Erector spinae plane block did not improve postoperative pain-related outcomes and recovery after video-assisted thoracoscopic surgery : a randomised controlled double-blinded multi-center trial.

INTRODUCTION: There is a sizable niche for a minimally invasive analgesic technique that could facilitate ambulatory video-assisted thoracoscopic surgery (VATS). Our study aimed to determine the analgesic potential of a single-shot erector spinae plane (ESP) block for VATS. The primary objective was the total hydromorphone consumption with patient-controlled analgesia (PCA) 24 h after surgery. METHODS: We conducted a randomized, controlled, double-blind study with patients scheduled for VATS in two major university-affiliated hospital centres. We randomized 52 patients into two groups: a single-shot ESP block using bupivacaine or an ESP block with normal saline (control). We administered a preoperative and postoperative (24 h) quality of recovery (QoR-15) questionnaire and assessed postoperative pain using a verbal numerical rating scale (VNRS) score. We evaluated the total standardized intraoperative fentanyl administration, total postoperative hydromorphone consumption (PCA; primary endpoint), and the incidence of adverse effects. RESULTS: There was no difference in the primary objective, hydromorphone consumption at 24 h (7.6 (4.4) mg for the Bupivacaine group versus 8.1 (4.2) mg for the Control group). Secondary objectives and incidence of adverse events were not different between the two groups at any time during the first 24 h following surgery. CONCLUSION: Our multi-centre randomized, controlled, double-blinded study found no advantage of an ESP block over placebo for VATS for opioid consumption, pain, or QoR-15 scores. Further studies are ongoing to establish the benefits of using a denser block (single-shot paravertebral with a continuous ESP block), which may provide a better quality of analgesia.

Anadromous fish as biomarkers for the combined impact of marine and freshwater heavy metal pollution.

Rivers along the eastern seaboard of the United States and Canada are becoming increasingly contaminated with heavy metals. This includes the Tusket River (Nova Scotia, Canada) which empties into the Gulf of Maine, near the Bay of Fundy. Whether anadromous fish such as alewife (Alosa pseudoharengus), exposed both to marine and freshwater contaminants, are accumulating these heavy metals and experiencing any changes in their morphology was explored in this study. Adult (4-6 years of age) Tusket River alewife (n = 38) were harvested and had external examinations including morphometrics (fork length, weight). Biopsies were taken and structural abnormalities noted. Morphometric data was compared to historical alewife reference data from 1985. Biopsies of muscle, liver and kidney had heavy metal profiles assessed. Major findings of this study include detectable levels (µg/g wet weight) of a number of heavy metals and concerning maximum concentrations achieved of arsenic (liver: 14 µg/g), cadmium (kidney: 2.6 µg/g), mercury (liver: 0.26 µg/g), magnesium (muscle: 460 µg/g), selenium (kidney: 4.0 µg/g) and zinc (liver: 38.0 µg/g). As well, reduced body weight for length and in 87% of fish, presence of spine curvatures (3-24°) not visible externally were noted. This study is the first detailed report in alewife of key tissue heavy metals, some at levels of concern, reductions in weight for length and spine abnormalities. These findings validate concerns regarding potential impacts of deteriorating conditions of rivers and their surrounding waters such as the Gulf of Maine on anadromous fish species.

Essential and non-essential heavy metal levels in key organs of winter flounder (Pseudopleuronectes americanus) and their potential impact on body condition.

This study explored whether winter flounder, a benthic species, are potentially exposed to contaminants such as heavy metals released from the sediment of the Bay of Fundy/Gulf of Maine, both critical habitats identified to have increases in heavy metal levels. Experimentally in fish, exposure to certain heavy metals resulted in reduced weight for length and structural abnormalities, but it is unknown if this occurs in wild fish. Winter flounder (n = 72), harvested between 2015 and 2018 from the aforementioned western Atlantic region of Canada/USA, had detectable levels of most heavy metals, with some exhibiting levels of concern (arsenic, cadmium, lead, selenium, zinc) in muscle, liver, and kidney. A 1.4% incidence of structural abnormalities was noted. When compared to 1980 regionally matched flounder data, the 2018 flounder had significantly reduced weight for length, exacerbated with age. Clearly winter flounder are affected by worsening heavy metal contaminant levels in this geographic area.

Effects of slow- v. fast-digested protein supplementation combined with mixed power training on muscle function and functional capacities in older men.

Ageing leads to a progressive loss of muscle function (MF) and quality (MQ: muscle strength (MS)/lean muscle mass (LM)). Power training and protein (PROT) supplementation have been proposed as efficient interventions to improve MF and MQ. Discrepancies between results appear to be mainly related to the type and/or dose of proteins used. The present study aimed at determining whether or not mixed power training (MPT) combined with fast-digested PROT (F-PROT) leads to greater improvements in MF and MQ in elderly men than MPT combined with slow-digested PROT (S-PROT) or MPT alone. Sixty elderly men (age 69 (sd 7) years; BMI 18-30 kg/m2) were randomised into three groups: (1) placebo + MPT (PLA; n 19); (2) F-PROT + MPT (n 21) and (3) S-PROT + MPT (n 20) completed the intervention. LM, handgrip and knee extensor MS and MQ, functional capacity, serum metabolic markers, skeletal muscle characteristics, dietary intake and total energy expenditure were measured. The interventions consisted in 12 weeks of MPT (3 times/week; 1 h/session) combined with a supplement (30 g:10 g per meal) of F-PROT (whey) or S-PROT (casein) or a placebo. No difference was observed among groups for age, BMI, number of steps and dietary intake pre- and post-intervention. All groups improved significantly their LM, lower limb MS/MQ, functional capacity, muscle characteristics and serum parameters following the MPT. Importantly, no difference between groups was observed following the MPT. Altogether, adding 30 g PROT/d to MPT, regardless of the type, does not provide additional benefits to MPT alone in older men ingesting an adequate (i.e. above RDA) amount of protein per d.

Assessment of the American Heart Association's "Life's simple 7" score in French-speaking adults from Québec.

BACKGROUND AND AIMS: The "Life's Simple 7" (LS7) metrics were developed by the American Heart Association (AHA) to assess and promote cardiovascular health in the American population. The purpose of this study was to assess the overall cardiovascular health of French-speaking adults from the Province of Quebec using the LS7 score. METHODS AND RESULTS: A total of 777 age and sex-representative participants of five different administrative regions in the Province of Quebec (387 men and 390 women; mean age ± SEM: 41.9 ± 0.1 years) were included in these analyses. Metrics of the LS7 score (smoking, physical activity, diet, body mass index, blood pressure, fasting total cholesterol and blood glucose) were analysed to generate a final score ranging from 0 to 7. Only 0.5% of participants met all criteria for ideal cardiovascular health. The diet metric showed the lowest prevalence of "ideal" scores (4.8%) whereas not smoking was the metric with the highest prevalence (88.1%). Women had a higher LS7 score than men, while age and education level (negative and positive association, respectively; p < 0.0001) were also associated with the LS7 score. CONCLUSION: Consistent with studies conducted among other populations, very few French-speaking adults from the Province of Quebec achieve an ideal cardiovascular health. These data indicate that further public health efforts aimed at promoting the LS7 metrics, focusing primarily on diet, are urgently needed. Specific groups, including older adults and those with lower levels of education, should be targeted when developing cardiovascular health promotion interventions.

Differences in muscle adaptation to a 12-week mixed power training in elderly men, depending on usual protein intake.

INTRODUCTION: Normal aging is often associated with a decline of muscle mass (MM), strength (MS) and quality (MQ: MS/MM), leading to functional incapacities. This aging-related deterioration of muscles may involve a decreased protein intake. Mixed power training has been recently shown to induce positive effects on MM, MS and MQ. However, to our knowledge, no study has examined if muscle adaptations following mixed power training could be influenced by the daily amount of protein ingested in elderly men. METHODS: Twenty-one men completed the intervention and were divided into 2 groups based on their usual protein intake: PROT 1.1- (<1.1 g·kg-1·d-1 [n = 10; 73 ±â€¯3 years]) and PROT 1.2+ (>1.2 g·kg-1·d-1 [n = 11; 73 ±â€¯3 years]). Body composition (DXA: lean and fat masses), MS (1-maximal repetition on leg-press and handgrip strength), MQ (MS/body mass and MS/lower limb lean mass), functional capacities (Short Physical Performance Battery/Senior Fitness Test), dietary intake (3-day food record) and energy expenditure (accelerometer; 7 days) were measured. Mixed power training intervention consisted in power and functional exercises (12 weeks; 3 times/week; 1 h/session). RESULTS: Lower limb MS increase in the PROT 1.2+ group was greater from that of the PROT 1.1- group when normalized to lower limbs lean mass (p = 0.036). In addition, a trend for greater gain in lower limb MS normalized to body mass (p = 0.053) was observed in the PROT 1.2+. CONCLUSION: To optimize mixed power training effects on muscle function, healthy older men should ingest daily at least 1.2 g·kg-1·d-1 of protein. These beneficial effects of a higher usual protein intake were observed especially for MQ, which is one of the best predictors of functional capacities in older adults.

Prospective evaluation of Doppler echocardiography, tissue Doppler imaging and biomarkers measurement for the detection of doxorubicin-induced cardiotoxicity in dogs: A pilot study.

The purpose of this pilot study was to evaluate the usefulness of selected echocardiographic parameters, NT-proBNP and cardiac troponin I (cTnI) in the detection of cardiotoxicity in dogs treated with doxorubicin for various malignancies. Echocardiographic studies and biomarker measurements were performed before each administration of doxorubicin, then 1 and 3 months after completion of therapy. Thirteen dogs were included, with a total cumulative dose of doxorubicin ranging from 30 to 150 mg/m(2). E/A ratio significantly decreased during doxorubicin administration (p=0.047). cTnI level was also significantly affected by treatment (p=0.046), increasing above normal at least at one time point in 11 of 13 dogs. The results of this pilot study suggest that monitoring of left ventricular diastolic function and cTnI level measurement might be useful in the early detection of cardiotoxic signs of doxorubicin therapy in dogs.

[Psychoeducation for overweight patients with psychiatric disorders: The Wellness program developed in Quebec]. / L'éducation thérapeutique du patient pour les clientèles psychiatriques présentant un surpoids : l'exemple du programme « Wellness ¼ développé au Québec.

OBJECTIVES: Patients with severe psychiatric disorders such as psychosis, bipolar disorder, and depression have a greater risk of suffering from being overweight or from obesity than the general population. This can in part be explained by medication-induced weight gain related to the use of antipsychotics, antidepressants and mood stabilizers. Fortunately, non-pharmacological interventions targeting modifications in lifestyle behaviors exist to help patients deal with weight gain and weight management. The main objective of this study is to assess the effectiveness of one of these interventions developed in Quebec (Canada), the Wellness Program. MATERIALS AND METHODS: The 12-week program, consisting of two to three weekly individual and group sessions, was administered to patients diagnosed with a severe psychiatric disorder (i.e. Psychotic Disorders, Bipolar Disorders, Major Depressive Disorder) and referred to a general hospital for significant weight problems. Topics of program sessions included: physical conditioning, nutrition, meal cooking, psychoeducation, motivation, relaxation training, and optional walking sessions. A total of 47 participants took part in this study and either initially received the intervention (n=31) or were placed in a waitlist control group and later received the intervention (n=16). The effectiveness of the program was measured using objective anthropometric (weight, Body Mass Index, waist circumference) and clinical (psychiatric symptoms, medication adherence, quality of life) variables from both experimental and control groups. Assessments were conducted at the end of the 12-week intervention and at a 3-month follow-up. RESULTS: After three months of active intervention, there were no significant differences between the two groups for most of the variables studied. Patients in the experimental group did show greater improvements in weight loss, Body Mass Index and waist circumference compared to the control group, but these positive changes were not statistically significant given the small sample size of the study. However, the results obtained at follow-up three months after the end of the program showed a significant impact of the program, albeit small, on weight, Body Mass Index, waist circumference and on some aspects of quality of life in the experimental group. CONCLUSION: Non-pharmacological interventions targeting healthy lifestyle behaviors and weight management, such as the Wellness Program, seem effective in improving anthropometric variables and quality of life in patients with severe psychiatric disorders such as psychosis and mood disorders. Given the potential clinical benefits, implementation in clinical settings and widespread dissemination is recommended. Indeed, these programs have the potential to limit weight gain associated with medications used to treat psychiatric disorders and to improve quality of life for these patients.

Systematic review of the relationship between childcare educators' practices and preschoolers' physical activity and eating behaviours.

The role of childcare educators is important given that 81% of preschoolers living in developed countries receive childcare outside their home. Since children learn by observing and imitating others, childcare educators may play a role in promoting healthy eating behaviours and physical activity in young children. Six databases were searched for quantitative peer-reviewed, English or French primary studies reporting the correlates, predictors or effectiveness of childcare educators' practices on preschoolers' healthy eating and physical activity behaviours. Risk of bias was assessed using the Quality Assessment Tool for Quantitative Studies. Fifteen articles were included in this review: 10 measured physical activity levels and five assessed eating behaviours. The quality score was rated as low for eight of these articles, and as moderate for the remaining seven. Two of four cross-sectional studies reported a positive relationship between educators and children's behaviours. Eleven intervention studies reported significant favourable effects of interventions. Educators may play a positive role in promoting healthy behaviours in children, but this is mainly based on a small number of intervention type studies of low or moderate quality. The influence of specific components of educators' practices on children's healthy eating and physical activity behaviours remains inconclusive.

Association between aortoseptal angle in Golden Retriever puppies and subaortic stenosis in adulthood.

BACKGROUND: Predicting subaortic stenosis (SAS) in adult Golden Retriever dogs (GRs) by evaluating them as puppies is hampered by the progressive expression of the SAS phenotype in youth. In some children who develop SAS as adults, an abnormal aortoseptal angle (AoSA) precedes development of stenosis. OBJECTIVES: To determine the normal AoSA in young adult GRs using echocardiography; to assess the value of AoSA in GR puppies for predicting development of the SAS phenotype. ANIMALS: Forty-eight 2- to 6-month-old GR puppies. METHODS: Prospective study. Puppies were recruited from clients and breeders. Puppies were evaluated with a physical examination and an echocardiogram, and this evaluation was repeated when they were 12-18-month-old adults. Puppies were classified as unaffected (WNL) or affected (SAS) retroactively, based on their results as adults. RESULTS: In WNL young adult GRs, mean ± SD AoSA was 152.3 ± 6.5°. Mean ± SD AoSA in SAS puppies (144.9 ± 8.6°) was significantly different from mean AoSA in WNL puppies (155.7 ± 8.8°, P < .01). No puppy with AoSA >160° had the SAS phenotype as a young adult; 93% (75.7-99.1%) of puppies with AoSA <145° had the SAS phenotype as young adults. Peak LVOT velocity increased significantly between evaluations (P < .0001) whereas AoSA did not (P = .45). CONCLUSION AND CLINICAL SIGNIFICANCE: A steep AoSA in GR puppies is associated with the SAS phenotype in young adulthood. Some GR puppies have an abnormal AoSA that persists in young adulthood and is detectable before peak LVOT velocity reaches levels consistent with SAS.

Screening for distress in patients with cancer: methodologic considerations.

Distress has been declared the 6th vital sign in Canadian cancer care. Accordingly, health care professionals in Canada are expected to screen for distress in patients with cancer, for which a toolkit has been developed. Identifying patients who may be in need of further resources has the potential to improve quality of care because those patients are more likely to have their existing distress identified and to be referred for appropriate follow-up services. The present article briefly reviews the background literature and the validation of the measures in the toolkit, and highlights future directions for methodologic validation of the toolkit for use according to the protocol.

Modelling the impact of compliance with dietary recommendations on cancer and cardiovascular disease mortality in Canada.

OBJECTIVES: Despite strong evidence indicating that unbalanced diets relate to chronic diseases and mortality, most adults do not comply with dietary recommendations. To help determine which recommendations could yield the most benefits, the number of deaths attributable to cardiovascular diseases and cancer that could be delayed or averted in Canada if adults changed their diet to adhere to recommendations were estimated. STUDY DESIGN: Macrosimulation based on national population-based survey and vital statistics data. METHODS: A macrosimulation model was used to draw age- and sex-specific changes in relative risks based on the results of meta-analyses of relationship between food components and risk of cardiovascular disease and diet-related cancers. Inputs in the model included Canadian recommendations (fruit and vegetable, fibre, salt, and total-, monounsaturated-, polyunsaturated-, saturated-, and trans-fats), average dietary intake (from 35,107 participants with 24-h recall), and mortality from specific causes (from Canadian Vital Statistics). Monte Carlo analyses were used to compute 95% credible intervals (CI). RESULTS: The estimates of this study suggest that 30,540 deaths (95% CI: 24,953, 34,989) per year could be averted or delayed if Canadians adhered to their dietary recommendations. By itself, the recommendation for fruit and vegetable intake could save as many as 72% (55-87%) of these deaths. It is followed by recommendations for fibres (29%, 13-43%) and salt (10%, 9-12%). CONCLUSIONS: A considerable number of lives could be saved if Canadians adhered to the national dietary intake recommendations. Given the scarce resources available to promote guideline adhesion, priority should be given to recommendations for fruit and vegetable intake.

Longitudinal analysis of quality of life, clinical, radiographic, echocardiographic, and laboratory variables in dogs with myxomatous mitral valve disease receiving pimobendan or benazepril: the QUEST study.

BACKGROUND: Myxomatous mitral valve disease (MMVD) is an important cause of morbidity and mortality in dogs. OBJECTIVES: To compare, throughout the period of follow-up of dogs that had not yet reached the primary endpoint, the longitudinal effects of pimobendan versus benazepril hydrochloride treatment on quality-of-life (QoL) variables, concomitant congestive heart failure (CHF) treatment, and other outcome variables in dogs suffering from CHF secondary to MMVD. ANIMALS: A total of 260 dogs in CHF because of MMVD. METHODS: A prospective single-blinded study with dogs randomized to receive pimobendan (0.4-0.6 mg/kg/day) or benazepril hydrochloride (0.25-1.0 mg/kg/day). Differences in outcome variables and time to intensification of CHF treatment were compared. RESULTS: A total of 124 dogs were randomized to pimobendan and 128 to benazepril. No difference was found between groups in QoL variables during the trial. Time from inclusion to 1st intensification of CHF treatment was longer in the pimobendan group (pimobendan 98 days, IQR 30-276 days versus benazepril 59 days, IQR 11-121 days; P = .0005). Postinclusion, dogs in the pimobendan group had smaller heart size based on VHS score (P = .013) and left ventricular diastolic (P = .035) and systolic (P = .0044) dimensions, higher body temperature (P = .030), serum sodium (P = .0027), and total protein (P = .0003) concentrations, and packed cell volume (P = .030). Incidence of arrhythmias was similar in treatment groups. CONCLUSIONS AND CLINICAL IMPORTANCE: Pimobendan versus benazepril resulted in similar QoL during the study, but conferred increased time before intensification of CHF treatment. Pimobendan treatment resulted in smaller heart size, higher body temperature, and less retention of free water.

[Validation of the French version of the situational characteristics questionnaire in the measurement of space and motion discomfort]. / Validation de la version française du questionnaire des caractéristiques situationnelles dans la mesure de l'inconfort spatio-moteur.

INTRODUCTION: Space and motion discomfort (SMD) refers to various symptoms that occur in environments with unreliable visual and kinesthetic information that do not permit adequate spatial orientation. Some studies have demonstrated that there is a stable and predictable relationship between vestibular dysfunction and anxiety disorders. Further, vestibular dysfunction can predispose or trigger the development of panic disorder with or without agoraphobia (PD/A) or reinforce phobic avoidance. It therefore seems clinically useful to develop and validate instruments for evaluating SMD in various populations. Measuring SMD could facilitate identification of individuals with PD/A who present comorbid vestibular dysfunction. Jacob et al. developed and validated such a questionnaire: the Situational characteristics questionnaire (SitQ). This questionnaire evaluates the presence of symptoms such as dizziness, vertigo, and instability under specific conditions. The SitQ comprises two subscales that measure SMD and one subscale (agoraphobia) that measures agoraphobic avoidance behaviours. The instrument has two sections. The first section is composed of the SMD-I and agoraphobia subscales, containing 19 and seven items, respectively. Each item consists of two contrasting descriptors of a specific situation or environment. The respondent is required to indicate to what extent the two described situations or environments cause discomfort. Each item includes a "criterion" descriptor for the situation (i.e., a descriptor that is presumed to engender SMD) and an alternative (non-criterion) descriptor. The second section comprises the SMD-II scale; this scale is composed of nine criterion situations, for which non-criterion situations are not supplied. The instrument takes approximately 20 minutes to complete. OBJECTIVE: The present study focuses on the validation of the French-language version of the SitQ: the questionnaire des caractéristiques situationnelles (QCS). METHOD: The sample was composed of French Canadians recruited across Quebec from an anxiety disorders treatment clinic, general psychiatric care clinics, a community organization for individuals with anxiety disorders, advertisements in local newspapers, and ads posted in various public locations. The sample included 141 participants who met the criteria for lifetime PD/A. Participants reported current PD/A (n=73) or PD/A in remission (n=68). The control sample was recruited from undergraduate courses in various disciplines. Two hundred and thirty-five (n=235) students completed the questionnaires. Data from 63 (26.8%) participants were excluded from the analyses due to failure to complete all of the research questionnaires. RESULTS: Analysis of the global descriptive data and the descriptive data for each dependent variable revealed that the data were independent of sociodemographic variables and respected the assumptions of normal distribution (skewness and kurtosis). Parametric tests were subsequently conducted. Using the combined data from the control and clinical groups, the internal consistency of the scales was analyzed using Cronbach's alpha. The SMD-I and SMD-II scales demonstrated good homogeneity. The results were comparable or superior to those obtained with the English-language version of the questionnaire. The agoraphobia scale demonstrated weaker internal consistency and corresponding weaker homogeneity. This result was consistent with that of the original version of the agoraphobia scale; this scale was eliminated for the subsequent analyses. Construct validity was analyzed via t-tests comparing clinical and control groups. Effect sizes were estimated using percentage of variance explained. The SMD-I scale demonstrated weak construct validity and was also eliminated from subsequent analyses. The SMD-II scale demonstrated good construct validity and provided an adequate measure of the theoretical construct of SMD. This scale permitted discrimination of participants according to the presence or absence of PD/A. It is therefore possible to identify participants with PD/A by their level of SMD. This result is comparable to that of Jacob et al. CONCLUSION: The results of the present study are generally consistent with the results of the validation of the original version of the questionnaire. However, the SMD-I and agoraphobia scales in the French-language version of the measure did not achieve a level of significance sufficient to definitively establish validity.

Physical activity fluctuations and body fat during adolescence.

OBJECTIVE: The objective of the study was to test the hypothesis that greater fluctuations in physical activity lead to greater increases in body fat during adolescence. METHODS: Seven hundred fifty-six adolescents in Montreal, Canada, aged 12-13 years at baseline, completed a 7-d physical activity recall questionnaire every 3 months over 5 years. Body mass index (BMI), waist circumference, and triceps and subscapular skinfold thickness were measured at baseline and at the end of follow-up. Subject-specific linear regressions, expressing physical activity as a function of time, were fitted and physical activity fluctuation scores were obtained by averaging the absolute values of regression residuals. The association between body fat after 5 years and the physical activity fluctuation score was assessed in linear regressions adjusting for baseline body fat, average number of physical activity sessions per week, diet and sociodemographic variables. RESULTS: Among boys, there were statistically significant positive associations between physical activity fluctuation and BMI (ß, 95% confidence interval: 0.12, 0.02-0.21) and triceps skinfold (0.40, 0.17-0.63). The associations with waist circumference or subscapular skinfold were not statistically significant (0.22, -0.04-0.49; 0.13, -0.05-0.32, respectively). In girls, there were statistically significant negative associations between physical activity fluctuation and BMI (-0.12, -0.20 to -0.03), waist circumference (-0.54, -0.91 to -0.17), subscapular skinfold (-0.41, -0.56 to -0.26) and triceps skinfold (-0.22, -0.38 to -0.05). CONCLUSION: Physical activity fluctuations appear to affect body fat during adolescence. Sex-specific interventions may be needed given that greater physical activity fluctuations seem unfavourable for boys and beneficial for girls.

Existence of compensatory defense mechanisms against oxidative stress and hypertension in preeclampsia.

OBJECTIVE: Preeclampsia is a complex obstetrical syndrome characterized by hypertension and proteinuria. This syndrome is associated with oxidative stress, antioxidant imbalance and impaired production of vasoactive eicosanoids such as thromboxane A(2) (TXA(2)), a potent vasoconstrictor, and prostacyclin (PGI(2)), a well-known vasodilator. We hypothesized that there was a relationship between antioxidant vitamins, such as vitamin E and coenzyme Q(10) (CoQ(10)), and the production of vasoactive eicosanoids- PGI(2) and TXA(2)-potentially regulated by pro-oxidants and antioxidants in preeclampsia. METHODS: Therefore, the plasma levels of vitamin E, CoQ(10), TXA(2) and PGI(2) in normotensive (n = 30) and preeclamptic (n = 29) pregnancies were evaluated. Reduced and oxidized forms of vitamin E and CoQ(10) in blood were measured using a HPLC coupled to electrochemical detection. The levels of TXB(2) and 6-keto-PGF(1alpha), stable metabolites of TXA(2) and PGI(2) respectively, were measured by ELISA. RESULTS: The CoQ(10) oxidized/reduced ratio was significantly higher in preeclamptic compared to normotensive pregnancies (p = 0.04). A strong correlation between plasma levels of reduced vitamin E and CoQ(10), corrected for apolipoprotein B, was observed only in preeclampsia (r = 0.69, p < 0.0001). The 6-keto-PGF(1alpha)/TXB(2) ratio was higher in preeclampsia than in controls (p = 0.02), and this ratio was correlated to the oxidized/reduced ratio of both, vitamin E and CoQ(10) in all pregnancies (p <0.023). CONCLUSION: The data indicated that CoQ(10) is a sensitive marker of oxidative stress in preeclampsia. The correlation between vitamin E and CoQ(10) suggested a coordinated defense mechanism against oxidation. Furthermore, the higher 6-keto-PGF(1alpha)/TXB(2) ratio that strongly correlated with oxidative stress markers, suggests a mechanism developed by the maternal cardiovascular system to counteract hypertension during preeclampsia.

Comparative analysis between scientific and the media communication following facial transplantation.

PURPOSE: Our aim was to analyze the communications about three outstanding medical reports. Was there any difference in the reports of the three allografts? Was there a correlation between the media and the scientific world? METHODS: The Internet sites of three major newspapers were used for the media database. Those results were compared with PubMed between 2005 and 2007 using these key words: "facial graft," "facial allograft," "composite tissue allograft," and names of surgeons of the graft. We did a comparative analysis using a word processor and a quality analysis software. RESULTS: We analyzed 51 articles from the media and six from the PubMed database. In PubMed, 100% of the articles were on the first graft and respected the privacy of the patient compared to 67% of the media who unveiled the identity. CONCLUSION: The communication following a medical premiere depends on the team, which performes the act. We observed a major difference between the three cases. Ethical considerations are different for the media and for scientists. The communication management of a medical premiere takes preparation and evaluation.

'I'm cured but....': perceptions of illness following treatment.

The current qualitative research studied representations of illness posttreatment from a heart transplant group, a panic disorder group, and a tic disorder group. All three groups were preoccupied with perceptions about the impact of the illness, perception of self and the perception of how others view the ill person. The heart transplant group seem to adopt an active style of coping compared to the panic disorder group who presented a more passive, anticipatory mode of coping, and the tic group who were preoccupied with control over the perceptions of others. This qualitative information could help optimize adaptation strategies.

Invasion of human coronary artery endothelial cells by Streptococcus mutans OMZ175.

INTRODUCTION: Dissemination of oral bacteria into the bloodstream has been associated with eating, oral hygiene, and dental procedures; including tooth extraction, endodontic treatment, and periodontal surgery. Recently, studies identified Streptococcus mutans, the primary etiological agent of dental caries, as the most prevalent bacterial species found in clinical samples from patients who underwent heart valve and atheromatous plaque surgery. METHODS: By using antibiotic protection assays, we tested the capacity of 14 strains of S. mutans to invade primary human coronary artery endothelial cells (HCAEC). RESULTS: Serotype e strain B14 and serotype f strain OMZ175 of S. mutans were able to efficiently invade HCAEC. Among the tested strains, serotype f S. mutans OMZ175 was the most invasive, whereas strains of serotype c S. mutans, the most prevalent serotype in dental plaque, were not invasive. Based on its high invasion rate, we further investigated the invasive properties of serotype f OMZ175. Using transmission electron microscopy and antibiotic protection assays we demonstrate that S. mutans OMZ175 is capable of attaching to the HCAEC surface, entering the cells and surviving in HCAEC for at least 29 h. DISCUSSION: Our findings highlight a potential role for S. mutans in the pathogenesis of certain cardiovascular diseases.

Effect of pimobendan on echocardiographic values in dogs with asymptomatic mitral valve disease.

BACKGROUND: Pimobendan (PIMO) is a novel inodilator that has shown promising results in the treatment of advanced mitral valve disease (MVD), but little is known about its hemodynamic effects, especially regarding the mitral regurgitant volume in naturally occurring MVD. HYPOTHESIS: The addition of pimobendan to treatment decreases the regurgitant fraction (RF) in dogs with asymptomatic MVD. ANIMALS: Twenty-four client-owned dogs affected by International Small Animal Cardiac Health Council class Ib MVD. METHODS: Prospective, blinded, and controlled clinical trial. Dogs were assigned to a PIMO treatment group (n = 19) (0.2-0.3 mg/kg q12h) or a control group (n = 5). Echocardiographic evaluations were performed over a 6-month period. RESULTS: The addition of PIMO to treatment did not decrease the RF of dogs affected by asymptomatic class 1b MVD over the study period (P= .85). There was a significant increase in the ejection fraction of the PIMO treated dogs at 30 days (80.8 +/- 1.42 versus 69.0 +/- 2.76, corrected P= .0064), and a decrease in systolic left ventricular diameter (corrected P= .011) within the PIMO group compared with baseline. However, this improvement in systolic function was not sustained over the 6-month trial period. CONCLUSION AND CLINICAL IMPORTANCE: This study did not identify beneficial long-term changes in the severity of mitral regurgitation after addition of PIMO to angiotensin converting enzyme inhibitor treatment of dogs with asymptomatic MVD.