Does vitamin C supplementation improve rotator cuff healing? A preliminary study.

PURPOSE: One of the complications after rotator cuff repair is a tendon non-healing. It has already been posited in the literature that vitamin C (VC) promotes tendon healing through its antioxidant properties and its role as a cofactor in collagen synthesis. The aim of this study was to evaluate the effect of postoperative VC supplementation on the tendon healing following repair. METHODS: This randomized monocentric prospective study included 98 patients who underwent arthroscopic rotator cuff repair in 1-year period and follow-up ultrasound 6 months postoperatively. The cohort was divided into two groups: the VC+ group (500 mg/day PO for 45 days postoperatively) and the VC- group (no supplementation). The evaluation criterion was tendon healing at 6 months postoperatively according to the Sugaya ultrasound classification. Preoperative and postoperative clinical evaluations were based on active mobilities, the Constant score and the subjective shoulder value. RESULTS: There was no difference in term of postoperative outcomes between the two groups. At an average follow-up of 6.3 months, the non-healing rate in the overall population was 17%. This rate was higher in VC- compared to VC+, respectively, 23% vs. 11%), p = 0.2. CONCLUSION: This study showed a trend to improve tendon healing after rotator cuff repair with VC supplementation. However, a prospective study with a larger patient population should be conducted to confirm this finding.

Chestnut extract but not sodium salicylate decreases the severity of diarrhea and enterotoxigenic Escherichia coli F4 shedding in artificially infected piglets.

The development of alternatives to antibiotics is crucial to limiting the incidence of antimicrobial resistance, especially in prophylactic and metaphylactic use to control post-weaning diarrhea (PWD). Feed additives, including bioactive compounds, could be a promising alternative. This study aimed to test two bioactive compounds, sodium salicylate (SA) and a chestnut extract (CE) containing hydrolysable tannins, on the occurrence of PWD. At weaning, 72 piglets were assigned to four treatments that combined two factors: CE supplementation (with 2% of CE (CE+) or without (CE-)) and SA supplementation (with 35 mg/kg BW of SA (SA+) or without (SA-)). Then, 4 days after weaning, all piglets were infected with a suspension at 108 CFU/ml of enterotoxigenic Escherichia coli (ETEC F4ac). Each piglet had free access to an electrolyte solution containing, or not, SA. This SA supplementation was administered for 5 days (i.e., from the day of infection (day 0) to 4 days post-infection (day 4). During the 2 weeks post-infection, supplementation with SA had no effect (P > 0.05) on growth performances nor on fecal scores. A significant SA × time interaction (P < 0.01) for fecal scores and the percentage of diarrhea indicated that piglets with SA did not recover faster and did have a second episode of diarrhea. In contrast to SA treatment, inclusion of CE increased (P < 0.05) growth performances and feed intake. In the first week post-infection, CE decreased (P < 0.001) the overall fecal scores, the percentage of piglets with diarrhea, the days in diarrhea, and ETEC shedding in the feces. There was a SA×CE interaction (P < 0.05) for ETEC shedding, suggesting a negative effect of combining SA with CE. This study highlighted that, in contrast to SA, CE could represent a promising alternative to antibiotics immediately after weaning for improving growth performance and reducing PWD.

In vivo selection of a multidrug-resistant Aeromonas salmonicida during medicinal leech therapy.

We report the selection in a 15-year-old boy of a multidrug-resistant, extended-spectrum ß-lactamase (ESBL)-producing Aeromonas salmonicida after medicinal leech therapy that required an antibiotic prophylaxis based on piperacillin/tazobactam and cotrimoxazole. Whole genome sequencing of the strain indeed revealed 13 antibiotic resistance genes, including the ESBL CTX-M-3 and the unusual ß-lactamase SCO-1.

Pollen loads and specificity of native pollinators of lowbush blueberry.

The reproduction of lowbush blueberry (Vaccinium angustifolium Aiton) is closely tied to insect pollination, owing to self-incompatibility. Many species are known to have greater pollination efficiency than the introduced Apis mellifera L., commonly used for commercial purposes. In this study, we measured the pollen loads of several antophilous insect species, mostly Apoidea and Syrphidae, present in four lowbush blueberry fields in Lac-St-Jean, Québec. To measure pollen loads and species specificity toward V. angustifolium, we net-collected 627 specimens of pollinators, retrieved their pollen loads, identified pollen taxa, and counted pollen grains. We found that the sizes of pollen loads were highly variable among species, ranging from a few hundred to more than 118,000 pollen grains per individual. Bombus and Andrena species in particular carried large amounts of Vaccinium pollen and thus may have greater pollination efficiency. Also, two species (Andrena bradleyi Viereck and Andrena carolina Viereck) showed nearly monolectic behavior toward lowbush blueberry. Finally, we identified alternative forage plants visited by native pollinators, notably species of Acer, Rubus, Ilex mucronata, Ledum groenlandicum, and Taraxacum. Protecting these flowering plants should be part of management practices to maintain healthy pollinator communities in a lowbush blueberry agroecosystem.

Enhanced mental image mapping in autism.

The formation and manipulation of mental images represents a key ability for successfully solving visuospatial tasks like Wechsler's Block Design or visual reasoning problems, tasks where autistics perform at higher levels than predicted by their Wechsler IQ. Visual imagery can be used to compare two mental images, allowing judgment of their relative properties. To examine higher visual processes in autism, and their possible role in explaining autistic visuospatial peaks, we carried out two mental imagery experiments in 23 autistic and 14 age and IQ matched, non-autistic adolescents and adults. Among autistics, 11 had significantly higher Block Design scores than predicted by their IQ. Experiment 1 involved imagining a letter inside a circle, followed by a decision concerning which of two highlighted portions of the circle would contain the greater proportion of the letter. Experiment 2 involved four classic mental rotation tasks utilizing two- and three-dimensional geometric figures, hands and letters. Autistics were more accurate in the formation and comparison of mental images than non-autistics. Autistics with a Block Design peak outperformed other participants in both speed and accuracy of mental rotation. Also, Performance IQ and Block Design scores were better predictors of mental rotation accuracy in autistic compared to non-autistic participants. The ability to form, access and manipulate visual mental representations may be more developed in autistics. We propose two complementary mechanisms to explain these processing advantages: (1) a global advantage in perceptual processing, discussed in the framework of the enhanced perceptual functioning model, and (2) particular strengths in veridical mapping, the ability to efficiently detect isomorphisms among entities and then to use these mappings to process stimulus characteristics, thereby facilitating judgments about their differences.

First Report of Cucumber vein yellowing virus in Melon in France.

During the fall of 2003, mild mosaic symptoms were observed in melon (Cucumis melo L.) plants grown in glasshouses near Eyragues (southeastern France) resembling those caused by the Bemisia tabaci transmitted Cucumber vein yellowing virus (CVYV, genus Ipomovirus, family Potyviridae). In addition, large numbers of B. tabaci were observed to be colonizing these crops. The identification of CVYV was established through differential host range reaction, immunosorbent electron microscopy (IEM), and reverse transcription (RT)-PCR experiments. Crude sap from symptomatic leaves was used to inoculate differential host plants. Mild mosaic symptoms were observed on melon, and cucumber developed vein-clearing symptoms typical of CVYV. No symptoms were observed in Chenopodium quinoa, C. amaranticolor, Nicotiana benthamiana, N. tabacum, and Vigna sinensis. Numerous, slightly flexuous, elongated virus particles were observed in infected plant extracts; these particles were decorated by a polyclonal antiserum raised against a Sudanese CVYV isolate. To confirm CVYV identification, total RNA extracts (TRI-Reagent, Sigma Chemical, St. Louis, MO) were obtained from the original symptomatic melon tissues. RT-PCR was carried out using CVYV-specific primers CVYV-CP-5': 5'-GCTTCTGGTTCTCAAGTGGA-3' and CVYV-CP- 3': 5'-GATGCATCAGTTGTCAGATG-3' designed according to the partial sequence of the coat protein gene of CVYV-Isr (GenBank Accession No. AF233429) (2). A 540-bp fragment corresponding to the central region of CVYV coat protein was amplified from total RNA extracted from symptomatic but not from asymptomatic melon tissue. Direct sequencing was done on RT-PCR products (GenBank Accession No. EF441272). The sequence was 95 and 99% identical to that reported for CVYV isolates from Israel and Spain, respectively. CVYV was first described in Israel and has recently emerged as the cause of important diseases in Spain and Portugal (1,3). Shortly after detecting CVYV during 2003, efforts were made to eradicate the virus in susceptible crops. CVYV was not detected again during intensive surveys conducted in southeastern France during 2004, 2005, and 2006, suggesting that the CVYV detected during 2003 resulted from an accidental introduction and that the virus has not become established in France. References: (1) I. M. Cuadrado et al. Plant Dis. 85:336, 2001. (2) H. Lecoq et al. J. Gen. Virol. 81:2289, 2000. (3) D. Louro et al. Plant Pathol. 53:241, 2004.

First Report of Cucumber vein yellowing virus on Cucumber, Melon, and Watermelon in Iran.

Several viral diseases are responsible for significant economic losses in commercial cucurbit production worldwide. During a survey conducted in July 2002 in cucurbit growing areas in southern Iran, vein-clearing symptoms and leaf chlorosis on older leaves were observed on a cucumber plant near Jiroft (Kerman Province). These symptoms were similar to those caused by Cucumber vein yellowing virus (CVYV, genus Ipomovirus, family Potyviridae), a virus first described in Israel (1) and now widespread in cucurbit crops in the Middle East and Mediterranean Regions (2). The identification of CVYV was established through differential host range reaction and immunosorbent electron microscopy (IEM) experiments. Typical vein-clearing symptoms were observed following mechanical inoculation of cucumber and melon plantlets, but no symptoms were observed in Chenopodium quinoa, C. amaranticolor, Nicotiana tabacum, or Vigna sinensis. Numerous, slightly flexuous, elongated virus particles were observed in infected plant extracts. The particles were decorated by a polyclonal antiserum raised against a Sudanese isolate of CVYV. To confirm CVYV identification, total RNA extracts (TRI-Reagent, Sigma Chemical, St. Louis, MO) were obtained from the original cucumber sample. Reverse transcription-polymerase chain reactions (RT-PCR) were carried out using CVYV-specific primers CVYV-CP-5': 5'-GCTTCTGGTTCTCAAGTGGA-3' and CVYV-CP-3': 5'-GATGCATCAGTTGTCAGATG-3' designed according to the partial sequence of the coat protein gene of CVYV-Isr (GenBank Accession No. AF233429) (2). A 540-bp fragment corresponding to the central region of CVYV coat protein was obtained from extracts of infected plants but not from healthy plant extracts. Additional watermelon (n = 6) and melon (n = 4) leaf samples collected from plants growing in the same farm were tested for the presence of CVYV using RT-PCR. All samples reacted positively for CVYV. However, a sample of Citrullus colocynthis, a wild relative of watermelon growing nearby, was negative. CVYV was not detected using RT-PCR in 123 additional cucurbit samples collected from the eastern and central regions of Iran during a survey conducted in 2002. To our knowledge, this is the first report of the occurrence of CVYV in Iran. Additional surveys in southern regions where Bemisia tabaci, the vector of CVYV, is abundant are required to better estimate the prevalence of this virus in cucurbit crops in Iran. References: (1) S. Cohen and F. E. Nitzany. Phytopathol. Mediterr. 1:44, 1960 (2) H. Lecoq et al. J. Gen. Virol. 81:2289, 2000.

Complete nucleotide sequence of the genomic RNA of a French isolate of Pepino mosaic virus (PepMV). Brief report.

The complete nucleotide sequence of the genomic RNA of a French isolate of Pepino mosaic virus (PepMV) was determined. With a length of 6,425 nucleotides excluding the poly(A) tail at the 3' terminus, the PepMV genome contains five major open reading frames encoding a 164 kDa replicase, triple gene block proteins of 26 kDa, 14 kDa and 9 kDa, and a 25 kDa coat protein. This genome organization, as well as characteristic consensus motifs and high degrees of similarity of PepMV proteins with those of other potexviruses confirmed that PepMV belongs to the Potexvirus genus. Phylogenetic analyses carried out on replicase, triple gene block protein 1 and coat protein amino acid sequences revealed that PepMV is closely related to species Narcissus mosaic virus (NMV), Scallion virus X (SVX), Cymbidium mosaic virus (CymMV), and Potato aucuba mosaic virus (PAMV).

Music decreases sedative requirements during spinal anesthesia.

UNLABELLED: Ambulatory surgery can create significant anxiety. This prospective study measured whether music can influence anxiety and perioperative sedative requirements in outpatients undergoing surgery with spinal anesthesia. We also evaluated the correlation between two anxiety measures, the State-Trait Anxiety Inventory test (STAI) and the 0- to 10-cm visual analog scale (VAS 0-10), with 0 meaning complete relaxation and 10 the worst feeling of anxiety possible. Fifty unpremedicated patients were randomly assigned to listen to music of their choice via headset during the perioperative period (Group I) or to have no music (Group II). All participants used patient-controlled IV midazolam sedation and underwent repeated evaluations of their anxiety level with the STAI and the VAS 0-10. Midazolam requirements during surgery (Group I, 0.6 +/- 0.7 versus Group II, 1.3 +/- 1.1 mg; P < 0.05) and for the whole perioperative period (Group I, 1.2 +/- 1.3 versus Group II, 2.5 +/- 2.0 mg; P < 0.05) were smaller in patients listening to music. Anxiety levels, measured with STAI or VAS 0-10, were similar in both groups. The Spearman's coefficient values between STAI and VAS 0-10 ranged from 0.532 to 0.687. We conclude that patients listening to music require less midazolam to achieve a similar degree of relaxation as controls and that measures of anxiety obtained from the STAI and the VAS 0-10 are positively, but only moderately, correlated. IMPLICATIONS: It is possible to decrease sedative requirements during surgery under spinal anesthesia by allowing patients to listen to music to reduce their anxiety.

[Locoregional neuraxial anesthesia and vascular surgery: the benefits]. / L'anesthésie loco-régionale neuraxiale et la chirurgie vasculaire: les bénéfices.

PURPOSE: To assess the advantages of neuraxial blockade (NB) during and after vascular surgery and to confront them with the risk of epidural or spinal hematoma. MAIN FINDINGS: NB may reduce the risk of thrombotic occlusion following lower extremity vascular reconstruction. This effect of NB may be attributed to reduced hypercoagulability, decreased peripheral resistance and increased graft flow. In patients under general anesthesia, only those authors using an aggressive perioperative management (pulmonary artery catheter monitoring, intensive care unit admission) were able to report grafts patency rates similar to those obtained with NB. NB facilitates the modulation of the hemodynamic and hormonal stress responses during the perioperative period. It also produces superior postoperative analgesia. Still, the impact of NB on cardiac morbidity following aortic reconstructive surgery remains open to debate. Only very few cases of epidural hematomas associated to NB following vascular surgery have been reported. They implicated patients who received either fibrinolytic medication, continuous heparin infusion, or both. Low molecular weight heparins may increase the risk or epidural hematoma and, should their administration become more frequent during vascular surgery, the safety of NB would then have to be reassessed. CONCLUSION: NB during vascular surgery is a safe and well-established practice. It offers many theoretical and demonstrated advantages. NB is particularly beneficial and economical for lower extremity vascular reconstruction. Still, NB may not be the best approach if the administration of fibrinolityc medication or prolonged heparin infusion is contemplated.

Groundwater contamination by nitrates associated with intensive potato culture in Québec.

In rural areas, groundwater contamination by nitrates is a problem related to the spreading of organic and chemical fertilizers by farmers and, to some extent, to effluents from domestic sewage systems. Health effects of groundwater contamination by nitrates have been assessed several times and may lead to important consequences for infants. Following pressures from citizens in 1990, a survey of well water quality around potato fields of the Portneuf county (Québec) found that nitrate contamination was frequently above the 10 mg-N/1 standard. Because this first survey was limited to areas of intensive potato culture, it was not possible to evaluate the real impact on the groundwater quality for the whole county and the subsequent public health intervention was spread over the entire region. A second survey was carried out in 1995 to reevaluate the situation using random sampling methods. This latter study took into account drinking water habits of the population, the relative importance of potato culture as a source of nitrogen loading, the effects of soil types, and waste-water disposal systems as well as land use on nitrate concentration in private well water. The data analysis was carried out by combining GIS and statistical methods to test hypotheses about the spatial relationship linking measured nitrate concentrations with their immediate environment. This paper presents the major findings from this second study which confirm the impact of intensive potato culture on groundwater nitrate concentrations, mainly localized in sandy soil areas within 2 km of fields. Finally, it illustrates the usefulness of GIS to focus public health interventions.

Reversed-phase LC assay method for deoxycholate in influenza vaccine.

Sodium deoxycholate is used for the disruption of particles in the manufacturing of some influenza vaccines. Residual deoxycholate in inactivated vaccines is currently determined using a labour-intensive colorimetric method which lacks complete specificity. An alternative assay method for residual deoxycholate in vaccine preparations was developed using reversed-phase LC. Cholic acid was used as internal standard and the ratio of internal standard to test solute was used for all calculations. Prior to LC analysis, deoxycholic acid was concentrated by solid-phase extraction, a procedure that also removed proteinaceous material in vaccine samples. The clean-up/concentration procedure recovery was examined using untreated samples and was found to be quantitative. The linearity range of the LC method was between 3 and 200 micrograms ml-1, with a limit of detection of approximately 0.4 micrograms on column, and a lower limit of quantitation of 1.6 micrograms on column. Replicate assays during intra-and inter-day experiments gave acceptable levels of variability. The DCA content of samples from three lots of influenza vaccine varied between 10 and 16 micrograms ml-1. These values were appreciably lower than those measured spectrophotometrically, indicating the higher specificity of the LC method.

[Nursing problems in intensive care for psychiatric patients]. / Les problèmes de nursing en soins intensifs pour les patients psychiatriques.

Two cases illustrate psychotherapeutic aspects of surgical intensive cares for psychiatric patients. Comparison with their style of expression in art-therapy allows a better understanding in their relations with the technical and non human environment.

[HMPAO radionuclide of temporal cortex in the study of deafness]. / La scintigraphie du cortex temporal au HMPAO dans l'exploration des surdités.

A new method of dynamic exploration of central auditory pathway is presented, using measurement of cortical temporal perfusion variations, during auditory stimulation (tonal stimulation in normal hearing patients, electrical stimulation with promontory test in profoundly deaf patients). This study shows a perfusion increment in normal hearing and deaf patients with positive promontory test, which doesn't exist in a patient with negative promontory test. Further development of this study could help for optimization of post implantation auditory results.

[Comparative risks and benefits of drugs. Methodological problems]. / Risques et bénéfices comparés des médicaments. Problèmes méthodologiques.

A focalizing toxicity is defined here as a specific toxicity which attracts much of the attention devoted to the safety of a drug: the hematotoxicity of "second generation" antidepressants is a typical example of such toxicity. The way in which it is handled is frequently biased, whether this be related to its perception or its reporting; as a result, it hampers the process of assessing the risk/benefit ratio of drugs. An attempt is made here to sketch the principles and methods of the validation of safety data; antidepressants furnish various examples of the different points that we make. Finally, we insist upon the fact that assessment of drug risk/benefit ratio must be global and comparative.

Technical expertise as an ethical form: towards an ethics of distance.

The present article proceeds from the observation that the therapeutic relationship is basically unequal. This inequality essentially concerns the respective situation of the patient and his or her doctor vis-à-vis medical knowledge. A strict professionalism guarantees that this inequality remains factual and without essential value. Yet, if both partners unreflectively allow affectivity excessively to intrude into their relationship, their behaviour may then be inspired by subconscious, rather than rational, motives. In that case, the unverifiable allegations of philanthropy or paternalism may be used to rationalise a kind of 'medical sadism' which attempts to justify the will to humiliate the patient by means of the constraints inherent in medical care. The concept of ethical form is introduced as a non-verbal criterion of ethical reliability. It is mainly a way of training the will through the application of rationally justified rules of behaviour. In this context, it is suggested that an effort to remain constantly within the limits of professionalism represents a method of training for the achievement of some degree of ethical credibility in the therapeutic relationship. In the long term, such abstinence could constitute a sort of catharsis, and thereby help to reveal the non-rational motives in medical behaviour. Contrary to the belief prevailing in modern society, the established limits of medical knowledge are not so broad. The application of these limits would probably be the best method of preventing emotions from interfering undesirably in the therapeutic relationship.

[Sensitivity of antigen Y ta to proteolytic enzyme]. / Etude de la sensibilité de l'antigène YTA aux enzymes protéolytiques.

The study of the agglutinability of Yt(a+) red cells by several examples of anti-Yta showed that Yta antigen is destroyed by papaïn, chymotrypsin, ficin, bromelin. Neuraminidase and trypsin are not active.

[A simple method for evaluation of the lecithin/sphingomyelin ratio in amniotic fluid. Variation in normal and abnormal pregnancies (138 cases) (author's transl)]. / Evaluation simple du rapport lécithines/sphingomyélines du liquide amniotique. Variations au cours des grossesses normales et pathologiques (a propos de 138 cas)

The determination of the lecithin/sphingomyelin ratio in amniotic fluid is a useful index for assessing fetal pulmonary maturity. The authors propose a simple and specific method : the amniotic lipids are extracted and thin layer chromatography is carried out in an acetic acid containing medium. The L/S ratio was studied and discussed in 138 normal and pathological cases.

[Coagglutination in continuous flow. Techniques and applications]. / Coagglutination en flux continu. Techniques et applications

The principle of coagglutination, the specific agglutination of uncoated red cells by antibody coated ones was applied to the two conventional continuous flow agglutination systems (bromelin-methylcellulose and polybrene-Na-citrate). The technique was used to study a large number of allo- and auto-antibodies of various specificities as well as some drug related antibodies. The sensitivity of the technique proved not to be higher than that of similar systems using free antibodies. It was however shown to be still more economical and elegantly allowed to avoid manual absorption-elution steps prior to investigation of antibody or antigen specificity.