Benefits of a multimodal analgesia compared to local anesthesia alone to alleviate pain following castration in sheep: a multiparametric approach.

Castration of male ruminants is a common livestock management practice, but induces pain. However, little is known about the effectiveness of multimodal analgesia compared to local anesthesia (LA) alone in reducing pain associated with burdizzo castration in sheep. This study aimed to monitor the pain response induced by castration in sheep and to assess the efficacy of analgesia strategies. Twenty-four 12-month-old male Texel sheep were burdizzo-castrated after administration of physiological serum (Burd), local anesthetic (Burd+LA) or LA plus non-steroidal anti-inflammatory drug (Burd+LA+NSAID). Sheep responses were monitored using behavioral and physiological indices of pain. Sampling occurred from 24 h pre-castration to 78 h post-castration, split into four periods based on the duration of analgesia: P0 (T-24 to T-1 h), P1 (T0 to T+2 h), P2 (T+3 to T+32 h) and P3 (T+36 to T+78 h). Behavioral indices were attention and head position, ear position, position of the eyelid, other facial expression, standing/lying postures, postures of the legs, clinical signs and abnormal activities. Physiological indices consisted in indicators of inflammation (haptoglobin, serum amyloid A (SAA), body temperature), hypothalamo-pituitary-adrenal axis (cortisol, non-esterified fatty acids, glucose), autonomous nervous system (heart rate variability (HRV)) and oxidative stress. The variables contributing most to discrimination of the period×treatment groups were analyzed by factorial discrimination analysis. Pre-castration (P0), there was no significant difference between treatments for all indicators (P > 0.05). Post-castration, eight indicators varied significantly according to period and treatment: cortisol, clinical signs, ratio of low frequency/high frequency (LF/HF) bands of the HRV, attention and head position, SAA, haptoglobin, body temperature and glucose. The treatment×periods groups were well discriminated by the 23 indicators. Burd in P0, Burd+LA in P0 and Burd+LA+NSAID in P0, P1 and P2 had low values for all indicators, likely reflecting absence of pain and discomfort. Burd in P1 and P2 and Burd+LA in P2 showed clinical signs and reduced attention, high LF/HF and high cortisol levels, reflecting acute pain. Burd and Burd+LA in P3 had high temperature, high haptoglobin, high glucose and high SAA, but no response from other pathways. These results suggest that (i) behavioral signs of pain were apparent up to 32 h post-castration, (ii) LA was partially effective, but only during its time of action (2 h) and (iii). multimodal analgesia (LA and NSAID) was effective for up to 3 days post-castration. These findings, and especially those related to sheep behavior, can help veterinarians and farmers better detect pain and refine their pain alleviation methods.

Therapeutic choices for curing dysodia?...three clinical cases.

These three clinical cases provide an approach to the management of anatomical voice disorders. When confronted with a laryngeal diagnosis, talented musicians often suffer a crisis of self-confidence which may propel them toward maladaptive compensations; these may destabilize their usual techniques, already disrupted by the changes in their vocal acoustics. In their forties, each of these patients presents with an angiomatous lesion of the vocal fold, associated in two of the cases with a congenital structural weakness. For the three of them, the recommended therapeutic choice was alternating recorded laryngoscopic follow-up, alternative medicine prescriptions, and "artistic sessions" that required that their phoniatrician adapt to their repertory, their temperament, the constraints of the stage and their laryngeal disorder in order that they achieve a compromise between the needs of their career and the laryngeal anatomic realities of the moment. These "artistic guidance sessions" are recorded so as to allow the patient to become aware of the quality of their public performance and to learn the functional elements contributing to it.

From public to occupational health: towards an inverse push-pull paradigm in nanotechnologies innovation.

Nanotechnologies are an important set of new technologies no longer at a very early stage in their development. The financial support for R&D in this domain is greater than a few Giga Euros/year for innovation and considerably lower (less than 1-2%) for risk management. At the factory level, As Low As Reasonably Achievable (ALARA) methods have to be used in order to protect workers against possible exposure. New "short-term" toxicological studies show that nano-particles are seldom exempt of effects in humans... Thus, for the general population, more and more anxious about the future, nanotechnologies are the object of numerous debates. Ultimately, the population is asking governmental bodies to take the required preventive measures. Social pressure is now initiated by the public towards innovative industries, which have to prove, before the marketing stage, the absence of any risk for the users and demonstrate a safety driven governance.

[The "intra-cordal polyp": a clinical alternative to recognize?]. / Le polype "intra-cordal" : une variante clinique à reconnaitre?

UNLABELLED: The vocal cord polyp is an inflammatory false tumour of the larynx. It is characterized mainly by the specific existence of fibrinous exsudats organized in loose network or mounds, surrounded by newly formed vascular slits. The epithelium covering the polyp is usually more or less impaired. CLINICAL CASES: The authors report two adult patients among whom the initial presentation in video-stroboscopy was that of an intracordal lesion of a cystic type, however; with unusual characteristics (purplish color, angiomatous aspect). The surgery consisted of a cordotomy, the surface epithelium appearing normal. After dissection, the two lesions seemed to be presenting the typical aspect of fibrinoïd mound of a polyp, observation confirmed by the anatomo-pathological study. In these cases, the resection was finally carried out with no mucous loss. CONCLUSION: The particular etiopathogeny of these lesions is been discussed. The treatment, medical and of rehabilitation could achieve a partial recovery. In the event of surgery, an access to the lesion through a cordotomy and not directly by removal with microcissors is advised.

[Acquired zinc deficiency in a breast-fed premature infant]. / Déficit acquis en zinc chez un prématuré nourri au sein.

UNLABELLED: Symptomatic zinc deficiency can occur in exclusively breast-fed infants. We report a case in a preterm infant. CASE REPORT: A 3-months-old exclusively breast-fed premature infant presented with peri-orificial and acral eczematoid lesions. Laboratory investigations revealed lowered zinc levels in the infant's serum and in her mother's milk. A rapid healing occurred after oral zinc supplementation. DISCUSSION: Zinc deficiency in breast-fed infants is a rare disease caused by a low level of zinc in mother's milk. The clinical features resemble those of acrodermatitis enteropathica. Oral zinc supplementation is required until weaning.

[Different therapeutic suggestions used in 4 types of laryngopathies presenting in professional singers]. / Suggestions thérapeutiques différentes appliquées à quatre types de laryngopathies présentées par des professionnels de l'expression chantée.

Four clinical cases involving non-surgical approaches to disorders usually treated surgically are considered. The emphasis is placed on the collaboration of artists with laryngologists combining their musical and medical training in their daily work at their office and an alternative clinical management of disorders.

Decreased flow-dependent dilation in carotid arteries of tissue kallikrein-knockout mice.

- Flow-dependent dilation is a fundamental mechanism by which large arteries ensure appropriate blood supply to tissues. We investigated whether or not the vascular kallikrein-kinin system, especially tissue kallikrein (TK), contributes to flow-dependent dilation by comparing wild-type and TK-knockout mice in which the presence or absence of TK expression was verified. We examined in vitro changes in the outer diameter of perfused carotid arteries from TK(+/+) and TK(-/-) mice. In both groups, exogenous bradykinin caused a similar dilation that was abolished by the B(2) receptor antagonist HOE-140, as well as by the NO synthase inhibitor N:(omega)-nitro-L-arginine methyl ester. However, purified kininogen dilated only TK(+/+) arteries, demonstrating the essential role of TK in the vascular formation of kinins. In TK(+/+) arteries, increasing intraluminal flow caused a larger endothelium-dependent dilation than that seen in TK(-/-). In both strains the flow response was mediated by NO and by endothelium-derived hyperpolarizing factor, whereas in TK(-/-) vasoconstrictor prostanoids participated as well. HOE-140 impaired flow-dependent dilation in TK(+/+) arteries while showing no effect in TK(-/-). This compound reduced the flow response in TK(+/+) arteries to a level similar to that in TK(-/-). After NO synthase inhibition, HOE-140 no longer affected the response of TK(+/+). Impaired flow-dependent dilation was also observed in arteries from knockout mice lacking bradykinin B(2) receptors as compared with wild-type animals. This study demonstrates the active contribution of the vascular kallikrein-kinin system to one-third of the flow-dependent dilation response via activation of B(2) receptors coupled to endothelial NO release.

[Ofuji's papulo-erythroderma: treatment with cyclosporin A]. / Papulo-érythrodermie d'Ofuji: traitement par ciclosporine-A.

BACKGROUND: Papuloerythroderma of Ofuji is an uncommon condition characterized by diffuse pruriginous eruptions of infiltrating papulae. The large folds are not involved. The eruptions are associated with lymphopenia and eosinophilia. Very few cases have been reported in the literature and because of their heterogeneous nature, there is some debate as to whether this is a single clinical entity or a particular presentation of erythrodermia; Immunomodulation is recommended. CASE REPORT: A 73 year-old man of asian origin living in France presented chronic pruriginous erythrodermia with flat purplish-brown confluent papulae which did not involve the large folds. Eosophilia and lymphopenia were present. The biopsy specimen evidenced dermal infiltration with CD4+CD45+RO+ T cells, eosinophils and DC1a+ dendritic cells. Further explorations did not reveal any sign favoring lymphoma, carcinoma or underlying infection. Dermocorticoids, PUVA-therapy and interferon-alpha were ineffective. Considerable clinical improvement was obtained with cyclosporine A. DISCUSSION: We used ciclosporine A in our patient after repeated failure of other therapies reported to be effective in this dermatosis. Despite the favorable outcome, this therapeutic approach should be used with prudence.

The effect of a high dose of 3-hydroxy-3-methylbutyrate on protein metabolism in growing lambs.

The effect of a high dose of 3-hydroxy-3-methylbutyrate (HMB, a leucine catabolite) on protein metabolism was investigated in growing male lambs fed on hay and concentrate. Concentrate was supplemented with either Ca(HMB)2 (4 g/kg) or Ca(CO3)2 in experimental (HMB) and control groups respectively. Both groups consisted of six 2-month old lambs. Three complementary methods to study protein metabolism were carried out consecutively 2.5 months after beginning the dietary treatment: whole body phenylalanine fluxes, postprandial plasma free amino acid time course and fractional rates of protein synthesis in skeletal muscles. Feeding a high dose of HMB led to a significant increase in some plasma free amino acids compared with controls. Total, oxidative and non-oxidative phenylalanine fluxes were not modified by dietary HMB supplementation. Similarly, an acute infusion of HMB, in the control group, did not change these fluxes. In skeletal muscles, fractional rates of protein synthesis were not affected by long-term dietary supplementation with HMB. Taken together our results showed that administration of a high dose of HMB to lambs was able to modify plasma free amino acid pattern without any effect on whole-body protein turnover and skeletal muscle protein synthesis.

cAMP and beta gamma subunits of heterotrimeric G proteins stimulate the mitogen-activated protein kinase pathway in COS-7 cells.

Mitogen-activated protein kinases (MAPKs) are activated by a variety of extracellular stimuli, including agonists for G protein-coupled receptors. Using transient transfection of COS-7 cells, we have studied the stimulation of a hemagglutinin-tagged p44mapk (p44HA-mapk) by receptors coupled to Gs, Gq, and Gi. Agonists that act via all three G proteins stimulated p44HA-mapk activity. A constitutively activated alpha s mutant, forskolin, and a cAMP analog also increased p44HA-mapk activity, indicating that cAMP in COS-7 cells, in contrast to other cell types, activates the MAPK pathway. Similarly, a constitutively activated alpha q mutant, overexpression of phospholipase C-beta 2, and a phorbol ester also stimulated p44HA-mapk, suggesting that Gq-coupled receptors stimulate the MAPK pathway by increasing phosphatidylinositol turnover and probably stimulating protein kinase C. In COS-7 cells, in contrast to Rat-1 cells, mutationally activated alpha i did not stimulate the MAPK pathway. G protein beta and gamma subunits, overexpressed together, did activate p44HA-mapk; this finding suggests that in COS-7 cells Gi-coupled receptors may stimulate the MAPK pathway through beta gamma. These unexpected results in COS-7 cells show that G proteins and second messengers regulate the MAPK pathway differently in different cell types.