[Environmental risk factors for schizophrenia: a review]. / Les facteurs de risque environnementaux de la schizophrénie.

BACKGROUND: Evidence of variations in schizophrenia incidence rates has been found in genetically homogenous populations, depending on changes within time or space of certain environmental characteristics. The consideration of the impact of environmental risk factors in etiopathogenic studies has put the environment in the forefront of research regarding psychotic illnesses. Various environmental factors such as urbanicity, migration, cannabis, childhood traumas, infectious agents, obstetrical complications and psychosocial factors have been associated with the risk of developing schizophrenia. These risk factors can be biological, physical, psychological as well as social and may operate at different times in an individual's life (fetal period, childhood, adolescence and early adulthood). Whilst some of these factors act on an individual level, others act on a populational level, modulating the individual risk. These factors can have a direct action on the development of schizophrenia, or on the other hand act as markers for directly implicated factors that have not yet been identified. LITERATURE FINDINGS: This article summarizes the current knowledge on this subject. An extensive literature search was conducted via the search engine Pubmed. Eight risk factors were selected and developed in the following paper: urbanicity (or living in an urban area), cannabis, migration (and ethnic density), obstetrical complications, seasonality of birth, infectious agents (and inflammatory responses), socio-demographic factors and childhood traumas. For each of these factors, we provide information on the importance of the risk, the vulnerability period, hypotheses made on the possible mechanisms behind the factors and the level of proof the current research offers (good, medium, or insufficient) according to the amount, type, quality and concordance of the studies at hand. Some factors, such as cannabis, are "unique" in their influence on the development of schizophrenia since it labels only one risk factor. Others, such as obstetrical complications, are grouped (or "composed") in that they include various sub-factors that can influence the development of schizophrenia. DISCUSSION: The data reviewed clearly demonstrates that environmental factors have an influence on the risk of developing schizophrenia. For certain factors - cannabis, migration, urbanicity, obstetrical complications, seasonality - there is enough evidence to establish an association with the risk of schizophrenia. This association, however, remains weak (especially for seasonality). With the exception of cannabis, no direct link can yet be established. Concerning the three remaining factors - childhood traumas, infectious agents, socio-demographic factors - the available proof is insufficient. One main limitation concerning all environmental factors is the generalization of results due to the fact that the studies were conducted on geographically limited populations. The current state of knowledge does not allow us to determine the mechanisms by which these factors may act. CONCLUSION: Further research is needed to fill the gaps in our understanding of the subject. In response to this need, a collaborative European project (European Study of Gene-Environment Interactions [EU GEI]) was set-up. This study proposes the analysis of those environmental factors that influence the incidence of schizophrenia in various European countries, in both rural and urban settings, migrant and native populations, as well as their interaction with genetic factors.

[Malnutrition risk assessment]. / Evaluation du risque de dénutrition.

Protein-energy malnutrition is most frequent in extremely frail elderly people. The malnutrition risk can be assessed through Mini nutritional assessment as well as clinical or biological parameters.

Genetic diversity and population structure in French populations of Mycosphaerella graminicola.

Mycosphaerella graminicola populations were examined in France with microsatellite markers and PCR-SSCP analysis of partial actin and ß-tubulin encoding sequences. A total of 363 isolates was sampled in 2005 from 17 provinces, and genotypes from corresponding strains were characterized. Unique haplotypes comprised 84% of the population, and gene diversity was high nationwide (0.70) and locally. A moderate genetic differentiation (G(ST) = 0.18) was found and indicated that in France the M. graminicola population was more structured than in other previously studied European countries. Bayesian structure analysis identified three genetic clusters distributed among the 17 provinces. Our results highlighted the potential for the adaptation of the fungus to local conditions, leading to genetic clusters among the French population of the fungus as well as genotype flow between regional clusters.

Mating type idiomorphs from a French population of the wheat pathogen Mycosphaerella graminicola: widespread equal distribution and low but distinct levels of molecular polymorphism.

Septoria tritici blotch caused by the heterothallic ascomycete Mycosphaerella graminicola is currently the most frequent and the most economically damaging disease on wheat worldwide. Five hundred and ten strains of this fungus were sampled from 16 geographical locations representing the major wheat producing areas in France. Multiplex PCR amplification, PCR-RFLP-SSCP screening and sequencing of parts of mating type encoding sequences were performed in order to assess the distribution and molecular polymorphism of the mating type idiomorphs. The two idiomorphs were scored at similar frequencies within all sampled locations. Both mating types were also identified at the leaf spatial scale, on 42% of leaves from which two or three strains were isolated. No correlation was found between distribution of mating types and either host cultivars from which the sampling was carried out or in vitro colony phenotypes observed during the culture of strains on potato dextrose agar (PDA) medium. PCR-RFLP-SSCP assay highlighted only one MAT1-1 strain exhibiting a profile distinct from all other MAT1-1 strains, whereas ten MAT1-2 strains (among which two and four with same profiles, respectively) showed profiles differing from the other MAT1-2 strains. Sequencing revealed that all polymorphisms corresponded to single nucleotide variations and all strains displaying the same single strand conformation polymorphism (SSCP) profiles showed identical nucleotide sequences, thereby confirming the high sensitivity of SSCP. Only two out of the disclosed nucleotide variations were nonsynonymous. This study strongly suggests a large potential for sexual reproduction in the French population of M. graminicola and reports a high conservation of mating type sequences in the fungus at both nucleotide and population levels, with a great difference in molecular variability between the two idiomorphs.

Distinct defenses induced in wheat against powdery mildew by acetylated and nonacetylated oligogalacturonides.

In wheat, little is known about disease resistance inducers and, more specifically, about the biological activities from those derived from endogenous elicitors, such as oligogalacturonides (OGAs). Therefore, we tested the ability of two fractions of OGAs, with polymerization degrees (DPs) of 2-25, to induce resistance to Blumeria graminis f. sp. tritici and defense responses in wheat. One fraction was unacetylated (OGAs-Ac) whereas the second one was 30% chemically acetylated (OGAs+Ac). Infection level was reduced to 57 and 58% relative to controls when OGAs-Ac and OGAs+Ac, respectively, were sprayed 48 h before inoculation. Activities of various defense-related enzymes were then assayed in noninoculated wheat leaves infiltrated with OGAs. Oxalate oxidase, peroxidase, and lipoxygenase were responsive to both OGAs-Ac and OGAs+Ac, which suggests involvement of reactive oxygen species and oxilipins in OGAs-mediated responses in wheat. In inoculated leaves, both fractions induced a similar increase in H2O2 accumulation at the site of fungal penetration. However, only OGAs+Ac led to an increase in papilla-associated fluorescence and to a reduction of formed fungal haustoria. Our work provides the first evidence for elicitation and protection effects of preventive treatments with OGAs in wheat and for new properties of acetylated OGAs.

Arbuscular mycorrhiza partially protect chicory roots against oxidative stress induced by two fungicides, fenpropimorph and fenhexamid.

The present work examined the oxidative stress induced by different concentrations (0.02 and 0.2 mg l-1) of two sterol biosynthesis inhibitor fungicides (fenpropimorph and fenhexamid) in non-target chicory root colonised or not by Glomus intraradices in a monoxenic system. The fungicides were found to cause oxidative damage by increasing lipid peroxidation measured by malondialdehyde production in non-colonised roots. Detoxification of the H(2)O(2) product was measured at 0.2 mg l-1 of fenpropimorph by an increase in peroxidase activities suggesting an antioxidant capacity in these roots. Moreover, this study pointed out the ability of arbuscular mycorrhiza to alleviate partially the oxidative stress in chicory roots, probably by lowering reactive oxygen species concentrations, resulting from increases in antioxidant defences. Our results suggest that the enhanced fungicide tolerance in the AM symbiosis could be related to less cell membrane damage.

Mycorrhization alleviates benzo[a]pyrene-induced oxidative stress in an in vitro chicory root model.

Among chemicals that are widely spread both in terrestrial and aquatic ecosystems, benzo[a]pyrene is a major source of concern. However, little is known about its adverse effects on plants, as well as about the role of mycorrhization in protection of plant grown in benzo[a]pyrene-polluted conditions. Hence, to contribute to a better understanding of the adverse effects of polycyclic aromatic hydrocarbons on the partners of mycorrhizal symbiotic association, benzo[a]pyrene-induced oxidative stress was studied in transformed Cichorium intybus roots grown in vitro and colonized or not by Glomus intraradices. The arbuscular mycorrhizal fungus development (colonization, extraradical hyphae length, and spore formation) was significantly reduced in response to increasing concentrations of benzo[a]pyrene (35-280 microM). The higher length of arbuscular mycorrhizal roots, compared to non-arbuscular mycorrhizal roots following benzo[a]pyrene exposure, pointed out a lower toxicity of benzo[a]pyrene in arbuscular mycorrhizal roots, thereby suggesting protection of the roots by mycorrhization. Accordingly, in benzo[a]pyrene-exposed arbuscular mycorrhizal roots, statistically significant decreases were observed in malondialdehyde concentration and 8-hydroxy-2'-desoxyguanosine formation. The higher superoxide dismutase activity detected in mycorrhizal chicory roots could explain the benzo[a]pyrene tolerance of the colonized roots. Taken together, these results support an essential role of mycorrhizal fungi in protecting plants submitted to polycyclic aromatic hydrocarbon, notably by reducing polycyclic aromatic hydrocarbon-induced oxidative stress damage.

Healthcare consumers' beliefs about medical malpractice lawsuits.

In the United States, malpractice tort reform has come to be regarded by many as a principal means of reducing the high costs of medical care. Despite growing popular sentiment for tort reform evidenced in public opinion polls and in earlier research, the authors wondered about the experiences and feelings that enhance this pro-malpractice-tort-reform position. The authors report the results of their comparative inquiry into consumers' beliefs that there are too many medical malpractice lawsuits. The authors analyze data derived from a nonprobability sample of consumer residents of West Virginia and of international residents of Houston, Texas, completed in 2007-2008. Only a small percentage (about 5%) of the consumer respondents reported having filed a medical malpractice claim. Of those who did file, about 70% agreed with the position that there are too many medical malpractice lawsuits filed each year. Consumers who reported that they did not feel that a lawsuit had much of an impact on a physician's practice or lifestyle were less inclined to also feel that too many medical malpractice lawsuits are filed. The authors also found evidence that feeling that there are too many medical malpractice lawsuits bore a weak, inverse relation to the belief that medical errors have been on the rise over the last 10 years.

Differential effects of fenpropimorph and fenhexamid, two sterol biosynthesis inhibitor fungicides, on arbuscular mycorrhizal development and sterol metabolism in carrot roots.

Sterols composition of transformed carrot roots incubated in presence of increasing concentrations of fenpropimorph (0.02; 0.2; 2mgl(-1)) and fenhexamid (0.02; 0.2; 2; 20mgl(-1)), colonized or not by Glomus intraradices was determined. In mycorrhizal roots treated with fenpropimorph, normal Delta(5)-sterols were replaced by unusual compounds such as 9beta,19-cyclopropylsterols (24-methylpollinastanol), Delta(8,14)-sterols (ergosta-8,14-dienol, stigmasta-8,14-dienol), Delta(8)-sterols (Delta(8) sitosterol) and Delta(7)-sterols (ergosta-7,22-dienol). After application of fenpropimorph, a drastic reduction of the mycorrhizal root growth, root colonization and extraradical fungal development was observed. Application of fenhexamid did not modify sterol profiles and the total colonization of roots. But the arbuscule frequency of the fungal partner was significantly affected. Comparison of the effects caused by the tested fungicides indicates that the usual phytosterols may be involved in symbiosis development. Indeed, observed modifications of root sterols composition could explain the high fenpropimorph toxicity to the AM symbiosis. However, the absence of sterolic modifications in the roots treated with fenhexamid could account for its more limited impact on mycorrhization.

Effects of two sterol biosynthesis inhibitor fungicides (fenpropimorph and fenhexamid) on the development of an arbuscular mycorrhizal fungus.

The effects of different concentrations (0.2, 2, 20, 200mgl(-1)) of two sterol biosynthesis inhibitor (SBI) fungicides, i.e. fenpropimorph and fenhexamid, were evaluated on the spore germination, germ tube elongation, sporulation, and root colonization of Glomus intraradices grown monoxenically in association with transformed carrot roots. The percentage of germinated spores incubated on the SBI fungicides and the length of the germ tubes decreased with increasing concentrations of both fungicides. However, for spore germination this impact was fungistatic rather than fungicidal. Extraradical mycelium architecture and spore production in contact with the SBI fungicides were also strongly impacted at high concentration (20mgl(-1)). Conversely, the colonization of roots developing in the fungicide-free compartment, but interconnected with the extraradical mycelium developing on the SBI fungicides, appeared unaffected. Our results demonstrated that the monoxenic culture system could be used as a standardized, reproducible technique to compare the impacts of different molecules on arbuscular mycorrhizal fungi, and for the initial screening of new candidate molecules before registration.

Iodus 40, salicylic acid, heptanoyl salicylic acid and trehalose exhibit different efficacies and defence targets during a wheat/powdery mildew interaction.

Prophylactic efficacies of Iodus 40 and salicylic acid (SA) against wheat powdery mildew caused by Blumeria graminis f. sp. tritici have been shown and compared with those of heptanoyl salicylic acid (HSA) and trehalose. Plantlets treated once exhibited 55%, 50%, 95%, and 38% protection levels, respectively. Two sprayings increased these levels up to 60%, 65%, 100%, and 60%, respectively. Biological effects of these resistance inducers on reactive oxygen species (ROS) metabolism and lipid peroxidation were also investigated. We found clear differences in the extent and the type of induced responses, with HSA exhibiting both the most numerous and the highest effects. HSA and SA induced a 5.5-fold increase of whole cell DAB staining due to hydrogen peroxide accumulation, whereas Iodus 40 and trehalose increased staining intensity at the penetration sites only. However, these effects were not correlated with any modification of catalase (CAT), oxalate oxidase (OXO) or lipoxygenase (LOX) activities, except for HSA which decreased CAT in non-inoculated conditions and increased LOX in infectious conditions. HSA also induced an increase in the rate of lipid peroxidation, whereas Iodus 40 induced a decrease. The effects of the inducers on germinating conidia and wheat epidermal cells responding to fungal penetration were also investigated. Papilla-linked autofluorescence was affected by SA and Iodus 40 whereas germination was slightly altered by Iodus 40. The newly described protective efficacies and the partial, distinct and non-overlapping activities of these inducers on the wheat/powdery mildew interaction are discussed.

Effect of the high polycyclic aromatic hydrocarbon, benzo[a]pyrene, on the lipid content of Fusarium solani.

The purpose of the present paper was to study the effect of the high polycyclic aromatic hydrocarbon (PAH), benzo[a]pyrene, on the lipid [fatty acid (FA) and sterol] composition and content of the fungi Fusarium solani and F. oxysporum, respectively recognized as good and poor PAH degraders. The major FAs and the major sterol that characterized the tested Fusarium strains were C16:0, C18:1, C18:2, and ergosterol. Lipid profiles of F. solani remained unchanged with the addition of benzo[a]pyrene in the culture media at all concentrations and duration of treatment. However, in the presence of benzo[a]pyrene, significant decreases in FA content, which reached 18% in young cultures and 28% in mature colonies, were registered. Similarly, the sterol content of F. solani was reduced by 27% in the presence of benzo[a]pyrene. In contrast, no modification in lipid profile and lipid content were observed with F. oxysporum, a strain recognized as a low benzo[a]pyrene degrader.

Inhibition of Blumeria graminis f. sp. tritici Germination and Partial Enhancement of Wheat Defenses by Milsana.

ABSTRACT The prophylactic efficiency of Milsana against powdery mildew was evaluated on wheat (Triticum aestivum). A single short spraying on 10-day-old plantlets reduced the infection level by 85% and two long sprayings led to the total restriction of the disease. Although microscopic studies showed that Milsana treatments enhance hydrogen peroxide accumulation at the fungal penetration site, biochemical analysis did not allow us to correlate this accumulation with the activation of several enzyme activities involved in active oxygen species (AOS) metabolism. Only lipoxygenase activity, which is involved in both AOS metabolism and lipid peroxidation, showed a 26 to 32% increase 48-h posttreatment in leaves infiltrated with Milsana. This weak effect of Milsana on wheat lipid metabolism was confirmed at the lipid peroxidation level, which surprisingly, was shown to decrease in treated plants. In order to explain the high efficacy of Milsana, the fungistatic effect on conidia germination was also examined. In planta, we showed that a Milsana treatment resulted in a higher proportion of abnormally long appressorial germ tubes, whereas in vitro, it dramatically inhibited fungal conidia germination. The partial activity of Milsana in terms of defense response induction in the wheat/powdery mildew pathosystem and its newly described direct fungistatic activity are discussed.

Leading the flock: organ donation feelings, beliefs, and intentions among African American clergy and community residents.

CONTEXT: Despite a considerable potential role in organ donation for African American clergy, there has been little investigation to date of the beliefs, attitudes, and personal intentions of such clergy regarding donation. OBJECTIVE: To compare the beliefs, attitudes, and behavioral intentions regarding organ donation among African American clergy to those of African American residents of the same large US city. DESIGN: Focus groups and 3 cross-sectional surveys. SETTING: Greater Houston, Tex, metropolitan area. PARTICIPANTS: A total of 761 randomly selected African American community residents and 311 African American clergy. MAIN OUTCOMES MEASURES: Beliefs about the importance of organ donation; how comfortable one is in thinking about donation; whether one believes that organ donation is against one's religion; trust in healthcare professionals regarding death declaration; concerns that donation leads to body mutilation; and the likelihood that one will donate one's own organs upon death. RESULTS: Compared to general African American residents, African American clergy in the Houston area were found more often to believe in the importance of donation; to be more comfortable with thinking about donation; to feel more certain that donation was not against their religion; to believe that they could trust healthcare professionals regarding death declaration; to feel less often that donation leads to mutilation of the body; and to indicate a greater likelihood of donating their own organs upon death. The same was found to be true among clergy and congregants of the largest religious denomination in Houston, the Baptists.

Polycyclic aromatic hydrocarbons storage by Fusarium solani in intracellular lipid vesicles.

Accumulation and elimination of polycyclic aromatic hydrocarbons (PAHs) were studied in the fungus Fusarium solani. When the fungus was grown on a synthetic medium containing benzo[a]pyrene, hyphae of F. solani contained numerous lipid vesicles which could be stained by the lipid-specific dyes: Sudan III and Rhodamine B. The fluorescence produced by Rhodamine B and PAH benzo[a]pyrene were at the same locations in the fungal hyphae, indicating that F. solani stored PAH in pre-existing lipid vesicles. A passive temperature-independent process is involved in the benzo[a]pyrene uptake and storage. Sodium azide, a cytochrome c oxidation inhibitor, and the two cytoskeleton inhibitors colchicine and cytochalasin did not prevent the transport and accumulation of PAH in lipid vesicles of F. solani hyphae. F. solani degraded a large range of PAHs at different rates. PAH intracellular storage in lipid vesicles was not necessarily accompanied by degradation and was common to numerous other fungi.

Increasing organ recovery from level I trauma centers: the in-house coordinator intervention.

PURPOSE: Daily presence of organ procurement organization staff in level I trauma centers combined with early family contact and interaction can increase donation rates. METHODS: A successful in-house coordinator program already in place at 2 level I trauma centers in Houston was replicated in 6 other level I trauma centers in New York City, Los Angeles, and Seattle. Organ procurement organization staff were placed inside the 8 trauma centers to provide early family support in potential donor situations and day-to-day donation system management. Comparison data were obtained on 83 level I trauma centers nationally. Data from 1999 to 2000 were compared with data from 2001 to 2002. RESULTS: Despite demographic differences, the 8 centers with in-house coordinators had higher consent rates (60% vs 53%) and conversion rates (55% vs 45%) than centers without them. Conversion of potential to actual donors was 22% higher in centers with in-house coordinators than in centers without them. Donation rates were affected by donor age, ethnicity, previous family discussion of donation, the family's initial reaction to the request (favorable, unfavorable, undecided), amount of time family spent with the in-house coordinator, presence of the in-house coordinator during explanation of brain death, whether the request was made at the same time as the brain-death explanation, and, in cases where donation was mentioned to the family before the formal request, who first mentioned donation to the family. CONCLUSIONS: In-house coordinators improve the donation process by interacting with families and staff earlier and more often during potential organ donations and improving donation systems through closer relationships with hospital staff.

Family discussion about organ donation among African Americans.

CONTEXT: Relatively little is known about family discussion concerning donation among African Americans in the United States, especially discussion predating the brain death of a family member and the donor request process. OBJECTIVES: To explore the inclination of African Americans to engage in family discussion about organ donation and the characteristics of those who expressed a desire to their families to donate their organs upon death. DESIGN: Focus groups and a cross-sectional survey. SETTING: A large metropolitan complex in Houston, Tex, with a relatively sizeable African American population. PARTICIPANTS: A total of 18 persons of African American background participated in 2 focus groups; 375 randomly selected African American residents were surveyed by questionnaire. MAIN OUTCOME MEASURE: Prodonation family discussion. RESULTS: Only 100% of subjects were found to be in the "action" (having had a prodonation discussion) or "maintenance" (having had a prodonation discussion and not inclined to alter one's wishes) stages with regard to family discussion. These subjects were not found distinguished from others by age, gender, education, or frequency of religious attendance. They were, however, found differentiated from others by feelings of diffuse support for donation, knowledge of donation, having read or heard a lot about donation, and by the belief that organ donation was not against one's religion-when these variables were individually considered. Yet, when these variables were simultaneously considered in a multivariate discriminant function analysis, diffuse support for donation no longer distinguished those in the action/maintenance stage from other subjects.

Location of in-house organ procurement organization staff in level I trauma centers increases conversion of potential donors to actual donors.

BACKGROUND: Of 5810 acute care hospitals in the United States, only 3.9% (231) are Level 1 Trauma Centers (L1TCs). L1TCs have a significant number of potential organ donors (PODs). Placement of Organ Procurement Organization (OPO) staff, In House Coordinators (IHCs), directly within the L1TC to increase the number of families who consent to donate and to provide system management for the trauma center's donation program, was evaluated. METHODS: Four OPO staff, IHCs, were placed in offices inside two L1TCs in Houston, Texas. The IHCs were responsible for development of a donation system, donor surveillance, management, and most importantly, family support. RESULTS: Calendar year 2000 data on conversion of PODs to actual donors were compared between the L1TCs with IHCs (IHC-L1TC) (n=2) and trauma centers without IHCs (n=4) within the OPO's service area. IHC-L1TCs converted 44% more of the PODs to actual donors. Furthermore, the IHC-L1TCs were compared with 85 L1TCs (37% of U.S. L1TCs) without IHCs. IHC-L1TCs had a 28% greater donor consent rate and a 48% greater conversion rate of PODs to actual donors than the national L1TCs. CONCLUSIONS: L1TC status is the America College of Surgeons' highest level of verification for trauma care. To be certified as a L1TC, hospitals must meet strict criteria in both services and patient care. The donation process is often profoundly affected by the burden of demands made on the resources of these institutions and from divergent responsibilities between specialty services within the facility. Dedicated IHCs (OPO staff) are needed to provide early family intervention and to orchestrate the donation process to maximize organ recovery.