Variable phenotypic expressivity in a Swiss family with autosomal dominant retinitis pigmentosa due to a T494M mutation in the PRPF3 gene.

PURPOSE: To characterize the clinical, psychophysical, and electrophysiological phenotypes in a five-generation Swiss family with dominantly inherited retinitis pigmentosa caused by a T494M mutation in the Precursor mRNA-Processing factor 3 (PRPF3) gene, and to relate the phenotype to the underlying genetic mutation. METHODS: Eleven affected patients were ascertained for phenotypic and genotypic characterization. Ophthalmologic evaluations included color vision testing, Goldmann perimetry, and digital fundus photography. Some patients had autofluorescence imaging, Optical Coherence Tomography, and ISCEV-standard full-field electroretinography. All affected patients had genetic testing. RESULTS: The age of onset of night blindness and the severity of the progression of the disease varied between members of the family. Some patients reported early onset of night blindness at age three, with subsequent severe deterioration of visual acuity, which was 0.4 in the best eye after their fifties. The second group of patients had a later onset of night blindness, in the mid-twenties, with a milder disease progression and a visual acuity of 0.8 at age 70. Fundus autofluorescence imaging and electrophysiological and visual field abnormalities also showed some degree of varying phenotypes. The autofluorescence imaging showed a large high-density ring bilaterally. Myopia (range: -0.75 to -8) was found in 10/11 affected subjects. Fundus findings showed areas of atrophy along the arcades. A T494M change was found in exon 11 of the PRPF3 gene. The change segregates with the disease in the family. CONCLUSIONS: A mutation in the PRPF3 gene is rare compared to other genes causing autosomal dominant retinitis pigmentosa (ADRP). Although a T494M change has been reported, the family in our study is the first with variable expressivity. Mutations in the PRPF3 gene can cause a variable ADRP phenotype, unlike in the previously described Danish, English, and Japanese families. Our report, based on one of the largest affected pedigree, provides a better understanding as to the phenotype/genotype description of ADRP caused by a PRPF3 mutation.

Mémoire sur la position du fort des Bains et fort de la Garde au dessus de Pratz de Mouillou et sur les chemins qui y communique en partant du Boulou ou de l'Ecluse basse au dessous de Bellegarde

Ancien possesseur : Argenson, Antoine-René de Voyer (1722-1787 ; marquis de Paulmy d')

Talking to kids about prescription drug abuse, 2007

A brochure to assist parents and other care givers when talking about drug abuse as it relates to prescription drugs.

The type-species of Psilochlorops Duda (Diptera, Chloropidae) and its position in the phylogeny of the genus, with the description of a new species

The type-species of Psilochlorops Duda (Diptera, Chloropidae) and its position in the phylogeny of the genus, with the description of a new species. The genus Psilochlorops is known only for the Neotropical Region and had six described species to date. Psilochlorops niger sp. nov. is herein described and the male genitalia of P. clavitibia, the type-species of the genus, is described in detail. A new cladistic analysis of Psilochlorops is presented, including all known species of the genus.

Effects of hatching asynchrony on sibling negotiation, begging, jostling for position and within-brood food allocation in the barn owl Tyto alba

When siblings differ markedly in their need for food, they may benefit from signalling to each other their willingness to contest the next indivisible food item delivered by the parents. This sib-sib communication system, referred to as 'sibling negotiation', may allow them to adjust optimally to investment in begging. Using barn owl (Two alba) broods. I assessed the role of within-brood age hierarchy on sibling negotiation, and in turn on jostling for position where parents predictably deliver food (i.e. nest-box entrance), begging and within-brood food allocation. More specifically, I examined three predictions derived from a game-theoretical model of sibling negotiation where a senior and a junior sibling compete for food resources (Roulin, 2002a, Johnstone and Roulin, 2003): (1) begging effort invested by the senior sibling should be less sensitive to the junior sibling's negotiation than vice versa; (2) the junior should invest less effort in sibling negotiation than its senior sibling but a similar amount of effort in begging; and (3) within-brood food allocation should be directly related to begging but only indirectly to sibling negotiation. Two-chick broods were created and vocalization in the absence (negotiation signals directed to siblings) and presence (begging signals directed to parents) of parents was recorded. In support of the first prediction, juniors begged at a low cadence after their senior sibling negotiated intensely, probably because negotiation reflects prospective investment in begging and hence willingness to compete. In contrast, the begging of senior siblings was not sensitive to their junior sibling's negotiation. In contrast to the second prediction, juniors negotiated and begged more intensely than their senior sibling apparently because they were hungrier rather than younger. In line with the third prediction, juniors monopolized food delivered by their parents when their senior sibling begged at a low level. The begging cadence of both the junior and senior sibling, the junior's negotiation cadence, the difference in age between the two nest-mates and jostling for position were not associated with the likelihood of monopolizing food. In conclusion, sibling negotiation appears to influence begging behaviour, which, in turn, affects within-brood food allocation. Juniors may negotiate to challenge their senior siblings, and thereby determine whether seniors are less hungry before deciding to beg for food. In contrast, seniors may negotiate to deter juniors from begging.

Evaluation of the Adolescent Drug Abuse Diagnosis instrument in a Swiss sample of drug abusers.

OBJECTIVE: The aim of this study was to evaluate a French language version of the Adolescent Drug Abuse Diagnosis (ADAD) instrument in a Swiss sample of adolescent illicit drug and/or alcohol users. PARTICIPANTS AND SETTING: The participants in the study were 102 French-speaking adolescents aged 13-19 years who fitted the criteria of illicit drug or alcohol use (at least one substance--except tobacco--once a week during the last 3 months). They were recruited in hospitals, institutions and leisure places. Procedure. The ADAD was administered individually by trained psychologists. It was integrated into a broader protocol including alcohol and drug abuse DSM-IV diagnoses, the BDI-13 (Beck Depression Inventory), life events and treatment trajectories. RESULTS: The ADAD appears to show good inter-rater reliability; the subscales showed good internal coherence and the correlations between the composite scores and the severity ratings were moderate to high. Finally, the results confirmed good concurrent validity for three out of eight ADAD dimensions. CONCLUSIONS: The French language version of the ADAD appears to be an adequate instrument for assessing drug use and associated problems in adolescents. Despite its complexity, the instrument has acceptable validity, reliability and usefulness criteria, enabling international and transcultural comparisons.

FRAX(®) Clinical Task Force of the 2010 Joint International Society for Clinical Densitometry & International Osteoporosis Foundation Position Development Conference.

The World Health Organization fracture risk assessment tool, FRAX(®), is an advance in clinical care that can assist in clinical decision-making. However, with increasing clinical utilization, numerous questions have arisen regarding how to best estimate fracture risk in an individual patient. Recognizing the need to assist clinicians in optimal use of FRAX(®), the International Osteoporosis Foundation (IOF) in conjunction with the International Society for Clinical Densitometry (ISCD) assembled an international panel of experts that ultimately developed joint Official Positions of the ISCD and IOF advising clinicians regarding FRAX(®) usage. As part of the process, the charge of the FRAX(®) Clinical Task Force was to review and synthesize data surrounding a number of recognized clinical risk factors including rheumatoid arthritis, smoking, alcohol, prior fracture, falls, bone turnover markers and glucocorticoid use. This synthesis was presented to the expert panel and constitutes the data on which the subsequent Official Positions are predicated. A summary of the Clinical Task Force composition and charge is presented here.

Décubitus ventral et syndrome de détresse respiratoire aiguë de l'adulte: de la théorie à la pratique [Prone position mechanical ventilation in the Acute Respiratory Distress syndrome: theoretical and practical considerations].

Mortality of the acute respiratory distress syndrome (ARDS) remains extremely high and only few evidence-based specific treatments are currently available. Protective mechanical ventilation has emerged as the comer stone of the management of ARDS to avoid the occurrence of ventilation-induced lung injuries (VILI). Mechanical ventilation in the prone position has often been considered as a rescue therapy reserved to refractory hypoxemia. Since the publication of the PROSEVA study in 2013, early prone positioning for mechanical ventilation should be recommended to improve survival of patients with severe ARDS. In this article, both the theoretical and practical aspects of mechanical ventilation in prone position are reviewed.

A single-base substitution within an intronic repetitive element causes dominant retinitis pigmentosa with reduced penetrance.

We report the study of a large American family displaying autosomal dominant retinitis pigmentosa with reduced penetrance, a form of hereditary retinal degeneration. Although the inheritance pattern and previous linkage mapping pointed to the involvement of the PRPF31 gene, extensive screening of all its exons and their boundaries failed in the past to reveal any mutation. In this work, we sequenced the entire PRPF31 genomic region by both the classical Sanger method and ultrahigh throughput (UHT) sequencing. Among the many variants identified, a single-base substitution (c.1374+654C>G) located deep within intron 13 and inside a repetitive DNA element was common to all patients and obligate asymptomatic carriers. This change created a new splice donor site leading to the synthesis of two mutant PRPF31 isoforms, degraded by nonsense-mediated mRNA decay. As a consequence, amounts of PRPF31 mRNA derived from the mutant allele were very reduced, with no evidence of mutant proteins being synthesized. Our results indicate that c.1374+654C>G causes retinitis pigmentosa via haploinsufficiency, similar to the vast majority of PRPF31 mutations described so far. We discuss the potential of UHT sequencing technologies in mutation screening and the continued identification of pathogenic splicing mutations buried deep within intronic regions.

Dinámica espacio temporal en la ecología trófica de la anchoveta (Engraulis ringens Jenyns, 1842; pisces: engraulide) en el mar peruano

El objetivo de este trabajo es estudiar las variaciones ontogénicas, espaciales y nictemerales en la dieta de la anchoveta peruana (Engraulis ringens). El trabajo se basa en el análisis de contenido estomacal de 13 430 anchovetas (peces de 4 a 19,5 cm) muestreados durante 22 cruceros de investigación realizados a bordo de las embarcaciones científicas del Instituto del Mar del Perú durante el período 1996-2003. Previo a los análisis estadísticos la contribución de cada grupo de presa fue convertido a carbonó. Los datos fueron procesados por medio de estadística uni y multivariada en función de la talla de la anchoveta, la latitud, la distancia de la costa, la distancia del borde de la plataforma continental y el período nictemeral. Los resultados enseñan que la anchoveta se alimenta mayormente de zooplancton cualquier sea su tamaño o su distribución espaciotemporal. La anchoveta cambio gradualmente su dieta a lo largo de su ciclo de vida. Así, los individuos mas pequeños han ingerido mayormente copépodos calanoideos (68.0%) y eufausidos (23.3%), mientras que los individuos mas grandes ingirieron mayormente eufausidos (84.9%) y copépodos calanoideos (11.5%). Latitudinalmente, la mayor contribución de los copépodos calanoideos se observó en las zonas de afloramiento de Chicama y San Juan, con el 52.3% y 47.5%, respectivamente. Hasta los 160 km de distancia de la costa, no se ha observado un patrón regular en la contribución de las principales presas, mientras que por fuera, se insinúa un patrón caracterizado por el predominio de los eufausidos (>84%) y la menor contribución de copépodos calanoideos (<14,1%). En la plataforma continental los eufausidos contribuyeron con el 55.6% y los copépodos calanoideos con el 36.9%; mientras que por fuera de esa zona, los eufausidos se incrementaron al 75.3% y los copépodos calanoideos disminuyeron al 20.1%. Al considerar el período nictemeral, el ítem presa predominante durante el día fueron los eufausidos (52.7%) seguido de los copépodos calanoideos (40.9%); mientras que durante la noche, los eufausidos se incrementaron al 80.2% y los copépodos calanoideos disminuyeron al 15.7%. Estos resultados contradicen lo que se conocía acerca de la variabilidad de la dieta de la anchoveta, desestimándose: (i) que en el norte es fitoplanctívora y en el sur es zooplanctívora; (ii) que la fracción zooplanctónica es mayor en la zona oceánica. Asimismo, se ha demostrado que: (i) la anchoveta es principalmente zooplanctófaga durante su ciclo de vida, con modificaciones que corresponden a la mayor ingesta de presas pequeñas cuando son juveniles y de presas grandes cuando son adultas, (ii) en la zona de influencia de la plataforma continental consume aproximadamente el doble de copépodos calanoideos que en la zona oceánica, y aproximadamente una tercera parte menos de eufausidos en la zona interna que en la zona oceánica, y (iii) durante la noche y el día ingiere principalmente eufausidos pero la contribución de los copépodos calanoideos sube al 40%.

European society of hypertension position paper on ambulatory blood pressure monitoring.

Ambulatory blood pressure monitoring (ABPM) is being used increasingly in both clinical practice and hypertension research. Although there are many guidelines that emphasize the indications for ABPM, there is no comprehensive guideline dealing with all aspects of the technique. It was agreed at a consensus meeting on ABPM in Milan in 2011 that the 34 attendees should prepare a comprehensive position paper on the scientific evidence for ABPM.This position paper considers the historical background, the advantages and limitations of ABPM, the threshold levels for practice, and the cost-effectiveness of the technique. It examines the need for selecting an appropriate device, the accuracy of devices, the additional information and indices that ABPM devices may provide, and the software requirements.At a practical level, the paper details the requirements for using ABPM in clinical practice, editing considerations, the number of measurements required, and the circumstances, such as obesity and arrhythmias, when particular care needs to be taken when using ABPM.The clinical indications for ABPM, among which white-coat phenomena, masked hypertension, and nocturnal hypertension appear to be prominent, are outlined in detail along with special considerations that apply in certain clinical circumstances, such as childhood, the elderly and pregnancy, and in cardiovascular illness, examples being stroke and chronic renal disease, and the place of home measurement of blood pressure in relation to ABPM is appraised.The role of ABPM in research circumstances, such as pharmacological trials and in the prediction of outcome in epidemiological studies is examined and finally the implementation of ABPM in practice is considered in relation to the issue of reimbursement in different countries, the provision of the technique by primary care practices, hospital clinics and pharmacies, and the growing role of registries of ABPM in many countries.

D-3 2008-2 Dependent Adult Abuse Report, January - June 2009

D-3 Dependent Adult Abuse Report