RESUMEN
Cathodic protection by galvanic anodes (GACP) is often used to protect immerged metallic structures in harbor environments, especially GACP employing aluminum-based anodes. To follow a previous study that was performed in a laboratory on Al-anode, two monitoring periods were performed in parallel, one in an in situ environment (in the Port of Calais) for 42 months and the other in a laboratory for 18 months, to evaluate the transfer of metals constituting the Al-anode towards the sedimentary compartment. During each monitoring, two conditions of agitation of water (weak and strong) were compared, and different factors of sediment quality were used to assess the enrichment and potential toxic effects of these released metals. The results showed that the dissolution of Al-anode-induced a greater Zn enrichment of sediment than an Al enrichment. This is in contrast with the abundance of these elements present in the composition of the anode and suggested a potential toxic effect for marine organisms with regards to the discovered Zn level, especially in confined areas.
Asunto(s)
Aluminio , Electrodos/efectos adversos , Monitoreo del Ambiente/métodos , Sedimentos Geológicos/análisis , Organismos Acuáticos , Sedimentos Geológicos/química , Metales Pesados/análisis , Contaminantes Químicos del Agua/análisis , Zinc/análisis , Zinc/toxicidadAsunto(s)
Infecciones Fúngicas Invasoras/diagnóstico , Leucemia Linfocítica Crónica de Células B/complicaciones , Mucormicosis/diagnóstico , Infecciones Oportunistas/diagnóstico , Abdomen/diagnóstico por imagen , Adenina/análogos & derivados , Anciano , Resultado Fatal , Humanos , Leucemia Linfocítica Crónica de Células B/tratamiento farmacológico , Masculino , Mucorales , Insuficiencia Multiorgánica , Recurrencia Local de Neoplasia , Infecciones Oportunistas/microbiología , Piperidinas , Pirazoles/uso terapéutico , Pirimidinas/uso terapéutico , Tórax/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
This cross-sectional study evaluates the prevalence and factors associated with sleep disturbances in French adult HIV-infected outpatients. Patients fullfilled a self-administered questionnaire on their health behavior, sleep attitudes (Pittsburgh sleep quality index, PSQI), quality of life and depression; 1354 patients were enrolled. Median sleeping time was 7 h. Poor sleep quality was observed in 47 % of the patients, and moderate to serious depressive symptoms in 19.7 %. Factors significantly associated with sleep disturbances were depression, male gender, active employment, living single, tobacco-smoking, duration of HIV infection, nevirapine or efavirenz-including regimen. Prevalence of poor sleepers is high in this HIV adult outpatient population. Associated factors seem poorly specific to HIV infection and more related to social and psychological status. Taking care of these disturbances may prove to be an effective health management strategy.
Asunto(s)
Depresión/epidemiología , Infecciones por VIH/complicaciones , Pacientes Ambulatorios/estadística & datos numéricos , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Trastornos del Sueño-Vigilia/epidemiología , Sueño , Adulto , Fármacos Anti-VIH/administración & dosificación , Estudios Transversales , Depresión/complicaciones , Femenino , Francia/epidemiología , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Calidad de Vida , Factores de Riesgo , Trastornos del Inicio y del Mantenimiento del Sueño/complicaciones , Trastornos del Sueño-Vigilia/diagnóstico , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVES: Nevirapine is an inducer of hepatic metabolism. After discontinuation, nevirapine has an inductive effect on cytochrome P450 3A4, which persists for a few weeks and which, after switching to rilpivirine, may reduce rilpivirine exposures and have a negative clinical impact. This study evaluates the virological outcome, pharmacokinetics and safety of switching virologically suppressed, HIV-1-infected patients from nevirapine to rilpivirine. PATIENTS AND METHODS: This 24 week open-label single-centre study included HIV-1-infected adults with HIV-1 RNA <50 copies/mL for >6 months on tenofovir/emtricitabine and nevirapine, who were willing to simplify their regimen to tenofovir/emtricitabine/rilpivirine. Virological suppression, safety and nevirapine and rilpivirine pharmacokinetics were assessed. RESULTS: At weeks 12 and 24, all 32 subjects remained virologically suppressed. One subject discontinued at week 1 for rilpivirine-associated insomnia and two patients chose to resume tenofovir/emtricitabine and nevirapine after week 12 because of rilpivirine-associated food constraint. There was no grade 3/4 laboratory abnormality. Rilpivirine trough concentrations were above the mean trough concentrations observed in Phase 3 studies by 1 week post-switch. Twenty-seven out of 32 patients had no measurable levels of nevirapine by 2 weeks post-switch. The meal accompanying tenofovir/emtricitabine/rilpivirine intake satisfied food requirements in 81% of cases. Overall general satisfaction was improved in 90% of the subjects despite food constraints. CONCLUSION: Nevirapine has a short and limited inductive effect on rilpivirine metabolism, which is not clinically significant. Tenofovir/emtricitabine/rilpivirine is an efficacious and safe option for virologically suppressed HIV-infected patients on nevirapine wishing to simplify their regimen.
Asunto(s)
Terapia Antirretroviral Altamente Activa , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/virología , VIH-1 , Adenina/administración & dosificación , Adenina/análogos & derivados , Adulto , Recuento de Linfocito CD4 , Desoxicitidina/administración & dosificación , Desoxicitidina/análogos & derivados , Combinación de Medicamentos , Sustitución de Medicamentos , Emtricitabina , Femenino , VIH-1/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Nevirapina/administración & dosificación , Nitrilos/administración & dosificación , Organofosfonatos/administración & dosificación , Estudios Prospectivos , Pirimidinas/administración & dosificación , Rilpivirina , Tenofovir , Resultado del Tratamiento , Carga ViralRESUMEN
BACKGROUND AND PURPOSE: Improved knowledge of brain maturation in fetuses and premature neonates is crucial for the early detection of pathologies and would help determine whether MR data from the premature brain might be used to evaluate fetal maturation. Using diffusion-weighted MR imaging and (1)H-MR spectroscopy, we compared cerebral microstructure and metabolism in normal in utero fetuses imaged near term and premature neonates imaged at term equivalent. MATERIALS AND METHODS: Forty-eight subjects were investigated: 24 in utero fetuses (mean gestational age, 37 ± 1 weeks) and 24 premature neonates (mean postconceptional age, 37 ± 1 weeks). ADC values were measured in cerebellum, pons, white matter, brain stem, basal ganglia, and thalamus. MR spectroscopy was performed in deep white matter. RESULTS: Mean ADC values from fetuses and premature neonates were comparable except for the pons and the parietal white matter. ADC values were lower in the pons of premature neonates, whereas greater values were found in their parietal white matter compared with fetuses. Proton MR spectroscopy showed higher levels of NAA/H(2)O, Glx/H(2)O, tCr/H(2)O, and mIns/H(2)O in premature neonates compared with fetuses. CONCLUSIONS: Our study provides evidence of subtle anomalies in the parietal white matter of healthy premature neonates. In addition, the reduced ADC values in the pons together with the increased levels of NAA/H(2)O, tCr/H(2)O, and Glx/H(2)O in the centrum semiovale suggest a more advanced maturation in some white matter regions. Our results indicate that MR data from the premature brain are not appropriate for the assessment of the fetal brain maturation.
Asunto(s)
Encéfalo/embriología , Encéfalo/crecimiento & desarrollo , Madurez de los Órganos Fetales , Recien Nacido Prematuro/crecimiento & desarrollo , Feto , Edad Gestacional , Humanos , Recién Nacido , Nacimiento a TérminoRESUMEN
PURPOSE: To determine the impact of exposing medical students to medical imaging during the first year of the second cycle of medical school (DCEM1) on their perception of this medical specialty and the acquisition of its basic concepts. MATERIALS AND METHODS: All students in the 2007-2008 graduation class entering into the first year of the second cycle of medical school were anonymously enrolled into this project that included pre-rotation and post-rotation questionnaires, theory classes followed by clinical rotations with clearly predetermined objectives. RESULTS: A total of 108 students were enrolled, with 70% being females. The parents of the students had a medical or paramedical profession in 46.3% of cases. Before the rotation, 61.6% of students perceived a difference between a hospital-based practice and private practice. Fifty-two percent of students had a clear idea of their professional future prior to the rotation. Five students (4.7%) believed prior to the rotation that it might have an impact on their professional future, versus 63% after the rotation (P<0.0001). The students whose parents work in the medical or paramedical field do not have a better defined idea of their professional future; on the other hand, they have more interest for radiology (73.6% with high or very high interest versus 52.8%, P=0.03). After the rotation, there was a significant increase in the number of students with high or very high interest for radiology (77.8% versus 66.7%, P=0.023). A student noted that he would redirect his career to radiology. There was also a significant increase in the number of students perceiving a difference between a hospital-based practice and private practice (82.2% versus 61.6%, P=0.003). With regards to radiology knowledge before and after the rotation, there was a significant increase of mean scores (P<0.001). Eighty-eight percent of students were satisfied or very satisfied with the radiology rotation. Overall, the students believe that 70% of the objectives were achieved. The only criticism from the students was that the clinical instructors were overworked. CONCLUSION: Early exposure of medical students to radiology increases their level of interest for the specialty and increases the perception of differences between a hospital-based practice and private practice. The overall knowledge of students about radiology was improved, but the workload of clinical instructors impaired the quality of the rotation.
Asunto(s)
Educación Médica , Radiología/educación , Estudiantes de Medicina , Actitud , Educación Médica/normas , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
Enterococcus hirae, a gram-positive bacterium, is a rare isolate in clinical specimens. We report an unusual case of a relapse of prosthetic valve endocarditis due to E. hirae 6 months after the initial episode. Clonal relationship was proven by genomic analysis.
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Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/microbiología , Enterococcus/aislamiento & purificación , Infecciones por Bacterias Grampositivas/diagnóstico , Infecciones por Bacterias Grampositivas/microbiología , Infecciones Relacionadas con Prótesis/diagnóstico , Infecciones Relacionadas con Prótesis/microbiología , Anciano , Técnicas de Tipificación Bacteriana , Electroforesis en Gel de Campo Pulsado , Endocarditis Bacteriana/patología , Enterococcus/clasificación , Enterococcus/genética , Femenino , Genotipo , Infecciones por Bacterias Grampositivas/patología , Humanos , Tipificación Molecular , Infecciones Relacionadas con Prótesis/patología , RecurrenciaAsunto(s)
Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/diagnóstico , Confusión/etiología , Linfoma de Células B/complicaciones , Linfoma de Células B/diagnóstico , Alcoholismo/complicaciones , Neoplasias Encefálicas/tratamiento farmacológico , Glucocorticoides/uso terapéutico , Humanos , Linfoma de Células B/tratamiento farmacológico , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Factores de Riesgo , Fumar/efectos adversos , Resultado del TratamientoRESUMEN
A semen extender made with low density lipoproteins (LDL) has been used instead of a standard extender that is already available on the market for the cryopreservation of bovine semen. However, in order to extend its use to artificial insemination centres, in vivo fertility studies were required. Semen was taken from three bulls and frozen-thawed in two extenders: the LDL extender and a standard Tris-egg-yolk (20%) extender used by AI centres. The quality of the semen was assessed prior to artificial insemination: motility was assessed using an image analyser (Computer Assisted Semen Analysis (Hamilton Thorne)), and the integrity of the plasma membrane was assessed using the hypo-osmotic test (HOS test). For the first time, gestations were obtained following the artificial insemination of cows in the field (n=193) with semen that had been frozen-thawed in the LDL extender. No significant difference (p>0.05) was detected between the success rates of AI between the semen that had been frozen-thawed in the LDL extender (59.2%) and the control extender, Tris-20% egg yolk (65.3%). In conclusion, the in vivo fertility of semen that has been frozen-thawed in the LDL extender is maintained since gestations are obtained following AI.
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Bovinos/fisiología , Criopreservación/veterinaria , Fertilidad/fisiología , Inseminación Artificial/veterinaria , Lipoproteínas LDL , Semen/fisiología , Animales , Criopreservación/métodos , Yema de Huevo , Femenino , Masculino , Embarazo , Análisis de Semen/veterinaria , Motilidad Espermática , TrometaminaRESUMEN
AIMS: A polyphasic approach was used to study the biodiversity bacteria associated with biocorrosion processes, in particular sulfate-reducing bacteria (SRB) and thiosulfate-reducing bacteria (TRB) which are described to be particularly aggressive towards metallic materials, notably via hydrogen sulfide release. METHODS AND RESULTS: To study this particular flora, an infrared spectra library of 22 SRB and TRB collection strains were created using a Common Minimum Medium (CMM) developed during this study and standardized culture conditions. The CMM proved its ability to allow for growth of both SRB and TRB strains. These sulfurogen collection strains were clearly discriminated and differentiated at the genus level by fourier transform infrared (FT-IR) spectroscopy. In a second step, infrared spectra of isolates, recovered from biofilms formed on carbon steel coupons immersed for 1 year in three different French harbour areas, were compared to the infrared reference spectra library. In parallel, molecular methods (M13-PCR and 16S rRNA gene sequencing) were used to qualitatively evaluate the intra- and inter-species genetic diversity of biofilm isolates. The biodiversity study indicated that strains belonging to the Vibrio genus were the dominant population; strains belonging to the Desulfovibrio genus (SRB) and Peptostreptococcaceae were also identified. CONCLUSION: Overall, the combination of the FT-IR spectroscopy and molecular approaches allowed for the taxonomic and ecological study of a bacterial flora, cultivated on CMM, associated with microbiology-induced corrosion (MIC) processes. SIGNIFICANCE AND IMPACT OF THE STUDY: Via the use of the CMM medium, the culture of marine bacteria (including both SRB and TRB bacteria) was allowed, and the implication of nonsulforogen bacteria in MIC was observed. Their involvement in the biocorrosion phenomena will have to be studied and taken into account in the future.
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Biodiversidad , Bacterias Reductoras del Azufre/clasificación , Microbiología del Agua , Biopelículas , Corrosión , Medios de Cultivo , ADN Bacteriano/genética , Genes Bacterianos , Genes de ARNr , Filogenia , Análisis de Secuencia de ADN , Espectroscopía Infrarroja por Transformada de Fourier , Acero , Sulfatos/metabolismo , Bacterias Reductoras del Azufre/genética , Bacterias Reductoras del Azufre/aislamiento & purificaciónRESUMEN
We report a case of a pulmonary histoplasmosis in an HIV-positive patient usually living in Cambodia, with a positive Aspergillus galactomannan antigenemia resulting from a cross-reaction, that decreased after antifungal therapy. We discuss the potential interest of the detection of fungal DNA by PCR and Aspergillus galactomannan antigenemia for the diagnosis of histoplasmosis, especially in countries where Histoplasma capsulatum antigen testing is not available.
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Antígenos Fúngicos/sangre , Aspergillus/inmunología , Histoplasmosis/sangre , Histoplasmosis/diagnóstico , Enfermedades Pulmonares Fúngicas/sangre , Enfermedades Pulmonares Fúngicas/diagnóstico , Mananos/inmunología , Galactosa/análogos & derivados , Humanos , Masculino , Persona de Mediana Edad , Biología MolecularRESUMEN
Few studies exist in the literature on pediatric brain tumors examined with advances MRI techniques. The aim of this review is to try to find out some specific tissular characteristics of the main cerebral tumors encountered in children, especially through diffusion imaging, perfusion imaging and proton magnetic resonance spectroscopy (MRS). However, hemispheric cerebral tumors are not as common as in the adult population.
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Neoplasias Encefálicas/diagnóstico , Encéfalo/patología , Imagen por Resonancia Magnética/métodos , Encéfalo/metabolismo , Niño , Preescolar , Medios de Contraste , Humanos , Lactante , Espectroscopía de Resonancia Magnética/métodosRESUMEN
Magnetic resonance imaging (MRI) is the imaging tool of choice to evaluate brain maturation and especially brain myelination. Magnetic resonance imaging also provides functional insight through diffusion images and proton spectroscopy. In this review the MRI techniques are analyzed for both pre- and postnatal periods. The origin of MR signal changes is also detailed in order to understand normal myelination evolution and the consequences on brain maturation of the different pathologies encountered prior and after birth. Because MRI is "blind" in terms of signal on conventional sequences after 2 years of age, a particular attention is given to diffusion images and proton spectroscopy of the developing brain.
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Encéfalo/embriología , Encéfalo/crecimiento & desarrollo , Imagen por Resonancia Magnética , Encéfalo/metabolismo , Preescolar , Humanos , Lactante , Recién Nacido , Espectroscopía de Resonancia MagnéticaRESUMEN
Neonatal brain disorders consist of a wide chapter including brain malformations, hypoxic-ischemic encephalopathy (HIE), intracranial infections, perinatal trauma and metabolic encephalopathy. We will focus here on HIE, intracranial infections (especially materno-fetal infection with or without prolonged and/or premature rupture of membranes) and metabolic encephalopathy, those three conditions being the most frequent so far in our experience. Neonatal stroke is also analyzed. Moreover minor perinatal events might be superimposed on an already damaged (infective, edematous, metabolically abnormal or maldeveloped) brain, highlighting the main role and potential benefits of neuroimaging during the neonatal period. The different methods of brain imaging are thus reported with their advantages and disadvantages.
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Encefalopatías/diagnóstico , Diagnóstico por Imagen , Encefalopatías/complicaciones , Encefalopatías/congénito , Humanos , Recién NacidoRESUMEN
We investigated the effects of a partial compared to a complete thrombotic occlusion of the left anterior descending coronary artery in dogs. A completely occlusive thrombus was associated with a full thickness myocardial infarction. Mural thrombus was associated with focal areas of myocardial injury, mainly subendocardial in location. The findings are compatible with the concept that mural thrombus can give rise to platelet or platelet-fibrin emboli in the microcirculation which cause focal areas of ischemic damage. This pathogenesis was further explored using a thrombogenic wire placed in the left anterior descending coronary artery by indirect technique. Five of 10 dogs had developed a completely occlusive thrombus, whereas five had a mural thrombus at death, which occurred within 2 days. Three of the five dogs with mural thrombus had focal ischemic myocardial damage and platelet-fibrin thrombi; the other two that died early showed only platelet fibrin masses in the microcirculation. When platelets were labeled with 111Indium, there was increased radioactivity in the territory of the myocardium served by the artery containing a developing thrombus.
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Arteriopatías Oclusivas/fisiopatología , Circulación Coronaria , Enfermedad Coronaria/fisiopatología , Infarto del Miocardio/fisiopatología , Animales , Arritmias Cardíacas/patología , Plaquetas/fisiología , Enfermedad Coronaria/patología , Perros , Electrocardiografía , Femenino , Masculino , Infarto del Miocardio/patología , Factores de TiempoRESUMEN
Mature dogs were vaccinated with a myxovirus vaccine. At this time, half of the dogs were also given a subcutaneous injection of levamisole hydrochloride (2.2 mg/kg). Blood platelets were counted daily. The dogs that had received only the vaccine showed, after 48 hours, a 48% decrease in platelets. Levamisole reduced the thrombocytopenia associated with myxovirus vaccination. Levamisole could have a protective effect on platelets by preventing their aggregation induced by viral neuraminidase.