Individual and regional factors of access to the renal transplant waiting list in france in a cohort of dialyzed patients.

Several studies have investigated geographical variations in access to renal transplant waiting lists, but none has assessed the impact on these variations of factors at both the patient and geographic levels. The objective of our study was to identify medical and non-medical factors at both these levels associated with these geographical variations in waiting-list placement in France. We included all incident patients aged 18-80 years in 11 French regions who started dialysis between January 1, 2006, and December 31, 2008. Both a multilevel Cox model with shared frailty and a competing risks model were used for the analyses. At the patient level, old age, comorbidities, diabetic nephropathy, non-autonomous first dialysis, and female gender were the major determinants of a lower probability of being waitlisted. At the regional level, the only factor associated with this probability was an increase in the number of patients on the waiting list from 2005 to 2009. This finding supports a slight but significant impact of a regional organ shortage on waitlisting practices. Our findings demonstrate that patients' age has a major impact on waitlisting practices, even for patients with no comorbidity or disability, whose survival would likely be improved by transplantation compared with dialysis.

Trypanosomatids are common and diverse parasites of Drosophila.

Drosophila melanogaster is an important model system of immunity and parasite resistance, yet most studies use parasites that do not naturally infect this organism. We have studied trypanosomatids in natural populations to assess the prevalence and diversity of these gut parasites. We collected several species of Drosophila from Europe and surveyed them for trypanosomatids using conserved primers for two genes. We have used the conserved GAPDH sequence to construct a phylogenetic tree and the highly variable spliced leader RNA to assay genetic diversity. All 5 of the species that we examined were infected, and the average prevalence ranged from 1 to 6%. There are several different groups of trypanosomatids, related to other monoxenous Trypanosomatidae. These may represent new trypanosomatid species and were found in different species of European Drosophila from different geographical locations. The detection of a little studied natural pathogen in D. melanogaster and related species provides new opportunities for research into both the Drosophila immune response and the evolution of hosts and parasites.

[Topical application of drugs in the ear]. / Topische Arzneimittelanwendung am Ohr.

From all topical otic preparations, eardrops are the most often used drug-containing application forms. There are some advantages for those ototopical drops like achievement of high concentration, good compliance, and rapid delivery. Furthermore those drugs are easy to administer. The risk of adverse drug reactions due to eardrops is small.

The type specimens of Bebryce (Cnidaria, Octocorallia, Plexauridae) re-examined, with emphasis on the sclerites.

Nineteen species of Bebryce are re-described and scanning electron microscopy (SEM) images of sclerites presented. For B. sulfurea Grasshoff, 2000, this is the first time SEM images of sclerites are presented. Two new species are described, Bebryce asteria n. sp. and B. cofferi n. sp., and B. stellata Hentschel, 1903 is synonymized with B. studeri Whitelegge, 1897. Bebryce acanthoides Thomson & Russell, 1910 is referred to Discogorgia Kükenthal, 1919. The status of the original type material is discussed.

Botulism: a pyrolysis-gas-liquid chromatographic study.

Forty samples of dried Clostridia bacteria were subjected to pyrolysis-gas-liquid chromatography (PGLC). Examination of the key fingerprint peaks enabled the analyst to differentiate the samples into their respective antigenic groups. Peaks occurring at the high boiling end of profile could be used to distinguish proteolytic from non-proteolytic strains of C-botulinum. PGLC has proven to be a highly reproducible as well as a rapid specific method for differentiating and identifying samples of Clostridium botulinum.

The influence of sympathetic nervous activity on regression of cardiac hypertrophy.

Pharmacotherapeutical means of reversing cardiac hypertrophy (prazosin, clonidine and nifedipine) were analysed in concentrically, as well as eccentrically, hypertrophied left ventricles. Regression of cardiac hypertrophy, i.e. a therapeutic intervention on a critical precursor of hypertensive congestive heart failure, can be obtained by various antihypertensive agents. Prazosin, calcium channel blockers, clonidine and angiotensin converting enzyme inhibitors as well as a combined treatment regimen using alpha-receptor blockers together with diuretics and vasodilators can all induce regression of hypertrophy associated with an improvement in left ventricular function. Moreover, an improved coronary reserve may reduce the ischaemic risk of the hypertrophied myocardium. However, not all antihypertensive drugs seem equally effective in bringing about coronary regression of left ventricular hypertrophy (LVH). No regression or little regression has been found with diuretic monotherapy despite a satisfactory reduction in blood pressure. On the other hand, a trend towards a regression has been observed in patients in whom treatment with clonidine significantly reduced catecholamines.

The threshold of regulation and its application to indirect food additive contaminants in recycled plastics.

Recycled plastics have been used in food-contact applications since 1990 in various countries around the world. To date, there have been no reported issues concerning health or off-taste resulting from the use of recycled plastics in food-contact applications. This is due to the fact that the criteria that have been established regarding safety and processing are based on extremely high standards that render the finished recycled material equivalent in virtually all aspects to virgin polymers. The basis for this conclusion is detailed in this document.

Global and regional wall motion and contractility of the left ventricle following cigarette smoking.

The hemodynamic and contractile effects of acute cigarette smoking were analyzed in 35 patients with normal cardiac and coronary function as well as with cardiac failure and with coronary artery disease. In normal patients (normal ventricular function, normal coronary arteriogram) cigarette smoking exhibited no contractile depressant effects. Moderate increase in global and in regional wall motion and contractility was found. Likewise, in patients with compensated hypertensive hypertrophy (normal ventriculogram, significant left ventricular hypertrophy, normal coronary arteriogram) cigarette smoking increased global and regional contraction function. In cardiac disease patients (dilatative cardiomyopathy, advanced coronary artery disease, decompensated hypertensive heart disease) cigarette smoking was associated with depression in the overall and regional contraction behavior of the left ventricular myocardium. In patients with coronary artery disease, cigarette smoking was accompanied by marked depression of the regional contraction pattern in hypokinetic, akinetic, and dyskinetic zones. Moreover, contractile depression also occurred in the non-ischemic zones, without pre-existing coronary artery stenoses. In conclusion, acute cigarette smoking may not cause contractile depressant effects in normal patients and patients with compensated hypertensive hypertrophy. However, in coronary patients, significant negative inotropic effects are present not only in the ischemic zones, but also in the non-ischemic myocardium.

Reversal of left ventricular hypertrophy and improvement of cardiac function in man by nifedipine.

The effects of long-term (mean 3.9 months) pharmacotherapy of hypertensive and normotensive hypertrophy (hypertensive heart disease, hypertrophic non-obstructive cardiomyopathy) as well as of advanced cardiac disease due to coronary artery disease and dilatative cardiomyopathy by large doses of nifedipine (mean 120 mg/day-1) were analyzed with regard to systolic blood pressure, to left ventricular function and to the hypertrophy degree of the ventricle. Nifedipine, in addition to conventional and maintained antihypertensive and cardiac therapy, lowers blood pressure in hypertensive patients, whereas hypotensive effects in the normotensive patients were absent. Nifedipine enhances left ventricular function in all patient groups significantly, i.e. in normotensive hypertrophic non-obstructive cardiomyopathy, in hypertensive heart disease and especially in heart disease due to coronary artery disease and dilatative cardiomyopathy. Significant regression of septal and of global hypertrophy was found in hypertrophic non-obstructive cardiomyopathy and in hypertensive heart disease. These results indicate, that long-term nifedipine treatment may be beneficial for left ventricular function in all patient groups and for hypertrophy regression in established left ventricular hypertrophy due to hypertrophic, non-obstructive cardiomyopathy and due to hypertensive left ventricular hypertrophy. It is concluded that long-term nifedipine treatment improves left ventricular function and leads to regression of established ventricular wall hypertrophy in hypertrophic non-obstructive cardiomyopathy and in hypertensive heart disease.

[Tarsonemus hominis in skin connective tissue]. / Tarsonemus hominis im Hautbindegewebe.

Histological examination of a skin biopsy from a 30-year-old male patient which had been performed because of a naevus-like lentigo revealed the presence of a mite within the upper part of the corium. To our knowledge, this may be the first description of such a finding. This mite was identified as a subspecies of Tarsonemus hominis Dahl. Basically, the possibility of a transport of viral material in this way cannot be excluded.