Dietary supplementation of vitamin D3 and calcium partially recover the compromised time budget and circadian rhythm of lying behavior in lactating cows under heat stress.

Heat stress (HS) impedes cattle behavior and performance and is an animal comfort and welfare issue. The objective of this study was to characterize the time budget and circadian rhythm of lying behavior in dairy cows during HS and to assess the effect of dietary supplementation of vitamin D3 and Ca. Twelve multiparous Holstein cows (42.2 ± 5.6 kg milk/d; 83 ± 27 d in milk) housed in tiestalls were used in a split-plot design with the concentration of dietary vitamin E and Se as main plots (LESe: 11.1 IU/kg and 0.55 mg/kg, and HESe: 223 IU/kg and 1.8 mg/kg, respectively). Within each plot cows were randomly assigned to (1) HS with low concentrations of vitamin D3 and Ca (HS, 1,012 IU/kg and 0.73%, respectively), (2) HS with high concentrations of vitamin D3 and Ca (HS+D3/Ca; 3,764 IU/kg and 0.97%, respectively), or (3) thermoneutral pair-fed (TNPF) with low concentrations of vitamin D3 and Ca (1,012 IU/kg and 0.73%, respectively) in a Latin square design with 14-d periods and 7-d washouts. Lying behavior was measured with HOBO Loggers in 15-min intervals. Overall, cows in HS spent less time lying per day relative to TNPF from d 7 to 14. Daily lying time was positively correlated with milk yield, energy-corrected milk yield, and feed efficiency, and was negatively correlated with rectal temperature, respiratory rate, fecal calprotectin, tumor necrosis factor-α, and C-reactive protein. A treatment by time interaction was observed for lying behavior: the time spent lying was lesser for cows in HS than in TNPF in the early morning (0000-0600 h) and in the night (1800-2400 h). The circadian rhythm of lying behavior was characterized by fitting a cosine function of time into linear mixed model. Daily rhythmicity of lying was detected for cows in TNPF and HS+D3/Ca, whereas only a tendency in HS cows was observed. Cows in TNPF had the highest mesor (the average level of diurnal fluctuations; 34.2 min/h) and amplitude (the distance between the peak and mesor; 17.9 min/h). Both the mesor and amplitude were higher in HS+D3/Ca relative to HS (26.6 vs. 25.2 min/h and 3.91 min/h vs. 2.18 min/h, respectively). The acrophase (time of the peak) of lying time in TNPF, HS, and HS+D3/Ca were 0028, 0152, and 0054 h, respectively. Lastly, a continuous increase in daily lying time in TNPF was observed during the first 4 d of the experimental period in which DMI was gradually restricted, suggesting that intake restrictions may shift feeding behavior and introduce biases in the behavior of animals. In conclusion, lying behavior was compromised in dairy cows under HS, characterizing reduced daily lying time and disrupted circadian rhythms, and the compromised lying behavior can be partially restored by supplementation of vitamin D3 and Ca. Further research may be required for a more suitable model to study behavior of cows under HS.

Early Transmural Response Assessed Using Magnetic Resonance Imaging Could Predict Sustained Clinical Remission and Prevent Bowel Damage in Patients with Crohn's Disease Treated with Anti-Tumour Necrosis Factor Therapy.

BACKGROUND: Magnetic resonance imaging [MRI] is a promising tool to evaluate therapeutic efficacy in ileocolonic Crohn's disease [CD]. AIMS: We aimed to assess the feasibility of early MRI evaluation (week 12 [W12]) to predict corticosteroid-free remission [CFREM] at W52 and prevent long-term bowel damage. METHODS: All patients with active CD needing anti-tumour necrosis factor [anti-TNF] therapy were consecutively enrolled in this multicentre prospective study. MRI was performed before starting therapy, at W12 and W52. CFREM was defined as Crohn's Disease Activity Index < 150, C-reactive protein < 5 mg/L and faecal calprotectin < 250 µg/g, with no switch of anti-TNF agents, no bowel resection and no therapeutic intensification between W12 and W52. RESULTS: Among 46 patients, 22 [47.8%] achieved CFREM at W52. Anti-TNF agents were able to heal almost all CD lesions as soon as W12 [p < 0.05]. Early transmural response defined as a 25% decrease of either Clermont score (odds ratio [OR] = 7.7 [1.7-34.0], p < 0.001) or Magnetic Resonance Index of Activity (OR = 4.2 [1.3-13.3], p = 0.015) was predictive of CFREM at W52. Achieving at least two items on W12-MRI among ulceration healing, disappearance of enlarged lymph nodes or sclerolipomatosis, ΔADC [apparent diffusion coefficient] > +10% or ΔRCE [relative contrast enhancement] > -30% was associated with a likelihood of CFREM at W52 of 84.6% vs 37.5% in patients without transmural response [p < 0.001]. Early transmural response could prevent bowel damage progression over time using Clermont score (hazard ratio = 0.21 [0.0-0.9]; p = 0.037). CONCLUSION: Evaluation of early transmural response by MRI is feasible and is a promising end point to monitor therapeutic efficacy in patients with CD.

A Multicenter Case-control Study of the Effect of Acute Rejection and Cytomegalovirus Infection on Pneumocystis Pneumonia in Solid Organ Transplant Recipients.

BACKGROUND: Pneumocystis pneumonia (PCP) is associated with morbidity and mortality in solid organ transplant (SOT) recipients. In this case-control study, we determined the association between posttransplant PCP and 3 variables: cytomegalovirus (CMV) infection, allograft rejection, and prophylaxis. METHODS: Eight transplant centers participated. For each case (SOT recipient with PCP), 3-5 controls (SOT recipients without PCP) were included. Controls were matched to the cases based on transplant center, type of allograft, and date of transplantation (±6 months). RESULTS: We enrolled 53 cases and 209 controls. Transplant types included kidney (n = 198), heart (n = 30), liver (n = 15), kidney-pancreas (n = 14), and lung (n = 5). PCP occurred beyond 12 months after transplantation in 43 (81.1%) cases. Thirty-four cases (64.1%) required admission to the intensive care unit, and 28 (52.8%) had mechanical ventilation. Allograft failure occurred in 20 (37.7%) cases, and 14 (26.9%) died. No patient developed PCP prophylaxis breakthrough. The proportion of female sex (P = .009), kidney dysfunction (P = .001), cardiac diseases (P = .005), diabetes mellitus (P = .03), allograft rejection (P = .001), CMV infection (P = .001), and severe lymphopenia (P = .001) were significantly higher in cases. In the logistic regression model, CMV infection (adjusted odds ratio [aOR], 4.6 [95% confidence interval {CI}, 2.0-10.5]) and allograft rejection (aOR, 3.0 [95% CI, 1.5-6.1]) significantly increased the likelihood of PCP. CONCLUSIONS: PCP was mostly a late-onset disease occurring after complete course of prophylaxis, particularly among patients with CMV infection or allograft rejection. PCP is associated with significant allograft loss. Extended prophylaxis targeting recipients with allograft rejection or CMV infection may reduce the risk of PCP.

Suppressive antibiotic therapy with oral tetracyclines for prosthetic joint infections: a retrospective study of 78 patients.

PURPOSE: This study aimed at describing the use of oral cyclines (i.e., doxycycline and minocycline) as suppressive antibiotic therapy (SAT) in patients with periprosthetic joint infections (PJIs). METHODS: Medical charts of all patients with surgical revisions for PJIs who were given cycline-based SAT because of a high failure of various origins were reviewed. Data regarding tolerability and effectiveness of cycline-based SAT were analysed. RESULTS: Seventy-eight patients of mean age 64 ± 17 years received cycline-base SAT in the period from January 2006 to January 2014. PJIs involved the knee in 37 patients (47%), the hip in 35 (45%), the elbow in 4 (5%), and the shoulder in 2 (3%) and were qualified as early in 31 patients (39.7%). Staphylococcus spp. were the most common pathogens accounting for 72.1% of the total number of bacterial strains identified. All included patients had surgery which consisted in debridement and implant retention in 59 of them (75.6%). Doxycycline and minocycline were prescribed as SAT in 72 (92%) and 6 (8%) patients, respectively. Adverse events were reported in 14 patients (18%), leading to SAT discontinuation in 6 of them (8%). After a mean follow-up of 1020 ± 597 days, a total of 22 (28.2%) patients had failed including 3 cases (3.8%) with documented acquisition of tetracycline resistance in initial pathogen(s). CONCLUSIONS: Our results suggest that oral cyclines used as SAT in patients treated for PJI have an acceptable tolerability and effectiveness and appear to be a reasonable option in this setting.

Epidemiology of infectious encephalitis causes in 2016.

We performed a literature search in the Medline database, using the PubMed website. The incidence of presumably infectious encephalitis is estimated at 1.5-7 cases/100,000 inhabitants/year, excluding epidemics. Infectious encephalitis and immune-mediated encephalitis share similar clinical signs and symptoms. The latter accounts for a significant proportion of presumably infectious encephalitis cases without any established etiological diagnosis; as shown from a prospective cohort study where 21% of cases were due to an immune cause. Several infectious agents are frequently reported in all studies: Herpes simplex virus (HSV) is the most frequent pathogen in 65% of studies, followed by Varicella-zoster virus (VZV) in several studies. Enteroviruses are also reported; being the most frequent viruses in two studies, and the 2nd or 3rd viruses in five other studies. There are important regional differences, especially in case of vector-borne transmission: Asia and the Japanese encephalitis virus, Eastern and Northern Europe/Eastern Russia and the tick-borne encephalitis virus, Northern America and Flavivirus or Alphavirus. Bacteria can also be incriminated: Mycobacterium tuberculosis and Listeria monocytogenes are the most frequent, after HSV and VZV, in a French prospective study. The epidemiology of encephalitis is constantly evolving. Epidemiological data may indicate the emergence and/or dissemination of new causative agents. The dissemination and emergence of causative agents are fostered by environmental, social, and economical changes, but prevention programs (vaccination, vector controls) help reduce the incidence of other infectious diseases and associated encephalitis (e.g., measles).

Study of the antimicrobial and antifouling properties of different oxide surfaces.

Membrane separation processes find applications in an array of fields as they use far less energy and chemical agents than competing processes. However, a major drawback of membrane technology is that biofilm formation alters membrane performances. Preventing biofilm formation is thus a pivotal challenge for larger-scale development of membrane processes. Here, we studied the comparative antibacterial activities of different inorganic membranes (ceramic and zeolite-coated ceramic with or without copper exchange) using several bacterial strains (Escherichia coli, Staphylococcus aureus, and Bacillus subtilis). In static conditions, alumina plates coated with Cu-exchanged zeolite showed significant bactericidal activity. In dynamic mode (circulation of a contaminated nutrient medium), there was no observable bacterial adhesion at the surface of the Cu-exchanged material. These results confirm the antifouling properties of the Cu-mordenite layer due to both the increased hydrophilicity and antibacterial properties of the active layer.Tests performed with tubular filtration membranes (without copper exchange) showed a significant decline in membrane hydraulic properties during filtration of culture media containing bacteria, whereas copper-exchanged membranes showed no decline in hydraulic permeability. Filtration tests performed with concentrated culture media containing spores of B. subtilis led to a significant decrease in membrane hydraulic permeabilities (but less so with Cu-exchanged membranes). The surfaces showed less effective global antifouling properties during the filtration of a concentrated culture medium due to competition between bacterial growth and the bactericidal effect of copper. Analyses of copper leached in solution show that after a conditioning step, the amount of copper released is negligible.

But other than mesothelioma? An estimate of the proportion of work-related cancers in Quebec.

BACKGROUND: More than 30 exposures in the workplace are proven carcinogens. In the present study, we aimed to estimate the burden of occupational cancer in Quebec so as to increase awareness among stakeholders and to prioritize research activities. METHODS: Work-attributable fractions-that is, the proportions of cancers attributable to work-as published in Finland and the United Kingdom were applied to Quebec 2002-2006 cancer incidence and mortality data to estimate the number of work-related cases for 28 cancer sites. RESULTS: Overall, 6.0% of incident cancers (men: 9.1%; women: 2.7%) and 7.6% of cancer deaths (men: 11.8%; women: 2.8%) could be attributable to work, resulting annually in an average of 2160 new cancer diagnoses and 1190 cancer deaths in Quebec. Incident cancers of the lung, prostate, skin, bladder, and (female) breast were the most numerous; cancer sites resulting in more deaths were lung, (female) breast, and pleura. During the same period, compensation statistics reported annual averages of 94.3 incident cancers and 61.9 cancer deaths, mostly involving mesothelioma (64% of compensated incident cancers) and lung cancer (30% of compensated incident cancers). CONCLUSIONS: Increased recognition of workplace cancers by all stakeholders, from workers and employers to treating physicians, will foster appropriate preventive measures for safer workplaces.

Metabolomics: Perspectives on potential biomarkers in organ transplantation and immunosuppressant toxicity.

Organ transplantation is the treatment of choice for many end stage diseases. The development and appropriate use of new immunosupressants have considerably improved the outcome of patients in the last decades. However, noninvasive, sensitive and specific biomarkers for early detection of complications leading to graft dysfunction are still needed. Current transplantation monitoring mostly relies on non-specific biochemical tests whereas diagnosis of rejection is generally based on invasive procedures such as biopsies. New approaches based on large scale profiling of body fluids and tissues are needed to address the complexity and multifactorial aspect of organ transplantation complications. Metabolomics aim to characterize and quantify the metabolome, which is the collection of the low-molecular weight compounds rising from metabolic pathways. Extracted from tissues or detected in body fluids, the small molecules are measured using nuclear magnetic resonance spectroscopy or mass spectrometry. By profiling the downstream products of cellular activity, metabolomics is most likely to represent the immediate cellular response to stresses. Diagnostic applications have been proposed in cancer, cardiovascular diseases, kidney diseases, neurological diseases and many more. This review will focus on the potential applications of metabolomics in organ transplantation including follow up of graft function recovery, diagnostic of alloimmune rejection as well as monitoring of immunosuppressant toxicity.

Endoscopic Factors Influencing Fecal Calprotectin Value in Crohn's Disease.

BACKGROUND AND AIMS: Fecal calprotectin [fcal] is a biomarker of Crohn's disease [CD] endoscopic activity. Identifying the endoscopic situations in which fcal is less reliable remains unexplored. We aimed to determine the endoscopic factors influencing fcal level in CD. METHODS: Overall, 53 CD patients consecutively and prospectively underwent colonoscopy, with CD Endoscopic Index of Severity [CDEIS] calculation and stool collection. Fcal was measured using a quantitative immunochromatographic test. Correlation analysis was done with Pearson statistics. RESULTS: Fcal was correlated with CDEIS [0.66, p < 0.001]. In univariate analysis, fcal was correlated with the affected surface [0.65, p < 0.001] and the ulcerated surface [0.47, p < 0.001]. Fcal was significantly associated with ulceration depth, with median fcal of 867.5 µg/g, 1251.0 µg/g, and 1800.0 µg/g, in patients presenting with non-ulcerated lesions, superficial ulcerations [SU], and deep ulcerations [DU], respectively. Lesion locations did not influence fcal. In multivariate analysis, fcal was associated with affected surface [p = 0.04] and the presence of CD lesions. Moreover, fcal increased with the ulceration depth [p = 0.03]. However, ulcerated surface and CD location did not affect fcal. Using a receiver operating characteristic [ROC] curve, we showed that fcal of 400 µg/g was the best compromise between sensitivity [0.76] and specificity [0.77], whereas fcal ≥ 200 µg/g was highly sensitive [0.86] to detect SU or DU. CONCLUSIONS: Fcal is a very reliable biomarker to detect endoscopic ulcerations in CD. We suggest repeating measurement in case of intermediary results [200-400 µg/g] in daily practice. Fcal level is mostly influenced by the presence of CD lesions [even non-ulcerated], in a depth-related manner and by the affected surface.

[Renal extramedullary hematopoietic tumor revealing a hereditary spherocytosis in an adult patient]. / Révélation à l'âge adulte d'une sphérocytose héréditaire devant une tumeur rénale: forme frontière entre myélolipome et foyer d'hématopoïèse extra-médullaire.

INTRODUCTION: Myelolipomas and extramedullary hematopoietic tumors are uncommon benign tumors. They are variably composed of mature adipose tissue and hematopoietic tissue. Myelolipoma is usually observed in the adrenal gland and extramedullary hematopoietic tumors in the liver and spleen but may occasionally be found within solid tumors. CASE REPORT: A 62-year-old man without previous haematological history presented with a voluminous solitary bilateral renal tumor. Contrast-enhanced ultrasound CT-scan and scintigraphy with technetium-99m-nanocolloid and indium-111-chloride bone marrow were highly suggestive of extramedullary hematopoietic tumor. CT-guided biopsy suggested a diagnosis of myelolipoma. An atypical hereditary spherocytosis, undiagnosed until now, was demonstrated. CONCLUSION: We report, for the first time to our knowledge, a border form between extramedullary hematopoiesis tumor and myelolipoma of renal localisation revealing a hereditary spherocytosis in an adult patient.

LANDSCAPE CHANGES IN A LOWLAND IN BENIN: ECOLOGICAL IMPACT ON PESTS AND NATURAL ENEMIES.

Habitat management involving conservative biological control could be a good crop pest management option in poor African countries. A survey was conducted from August 2013 to July 2014 in a rainfed lowland region near Pélébina, northern Benin, in order to characterize spatiotemporal landscape changes and investigate their influence on the main crop pests and their associated natural enemies. The area was mapped mainly regarding crop fields and fallows. Visual observations were recorded and a database was compiled. Major landscape composition changes were noted between rainy and dry seasons, which affected the presence of both pests and natural enemies. Cereals (rice, maize and sorghum) and cotton were grown in the humid season, and then okra (Abelmoschus esculentus) was the dominant vegetable crop in dry season. These modifications impacted fallow abundance throughout the lowland. Different cotton (e.g. Helicoverpa armigera, Dysdercus sp., Zonocerus variegatus) or rice (e.g. Diopsis longicornis, D. apicalis) pests were observed during dry season in okra crops. Dry season surveys of Poaceae in two types of fallows ('humid', 'dry') revealed the presence of very few stem borers: only 0.04% of stems sampled were infested by stem borers, with a mean of 1.13 larvae per stem. Known cereal stem borer species such as Busseola fusco, Coniesta ignefusalis, Sesamia calamistis were not clearly identified among these larvae because of their diapausing stage and white color. Unexpected pollinators (Hymenoptera Apidae, genus Braunsapis, Ceratina and Xylocopa) and predators (Crabronidae, genus Dasyproctus) were found in the stems. Sweep-net collection of insects in humid fallows allowed us to describe for the first time in Benin seven Diopsidae species (23% of adults bearing Laboulbeniomycetes ectoparasitic fungi). Some of these species were captured in rice fields during rainy season. Parasitoids (adult Chalcidoidae and Ichneumonoidae) were observed during both seasons but their impact on stem borers was hard to determine, even during the rainy season, due to their low abundance and the difficulty of identification. Predators (Reduviidae, Odonata) were found mainly in humid fallows and rice fields. Regarding our observations, we suggest the presence of alternate host crops such as okra during the dry season for rainy season crop pests. Moreover, fallows also had a real ecological role as a habitat resource for many guilds of insects (pollinators, pests, predators). The management of these landscape components should be the focus of a long-term study with the aim of enhancing pest management of rainy season crop pests.

Telesonography: virtual 3D image processing of remotely acquired abdominal, vascular, and fetal sonograms.

PURPOSE: To design and test a new telesonography technique using remote volume acquisition by untrained operators in locations without access to trained sonographers, postprocessing, and interpretation done at expert centers. MATERIALS AND METHODS: The technique was tested with 84 sonograms of organs acquired in pregnant women (n = 8) and patients with various abdominal pathologic conditions (n = 11) located in French Guyana (France), Ceuta (Spain), and Murighiol (Romania). An operator inexperienced in sonography (US) placed the transducer over the predetermined acoustic window for each organ, then swept it from a -45° to a +45° position to scan the targeted organ. The acquired volume dataset was sent to an expert center via the Internet and reconstructed using a proprietary software, which allowed a trained sonographer to navigate through the appropriately reconstructed sonograms. RESULTS: After three-dimensional processing at the expert center, the organs scanned in the obstetrical cases were adequately visualized by the expert in seven of eight (88%) examinations of the fetal head, femur, and umbilical cord and eight of eight (100%) examinations of the fetal abdomen and placenta, whereas in the general abdominal cases, the liver, gallbladder, portal vein, and right kidney were correctly visualized in 10 of 11 (91%) examinations. CONCLUSIONS: Telesonography allowed untrained operators to scan and transfer the US volume datasets over the Internet to an expert center where an expert sonographer could navigate through the reconstructed US volume and visualize sonograms of diagnostic quality.

[System of telesonography with synchronous teleconsultations and asynchronous telediagnoses (Togo)]. / Système de télé-expertise échographique temps réel et de télédiagnostic échographique temps différé. Étude pilote au Togo.

INTRODUCTION: Ultrasonography is an important nonirradiating diagnostic medical imaging procedure, frequently used, especially in urgent circumstances. This relatively inexpensive noninvasive examination makes it possible to diagnose disorders in various parts of the human body, by examining, for example, the abdomen and pelvis, the cardiovascular system, and the muscles and joints. Ultrasound is also an operator-dependent examination, in that the quality of the result depends on precision in the manipulation of the probe. Unfortunately, many small medical centers and isolated sites do not have an appropriate well-trained sonographer to perform initial evaluations, and an untrained operator cannot capture the appropriate echographic views required for a safe diagnosis of current patients, even with realtime vocal guidance (personal data). The lack of experienced physicians or qualified technicians means that diagnostic ultrasound is not always accessible to patients for rapid examination worldwide, especially in Africa, Amazonia or near the North or South Poles. This situation has led to the development of a new concept of telemedicine: telesonography, with a remote ultrasound diagnosis either in real time (synchronous) or delayed (asynchronous; store-and-forward). These systems of real-time telesonography and data transmission require expensive and complex technology with sophisticated equipment not available in many developing countries. The purpose of this study is to design a low-cost real-time system of telesonography for teleconsultations with experts and a delayed telediagnostic mode between isolated peripheral hospitals and a University Hospital center (UHC). METHODS AND MATERIALS: An IP camera and an internet video server were installed in a geographically isolated site equipped with an ultrasound machine and an operator with basic training in its use. Synchronous teleconsultation (second-opinion diagnosis) is possible via internet with a UHC expert. If no ultrasound operator is available at the isolated center, volume capture-and-store software is used. Later on, the UHC expert uses Echo-Cnes 3D software to reconstruct the organs scanned. The expert can then navigate within the reconstructed volume and display any plane. Volume capture is performed by tilting (± 40°) to both sides vertically to the skin. To locate the probe on the organ acoustic window, the novice operator uses acoustic window mapping designed by our laboratory (UMPS-Tours). The system was tested between the Tsévié regional hospital in Togo (40 km from Lomé, Togo, and 4500 km from Tours, France) and the UHC at Lomé and the Trousseau UHC in Tours. RESULTS: With an average internet connection of 2 Mbps, the quality of transmission of the background video and ultrasound sequence videos from Tsévié towards Lomé was satisfactory (16 images/s) with a maximal transmission delay of 1.5 s (almost in real time). A video conference between the Trousseau UHC in Tours, the UHC Campus in Lomé and the Tsévié Hospital was possible and the bandwidth allowed the Lomé experts (radiologists) to perform real-time telesonography with very satisfactory results (ultrasound diagnoses obtained) for abdominal (n = 5), pelvic (n = 3), obstetric (n = 2), prostate (n = 2) and mammary (n = 2) ultrasound, both normal and pathological. Because the doctors at Tsévié had minimal experience with ultrasound, complete ultrasound diagnoses were obtained by combining remote voice instruction for image capture and full diagnosis by Echo-Cnes. Asynchronous telediagnosis was also performed with Tsévié operators who lacked ultrasound expertise but could perform the required tilt movements (after 3 training sessions). The expert at Trousseau UHC performed real-time telesonography with the Tsévié Hospital for two cases requiring abdominal images and another viewing of the prostate. He also performed asynchronous reconstruction of the abdominal organs with Echo-Cnes. A demonstration seminar of our platform was organized successfully for 2 days during the 9(th) Congress of the French-speaking Black Africa Society of Radiology (SRANF in French) held from 4 till 6 May 2011 at the hotel EDA OBA. During this seminar, 4 ultrasound teleconsultations were performed from the hotel by eminent African radiologists. DISCUSSION AND CONCLUSION: This preliminary study, although limited in the number of patients, allowed us to assess the technical features of our telesonography system. Togo, a developing country with a very modest infrastructure for information and communication, was an ideal site for a first test of this platform. Our system of remote ultrasound requires the local patient center to be equipped simply with a 2D ultrasound machine. The cost is quite low, in comparison to the asynchronous techniques requiring 3D devices. The high cost of 3D or 4D ultrasound machines and their fragility make it difficult to install them at the isolated sites and was a serious obstacle in the development of this system. If the center already has a 2D device and a computer, the cost to equip it with the remaining communications materials is 1,500 €. The experience in Togo clearly highlighted the possibility of teletraining and complete teleradiology with our system. The next stage of this work will seek to validate the results of this preliminary experience on a larger sample with more precise assessment criteria in 2012. The results will allow the widespread dissemination and routine use of this system in developing countries.

Preliminary experience with tele-sonography and tele-mammography in Togo.

Many medical centres are equipped with a sonograph. However, a sonographist is not always present or is not trained in all of the specialised domains of sonography. . A sonogram is not always possible due to a lack of physicians. This situation has given rise to the concept of remote-controlled sonography: tele-sonography, a medical procedure used in remote sonographic diagnosis in real time or deferred time. Tele-sonography can now be carried out in real time by the transmission of the expert's procedure (robotic system) or by the use of a 3D sonograph in real time. These modes of real time tele-sonography rely on expensive technologies requiring budgets and an infrastructure that is not always possible in developing countries where the needs in tele-medicine are increasing. This paper aimed to present a preliminary evaluation of a "low cost" system of sonographic tele-expertise in real time and the deferred sonographic telediagnosis accompanied by a tele-mammography between expert sites (university hospitals) and isolated sites (peripheral hospitals, dispensaries).

The yin and yang of cannabis-induced psychosis: the actions of Δ(9)-tetrahydrocannabinol and cannabidiol in rodent models of schizophrenia.

The link between cannabis and psychosis has often been debated with polarized views on the topic. There is substantial epidemiological evidence showing that cannabis increases the risk of psychosis, whereas other research suggests that schizophrenia patients self-medicate with the substance. These conflicting accounts may at least be partially explained by the two phytocannabinoids cannabidiol (CBD) and Δ(9)-tetrahydrocannabinol (THC) and their opposing actions on schizophrenia-related symptoms. In the present review we will first focus on how traditional rodent models of schizophrenia have been used to improve our understanding of the propsychotic actions of THC and the antipsychotic actions of CBD. We will also review novel rodent models used to address genetic vulnerability to cannabis-induced schizophrenia and show that specific genes are being uncovered that modulate cannabinoid action (e.g. the schizophrenia susceptibility gene neuregulin 1). We will also review rodent studies that have addressed interactions between THC and CBD. These animal studies underscore great complexity with some studies showing that CBD antagonises the neurobehavioural effects of THC, while others show the opposite, that CBD potentiates the actions of THC. Various mechanisms are put forth to explain these divergent effects such as CBD antagonism at central CB1 receptors or that CBD inhibits proteins that regulate THC disposition and metabolism (e.g. the ABC transporter, P-glycoprotein).

Resilience and reduced c-Fos expression in P2X7 receptor knockout mice exposed to repeated forced swim test.

There is considerable evidence suggesting genetic factors play an important role in the pathophysiology of depression, possibly by increasing susceptibility to repeated environmental stressors. Recent linkage studies have associated a polymorphism of the gene coding for the P2X7 receptor (P2X7R) with both major depressive disorder and bipolar disorder. Here we assessed whether P2X7 deletion affected the behavioural and neural response to repeated stress. P2X7R knockout (P2X7-/-) mice were subjected to the forced swim test for three consecutive days and neuronal activation in response to the third exposure was assessed using c-Fos immunohistochemistry. In addition, anxiety was evaluated in another group of P2X7-/- mice using the elevated plus maze (EPM) and light dark emergence (LDE) tests. Equivalent levels of immobility were observed in P2X7-/- mice and wild-type (WT) mice on the first exposure to forced swim, but much greater immobility was seen in WT mice on second and third exposures. This suggests that P2X7-/- mice exhibit an impaired adaptive coping response to repeated stress. Reinforcing this view, c-Fos expression in the dentate gyrus of the hippocampus and in the basolateral amygdala was seen in WT mice but not P2X7-/- mice following repeated forced swim. In addition, decreased locomotor activity was detected in P2X7-/- mice without any specific effects on anxiety in the LDE test. However, P2X7-/- mice showed greater anxiety-like behaviour in the EPM. These data suggest that the P2X7R may be involved in the adaptive mechanisms elicited by exposure to repeated environmental stressors that leads to the development of depression-like behaviours. This suggests that P2X7R antagonists may be useful therapeutics for the treatment of major depression, possibly by increasing resilience in the face of repeated stress.

Cognition in transmembrane domain neuregulin 1 mutant mice.

Neuregulin 1 (NRG1), which has been implicated in the development of schizophrenia, is expressed widely throughout the brain and influences key neurodevelopmental processes such as myelination and neuronal migration. The heterozygous transmembrane domain Nrg1 mutant mouse (Nrg1 TM HET) exhibits a neurobehavioural phenotype relevant for schizophrenia research, characterized by the development of locomotor hyperactivity, social withdrawal, increased sensitivity to environmental manipulation, and changes to the serotonergic system. As only limited data are available on the learning and memory performance of Nrg1 TM HET mice, we conducted a comprehensive examination of these mice and their wild type-like littermates in a variety of paradigms, including fear conditioning (FC), radial arm maze (RAM), Y maze, object exploration and passive avoidance (PA). Male neuregulin 1 hypomorphic mice displayed impairments in the novel object recognition and FC tasks, including reduced interest in the novel object and reduced FC to a context, but not a discrete cue. These cognitive deficits were task-specific, as no differences were seen between mutant and control mice in spatial learning (i.e. RAM and Y maze) for both working and reference memory measures, or in the PA paradigm. These findings indicate that neuregulin 1 plays a moderate role in cognition and present further behavioural validation of this genetic mouse model for the schizophrenia candidate gene neuregulin 1.