Assessment of the severity of infant crying and its impact on parents: Development and validation of the ColiQ Questionnaire in France.

OBJECTIVES: The purpose of this study was to develop and validate a questionnaire that comprehensively assesses symptoms and severity of crying, symptoms suggesting infant functional gastrointestinal discomfort, and its impact on parents' quality of life: the Infant Colic Questionnaire (ColiQ©). For the first time, parents had access to a web application to follow their infants' evolving symptoms with a daily questionnaire. METHODS: The ColiQ was developed with a board of clinical experts (physicians and psychologists) based on extensive parent input. A longitudinal, observational study was conducted in France for 3 months. ColiQ assessments were collected online at six different time points. Psychometric testing demonstrated that ColiQ has acceptable psychometric properties (reliability, internal consistency, construct validity, and responsiveness). RESULTS: The ColiQ is a 16-question instrument developed in French including ten questions describing symptoms (Infant score) and six questions describing impacts (Parent score). The ColiQ demonstrated good test-retest reliability (ICC >0.70), internal consistency for both the Symptom and Impact subscale scores (Cronbach's α >0.70), and construct validity. Responsiveness was good; the ColiQ was able to detect significant improvement in the target population as early as 1 month (p<0.05). The global ColiQ score discriminated between severity levels (mild, medium, severe). CONCLUSIONS: The ColiQ was developed with input from parents and healthcare professionals and has shown validity, reliably, and responsiveness to change. Parents can use the web application to follow how their infants' symptoms evolve. The ColiQ can help parents quantify and verbalize their concerns during consultations, and provides an opportunity to facilitate conversations between the physician and parents.

[Quantification of right ventricular function by 2D speckle imaging and three dimensional echography. Comparison with MRI]. / Etude de la fonction ventriculaire droite par 2D speckle imaging et échographie tridimensionnelle. Comparaison à l'IRM myocardique.

PURPOSE: The echocardiographic assessment of right ventricular (RV) function requires many different parameters. We studied and compared with magnetic resonance imaging (MRI) two markers of RV function derived from new imaging tools: 2D speckle imaging (2DSI) and three dimensional echography. METHODS AND RESULTS: Thirty-two patients (19 with RV ejection fraction [RVEF]< or =45%) underwent both complete echocardiography--including standard parameters of RV function (fractional area change [FAC], Tei index, systolic velocity of tricuspid annulus by DTI), 3D full-volume acquisition on RV--and MRI for the evaluation of RV volumes and RVEF. 2DSI was applied to high frame rate cine loops centred on the RV free wall with measurement of peak systolic strain (%) in the basal, median and apical segments of this wall. Strain, especially in RV median and apical segments, is reduced in patients with RVEF less or equal to 45% (median strain: -16.39+/-5.27 vs. -24.74+/-8.00 [p=0.002]; apical strain -13.01+/-6.84 vs. 22.53+/-11.32 [p=0.03]) with a very good correlation with RVEF (r=-0.717, p=0.0001) but also with the usual echographic parameters of RV function, (FAC: r=0.019; Tei: r=0.01; peak systolic velocity: r=0.002). The 3D RVEF is also but poorly correlated with MRI RVEF, (r=0.447, p=0.017). Furthermore, 3D significantly underestimated RV volumes. By multivariate analysis, apical strain (p=0.004) and FAC (p=0.029) were predictive of a decreased RVEF. CONCLUSION: Apical strain as measured from 2DSI seems a promising parameter in the estimation of RV function. 3D estimation of RVEF is more disappointing because of an important underestimation of RV volumes.

Direct vascular actions of methyclothiazide and indapamide in aorta of spontaneously hypertensive rats.

In vitro experiments were designed to assess the inhibitory effect of the thiazide diuretics methyclothiazide (MCTZ), the hydrochlorothiazide (HCTZ), and the thiazide-related diuretic indapamide (IND) on contractile responses to norepinephrine (NE) and arginine vasopressin (AVP) of aortic rings from spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY). Changes in the tension of aortic ring preparations were measured isometrically. MCTZ (10(-4) M) induced endothelium-dependent inhibition of the vasoconstrictor responses to NE and AVP only in aortas from SHR, and the maximal vasoconstrictive effect of NE and AVP was decreased by 59 +/- 11% and 32.3 +/- 13%, respectively. Indapamide (10(-4) M) also induced endothelium-dependent inhibition of the contractile response to AVP in aortic rings from SHR, and the maximal vasoconstrictive effect of AVP was decreased by 33 +/- 5%. In contrast, HCTZ did not inhibit the contractile response to either NE or AVP, even at the highest concentration. This study provides evidence that methyclothiazide and indapamide inhibit the contractile response induced by norepinephrine and/or arginine vasopressin on SHR aortic preparations via an endothelium-dependent mechanism.

Heart Messages: a tailored message intervention for improving heart failure outcomes.

Heart failure is a major health problem in the United States leading to high rates of mortality and morbidity and impaired quality of life. Assisting patients to improve compliance with their self-care regimen, including medications, dietary sodium restrictions, and self-monitoring (daily weights, edema assessment), may improve these poor outcomes. This article describes the development and initial evaluation of Heart Messages, a theory-based, tailored message intervention to improve compliance with the self-care regimen recommended for patients with heart failure. The project involved four phases, each of which is described in this article. The Heart Messages tailored message intervention program is available in both printed and Web-based formats. In a pilot study and clinical evaluation project, the program was found to be useful for patient education and feasible for implementation. Larger randomized trials are now warranted to evaluate the effectiveness of the intervention in improving compliance with the self-care regimen and thereby improving outcomes among patients with heart failure.

Hepatic and splenic involvement in cat-scratch disease: imaging features.

Hepatosplenic involvement in cat-scratch disease, probably underdiagnosed, is characterized by multinodular lesions throughout the liver and spleen. Radiologic features of ultrasound, computed tomography, and magnetic resonance imaging are not specific. The key of the diagnosis relies on a history of cat or kitten contact. A specific serological test can confirm the diagnosis without invasive procedures such as biopsy.

Anterior uveitis as the initial sign of adult Kawasaki syndrome (mucocutaneous lymph node syndrome).

PURPOSE: To report anterior uveitis as the initial sign of adult Kawasaki syndrome (mucocutaneous lymph node syndrome). METHODS: Case report. RESULTS: Kawasaki syndrome was diagnosed in an 18-year-old woman with reduction of vision caused by anterior uveitis, fever, erythemateous cutaneous rash, conjunctival injection, and cervical lymph adenopathy, after medical examination including serologic tests. Aspirin and intravenous immunoglobulin were given, resulting in improvement of the condition. CONCLUSION: Slit-lamp examination should be useful in the evaluation of patients with suspected Kawasaki syndrome, differentiating this condition from streptococcal and staphylococcal toxin-mediated diseases, viral infections, and drug reactions, not commonly associated with anterior uveitis.

[Papillary solid tumor of the pancreas in a child: a case report]. / Tumeur papillaire solide du pancréas chez un enfant.

We present a case of a papillary solid neoplasm of the head of the pancreas incidentally diagnosed after an abdominal trauma in a thirteen year old boy. Imaging features (US, CT) of the lesion were not specific enough to permit a precise diagnosis with certainty. Preoperative percutaneous needle biopsy can give presumptive evidence which may guide the treatment. Prognosis is fairly better than other pancreatic neoplasms in children (particularly pancreatoblastoma). Treatment relies only on surgery.

[Subfulminant hepatitis A treated by hepatic transplant]. / Hépatite subfulminante à virus A traitée par transplantation hépatique.

A case of subfulminant hepatitis A in a 3 1/2 year-old boy is reported. This child is alive after a liver transplantation. Such a procedure should modify the prognosis of severe hepatic failure whatever its origin, viral or toxic. Some practical problems concerning this new management of fulminant hepatitis are considered.

[Treatment by prostaglandin E1 of isolated coarctations in newborn infants with acute cardiac failure]. / Traitement par la prostaglandine E1 des coarctations isolées du nouveau-né en défaillance cardiaque aiguë.

In neonates with isolated coarctation of the aorta presenting with acute neonatal heart failure refractory to classical treatment, emergency surgery is associated with a 30% death-rate. We rather suggest to add to treatment a perfusion of prostaglandin E1 in order to dilate the ductus arteriosus and thereby the aortic isthmus. This was performed successfully in 9 of 12 neonates aged 5 to 16 days: coarctation was relieved and heart failure disappeared. As soon as the left ventricle became hyperkinetic again (2 to 6 days later), prostaglandin was discontinued. Coarctation reappeared with either chronic heart failure (3 cases) or severe arterial hypertension (5 cases). Eventually one child recovered without surgery and the other 11 were operated on at an average age of 24 days, with only one death.

[Ultrastructural study of the biodegradation processes. I. Beech (Fagus sylvaticus L.) leaf white rot]. / Etude ultrastructurale des processus de biodégradation. I. Pourriture blanche des feuilles de Hêtre (Fagus sylvatica L.).

An electron microscopic study of beech leaf white rot shows a certain number of characteristic developmental stages which are identical whether the material is from in vitro experimentation or from natural incubation. Endowed with a cellulolytic properly seemingly localized in the apical region only, hyphae of the white rot agent only traverse the plant cell walls. Subsequently, hyphae penetrate condensed protoplasmic residues and make them progressively transparent to electrons. During this discoloring process, a lethal factor of as yet unknown nature appears, affecting other microorganisms already present in the leaves. Phloem and xylem vascular bundles do not present notable ultrastructural modifications. Therefore, leaf discoloration is not due to an alteration of the xylem constituents but to changes having occurred in the condensed cytoplasmic residues of the dead tissues.

[Influence of clay on microorganisms conservation. I. Ultrastructural study of the biodegradation of Beauveria bassiana (Bals). Vuill. (entomopathogenous hyphomycete) in soil (author's transl)]. / Effet de l'argile sur la conservation des microorganismes. I. Etude ultrastructurale de la biodégradation dans le sol de l'hypomycète entomopathogène Beauveria bassiana (Bals.) Vuill.

Blastospores of B. bassiana enclosed in fine mesh bags were submitted to soil microflora. Clay minerals coating fungal spores protected from by decreasing bacterial activity. The role of amoeba in biodegradation of fungi is also considered.