Physical activity in 22 African countries: results from the World Health Organization STEPwise approach to chronic disease risk factor surveillance.

BACKGROUND: Baseline physical activity data are needed to effectively plan programs and policies to prevent noncommunicable diseases, but for many African countries these data are lacking. PURPOSE: To describe and compare levels and patterns of physical activity among adults across 22 African countries. METHODS: Data from 57,038 individuals from 22 countries (11 national and 11 subnational samples) that participated in the STEPwise approach to chronic disease risk factor surveillance (2003-2009) were analyzed in 2010. The validated Global Physical Activity Questionnaire (GPAQ) was used to assess days and duration of physical activity at work, for transport, and during leisure time in a typical week. RESULTS: Overall, 83.8% of men and 75.7% of women met WHO physical activity recommendations (at least 150 minutes of moderate activity per week or equivalent). Country prevalence ranged from 46.8% (Mali) to 96.0% (Mozambique). Physical activity, both at work and for transport, including walking, had large contributions to overall physical activity, while physical activity during leisure time was rare in the analyzed countries. CONCLUSIONS: Physical activity levels varied greatly across African countries and population subgroups. Leisure time activity was consistently low. These data will be useful to inform policymakers and to guide interventions to promote physical activity.

Appropriateness of colonoscopy in Europe (EPAGE II). Surveillance after polypectomy and after resection of colorectal cancer.

BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for surveillance after polypectomy and after curative-intent resection of colorectal cancer (CRC), and report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II. METHODS: A systematic search of guidelines, systematic reviews and primary studies regarding the evaluation and management of surveillance colonoscopy after polypectomy and after resection of CRC was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy for these conditions. RESULTS: Most CRCs arise from adenomatous polyps. The characteristics of removed polyps, especially the distinction between low-risk adenomas (1 or 2, small [< 1 cm], tubular, no high-grade dysplasia) vs. high-risk adenomas (large [> or = 1 cm], multiple [> 3], high-grade dysplasia or villous features), have an impact on advanced adenoma recurrence. Most guidelines recommend a 3-year follow-up colonoscopy for high-risk adenomas and a 5-year colonoscopy for low-risk adenomas. Despite the lack of evidence to support or refute any survival benefit for follow-up colonoscopy after curative-intent CRC resection, surveillance colonoscopy is recommended by most guidelines. The timing of the first surveillance colonoscopy differs. The expert panel considered that 56 % of the clinical indications for colonoscopy for surveillance after polypectomy were appropriate. For surveillance after CRC resection, it considered colonoscopy appropriate 1 year after resection. CONCLUSIONS: Colonoscopy is recommended as a first-choice procedure for surveillance after polypectomy by all published guidelines and by the EPAGE II criteria. Despite the limitations of the published studies, colonoscopy is also recommended by most of the guidelines and by EPAGE II criteria for surveillance after curative-intent CRC resection.

Phase I and phase II xenobiotic reactions and metabolism of the food-borne carcinogen 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline in aggregating liver cell cultures.

Aggregating fetal liver cell cultures were tested for their ability to metabolize xenobiotics using ethoxycoumarin-O-deethylase (ECOD), as marker of phase I metabolism, and glutathione S-transferase (GST), as marker for phase II reactions. Significant basal activities, stable over 14 days in culture were measured for both ECOD and GST activities. The prototype cytochrome P450 inducers, 3-methylcholanthrene (3-MC) and phenobarbital (PB), increased ECOD and GST activities reaching an optimum 7 days after culturing, followed by a decline in activity. This decline was partially prevented by 1% dimethyl sulfoxide (DMSO) added chronically to the culture medium. DMSO was also found to induce ECOD activity and to a lesser extent GST activity. Furthermore, it potentiated in a dose-dependent manner the induction of ECOD by PB. The food-borne carcinogen 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) is metabolically transformed through a number of pathways in vivo. It was therefore used to examine the metabolic capacity in fetal and adult liver cell aggregates. Metabolism of MeIQx was mainly through N2-conjugation, resulting in formation of the N2-glucuronide and sulfamate conjugates for non-induced fetal liver cells. These metabolites were also found in large amounts in non-induced adult liver cells. Low levels of cytochrome P450-mediated ring-hydroxylated metabolites were detected in both non-induced fetal and adult liver cells. After induction with arochlor (PCB) or 3-MC, the major pathway was ring-hydroxylation (cytochrome P450 dependent), followed by conjugation to beta-glucuronic or sulfuric acid. The presence of the glucuronide conjugate of N-hydroxy-MeIQx, a mutagenic metabolite, suggested an induction of P450 CYP1A2. The metabolism of MeIQx by liver cell aggregates is very similar to that observed in vivo and suggests that aggregating liver cell cultures are a useful model for in vitro metabolic studies in toxicology.

Muscimol-induced death of GABAergic neurons in rat brain aggregating cell cultures.

During brain development, spontaneous neuronal activity has been shown to play a crucial role in the maturation of neuronal circuitries. Activity-related signals may cause selective neuronal cell death and/or rearrangement of neuronal connectivity. To study the effects of sustained inhibitory activity on developing inhibitory (GABAergic) neurons, three-dimensional primary cell cultures of fetal rat telencephalon were used. In relatively immature cultures, muscimol (10 microns), a GABAA receptor agonist, induced a transient increase in apoptotic cell death, as evidenced by a cycloheximide-sensitive increase of free nucleosomes and an increased frequency of DNA double strand breaks (TUNEL labeling). Furthermore, muscimol caused an irreversible reduction of glutamic acid decarboxylase activity, indicating a loss of GABAergic neurons. The muscimol-induced death of GABAergic neurons was attenuated by the GABAA receptor blockers bicuculline (100 microns) and picrotoxin (100 microns), by depolarizing potassium concentrations (30 mM KCl) and by the L-type calcium channel activator BAY K8644 (2 microns). As compared to the cholinergic marker (choline acetyltransferase activity), glutamic acid decarboxylase activity was significantly more affected by various agents known to inhibit neuronal activity, including tetrodotoxin (1 micron), flunarizine (5 microns), MK 801 (50 microns) and propofol (40 microns). The present results suggest that the survival of a subpopulation of immature GABAergic neurons is dependent on sustained neuronal activity and that these neurons may undergo apoptotic cell death in response to GABAA autoreceptor activation.

Exposition aux bioaérosols dans deux milieux professionnels : les cabinets de dentistes et les cultures de concombres et tomates

L'exposition aux bioaérosols (endotoxines, bactéries et spores de champignons en suspension dans l'air) et les problèmes de santé qui en découlent sont bien connus dans certains milieux professionnels (station d'épuration des eaux usées, élevages d'animaux, traitements des déchets organiques, travailleurs du bois, récolte et manutention des céréales, agriculture...). Cependant, les études avec investigations des concentrations aéroportées d'endotoxines et de micro-organismes se font très rares dans d'autres milieux professionnels à risque. Cette note d'actualité scientifique présente la synthèse de deux publications visant à quantifier les bioaérosols dans deux milieux professionnels rarement étudiés : les cabinets dentaires et les cultures maraîchères de concombres et tomates. Les dentistes ainsi que leurs assistants sont souvent bien informés sur les risques chimiques, les risques liés aux postures et les risques d'accidents avec exposition au sang. En revanche, le risque infectieux lié à une exposition aux bioaérosols est la plupart du temps méconnu. La flore bactérienne buccale est très riche et l'utilisation d'instruments tels que la fraise, le détartreur à ultrasons et le pistolet air-eau entraîne la dissémination aéroportée d'une grande quantité de bactéries. De plus, la conception des instruments générant un jet d'eau (diamètre des tubulures) favorise la formation de biofilm propice à l'adhérence et à la multiplication de micro-organismes à l'intérieur même des tuyaux. Ces micro-organismes se retrouvent alors en suspension dans l'air lors de l'utilisation de ces pistolets.L'inhalation de grandes quantités de ces micro-organismes pourrait alors engendrer des problèmes respiratoires (hypersensibilisation, asthme). De plus la présence de pathogènes, tels que les légionelles, les pseudomonas et les mycobactéries à croissance rapide, dans l'eau de ces unités dentaires peut aussi entraîner des risques infectieux pour les patients et pour les soignants. La production de tomates et concombres en Europe en 2008, était respectivement de 17 et 2 millions de tonnes dont 850 000 et 140 000 tonnes pour la France. La récolte, le tri et la mise en cageots ou en barquette individuelle de ces légumes génèrent de la poussière riche en matières organiques. Très peu d'études ont investigué l'exposition à ces poussières et aux endotoxines dans les serres de cultures intensives. Notamment, les données concernant les cultures de tomates sont inexistantes bien que ce légume soit un des plus cultivés en Europe. [Auteur]

Ultrastructural study of the TG180 murine sarcoma cell invasion by Toxoplasma gondii: comparison between in vivo and in vitro cell cultures

Infection of non-adherent TG180 murine sarcoma cells with Toxoplasma gondii was compared, at the ultrastructural level, in both in vivo and in vitro conditions. Suspensions of 3.0 x 10(6) TG180 cells infected in vitro with 1.0 x 10(6) parasites of the RH strain were harvested between the first and 6th day post-infection and processed for transmission electron microscopy. In vivo infection was made by intraperitoneal inoculation in mice of 1.0 x 10(6) TG180 cells, that were co-inoculated with a parasite suspension at the same cell concentration. Cells were harvested 10, 20, 30 min and 24, 48 h post-inoculation and processed for transmission electron microscopy at the same conditions of the in vitro culture. It was observed TG180 murine sarcoma cells with intense and equivalent intracellular parasitism in both conditions. Host cells with parasitophorous vacuoles containing up to 16 parasites, as well as parasites undergoing mitoses or presenting a bradyzoite-like morphology, were frequently seen in both culture methods.

Epidermal growth factor enhances the expression of an endogenous lectin in aggregating fetal brain cell cultures.

Aggregating cell cultures prepared from fetal rat telencephalon express the two subunits [cerebellar soluble lectins (CSL) 1 and 2] of a soluble, mannose-specific endogenous lectin (CSL) in a development-dependent manner. Increased CSL synthesis was found at an early postmitotic stage as well as during the period of maximal myelination. Repetitive treatment of early cultures with epidermal growth factor (EGF, 3nM) caused a great stimulation of CSL biosynthesis. Immunocytochemical studies revealed particularly intense CSL-specific staining in small, EGF-responsive cells, presumably glial cells. Large quantities of CSL-immunoreactive material were found also in the extracellular space and on the external side of the plasma membrane, indicating abundant release of CSL. The present findings suggest that EGF or EGF-related factors in the brain are able to regulate the expression of an endogenous lectin, affecting brain ontogeny.

Differential time to positivity of blood cultures: a valid method for diagnosing catheter-related bloodstream infections in the intensive care unit

iii. Catheter-related bloodstream infection (CR-BSI) diagnosis usually involves catheter withdrawal. An alternative method for CR-BSI diagnosis is the differential time to positivity (DTP) between peripheral and catheter hub blood cultures. This study aims to validate the DTP method in short-term catheters. The results show a low prevalence of CR-BSI in the sample (8.4%). The DTP method is a valid alternative for CR-BSI diagnosis in those cases with monomicrobial cultures (80% sensitivity, 99% specificity, 92% positive predictive value, and 98% negative predictive value) and a cut-off point of 17.7 hours for positivity of hub blood culture may assess in CR-BSI diagnosis.

Cultures jeunes et religions en Europe

Après la révolution religieuse des années 60, une nouvelle religiosité est-elle née ? Cette question est au coeur du livre. Il met, en effet, en scène les jeunes des années 80, les filles et les fils de la génération d'après-guerre, celle de Mai 68. Les parents ont pris leurs distances avec les différentes formes institutionnelles de l'autorité, y compris celle des Églises. Ils avaient été laissés libres de s'initier à une voie « spirituelle » : liberté de conscience et autonomie individuelle, deux valeurs clés attachées à la génération d'après-guerre, avaient orienté leur démarche religieuse. Les années 80 constituent de plus un contexte spécifique. Derrière le rideau de l'abondance, les contours de la précarité se dessinent. L'effondrement du mur de Berlin a entraîné celui des certitudes et des points de repère. L'apparition du sida a mis en cause le mythe dominant d'une jeunesse presque éternelle ouvrant sur une société sans âge et sans conflits de génération. Ces événements ont infléchi les quêtes de sens contemporaines. Fruit de la collaboration de vingt-deux sociologues venant de différents pays de l'Union européenne et de la Suisse, l'ouvrage, plutôt que de mettre côte à côte des observations empruntées aux pays concernés, propose des analyses transversales. Il permet ainsi de se faire une idée du changement religieux qui touche l'Europe dans son ensemble et de dégager quelques enjeux communs suscités par l'incertitude ambiante. Partant de l'analyse de la condition des jeunes dans les années 80, l'ouvrage aborde tour à tour la question de leur identité religieuse, celle de leurs systèmes de croyance, puis s'attarde sur les institutions qui ont contribué à leur socialisation religieuse. L'expérience constitue une caractéristique de la vie religieuse contemporaine, alors que la pluralité de l'offre reflète le changement socioculturel. Un chapitre est ainsi consacré à la présentation de quelques trajectoires typiques illustrant la gestion de l'incertitude dans laquelle est plongée la génération en cause. Enfin est abordée la question posée par une jeunesse qui apparaît aujourd'hui dépourvue d'encadrement institutionnel dans le champ religieux comme dans d'autres domaines : cette situation ne traduit-elle pas la crise de reproduction des institutions elles-mêmes ?

Aggregating brain cell cultures for neurotoxicological studies.

Because of the limited accessibility of the brain for experimentation, but also for ethical and economical reasons, there is considerable interest in culture models suitable for neurotoxicological research. Although it is generally accepted that in vitro models cannot cover the entire spectrum of brain functions, they have proven to be indispensable for investigations in the life sciences since the early work of Harrison (1). To date, many in vitro models of various complexity are available, ranging from monolayer cultures of immortalized cell lines to organotypic cultures. Each of these culture systems has its particularities, therefore, it is of great importance to select the model that is most appropriate for the question to be solved.

European Home and Leisure Accident Surveillance System report for Ireland 2001

EHLASS provides a harmonised approach throughout the EU to facilitate the analyses of intercountry differences in modes and distributions of home and leisure accidents. EHLASS contributes to the formulation of EU policies and initiatives on accidents and product safety. EHLASS is the only source of detailed information on home and leisure accidents in Ireland. Some general information is available through the Hospital In-Patient Enquiry (HIPE) system but this concentrates on medical diagnoses rather than on specific causes of accidents.This report is the eleventh national EHLASS report for Ireland. Download document here

New nonculture-based methods for the diagnosis of invasive candidiasis.

PURPOSE OF REVIEW: Invasive candidiasis is a severe infectious complication occurring mostly in onco-hematologic and surgical patients. Its conventional diagnosis is insensitive and often late, leading to a delayed treatment and a high mortality. The purpose of this article is to review recent contributions in the nonconventional diagnostic approaches of invasive candidiasis, both for the detection of the epidose and the characterization of the etiologic agent. RECENT FINDINGS: Antigen-based tests to detect invasive candidiasis comprise a specific test, mannan, as well as a nonspecific test, beta-D-glucan. Both have a moderate sensitivity and a high specificity, and cannot be recommended alone as a negative screening tool or a positive syndrome driven diagnostic tool. Molecular-based tests still have not reached the stage of rapid, easy to use, standardized tests ideally complementing blood culture at the time of blood sampling. New tests (fluorescence in-situ hybridization or mass spectrometry) significantly reduce the delay of identification of Candida at the species level in positive blood cultures, and should have a positive impact on earlier appropriate antifungal therapy and possibly on outcome. SUMMARY: Both antigen-based and molecular tests appear as promising new tools to complement and accelerate the conventional diagnosis of invasive candidiasis with an expected significant impact on earlier and more focused treatment and on prognosis.