Early life stress in mice is a suitable model for Irritable Bowel Syndrome but does not predispose to colitis nor increase susceptibility to enteric infections.

Neonatal period is characterized by an immature intestinal barrier. Scattered evidence suggests that early life stressful events induce long lasting alterations of intestinal homeostasis mimicking Irritable Bowel Syndrome (IBS). Those observations highlighting defect of intestinal barrier by early life stress questioned its potential role as a risk factor for gastrointestinal disorders such as colitis and infections. In this study, we aimed to analyze if maternal separation (MS) in mice mimicks IBS main features. We next addressed whether MS could trigger or exacerbate colitis in genetically predisposed mice and/or enhance susceptibility to gastrointestinal infections in wild type mice. MS induced main features of IBS in adult wild type male mice i.e. intestinal hyperpermeability, visceral hypersensitivity, microbiota dysbiosis, bile acid malabsorption and low grade inflammation in intestine associated with a defect of Paneth cells and the ILC3 population. This breach in mucosal barrier functions in adults was associated with a systemic IgG response against commensal E. coli and increased IFNγ secretion by splenocytes. However, in IL10-/- mice, MS did not trigger nor worsen colitis. Furthermore, wild type mice submitted to MS did not show increase susceptibility to gastrointestinal infections (S. Typhimurium, L. monocytogenes or T. gondii) compared to controls. Altogether, our results identify MS in mice as a good experimental model for IBS mimicking all the main features. In addition, early life stress, even though it has long lasting consequences on intestinal homeostasis, does not constitute a facilitating factor to colitis in predisposed individuals nor to gastrointestinal infections in wild type mice.

Mycoflora and ochratoxin A producing strains of Aspergillus in Algerian wheat.

Wheat is a basic staple food for very large segments of the population of Algeria. The aim of this study is to analyse ochratoxin A (OTA)-producing mould and OTA-contaminated wheat. To evaluate the mycoflora and the potential for OTA production by Aspergillus strains, a total of 85 samples of wheat destined for human consumption were collected from two regions in Algeria (Tizi Ouzou and Setif) during the following phases: preharvest, storage in silos, and after processing. The mean value counts of fungi ranged from 275 to 1277 CFU g(-1). The dominant genus was Aspergillus, predominantly A. flavus, A. niger and A. versicolor. The other isolated species were A. ochraceus, A. alliaceus, A. carbonarius, A. terreus, A. fumigatus, A. candidus and Aspergillus spp. The occurrence and the levels of the genus Penicillium, Fusarium, Alternaria and Mucor were substantially lower than those of Aspergillus. The storage in silos shows high levels of Aspergillus (66 to 84%), especially A. flavus, but A. niger and other fungi were isolated at relatively low percentages. Equal distribution of the fungal contamination into the bran, flour and semolina fractions was observed from Flour Mill and Semolina Mill. The genus Aspergillus remained present at high levels at several phases of the production process. In addition, the ability to produce OTA by 135 isolates belonging to eleven species of Aspergillus and 23 isolates of Penicillium spp. was analyzed using fluorescent detection-based HPLC. Thus, it was found that 51 isolates (32.3%) were ochratoxigenic. All isolated strains of A. ochraceus (12) and A. alliaceus (6) produced OTA at concentrations ranging from 0.23 to 11.50 microg g(-1). Most of the A. carbonarius strains (80%) were OTA producers (0.01 to 9.35 microg g(-1)), whereas A. terreus (50%), A. niger (28%), A. fumigatus (40%), A. versicolor (18%) and Penicillium spp. (21.7%) were low level producers (0.01 to 0.07 microg g(-1)). The concentration of OTA was determined in 30 samples of wheat. OTA was detected in 12 (40%) of the samples at levels ranging from 0.21 to 41.55 microg kg(-1).

Rapid ventricular filling in left ventricular hypertrophy: I. Physiologic hypertrophy.

The effects of endurance training on the diastolic properties of the left ventricle were examined by comparing left ventricular filling rates in 11 male distance runners and 12 age-matched nonathletic control subjects selected to have nearly similar heart rates at rest. Maximal oxygen consumption was 69 +/- 11 ml/kg-min for the athletes and 48 +/- 8 ml/kg X min for the control subjects (p less than 0.001). Left ventricular end-diastolic dimension, posterior wall thickness and mass were determined by echocardiography, and average left ventricular filling rate was determined with a nonimaging scintillation probe. Electrocardiographic voltage was significantly greater in the athlete group than in the control group (sums of the voltages of the S wave in lead V1 and the R wave in lead V5 were 40 +/- 10 and 26 +/- 7 mV, respectively) (p less than 0.001), whereas ejection fraction was similar in the two groups. Despite a modest degree of left ventricular hypertrophy in the athlete group compared with the control group (left ventricular mass index 127 +/- 30 and 82 +/- 13 g/m2, respectively) (p less than 0.001), the average left ventricular filling rate was similar in the two groups (2.53 +/- 0.34 versus 2.38 +/- 0.29 end-diastolic counts/s, p = NS). There was no trend for the athletes with a higher left ventricular mass to exhibit a slower filling rate. These findings demonstrate that unlike pathologic hypertrophy associated with chronic hemodynamic over-loading, physiologic left ventricular hypertrophy is not accompanied by slowed left ventricular diastolic filling.

A randomized trial comparing primary angioplasty with a strategy of short-acting thrombolysis and immediate planned rescue angioplasty in acute myocardial infarction: the PACT trial. PACT investigators. Plasminogen-activator Angioplasty Compatibility Trial.

OBJECTIVES: The study evaluated the efficacy and safety of a short-acting reduced-dose fibrinolytic regimen to promote early infarct-related artery (IRA) patency during the inherent delay experienced by infarct patients referred for angioplasty as the principal recanalization modality. BACKGROUND: Previous approaches using long-acting, full-dose thrombolytic infusions rarely showed benefit, but they did increase adverse event rates. METHODS: Following aspirin and heparin, 606 patients were randomized to a 50-mg bolus of recombinant tissue-type plasminogen activator (rt-PA) (alpha half-life 4.5 min) or to placebo followed by immediate angiography with angioplasty if needed. The end points included patency rates on catheterization laboratory (cath lab) arrival, technical results when PTCA (percutaneous transluminal coronary angioplasty) was performed, complication rates, and left ventricular (LV) function by treatment assignment and time to restored patency following angioplasty. RESULTS: Patency on cath lab arrival was 61% with rt-PA (28% Thrombolysis in Myocardial Infarction trial [TIMI]-2, 33% TIMI-3), and 34% with placebo (19% TIMI-2, 15% TIMI-3) (p = 0.001). Rescue and primary PTCA restored TIMI-3 in closed arteries equally (77%, 79%). No differences were observed in stroke or major bleeding. Left ventricular function was similar in both treatment groups, but convalescent ejection fraction (EF) was highest with a patent IRA (TIMI-3) on cath lab arrival (62.4%) or when produced by angioplasty within an hour of bolus (62.5%). However, in 88% of angioplasties, the delay exceeded 1 h: convalescent EF 57.3%. CONCLUSIONS: Tailored thrombolytic regimens compatible with subsequent interventions lead to more frequent early recanalization (before cath arrival), which facilitates greater LV function preservation with no augmentation of adverse events.

Streptokinase dissolution of a right atrial thrombus associated with a temporary pacemaker.

Thrombosis of intravascular catheters is a well-recognized and potentially serious complication, which has been treated successfully with thrombolytic agents. A routine echocardiogram in a patient with a temporary transvenous pacemaker demonstrated a large thrombus attached to the pacing electrode. This was dissolved successfully and uneventfully with high-dose intravenous streptokinase therapy. To our knowledge, this is the first report of the successful lysis of a right atrial thrombus complicating a temporary transvenous pacemaker.

Diagnostic value of bronchoalveolar lavage in suspected pulmonary tuberculosis.

Of 222 patients suspected of having pulmonary tuberculosis (PT), studied during a one-year period, we performed fiberoptic bronchoscopy together with bronchoalveolar lavage (BAL), bronchial washing and postbronchoscopy sputum smears and Löwenstein cultures in 20 patients. Bronchoalveolar lavage proved to be the most effective method leading to diagnosis in 17 of 20 cases. Diagnosis was obtained in 11 of 20 cases using bronchial washing and postbronchoscopy sputum. The results of this study suggest that bronchoscopy may be required in selected cases for the diagnosis of PT. However, it should be accompanied by BAL, bronchial washings and postbronchoscopy sputum smears. Indications for bronchoscopy as a diagnostic tool for PT may include: (a) patients suspected of having PT with negative smears and in whom treatment must be started due to clinical status; (b) suspicion of associated neoplasia; (c) selected patients with negative Löwenstein cultures; (d) lack of material being obtained by simpler methods.

Intraoperative use of nifedipine for hemodynamic collapse due to coronary artery spasm following myocardial revascularization.

Sudden hemodynamic collapse in the perioperative period following myocardial revascularization may be due to coronary artery spasm. Nitroglycerin has been the standard treatment for this; however, it is not always effective, and the resultant morbidity and mortality are high. We present the case of a patient in whom sudden hemodynamic collapse due to coronary artery spasm was refractory to intravenously administered nitroglycerin but was relieved quickly with sublingually administered nifedipine. In certain selected patients in whom coronary artery spasm is responsible for myocardial collapse, the drug nifedipine may be effective in relieving this spasm and allowing for myocardial recovery.

Assessment of metal mobility in dredged harbour sediments from Barcelona, Spain.

In order to assess heavy metal mobility in dredged harbour sediments, six superficial sediment samples covering a range of pollution levels and environments were collected in Barcelona Harbour. Samples were characterised in terms of major compounds (Al, Ca, Fe, Mn, Si, Ti, Mg, K and Na); total C, N and S contents; organic matter; and water content. Pseudo-total trace metal contents were assessed after aqua regia digestion (ISO 11466:1995). The modified BCR three-step sequential extraction procedure (BCR-SEP) was applied, and both major compounds (Al, Ca, Fe and Mn) and trace metals (Cd, Cr, Cu, Ni, Pb and Zn) were determined in the different extracts. Both the pseudo-total digestion method and the BCR-SEP were validated using two sediment certified materials from lakes (BCR CRM 701 and BCR CRM 601). The highest metal concentrations were observed in one of the sampling points which receives an urban discharge. The observed mobility order (percentage of metal extracted in the first step) of the six trace metals studied was Cd>Zn>Pb>Cu>Ni>Cr. The good agreement observed with the results obtained as the sum of the four steps (extractable+residue) and the pseudo-total content shows that laboratory working conditions were under control.

Effect of aerobic training on left ventricular diastolic filling.

The effects of aerobic training on left ventricular diastolic filling were determined and related to the effects on maximal oxygen uptake, left ventricular systolic function, and left ventricular mass. Nine untrained healthy males with a mean age of 32 years underwent a ten-week program of bicycle training. Echocardiographic left ventricular mass, maximal oxygen uptake, radionuclide-derived left ventricular ejection fraction, and average left ventricular filling rate were obtained before and after training. Training resulted in significant increases in maximal oxygen uptake (from 30 +/- 6 (mean +/- S.D.) to 40 +/- 7 ml/kg/min, p less than 0.001) and average left ventricular filling rate (from 2.04 +/- 0.36 to 2.22 +/- 0.31 end-diastolic volumes/sec, p less than 0.05), but no changes in heart rate, systolic blood pressure, left ventricular ejection fraction, or left ventricular mass. These data indicate that short-term high-intensity aerobic training enhances average left ventricular diastolic filling independent of any change in left ventricular geometry, systolic function, heart rate, or blood pressure.

[Conners' rating scales in the assessment of attention deficit disorder with hyperactivity (ADHD). A new validation and factor analysis in Spanish children]. / Escalas de Conners en la evaluación del trastorno por déficit de atención con hiperactividad: nuevo estudio factorial en niños españoles.

The use of Conner's Rating Scales (CRS) is very extended for the assessment of attention deficit disorder with hyperactivity (ADD-H). The main objective of this work is to study the validity of construct of CRS from theoretical basis and data statistical analysis. The study is based on a control group of 633 children and a clinical group of 33 subjects. We used a Spanish version of the Conner's Teacher Rating Scale (CTRS) and Conner's Parents Rating Scale (CPRS) in both groups. From the analysis of scales contents we attribute the items to several behavioral areas and we performed a factorial analysis. Studies of reliability, external validity versus clinical criteria, and analysis of correlations between parents and teachers scales were also performed. Findings from factorial analysis and study of reliability have shown the questions of CTRS to be clustered in three well-defined and reliable factors: hyperactivity, attention deficit, and conduct disorder. The questions dealing with emotional disorders are not sufficiently consistent to constitute a separate factor. CPRS has a lower reliability than CTRS, and its factorial analysis does not allow to consider a factorial distribution. The validity is high in CTRS and no significative in CPRS. Correlation between scales is also low. As a consequence of these results we propose a Spanish experimental revised form of the CTRS, with 20 items. This new form can assess separately: attention deficit; hyperactivity and conduct disorder, according to the current clinical criteria of CIE-10 and DSM-IV.

Comparison of three strategies to evaluate uncertainty from in-house validation data. A case study: mercury determination in sediments.

In the present paper, three approaches are compared for the evaluation of the combined uncertainty in the determination of mercury in aquatic sediments by an aqua regia extraction procedure. For this, the data obtained in validation studies from five certified reference materials (CRMs), covering a range of concentrations from 0.8 to 130 mg kg(-1) of mercury and analysed by three atomic spectroscopic techniques (cold vapour generation atomic fluorescence spectrometry, CV-AFS, cold vapour generation atomic absorption spectroscopy, and inductively coupled plasma mass spectroscopy), were considered. The combined uncertainty was firstly assessed by considering separately the data obtained for each CRM analysed (approach A). Moreover, this assessment was also performed with two other calculation approaches (B and C) based on the pooled data obtained from the validation step. The comparison of the results obtained for the different techniques showed a clear bias effect when using CV-AFS with nitric acid as a diluent. In relation to the strategies tested for the combined uncertainty assessment, approach C proved to be the easiest and friendliest method for uncertainty assessment.

Neuropsychological predictors of dependency in patients with Alzheimer disease.

OBJECTIVE: To determine whether specific cognitive deficits can predict the progression of Alzheimer disease (AD). METHODS: Two hundred fifty-two patients with AD enrolled in the Predictors Study were followed at 6-month intervals for up to 4.5 years with neurologic, cognitive, and psychiatric examinations. Neuropsychological functions were assessed by the Modified Mini-Mental State Examination (mMMSE). Items of mMMSE were divided into five cognitive domains: temporospatial orientation, short-term memory, long-term memory, language, and visuoconstructive functions. Loss of autonomy was assessed by both the Dependency Scale (DS) and the Equivalent Institutional Care (EIC) rating. Cox proportional hazards models, adjusted for age, sex, estimated duration of illness at entry into the study, and presence of extrapyramidal signs and behavioral disturbances, were used to determine the predictive value of each neuropsychological domain on dependency outcomes. RESULTS: Global mMMSE, temporospatial orientation, and short-term memory scores were associated with a greater relative risk of moderate or severe dependency. The visuoconstructive score predicted the development of severe dependency. Long-term memory and language scores were not predictive of the EIC or DS endpoints. CONCLUSIONS: The presence of certain neuropsychological deficits at a patient's initial visit, such as short-term memory, temporospatial orientation, and constructive apraxia, predict more rapid dependency in patients with Alzheimer disease. Neuropsychological items have different weights in term of predictive power, and these effects are independent of the influence of age and disease duration at baseline.

Effect of chloride on heavy metal mobility of harbour sediments.

To evaluate the environmental impact of polluted sediments, several operationally defined sequential extraction procedures (SEPs) have been described. Salinity has long been recognised as an important variable determining the physicochemical behaviour of heavy metals in marine sediments. Thus, in the present paper, the modified BCR-SEP has been applied to harbour sediments in order to assess to what extent trace metal mobility (Cd, Cr, Cu, Ni, Pb and Zn) could be influenced by chloride content in sediments. For this, washed (W) and non-washed (NW) sediments were compared. The relative mobility order observed for the six trace metals studied was not seen to be influenced by the presence of chloride in the sediments, but an increase of mobility was observed for Cd and Zn (the most mobile metals) when chloride was present in the sediments. Characterisation of the sediments and of the pseudo-total metal contents by means of an aqua regia extraction was also assessed.

Unsuspected substantial pericardial effusions detected by echocardiography.

In a consecutive series of 1,225 routine echocardiograms, a pericardial effusion (PE) was present in 15% and was considered substantial in 10%. Sixty-one percent (68/111) of the latter were clinically unsuspected. A retrospective analysis of these patients showed that 60% (41/68) had underlying heart disease such as congestive heart failure, left ventricular hypertrophy, or asymmetric septal hypertrophy without other discernible causes for PE. In patients referred specifically for suspected pericardial effusion, 67% (29/43) had diseases recognized as causes of pericardial effusion. Unsuspected substantial PE are commonly detected by echocardiography, especially in patients with underlying heart disease.