysteine (AdoHcy) is reduced threefold in liver. We conclude that ADA plays a more critical role in murine than human fetal development. The murine liver pathology may be due to AdoHcy-mediated inhibition of AdoMet-dependent transmethylation reactions.
Asunto(s)
Adenosina Desaminasa/deficiencia , Adenosina Desaminasa/genética , Intestino Delgado/patología , Hígado/patología , Atelectasia Pulmonar/genética , Animales , Animales Recién Nacidos , Secuencia de Bases , Muerte Celular , Cartilla de ADN/genética , Modelos Animales de Enfermedad , Desarrollo Embrionario y Fetal/genética , Desarrollo Embrionario y Fetal/fisiología , Femenino , Marcación de Gen , Homocigoto , Humanos , Masculino , Metilación , Ratones , Datos de Secuencia Molecular , Mutación , Embarazo , Purinas/metabolismo , Inmunodeficiencia Combinada Grave/etiología , Subgrupos de Linfocitos T/inmunologíaRESUMEN
BACKGROUND: This paper aims at showing the immediate and long-term consequences affecting newborns whose mothers did not reduce or stop their consumption of alcohol when they were pregnant; these women were chosen among women who also used psychoactive substances. METHODS: A retrospective cohort was constituted of babies who were found to have been exposed in utero to one or more legal or illegal psychoactive substance(s) and who were born or hospitalized between 1999 and 2008 in a hospital near Paris. Among the cohort of 170 babies, 56 had mothers who had not modified their alcohol consumption when they were pregnant, 30 had mothers who had reduced their alcohol consumption, and 84 had mothers who declared having been abstinent. RESULTS: The babies born to mothers who did not modify their alcohol consumption when pregnant were more likely to be premature (30%) and hospitalized in the neonatology hospital unit (60.7%). They needed specific care for durations significantly longer than the babies exposed in utero to other psychoactive substances (P<0.005). They were more often diagnosed with fetal alcohol spectrum disorders (18%) and placed in a foster family (18%). CONCLUSION: Given the negative consequences on the babies born to mothers who do not modify their alcohol consumption when pregnant, these mothers should be identified and provided with better care. The successful strategies for early therapeutic interventions used in other countries should be studied as examples. This would make it possible to reduce the enormous financial, material and human costs that are a direct consequence of alcohol consumption during pregnancy.
Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Trastornos del Espectro Alcohólico Fetal/etiología , Retardo del Crecimiento Fetal/etiología , Recien Nacido Prematuro , Madres , Consumo de Bebidas Alcohólicas/economía , Consumo de Bebidas Alcohólicas/prevención & control , Estudios de Cohortes , Consejo/métodos , Femenino , Trastornos del Espectro Alcohólico Fetal/economía , Retardo del Crecimiento Fetal/economía , Francia , Conocimientos, Actitudes y Práctica en Salud , Humanos , Recién Nacido , Tiempo de Internación/economía , Embarazo , Estudios RetrospectivosRESUMEN
OBJECTIVES: Polydrug use in pregnancy is harmful. This survey aimed to explore the issue of the associations of substances during pregnancy and to determine the consumer profiles. PATIENTS AND METHODS: One hundred and seventy newborns whose mothers were psychoactive substances users were identified over the period 1999 to 2008. The data relating to maternal consumption, their reproductive history, and their living environment were collated. RESULTS: At the end of their pregnancy, the mothers reported using on average 3.14 substances. Three profiles were determined: 65 women were heroin users or had consumed it in their lifetime and were currently on substitution treatment, and had a very unfavourable social living environment; 30 women were mainly consumers of alcohol, with or without benzodiazepines or other psychotropic drugs, and had a history of abortions; 75 women were mainly tobacco and cannabis smokers, with or without substitution treatment, had good social living conditions and had wanted the pregnancy. CONCLUSION: Polydrug use increases the risk for the women to avoid prenatal care and is often linked with a history of abortions.
Asunto(s)
Complicaciones del Embarazo , Resultado del Embarazo , Trastornos Relacionados con Sustancias/complicaciones , Aborto Inducido/estadística & datos numéricos , Trastornos Relacionados con Cocaína/complicaciones , Estudios de Cohortes , Etanol/efectos adversos , Femenino , Dependencia de Heroína/complicaciones , Humanos , Recién Nacido , Fumar Marihuana/efectos adversos , N-Metil-3,4-metilenodioxianfetamina/efectos adversos , Embarazo , Psicotrópicos/administración & dosificación , Psicotrópicos/efectos adversos , Estudios Retrospectivos , Fumar/efectos adversosRESUMEN
PIP: "In accordance with demographic developments, the age of retirement should increase as a result of [the] ageing of the population.... This article proposes to examine the relevance of this diagnosis as well as its implications [for France]. However as population ageing seems to go hand in hand with a decrease in the proposed retirement age, factors likely to explain this phenomenon are highlighted. Two analyses are proposed: one based on labour demand and income/leisure options and choices, and another on labour supply highlighting the untimely exclusion of older workers from the job market, especially marked in developed countries." (EXCERPT)^ieng
Asunto(s)
Factores de Edad , Empleo , Fuerza Laboral en Salud , Dinámica Poblacional , Jubilación , Demografía , Países Desarrollados , Economía , Europa (Continente) , Francia , Población , Características de la Población , Clase Social , Factores SocioeconómicosRESUMEN
Adenosine deaminase (ADA) deficiency causes lymphopenia and immunodeficiency due to toxic effects of its substrates. Most patients are infants with severe combined immunodeficiency disease (SCID), but others are diagnosed later in childhood (delayed onset) or as adults (late onset); healthy individuals with "partial" ADA deficiency have been identified. More than 50 ADA mutations are known; most patients are heteroallelic, and most alleles are rare. To analyze the relationship of genotype to phenotype, we quantitated the expression of 29 amino acid sequence-altering alleles in the ADA-deleted Escherichia coli strain SO3834. Expressed ADA activity of wild-type and mutant alleles ranged over five orders of magnitude. The 26 disease-associated alleles expressed 0.001%-0.6% of wild-type activity, versus 5%-28% for 3 alleles from "partials." We related these data to the clinical phenotypes and erythrocyte deoxyadenosine nucleotide (dAXP) levels of 52 patients (49 immunodeficient and 3 with partial deficiency) who had 43 genotypes derived from 42 different mutations, including 28 of the expressed alleles. We reduced this complexity to 13 "genotype categories," ranked according to the potential of their constituent alleles to provide ADA activity. Of 31 SCID patients, 28 fell into 3 genotype categories that could express <=0.05% of wild-type ADA activity. Only 2 of 21 patients with delayed, late-onset, or partial phenotypes had one of these "severe" genotypes. Among 37 patients for whom pretreatment metabolic data were available, we found a strong inverse correlation between red-cell dAXP level and total ADA activity expressed by each patient's alleles in SO3834. Our system provides a quantitative framework and ranking system for relating genotype to phenotype.
Asunto(s)
Adenosina Desaminasa/deficiencia , Mutación , Errores Innatos del Metabolismo de la Purina-Pirimidina/genética , Inmunodeficiencia Combinada Grave/genética , Nucleótidos de Adenina/análisis , Adenosina Desaminasa/genética , Adolescente , Adulto , Edad de Inicio , Alelos , Niño , Preescolar , Eritrocitos/química , Expresión Génica , Heterogeneidad Genética , Genotipo , Humanos , Lactante , Fenotipo , Estándares de ReferenciaRESUMEN
The clinical presentations of adenosine deaminase deficiency and purine nucleoside phosphorylase deficiency are widely variable and include clinical and immunologic findings compatible with common variable immunodeficiency. The screening of 44 patients with common variable immunodeficiency failed to identify any individuals with deficiencies of these enzymes.
Asunto(s)
Adenosina Desaminasa/deficiencia , Inmunodeficiencia Variable Común/enzimología , Purina-Nucleósido Fosforilasa/deficiencia , Adenosina Desaminasa/metabolismo , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Purina-Nucleósido Fosforilasa/metabolismoRESUMEN
Grapevine fanleaf virus (GFLV), responsible for the economically important court-noué disease, is exclusively transmitted to its natural host in the vineyards through Xiphinema nematodes. We have developed direct inoculation of GFLV into grapevine through protoplast electroporation. Protoplasts were isolated from mesophyll of in vitro-grown plants and from embryogenic cell suspensions. Permeation conditions were determined by monitoring calcein uptake. Low salt poration medium was selected. Electrical conditions leading to strong transient gene expression were also tested for GFLV inoculation (isolate F13). GFLV replication was detected with either virus particles (2 µg) or viral RNA (10 ng) in both protoplast populations, as shown by anti-P38 Western blotting. Direct inoculation and replication were also observed with Arabis mosaic virus (ArMV), a closely related nepovirus, as well as with another GFLV isolate. These results will be valuable in grapevine biotechnology, for GFLV replication studies, transgenic plant screening for GFLV resistance, and biorisk evaluation.