[Evaluation of the prescription of furosemide in persons aged 75years and older in a geriatric acute-care unit]. / Évaluation de la prescription du furosémide chez la personne âgée de 75 ans et plus dans un service de gériatrie aiguë.

INTRODUCTION: Furosemide is very often prescribed in France. It may cause important adverse effects especially in elderly persons. In order to limit its misuse and excessive expenditure for health insurance organizations, the European Society of Cardiology drafted strict guidelines for its prescription. We conducted a study in this population to determine the rate of prescription of furosemide in elderly persons outside the guidelines. METHOD: This was a prospective, single-centre, observational study bearing on elderly persons aged 75years and more admitted to a geriatric acute-care unit over a period of 6months. The prevalence of furosemide prescription and the proportion of prescriptions outside guidelines were calculated. The sociodemographic and medical characteristics of patients treated with furosemide were studied as were the modalities of furosemide prescription. RESULTS: In the 818 patients hospitalized during the period of the study, 267 were taking furosemide at admission (32.6%). Among these prescriptions, 69.2% were outside the guidelines. Arterial hypertension was the leading indication for furosemide (38.2%), followed by chronic heart failure (24.3%). CONCLUSION: This study confirmed the high prevalence of furosemide prescription and its misuse. Furosemide is often re-prescribed with no medical re-evaluation.

Phosphorus-Containing Bis-allenes: Synthesis and Heterocyclization Reactions Mediated by Iodine or Copper Dibromide.

Bisphosphorylallenes were easily obtained in multigram scale from the Wittig-type rearrangement of bispropargyl alcohols. Unlike other conjugated bis-allenes, these reagents underwent a double cyclization mediated by iodine or copper dibromide leading to the formation of bis-1,2-oxaphospholenes.

Instantaneous frequency measurement of dissipative soliton resonant light pulses.

We measured the instantaneous frequency profile of two different dissipative soliton resonant (DSR) light pulses, the usual flat-top and less-common trapezoid-shaped light pulses. The DSR light pulses were provided by an ytterbium-doped polarization-maintaining fiber ring passively mode-locked laser using the adequately selected amount of net-normal dispersion. We confirmed that the DSR light pulses have a (moderately) low linear chirp across the pulse, except at the edges, where the chirp changes exponentially. This unique instantaneous frequency behavior can be succinctly resumed by the following parameters: linear chirp slope and leading and trailing chirp lifetimes. As the pump power increases, the linear chirp slope decreases, whereas the leading and trailing chirp lifetimes do not show an appreciable change. The results are compared with previous theoretical works.

Dissipative soliton resonance in a full polarization-maintaining fiber ring laser at different values of dispersion.

We investigated the dissipative solitons resonance in an ytterbium-doped fiber ring laser in which all the elements are polarization maintaining (PM). A semiconductor saturable absorber mirror was used as a mode-locker. The cavity included a normal dispersion single-mode fiber (SMF) and an anomalous dispersion photonic crystal fiber. The change of the length of the PM SMF allows the variation of the net-normal dispersion of the cavity in the range from 0.022 ps2 to 0.262 ps2. As the absolute value of the net-normal dispersion increases from 0.022 ps2 to 0.21 ps2, a square-shaped single pulse transformed to a single right-angle trapezoid-shaped pulse, and, at the dispersion of 0.262 ps2, to multiple right-angle trapezoid-shaped pulses, per round-trip.

Real-time imaging of microparticles and living cells with CMOS nanocapacitor arrays.

Platforms that offer massively parallel, label-free biosensing can, in principle, be created by combining all-electrical detection with low-cost integrated circuits. Examples include field-effect transistor arrays, which are used for mapping neuronal signals and sequencing DNA. Despite these successes, however, bioelectronics has so far failed to deliver a broadly applicable biosensing platform. This is due, in part, to the fact that d.c. or low-frequency signals cannot be used to probe beyond the electrical double layer formed by screening salt ions, which means that under physiological conditions the sensing of a target analyte located even a short distance from the sensor (∼1 nm) is severely hampered. Here, we show that high-frequency impedance spectroscopy can be used to detect and image microparticles and living cells under physiological salt conditions. Our assay employs a large-scale, high-density array of nanoelectrodes integrated with CMOS electronics on a single chip and the sensor response depends on the electrical properties of the analyte, allowing impedance-based fingerprinting. With our platform, we image the dynamic attachment and micromotion of BEAS, THP1 and MCF7 cancer cell lines in real time at submicrometre resolution in growth medium, demonstrating the potential of the platform for label/tracer-free high-throughput screening of anti-tumour drug candidates.

Phase recovery by using optical fiber dispersion.

We propose a simple and fast procedure to retrieve the phase profile of arbitrary light pulses. It combines a first experimental stage, followed by a one-step numerical stage. To this end, it is necessary to perform a Fresnel transform, which is obtained just by propagating the light pulses through an optical fiber. We experimentally test this proposal recovering the phase profile in the light pulses provided by a passively mode-locked laser. The proposal is then compared with a temporal variation of the Gerchberg-Saxton recursive algorithm, which is specially modified for this purpose.

Long-cavity all-fiber ring laser actively mode locked with an in-fiber bandpass acousto-optic modulator.

We demonstrate low-frequency active mode locking of an erbium-doped all-fiber ring laser. As the mode locker, we used a new in-fiber bandpass acousto-optic modulator showing 74% modulation depth, 3.7 dB power insertion losses, 4.5 nm of optical bandwidth, and 20 dB of nonresonant light suppression. The laser generates 330 ps mode-locked pulses over a 10 ns pedestal, at a 1.538 MHz frequency, with 130 mW of pump power.

First evidence of increased plasma serotonin levels in Tako-Tsubo cardiomyopathy.

BACKGROUND: There is no data about the serotonergic activity during the acute phase of Tako-Tsubo Cardiomyopathy (TTC). The objective of our study was to investigate evidence of serotonin release from patients with TTC in comparison with patients with ST elevation myocardial infarction (STEMI) and healthy control subjects (HCS). METHODS AND RESULTS: Plasma serotonin levels in 14 consecutive patients with TTC were compared with those in 14 patients with STEMI and 14 HCS. Plasma serotonin levels at admission were markedly higher in patients with TTC and STEMI as compared to HCS (3.9 ± 4.6, P = 0.02 versus control; 5.7 ± 5.6, P = 0.001 versus control; and 1 ± 0.4 ng/mL, resp.). There was no difference in serotonin levels between patients with TTC and those with STEMI (P = 0.33). CONCLUSION: This finding suggests that serotonin could participate to the pathophysiology of TTC.

Photonic fractional Fourier transformer with a single dispersive device.

In this work we used the temporal analog of spatial Fresnel diffraction to design a temporal fractional Fourier transformer with a single dispersive device, in this way avoiding the use of quadratic phase modulators. We demonstrate that a single dispersive passive device inherently provides the fractional Fourier transform of an incident optical pulse. The relationships linking the fractional Fourier transform order and scaling factor with the dispersion parameters are derived. We first provide some numerical results in order to prove the validity of our proposal, using a fiber Bragg grating as the dispersive device. Next, we experimentally demonstrate the feasibility of this proposal by using a spool of a standard optical fiber as the dispersive device.

Actively mode-locked fiber ring laser by intermodal acousto-optic modulation.

We report an actively mode-locked fiber ring laser. A simple and low-insertion-loss acousto-optic modulator driven by standing flexural waves, which couples core-to-cladding modes in a standard single-mode optical fiber, is used as an active mechanism for mode locking. Among the remarkable features of the modulator, we mention its high modulation depth (72%), broad bandwidth (187 GHz), easy tunability in the optical wavelength, and low insertion losses (0.7 dB). The narrowest optical pulses obtained were of 95 ps time width, 21 mW peak power, repetition rate of 4.758 MHz, and 110 mW of pump power.

Mode locking of an all-fiber laser by acousto-optic superlattice modulation.

Active mode locking of an erbium-doped all-fiber laser with a Bragg-grating-based acousto-optic modulator is demonstrated. The fiber Bragg grating was acoustically modulated by a standing longitudinal elastic wave, which periodically modulates the sidebands at twice the acoustic frequency. The laser has a Fabry-Perot configuration in which cavity loss modulation is achieved by tuning the output fiber Bragg grating to one of the acoustically induced sidebands. Optical pulses at 9 MHz repetition rate, 120 mW peak power, and 780 ps temporal width were obtained. The output results to be stable and has a timing jitter below 40 ps. The measured linewidth, 2.8 pm, demonstrates that these pulses are transform limited.

In-fiber all-optical fractional differentiator.

We demonstrate that an asymmetrical pi phase-shifted fiber Bragg grating operated in reflection can provide the required spectral response for implementing an all-optical fractional differentiator. There are different (but equivalent) ways to design it, e.g., by using different gratings lengths and keeping the same index modulation depth at both sides of the pi phase shift, or vice versa. Analytical expressions were found relating the fractional differentiator order with the grating parameters. The device shows a good accuracy calculating the fractional time derivatives of the complex field of an arbitrary input optical waveform. The introduced concept is supported by numerical simulations.

Transform-limited pulses generated by an actively Q-switched distributed fiber laser.

A single-mode, transform-limited, actively Q-switched distributed-feedback fiber laser is presented, based on a new in-line acoustic pulse generator. Our technique permits a continuous adjustment of the repetition rate that modulates the Q factor of the cavity. Optical pulses of 800 mW peak power, 32 ns temporal width, and up to 20 kHz repetition rates were obtained. The measured linewidth demonstrates that these pulses are transform limited: 6 MHz for a train of pulses of 10 kHz repetition rate, 80 ns temporal width, and 60 mW peak power. Efficient excitation of spontaneous Brillouin scattering is demonstrated.

Overexpression of ovine leptin in Pichia pastoris: physiological yeast response to leptin production and characterization of the recombinant hormone.

Ovine leptin was cloned in the methylotrophic yeast Pichia pastoris using a pPIC9K vector. Leptin was produced and secreted into the culture medium using the Saccharomyces cerevisiae alpha-mating factor prepro signal by five clones. Expression levels of leptin varied from clone to clone, depending on the copy number of the ob gene. Highest expression was observed with the single-copy clone S27 (250 mg/l). The modifications of culture conditions in batch and fed-batch culture increase the yield of protein. The use of higher cell concentration (63 g/l) before induction of oLept associate with a regulation of pH at 3.2, which decreases the effects of proteolysis, increases the expression level of the oLept to 402 mg/l. Moreover, compared with the non-producer clone, we observed a drastic decrease in growth rate and biomass yield in the leptin-producing clones. At the end of the fed-batch phase at pH 3.2 with clone S27, mortality rate reached 17.3%. Results showed that recombinant leptin production induced metabolic stress, and a negative impact on biomass yield and growth rate. We characterized the recombinant leptin produced by clone S27. It exhibited a molecular mass of 16 kDa, an N-terminal amino acid sequence identical to that of ovine leptin but with an additional tyrosine introduced by the cloning site. Moreover, it was found to be biologically active in vitro. The available production of a large quantity of oLept will strengthen the functional study for theoretical and practical purposes.

gamma-Aminobutyric acid (GABA)--A function and binding in the paraventricular nucleus of the hypothalamus in chronic renal-wrap hypertension.

The goal of this study was to determine whether gamma-aminobutyric acid (GABA)ergic transmission and GABA binding are altered in chronic renal-wrap hypertension. Three groups of hypertensive and sham-operated rats were prepared for separate protocols. Four weeks later, the animals were prepared with femoral artery catheters for the measurement of mean arterial pressure. In all groups, blood pressure was significantly higher in the renal-wrapped animals. In the first study, bilateral microinjection of the GABA-A antagonist, bicuculline (50 pmol/site), into the paraventricular nucleus of the hypothalamus (PVN) caused a greater increase in arterial pressure (21.9+/-1.4 versus 16.7+/-1.8 mm Hg, P<0.05) and heart rate (135+/-15 versus 98+/-12 bpm, P=0.064) in hypertensive rats. [(3)H]Flunitrazepam was used to measure binding to the GABA-A receptor. Magnocellular neurons and the adjacent medial parvicellular neurons had more intense binding compared with the remainder of the PVN. B(max) was greater for the higher density binding area; the K(d) value was less in the high-density region. There were no differences in these parameters between normotensive and hypertensive animals. Competitive reverse transcription-polymerase chain reaction was used to measure the expression of mRNA for the alpha(1) subunit of the GABA-A receptor. No difference was observed in the mRNA between renal-wrapped and sham-operated rats. In summary, inhibition of GABA-A receptors in the PVN is augmented in the chronic phase of hypertension and is unrelated to a change in the expression of the number or affinity to the receptor. These findings suggest that the greater GABAergic activity is the result of an increase in GABA release in the PVN in chronic renal-wrap hypertension.

Endothelin enhances and inhibits adrenal catecholamine release in deoxycorticosterone acetate-salt hypertensive rats.

Endothelin (ET) and the sympathoadrenal system contribute to the development and maintenance of deoxycorticosterone acetate (DOCA)-salt hypertension. ET can act directly on the adrenal medulla to enhance the release of catecholamines. In addition, the level of ET peptide is increased in the adrenal glands of DOCA-salt hypertensive rats. Therefore, we tested the hypothesis that ET enhances adrenal medullary catecholamine release during DOCA-salt hypertension. The infusion of exogenous ET-1 into an isolated, perfused adrenal gland preparation resulted in an increase in the basal release of norepinephrine (NE) and epinephrine (EPI) in control and DOCA-salt hypertensive rats. Nerve-stimulated (0.3 Hz) release of NE was significantly inhibited during ET-1 infusion in the DOCA-salt hypertensive rats but not in the control rats. The role of endogenous ET on basal and nerve-stimulated NE and EPI release was also examined. An infusion of either BQ-123 (10(-7) mol/L), an ET(A) receptor antagonist, or BQ-788 (10(-7) mol/L), an ET(B) receptor antagonist, did not alter basal NE or EPI release in either control or DOCA-salt hypertensive rats. BQ-788 did not alter nerve-stimulated release of NE and EPI. In contrast, the nerve-stimulated release of EPI, but not NE, was enhanced during BQ-123 infusion in DOCA-salt hypertensive rats. Nerve-stimulated NE and EPI release was unaffected by BQ-123 in the control rats. These data suggest that ET can stimulate adrenal medullary catecholamine release in normotensive and DOCA-salt hypertensive rats. However, ET also inhibits adrenal medullary catecholamine release in DOCA-salt hypertensive rats.

Role of female sex hormones in the development and reversal of dahl hypertension.

Female sex hormones protect against the development of Dahl hypertension mediated by increases in dietary sodium. The role of female sex hormones in the reversal of Dahl hypertension mediated by decreases in dietary sodium is unknown. The goal of this study was to identify sex differences in the reversal of Dahl hypertension and the associated changes in water and electrolyte homeostasis. Male (M, n=8), female (F, n=8), and ovariectomized female (OVX, n=9) Dahl salt-sensitive rats were instrumented with an abdominal radiotelemetry device for 24-hour monitoring of blood pressure (BP) and heart rate. Daily measurements of food intake, water intake, and urine output were recorded as diet was changed from a low-sodium diet (0.15% NaCl) to a diet containing 8% NaCl. The diet was then changed back to 0.15% NaCl. The responses to changes in the salt diet were compared with responses observed in rats (M, n=4; F, n=4; OVX, n=4) that were maintained on 0.15% NaCl during the experiment. Sex differences in BP were observed when M, F, and OVX rats were fed 8% NaCl diet for 2 weeks (152+/-4, 141+/-3, and 154+/-5 mm Hg, respectively). BP was significantly greater (P<0.05) in M and OVX rats than in F rats. Fluid balance (water intake minus urine volume) and sodium balance (sodium intake minus sodium excretion) were similar in all groups on the 8% NaCl diet. BP in time-control M, F, and OVX rats was 121+/-3, 130+/-4, and 162+/-11 mm Hg, respectively. Compared with time-control groups, differences in BP while rats were eating the 8% NaCl diet were observed in M and F rats but not OVX rats. Reinstatement of an NaCl-deficient diet reversed the hypertension in M and F but not OVX rats (124+/-4, 124+/-2, and 145+/-5 mm Hg, respectively). The changes in dietary sodium caused similar changes in renal handling of sodium and water in all groups of rats; therefore, the effect on blood pressure was independent of renal excretory function. The inability to reverse the hypertension by decreasing sodium intake in OVX rats and the development of spontaneous hypertension in OVX females maintained on a low-sodium diet indicates that removal of the female sex hormones predisposes the animal to the development of hypertension that is sodium independent. We conclude that female sex hormones protect Dahl S rats against the development of sodium-dependent and -independent hypertension.