Combination of enteral and parenteral nutrition in intensive care patients: A new concept of optimization

Undernutrition is a widespread problem in intensive care unit and is associated with a worse clinical outcome. A state of negative energy balance increases stress catabolism and is associated with increased morbidity and mortality in ICU patients. Undernutrition-related increased morbidity is correlated with an increase in the length of hospital stay and health care costs. Enteral nutrition is the recommended feeding route in critically ill patients, but it is often insufficient to cover the nutritional needs. The initiation of supplemental parenteral nutrition, when enteral nutrition is insufficient, could optimize the nutritional therapy by preventing the onset of early energy deficiency, and thus, could allow to reduce morbidity, length of stay and costs, shorten recovery period and, finally, improve quality of life. (C) 2009 Elsevier Masson SAS. All rights reserved.

Precursor-product relationship between vitellogenin and the yolk proteins as derived from the complete sequence of a Xenopus vitellogenin gene.

In Xenopus laevis four estrogen-responsive genes are expressed simultaneously to produce vitellogenin, the precursor of the yolk proteins. One of these four genes, the gene A2, was sequenced completely, as well as cDNAs representing 75% of the coding region of the gene. From this data the exon-intron structure of the gene was established, revealing 35 exons that give a transcript of 5,619 bp without the poly A-tail. This A2 transcript encodes a vitellogenin of 1,807 amino acids, whose structure is discussed with respect to its function. At the nucleic acid as well as at the protein level no extensive homologies with any sequences other than vitellogenin were observed. Comparison of the amino acid sequence of the vitellogenin A2 molecule with biochemical data obtained from the different yolk proteins allowed us to localize the cleavage products on the vitellogenin precursor as follows: NH2 - lipovitellin I - phosvitin (or phosvette II - phosvette I) - lipovitellin II - COOH.

Mega Sporting Event Legacy : A Multifaceted Concept

L'héritage d'un grand événement sportif peut être perçu de multiples façons. On peut le voir comme positif ou négatif, tangible ou intangible, territorial ou personnel, intentionnel ou non, global ou local, à court ou long terme, lié au sport ou non, et aussi selon la perspective de ses différentes parties prenantes. En fait, il est bien plus approprié d'employer le terme d'héritages au pluriel qu'au singulier. Cet article donne une vue d'ensemble d'un concept souvent utilisé mais rarement défini - celui d'héritage (legacy en anglais) - en utilisant des exemples provenant des Jeux olympiques et des Jeux du Commonwealth, deux des plus grands événements sportifs multisports régulièrement organisés. Il conclue que l'héritage est pour l'essentiel un rêve à poursuivre plutôt qu'une certitude à atteindre pour ce qui concerne les grands événements sportifs.

What Price Salvation? The Exchange of Salvation goods between India and the West

Does Weber's notion of salvation goods, along with the connected one of the religious market, apply to the modern history of yoga? The case study chosen here (the yoga of Pattabhi Jois) clearly shows that these notions highlight many aspects of the expansion of yoga into a global market product. However, the notion of salvation goods resists the new hermeneutical situation of encounter and has to be adapted to the present situation of religious "patchwork". The notion of religious market lacks depth to describe the various understandings and appropriations of yoga in precise historical situations. Other aspects of the current global status of yoga may be highlighted by applying the concept of pilgrimage. La notion de bien de salut que nous lègue Max Weber et la notion de marché religieux qui en découle peuvent-elles s'appliquer à l'histoire moderne du yoga? L'étude de cas que nous consacrons au yoga de Pattabhi Jois montre que ces notions éclairent bien certains aspects de l'expansion du yoga en tant que produit d'un marché globalisé. Cependant la notion de bien de salut résiste à une réflexion de type herméneutique sur les processus de rencontres et doit être adaptée à la situation contemporaine, ou` les religions se présentent comme des ensembles composites. La notion de marché religieux ne permet pas d'expliquer les diverses compréhensions et appropriations du yoga dans des situations historiques précises. D'autres aspects de la situation du yoga sont mieux explicités si on prend le concept de pèlerinage comme point de référence.

Organisation des secours extrahospitaliers lors du sommet 2003 du G8: nouveau concept de poste médical mobile (PMM) [Prehospital medical care organization during the 2003 G8 summit: a new concept of Mobile Medical Squadrons (MMS)].

OBJECTIVE: The occurrence of the 2003 G8 summit in Evian and the threat of major civil riots or even terrorist attacks in the Swiss neighbourhood forced us to imagine a new system of rescue and medical care in case of numerous victims. Previous occurrences of the G8 in Europe or America have demonstrated the need of flexible and mobile structures, able to respond quickly to crowd movements, unlike the usual static structure of rescue systems designed for major accidents. METHODS: We developed a new concept of Mobile Medical Squadrons (MMS) consisting of several vehicles and medical care and rescue human resources. In our concept, each MMS consisted of 3 emergency doctors, 5 paramedics and 9 first-aid workers. They were designed to handle 15 patients, with a large autonomy in terms of rescue, medical care, evacuation and medical authority. The equipment included medical, resuscitation, simple decontamination, evacuation and communication materials. RESULTS: The MMS were dispatched four times during the G8 summit following civil riots. They took care of 12 injured patients. CONCLUSION: The concept of MMS as a reinforcement of the existing rescue and health care resources appears as a new flexible, a modular and useful concept for the medical management of collective prehospital emergency situations. Its use is suggested instead of the traditional static concept of rescue systems designed for major accidents.

Equine herpesvirus-2 E10 gene product, but not its cellular homologue, activates NF-kappaB transcription factor and c-Jun N-terminal kinase.

We have previously reported on the death effector domain containing E8 gene product from equine herpesvirus-2, designated FLICE inhibitory protein (v-FLIP), and on its cellular homologue, c-FLIP, which inhibit the activation of caspase-8 by death receptors. Here we report on the structure and function of the E10 gene product of equine herpesvirus-2, designated v-CARMEN, and on its cellular homologue, c-CARMEN, which contain a caspase-recruiting domain (CARD) motif. c-CARMEN is highly homologous to the viral protein in its N-terminal CARD motif but differs in its C-terminal extension. v-CARMEN and c-CARMEN interact directly in a CARD-dependent manner yet reveal different binding specificities toward members of the tumor necrosis factor receptor-associated factor (TRAF) family. v-CARMEN binds to TRAF6 and weakly to TRAF3 and, upon overexpression, potently induces the c-Jun N-terminal kinase (JNK), p38, and nuclear factor (NF)-kappaB transcriptional pathways. c-CARMEN or truncated versions thereof do not appear to induce JNK and NF-kappaB activation by themselves, nor do they affect the JNK and NF-kappaB activating potential of v-CARMEN. Thus, in contrast to the cellular homologue, v-CARMEN may have additional properties in its unique C terminus that allow for an autonomous activator effect on NF-kappaB and JNK. Through activation of NF-kappaB, v-CARMEN may regulate the expression of the cellular and viral genes important for viral replication.