Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial.

OBJECTIVE: To determine the subjective response to iron therapy in non-anaemic women with unexplained fatigue. DESIGN: Double blind randomised placebo controlled trial. SETTING: Academic primary care centre and eight general practices in western Switzerland. PARTICIPANTS: 144 women aged 18 to 55, assigned to either oral ferrous sulphate (80 mg/day of elemental iron daily; n=75) or placebo (n=69) for four weeks. MAIN OUTCOME MEASURES: Level of fatigue, measured by a 10 point visual analogue scale. RESULTS: 136 (94%) women completed the study. Most had a low serum ferritin concentration; <or= 20 microg/l in 69 (51%) women. Mean age, haemoglobin concentration, serum ferritin concentration, level of fatigue, depression, and anxiety were similar in both groups at baseline. Both groups were also similar for compliance and dropout rates. The level of fatigue after one month decreased by -1.82/6.37 points (29%) in the iron group compared with -0.85/6.46 points (13%) in the placebo group (difference 0.95 points, 95% confidence interval 0.32 to 1.62; P=0.004). Subgroups analysis showed that only women with ferritin concentrations <or= 50 microg/l improved with oral supplementation. CONCLUSION: Non-anaemic women with unexplained fatigue may benefit from iron supplementation. The effect may be restricted to women with low or borderline serum ferritin concentrations.

Uncontrollable hypertension in patients on hemodialysis: long-term treatment with captopril and salt subtraction

It has been suggested that an inappropriate relationship between renin and exchangeable sodium is responsible for the hypertension of patients with chronic renal failure. Long-term blockade of the renin system by captopril made it possible to test this hypothesis in 8 patients on maintenance hemodialysis. Captopril was administered orally in 2 daily doses of 25 to 200 mg. Previously, blood pressure averaged 179/105 +/- 6/3 (mean +/- SEM) pre- and 182/103 +/- 7/3 mm HG post-dialysis, despite intensive ultrafiltration and conventional antihypertensive therapy. The 4 patients with the highest plasma renin activity normalized their blood pressure with captopril alone, whereas in the 4 remaining patients, captopril therapy was complemented by salt subtraction which consisted in replacement of 1-2 liters of ultrafiltrate by an equal volume of 5% dextrose until blood pressure was controlled. After an average treatment period of 5 months, blood pressure of all 8 patients was reduced to 134/76 +/- 7/5 mm Hg (P less than 0.001) pre- and 144/81 +/- 9/5 mm Hg (P less than 0.001) post-dialysis without a significant change in body weight. The present data suggest that captopril alone or combined with salt subtraction normalizes blood pressure of patients on chronic hemodialysis with so called uncontrollable hypertension.

Circulating microRNAs as long-term biomarkers for the detection of erythropoiesis-stimulating agent abuse.

MicroRNAs (miRNAs) are small, non-protein coding transcripts involved in many cellular and physiological mechanisms. Recently, a new class of miRNA called 'circulating miRNAs' was found in cell-free body fluids such as plasma and urine. Circulating miRNAs have been shown to be very stable, specific, and sensitive biomarkers. In this paper, we investigate whether circulating miRNAs can serve as biomarkers for erythropoiesis-stimulating agent abuse. To this end, we analyzed miRNA levels in plasma by miRNA microarrays and quantitative real-time polymerase chain reaction (PCR). Plasma samples are derived from a clinical study with healthy subjects injected with erythropoiesis-stimulating agent (C.E.R.A.). Based on microarray results, we observed a significant difference in the levels of miRNAs in plasma after C.E.R.A. injection. We demonstrated that a specific miRNA, miR-144, exhibit a high increase that lasts 27 days after C.E.R.A. stimulation. Considering the fact that miR-144 is an essential erythropoiesis agent in different organisms, these findings suggest the possibility of using miR-144 as a sensitive and informative biomarker to detect C.E.R.A. abuse. Copyright © 2011 John Wiley & Sons, Ltd.

Dihydroaeruginoic acid synthetase and pyochelin synthetase, products of the pchEF genes, are induced by extracellular pyochelin in Pseudomonas aeruginosa.

The siderophore pyochelin of Pseudomonas aeruginosa is derived from one molecule of salicylate and two molecules of cysteine. Two cotranscribed genes, pchEF, encoding peptide synthetases have been identified and characterized. pchE was required for the conversion of salicylate to dihydroaeruginoate (Dha), the condensation product of salicylate and one cysteine residue and pchF was essential for the synthesis of pyochelin from Dha. The deduced PchE (156 kDa) and PchF (197 kDa) proteins had adenylation, thiolation and condensation/cyclization motifs arranged as modules which are typical of those peptide synthetases forming thiazoline rings. The pchEF genes were coregulated with the pchDCBA operon, which provides enzymes for the synthesis (PchBA) and activation (PchD) of salicylate as well as a putative thioesterase (PchC). Expression of a translational pchE'-'lacZ fusion was strictly dependent on the PchR regulator and was induced by extracellular pyochelin, the end product of the pathway. Iron replete conditions led to Fur (ferric uptake regulator)-dependent repression of the pchE'-'lacZ fusion. A translational pchD'-'lacZ fusion was also positively regulated by PchR and pyochelin and repressed by Fur and iron. Thus, autoinduction by pyochelin (or ferric pyochelin) and repression by iron ensure a sensitive control of the pyochelin pathway in P. aeruginosa.

Calibration of surface contamination monitors for the detection of iodine incorporation in the thyroid gland.

In Switzerland, individuals exposed to the risk of activity intake are required to perform regular monitoring. Monitoring consists in a screening measurement and is meant to be performed using commonly available laboratory instruments. More particularly, iodine intake is measured using a surface contamination monitor. The goal of the present paper is to report the calibration method developed for thyroid screening instruments. It consists of measuring the instrument response to a known activity located in the thyroid gland of a standard neck phantom. One issue of this procedure remains that the iodine radioisotopes have a short half-life. Therefore, the adequacy and limitations to simulate the short-lived radionuclides with so-called mock radionuclides of longer half-life were also evaluated. In light of the results, it has been decided to use only the appropriate iodine sources to perform the calibration.

Traduir la Terra Mitjana: la traducció de referents culturals i jocs de paraules en "El Senyor dels anells"

RESUM: En aquest treball de recerca s’han analitzat els referents culturals i els jocs de paraules que apareixen en l’obra El senyor dels anells. Com a reflexió inicial em baso en la hipòtesi que la caracterització de hòbbits, ents i homes, tres races que apareixen en la Terra Mitjana, el món secundari creat per Tolkien, es nodreix, a banda d’altres elements, de jocs de paraules i referents culturals britànics. És fonamental que aquesta afirmació sigui tinguda en compte en l’acte de traducció per respectar la intenció de J. R. R. Tolkien, que en aquesta obra buscava també la creació d’una mitologia britànica versemblant, com si de veritat la Terra Mitjana hagués constituït el passat real del nostre planeta amb els avantpassats britànics com a protagonistes. La composició d’aquest estudi es divideix en: (1) característiques de la literatura fantàstica; (2) aspectes relacionats amb l’autor des de dues vessants: l’una com a acadèmic i l’altra com a escriptor i creador; (3) teoria de la traducció de referents culturals i de jocs de paraules; i (4) corpus de 144 termes extrets del text de sortida analitzats i traduïts a partir de fitxes de traducció. Puc concloure que s’ha demostrat la hipòtesi que em plantejava: els referents culturals i els jocs de paraules són recursos actius en El senyor dels anells i una bona anàlisi d’aquests camps és pertinent per comprendre la magnitud de l’imaginari de J. R. R. Tolkien i realitzar una traducció respectuosa amb la intencionalitat de l’autor. El senyor dels anells és una fairy-story, una obra de fantasia, una fugida de la realitat consensuada (Tolkien no s’amaga d’aquesta fugida i la veu positiva) en què els elements propis del món primari (la cultura britànica i comunitats antigues com l’anglosaxona, la celta o l’escandinava) i del món secundari (els personatges que habiten la Terra Mitjana en el marc temporal de la Tercera Edat) funcionen d’acord amb els principis dels dos móns. Considero que el procés seguit tant en la metodologia, com en l’elaboració dels continguts, com en la traducció dels termes analitzats a través de les fitxes és positiu i útil. Aquesta sistematització del procés i el resultat final poden ser rellevants per a la comunitat traductora, tant per al futur traductor com per al professional.

Extremity and eye lens doses in interventional radiology and cardiology procedures: first results of the ORAMED project.

The main objective of WP1 of the ORAMED (Optimization of RAdiation protection for MEDical staff) project is to obtain a set of standardised data on extremity and eye lens doses for staff in interventional radiology (IR) and cardiology (IC) and to optimise staff protection. A coordinated measurement program in different hospitals in Europe will help towards this direction. This study aims at analysing the first results of the measurement campaign performed in IR and IC procedures in 34 European hospitals. The highest doses were found for pacemakers, renal angioplasties and embolisations. Left finger and wrist seem to receive the highest extremity doses, while the highest eye lens doses are measured during embolisations. Finally, it was concluded that it is difficult to find a general correlation between kerma area product and extremity or eye lens doses.

Història natural dels pacients amb arteriopatia perifèrica

Introducció: Estudiar la història natural de la malaltia arterial perifèrica. Pacients i mètode: Registre observacional, multicèntric, prospectiu de pacients amb malaltia arterial perifèrica (FRENA) Resultats: Es registren 1205 pacients, 604 grau IIa de Fontaine; 336 grau IIb; 121 grau III i 144 grau IV. Durant el seguiment, 172 desenvolupen episodis isquèmics i 83 moren. En l’anàlisi multivariant pacients amb altres patologies, estadis III-IV, PAS&130mmHg i anticoagulats tenen risc de mort augmentat. Conclusions: Quan avança la malaltia augmenten episodis isquèmics i mortalitat. En l’estadi IIa, la incidència d’isquèmia crítica és com la d’infart de miocardi o d’ictus. Els pacients amb PAS &130mmHg tenen 3 vegades més risc de morir.

A 35.7 kb DNA fragment from the Bacillus subtilis chromosome containing a putative 12.3 kb operon involved in hexuronate catabolism and a perfectly symmetrical hypothetical catabolite-responsive element.

The Bacillus subtilis strain 168 chromosomal region extending from 109 degrees to 112 degrees has been sequenced. Among the 35 ORFs identified, cotT and rapA were the only genes that had been previously mapped and sequenced. Out of ten ORFs belonging to a single putative transcription unit, seven are probably involved in hexuronate catabolism. Their sequences are homologous to Escherichia coli genes exuT, uidB, uxaA, uxaB, uxaC, uxuA and uxuB, which are all required for the uptake of free D-glucuronate, D-galacturonate and beta-glucuronide, and their transformation into glyceraldehyde 3-phosphate and pyruvate via 2-keto-3-deoxygluconate. The remaining three ORFs encode two dehydrogenases and a transcriptional regulator. The operon is preceded by a putative catabolite-responsive element (CRE), located between a hypothetical promoter and the RBS of the first gene. This element, the longest and the only so far described that is fully symmetrical, consists of a 26 bp palindrome matching the theoretical B. subtilis CRE sequence. The remaining predicted amino acid sequences that share homologies with other proteins comprise: a cytochrome P-450, a glycosyltransferase, an ATP-binding cassette transporter, a protein similar to the formate dehydrogenase alpha-subunit (FdhA), protein similar to NADH dehydrogenases, and three homologues of polypeptides that have undefined functions.

Strategies of use of a specific immunoglobulin-rich egg yolk powder in weaning piglets

Two experiments were performed to determine the best strategy of use of the product TRACTcare® 4P (ITPSA) (TC, specific immunoglobulin-rich egg yolk powder within an energetic fatty acid matrix) in piglets from weaning and for 6 weeks, in diets without or with inclusion of antibiotics. Each trial was performed with 144 piglets in 24 pens, in a completely randomized design blocked by initial body weight. Feeds were formulated according to animal requirements in two periods. In the first trial no antibiotics were included in the feeds and no room disinfection from previous trial was performed; treatments were: 1) Negative control (NC); 2) NC+TC on top of the feed within the hopper for the first 3 days on trial (30 g/pig×day), and eventually if diarrhea appeared (TCOT); 3) NC+TC ad libitum provided in an extra hopper within the pen (TCAL); and 4) NC+TC at 5 g/kg added to the feed in the mixer (TC5). In the second trial, treatments were: 1) Positive control: basal diet that included 250 mg/kg amoxiciline (BD)+100 mg/kg colistine (AC); 2) BD+2 g/kg TC (TC2A); 3) BD+5 g/kg TC (TC5A); and 4) BD+8 g/kg TC (TC8A). In diets without antibiotics, the product TC at 5 g/kg in the feed numerically improved BW by 8% compared to Control animals, while G:F was almost identical between both groups. When antibiotics were used in the feed, replacement of colistin at 100 mg/kg for TC at 2 g/kg in feed numerically improved the performance compared to Positive control animals (for the whole trial period ADG 8% better: 390 g vs. 361 g; G:F 1% better: 0.748 kg/kg vs. 0.742 kg/kg), possibly due to the stimulation of feed consumption at weaning. In both trials, the lower number of dead and culled animals from TC5 and TC2A together with higher BW represented an advantage over Control treatments of 6% to 10% animals more and 15% to 17% total BW more at the end of the trial.

The cuticle : not only a barrier for plant defence: A novel defence syndrome in plants with cuticular defects.

The cuticle is a physical barrier that prevents water loss and protects against irradiation, xenobiotics and pathogens. This classic textbook statement has recently been revisited and several observations were made showing that this dogma falls short of being universally true. Both transgenic Arabidopsis thaliana lines expressing cell wall-targeted fungal cutinase (so-called CUTE plants) or lipase as well as several A. thaliana mutants with altered cuticular structure remained free of symptoms after an inoculation with Botrytis cinerea. The alterations in cuticular structure lead to the release of fungitoxic substances and changes in gene expression that form a multifactorial defence response. Several models to explain this syndrome are discussed.

Activité des services d'urgence dans le canton de Vaud: analyse rétrospective 2000-2010

[TABLE DES MATIERES] 1 Résumé des travaux effectues ( Méthode. - Résultats. - Conclusion). - 2 Introduction. - 3 But et objectifs. - 4 Contexte. - 5 Méthode (Type d'étude. - Bases de données consultées. - Base des missions engagées par la Centrale 144 Vaud (référencée sous « base 144 »). - Base des missions ambulancières effectuées sur territoire vaudois (référencée sous « base AMB »). - Base des missions SMUR effectuées par les SMUR du Canton de Vaud (référencée sous « base SMUR »). - Définitions et descriptions des variables. - Analyses statistiques). - 6 Résultats (Préambule - difficultés rencontrées. - Evaluation du processus d'enregistrement. - Couverture d'enregistrement des missions. - Evaluation de la qualité du remplissage des fiches de missions. - Indicateurs de l'activité des services d'urgence pré hospitalière terrestres - évolution sur la période 2000-2010. - APPELS AU 144. - Volume d'activité des ambulances et des SMUR. - Démographie de la population prise en charge par les ambulances et par les SMUR. - Types de missions ambulances et SMUR. - Chronologie des missions ambulances et SMUR. - Lieux de prise en charge et orientation des missions ambulances et SMUR. - Devenir immédiat des patients pris en charge par le SMUR. - Devenir a 48h des patients pris en charge par les SMUR). - 7 Suite des analyses (Etude de l'adéquation de l'utilisation des services d'urgence pré hospitalière. - Etude de l'adéquation des soins prodigués sur le lieu de la mission. - Etude de l'adéquation de la durée des interventions pour les prises en charges de maladies cardio-vasculaires et cérébro-vasculaires). - 8 Discussion. - conclusions. - propositions . - 9 Références