[Transfer of skills: implementing post-transplant follow-up care status for transplant nurses: a report by the SFGM-TC]. / Transfert de compétence : la mise en place d'un statut infirmier(ère) de greffe pour le suivi post-greffe : un rapport par la SFGM-TC.

The number of Hematopoietic Stem Cell Transplantations has globally taken off in the past decade. However, this increase in transplantation activity has put in the spotlight the need to create a special transplantation-skilled population of nurses. This type of specialisation allocated solely to this activity has not existed within the French nursing community until now. In the attempt to harmonize clinical practices between different French transplantation centers, the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) sets up its forth annual series of workshops which brought together practitioners from all member centers and took place in September 2013 in Lille. Here we report our results and recommendations regarding the implementation of a transplant nurse status for post-transplant follow-up care.

Measurements of an ablator-gas atomic mix in indirectly driven implosions at the National Ignition Facility.

We present the first results from an experimental campaign to measure the atomic ablator-gas mix in the deceleration phase of gas-filled capsule implosions on the National Ignition Facility. Plastic capsules containing CD layers were filled with tritium gas; as the reactants are initially separated, DT fusion yield provides a direct measure of the atomic mix of ablator into the hot spot gas. Capsules were imploded with x rays generated in hohlraums with peak radiation temperatures of ∼294 eV. While the TT fusion reaction probes conditions in the central part (core) of the implosion hot spot, the DT reaction probes a mixed region on the outer part of the hot spot near the ablator-hot-spot interface. Experimental data were used to develop and validate the atomic-mix model used in two-dimensional simulations.

Measurement of the T + T neutron spectrum using the national ignition facility.

Neutron time-of-flight spectra from inertial confinement fusion experiments with tritium-filled targets have been measured at the National Ignition Facility. These spectra represent a significant improvement in energy resolution and statistics over previous measurements, and afford the first definitive observation of a peak resulting from sequential decay through the ground state of (5)He at low reaction energies E(c.m.) 100

Hohlraum-driven ignitionlike double-shell implosions on the omega laser facility.

High-convergence ignitionlike double-shell implosion experiments have been performed on the Omega laser facility [T. R. Boehly, Opt. Commun. 133, 495 (1997)] using cylindrical gold hohlraums with 40 drive beams. Repeatable, dominant primary (2.45 MeV) neutron production from the mix-susceptible compressional phase of a double-shell implosion, using fall-line design optimization and exacting fabrication standards, is experimentally inferred from time-resolved core x-ray imaging. Effective control of fuel-pusher mix during final compression is essential for achieving noncryogenic ignition with double-shell targets on the National Ignition Facility [Paisner, Laser Focus World 30, 75 (1994)].

Effect of N(G)-nitro-L-arginine methyl ester on autonomic modulation of heart rate variability during hypovolemic shock.

OBJECTIVE: To study the changes in neuroautonomic regulation of heart rate and the effects of N(G)-nitro-L-arginine methyl ester (L-NAME), a competitive inhibitor of nitric oxide synthase, on efferent sympathetic cardiac activity and blood pressure during hypovolemic shock. Hypotension during hypovolemic shock may be attributable, in part, to the failure of neuroautonomic regulation of heart rate and blood pressure. In addition, the release of nitric oxide may contribute to hypotension through vasodilation and inhibition of efferent sympathetic activity. DESIGN: Prospective, controlled trial. SETTING: Experimental laboratory in a university hospital. SUBJECTS: Seventeen anesthetized adult male New Zealand White rabbits. INTERVENTIONS: The rabbits were divided into four groups: control (n = 3), control plus L-NAME (n = 5), hypovolemic (n = 4), and hypovolemic plus L-NAME (n = 5). Hypovolemic rabbits were bled of 10% of their circulating blood volume (85 mL/kg) every 10 mins until 30% cumulative hypovolemia was reached. Rabbits received either three doses of saline 1 mL/kg every 10 mins or L-NAME 10 mg/kg in 1 mL/kg of saline solution administered after each hemorrhage for a total of three doses. Changes in heart rate, respiratory rate, mean arterial pressure, plasma catecholamine levels, and heart rate power spectra were recorded every 10 mins during serial hypovolemia and during a 30-min recovery period. MEASUREMENTS AND MAIN RESULTS: During hypovolemic shock there was a decrease in log low-frequency heart rate power (p = .001) and in systolic (p = .003), diastolic (p < .001), and mean (p < .001) blood pressures compared with control rabbits. Treatment with L-NAME during hypovolemia resulted in increased log low-frequency heart rate power (p = .03) and systolic (p = .01), diastolic (p = .007), and mean (p = .009) blood pressures compared with hypovolemic rabbits who received saline placebo. CONCLUSIONS: We found that treatment with L-NAME increased efferent sympathetic cardiac activity and mean arterial pressure during hypovolemic shock compared with control rabbits. We conclude that L-NAME may blunt hypotension during hypovolemic shock by inhibiting nitric oxide synthase and may act to restore neuroautonomic cardiovascular reactivity. Spectral analysis of heart rate variability may allow for insights into the pathophysiology of shock and provide a means of monitoring the neuroautonomic cardiovascular response to therapy.

Jacobsen syndrome: report of a patient with severe eye anomalies, growth hormone deficiency, and hypothyroidism associated with deletion 11 (q23q25) and review of 52 cases.

We have evaluated a patient with Jacobsen syndrome. The patient presented with growth retardation, hypotonia, trigonocephaly, telecanthus, downward slanting palpebral fissures, bilateral inferior colobomas (of the iris, choroid, and retina), hydrocephalus, central nervous system (CNS) abnormalities, and an endocardial cushion defect, features commonly seen in Jacobsen syndrome. Endocrine evaluation showed growth hormone deficiency and central hypothyroidism. Chromosome analysis showed a 46,XX,del(11)(q23q25) de novo karyotype. Cytogenetically, the deletion appeared to include most of bands 11q23 and q24 and a portion of q25. Using chromosome specific paint probe, a combination of chromosome 11 centromere, telomere, and region specific cosmid probes from 11q14.1-14.3, 11q23.3, and 11q24.1, we have localised the deletion breakpoint to q24.1. Phenotype-karyotype correlation of patients with Jacobsen syndrome and specific deletions of chromosome 11q has enabled us to suggest that the critical region for this syndrome lies in close proximity to cytogenetic band 11q24. Although growth retardation is a consistent finding in 11q deletion syndrome, the presence of hypothalamic-pituitary hormone deficiency has not been reported previously.

Autonomic modulation of heart rate variability during endotoxin shock in rabbits.

OBJECTIVE: Gram-negative septic shock is associated with severe hypotension and autonomic cardiovascular dysfunction. We hypothesized that in an anesthetized rabbit model of endotoxin shock, autonomic modulation of cardiac activity, as measured by power spectral analysis of heart rate (HR) variability, would be decreased compared with the anesthetized control rabbits. DESIGN: Experimental, comparative study. SETTING: Laboratory of a university hospital. SUBJECTS: Fourteen adult male New Zealand white rabbits (2.7 to 3.1 kg body weight) were studied under anesthesia. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We studied the absolute and temporal changes in HR power spectra and plasma catecholamine concentrations in eight experimental and six control New Zealand white rabbits during Escherichia coli endotoxin-induced shock. HR, respirations, arterial blood pressure (BP), HR power spectra, and plasma catecholamine concentrations were measured at 5- to 10-min intervals for 60 mins in control rabbits or until the mean arterial pressure (MAP) decreased by > or = 20 mm Hg in experimental rabbits. There were no differences in basal HR, respiratory rate, BP, HR power spectra, or catecholamine concentrations between groups. After endotoxin administration, MAP decreased (82 +/- 7 vs. 62 +/- 5 mm Hg; p < .05) as did log low-frequency HR power (-2.14 +/- 2.46 vs. -2.20 +/- 2.48 beats/min2; p < .05). Low-frequency HR power and MAP remained unchanged in control animals. Log high-frequency HR power decreased in control and experimental rabbits (-1.02 +/- 1.34 vs. -1.69 +/- 2.12 [control], p < .05; -1.53 +/- 2.19 vs. -2.19 +/- 2.85 beats/min2 [experimental], p < .05). While there was an inverse relationship between low- and high-frequency HR power and MAP, the direction of change was opposite in six of six rabbits in the control group and in six of eight rabbits in the experimental group. Plasma catecholamine concentrations did not change during the experiment in either group. CONCLUSIONS: Sympathetic modulation of cardiac activity decreased, while the sympathomedullary response remained unchanged during endotoxin shock. We speculate that a concomitant decrease in low-frequency HR power as MAP decreases may prove to be an early marker for impending shock.

Heart rate power spectrum analysis of autonomic dysfunction in adolescents with anorexia nervosa.

We studied autonomic modulation of heart rate in 8 females with anorexia nervosa (AN) using power spectral analysis (PSA) of heart rate variability in the supine and standing positions at baseline and after 2 weeks of intensive nutritional rehabilitation, and compared findings with healthy female control subjects. The results indicate that there is a decrease in sympathetic modulation of heart rate, evident by a deficit of low frequency (0.01-0.15 Hz) heart rate power in the supine position in AN compared with control subjects. In addition, parasympathetic modulation of heart rate failed to decrease with standing. A trend toward improvement in autonomic control of heart rate in adolescents with AN occurs in the supine position relatively early in weight rehabilitation. PSA is a sensitive, quantitative, and noninvasive means of determining autonomic control of heart rate and could be a useful tool in monitoring the health of patients with AN.

The relationship between static occlusion and functional occlusion in a dental school population.

The relationship between static occlusion and functional occlusion was evaluated in 101 dental and dental hygiene students. The sample was selected from a population of 467 students who were enrolled at one dental school during the 1987-1988 academic year based upon the following criteria: age range 18 to 32 years; caucasian race; no prior orthodontic treatment; at least 28 natural teeth present; no occlusal adjustments; and no large restorations, crowns or bridges. Fifty-two (52) of the subjects possessed "normal" static occlusion, 26 had a Class I malocclusion, 16 were found to have a Class II malocclusion, and 7 had a Class III malocclusion. The majority (i.e., 75%) of the 101 subjects possessed non-working (balancing) functional contacts. Seventy-five (75) of the subjects possessed balanced occlusion, nine had canine-protected occlusion, nine possessed group function occlusion, and eight had mixed canine-protected/group functional occlusion. This study found no statistically significant relationship between static occlusion and functional occlusion, however, there was a trend for balanced occlusion to be more often associated with "normal" (ideal) static occlusion.

The effects of mandatory seat belt legislation on self-reported seat belt use among male and female college students.

The effect of seat belt legislation on self-reported seat belt use among male and female college students was investigated. Questionnaires inquiring about seat belt use were administered to college students on three separate occasions: (i) two months prior to the time a mandatory seat belt law went into effect, (ii) two months after the law went into effect, and (iii) 16 months after the law went into effect. Reported seat belt use increased significantly for male and female college students two months after the law took effect. At 16 months postlaw, reported seat belt use remained high for female students but declined almost to the prelaw level for males. Possible reasons offered for these findings are that male college students may be more resistant to having their behavior regulated and, therefore, less likely to internalize changes forced on them, and college-age males may be more inclined to engage in risk-taking behavior than college-age females. The importance of considering males and females separately with respect to seat belt use and interventions designed to increase seat belt use is discussed.

Diagnosis of trisomy 18 using spontaneously dividing cells from fetal umbilical cord blood: a novel approach for rapid late second and third trimester prenatal diagnosis.

Cytogenetic methodology recently developed by us allows spontaneously dividing cells in fetal cord blood to be used for rapid (24 hours) chromosome analysis. We utilized this methodology to diagnose trisomy 18 and facilitate clinical management in a 32-week pregnancy characterized by multiple fetal anomalies and intrauterine growth retardation.

Rapid chromosome analysis with the use of spontaneously dividing cells derived from umbilical cord blood (fetal and neonatal).

An accurate and reproducible method to obtain high-quality metaphases within 24 hours has been developed. Preparations can be derived from cord blood samples obtained either at delivery or by percutaneous umbilical blood sampling. Mitogens are not required. Rapid cytogenetic analysis can facilitate management of pregnancies characterized by malformations or intrauterine growth retardation.

The effects of beliefs about smoking and health on smoking cessation.

The purpose of this study was to examine whether beliefs of an American sample about smoking and health, as defined by cognitive orientation theory, would determine those smoking cessation program participants who would become abstainers and those who would not. Although the smoking cessation program was not designed to influence the specific kinds of beliefs studied, subscales measuring two of the four types of beliefs differentiated participants who would become abstainers from those who would not. Abstainers tended to have stronger goal beliefs about their desire to quit smoking, and stronger beliefs about the health-related implications of smoking. Participants' beliefs that they could resist an urge to smoke, which implied the use of coping skills, were more important in determining who would abstain from smoking than was their confidence that they could quit smoking, which implied the use of willpower.

Beliefs about smoking and health: their measurement and relationship to smoking behavior.

A scale was constructed to measure four types of beliefs about smoking and health. According to Krietler and Krietler's (Cognitive Orientation and Behavior, New York, Springer, 1976) cognitive orientation model these four types of beliefs--general beliefs, goal beliefs, self beliefs, and norm beliefs--direct an individual's molar behavior. Four subscales, representing each of the four belief types were found to have moderately high levels of internal consistency and test-retest reliability. Factor analysis indicated a relatively high independence for the two subscales measuring self and goal beliefs, but found some overlap between the two subscales measuring norm and general beliefs. Smokers, former smokers, and nonsmokers were found to differ in predictable ways on the four subscales and the combined scale. Also the length of time that former smokers had been abstinent as well as length of smoking habit and number of cigarettes smoked per day by smokers were found to be related to some of these beliefs. Implications of these findings for smoking cessation intervention programs are discussed.

Expression and genetic segregation of parental BoLA serotypes in bovine embryos.

The detection of parentally derived BoLA serotypes was attempted in 68 bovine embryos. 23 bovine embryos were tested for genetic segregation of maternally derived BoLA serotypes. 45 bovine embryos were tested for genetic segregation of paternally derived BoLA serotypes. The expected parentally derived BoLA gene products were detectable on approximately 50% of the embryos tested. A 1:1 segregation ratio of expression or non-expression of parental BoLA serotypes in 7-day-old preimplantation bovine embryos, which is expected for codominant alleles, could not be rejected.

Alterations in intravascular volume affect the relation between right ventricular diastolic collapse and the hemodynamic severity of cardiac tamponade.

Right ventricular diastolic collapse has been demonstrated to be a sensitive and specific sign of cardiac tamponade. Because the shape and position of the right ventricular wall are related to the relative pressures within the pericardial space and the right ventricular chamber, the usefulness of right ventricular diastolic collapse as a marker of cardiac tamponade may be influenced by intravascular volume and right heart filling pressures. This study was undertaken to determine the effects of volume loading and hemorrhage on the point within the hemodynamic progression of cardiac tamponade at which right ventricular diastolic collapse first appears. Five unanesthetized, chronically instrumented dogs were studied with two-dimensional echocardiography during 41 episodes of cardiac tamponade induced by the intrapericardial infusion of warm saline solution. Intravascular volume was adjusted before cardiac tamponade to a hypovolemic, euvolemic or hypervolemic state using saline solution and dextran infusion or hemorrhaging to achieve the prescribed mean right atrial blood pressure. The measurements recorded during each episode of cardiac tamponade were right atrial blood pressure, aortic blood pressure, cardiac output (by electromagnetic flow meter), heart rate and intrapericardial pressure. When compared with the euvolemic state, the onset of right ventricular diastolic collapse in volume contraction occurred at a lower intrapericardial pressure (with a lower aortic blood pressure and cardiac output), whereas in volume expansion it occurred at a higher intrapericardial pressure (with a higher aortic blood pressure and cardiac output). Volume expansion delayed the decrease in hemodynamic variables during cardiac tamponade in this canine model.

Growth retardation, alopecia, pseudo-anodontia, and optic atrophy--the GAPO syndrome: report of a patient and review of the literature.

The GAPO syndrome is a rare but distinct autosomal-recessive disorder. The term GAPO is an acronym for the manifestations of Growth retardation. Alopecia, Pseudo- anodontia (failure of tooth eruption), and progressive Optic atrophy. We are aware of five other published patients. All have a strikingly similar appearance. This, along with other distinct manifestations, should allow clear differentiation from other causes of growth retardation. The hypothesis of autosomal-recessive inheritance is based on parental consanguinity and affected sibs in several cases.