Liquid crystal elastomer foams with elastic properties specifically engineered as biodegradable brain tissue scaffolds.

Tissue regeneration requires 3-dimensional (3D) smart materials as scaffolds to promote transport of nutrients. To mimic mechanical properties of extracellular matrices, biocompatible polymers have been widely studied and a diverse range of 3D scaffolds have been produced. We propose the use of responsive polymeric materials to create dynamic substrates for cell culture, which goes beyond designing only a physical static 3D scaffold. Here, we demonstrated that lactone- and lactide-based star block-copolymers (SBCs), where a liquid crystal (LC) moiety has been attached as a side-group, can be crosslinked to obtain Liquid Crystal Elastomers (LCEs) with a porous architecture using a salt-leaching method to promote cell infiltration. The obtained SmA LCE-based fully interconnected-porous foams exhibit a Young modulus of 0.23 ± 0.07 MPa and a biodegradability rate of around 20% after 15 weeks both of which are optimized to mimic native environments. We present cell culture results showing growth and proliferation of neurons on the scaffold after four weeks. This research provides a new platform to analyse LCE scaffold-cell interactions where the presence of liquid crystal moieties promotes cell alignment paving the way for a stimulated brain-like tissue.

Pristinamycin-induced arthralgia and myalgia: Analysis of the French Pharmacovigilance Database.

INTRODUCTION: Pristinamycin is an antibiotic of the streptogramin family; few adverse effects of this drug are reported, only cutaneous and digestive ones. Arthralgia and myalgia may however be observed although not mentioned in the summary of product characteristics. OBJECTIVE: Description and analysis of cases of pristinamycin-induced arthralgia and/or myalgia registered in the French database of pharmacovigilance. METHOD: We carried out a targeted search of the database, selecting case patients presenting with arthralgia and muscle pain and excluding those associated with sensitivities or allergies to pristinamycin. RESULTS: We retrieved 15 case patients of pristinamycin-induced arthralgia and myalgia. Pristinamycin was the only potentially incriminated drug for seven case patients. CONCLUSION: Although not serious, this adverse effect deserves to be better known by physicians to optimize therapeutic management.

[Forehead rejuvenation]. / Le rajeunissement du front.

The goal of this article is to provide a systemic approach to forehead rejuvenation. Fillers, botulinic toxin injections, transpalpebral, endoscopic or bicoronal brow lift must be usual techniques for every plastic surgeon in overall facial rejuvenation. Achieving a long lasting and aesthetically pleasing forehead is possible only with surgical techniques when aging is obvious.

[Self-medication of regular headache: a community pharmacy-based survey in Belgium]. / Automédication des céphalées fréquentes: étude dans les officines belges.

AIM: This observational community pharmacy-based study aimed to investigate headache characteristics and medication use of persons with regular headache presenting for self-medication. METHODS: Participants (n=1205) completed ii) a questionnaire to assess current headache medication and previous physician diagnosis, (ii) the ID Migraine Screener [ID-M] and (iii) the MIDAS questionnaire. RESULTS: Forty-four % of the study population (n=528) did not have a physician diagnosis of their headache, and 225 of them (225/528, 42.6%) were found to be ID-M positive. The most commonly used acute headache drugs were paracetamol (used by 62% of the study population), NSAIDs (39%) and combination analgesics (36%). Only 12% of patients physician-diagnosed with migraine used prophylactic migraine medication, and 25% used triptans. About 24% of our sample (n=292) chronically overused acute medication, which was combination analgesic overuse (n=166), simple analgesic overuse (n=130), triptan overuse (n=19), ergot overuse (n=6) and opioid overuse (n=51). Only 14.5% was ever advised to limit intake frequency of acute headache treatments. CONCLUSIONS: This study identified underdiagnosis of migraine, low use of migraine prophylaxis and triptans, and high prevalence of medication overuse among subjects seeking self-medication for regular headache. Community pharmacists have a strategic position in education and referral of these self-medicating headache patients.

[Risk factors for hepatitis C virus transmission to Health Care Workers after occupational exposure: a European case-control study]. / Facteurs de risque de transmission accidentelle du VHC au personnel soignant au décours d'un accident exposant au sang: une étude cas-témoins européenne.

BACKGROUND: Factors that influence the risk for HCV infection after occupational exposure to hepatitis C virus (HCV) have not yet been determined. The objective of this study was to assess potential risk factors for Hepatitis C seroconversion after occupational exposure to HCV. METHODS: We conducted a European matched case-control study from 01/01/1991 through 31/12/ 2002. Cases were Health Care Workers (HCWs) who were HCV seronegative at the time of exposure, sustained a documented exposure to HCV, and present documented HCV seroconversion temporally associated with the exposure. Controls-HCWs had a documented exposure to HCV, were HCV seronegative at the time of exposure, and remained so at least 6 months later. Controls were matched to cases for the center and the time period of the exposure occurrence. RESULTS: 60 cases and 204 controls were included. All cases were exposed to HCV-infected materials through percutaneous injuries. Those for whom information was available (61.6%) were exposed to viremic source patients. Multivariate conditional logistic regression analysis, in which HCV viral load was not introduced because of missing values, identified needle placed in the source patient's vein or artery (Odds Ratio [OR]=100.1; 95% Confidence Interval [CI]=7.3-1365.7), deep injury (OR=155.2; 95%CI=7.1-3417.2), and HCW's gender (M vs. F: OR=3.1; 95%CI=1.0-10.0) as risk factors for HCV infection. In univariate unmatched analysis the risk of HCV transmission was increased 11-fold (C195%=1.1-114.1) in HCWs exposed to sources with a viral load>6 log10 copies/mL when compared to sources with a HCV viral load<4 log10 copies/mL. CONCLUSION: The risk of HCV transmission after percutaneous exposure increases with a larger volume of blood, and, a higher titer of HCV in the source patient's blood. The role of HCW's gender need to be further investigated. The results of this study have important implications for counselling and follow-up of HCWs after exposure.

Risk factors for hepatitis C virus transmission to health care workers after occupational exposure: a European case-control study.

BACKGROUND: Additional studies are required to identify risk factors for hepatitis C virus (HCV) transmission to health care workers after occupational exposure to HCV. METHODS: We conducted a matched case-control study in 5 European countries from 1 January 1991 through 31 December 2002. Case patients were health care workers who experienced seroconversion after percutaneous or mucocutaneous exposure to HCV. Control subjects were HCV-exposed health care workers who did not experience seroconversion and were matched with case patients for center and period of exposure. RESULTS: Sixty case patients and 204 control subjects were included in the study. All case patients were exposed to HCV-infected fluids through percutaneous injuries. The 37 case patients for whom information was available were exposed to viremic source patients. As risk factors for HCV infection, multivariate analysis identified needle placement in a source patient's vein or artery (odds ratio [OR], 100.1; 95% confidence interval [CI], 7.3-1365.7), deep injury (OR, 155.2; 95% CI, 7.1-3417.2), and sex of the health care worker (OR for male vs. female, 3.1; 95% CI, 1.0-10.0). Source patient HCV load was not introduced in the multivariate model. In unmatched univariate analysis, the risk of HCV transmission increased 11-fold for health care workers exposed to source patients with a viral load >6 log(10) copies/mL (95% CI, 1.1-114.1), compared with exposures to source patients with a viral load < or =4 log10 copies/mL. CONCLUSION: In this study, HCV occupational transmission was found to occur after percutaneous exposures. The risk of HCV transmission after percutaneous exposure increased with deep injuries and procedures involving hollow-bore needle placement in the source patient's vein or artery. These results highlight the need for widespread adoption of needlestick-prevention devices in health care settings, together with other preventive measures.

Urolithiasis and the protease inhibitor indinavir.

OBJECTIVE: To evaluate specific urological abnormalities in patients treated with the protease inhibitor indinavir. METHODS: A series of 155 consecutive human immunodeficiency virus-positive patients were treated with indinavir 800 mg p.o. three times a day. Of these, 14 (9%) treated for 1-321 (average 110) days experienced severe flank pain and were subjected to clinical and laboratory examinations. RESULTS: Abdominal X-ray was consistently negative for stones. Ultrasonography showed upper-tract dilatation in 12 patients. Intravenous urography showed obstruction above a radiolucent obstacle in 7 patients; in 2 cases, there was a marked delay in urine excretion on the obstructed side. The mean urine pH was 6. Urine culture was negative. Serum uric acid, phosphorus, and calcium levels were normal. In 8 patients there was slight renal insufficiency, and 4 patients required ureteral stenting. In all cases, hyperhydration and oral analgesia led to a favorable outcome. In 3 patients, chemical analysis of the stone demonstrated monohydrate indinavir crystals. CONCLUSIONS: In our experience, indinavir therapy is associated with urolithiasis in 9% of the cases. Hydration, analgesia, and acidification of the urine usually lead to a favorable clinical outcome. Prophylactic hydration and acidification of the urine are extremely important.

[Nephritic colic due to indinavir]. / Coliques néphrétiques sous indinavir.

OBJECTIVE: Evaluate the frequency and assess curative and preventive measures against urinary lithiasis in patients treated with indinavir. PATIENTS AND METHODS: Fourteen HIV seropositive patients who developed severe and acute flank pain were included. Four of the patients receiving 800 mg indinavir t.i.d. had fever (38.5 degrees C) or delayed secretion (> 2 h). Delay from indinavir treatment onset was 1 to 321 days. During the same period, 155 patients had been treated with indinavir. Clinical features, radiology and laboratory results were recorded in addition to an analysis of the lithiasis if possible. RESULTS: Transient moderate renal failure occurred in 8 patients. Mean urine pH was 6. Serum phosphorus, calcium, and uric acid, liver tests and urinalysis were normal. A JJ ureteral stent was inserted in 4 cases due to complications. In all cases, fluids, analgesics and antispasmodics provided favorable outcome. Inversely, nonsteroid antiinflammatory drugs given in 2 patients had a deleterious effect on renal function. The lithiasis was eliminated in 3 cases and infrared spectrophotometry demonstrated a structure compatible with indinavir monohydrate. CONCLUSION: The formation of urinary lithiasis is a frequent complication of indinavir therapy (9%). Hyperhydration and urine acidification are usually successful but emergency drainage is required in approximately 3% of cases. Nonsteroidal antiinflammatory drugs should be avoided due to the risk of renal toxicity. A precise evaluation of fluid intake and diet, drug associations and personal history is needed to recognize patients at risk of recurrent lithiasis formation.

Pharmacokinetics of a new oral formulation of amoxicillin.

The bioavailability of the recently developed 1 g dispersible tablet form of amoxicillin (B) and the 1 g dispersible tablet in suspension form (C) were compared to that of the 1 g standard reference formulation (A). Twelve healthy volunteers were involved in this single-dose, open, randomized, three-way cross-over study. The mean peak serum levels were 14.1 +/- 4.1 micrograms/ml after A, 15.1 +/- 3.1 micrograms/ml after B and 15.1 +/- 5.4 micrograms/ml after C. The area under the drug concentration versus time curves were 47.6 +/- 12.0 micrograms.h/ml after A, 52.8 +/- 10.2 micrograms.h/ml after B and 51.1 +/- 13.8 micrograms.h/ml after C. On the basis of these two pharmacokinetic parameters, the three formulations were found to be bioequivalent. In addition, the predicted serum concentrations during multiple dosing (3 times a day), derived from the corresponding mean concentrations after a single 1 g dose of C showed that 8 hourly administration would yield therapeutic serum concentrations for infections such as uncomplicated community-acquired pneumonia due to susceptible or less susceptible strains in otherwise healthy subjects.

[About prions...]. / A propos des prions....

Iatrogenic Creutzfeldt-Jakob disease (CJD) was first reported in 1974, in a 55-year-old woman whose symptoms started 18 months following corneal implant surgery. The transplant donor died of CJD. More recently, the epidemy of bovine spongiform encephalopathy in the U.K., and the reported cases of iatrogenic CJD due to extractive pituitary hormone injections, emphasized the problems of its etiology and the way these neurodegenerative diseases get transmitted. A new infectious pathogen was described as a prion: "small proteinaceous infectious particle", responsible of transmissible neurodegenerative diseases. The lethal evolution of these diseases, and the complete absence of preventive procedures are fearful regarding the extension of the disease, specially during the procedure of grafting originating from possibly infected people whose screening is currently impossible. It is mandatory for the surgeon to update its knowledges including the legal bylaws regarding a good surgical prevention. One must be certain the implant, wether autologous or heterologous, is completely free of disease, mainly in aesthetic surgery. This paper attempts to summarise this topics. One must bear in mind that the current knowledges could soon turn obsolete with a constant progression of scientific research and of the epidemiologic data.

A Statistical Model of the Fluctuations in the Geomagnetic Field from Paleosecular Variation to Reversal

The statistical characteristics of the local magnetic field of Earth during paleosecular variation, excursions, and reversals are described on the basis of a database that gathers the cleaned mean direction and average remanent intensity of 2741 lava flows that have erupted over the last 20 million years. A model consisting of a normally distributed axial dipole component plus an independent isotropic set of vectors with a Maxwellian distribution that simulates secular variation fits the range of geomagnetic fluctuations, in terms of both direction and intensity. This result suggests that the magnitude of secular variation vectors is independent of the magnitude of Earth's axial dipole moment and that the amplitude of secular variation is unchanged during reversals.

[Lack of ossification of the skull after surgery for craniosynostosis. A study of risk factors apropos of 592 cases]. / Défauts d'ossification du crâne après chirurgie pour craniosténose. Etude des facteurs de risque à propos de 592 cas.

The Center for Craniofacial Anomalies of Necker-Enfants-Malades Hospital presents a retrospective study of the outcome of 592 patients who were operated for craniosynostosis between 1976 and 1991. The quality of ossification one year after operation is reported with a focus on influencing factors. The lack of ossification rate is 5% (30/592). Three parameters are identified as increasing the risk of poor osseous wound healing: local postoperative infection, forehead advancement especially when accomplished with resorbable osteosynthesis, and brachycephaly. On the contrary, repaired tears of the dura mater do not seem to pose a risk. Seventy five per cent of patients with local infection and 12.4% of forehead advancement presented a lack of ossification which is statistically significant (p < 0.001). Lack of ossification can compromise aesthetic and functional results. Decreasing postoperative infection and stable fixation may help to avoid it.

[Outcome of nasal deviation in plgiocaphaly after bilateral frontocranial modeling in childhood]. / Evolution de la déviation nasale dans les plagiocéphalies après remodelage fronto-crânien bilatéral dans l'enfance.

The deviation of the nasal root is one of the major deformities in unilateral coronal synostosis. The objectives of this study are to evaluate the results of bilateral frontocranial remodeling on nasal deviation, focusing on the patient's age at the time of the operation. All the patients undergoing bilateral frontocranial remodeling for plagiocephaly and followed for a minimum of 5 years postoperatively, without any other craniofacial surgery were included in the study. Based on photographic data, 42 patients were assigned to one of 4 morphologic categories: M1 = absence of nasal deviation; M2 = minor nasal deviation with no or minor revision required; M3 = severe nasal deviation with major alternative osteotomies required or performed; M4 = major nasal deviation with major craniofacial procedure and bone-grafting required or performed. Thirty-nine patients presented with significant nasal deviation before surgery. Ninety-two percent had a morphologic improvement and 62% had no residual nasal deviation (M1) more than 5 years after the procedure. The best results were obtained in patients operated between the ages of 12 and 24 months. All patients who underwent surgery during this period obtained improvement of the deformity, and 90% had no residual deviation. In contrast, when patients were operated before the age of 12 months, 91% obtained improvement of the nasal deformity, and 57% were assigned to the M1 category. Additionally, surgery performed between the ages of 2 and 4 resulted in 67% of partial correction and 33% of ideal correction. The most difficult age group to correct were children 4 years and older. Of the 4 patients in this group, one required major secondary reconstruction (M3), and only one patient achieved complete correction. Although the endpoint for correction is an aesthetic assessment, cephalometric analysis was also performed in 29 cases. Comparison of the evaluations gave equivalent results.

Impairment of polymorphonuclear neutrophil function in HIV-infected patients.

Impaired polymorphonuclear neutrophil (PMN) function may contribute to the onset of certain bacterial and fungal infections and to tissue damage in human immunodeficiency virus (HIV)-infected patients. Published data on PMN function in HIV infection are controversial, possibly because most studies have involved PMNs isolated from the normal blood environment by various procedures that may modify PMN responses. We therefore used flow cytometry to study the expression of adhesion molecules at the PMN surface, actin polymerization, and the oxidative burst of whole-blood PMNs in 42 HIV-infected patients at different stages of the disease. These PMNs were activated in vivo, as shown by increased expression of the adhesion molecule CD11b/CD18, reduced L-selectin antigen expression, increased actin polymerization, and increased H2O2 production. The alterations were present in asymptomatic patients with CD4+ cell counts above 500/microliters and did not increase with progression of the disease. This PMN activation could contribute to the oxidative stress described in HIV infection. Stimulation by bacterial N-formyl peptides showed dysregulation of L-selectin shedding and decreased H2O2 production after cx vivo priming with tumor necrosis factor-alpha or interleukin-8. These latter impairments, which correlated with the decrease in CD4+ lymphocyte numbers, could contribute to the increased susceptibility of HIV-infected patients to bacterial infections.

Polymorphonuclear neutrophils from human immunodeficiency virus-infected patients show enhanced activation, diminished fMLP-induced L-selectin shedding, and an impaired oxidative burst after cytokine priming.

Impaired polymorphonuclear neutrophil (PMN) function may contribute to the onset of certain life-threatening bacterial and fungal infections in human immunodeficiency virus (HIV)-infected patients. Published data on PMN functional activity in HIV infection are controversial, possibly because most studies have involved PMNs isolated from their blood environment by means of various procedures that may differently affect surface receptor expression and thereby alter cellular responses. We therefore used flow cytometry to study the expression of adhesion molecules at the PMN surface, actin polymerization, and the oxidative burst of whole-blood polymorphonuclear neutrophils in 42 HIV-infected patients at different stages of the disease. These PMNs were activated in vivo, as demonstrated by increased expression of the adhesion molecule CD11b/CD18, reduced L-selectin antigen expression, increased actin polymerization, and increased H2O2 production. The alterations were present in asymptomatic patients with CD4+ cell counts greater than 500/microL and did not increase with the progression of the disease. Stimulation by bacterial N-formyl peptides showed dysregulation of L-selectin shedding and decreased H2O2 production after ex vivo priming with tumor necrosis factor alpha or interleukin-8 (IL-8). These latter impairments, which correlated with the decrease in CD4+ lymphocyte numbers and with IL-8 and IL-6 plasma levels, could contribute to the increased susceptibility of HIV-infected patients to bacterial infections.

Lack of ossification after cranioplasty for craniosynostosis: a review of relevant factors in 592 consecutive patients.

The Center for Craniofacial Anomalies of Necker-Enfants-Malades Hospital presents a retrospective study of the outcome of 592 patients who were operated on for craniosynostosis between 1976 and 1991. The quality of ossification 1 year after operation is reported, with a focus on influencing factors. The lack of ossification rate was 5% (30 of 592). Three parameters are identified as increasing the risk of poor osseous wound healing: local postoperative infection; forehead advancement, especially when accomplished with resorbable osteosynthesis; and brachycephaly. In contrast, repaired tears of the dura mater do not seem to pose a risk. Seventy-five percent of patients with local infection and 12.4% with forehead advancement presented a lack of ossification, which is statistically significant (p < 0.001). Lack of ossification can compromise aesthetic and functional results. Decreasing postoperative infection and stable fixation may help promote ossification.

The age of parana flood volcanism, rifting of gondwanaland, and the jurassic-cretaceous boundary.

The Paraná-Etendeka flood volcanic event produced approximately 1.5 x 10(6) cubic kilometers of volcanic rocks, ranging from basalts to rhyolites, before the separation of South America and Africa during the Cretaceous period. New (40)Ar/(39)Ar data combined with earlier paleomagnetic results indicate that Paraná flood volcanism in southern Brazil began at 133 +/- 1 million years ago and lasted less than 1 million years. The implied mean eruption rate on the order of 1.5 cubic kilometers per year is consistent with a mantle plume origin for the event and is comparable to eruption rates determined for other well-documented continental flood volcanic events. Paraná flood volcanism occurred before the initiation of sea floor spreading in the South Atlantic and was probably precipitated by uplift and weakening of the lithosphere by the Tristan da Cunha plume. The Parana event postdates most current estimates for the age of the faunal mass extinction associated with the Jurassic-Cretaceous boundary.

Epidemiology of intestinal colonization by members of the family Enterobacteriaceae resistant to cefotaxime in a hematology-oncology unit.

Intestinal colonization by members of the family Enterobacteriaceae resistant to cefotaxime was surveyed for 3 years in a hematology-oncology unit. Of 416 patients, 66 (15.9%) were colonized, each with a different strain. The incidence of intestinal carriage was not correlated with cefotaxime consumption in the ward but was strongly associated with individual exposure to cefotaxime.