« En fonction de la prise de Méthadone® maternelle peut-on prévoir l'outcome et l'adaptation néonatale, ainsi que la survenue d'un sevrage néonatal, sa durée et le développement à court terme de l'enfant ? »

Objectif : Abstract Le but de cette étude consiste à étudier un éventuel lien entre le dosage du traitement de substitution par la Méthadone® pendant la grossesse et les issues obstétricales (rupture prématurée des membranes, menace d'accouchement prématuré), ainsi que néonatales (telles que le retard de croissance intrautérin, l'adaptation néonatale, le sevrage néonatal aux opiacés et l'hypoglycémie néonatale). Nous évaluerons également le développement psychomoteur de l'enfant à court terme (jusqu'à 18 mois de vie) via l'échelle de Griffiths. Méthode : Il s'agit d'une étude rétrospective sur 50 femmes enceintes sous Méthadone® suivies au CHUV et ayant accouché entre les années 2000 et 2010, ainsi que sur leurs enfants suivis par l'Unité du Développement du CHUV et évalués moyennant l'échelle du développement psychomoteur appelée Griffiths (il s'agit de 26 enfants entre 6-9 mois et 20 entre 18-19 mois). Pour ce faire, nous avons parcouru les différentes archives du CHUV (informatiques et papiers) dans un premier temps. Ces données ont été ensuite saisies dans un tableau Excel avant d'être analysées via STATA. Résumé des résultats : En fonction du dosage de la Méthadone®, 27% (dose plus faible) à 47 % (dose plus élevée) des femmes de notre collectif accouchent prématurément (p = 0.139). 48 % de leurs nouveau-nés présentent un retard de croissance intra-utérin (RCIU). Ce risque est d'autant plus élevé que la Méthadone est faiblement dosée (p = 0.073). Inversement au RCIU, le risque d'hypoglycémie néonatale croît avec la dose maternelle de Méthadone® (p = 0.148). La survenue du syndrome de sevrage néonatal aux opiacés ainsi que sa durée sont significativement plus importantes lorsque le dosage maternel de Méthadone est élevé (p = 0.022 ; p = 0.0118) ou lors de la prise concomitante de benzodiazépines (p = 0.004 ; p = 0.0129). La prise d'autres substances illicites a elle aussi tendance à prolonger le sevrage (p = 0.065). Entre 6-9 mois de vie, il y a plus de microcéphalie (périmètre crânien inférieur au P10) lorsque les enfants reçoivent une dose plus faible in utéro (p = 0.005). Le développement psychomoteur est quant à lui plus favorable lorsque le traitement de substitution est fortement dosé (p = 0.039) et que l'enfant vit chez sa mère biologique (p = 0.050) ou bénéficie d'un contact maternel régulier (p = 0.008). L'effet du dosage de la Méthadone® (p = 0.683) et du lieu de vie (p = 0.211) sur le développement psychomoteur ont néanmoins tendance à s'estomper entre 18-19 mois de vie. Conclusions : Bien qu'un traitement de substitution par la Méthadone hautement dosé augmente la survenue et la durée du syndrome de sevrage néonatal aux opiacés, il y a maintenant des indices pour un meilleur outcome de l'enfant lorsque la substitution est importante (moins de RCIU, de microcéphalie et un développement psychomoteur plus favorable). A propos de l'issue néonatale, tous les enfants nés de mères toxicodépendantes semblent être à risque d'hypoglycémie néonatale. Implications pratiques : Il serait désormais préférable d'augmenter les doses de substitution des futures mères toxicomanes d'autant plus lorsque celles-ci le réclament et tous leurs enfants devraient bénéficier d'une alimentation précoce et de contrôles glycémiques, même s'ils sont eutrophiques.

Validation of an instrument to evaluate quality of life in the aging population: WHOQOL-AGE.

BACKGROUND: There is a need for short, specific instruments that assess quality of life (QOL) adequately in the older adult population. The aims of the present study were to obtain evidence on the validity of the inferences that could be drawn from an instrument to measure QOL in the aging population (people 50+ years old), and to test its psychometric properties. METHODS: The instrument, WHOQOL-AGE, comprised 13 positive items, assessed on a five-point rating scale, and was administered to nationally representative samples (n = 9987) from Finland, Poland, and Spain. Cronbach's alpha was employed to assess internal consistency reliability, whereas the validity of the questionnaire was assessed by means of factor analysis, graded response model, Pearson's correlation coefficient and unpaired t-test. Normative values were calculated across countries and for different age groups. RESULTS: The satisfactory goodness-of-fit indices confirmed that the factorial structure of WHOQOL-AGE comprises two first-order factors. Cronbach's alpha was 0.88 for factor 1, and 0.84 for factor 2. Evidence supporting a global score was found with a second-order factor model, according to the goodness-of-fit indices: CFI = 0.93, TLI = 0.91, RMSEA = 0.073. Convergent validity was estimated at r = 0.75 and adequate discriminant validity was also found. Significant differences were found between healthy individuals (74.19 ± 13.21) and individuals with at least one chronic condition (64.29 ± 16.29), supporting adequate known-groups validity. CONCLUSIONS: WHOQOL-AGE has shown good psychometric properties in Finland, Poland, and Spain. Therefore, considerable support is provided to using the WHOQOL-AGE to measure QOL in older adults in these countries, and to compare the QOL of older and younger adults.

Spectrophotometric determination of nevirapine using tetrathiocyanatocobalt(II) ion as a reagent

A simple and rapid spectrophotometric method for the determination of nevirapine is described. The method is based on the reaction of nevirapine with tetrathiocyanatocobalt(II) ion in buffer of pH 4 to form the corresponding complex. Beer's law is obeyed in the range of 0.2 - 2.0 µg mL-1 for nevirapine. The optical parameters such as molar absorptivity, Sandell's sensitivity, detection limit and quantitation limit were found to be 1.16× 10(4) Lmol-1cm-1, 2.09 X 10-3 µg cm-2, 0.073 µg mL-1 and 0.222 µg mL-1 respectively. The optimum reaction conditions and other analytical parameters were evaluated. The statistical evaluation of the method was examined by determining intra-day and inter-day precision. The proposed method has been successfully applied for the determination of nevirapine in pharmaceutical formulations.

Sistema de reprodução em populações de Eschweilera ovata (Cambess.) Miers

O sistema de reprodução de duas populações de Eschweilera ovata foi quantificado por análise de isoenzimas em estrutura de progênies usando os modelos misto de reprodução e cruzamentos correlacionados. Desvios do modelo misto de reprodução foram evidenciados entre as freqüências alélicas dos óvulos e do pólen e pela heterogeneidade nas freqüências alélicas do pólen que fecundou as diferentes árvores. A taxa de cruzamento multilocos foi alta em ambas populações Camarugipe (t m =0,999±0,004) e Itaparica (t m=0,985±0,023). A alta variação na taxa de cruzamento individual (t variando de 0,320 a 1,000) indicou que a espécie não é auto-incompatível. Diferenças positivas e significativamente diferentes de zero foram detectadas entre a taxa de cruzamento multiloco e uniloco, indicando cruzamentos endogâmicos em ambas populações Camarugipe (t m-t s =0,066±0,014) e Itaparica (t m-t s =0,073±0,016) e possível estruturação genética espacial. Valores altos de cruzamentos biparentais foram detectados nas populações (Camarugipe, r p=0,577±0,088; Itaparica r p =0,423±0,070), demonstrando que as progênies são constituídas principalmente por misturas de meios-irmãos e irmãos-completos. O coeficiente de coancestria nas progênies de ambas as populações (Camarugipe, tetaxy=0,211; Itaparica tetaxy =0,191) foi superior ao esperado em progênies de meios irmãos (0,125). Os resultados foram discutidos sob a ótica de amostragens para melhoramento, conservação genética e coleta de sementes para recuperação ambiental.

L'Univers

1904/05/06 (Numéro 13200).

Biodigestão anaeróbia dos resíduos da produção avícola: cama de frangos e carcaças

O propósito deste trabalho foi avaliar a produção de biogás, bem como os potenciais de produção e a qualidade do biofertilizante obtido com a biodigestão anaeróbia dos resíduos cama de frangos e carcaças de aves pré-compostados. Para tanto, foram pré-compostados cama de frango e carcaças de aves mortas em uma composteira durante um período de 60 dias, período necessário para que ocorresse decomposição prévia das carcaças e assim fosse possível manipular o material para abastecer os biodigestores. Após este período, o material foi utilizado para abastecer os biodigestores batelada de campo com capacidade de 60 litros de material em fermentação. Para o processo de biodigestão anaeróbia, foram efetuadas análises dos teores de sólidos totais (ST), sólidos voláteis (SV), composição química do efluente, potenciais de produção, além do número mais provável (NMP) de coliformes totais e termotolerantes no afluente e efluente. Os potenciais médios de produção de biogás foram: 0,073; 0,152 e 0,141m³.kg-1 de material, SV e ST adicionados, respectivamente. Foram observadas reduções acima de 99% no NMP de coliformes totais e termotolerantes, sendo observado NMP de 3,7 x 10(5) g-1 no início e 7,45 x 10² g-1 no final.

Etelä-Savon pohjavesien hoidon toimenpideohjelma 2010-2015

Etelä-Savon pohjavesienhoidon toimenpideohjelmassa esitetyillä toimenpiteillä pyritään EU:n asettamaan tavoitteeseen pohjavesien hyvästä tilasta vuoteen 2015 mennessä. Tämän toimenpideohjelman tavoitteena on esittää ne keinot, joilla Etelä-Savon arvokkaat pohjavesivarat pysyisivät hyödyntämiskelpoisina myös tulevaisuudessa. Pohjavesien toimenpideohjelmissa on rajattu tarkasteltaviksi pohjavesiksi vain tärkeiden (luokka I) ja vedenhankintaan soveltuvien pohjavesialueiden (luokka II) vesi, vaikka pohjavettä on muuallakin maaperässä ja kallioperässä. Pohjavettä vaarantava ja muuttava toiminta näillä pohjavesialueilla on tunnistettu, pohjaveden tila on määritelty ja pohjaveden hyvän tilan saavuttamiseksi ja ylläpitämiseksi on esitetty toimenpiteet eri sektoreille (esim. asutus, teollisuus- ja yritystoiminta, maatalous jne.) kustannuksineen. Toimenpiteistä ja niiden kustannuksista on esitetty yhteenveto valtioneuvoston 10.12.2009 hyväksymissä Vuoksen ja Kymijoen-Suomenlahden vesienhoitoalueiden vesienhoitosuunnitelmissa. Tärkeimmät toimenpideohjelmassa esitettävät toimet pohjavesien hyvään tilaan saattamiseksi ovat seuraavat: pohjavesialueiden suojelusuunnitelmien laatiminen ja päivittäminen tarkempien pohjavesialuekohtaisten toimenpiteiden suunnittelemiseksi, uusien riskitoimintojen ohjaaminen pohjavesialueiden ulkopuolelle, pohjaveden kemiallisen ja määrällisen tilan seurannan lisääminen, tietoperustan lisääminen pohjavesialueiden sisäisestä rakenteesta, pilaantuneiden maa-alueiden ja pohjaveden sekä maa-ainesottoalueiden kunnostaminen, liikennealueiden pohjavesisuojausten rakentaminen, maatalouden erityisympäristötuen käyttö sekä valvonnan, neuvonnan ja koulutuksen lisääminen pohjavesiasioissa.

Avaliação do estado imune de mulheres em idade reprodutiva em relação ao vírus da rubéola

Objetivo: avaliar o estado imune de mulheres em idade reprodutiva, em relação ao vírus da rubéola. Métodos: foram analisadas alíquotas de soros de 2.243 mulheres na faixa etária dos 15 aos 45 anos (média de 26 anos), residentes na área urbana de Natal, RN, para avaliação do estado imune em relação ao vírus da rubéola. Do total das mulheres examinadas, 1.170 (52,1%) eram gestantes e 1.073 (47,9%) não-gestantes. Foi pesquisada a presença de anticorpos das classes IgM e IgG no soro de todas as pacientes, empregando-se a técnica de ELISA em fase sólida, revelada mediante fluorescência (ELFA). Resultados: do total das pacientes analisadas, 1.632 se apresentaram imunes e 611 se mostraram suscetíveis ao vírus da rubéola. Os índices médios de imunidade e de suscetibilidade observados nos 4 anos estudados foram 73,0 e 27,0% respectivamente. No grupo das mulheres consideradas suscetíveis, 14,5% não apresentaram qualquer sinal da presença de anticorpos contra o vírus da rubéola, 7,7% apresentaram anticorpos da classe IgM isoladamente e em 4,8% delas foi detectada a presença simultânea de anticorpos IgM e IgG. Conclusão: os achados revelaram que uma parcela significativa da população feminina de Natal, em idade reprodutiva, ainda se encontra suscetível ao vírus da rubéola, revelando a existência real de risco de infecção congênita por esse patógeno. Recomenda-se a vacinação seletiva dessas mulheres contra a rubéola, como forma segura de prevenir as manifestações relacionadas à síndrome de rubéola congênita.

Mode B ultrasonography and abdominal Doppler in crab-eating-foxes ( Cerdocyon thous )

Abstract: Annually hundreds of crab-eating foxes (Cerdocyon thous) are referred to rehabilitation centers and zoos in Brazil. The ultrasonographic study of wildlife species is an important tool for a non-invasive and accurate anatomical description and provides important information for wildlife veterinary care. The aim of the present study was to determine the characteristics of the main abdominal organs as well as the vascular indexes of the abdominal aorta and renal arteries of crab-eating foxes (Cerdocyon thous) using mode B ultrasonography and Doppler ultrasonography, respectively. Ultrasonographic features of the main abdominal organs were described and slight differences were noticed between ultrasound imaging of abdominal organs of crab-eating foxes and other species. The bladder presented wall thickness of 12±0.01mm, with three defined layers. Both, the right and left kidneys presented corticomedullary ratio of 1:1 and similarly to the adrenals and the liver, they were homogeneous and hypoechoic compared to the spleen. The spleen was homogeneous and hyperechoic compared to the kidneys. The stomach presented 3 to 5 peristaltic movements per minute, wall thickness of 39±0.05mm and lumen and mucosa with hyperechoic and hypoechoic features, respectively. Small and large intestines presented 2 to 3 peristaltic movements per minute, wall thickness of 34±0.03mm and three defined layers with hyperechogenic (submucosa and serosa) and hypoechogenic (muscular) features. Ovaries of the female crab-eating fox were hypoechoic compared to the spleen and with heterogeneous parenchyma due to the presence of 2x2mm ovarian follicles. Prostates of the six males were regular and with a well defined boundary, with a homogeneous and hyperechoic parenchyma compared to the spleen. Vascular indexes of the abdominal aorta (PSV: 25.60±0.32cm/s; EDV: 6.96±1.68cm/s; PI: 1.15±0.07 e RI: 0.73±0.07) and right (PSV: 23.08±3.34cm/s; EDV: 9.33±2.36cm/s; PI: 1.01±0.65 e RI: 0.65±0.16) and left renal arteries (PSV: 23.74±3.94cm/s; EDV: 9.07±3.02cm/s; PI: 1.04±0.31 e RI: 0.64±0.10) were determined. Thus, conventional and Doppler ultrasonographic imaging provides basic information that can be used as reference for the species as well for other wild canids and it is a precise and non-invasive method that can be safely used to evaluate and diagnose abdominal injuries in these patients.

Kälviä-Kruunupyy-Kokkola-Pedersöre-Pietarsaari-Luoto joukkoliikenteen laatukäytävä

Laatukäytävätyötä lähdettiin toteuttamaan aiempien Etelä-Pohjanmaan ELY-keskuksen toimivalta-alueella toteutettujen laatukäytäväselvityksen (Kurikka-Ilmajoki, Seinäjoki-Lapua), Kokkolan ja Pietarsaaren rakennemallitöiden ja alueella tehtyjen kehitysvyöhykeselvitysten pohjalta. Tarkastelutapaa laajennettiin työssä kysyntäpotentiaaliarvioilla, kysynnän synnyttämisen keinovalikoimalla ja liikennöitsijöiden näkemyksillä alueen joukkoliikennemarkkinoiden kehittämisestä. Kysyntäpotentiaaliarviot tehtiin suunnittelualueen taajamista ja pääreiteiltä (Vt 8 ja Rantatie 749). Nykyisin suunnittelualueen liikenne perustuu lähes täysin oppilaskuljetuksiin ja kaupunkien väliseen pikavuoroliikenteeseen. Päivittäisen työssäkäynnin näkökulmasta joukkoliikennepalvelut ovat toimivia ainoastaan joidenkin taajamien välillä, mutta työssäkäyntialueen kattavasta, työssäkäynnin mahdollistavasta joukkoliikennetarjonnasta ei voida puhua. Nopeiden työssäkäyntiyhteyksien ja tätä tukevan infrastruktuurin parantamiseksi selvitystyössä ehdotettiin joukkoliikenteen palvelutason parantamistoimenpiteiden keskittämistä valtatien 8 suuntaiselle käytävälle. Kysynnän lisäämiseen tähtääviä toimenpiteitä, kuten lippuvalikoiman monipuolistamista ja informaation selkeään parantamiseen tähtääviä toimenpiteitä ehdotettiin koko suunnittelualueelle. Riippuen toteutustapojen painotuksesta alueen kuntien ja ELY-keskuksen olisi panostettava alueen joukkoliikenteeseen lisää kymmenistä tuhansista aina satoihin tuhansiin euroihin vuositasolla tarjonta- ja kysyntätavoitteiden saavuttamiseksi. Etelä-Pohjanmaan ELY-keskus ilmoitti projektin aikana valmiuden lisäpanostuksiin, mikäli kunnat osallistuvat tasapuolisina kumppaneina oman alueensa liikenteen kehittämiseen.

Gentamicin-induced preconditioning of proximal tubular LLC-PK1 cells stimulates nitric oxide production but not the synthesis of heat shock protein

Nephrotoxicity is the main side effect of antibiotics such as gentamicin. Preconditioning has been reported to protect against injuries as ischemia/reperfusion. The objective of the present study was to determine the effect of preconditioning with gentamicin on LLC-PK1 cells. Preconditioning was induced in LLC-PK1 cells by 24-h exposure to 2.0 mM gentamicin (G/IU). After 4 or 15 days of preconditioning, cells were again exposed to gentamicin (2.0 mM) and compared to untreated control or G/IU cells. Necrosis and apoptosis were assessed by acridine orange and HOESCHT 33346. Nitric oxide (NO) and endothelin-1 were assessed by the Griess method and available kit. Heat shock proteins were analyzed by Western blotting. After 15 days of preconditioning, LLC-PK1 cells exhibited a significant decrease in necrosis (23.5 ± 4.3 to 6.5 ± 0.3%) and apoptosis (23.5 ± 4.3 to 6.5 ± 2.1%) and an increase in cell proliferation compared to G/IU. NO (0.177 ± 0.05 to 0.368 ± 0.073 µg/mg protein) and endothelin-1 (1.88 ± 0.47 to 2.75 ± 0.53 pg/mL) production significantly increased after 15 days of preconditioning compared to G/IU. No difference in inducible HSP 70, constitutive HSC 70 or HSP 90 synthesis in tubular cells was observed after preconditioning with gentamicin. The present data suggest that preconditioning with gentamicin has protective effects on proximal tubular cells, that involved NO synthesis but not reduction of endothelin-1 or production of HSP 70, HSC 70, or HSP 90. We conclude that preconditioning could be a useful tool to prevent the nephrotoxicity induced by gentamicin.

CHRNA5 polymorphism and susceptibility to lung cancer in a Chinese population

Polymorphisms in the nicotinic acetylcholine receptor subunit CHRNA5 gene have been associated with lung cancer positive susceptibility in European and American populations. In the present hospital-based, case-control study, we determined whether polymorphism in rs503464 of CHRNA5 is associated with lung cancer risk in Chinese individuals. A single nucleotide polymorphism in CHRNA5 rs503464, c.-166T>A (hereafter T>A), was identified using TaqMan-MGB probes with sequencing via PCR in 600 lung cancer cases and 600 healthy individuals. Genotype frequencies for rs503464 (T>A) were in Hardy-Weinberg equilibrium for the control population. However, genotype frequencies were significantly different between cases and controls (P < 0.05), while allele frequencies were not significantly different between groups. Compared to homozygous genotypes (TT or AA), the risk of lung cancer in those with the heterozygous genotype (TA) was significantly lower (OR = 0.611, 95%CI = 0.486-0.768, P = 0.001). Using genotype AA as a reference, the risk of lung cancer for those with genotype TA was increased 1.5 times (OR = 1.496, 95%CI = 1.120-1.997, P = 0.006). However, no difference in risk was observed between T allele carriers and A allele carriers (OR = 0.914, 95%CI = 0.779-1.073, P = 0.270). Stratification analysis showed that the protective effect of TA was more pronounced in those younger than 60 years, nonsmokers, or those without a family history of cancer, as well as in patients with adenocarcinoma or squamous cell carcinoma in clinical stages III or IV (P < 0.05). Therefore, the heterozygous genotype c.-166T>A at rs503464 of CHRNA5 may be associated with reduced risk of lung cancer, thus representing a susceptibility allele in Chinese individuals.

Aspirin plus calcium supplementation to prevent superimposed preeclampsia: a randomized trial

Preeclampsia is an important cause of maternal and perinatal morbidity and mortality. Previous studies have tested calcium supplementation and aspirin separately to reduce the incidence of preeclampsia but not the effects of combined supplementation. The objective of this study was to investigate the effectiveness of aspirin combined with calcium supplementation to prevent preeclampsia in women with chronic hypertension. A double-blind, placebo-controlled randomized clinical trial was carried out at the antenatal clinic of a large university hospital in São Paulo, SP, Brazil. A total of 49 women with chronic hypertension and abnormal uterine artery Doppler at 20-27 weeks gestation were randomly assigned to receive placebo (N = 26) or 100 mg aspirin plus 2 g calcium (N = 23) daily until delivery. The main outcome of this pilot study was development of superimposed preeclampsia. Secondary outcomes were fetal growth restriction and preterm birth. The rate of superimposed preeclampsia was 28.6% lower among women receiving aspirin plus calcium than in the placebo group (52.2 vs 73.1%, respectively, P=0.112). The rate of fetal growth restriction was reduced by 80.8% in the supplemented group (25 vs 4.8% in the placebo vs supplemented groups, respectively; P=0.073). The rate of preterm birth was 33.3% in both groups. The combined supplementation of aspirin and calcium starting at 20-27 weeks of gestation produced a nonsignificant decrease in the incidence of superimposed preeclampsia and fetal growth restriction in hypertensive women with abnormal uterine artery Doppler.