Potential biomarkers of preeclampsia: inverse correlation between hydrogen peroxide and nitric oxide early in maternal circulation and at term in placenta of women with preeclampsia.

Preeclampsia (PE) is a pregnancy-specific disease that has been associated with future cardiovascular disease for the mother and her child. The etiology of PE is unclear but oxidative stress seems to play a major role in endothelial dysfunction and permanent systemic vasoconstriction shown in PE. Hydrogen peroxide (H(2)O(2)), a terminal metabolite of the cellular oxidative stress cascade, is also revealed as a component of oxidative ischemia/reperfusion stress in placenta. We were the first to show an increase in the levels of H(2)O(2) in the serum of preeclamptic women at term. H(2)O(2) is already known to reduce the production of NO by increasing the metabolism of arginases. The objective of this study was to investigate a possible correlation between nitric oxide (NO), a potent vasodilator, and H(2)O(2) throughout pregnancy. Thus, we simultaneously assessed the levels of NO and H(2)O(2) in the serum of normal and preeclamptic women at 10-15 and 37-40 weeks of pregnancy, and in placentas at delivery. Our findings showed an inverse correlation between increased levels of H(2)O(2) and decreased levels of NO early in maternal circulation and at term in placenta. This relationship is confirmed by our in vitro experiments which demonstrate that H(2)O(2) inhibits NO synthesis of cytotrophoblasts. In conclusion, our findings highlight an inverse correlation between H(2)O(2) and NO early in maternal circulation and in placenta of women with preeclampsia, paving the way for further studies examining the potential use of NO and H(2)O(2) as biomarkers in the prediction of preeclampsia.

[Peristomal pyoderma gangrenosum in a patient with ulcero-hemorrhagic rectocolitis]. / Pyoderma gangrenosum péri-stomale chez un patient atteint de recto-colite ulcéro-hémorragique.

Cutaneous manifestations of chronic ulcerative colitis are numerous and present in 20 p. 100 of the patients. The case of a 49-year old man with peristomal pyoderma gangrenosum (PG) is presented. In November, 1983, one year after the onset of chronic ulcerative colitis, the patient underwent total colectomy. The formation of an ileal reservoir resulted in a pelvic abscess which necessitated right lower ileostomy. Because of severe ulcerations around the stoma, the ileostomy was transferred to the left lower abdomen. Similar inflammatory ulcerations developed, and the diagnosis of pyoderma gangrenosum was made. The patient responded very well to dapsone combined with prednisone for only 6 months. The possibility of PG being an autoimmune condition is discussed, as well as the differential diagnosis. The several therapeutic approaches are summarized. The peristomal localization of PG in this patient suffering from chronic ulcerative colitis seems to be rather unique. No other case has been reported so far, to our knowledge.

Treatment of stable angina pectoris with calcium antagonists alone or combined with beta-blocking agents: a review of the literature.

The calcium antagonists are presently accepted as the treatment of choice for vasospastic angina. They are accepted by some as a good second choice therapy in the treatment of stable angina pectoris, while by others as an excellent first choice in its treatment. When introduced to the North American market, warning was given of the risk of left ventricular failure and/or atrioventricular block from their combination with beta-blockers. Perhaps now a deeper knowledge of their hemodynamic and electrophysiologic properties allows us to conceptualize potent and safe anti-anginal associations by use, in specific patients, of differing combinations. Thus we must learn to use with care and flair this new form of treatment which offers our severely afflicted patients much greater symptomatic relief.

[Awareness and perception of psychiatric services in Québec.]. / Connaissance et perception des services psychiatriques au Québec.

This study analyses the knowledge and perception of psychiatric services, mental health and the mentally ill among a sampling of 990 people selected throughout the province of Quebec. The results indicate that the population is still badly informed on several aspects of mental health services, and that it still shows considerable intolerance towards former mental patients, particularly in situations where there is greater degree of social contact.