[Amatoxin-containing mushroom poisoning: An update]. / Syndrome phalloïdien : mise au point.

Amatoxin-containing mushroom poisoning occurs after consumption of certain mushroom species, of the genera Amanita, Lepiota and Galerina. Amanita phalloides is the most implicated species, responsible for over more than 90% of mushroom-related deaths. The α-amanitin is responsible for most of the observed effects. Symptoms are characterized by severe delayed gastrointestinal disorders (more than six hours after ingestion). The liver being the main target organ, outcome is marked by an often severe hepatitis which can evolve towards terminal liver failure, justifying orthotopic liver transplantation. Acute renal failure is common. Diagnosis of amatoxin-containing mushroom poisoning is based primarily on clinical data; it can be biologically confirmed using detection of amatoxins, especially from urine samples. In the absence of an antidote, early hospital management is essential. It is based on supportive care (early compensation of hydroelectrolytic losses), gastrointestinal digestive decontamination, elimination enhancement, amatoxin uptake inhibitors and antioxidant therapy. Combined therapy associating silibinin and N-acetylcysteine is recommended. Prognosis of this severe poisoning has greatly benefited from improved resuscitation techniques. Mortality is currently less than 10%. In the event of a suspected or confirmed case, referral to a Poison Control Center is warranted in order to establish the diagnosis and guide the medical management of patients in an early and appropriate way.

Non-linear oscillatory rheological properties of a generic continuum foam model: comparison with experiments and shear-banding predictions.

The occurrence of shear bands in a complex fluid is generally understood as resulting from a structural evolution of the material under shear, which leads (from a theoretical perspective) to a non-monotonic stationary flow curve related to the coexistence of different states of the material under shear. In this paper we present a scenario for shear-banding in a particular class of complex fluids, namely foams and concentrated emulsions, which differs from other scenarios in two important ways. First, the appearance of shear bands is shown to be possible both without any intrinsic physical evolution of the material (e.g. via a parameter coupled to the flow such as concentration or entanglements) and without any finite critical shear rate below which the flow does not remain stationary and homogeneous. Secondly, the appearance of shear bands depends on the initial conditions, i.e. the preparation of the material. In other words, it is history dependent. This behaviour relies on the tensorial character of the underlying model (2D or 3D) and is triggered by an initially inhomogeneous strain distribution in the material. The shear rate displays a discontinuity at the band boundary whose amplitude is history dependent and thus depends on the sample preparation.

Determination of Glyphosate and AMPA in Blood Can Predict the Severity of Acute Glyphosate Herbicide Poisoning.

OBJECTIVE: To evaluate a potential association between blood and urine concentration of glyphosate and its metabolite, aminomethylphosphonic acid (AMPA), with severity of acute glyphosate (herbicide) poisoning. METHODS: In our retrospective study of acute glyphosate poisoning, we examined records from the French National Database of Poisonings, dated between January 1, 2004, and December 31, 2016. We compared the severity of poisoning among case individuals using the Fisher exact test and Wilcoxon test. Also, we calculated ROC curves to determine the cutoff for blood and urine concentration. RESULTS: A total of 17 plasma glyphosate, 11 urine glyphosate, 13 plasma AMPA, and 10 urine AMPA specimens were included in our study, with collection dates ranging from January 1, 2004, through December 31, 2016. CONCLUSION: The optimal cutoff we discovered for blood concentration of AMPA was 0.88 mg/L; for glyphosate, it was 600 mg/L. The cutoff plasma concentration of AMPA has never been described in the literature, to our knowledge.

[Perception of health care quality by patients with chronic conditions]. / Perception de la qualité des soins reçus par les personnes atteintes de maladie chronique.

BACKGROUND: Patient opinion is becoming ever more important when considering healthcare quality and the reforms required to improve healthcare quality. The main aim of this study was to explore factors determining perceived healthcare quality among patients with chronic diseases. METHODS: Data are drawn from the survey carried out in 2008 by the Commonwealth Fund, in partnership with the French Superior Health Authority (Haute Autorité de santé). The prospective telephone survey targeted adults in eight countries who had serious health problems (chronic or severe disease, declared poor state of health, hospital admission or major surgery). Of the 1202 French respondents, 851 had at least one diagnosed chronic disease. A multinomial logistic model was used to identify the relationship between perceived healthcare quality and patients' recent experience with the healthcare system. RESULTS: People with chronic disease in general perceived that healthcare quality was excellent (45%) or good (44%). Only 11% of respondents judged it to be average or poor. There was a hint of "could do better", for example when considering podology and ophthalmology follow-up in diabetes or the management of multiple medications. The explanatory model revealed a positive correlation between excellent perceived healthcare quality and a strong doctor-patient relationship, taking into account both the length of this relationship and the ability of the doctor to involve the patient at all stages of decision-making concerning therapeutic management. There was no major link between the perceived quality of care and objective care quality, the quality of procedures, the cost of care to the patient or how frequently patients access the healthcare system. CONCLUSION: The quality of the relationship between the patient and his/her doctor is a determining factor in the patient's judgement of the quality of healthcare he/she receives.

2,2'-Dipyridylamines: more than just sister members of the bipyridine family. Applications and achievements in homogeneous catalysis and photoluminescent materials.

2,2'-Dipyridylamines (dpa) and related compounds belong to the family of polydentate nitrogen ligands. More than a century has passed since their first report but new complexes and applications have been emerging in recent years owing to the versatility of dpa-based architectures. This review aims to present and highlight the main achievements attained with dpa-containing metal complexes in the domains of homogeneous catalysis and luminescent materials.

Effects of rotation on temperature fluctuations in turbulent thermal convection on a hemisphere.

Rotation is present in many physical and geophysical systems and its role in determining flow properties and modifying turbulent fluctuations is of crucial importance. Here we focus on the role of rotation on temperature fluctuations in turbulent thermal convection. The system used consists of a rotating half soap bubble heated from below. This system has features, curvature and a quasi two dimensional character, which are reminiscent of atmospheric and planetary systems. Our experiments and numerical simulations show that rotation changes the nature of turbulent fluctuations and a new scaling regime is obtained for the temperature field. This change in the scaling behavior of temperature fluctuations, due to rotation, is put forth by studying the so called second moment of temperature differences across different scales. For high enough rotation rates, these temperature differences display a transition from Bolgiano Obukhov scaling to a new scaling regime. This scaling is at odds with expectations from theory, numerics, and experiments in three dimensions, suggesting that the effects of rotation on turbulent flows depend strongly on geometry and spatial dimension.

Circulating DNA:anti-DNA complexes in systemic lupus erythematosus. Detection and characterization by ultracentrifugation.

Although it is generally accepted that DNA:anti-DNA immune complexes play a significant role in the pathogenesis of tissue injury in systemic lupus erythematosus, their presence in the circulation is still a matter of controversy. In this study, we detected DNA:anti-DNA compexes by identification of both the antigen and(or) the antibody, the necessary requisites for immune complex definition, in 14 of 24 plasmas (7 of 11 patients). These antibodies were specific for native DNA and could be adsorbed by anti-immunoglobulin (Ig)G antisera. The DNA recovered was, at least in part, of low molecular weight. The presence of DNA:anti-DNA compexes was not related to high molecular weight IgG, cryoprecipitins, positive polyethylene glycol precipitation, or low plasma C3 levels. It was related significantly to low plasma C4 levels and to the presence of diffuse proliferative nephritis. The lack of correlation with other methods of detection of immune complexes and with the presence of heavy IgG (above 13 S) is in favor of the existence of other antigen-antibody systems (or aggregated immunoglobulins) in systemic lupus erythematosus plasmas. From the results, it appears that methods directed towards the demonstration of specific immune complexes are more informative than those detecting heavy or altered immunoglobulins.

Modifications of cellular lipids induce insulin resistance in cultured hepatoma cells.

We altered the cellular lipid composition of an insulin sensitive rat hepatoma cell line through supplementation of the culture medium with linoleic acid (18:2) or 25-hydroxycholesterol, and we studied the effects on insulin stimulation of aminoacid transport system A and glycogen synthesis. The basal rate of sodium-dependent aminoisobutyric acid uptake was slightly reduced in hydroxysterol-treated cells and increased in 18:2-enriched cells. Maximal insulin stimulation of transport was decreased by about 40% in both 18:2 and 25-hydroxycholesterol modified cells, as compared to control cells. In addition to reduced responsiveness, the hydroxysterol-treated cells also showed a diminished sensitivity to insulin, as revealed by a right-shift of the dose-response curve leading to a ED50 of 1.2 X 10(-8) M (P less than 0.02), as compared to 2.45 X 10(-9) M in control cells and 2.13 X 10(-9) M in 18:2 enriched cells. Concerning glycogen synthesis, the basal rate was unaffected by 25-hydroxycholesterol supplementation and slightly reduced in cells enriched in 18:2. Maximal insulin stimulation of glycogen synthesis was reduced by about 40% in both types of lipid modified cells. 25-Hydroxycholesterol again provoked a decrease in sensitivity to insulin: the ED50 was enhanced to 4.9 X 10(-9) M (P less than 0.05), as compared to 1.25 X 10(-9) M in control cells and 1.57 X 10(-9) M in 18:2-supplemented cells. Taken together with the previously reported changes of insulin binding to lipid modified hepatoma cells (Bruneau et al. (1987) Biochim. Biophys. Acta 928, 287-296) our results demonstrate an influence of alterations of the cellular lipid composition on both binding and biological actions of insulin, leading to an insulin-resistant state. Divergences between insulin binding and action were obtained and it was suggested that post-binding events may be responsible for the observed changes. Our findings may be relevant to experimental and clinical states of insulin resistance.

Induction, by adriamycin and mitomycin C, of modifications in lipid composition, size distribution, membrane fluidity and permeability of cultured RDM4 lymphoma cells.

Adriamycin and mitomycin C were previously found to modulate the sensitivity of lymphoma cells to lysis by certain effectors of immunity and this modulation was dependent on drug concentration. In the present studies, RDM4 lymphoma cells were treated with different concentrations of the two drugs for 24 h in culture. These treatments resulted in changes in the lipid composition, membrane fluidity, cell size distribution, and permeability to 51CrO4, Trypan blue, Acridine orange and trimethylaminodiphenylhexatriene (TMA-DPH) of the cells. Changes in some of these parameters, as a function of drug concentration, resulted in dose-response curves which were bell-like shaped, hence paradoxical similarities between non-drug-treated cells and cells treated with higher drug concentrations were observed.

Influence of lipid environment on insulin binding in cultured hepatoma cells.

The influence of alterations of plasma membrane physico-chemical properties on insulin binding have been characterized in an insulin-sensitive rat hepatoma cell line adapted to grow for several generations in culture medium enriched with linoleic acid (18:2) or with 25-hydroxycholesterol. The cells took up 18:2 and 25-hydroxycholesterol added to the culture medium, without exhibiting any sign of intolerance or intoxication. These compounds respectively increased and decreased membrane fluidity at 37 degrees C. The cells demonstrated extensive changes in insulin binding parameters in response to experimental modifications of their membrane lipid composition. When determined at 4 degrees C, insulin receptors were present in the control cells at 136,000 sites/cell but this fell to 111,000 (P less than 0.05) in cells enriched in 18:2, and rose to 176,000 (P less than 0.001) in hydroxysterol-grown cells. According to a two-site model, the main effect of 18:2 was a significant increase of the number of high-affinity sites with a concomitant decrease of low-affinity sites. The hydroxysterol had the opposite effects on these parameters. The high-affinity insulin binding capacity of the hepatoma cells was affected by lipid supplementation in a similar way, whether it was determined at 4 degrees C or at 37 degrees C. Assuming a negative cooperativity model, 18:2 enhanced the degree of negative cooperativity among the sites, while 25-hydroxycholesterol reduced it. The time-course of insulin-induced receptor down-regulation was accelerated in the cells enriched in polyunsaturated fatty acids, but reduced in cells exposed to 25-hydroxycholesterol. These insulin-binding alterations cannot be directly related to modifications of cellular growth rate, receptor internalization or membrane fluidity per se, and are discussed as being more likely due to membrane lipid composition than to overall cell metabolism modifications.

Experiments and direct numerical simulations of two-dimensional turbulence.

Experiments and direct numerical simulations reveal the coexistence of two cascades in two-dimensional grid turbulence. Several features of this flow such as the energy density and the scalar spectra are found to be consistent with well known theoretical predictions. The energy transfer function displays the expected up-scale energy transfers. The vorticity correlation function is logarithmic and thus consistent with recently proposed models.

Ruthenium(II) and iridium(III) complexes featuring NHC-sulfonate chelate.

Three new complexes bearing a chelating (κ(2)C,O) NHC-SO3 ligand have been prepared. An original method for the synthesis of the imidazolium-sulfonate NHC precursor is described. The 5-membered ruthena- and irida-cycle containing complexes were fully characterized and evaluated in a series of catalytic transformations involving hydrogen auto-transfer processes.

Cationic ruthenium allenylidene complexes as catalysts for ring closing olefin metathesis

A series of well accessible cationic ruthenium allenylidene complexes of the general type [(eta6-arene)(R3P)RuCl(=C=CR'2)]+ X- is described which constitute a new class of pre-catalysts for ring closing olefin metathesis reactions (RCM) and provide an unprecedented example for the involvement of metal allenylidenes in catalysis. They effect the cyclization of various functionalized dienes and enynes with good to excellent yields and show a great tolerance towards an array of functional groups. Systematic variations of their basic structural motif have provided insights into the essential parameters responsible for catalytic activity which can be enhanced further by addition of Lewis or Bronsted acids, by irradiation with UV light, or by the adequate choice of the "non-coordinating" counterion X-. The latter turned out to play a particularly important role in determining the rate and selectivity of the reaction. A similarly pronounced influence is exerted by remote substituents on the allenylidene residue which indicates that this ligand (or a ligand derived thereof) may remain attached to the metal throughout the catalytic process. X-ray crystal structures of the catalytically active allenylidene complexes 3b.PF6 and 15.OTf as well as of the chelate complex 10 required for the preparation of the latter catalyst are reported.

Vasculitis as a presenting manifestation of primary biliary cirrhosis: a case report.

The association of vasculitis and asymptomatic primary biliary cirrhosis (PBC) was documented in a 39 year old female. Cyclophosphamide was used with good results. The Raji cell assay for circulating immune complexes (CIC) was positive initially with further values changing in parallel with disease activity. The C1q binding assay failed to reveal significant levels of CIC at any time. Lymphocytotoxic antibodies were not detected in the serum. Sucrose density ultra-centrifugation experiments revealed 9-17S material in sera that were positive for CIC by the Raji cell assay. We conclude that intermediate size CIC may be important in the pathogenesis of the vasculitis associated with PBC.

Transfection of TCR alpha/beta genes in T cell hybridoma induces expression of CD5 molecules and increases allogenic proliferative and cytotoxic response.

In the present work, we have studied the activity in vitro of T cell hybridoma (DO11107) in which the alpha/beta TCR genes of a cytotoxic T cell clone (KB5C20) were transfected. All clones transfected expressed CD5 molecule and have an important proliferative and cytotoxic allogenic activity.

A new dicoumarinyl ether and two rare furocoumarins from Ruta montana.

A new dicoumarinyl ether, rutamontine and two rare furocoumarins, heraclenol and isopimpinellin, were isolated from Ruta montana. The structure of rutamontine as 6-hydroxy-7-methoxy-3,7'-dicoumarinylether was determined by spectroscopic methods.

[Frequency of childhood injuries: first results of the Boulogne-Billancourt registry]. / Analyse des accidents de l'enfant: premiers résultats de l'Observatoire de Boulogne-Billancourt.

BACKGROUND: Boulogne-Billancourt database is in France the only permanent and specific childhood injury surveillance system. Integrated in an safe community program designed by the World Health Organization (WHO), the aims of a local database are to provide precise information intended to implement prevention actions. METHOD: All children less than sixteen years old living in Boulogne-Billancourt, victims of injuries occurring in that town, and requiring hospital care, are targeted. RESULTS: Two thousand five hundred and eighty accidents have been computed between 1(st) January 1998 and 31 December 1999, i.e. an average annual incidence of 79.7/1000 children. As in other similar databases, domestic accidents are prevalent in the average (40%), even though after five years old school injuries become the most frequent ones (36%). Falls are the main mechanism involved in injury at any age (44 to 54%). Distribution of other mechanisms varies with respect to age: foreign body prevalence is maximum between one and four (2.5%), struck-collisions (38%) between ten and fifteen years old. A significant increase of falls involving roller-skates or skateboards has been observed between 1998 and 1999 (3.8% versus 1.1%, p<0.001). Predominanting injury causes are contusions (38%), mainly head trauma (10%), open wounds (16%), fractures (10%), and sprains (6%). Two hundred and twenty four injuried children have been admitted in 1998, 205 in 1999, i.e. respectively 13.8/1000 and 12.7/1000 children dwelling in Boulogne. Overall recurrence rate is 32%, reaching 47% after eleven years old. A significant relationship has been observed between injury recurrence and problems related to education (odds ratio: 2.95; 95% CI: 1.75-5.00), atypical parenting situation (odds ratio: 1.70; 95% CI: 1.20-2.30), and family discord (odds ratio: 1.62; 95% CI: 1.05-2.50). Household accidents are the most avoidable ones in parents'opinion. This is not the case for road-traffic accidents, given evidence of the lack of means of protection observed in bicycle injuries. CONCLUSION: In spite of methodological issues such as control of exhaustivity of data, or difficulties to maintain a long-term surveillance sytem, this project worth carrying on with regard to provided information and usefulness for prevention. Other similar community experiences should be implemented with the aim of setting up a national-wide surveillance system, based on an homogenous data collection.

A transient monocyte defective function in idiopathic nephrotic syndrome (lipoid nephrosis).

Alterations in phagocytosis have been studied in 25 patients with idiopathic nephrotic syndrome (INS). At the time of investigation all patients had normal renal function.

Shiitake dermatitis recorded by French Poison Control Centers - new case series with clinical observations.

CONTEXT: Shiitake (Lentinula edodes) is an edible mushroom which was initially grown in Japan and China and is now sold on the European market. Flagellate erythema may arise following shiitake consumption and was first described in Japan in 1974. OBJECTIVE: This paper reports a French shiitake dermatitis case series. METHODS: The findings of retrospective study of shiitake dermatitis cases, reported to French Poison Control Centres (PCC) from January 2000 to December 2013, are reported. RESULTS: Among 32 exposed patients, 15 presented flagellate urticarial lesions after raw shiitake consumption. The first case of this series was reported in 2006 and the last nine cases were reported as of 2012. After shared meals, no symptoms were reported among guests, who preferred cooked shiitake to the raw mushroom. In this series, rashes appeared 12 h to 5 days (median: 24 h) after raw shiitake ingestion. Linear and itchy urticarial lesions formed on the trunk, arms, and legs within a few hours and persisted for 3-21 days. In four cases, rash and pruritus were either triggered or worsened by sun exposure. Eleven patients received corticosteroids, antihistamines, or both. All patients completely recovered. CONCLUSION: Due to the rapidly increasing consumption of exotic food in Western countries, it is no surprise that cases of shiitake dermatitis are now appearing in Europe. The mechanism of shiitake dermatitis is thought to be toxic and due to lentinan, a polysaccharide component of the mushroom. There is no specific validated treatment for shiitake dermatitis. Health professionals and the general population should be aware of both the risk associated with raw shiitake consumption and of the good prognosis of this very spectacular and uncomfortable toxic dermatitis.

Intensity of vortices: from soap bubbles to hurricanes.

By using a half soap bubble heated from below, we obtain large isolated single vortices whose properties as well as their intensity are measured under different conditions. By studying the effects of rotation of the bubble on the vortex properties, we found that rotation favors vortices near the pole. Rotation also inhibits long life time vortices. The velocity and vorticity profiles of the vortices obtained are well described by a Gaussian vortex. Besides, the intensity of these vortices can be followed over long time spans revealing periods of intensification accompanied by trochoidal motion of the vortex center, features which are reminiscent of the behavior of tropical cyclones. An analysis of this intensification period suggests a simple relation valid for both the vortices observed here and for tropical cyclones.