Ingestion of foreign materials by odontocetes along the Catalan coast: causes and consequences.

Ingestion of abnormal materials by cetaceans has been reported worldwide, but few studies have investigated the causes of foreign material ingestion. We retrospectively analysed necropsies performed between 2012 and 2019 on 88 cetaceans stranded along the coast of Catalonia, Spain, and evaluated the association of abnormal ingested materials with 2 risk factors, namely disease of the central nervous system (CNS) and maternal separation. Abnormal materials were found in the digestive tract in 19 of 88 (21.6%) cetaceans; of these, 13 (60%) had lesions in the CNS, such as morbilliviral encephalitis, neurobrucellosis or encephalomalacia, and 3 were diagnosed as having experienced maternal separation. In a logistic regression model, CNS lesions and maternal separation were identified as risk factors for ingestion of foreign material, but with wide confidence intervals, probably due to the small sample size. In contrast, abnormal ingestion was not identified in any of the 25 (28%) cetaceans whose cause of death was attributed to interaction with humans. Abnormal ingestion should be interpreted with caution, and efforts should be made at necropsy to exclude CNS diseases through pathologic and microbiologic investigations. If disease of the CNS is a significant risk factor for ingestion of marine debris by small odontocetes, results of monitoring programmes may be biased by the prevalence of CNS disease in a specific area or population.

Secukinumab demonstrates high sustained efficacy and a favourable safety profile in patients with moderate-to-severe psoriasis through 5 years of treatment (SCULPTURE Extension Study).

BACKGROUND: Secukinumab, a fully human monoclonal antibody that selectively neutralizes IL-17A, has been shown to have significant efficacy and a favourable safety profile in the treatment of moderate-to-severe psoriasis and psoriatic arthritis. OBJECTIVE: To assess the efficacy and safety of secukinumab through 5 years of treatment in moderate-to-severe psoriasis. METHODS: In the core SCULPTURE study, Psoriasis Area and Severity Index (PASI) 75 responders at Week 12 continued receiving subcutaneous secukinumab until Year 1. Thereafter, patients entered the extension phase and continued treatment as per the core trial. Treatment was double-blinded until the end of Year 3 and open-label from Year 4. Here, we focus on the 300 mg fixed-interval (every 4 weeks) treatment, the recommended per label dose. Efficacy data are primarily reported as observed, but multiple imputation (MI) and last observation carried forward (LOCF) techniques were also undertaken as supportive analyses. RESULTS: At Year 1, 168 patients entered the extension study and at the end of Year 5, 126 patients completed 300 mg (every 4 weeks) treatment. PASI 75/90/100 responses at Year 1 (88.9%, 68.5% and 43.8%, respectively) were sustained to Year 5 (88.5%, 66.4% and 41%). PASI responses were consistent regardless of the analysis undertaken (as observed, MI, or LOCF). The average improvement in mean PASI was approximately 90% through 5 years compared with core study baseline. DLQI (dermatology life quality index) 0/1 response also sustained through 5 years (72.7% at Year 1 and 65.5% at Year 5). The safety profile of secukinumab remained favourable, with no cumulative or unexpected safety concerns identified. CONCLUSION: Secukinumab 300 mg treatment delivered high and sustained levels of skin clearance and improved quality of life through 5 years in patients with moderate-to-severe psoriasis. Favourable safety established in the secukinumab phase 2/3 programme was maintained through 5 years.

Electronic tracking system and wandering in Alzheimer's disease: a case study.

INTRODUCTION: Wandering is a behavioural disorder, which occurs in Alzheimer's disease or other dementia. People who wander are at risk of physical harm and untimely death. Moreover, wandering behaviour causes a lot of stress to the caregivers. In the last few years, different geolocation devices have been developed in order to minimise risk and manage unsafe wandering. These detection systems rarely meet patients and caregivers' needs because they are not involved in the devices building process. AIM: The aim is to explore the needs and perceptions of wandering persons and their caregivers towards existing tracking devices as well as their acceptability and usability. This paper reports a dyad case. MATERIALS: The tracking system tested is presented as a mobile Global Positioning System (GPS) receiver-shaped, including function of telephony and data transfer via GSM/GPRS. METHOD: Dyad patient/caregiver expressed their needs and perceptions towards tracking devices and gave their impressions about the functioning of the tested device at the end of the test. RESULTS: The patient focused on the device's shape which he found too voluminous and unaesthetic, and was unable to give an opinion about the device's functioning. The spouse highlighted malfunctions and usage difficulties, which made the device not appropriate to her needs. CONCLUSION: Involving end-users in the co-design of new technologies is necessary for building tailored devices. Moreover, in this area of dementia care, the person-centred approach is essential to a tailored wandering management.

TLR2 sensing of F. nucleatum and S. sanguinis distinctly triggered gingival innate response.

Gingival tissue faces constant exposure to micro-organisms. It functions as part of the host response, an anti-microbial barrier that recognizes and discriminates between commensal and pathogenic bacteria. This study aimed to evaluate and compare the effects of cell wall extracts from different periodontal bacteria, commensals Streptococcus sanguinis and Fusobacterium nucleatum and the pathogen Porphyromonas gingivalis, on the innate immune response of gingival keratinocytes and the role of TLR2 in regulating this. We assayed mRNA levels to determine the expression of human beta-defensins (hbetaD2, hbetaD3), interleukin-1alpha, -1beta, 6 and 8 and matrix metalloproteinase-9. F. nucleatum extracts induced beta-defensin and inflammatory marker mRNA expression at higher levels than P. gingivalis. Extracts from the Gram-positive commensal S. sanguinis did not upregulate the host response. TLR2 extinction inhibited the upregulation of beta-defensin and cytokine transcripts by F. nucleatum extracts but, in contrast, led to a weak induction of hbetaD3 after challenge with S. sanguinis extracts. Although F. nucleatum strongly induces innate immune and inflammatory mediators, S. sanguinis limits their expression through TLR2. Together, our data demonstrate that gingival keratinocytes recognize and discriminate between Gram-positive and Gram-negative commensal extracts, in part through TLR2, to activate different signaling pathways of the innate immune host response.

Electroluminescence microspectroscopy of silicon nanocrystals obtained by Si(+) ion implantation in SiO(2).

Room-temperature electroluminescence (EL) has been measured at both macroscopic and microscopic levels from metal-oxide-semiconductor devices containing silicon nanocrystals (Si-nc) embedded in silicon dioxide (SiO(2)) obtained by high-temperature annealing (1050 and 1100 °C) after Si(+) ion implantation. It is found that spatially integrated (macroscopic) EL is dominated by a near-infrared band centered where the photoluminescence (PL) band of Si-nc (from 700 to 1000 nm) is located. However, on a microscopic scale, EL emission is inhomogeneous, the sample surface exhibiting many visible spots of micron-order diameter. EL spectra from a microscopic surface of ∼1 µm(2)(µEL) on visible spots have revealed dominant contributions between ∼550 and ∼650 nm, attributed to oxide defects. These spectral features rapidly decrease with distance from a bright spot, while lower-intensity near-infrared contributions (750-950 nm) remain unaffected up to relatively large distances before eventually becoming extinct. The macroscopic EL measurements can be explained as a superposition of the µEL and PL spectra. A luminescent mechanism is proposed in which charge carriers mostly tunnel through high-defect-density channels in the oxide, yielding bright visible spots, while Si-nc in these channels and their surroundings contribute to the luminescence by hosting electron-hole recombinations (EL) and/or exhibiting PL due to optical excitation from the nearby visible EL spot.

Development of a molecular diagnostic test applied to experimental abattoir surveillance on bovine tuberculosis.

One of the most essential systems applied to the eradication of bovine tuberculosis by Mycobacterium bovis is the epidemiologic surveillance of animals slaughtered in abattoir by means of inspection and sample taking of lesions compatible with tuberculosis, confirming the existence of the disease through culture and molecular detection, which takes weeks before a result can be obtained. An interesting alternative is to develop high-throughput molecular systems for the direct detection of M. bovis on biological samples. In this sense, our research has developed a molecular detection system by means of a real-time based PCR process which is applied directly to bovine biological samples and it allows to differentiate between Mycobacterium tuberculosis complex, Mycobacterium avium complex and other atypical mycobacteria that are interesting from the veterinary point of view. The sensitivity was analyzed by applying a conventional extraction system based on guanidine thiocyanate and a robotized system based on the selective magnetic capture of mycobacterial DNA. The molecular detection system showed a high specificity and a detection threshold of only two to three genomes. The sensitivity depended on the DNA extraction system being used and on the kind of lesions on which it was used; the sensitivity ranged from 61.11% for samples with non-visible lesions to 80.64% for chronic lesions, with an average sensitivity of 73.87% when using the manual extraction system and between 27.77 and 74.19% (average sensitivity 47.74%) when using the automated robotic system. In conclusion, our multiplex real-time PCR assay represents a fully controlled, high-throughput diagnostic tool for the rapid detection of Myobacterium presence directly in animal clinical specimens, which could be a practical tool in the context of bovine tuberculosis abattoir surveillance programs and granuloma submission programs.

Antimicrobial peptide modulation in a differentiated reconstructed gingival epithelium.

Gingival innate immunity has been studied by using biopsies and normal or transformed epithelial cell monolayers. To overcome individual biological variabilities and as a physiological alternative, we have proposed using a reconstructed tissue equivalent. In this study, we investigated the functionality and the stage of differentiation of a reconstructed human gingival epithelium. We also characterized this epithelium at the molecular level to investigate its differentiation stage compared with native human gingival epithelium. The expression levels and localization of markers related to proteins and lipids of well-differentiated stratified epithelium, such as cytokeratins, cornified envelope proteins and enzymes, or to factors in lipid synthesis and trafficking were examined. Immunohistochemistry revealed similar localization patterns in both types of epithelia and mRNA quantification showed a close resemblance of their expression profiles. We further revealed that, like native gingiva, reconstructed gingival epithelium was able to respond to pro-inflammatory or lipopolysaccharide stimuli by producing antimicrobial peptides hbetaD-2, hbetaD-3 or LL-37. Finally, we demonstrated that reconstructed human gingival epithelium, as a model, was good enough to be proposed as a functional equivalent for native human gingival epithelium in order to study the regulation of gingival innate immunity against periodontal infections.

Thermal diffuse x-ray scattering in a model columnar liquid crystal.

The fluctuation correlation functions and the density-density correlation functions for a realistic model of a columnar liquid crystal in its helically ordered phase are derived. The influence of positional and orientational molecular fluctuations on the thermal diffuse x-ray scattering is studied within a three-dimensional model of columns inscribed on a triangular lattice. Resulting from quasi-long-range ordering, very anisotropic long-tail scattered intensities are predicted, giving a nonuniversal signature for the helically ordered columnar liquid crystal phase. Scattered intensities both near the Bragg maxima at the inverse lattice vectors and at the Bragg condition due to periodic orientational ordering are treated. The percolation of the long-range behavior for a screw variable composed of two quantities having only quasi-long-range behavior is predicted.

Arabidopsis SGS2 and SGS3 genes are required for posttranscriptional gene silencing and natural virus resistance.

Posttranscriptional gene silencing (PTGS) in plants resuits from the degradation of mRNAs and shows phenomenological similarities with quelling in fungi and RNAi in animals. Here, we report the isolation of sgs2 and sgs3 Arabidopsis mutants impaired in PTGS. We establish a mechanistic link between PTGS, quelling, and RNAi since the Arabidopsis SGS2 protein is similar to an RNA-dependent RNA polymerase like N. crassa QDE-1, controlling quelling, and C. elegans EGO-1, controlling RNAi. In contrast, SGS3 shows no significant similarity with any known or putative protein, thus defining a specific step of PTGS in plants. Both sgs2 and sgs3 mutants show enhanced susceptibility to virus, definitively proving that PTGS is an antiviral defense mechanism that can also target transgene RNA for degradation.

[Urinary lithotripsy in children. Multicenter study of the Pediatric Urology Study Group]. / Lithotritie urinaire de l'enfant. Etude multicentrique du Groupe d'Etudes en Urologie Pédiatrique (GEUP).

The authors present the results of a survey conducted among French paediatric urologists belonging to the Groupe d'Etudes en Urologie Pédiatrique (GEUP) (Paediatric Urology Study Group). This study, based on 122 cases observed in 13 centres, is not exhaustive, but is nevertheless statistically significant. The preoperative assessment confirms the usual findings of urinary stones in children: pyelonephritis, haematuria and abdominal pain, the usual presenting complaint, concomitant malformative uropathy (10% of cases) and a predominance of calcium stones. More than 200 stones were treated, larger than 10 millimeters in diameter in one-third of cases. Renal stones, mainly caliceal (more than 50%), included 11 staghorn calculi. This study also included 22 ureteric stones, mainly in the pelvic ureter, and 2 bladder stones. Lithotripsy was ultrasound-guided in 2/3 of cases and required general anaesthesia in about 3/4 of cases. Ureteric catheterization was required in 19 infants preoperatively, but in only 2 infants (stein strasse) postoperatively. One or two lithotripsy sessions were sufficient in most cases, but 4 sessions were necessary in 5 patients, to the same kidney in 1 case. The mean hospital stay was 2 to 3 days, but the procedure was performed on an outpatient basis in 15 cases. The immediate postoperative course was uneventful and asymptomatic. This survey revealed about 10% of complete failures, corresponding to solitary caliceal stones in 2/3 of cases; 29 partial failures were essentially due to lower caliceal stones and staghorn calculi; 84 successes (stone-free), mainly pelvic or simple caliceal stones. Scintigraphy did not reveal any immediate postoperative impairment of renal function. This study reported a success rate of about 70%, regardless of the type of apparatus used. Assessment of the results of ESWL requires sufficient follow-up both concerning the outcome of fragmented stones and evaluation of possible functional repercussions. This survey defines the main indications: although ESWL can be applied to most stones, some stones constitute poor indications (cystine stones, stenotic malformative uropathy) or dubious indications: small lower caliceal stones, densely calcified staghorn calculi in older children. This study confirmed the efficacy and low morbidity of ESWL in children. A prospective study needs to be conducted according to a rigorous protocol in order to refine the technique and indications while reducing the possible long-term risks.

[Bladder paraganglioma (pheochromocytoma): a rare tumor in children. Apropos of a case]. / Le paragangliome vésical (phéochromocytome): tumeur rare de l'enfant. A propos d'un cas.

The authors report the first case of bladder paraganglioma in a child admitted to their department successfully treated by partial cystectomy. The diagnosis was established histologically, after failure of clinical diagnosis. Retrospectively' the authors think that preoperative diagnosis should have been possible and emphasize the importance of a thorough clinical examination.

[Ethical problems raised by the current French practice of therapeutic abortions. Part I: prospective study for 24 months at the University Hospital of Tours (76 cases)]. / Problèmes éthiques soulevés par les pratiques françaises actuelles de l'interruption médicale de grossesse. 1re Partie: Etude prospective sur 24 mois au CHU de Tours (76 cas).

OBJECTIVE: Determine the circumstances and conditions concerning ethical problems raised by medical abortions treated in a University hospital. METHODS: Prospective study for 2 years (1 Sept 1991--31 Aug 1993) conducted with a consulting Committee for the antenatal diagnosis and fetal medicine at the University Hospital at Tours. Each discussion of the medical file for proposed medical abortions, the conditions leading to the decision and the ethical recommendations formulated were registered as well as the outcome of the pregnancy and for the infant. RESULTS: There were 76 cases raising ethical problems. They were divided into 3 categories of recommendations: medical abortion (55 cases), abstention with acceptation of possible fetal death in utero (11 cases), conservation of the pregnancy (10 cases). CONCLUSION: A practical attitude could usually be decided after discussion between parents and physicians. A few cases of disagreement were observed which led to uncertainty [correction of incertainty] and diverging opinions concerning the diagnosis and prognosis for the fetal pathology.

[Embryofetopathy of the newborn infant of a phenylketonuric mother. A diagnosis not to be missed]. / L'embryofoetopathie du nouveau-né de mère phénylcétonurique. Un diagnostic à ne pas manquer.

Children with phenylketonuria (PKU) detected in the neonatal period and who have received the appropriate diet develop normally whatever their sex. However, female PKU patients who, before becoming pregnant, do not take the precaution to follow a diet bringing phenylalanine to "normal levels" (2 to 5 mg in 100 ml of blood) give birth to children presenting with severe embryofoetal damage (e.g. intrauterine growth retardation, microcephaly, mental retardation, various malformations) directly due to their hyperphenylalaninaemia (20 mg or more in 100 ml of blood under a free diet). It is important to know these facts, since the benefits of systematic neonatal PKU detection may be cancelled by this late complication. The therapeutic approach in such cases is a follows: 1. Young women with known PKU must be informed of this risk and how it can be avoided by a preconception therapeutic diet. This means that they must permanently reside in the same geographical area, receive an adequate information at the end of puberty, use and effective contraception method and program their pregnancies preceded by a return to low phenylalanine diet. 2. Doctors must remember that because PKU detection has not become systematic until 1978, PKU girls of child-bearing are remain undetected, that they are not always mentally debilitated and can normally five birth to children with embryofoetal damage. In case of e.g. unexplained intrauterine growth retardation or microcephaly, it is necessary to perform a Guthrie test on the woman, since a prenatal diagnosis may lead to therapeutic abortion, and a postnatal diagnosis to a genetic counselling which will avoid recurrences.(ABSTRACT TRUNCATED AT 250 WORDS)

Role of adrenal catecholamines during forced submergence in ducks.

Maximum underwater tolerance (UTmax) of chronically adrenalectomized ducks (ADX, 5.3 +/- 0.3 min) and chronically adrenal-denervated ducks (DNX, 7.2 +/- 0.2 min) was significantly lower than sham-operated controls (SH-ADX, 10 +/- 0.8 min; SH-DNX, 12.2 +/- 0.5 min). After 4 min forced submergence, heart rates of ADX (62 +/- 16 beats/min) and DNX (31 +/- 2 beats/min) ducks were significantly higher than in their respective sham-operated controls (23 +/- 3 and 17 +/- 2 beats/min), although their blood pressure was significantly lower. Arterial partial pressure of O2, arterial O2 content, arterial pH, and lactate levels in DNX ducks (42 +/- 2 mmHg, 4.5 +/- 0.8 ml O2/100 ml blood, 7.233 +/- 0.016, 3.1 +/- 0.3 mM, respectively) were significantly lower than in SH-DNX ducks after 5 min forced submergence (53 +/- 1 mmHg, 6.8 +/- 0.4 ml O2/100 ml blood, 7.301 +/- 0.007, 4.8 +/- 0.4 mM, respectively). Venous infusion of catecholamines in ADX and DNX ducks during forced submergence significantly increased UTmax. It is suggested that adrenal catecholamines increase tolerance to underwater submersion by enhancing peripheral vasoconstriction, thus preserving the O2 stores for the heart and brain. Other adrenal products could also be involved.

Neural and humoral effects on hindlimb vascular resistance of ducks during forced submergence.

Circulating catecholamines increase by three orders of magnitude in forced submerged ducks; their role in promoting vascular resistance was studied using vascular perfusion of hindlimbs. Perfusion pressure and blood flow were recorded simultaneously in hindlimbs of ducks during forced submergence. One leg was perfused with blood mixtures devoid of catecholamines (test leg) and compared with the other autoperfused leg. Perfusion pressures in test legs perfused with hyperoxic and hypocapnic blood or with hypoxic and hypocapnic blood were not significantly different from those in the matching autoperfused legs. However, when test legs were perfused with hypercapnic blood, regardless of whether blood was hypoxic or hyperoxic, perfusion pressures were significantly lower than in autoperfused legs. Adding catecholamines to test legs perfused with hypoxic and hypercapnic blood, after 3 min submergence, significantly enhanced vasoconstriction. Hypercapnia acts directly on the peripheral vascular beds and impairs the neurally mediated vasoconstriction during submergence, while circulating catecholamines restore peripheral vasoconstriction. Thus circulating catecholamines are needed to compensate for the depressant action of hypercapnia on neurally mediated vasoconstriction.

Treinamento de autocuidados em pacientes portadores de bronquiectasia / Training of autocare in patients with bronchiectasis

Este trabalho mostra uma abordagem de treinamento de autocuidados e fisioterapia para sujeitos portadores de bronquiectasia nao sujeitos a cirurgia. A analise da eficacia deste programa foi demonstrada atraves de um controle de hidratacao, expectoracao e atividades fisioterapicas. Consideramos os resultados satisfatorios tanto a nivel comportamental quanto clinico-funcional.

[Early detection of visual disorders by pediatricians]. / Dépistage précoce des troubles visuels en cabinet de pédiatrie.

A group of pediatricians from Northern France whose aim was to develop research projects in ambulatory pediatrics, elaborated a method of rapid assessment of visual acuity that can be applied by the pediatrician in the consulting room. This test was included in the routine examination of children between the age of 2 1/2 and 4, the age of 3 years being the most appropriate. The method is simple, reliable, reproducible and cheap since it is part of the pediatrician's consultation. Visual defects can be detected at an early stage and children can be treated when they still have a maximum chance of being cured. Thus it appears a useful test in terms of prevention of disease and public health.