[Physical training with beta-blockers in chronic heart failure]. / Insuffisance cardiaque chronique et réadaptation à l'effort sous bêtabloquants.

In patients with chronic heart failure, the efficacy of beta-blocker therapy on mortality and the multiple benefits observed with physical training justify the association of the both. The effects of betablockade on different systems solicited in the exercise, particularly on the cardiocirculatory response during exercise test, rise many questions about the impact of beta blocker treatment on the changes induced by physical training. The cardioselective and vasodilating properties of beta-blockers play a role. It seems that the improved performance assessed by peak oxygen uptake (peak VO2) resulting from physical training is not limited by the beta-blocker treatment in patients with chronic heart failure. Synergistic effects have been observed, but many issues remain unsolved.

[Anaemia, cardiac failure and erythropoietin]. / Anémie, insuffisance cardiaque et érythropoïétine.

Anaemia is common in severe cardiac failure due to systolic dysfunction. The mechanisms are varied. Anaemia is a negative prognostic factor. Treatment with erythropoietin seems to improve the quality of life, functional status, effort tolerance and systolic function of these patients. Large scale clinical trials are on-going.

[Therapeutic education for cardiac failure patients: the I-care programme]. / Education thérapeutique des patients insuffisants cardiaques: le programme I-care.

Therapeutic education is becoming increasingly important in the management of chronic diseases including cardiac failure. The I-CARE programme consists of an evaluation of the role of therapeutic education in France, creating standardised tools and setting up training sessions for therapeutic education in the context of cardiac failure. Approximately two thirds of the French centres contacted perform therapeutic education with their available means. The lack of personnel, space, and training tools represent obstacles to the development of therapeutic education. The tools developed in the programme fall into 5 areas: diagnosis education, understanding the illness, diet, physical activity/daily life, and treatment. Training sessions were organised for the teams, consisting of at least one cardiologist and nurse. The I-CARE programme should allow the expansion of therapeutic education for cardiac failure and improve the multidisciplinary management of this disease which increasingly affects often elderly subjects.

[Medical treatment of acute heart failure]. / Traitement médical de l'insuffisance cardiaque aiguë décompensée.

Medical treatment of acute decompensated heart failure has little changed in the last years, except with the advent of non-invasive ventilation. Doppler-echocardiography and BNP dosing have simplified the diagnostic approach and limited the need for invasion evaluation. Vasodilators remain probably underused whereas some doubts have emergency regarding the safety of positive inotropes. Analysis of the hemodynamic profile is mandatory for an optimal management of these patients. The next decade will be that of morbimortality trials in this common form of heart failure with severe prognosis.

Effects of nitric oxide on the eosinophil survival in vitro. A role for nitrosyl-heme.

In a previous paper we showed that the nitric oxide (NO) donors azide and hydroxylamine inhibited eosinophil apoptosis. Azide and hydroxylamine generate a nitrosyl-heme complex - due to endogenous catalase activity - which activates soluble guanylate cyclase. In contrast, in the present paper, we show that NO donors (SNAP, SIN-1, S-nitroso-L-cysteine, NOC-18) which spontaneously release NO in physiological solutions did not support the survival of eosinophils and induced apoptosis or necrosis. However, the addition of hematin (the ferric form of heme) together with low doses of NO (SNAP 10 microM) promoted eosinophil survival. In conclusion, we propose that NO and heme (e.g. from heme-containing enzymes such as peroxidase or catalase), both released in inflammation sites, could form nitrosyl-heme and thus promote eosinophilic inflammation.

Primary socialization theory: culture, ethnicity, and cultural identification. The links between culture and substance use. IV.

Ethnicity, perceived membership in a cultural group, and cultural identification, the strength of one's affiliation with a group, develop primarily through interactions with the primary socialization sources, the family, the school, and peer clusters. Cultural norms for substance use are also transmitted as part of these interactions. Substance use differs across cultures; in different cultures some forms of substance use are culturally required, others are tolerated, and others are sanctioned. Ethnicity and cultural identification, therefore, should relate to substance use. However, primary socialization theory indicates that simple relationships are not likely to be found for a number of reasons: 1) All members of an ethnic group do not have the same level of cultural identification and may not, therefore, have the same conformance to substance use norms. 2) Primary socialization,sources are embedded in subcultures, and subcultures have norms that may differ from those of the larger ethnic group. 3) The individual may experience and report differing levels of cultural identification and different substance use norms in different social contexts. 4) For an individual, ethnicity and cultural identification may derive from different primary socialization sources than drug use norms.

In vitro effects of Uriage spring water on the apoptosis of human eosinophils.

The influx of eosinophils in tissues plays a central role in the pathophysiology of allergic diseases such as allergic rhinitis, allergic asthma or atopic dermatitis. The death of eosinophils by apoptosis is an important factor for the resolution of hypereosinophilia. In the present study, we have shown that Uriage spring water induced in vitro the apoptosis of IL-5-primed eosinophils. This effect was dose-dependent and was statistically significant at Uriage water concentrations above 20%. The induction of apoptosis was related to the Ca2+ content of Uriage water. Indeed, Ca2+ at the same concentration as in Uriage water mimicked the apoptotic effect of the spring water. Furthermore, EGTA reversed the apoptotic effect of Uriage water. These results suggest that topically applied, Uriage water could contribute to the resolution of eosinophilic inflammation.

Effect of Avène spring water on the activation of rat mast cell by substance P or antigen.

The biological activity of Avène water from two different springs ('Sainte Odile' and 'Val d'Orb') was studied in vitro on rat peritoneal mast cell activation. A dilution-dependent inhibition of both histamine and prostaglandin D2 antigen-induced release was observed when cells were preincubated with both Avène spring waters. They also inhibited histamine release triggered by substance P. The ability of Avène water to inhibit mast cell activation in vitro may be related with its antiallergic and anti-inflammatory properties and its use in hydrotherapy.

Cultural identification and substance use in North America--an annotated bibliography.

Level of identification with one's culture has long been thought to be a predictor of substance use among ethnic minority populations. However, cultural identification is a complex construct that has been difficult to capture in a coherent theoretical way. Additionally, the various theoretical approaches have led to numerous and divergent methods of measurement. Although measurement is becoming more sophisticated, the evidence for a link between cultural identification and drug use remains elusive. There is evidence that immigrants to a new culture do change their pattern of substance use to match that of the host culture, but the mechanism of that change is not well understood. That culture impacts behavior is without question although how culture operates specifically with respect to substance use will require further effort.

[The echocardiographic examination in adult cardiomyopathy]. / L'examen échocardiographique des cardiomyopathies de l'adulte.

Echocardiography allows distinction between the diastolic dysfunction of hypertrophic or restrictive cardiomyopathies and the systolic dysfunction of dilated cardiomyopathy. The diagnosis and prognosis may be deduced from echocardiographic parameters. In hypertrophic cardiomyopathy systolic function is normal and there is asymmetric left ventricular hypertrophy (> 13 mm) associated with a reduced diastolic dimension and atrial dilatation resulting from diastolic dysfunction. The prognosis could be related to the severity of left ventricular hypertrophy; right ventricular hypertrophy is uncommon and its severity seems to be related to that of left ventricular hypertrophy. Restrictive cardiomyopathies are less common and amyloidosis is the commonest cause. Symmetric hypertrophy with reduced diastolic dimensions is observed; right ventricular involvement occurs in about 30% of cases. The prognosis seems to be related to the degree of parietal infiltration and, at advanced stages, systolic function is abnormal (fractional shortening < 20% with a left ventricular diastolic dimension > or = 55 mm) and rapidly fatal. Dilated cardiomyopathy is diagnosed when wall thickness is normal but left ventricular diastolic dimensions > 27 mm/m2 and ejection fraction < 45%. Right and left ventricular dimensions of the same size, left ventricular diastolic dimensions > 70 mm and left ventricular ejection fractions < 20% are poor prognostic indicators.

American Indians and alcohol.

The high prevalence of alcohol use and its consequences among American Indians may be attributed to a number of factors, including the influence of the European colonists who first made large amounts of alcohol available to Indians, as well as current social and cultural factors. Efforts to prevent and treat alcohol problems among the American Indian population may be more effective if native beliefs and approaches are incorporated. Alcohol problems also may be prevented through policies regulating the sale and use of alcohol in Indian communities.

The politicizing of science: when "protection" of subjects' rights leads to a wrong.

Scientific inquiry is becoming increasingly under attack by political and legalistic forces. The ability to conduct survey research is becoming more difficult, and if the trend continues there will be little useful information available about the size and nature of social problems that affect the lives of many people. Current procedures for the protection of subjects in survey research are more than adequate and new restrictions are unnecessary.

The effect of school dropout rates on estimates of adolescent substance use among three racial/ethnic groups.

OBJECTIVES: This study examined, across three racial/ethnic groups, how the inclusion of data on drug use of dropouts can alter estimates of adolescent drug use rates. METHODS: Self-report rates of lifetime prevalence and use in the previous 30 days were obtained from Mexican American, White non-Hispanic, and Native American student (n = 738) and dropouts (n = 774). Rates for the age cohort (students and dropouts) were estimated with a weighted correction formula. RESULTS: Rates of use reported by dropouts were 1.2 to 6.4 times higher than those reported by students. Corrected rates resulted in changes in relative rates of use by different ethnic groups. CONCLUSIONS: When only in-school data are available, errors in estimating drug use among groups with high rates of school dropout can be substantial. Correction of student-based data to include drug use of dropouts leads to important changes in estimated levels of drug use and alters estimates of the relative rates of use for racial/ethnic minority groups with high dropout rates.

American Indian adolescent alcohol involvement and ethnic identification.

Structural equation modeling (SEM) techniques were used to explore the relationship between American Indian ethnic identification and alcohol involvement. The subject pool was comprised of 202 American Indian adolescents (114 females, 88 males). Measures of ethnic identity, frequency and style of alcohol use, peer alcohol associations, and family sanctions against alcohol were obtained through survey research. Results of the model analysis revealed that while peer alcohol associations significantly predicted alcohol involvement for both males and females, and family sanctions against alcohol were predictive for the females in the sample, ethnic identity did not predict alcohol involvement, directly or indirectly, for either males nor females. Results are discussed in terms of past theoretical explanations of American Indian youth involvement with alcohol.

Male adolescents' reactions to TV beer advertisements: the effects of sports content and programming context.

OBJECTIVE: This study examines white male adolescent responses to TV beer advertisements with and without sports content and to nonbeer ads when embedded in sports and entertainment programming. METHOD: A total of 72 advertisements and 24 television program excerpts were randomly sampled from national television programming. White male adolescents (N = 157) recruited in a public school system each viewed six ads (one of each of three types of ad embedded in each of two types of programming) comprising the 2 x 2 x 3 factorial, within-subjects, mixed-model (random and fixed effects) experimental design along with an age-level blocking factor and random factors for commercial and program stimuli. Cognitive responses to each ad were content-analyzed. Individual difference variables including alcohol use behavior, sensation-seeking, masculinity and sports involvement were also measured. RESULTS: Subjects showed a consistent preference for beer ads with sports content. A significant three-way interaction between ad type, programming type and junior versus senior high-school age level also indicated that sports programming had an inconsistent effect on responses to beer ads but that nonbeer ads were responded to more positively during sports than during entertainment programming. Other analyses showed that subjects were more cognitively resistant to beer ads than to nonbeer ads. CONCLUSIONS: These results support public and official concerns that sports content in beer ads increase the ads appeal to underage youth. They do not support hypothesized concerns that sports programming might prime adolescents to be more receptive to beer ads. Implications for alcohol education efforts are discussed.

Adolescent counterarguing of TV beer advertisements: evidence for effectiveness of alcohol education and critical viewing discussions.

The pervasiveness of American youth's exposure to alcohol advertising is well-documented, as is the correlational evidence linking such exposure to alcohol-related attitudes, use, and expectancies. While efforts to train young people to resist persuasive appeals are often made in alcohol education programs, little evidence exists concerning the effectiveness of such efforts. The present study (N = 83) found that recency of exposure to alcohol education classes and discussion of alcohol advertising in such classes predicts cognitive resistance (counterarguing) of such advertisements months or even years after class exposure. Age, gender, and ethnicity were statistically controlled. While females tended to counterargue the alcohol advertisements more than did males, there was no statistically significant difference in the impact of education on males and females.

Exogenous nitric oxide elicits chemotaxis of neutrophils in vitro.

Nitric oxide (NO) has been shown to be both an intercellular and intracellular messenger. We propose here that exogenous NO induces chemotactic locomotion of human neutrophils. Indeed, when human neutrophils were placed in a gradient of a nitric oxide donor (S-nitroso-N-acetylpenicillamine; SNAP), a directed locomotion was induced, as evidenced by experiments of chemotaxis under agarose. Degraded SNAP (i.e., SNAP solution which had previously released NO) did not induce directed locomotion. Moreover, oxyhemoglobin, a scavenger of free NO, suppressed the chemotactic effect of SNAP, whereas LY-83583, a soluble guanylate cyclase inhibitor, inhibited the SNAP-mediated chemotaxis in a dose-response manner. Other unrelated NO donors, SIN-1 and S-nitroso-cysteine--a natural S-nitroso-compound, also induced a directed locomotion of neutrophils. Taken together, these in vitro experiments indicate that exogenous NO could mediate the chemotaxis of neutrophils and thus suggest that NO could contribute to neutrophil recruitment in vivo.