[Nursing consultations in pain assessment and treatment facilities]. / La consultation infirmière en structure d'évaluation et de traitement de la douleur.

The concept of nursing consultation takes on its full meaning with people suffering from chronic pain. The Société française d'étude et de traitement de la douleur (French Society for the Study and Treatment of Pain), and more specifically its professional nursing commission, has drawn up a reference framework of consultation activities on which pain resource nurses (PRNs) can draw. This describes the various stages in the management of chronic pain patients. In view of the needs and expectations expressed by the population in terms of care, the PRN function is likely to evolve towards that of advanced practice nurse.

Synergistic Antimicrobial Effect of Chitosan Polymers and Oligomers.

This study evaluated the efficacy of the combined application of well-characterized chitosan polymer (degree of acetylation = 10%, degree of polymerization [DPn] = 90, and dispersity [ÐDP] = 2.8) and oligomers (partially acetylated chitosan polymers and oligosaccharides [paCOS]) (DP = 2 to 17) on conidia germination and mycelial growth of Fusarium graminearum, the major causal agent of Fusarium head blight in wheat. The polymer alone showed a higher inhibitory effect than the paCOS mixture alone, with half-maximal inhibitory concentrations of less than 50 µg ml-1 and more than 100 µg ml-1, respectively. Using time-lapse microscopy, we also showed that paCOS did not affect conidia germination at 50 µg ml-1, whereas chitosan polymer at the same concentration led to a delay in germination and in elongation of germ tubes. Scanning electron microscopy was used to observe the chitosan-induced changes in hyphal morphology. Surprisingly, the combination of chitosan polymer and paCOS led to strong synergistic effects in inhibiting conidia germination and fungal growth, as quantified by both the Abbot and Wadley equations. To our knowledge, this is the first report on a synergistic effect of a combination of chitosan polymers and oligomers, also highlighting for the first time the importance of ÐDP when studying structure-function relationships of functional biopolymers such as chitosan. The consequences of this finding for the improvement of chitosan-based antimicrobial or plant protective products are discussed. Given the economic importance of F. graminearum, this study suggests that the combination of chitosan polymer and oligomers can be used to support an efficient, sustainable plant protection strategy.[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.

[An educational tool for patients with chronic pain]. / Un outil éducatif pour le patient douloureux chronique.

Therapeutic education is an essential element of the care pathway in the case of chronic pain. It enables patients to acquire skills and to mobilise their resources to help them cope better with this pain. Nursing teams have a tool at their disposal to help them meet patients' needs.

A High Diversity in Chitinolytic and Chitosanolytic Species and Enzymes and Their Oligomeric Products Exist in Soil with a History of Chitin and Chitosan Exposure.

Chitin is one of the most abundant biomolecules on earth, and its partially de-N-acetylated counterpart, chitosan, is one of the most promising biotechnological resources due to its diversity in structure and function. Recently, chitin and chitosan modifying enzymes (CCMEs) have gained increasing interest as tools to engineer chitosans with specific functions and reliable performance in biotechnological and biomedical applications. In a search for novel CCME, we isolated chitinolytic and chitosanolytic microorganisms from soils with more than ten-years history of chitin and chitosan exposure and screened them for chitinase and chitosanase isoenzymes as well as for their patterns of oligomeric products by incubating their secretomes with chitosan polymers. Of the 60 bacterial strains isolated, only eight were chitinolytic and/or chitosanolytic, while 20 out of 25 fungal isolates were chitinolytic and/or chitosanolytic. The bacterial isolates produced rather similar patterns of chitinolytic and chitosanolytic enzymes, while the fungal isolates produced a much broader range of different isoenzymes. Furthermore, diverse mixtures of oligosaccharides were formed when chitosan polymers were incubated with the secretomes of select fungal species. Our study indicates that soils with a history of chitin and chitosan exposure are a good source of novel CCME for chitosan bioengineering.

Spatial and temporal distribution of cystic fibrosis and of its mutations in Brittany, France: a retrospective study from 1960.

Cystic fibrosis (CF) is the most common severe inherited disorder that affects children in Caucasian populations. The aim of this study was to define the spatial and temporal distribution of CF and its mutations in Brittany (western France) where the frequency of the disease is high. We retrospectively registered all CF patients born in Brittany since 1960 by cross-checking various data sources (e.g. medical care centres, genetics laboratories, hospital archives). Councils were contacted so that the place of residence of patients at birth could be determined. Moreover, the spectrum of CF transmembrane conductance regulator (CFTR) mutations and their spatial distribution across Brittany were determined. A total of 520 patients was registered in this study. The incidence of CF was assessed according to administrative (department, district) and diocesan divisions of Brittany and its evolution analysed over four decades. The incidence of CF was 1/2630, with a west/east gradient that was confirmed over time (Finistère: 1/2071 vs Ille-et-Vilaine: 1/3286). At present, the incidence of CF is decreasing, mainly as a result of prenatal diagnosis. An excellent mutation detection rate of 99.7% was obtained. Western Brittany presented a specific spectrum of mutations: 1078delT (9.4% of mutated alleles in the diocese of Cornouaille), G551D (7.7% in the diocese of Léon), 4005+1G-->A (2.9% in Cornouaille) and W846X (1.5% in western Brittany). On the other hand, the eastern region showed a spectrum more similar to the overall picture in France as a whole. This study enabled a precise measurement of the incidence of CF in Brittany to be obtained. The high frequency of the CFTR mutated alleles may result from founder effects and genetic drifts. Moreover, the study brings together the regional specificities of the CFTR gene and highlights disparities that exist in this part of France, both in incidence and in mutation distribution. These are attributable to different degrees of isolation and of population movements between the eastern and western parts of the region. Given that this is the first time that such a detailed study of the CFTR gene has been performed on a large population, this heightened knowledge of the epidemiology of CF in Brittany should provide a basis for the improvement of diagnostic strategies and refinement of genetic counselling.

Cystic fibrosis and pregnancy. Report from French data (1980-1999).

OBJECTIVE: To study the consequences of pregnancy on women affected by cystic fibrosis and to clarify the impact of the disease on maternal and newborn health. DESIGN: Retrospective study. SETTING: Pregnancy survey from the French Cystic Fibrosis Registry. POPULATION: Women with cystic fibrosis having a pregnancy between 1980 and 1999. METHODS: During the 1980-1999 period, 90 pregnancies in 80 French female patients were registered in the pregnancy survey of the French Cystic Fibrosis Registry. General and clinical data before pregnancy were noted. Outcome of the pregnancy was described. Variations of pulmonary function and body weight during pregnancy were evaluated. Comparison between a group of pregnant women and a group of non-pregnant cystic fibrotic women of same age and genotype, followed in the same care centre network, was made. MAIN OUTCOME MEASURES: Spirometric and nutritional parameters, vital status and perinatal health indicators. RESULTS: The outcome was identified for 75 cases: 64 delivered babies (45 at term and 10 prematurely, prematurity rate: 18%), 10 abortions (five spontaneous and five therapeutic or medical), and one maternal death during pregnancy. The proportion of newborns with low weight was 29.8%. Mean maternal weight gain during pregnancy was 5.5 kg. Four affected children were diagnosed after birth. A decline in the forced expiratory volume in one second (FEV1) and forced vital capacity was observed between the beginning of pregnancy and the year following the delivery. However, no significant difference was found when comparing the variation in the pulmonary function during pregnancy between cases and controls. Moreover, the pulmonary status before pregnancy was better than the status of non-pregnant women. Among 12 deaths recorded after pregnancy, only three happened in the year following the pregnancy. All three women had an FEV1 < 50% before pregnancy. CONCLUSION: Pregnancy only has a slight adverse effect on maternal health if the women are in good general condition before starting pregnancy. Women with a better health status are more inclined to initiate and successfully complete a pregnancy. Complete collaboration between cystic fibrosis practitioners and obstetricians should be observed to allow women to deliver children in the best conditions.

Is there a link between writing ability, drawing aptitude and manual skills of dental students?

In France, students have to choose between medical or dental courses, according to their rank, after a competitive examination at the end of their first year of study. Intellectual ability is evaluated, while manual competence is not, and this is a paradox. The purpose of the present study is to investigate whether it is possible to predict the manual aptitude of a dental student through tests that allow the qualities of reflection and organization to be judged. We administered writing tests and drawing tests to 45 students of the Bordeaux dental school to ascertain whether there was a correlation between the competitive examination, the criterion examined (reflection, organization, aesthetics em leader) and the results of the dental practical assessments during the first year of dental study. The results showed that although manual competence in dental practical work, graphic qualities and writing skills are connected, it is difficult to correlate them directly with competitive examination performance. In view of the number of uncontrolled variables influencing the students' outcome, is it useful to be able to predict who will become a good practitioner? One indication may be found in the moral reasoning of candidates.