309 resultados para Post-discharge
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In the vast majority of bottom-up proteomics studies, protein digestion is performed using only mammalian trypsin. Although it is clearly the best enzyme available, the sole use of trypsin rarely leads to complete sequence coverage, even for abundant proteins. It is commonly assumed that this is because many tryptic peptides are either too short or too long to be identified by RPLC-MS/MS. We show through in silico analysis that 20-30% of the total sequence of three proteomes (Schizosaccharomyces pombe, Saccharomyces cerevisiae, and Homo sapiens) is expected to be covered by Large post-Trypsin Peptides (LpTPs) with M(r) above 3000 Da. We then established size exclusion chromatography to fractionate complex yeast tryptic digests into pools of peptides based on size. We found that secondary digestion of LpTPs followed by LC-MS/MS analysis leads to a significant increase in identified proteins and a 32-50% relative increase in average sequence coverage compared to trypsin digestion alone. Application of the developed strategy to analyze the phosphoproteomes of S. pombe and of a human cell line identified a significant fraction of novel phosphosites. Overall our data indicate that specific targeting of LpTPs can complement standard bottom-up workflows to reveal a largely neglected portion of the proteome.
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A wealth of literature has provided evidence that reactive tissue at the site of CNS injury is rich in chondroitin sulfate proteoglycans which may contribute to the non-permissive nature of the CNS. We have recently demonstrated using a murine model of human brachial plexus injury that the chondroitin sulfate proteoglycans Neurocan and Brevican are differentially expressed by two subsets of astrocytes in the spinal cord dorsal root entry zone (DREZ) following dorsal root lesion (Beggah et al., Neuroscience 133: 749-762, 2005). However, direct evidence for a growth-inhibitory role of these proteoglycans in vivo is still lacking. We therefore performed dorsal root lesion (rhizotomy) in mice deficient in both Neurocan and Brevican. Rhizotomy in these animals resulted in no significant increase in the number of sensory fibres regenerating through the DREZ compared to genetically matched controls. Likewise, a conditioning peripheral nerve lesion prior to rhizotomy, which increases the intrinsic growth capacity of sensory neurons, enhanced growth to the same extent in transgenic and control mice, indicating that absence of these proteoglycans alone is not sufficient to further promote entry into the spinal cord. In contrast, when priming of the median nerve was performed at a clinically relevant time, i.e. 7 weeks post-rhizotomy, the growth of a subpopulation of sensory axons across the DREZ was facilitated in Neurocan/Brevican-deficient, but not in control animals. This demonstrates for the first time that (i) Neurocan and/or Brevican contribute to the non-permissive environment of the DREZ several weeks after lesion and that (ii) delayed stimulation of the growth program of sensory neurons can facilitate regeneration across the DREZ provided its growth-inhibitory properties are attenuated. Post-injury enhancement of the intrinsic growth capacity of sensory neurons combined with removal of inhibitory chondroitin sulfate proteoglycans may therefore help to restore sensory function and thus attenuate the chronic pain resulting from human brachial plexus injury.
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L'angio-CT post-mortem est un examen peu invasif qui permet d'investiguer le système vasculaire d'une manière détaillée impossible à obtenir lors d'une autopsie conventionnelle. Le groupe de recherche lausannois sur l'angio-CT a développé un protocole standardisé pour une technique appelée «angio-CT post-mortem en phases multiples», qui permet de réaliser des angio-CT de manière simple et d'améliorer le diagnostic radiologique. De plus, de nouveaux équipements incluant une pompe à perfusion, du matériel prêt à l'emploi et un produit de contraste spécifique ont été développés. L'angio-CT permet la détection d'une source d'hémorragie, d'une malformation du système vasculaire, de lésions d'artériosclérose, d'une occlusion d'un vaisseau et la visualisation de l'anatomie vasculaire.
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One third of all stroke survivors develop post-stroke depression (PSD). Depressive symptoms adversely affect rehabilitation and significantly increase risk of death in the post-stroke period. One of the theoretical views on the determinants of PSD focuses on psychosocial factors like disability and social support. Others emphasize biologic mechanisms such as disruption of biogenic amine neurotransmission and release of proinflammatory cytokines. The "lesion location" perspective attempts to establish a relationship between localization of stroke and occurrence of depression, but empirical results remain contradictory. These divergences are partly related to the fact that neuroimaging methods, unlike neuropathology, are not able to assess precisely the full extent of stroke-affected areas and do not specify the different types of vascular lesions. We provide here an overview of the known phenomenological profile and current pathogenic hypotheses of PSD and present neuropathological data challenging the classic "single-stroke"-based neuroanatomical model of PSD. We suggest that vascular burden due to the chronic accumulation of small macrovascular and microvascular lesions may be a crucial determinant of the development and evolution of PSD.
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L'imagerie est de plus en plus utilisée en médecine forensique. Actuellement, les connaissances nécessaires pour interpréter les images post mortem sont faibles et surtout celles concernant les artéfacts post mortem. Le moyen radiologique le plus utilisé en médecine légale est la tomodensitométrie multi-coupes (TDMC). Un de ses avantages est la détection de gaz dans le corps. Cette technique est utile au diagnostic d'embolie gazeuse mais sa très grande sensibilité rend visible du gaz présent même en petite quantité. Les premières expériences montrent que presque tous les corps scannés présentent du gaz surtout dans le système vasculaire. Pour cette raison, le médecin légiste est confronté à un nouveau problème : la distinction entre du gaz d'origine post-mortem et une embolie gazeuse vraie. Pour parvenir à cette distinction, il est essentiel d'étudier la distribution de ces gaz en post mortem. Aucune étude systématique n'a encore été réalisée à ce jour sur ce sujet.¦Nous avons étudié l'incidence et la distribution des gaz présents en post mortem dans les vaisseaux, dans les os, dans les tissus sous-cutanés, dans l'espace sous-dural ainsi que dans les cavités crânienne, thoracique et abdominale (82 sites au total) de manière à identifier les facteurs qui pourraient distinguer le gaz post-mortem artéfactuel d'une embolie gazeuse¦Les données TDMC de 119 cadavres ont été étudiées rétrospectivement. Les critères d'inclusion des sujets sont l'absence de lésion corporelle permettant la contamination avec l'air extérieur, et, la documentation du délai entre le moment du décès et celui du CT-scan (p.ex. rapport de police, protocole de réanimation ou témoin). La présence de gaz a été évaluée semi-quantitativement par deux radiologues et codifiée. La codification est la suivante : grade 0 = pas de gaz, grade 1 = une à quelques bulles d'air, grade 2 = structure partiellement remplie d'air, grade 3 = structure complètement remplie d'air.¦Soixante-quatre des 119 cadavres présentent du gaz (62,2%), et 56 (75,7%) ont montré du gaz dans le coeur. Du gaz a été détecté le plus fréquemment dans le parenchyme hépatique (40%); le coeur droit (ventricule 38%, atrium 35%), la veine cave inférieure (infra-rénale 30%, supra-rénale 26%), les veines sus-hépatiques (gauche 26%, moyenne 29%, droite 22 %), et les espaces du porte (29%). Nous avons constaté qu'une grande quantité de gaz liée à la putréfaction présente dans le coeur droit (grade 3) est associée à des collections de gaz dans le parenchyme hépatique (sensibilité = 100%, spécificité = 89,7%). Pour décrire nos résultats, nous avons construit une séquence d'animation qui illustre le processus de putréfaction et l'apparition des gaz à la TDMC post-mortem.¦Cette étude est la première à montrer que l'apparition post-mortem des gaz suit un modèle de distribution spécifique. L'association entre la présence de gaz intracardiaque et dans le parenchyme hépatique pourrait permettre de distinguer du gaz artéfactuel d'origine post-mortem d'une embolie gazeuse vraie. Cette étude fournit une clé pour le diagnostic de la mort due à une embolie gazeuse cardiaque sur la base d'une TDMC post-mortem.¦Abstract¦Purpose: We investigated the incidence and distribution of post-mortem gas detected with multidetector computed tomography (MDCT) to identify factors that could distinguish artifactual gas from cardiac air embolism.¦Material and Methods: MDCT data of 119 cadavers were retrospectively examined. Gas was semiquantitatively assessed in selected blood vessels, organs and body spaces (82 total sites).¦Results: Seventy-four of the 119 cadavers displayed gas (62.2%; CI 95% 52.8 to 70.9), and 56 (75.7%) displayed gas in the heart. Most gas was detected in the hepatic parenchyma (40%); right heart (38% ventricle, 35% atrium), inferior vena cava (30% infrarenally, 26% suprarenally), hepatic veins (26% left, 29% middle, 22% right), and portal spaces (29%). Male cadavers displayed gas more frequently than female cadavers. Gas was detected 5-84 h after death; therefore, the post-mortem interval could not reliably predict gas distribution (rho=0.719, p<0.0001). We found that a large amount of putrefaction-generated gas in the right heart was associated with aggregated gas bubbles in the hepatic parenchyma (sensitivity = 100%, specificity = 89.7%). In contrast, gas in the left heart (sensitivity = 41.7%, specificity = 100%) or in peri-umbilical subcutaneous tissues (sensitivity = 50%, specificity = 96.3%) could not predict gas due to putrefaction.¦Conclusion: This study is the first to show that the appearance of post-mortem gas follows a specific distribution pattern. An association between intracardiac gas and hepatic parenchymal gas could distinguish between post- mortem-generated gas and vital air embolism. We propose that this finding provides a key for diagnosing death due to cardiac air embolism.
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This prospective study was designed to identify abnormalities of energy expenditure and fuel utilization which distinguish post-obese women from never-obese controls. 24 moderately obese, postmenopausal, nondiabetic women with a familial predisposition to obesity underwent assessments of body composition, fasting and postprandial energy expenditure, and fuel utilization in the obese state and after weight loss (mean 12.9 kg) to a post-obese, normal-weight state. The post-obese women were compared with 24 never-obese women of comparable age and body composition. Four years later, without intervention, body weight was reassessed in both groups. Results indicated that all parameters measured in the post-obese women were similar to the never-obese controls: mean resting energy expenditure, thermic effect of food, and fasting and postprandial substrate oxidation and insulin-glucose patterns. Four years later, post-obese women regained a mean of 10.9 kg while control subjects remained lean (mean gain 1.7 kg) (P < 0.001 between groups). Neither energy expenditure nor fuel oxidation correlated with 4-yr weight changes, whereas self-reported physical inactivity was associated with greater weight regain. The data suggest that weight gain in obesity-prone women may be due to maladaptive responses to the environment, such as physical inactivity or excess energy intake, rather than to reduced energy requirements.
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Background and Objectives: (i) to assess the prevalence of PTSD in a psychiatric emergency setting by means of a diagnostic instrument and to compare it with PTSD-prevalence of a clinically evaluated, historical sample; and (ii) to assess psychiatric residents' perception of the systematic use of this diagnostic instrument. Methods: A consecutive sample of patients (N = 403) evaluated for a psychiatric emergency was assessed with the module J (PTSD) of the MINI, the historical sample (N = 350), assessed by chart review, consisted of consecutive patients of the same setting evaluated one year prior to the study period. Residents' perceptions were assessed by means of a focus group. Results: While in only 0.57% of the historical sample (N = 350) a diagnosis of PTSD was recorded, 20.3% (N = 64) of the patients assessed with the diagnostic instrument (N = 316) qualified for a diagnosis of PTSD. Higher prevalence rates were observed in refugees and those without legal residency status (50%); patients from countries with a recent history of war (47.1%); those with four (44.4%) or three psychiatric co-morbidities (35.3%); migrants (29.8%) and patients without professional income (25%). Residents felt that the systematic use of the tool was not adequate in the psychiatric emergency setting for various reasons (e.g.: not suitable for a first or single consultation, negative impact on the clinical evaluation). Conclusions: The study confirms that PTSD is underdiagnosed in the psychiatric emergency setting. To improve the situation, targeted screening or educational and institutional strategies are needed.
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Cytosolic acetyl-CoA is involved in the synthesis of a variety of compounds, including waxes, sterols and rubber, and is generated by the ATP citrate lyase (ACL). Plants over-expressing ACL were generated in an effort to understand the contribution of ACL activity to the carbon flux of acetyl-CoA to metabolic pathways occurring in the cytosol. Transgenic Arabidopsis plants synthesizing the polyester polyhydroxybutyrate (PHB) from cytosolic acetyl-CoA have reduced growth and wax content, consistent with a reduction in the availability of cytosolic acetyl-CoA to endogenous pathways. Increasing the ACL activity via the over-expression of the ACLA and ACLB subunits reversed the phenotypes associated with PHB synthesis while maintaining polymer synthesis. PHB production by itself was associated with an increase in ACL activity that occurred in the absence of changes in steady-state mRNA or protein level, indicating a post-translational regulation of ACL activity in response to sink strength. Over-expression of ACL in Arabidopsis was associated with a 30% increase in wax on stems, while over-expression of a chimeric homomeric ACL in the laticifer of roots of dandelion led to a four- and two-fold increase in rubber and triterpene content, respectively. Synthesis of PHB and over-expression of ACL also changed the amount of the cutin monomer octadecadien-1,18-dioic acid, revealing an unsuspected link between cytosolic acetyl-CoA and cutin biosynthesis. Together, these results reveal the complexity of ACL regulation and its central role in influencing the carbon flux to metabolic pathways using cytosolic acetyl-CoA, including wax and polyisoprenoids.
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Context: Cross-cultural clinical competence (CCC) requires a mixtureof "knowledge" (K), "attitude" (A) and "skills" (S), in order to develop theability to give quality care to patients of different cultures. Theseattributes allow, while providing medical care, consideration of thepatient's medical, social, cultural and language needs. The LausanneUniversity Medical Policlinic (PMU) provides approximately 30000consultations per year to migrant patients and over the past five yearshas implemented a training course on CCC that focuses on trialogue,stereotypes and administrative procedures for the healthcare ofmigrants.Method: A quantitative survey of 18 new residents, was carried outusing a validated questionnaire, the "Multicultural AssessmentQuestionnaire" (the MAQ, 16 questions on K, A and S) to evaluate theimpact of CCC training. The questionnaire was distributed before theCCC course (J-1), three days after (J+3) and three months later (J+90).A descriptive univariate analysis of the difference in MAQ scoresbetween the times J-1 - J+3 and J-1 - J+90 was made. Three FocusGroups were conducted, at three months, to explore residents' thoughtsabout the course.Results: A significant increase was observed in global performancedeclared by residents. Following the intervention, the score of the MAQincreased from 31.4 points to 38.0 points at three days (p = 0.004) andto 37.7 points at three months (p = 0.003). This increase was mostnoticeable in the field of acquiring K: total score J-1: 118, J+3: 189,J+90: 190 (difference J-1 - J+3 and J-1 - J+90: p <0.005). There was nosignificant difference in acquiring A (J-1: 222, J+3: 228, J+90: 229), andS increases in a significant way at first (J-1: 222, J+3: 265, J-1 - J+3:p = 0.035), then comes back to the start value (J+90: 217). The residentswere interested by the course which they felt provides useful informationfor clinical practice. They had a great number of expectations in varyingfields (medical anthropology, cultural differences, epidemiology, etc.),hoping a "ready-made" solution for the approach of migrant patients.Conclusions: A unique training of CCC at the post-graduate level,upgraded K, and to a lesser extent A and S, for these 18 residents. Theywere interest and they had many expectations. Subsequent coursesshould consolidate these acquisitions. Future study should demonstratethe impact on patients' clinical outcome.
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Introduction Exposure to hypoxia leads to several reactions of the organism, which try to compensate the reduced oxygen level in the blood. Acute response is characterized by an increase in pulmonary ventilation (Hypoxia Ventilatory Response, HVR) and in cardiac output (cardiac response to hypoxia). Heart rate (HR) at rest and during exercise is higher at high altitude than at sea level, whereas HRmax is lower. These cardiac adaptations are partially explained by an increased sympathetic stimulation associated with a reduced parasympathetic tone (12). The precise mechanisms of HRmax decline in acute hypoxia are however still to be identified, although several hypothesis have been suggested, such as a direct effect of hypoxia on the electrophysiological properties, an influence of skeletal maximal VO2 or a modulation of the autonomic nervous system (8). Some authors have reported that endurance trained athletes present an increased sensitivity to hypoxia shown by a large reduction in VO2max and an important decrease in arterial saturation. (9,11, 13) A hypoxia test can assess the sensibility of chemoreceptors to the reduction of oxygen by calculating hypoxic ventilatory and cardiac responses, knowing that low sensibility is correlated with poor acclimatization. Two parameters results from the differences in ventilation (and heart rate) divided by the difference in the arterial oxygen saturation between normoxia and hypoxia (18). Objective The hypothesis tested by this study is that parasympathetic reactivation after moderate effort in hypoxic condition can be used as a marker of individual sensibility to hypoxia. Parasympathetic reactivation is a marker of vagal tone that predict endurance capacity and aerobic fitness (2,7). Methods Subjects This study uses data obtained from two groups of athletes participating into two larger studies about adaptation to hypoxia. One group is composed of elite athletes (Swiss ski mountaineering team), the other one of mid-level athletes (ski mountaineering amateurs). The particularity of this target population is that they often train at high altitude, and therefore could show a better response to hypoxia than athleltes of other disciplines. Protocol The athletes performed a submaximal exercise (6min run at 9 km/h, flat) followed by 10 min of seated rest either in an hypoxic chamber (simulated altitude of 3000m) or in normoxic conditions. During the resting phase parasympathetic reactivation was assessed by beat-to-beat HR measurements.A test of tolerance to altitude was also performed. Analysis Parasympathetic reactivation, assessed by the calculation of the root mean square of successive differences in the R-R intervals (RMSSD)(4), is compared to individual responses at altitude, in order to appreciate the correlation between the two phenomena.
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BACKGROUND: The annotation of protein post-translational modifications (PTMs) is an important task of UniProtKB curators and, with continuing improvements in experimental methodology, an ever greater number of articles are being published on this topic. To help curators cope with this growing body of information we have developed a system which extracts information from the scientific literature for the most frequently annotated PTMs in UniProtKB. RESULTS: The procedure uses a pattern-matching and rule-based approach to extract sentences with information on the type and site of modification. A ranked list of protein candidates for the modification is also provided. For PTM extraction, precision varies from 57% to 94%, and recall from 75% to 95%, according to the type of modification. The procedure was used to track new publications on PTMs and to recover potential supporting evidence for phosphorylation sites annotated based on the results of large scale proteomics experiments. CONCLUSIONS: The information retrieval and extraction method we have developed in this study forms the basis of a simple tool for the manual curation of protein post-translational modifications in UniProtKB/Swiss-Prot. Our work demonstrates that even simple text-mining tools can be effectively adapted for database curation tasks, providing that a thorough understanding of the working process and requirements are first obtained. This system can be accessed at http://eagl.unige.ch/PTM/.