[Knowledge, attitudes and practise of the general practitioners with the epileptic patients: qualitative research with 11 semi-structured interviews]. / Connaissances, attitudes et pratiques du médecin généraliste d'Eure-et-Loir face au patient épileptique : étude qualitative à partir de 11 entretiens semi-dirigés.

Studies on how general practitioners follow epileptic patients are few and far between. This is surprising, since for these patients, the general practitioner is the first person to be consulted in the context of the current standardised treatment pathway. Our goal was to describe and analyze general practitioners' knowledge, attitudes and habits concerning medical, psychological and social care of epileptic patients. We applied a qualitative method using semi-structured interviews with 11 general practitioners in the Eure-et-Loir, an administrative district in France. The interviews were recorded, with full transcripts being written and analyzed by themes. The results revealed great variability in care practices and in the perception general practitioners have of epilepsy. They report not knowing enough about the illness. They perceive clearly the anxiety of patients and their families, but exert little medical, psychiatric or social impact on patients. Treatment of the disease is at the core of the general practitioner's relationship with the patient. If attitudes towards epilepsy are to be changed, relevant knowledge and correct practices remain to be implemented. Demand for training is currently centred on treatment but it would be helpful to introduce inter-disciplinary training on standardisation of practices and more detailed correspondence with neurologists.

Postmortem degradation of white fish skeletal muscle (sea bass, Dicentrarchus labrax): fat diet effects on in situ dystrophin proteolysis during the prerigor stage.

All during fish postmortem evolution, structural muscle proteins are targets for various proteases. During the prerigor period (24 hours at 4 degrees C for sea bass), cytoskeletal proteins are affected by the first proteolytic events. These cleavages disrupt connections between myofibrils and the extracellular matrix, induce segmentation of myofibril cores, and modify the rheological properties of tissue. Dystrophin, a cytoskeletal actin-binding protein, is a relevant in situ marker for muscular proteolysis in the prerigor period. The immunodetection of dystrophin allowed the monitoring of early proteolysis during fish storage. Using antidystrophin antibodies directed toward the carboxy-terminal region, a highly sensitive domain exposed to calpain activity, we showed that proteolysis kinetics are strongly influenced by the muscular lipid content. In particular, comparison between low-fat diets (11.3% lipid) and high-fat diets (30% lipid), used during sea bass farming (90 days), revealed a faster proteolysis rate during the first 8 hours of storage at 0 degrees C with the high-fat diet. The origin of this faster proteolysis is discussed on the basis of a possible activation or translocation of calpains related to lipid accumulation in muscle fibers and cytoskeleton alterations.

Relation between dietary lipid level and voluntary feed intake, growth, nutrient gain, lipid deposition and hepatic lipogenesis in rainbow trout.

Four diets with differing lipid contents (15, 20, 25 or 30% DM) were tested on small (initial body weight: 27 g) and larger (IBW: 93 g) rainbow trout (Oncorhynchus mykiss) fed on demand or by hand, respectively. In both trials, voluntary feed intake was inversely related to dietary lipid levels. Protein efficiency increased when dietary fat content increased. Final whole-body lipid content was positively related to dietary lipid levels. The main sites of lipid storage were visceral adipose tissue and to a lesser extent muscle. Increased fat deposition in the visceral cavity of young trout was due to both hyperplasic and hypertrophic responses and in larger trout mostly due to a hypertrophic response. Liver activities of glucose-6-phosphate dehydrogenase and fatty acid synthetase were negatively correlated with fat intake and positively with starch intake, whereas malic enzyme was little affected by dietary treatments.

Effect of dietary lipid content on circadian rhythm of feeding activity in European sea bass.

In fish, dietary digestible energy (DE) content is a major factor controlling feed intake. It was therefore of interest to determine how circadian rhythm of feeding activity is influenced by the dietary DE levels. To that end, groups of European sea bass were fed on demand by means of self feeders, under light-dark and constant light conditions, with a fixed or an unlimited amount of feed with variable lipid contents. Daily total feed intake, but not the feeding rhythm, was adjusted in relation to the DE content of the diet regardless of the lighting conditions. We conclude that a satiation mechanism was likely responsible for the regulation of feed intake in relation to the dietary fat content but was not acting in itself on the mechanisms that drive the free-running rhythms of feeding activity. These results are giving additional evidence that a true endogenous clock is driving feeding activity rhythms in fish.

Effect of feeding time on hepatic nucleic acid, plasma T3, T4, and GH concentrations in rainbow trout.

The effect of feeding time (dawn, midnight) on the growth performance and daily pattern of liver nucleic acid concentrations, plasma thyroid hormone, and growth hormone concentrations was studied in immature rainbow trout (Oncorhynchus mykiss, mean individual weight: 55 g). Fish were held in groups of 20 individuals (12 groups per treatment) and maintained in flow-through tanks supplied with river water under natural photoperiod. Food pellets (Aqualim, 49% crude protein) were delivered daily over a 30-min period by means of belt feeders. Growth performance and protein retention efficiency were higher for trout fed at dawn than for those fed at midnight, whereas both groups of fish ingested the same total amount of feed. All parameters studied showed significant daily variations. The daily patterns of liver RNA concentrations, RNA/DNA, and protein/DNA ratios were significantly different between fish fed at dawn and at midnight, indicative of a higher liver protein synthesis in the trout fed at dawn. On average, plasma thyroid hormone levels were higher and plasma GH concentrations were lower in trout fed at dawn compared with those fed at midnight. The hormonal patterns were only affected by feeding time when the fish were fed at dawn. These results suggested that the observed differences in growth and protein retention efficiency were linked to the observed differences in plasma hormone levels.