Comparison of LDL fatty acid and carotenoid concentrations and oxidative resistance of LDL in volunteers from countries with different rates of cardiovascular disease

Within Europe there are differences in cardiovascular disease (CVD) risk between countries and this might be related to dietary habits. Oxidative modification of LDL is suggested to increase the risk of CVD and both the fatty acid and antioxidant content of LDL can affect its oxidation. In the present study, concentration of LDL fatty acid and antioxidant micronutrients (tocopherols and carotenoids) and ex vivo oxidative resistance of LDL (lag phase) was compared in volunteers from five countries with different fruit and vegetable intakes and reported rates of CVD. Eighty volunteers (forty males, forty females per centre), age range 25-45 years, were recruited from France, Northern Ireland, UK, Republic of Ireland, The Netherlands, and Spain, and their LDL composition and lag phase were measured. There were some differences in LDL carotenoid and α-tocopherol concentrations between countries. α-Tocopherol was low and β- + γ-tocopherol were high (P<0·001) in the Dutch subjects. β-Carotene concentrations were significantly different between the French and Spanish volunteers, with French showing the highest and Spanish the lowest concentration. LDL lycopene was not different between centres in contrast to lutein, which was highest in French (twofold that in the Dutch and Spanish and threefold that in Northern Ireland and the Republic of Ireland, P<0·001). However absolute LDL saturated, monounsaturated, polyunsaturated and total unsaturated fatty acid concentrations were different between countries (P<0·001, total unsaturated highest in Northern Ireland) there was little difference in unsaturated:saturated fatty acid concentration ratios and no difference in polyunsaturated:saturated fatty acid concentration ratios. LDL from the Republic of Ireland (a region with a high rate of CVD) had greater resistance to Cu-stimulated oxidation than samples obtained from volunteers in other countries. In conclusion, LDL composition did not predict resistance to Cu-stimulated oxidation, nor is there evidence that LDL from volunteers in countries with lower rates of CVD have greater resistance to oxidatio

La prise en charge de l'allaitement artificiel par les méthodes alternatives à la bromocriptine dans le post-partum : ses effets et limites sur le moyen terme

Introduction: Since March 2013, the "Agence Nationale de Sécurité du médicament" has evaluated that the benefit-risk ratio of the bromocriptine was unfavourable in the indication of "inhibition of physiological lactation for medical reason in the immediate and late postpartum". Review: The current recommendations rest on the use of the nonmedicamentous methods, while specifying not to replace the bromocriptine by another lactation's inhibitor molecule (lisuride, cabergoline). Material: A study was conducted near 89 patients to the CHU Estaing of Clermont-Ferrand, in order to know if the care of the non nursing mothers was sufficient within fifteen days after childbirth with the bromocriptine's alternatives methods. Method: A transverse, observational and unicentric descriptive study carried out by a telephone interrogation at the fifteenth day after childbirth. The differents mammaries disconfort were quantified, and also their day of occurred. The pain intensity was evaluated for algic patients, as well as the satisfaction of the mothers on their total care. Results: 87,6% of the women felt mammary disconfort with the alternative treatments. Mammary tension (87.6%), milk flows (84.3%) and pain (79.8%) were the three principals disconfort felt. Among the algic women, 79% felt moderated to intense pain. They could appear during the stay in the maternity but also come out at home. 31.6% of the patients remain overall unsatisfied of the suggested treatments. 84.3% of the sample is satisfied with the given advices and support. Discussion: Improvements could be collected for a better acceptability of the care by an active participation of the patients. A clear, honest and a complete information should systematically delivered during pregnancy for patients to make their choice and anticipate prescription in order to ensure an optimal early care. Conclusion: Information and anticipation must be the most important point, and have to be in the middle of women care.Introduction : Depuis mars 2013, l'Agence Nationale de Sécurité du médicament a évalué que le rapport bénéfice-risque de la bromocriptine était défavorable dans l'indication de « l'inhibition de la lactation physiologique pour raison médicale dans le post-partum immédiat et tardif ». Rappels : Les recommandations actuelles reposent sur l'utilisation des méthodes non médicamenteuses, en précisant de ne pas remplacer la bromocriptine par une autre molécule inhibiteur de la lactation (lisuride, cabergoline). Matériel : Une étude a été menée auprès de 89 patientes au CHU Estaing de Clermont-Ferrand, afin de savoir si la prise en charge des mères non allaitantes était suffisante dans les quinze jours après l'accouchement avec les méthodes alternatives à la bromocriptine. Méthode : Étude observationnelle descriptive transversale et unicentrique réalisée par le biais d'un questionnaire téléphonique au quinzième jour après l'accouchement. Les différentes gènes mammaires ont été quantifiées, ainsi que leur jour de survenue. L'intensité de la douleur a été évaluée chez les patientes algiques ainsi que la satisfaction des mères sur leur prise en charge globale. Résultats : 87,6 % des femmes ont ressenti des gènes mammaires avec les traitements alternatifs. La tension mammaire (87,6%), les écoulements de lait (84,3%) et la douleur (79,8%) ont été les trois principales gènes ressenties. Parmi les femmes algiques, 79 % ont ressenti une douleur modérée à intense. Elles pouvaient apparaître pendant le séjour en maternité mais aussi se déclarer à domicile. 31,6% des patientes restent globalement insatisfaites des traitements proposés même si 84,3% de l'échantillon est satisfait des conseils et accompagnements reçus. Discussion : Des améliorations pourraient être apportées pour une meilleure acceptabilité de la prise en charge par la participation active des patientes. Une information claire, loyale, complète devrait être délivrée systématiquement pendant la grossesse pour permettre aux patientes de faire leur choix, et d'anticiper alors la prescription afin d'assurer une prise en charge précoce optimale.Conclusion : L'information des patientes doit être replacée au centre de la prise en charge des femmes

Physiological Effects of Training in Elite German Winter Sport Athletes: Sport Specific Remodeling Determined Using Echocardiographic Data and CPET Performance Parameters

Nine ski mountaineering (Ski-Mo), ten Nordic-cross country (NCC), and twelve world elite biathlon (Bia) athletes were evaluated for cardiopulmonary exercise test (CPET) performance and pronounced echocardiographic physiological cardiac remodeling as a primary aim of our descriptive preliminary report. In this context, a multicenter retrospective analysis of two-dimensional echocardiographic data including speckle tracking of the left ventricle (LV-GLS) and CPET performance analysis was performed in 31 elite world winter sports athletes, which were obtained during the annual sports medicine examination between 2020 and 2021. The matched data of the elite winter sports athletes (14 women, 17 male athletes, age: 18-32 years) were compared for different CPET and echocardiographic parameters, anthropometric data, and sport-specific training schedules. Significant differences could be revealed for left atrial (LA) remodeling by LA volume index (LAVI, p = 0.0052), LV-GLS (p = 0.0003), and LV mass index (LV Mass index, p = 0.0078) between the participating disciplines. All participating athletes showed excellent performance data in the CPET analyses, whereby significant differences were revealed for highest maximum respiratory minute volume (VE (maximum)) and the maximum oxygen pulse level across the participating athletes. This study on sport specific physiological demands in elite winter sport athletes provides new evidence that significant differences in CPET and cardiac remodeling of the left heart can be identified based on the individual athlete's training schedule, frequency, and physique

Critical care staffing ratio and outcome of COVID-19 patients requiring intensive care unit admission during the first pandemic wave: a retrospective analysis across Switzerland from the RISC-19-ICU observational cohort.

STUDY AIM The surge of admissions due to severe COVID-19 increased the patients-to-critical care staffing ratio within the ICUs. We investigated whether the daily level of staffing was associated with an increased risk of ICU mortality (primary endpoint), length of stay (LOS), mechanical ventilation and the evolution of disease (secondary endpoints). METHODS We employed a retrospective multicentre analysis of the international Risk Stratification in COVID-19 patients in the ICU (RISC-19-ICU) registry, limited to the period between March 1 and May 31, 2020, and to Switzerland. Hierarchical regression models were used to investigate crude and adjusted effects of the critical care staffing ratio on study endpoints. We adjusted for disease severity and weekly caseload. RESULTS Among the 38 participating Swiss ICUs, 17 recorded staffing information. The study population included 437 patients and 2,342 daily assessments of patient-to-critical care staffing ratio. Median of daily patient-to-nurse ratio started at 1.0 [IQR 0.5-1.5; calendar week 9] and peaked at 2.4 (IQR 0.4-2.0; calendar week 16), while the median of daily patient-to-physician ratio started at 4.0 (IQR 2.1-5.0; calendar week 9) and peaked at 6.8 (IQR 6.3-7.3; calendar week 19). Neither the patient-to-nurse (adjusted OR 1.28, 95% CI 0.85-1.93; doubling of ratio) nor the patient-to-physician ratio (adjusted OR 1.07, 95% CI 0.87-1.32; doubling of ratio) were associated with ICU mortality. We found no association of daily critical care staffing on the secondary endpoints in adjusted models. CONCLUSION We found no association of reduced availability of critical care staffing resources in Swiss ICUs with overall ICU length of stay nor mortality. Whether long-term outcome of critically ill patients with COVID-19 have been affected remains to be studied

Critical care staffing ratio and outcome of COVID-19 patients requiring intensive care unit admission during the first pandemic wave: a retrospective analysis across Switzerland from the RISC-19-ICU observational cohort

STUDY AIM: The surge of admissions due to severe COVID-19 increased the patients-to-critical care staffing ratio within the ICUs. We investigated whether the daily level of staffing was associated with an increased risk of ICU mortality (primary endpoint), length of stay (LOS), mechanical ventilation and the evolution of disease (secondary endpoints). METHODS: We employed a retrospective multicentre analysis of the international Risk Stratification in COVID-19 patients in the ICU (RISC-19-ICU) registry, limited to the period between March 1 and May 31, 2020, and to Switzerland. Hierarchical regression models were used to investigate crude and adjusted effects of the critical care staffing ratio on study endpoints. We adjusted for disease severity and weekly caseload. RESULTS: Among the 38 participating Swiss ICUs, 17 recorded staffing information. The study population included 437 patients and 2,342 daily assessments of patient-to-critical care staffing ratio. Median of daily patient-to-nurse ratio started at 1.0 [IQR 0.5–1.5; calendar week 9] and peaked at 2.4 (IQR 0.4–2.0; calendar week 16), while the median of daily patient-to-physician ratio started at 4.0 (IQR 2.1–5.0; calendar week 9) and peaked at 6.8 (IQR 6.3–7.3; calendar week 19). Neither the patient-to-nurse (adjusted OR 1.28, 95% CI 0.85–1.93; doubling of ratio) nor the patient-to-physician ratio (adjusted OR 1.07, 95% CI 0.87–1.32; doubling of ratio) were associated with ICU mortality. We found no association of daily critical care staffing on the secondary endpoints in adjusted models. CONCLUSION: We found no association of reduced availability of critical care staffing resources in Swiss ICUs with overall ICU length of stay nor mortality. Whether long-term outcome of critically ill patients with COVID-19 have been affected remains to be studied

Tumour dimension is a prognostic factor in thymic epithelial tumours : An update analysis from the ESTS thymic database: Tumour dimension in thymic tumours

The 9thTNM proposal for thymic epithelial tumours (TETs) introduced size as category in stage I, confirming tumour infiltration type as descriptor for the other stages. Aim of this study is to evaluate the role of tumour size in TETs considering different possible cut-offs also among different subgroups.Clinical and pathological data of patients from ESTS thymic database who underwent surgery for TETs from1/2000 to 12/2022 were reviewed and analysed. Patients clinical data, tumour characteristics, size and organs infiltration were collected and correlated to overall survival (OS), Disease free Survival (DFS) and Cancer specific Survival (CSS) using Kaplan Meier curves. The log-rank test was used to assess differences between subgroups. A multivariable model was built using Cox-regression analysis including clinical relevant variables resulting significant at univariable (p-value 5 cm(59 %)and without surrounding structures infiltrations (51.3 %). During FUP, a recurrence occurred in 235 (11%) patients, 199 (9.3%) died, 38 due to tumour progression. Multivariable confirmed as independent negative prognostic factors age (p 5 cm (p 5 cm (p = 0.024, p < 0.001 and p < 0.001).Tumour size resulted a significant prognosticator in TETs, and its associations with infiltration permits to identify different prognostic groups

Parenthood in survivors of Hodgkin lymphoma: an EORTC-GELA general population case-control study.

Contains fulltext : 108966.pdf (publisher's version ) (Open Access)PURPOSE: We investigated the impact of Hodgkin lymphoma (HL) on parenthood, including factors influencing parenthood probability, by comparing long-term HL survivors with matched general population controls. PATIENTS AND METHODS: A Life Situation Questionnaire was sent to 3,604 survivors treated from 1964 to 2004 in successive clinical trials. Responders were matched with controls (1:3 or 4) for sex, country, education, and year of birth (10-year groups). Controls were given an artificial date of start of treatment equal to that of their matched case. The main end point was presence of biologic children after treatment, which was evaluated by using conditional logistic regression analysis. Logistic regression analysis was used to analyze factors influencing spontaneous post-treatment parenthood. RESULTS: In all, 1,654 French and Dutch survivors were matched with 6,414 controls. Median follow-up was 14 years (range, 5 to 44 years). After treatment, the odds ratio (OR) for having children was 0.77 (95% CI, 0.68 to 0.87; P < .001) for survivors compared with controls. Of 898 survivors who were childless before treatment, 46.7% achieved post-treatment parenthood compared with 49.3% of 3,196 childless controls (OR, 0.87; P = .08). Among 756 survivors with children before treatment, 12.4% became parents after HL treatment compared with 22.2% of 3,218 controls with children before treatment (OR, 0.49; P < .001). Treatment with alkylating agents, second-line therapy, and age older than 35 years at treatment appeared to reduce the chances of spontaneous post-treatment parenthood. CONCLUSION: Survivors of HL had slightly but significantly fewer children after treatment than matched general population controls. The difference concerned only survivors who had children before treatment and appears to have more personal than biologic reasons. The chance of successful post-treatment parenthood was 76%

A low mortality, high morbidity Reduced Intensity Status Epilepticus (RISE) model of epilepsy and epileptogenesis in the rat

Animal models of acquired epilepsies aim to provide researchers with tools for use in understanding the processes underlying the acquisition, development and establishment of the disorder. Typically, following a systemic or local insult, vulnerable brain regions undergo a process leading to the development, over time, of spontaneous recurrent seizures. Many such models make use of a period of intense seizure activity or status epilepticus, and this may be associated with high mortality and/or global damage to large areas of the brain. These undesirable elements have driven improvements in the design of chronic epilepsy models, for example the lithium-pilocarpine epileptogenesis model. Here, we present an optimised model of chronic epilepsy that reduces mortality to 1% whilst retaining features of high epileptogenicity and development of spontaneous seizures. Using local field potential recordings from hippocampus in vitro as a probe, we show that the model does not result in significant loss of neuronal network function in area CA3 and, instead, subtle alterations in network dynamics appear during a process of epileptogenesis, which eventually leads to a chronic seizure state. The model’s features of very low mortality and high morbidity in the absence of global neuronal damage offer the chance to explore the processes underlying epileptogenesis in detail, in a population of animals not defined by their resistance to seizures, whilst acknowledging and being driven by the 3Rs (Replacement, Refinement and Reduction of animal use in scientific procedures) principles

Peroxisomal very long-chain fatty acid transport is targeted by herpesviruses and the antiviral host response

Very long-chain fatty acids (VLCFA) are critical for human cytomegalovirus replication and accumulate upon infection. Here, we used Epstein-Barr virus (EBV) infection of human B cells to elucidate how herpesviruses target VLCFA metabolism. Gene expression profiling revealed that, despite a general induction of peroxisome-related genes, EBV early infection decreased expression of the peroxisomal VLCFA transporters ABCD1 and ABCD2, thus impairing VLCFA degradation. The mechanism underlying ABCD1 and ABCD2 repression involved RNA interference by the EBV-induced microRNAs miR-9-5p and miR-155, respectively, causing significantly increased VLCFA levels. Treatment with 25-hydroxycholesterol, an antiviral innate immune modulator produced by macrophages, restored ABCD1 expression and reduced VLCFA accumulation in EBV-infected B-lymphocytes, and, upon lytic reactivation, reduced virus production in control but not ABCD1-deficient cells. Finally, also other herpesviruses and coronaviruses target ABCD1 expression. Because viral infection might trigger neuroinflammation in X-linked adrenoleukodystrophy (X-ALD, inherited ABCD1 deficiency), we explored a possible link between EBV infection and cerebral X-ALD. However, neither immunohistochemistry of post-mortem brains nor analysis of EBV seropositivity in 35 X-ALD children supported involvement of EBV in the onset of neuroinflammation. Collectively, our findings indicate a previously unrecognized, pivotal role of ABCD1 in viral infection and host defence, prompting consideration of other viral triggers in cerebral X-ALD