Impact de l’évolution du statut nutritionnel durant l’attente d’une transplantation pulmonaire sur la mortalité postopératoire

Cette étude vise à évaluer l’impact de l’état nutritionnel et de son évolution durant l’attente d’une transplantation pulmonaire sur la mortalité et la morbidité postopératoire. Nous avons examiné les 209 dossiers de patients greffés pulmonaires au Programme de Transplantation Pulmonaire du CHUM entre 2000 et 2007 et regardé la mortalité et les complications post-transplantation en fonction de l’IMC, des apports protéino-énergétiques, de certains paramètres biochimiques et selon l’évolution pondérale durant la période d’attente. Les résultats montrent que la mortalité augmente en fonction de l’augmentation des strates d’IMC avec un risque relatif de décès au cours du séjour hospitalier de 3,31 (IC95% 1,19-9,26) pour un IMC 25-29,9 et de 8,83 (IC95% 2,98-26,18) pour un IMC ≥ 30 avec une issue postopératoire plus sombre en terme de complications chirurgicales (p=0,003), de durée de séjour aux soins intensifs (p=0,031) et de durée de séjour à l’hôpital (p<0,001) chez les patients avec IMC ≥ 30 comparativement aux patients de poids normal. Les patients ayant présenté une évolution inadéquate de l’IMC durant la période d’attente ont connu une durée de séjour hospitalier prolongée (p=0,015). Ceux dont les apports nutritionnels étaient sous-optimaux en pré-greffe ont aussi connu une durée de séjour hospitalier prolongée (p=0,002) et davantage de complications infectieuses (p=0,038), digestives (p=0,003) et chirurgicales (p=0,029) mais sans impact détectable sur la mortalité. Nos résultats suggèrent que l’obésité et l’embonpoint ainsi qu’une évolution inadéquate de l’IMC durant la période d’attente de même que des apports protéino-énergétiques sous-optimaux affectent négativement l’issue d’une transplantation pulmonaire.

Synthèse du LiXFePO4 par voie fondue et l’étude de la couche de carbone sur LiFePO4

Le LiFePO4 est un matériau prometteur pour les cathodes des batteries au lithium. Il possède une bonne stabilité à haute température et les précurseurs utilisés pour la synthèse sont peu couteux. Malheureusement, sa faible conductivité nuit aux performances électrochimiques. Le fait de diminuer la taille des particules ou d’enrober les particules d’une couche de carbone permet d’augmenter la conductivité. Nous avons utilisé une nouvelle méthode appelée « synthèse par voie fondue » pour synthétiser le LiFePO4. Cette synthèse donne des gros cristaux et aucune impureté n’est détectée par analyse Rayon-X. En revanche, la synthèse de LiXFePO4 donne un mélange de LiFePO4 pur et d’impureté à base de lithium ou de fer selon l’excès de fer ou de lithium utilisé. La taille des particules de LiFePO4 est réduite à l’aide d’un broyeur planétaire et plusieurs paramètres de broyage sont étudiés. Une couche de carbone est ensuite déposée sur la surface des particules broyées par un traitement thermique sur le LiFePO4 avec du -lactose. L’influence de plusieurs paramètres comme la température du traitement thermique ou la durée du chauffage sont étudiés. Ces expériences sont réalisées avec un appareil d’analyse thermogravimétrique (ATG) qui donne la quantité de chaleur ainsi que la variation de masse durant le chauffage de l’échantillon. Ce nouveau chauffage pour la couche de carbone donne des échantillons dont les performances électrochimiques sont similaires à celles obtenues précédemment avec la méthode de chauffage pour la couche de carbone utilisant le four tubulaire.

Presión arterial en preescolares de la localidad de Usaquén en Bogotá

Introducción: La hipertensión arterial es un problema de salud pública tanto en países industrializados como en vía de desarrollo. Su prevalencia en la infancia viene en aumento por lo que es relevante determinarla en niños preescolares a nivel local. Objetivo: Determinar la prevalencia de hipertensión arterial en niños de tres a cinco años de una cohorte de 14 hogares infantiles del ICBF de la localidad de Usaquén en Bogotá. Materiales y métodos: Se realizó un estudio de corte transversal analítico, utilizando la base de datos de un ensayo aleatorizado y controlado del año 200913, y se evaluaron las cifras de tensión arterial de acuerdo a sexo, edad, talla y su correlación con el IMC con un nivel de confianza del 95% y precisión del 1%. Se calcularon las medias, desviaciones estándar, percentiles y prevalencia. Resultados: Se obtuvo una muestra de 1035 casos, encontrándose una prevalencia de 4,5% de HTA sistólica, 10,4% de diastólica, ambas en estadio I; teniendo en cuenta tanto sistólica como diastólica, fue de 11,6% en estadio I. Se determinaron los valores de presión arterial sistólica y diastólica en cuartiles de acuerdo a edad, sexo y talla. El coeficiente de correlación entre el IMC y los niveles de presión arterial sistólica y diastólica fueron de 0.0992 y 0.0362 respectivamente. Conclusión: La prevalencia de HTA general fue de 11,6%, predominando la diastólica en estadio I en niños preescolares. No se encontró correlación entre el IMC y las cifras de tensión arterial sistólica y diastólica.

A Cu tolerant population of the earthworm Dendrodrilus rubidus (Savigny, 1862) at Coniston Copper Mines, Cumbria, UK

Dendrodrilus rubidus were sampled from a mine spoil soil at Coniston Copper Mine, an abandoned Cu mine in Cumbria, UK and a Cu-free control site. Earthworms were maintained for 14 d in both Kettering loam and a Moorland soil amended with Cu nitrate. Mortality, condition index, weight change and tissue concentration were determined. In both soils D. rubidus native to the mine site were able to tolerate significantly higher soil Cu concentrations (MWRT, p <= 0.001), and exhibited significantly less change in weight (t-test, p <= 0.001) and a lower loss in condition (t-test, p <= 0.001) than control earthworms. For a given soil Cu concentration tissue Cu concentrations were greater in the mine site earthworms. Low cocoon production and viability from the mine site population prevented the determination of toxicity parameters on the F1 generation and may be an indicator of the cost of tolerance to the population. (c) 2007 Elsevier Ltd. All rights reserved.

Single versus multiple occupancy - Effects on toxicity parameters measured on Eisenia fetida in lead nitrate-treated soil

The mortality (7 and 14 d), weight change (7 and 14 d), and metal uptake of Eisenia fetida (Savigny, 1826) kept in Pb(NO3)(2)-treated Kettering loam soil in single- and multiple-occupancy (10 earthworms) test containers were determined. The number of earthworms to dry mass (g) ratio of soil was 1:50 in both sets of test containers. Lead concentrations were in the nominal range of 0 to 10,000 mg Pb/kg soil (mg/kg hereafter). Levels of mortality at a given concentration were statistically identical between the single- and multiple-occupancy tests, except at 1,800 mg/kg, at which significantly (p less than or equal to 0.05) more mortality occurred in the multiple-occupancy tests. Death of individual earthworms in the multiple-occupancy tests did not trigger death of the other earthworms in that soil. The LC50 values (concentration statistically likely to kill 50% of the population) were identical between the multiple- and single-occupancy soils: 2,662 mg/kg (2,598-2,984, 7 d) and 2,589 mg/kg (2,251-3,013, 14 d) for the multiple-occupancy soils and 2,827 mg/kg (2,443-3,168, both 7 and 14 d) for the single-occupancy soils (values in brackets represent the 95% confidence intervals). Data were insufficient to calculate the concentration statistically likely to reduce individual earthworm mass by 50% (EC50), but after 14 d, the decrease in earthworm weight in the 1,800 and 3,000 mg/kg tests was significantly greater in the multiple- than in the single-occupancy soils. At 1,000, 1,800, and 3,000 mg/kg tests, earthworm Pb tissue concentration was significantly (p less than or equal to 0.05) greater in earthworms from the multiple-occupancy soils. The presence of earthworms increased the NH3 content of the soil; earthworm mortality increased NH3 concentrations further but not to toxic levels.

Survival, Pb-uptake and behaviour of three species of earthworm in Pb treated soils determined using an OECD-style toxicity test and a soil avoidance test

Mature (clitellate) Eisenia andrei Bouche (ultra epigeic), Lumbricus rubellus Hoffmeister (epigeic), and Aporrectodea caliginosa (Savigny) (endogeic) earthworms were placed in soils treated with Pb(NO3)(2) to have concentrations in the range 1000 to 10 000 mg Pb kg(-1). After 28 days LC50(-95%confidence limit) (+95%confidence limit) values were E. andrei 5824(-361)(+898) mg Pb kg(-1), L. rubellus 2867(-193)(+145) mg Pb kg(-1) and A. caliginosa 2747(-304)(+239) mg Pb kg(-1) and EC50s for weight change were E. andrei 2841(-68)(+150) Pb kg(-1), L. rubellus 1303(-201)(+204) mg Pb kg(-1) and A. caliginosa 1208(-206)(+212) Mg Pb kg(-1). At any given soil Pb concentration, Pb tissue concentrations after 28 days were the same for all three earthworm species. In a soil avoidance test there was no difference between the behaviour of the different species. The lower sensitivity to Pb exhibited by E. andrei is most likely due to physiological adaptations associated with the modes of life of the earthworms, and could have serious implications for the use of this earthworm as the species of choice in standard toxicological testing. (c) 2005 Elsevier Ltd. All rights reserved.

Effects of metals on life cycle parameters of the earthworm Eisenia fetida exposed to field-contaminated, metal-polluted soils

Two control and eight field-contaminated, metal-polluted soils were inoculated with Eisenia fetida (Savigny, 1826). Three, 7, 14, 21, 28 and 42 days after inoculation, earthworm survival, body weight, cocoon production and hatching rate were measured. Seventeen metals were analysed in E.fetida tissue, bulk soil and soil solution. Soil organic carbon content, texture, pH and cation exchange capacity were also measured. Cocoon production and hatching rate were more sensitive to adverse conditions than survival or weight change. Soil properties other than metal concentration impacted toxicity. The most toxic soils were organic-poor (1-10 g C kg(-1)), sandy soils (c. 74% sand), with intermediate metal concentrations (e.g. 7150-13, 100 mg Ph kg(-1), 2970-53,400 mg Zn kg(-1)). Significant relationships between soil properties and the life cycle parameters were determined. The best coefficients of correlation were generally found for texture, pH, Ag, Cd, Mg, Pb, Tl, and Zn both singularly and in multivariate regressions. Studies that use metal-amended artificial soils are not useful to predict toxicity of field multi-contaminated soils. (c) 2007 Elsevier Ltd. All rights reserved.

Energy density of foods and beverages in the Australian food supply: influence of macronutrients and comparison to dietary intake

Objectives: The energy density (ED) of the diet is considered an important determinant of total energy intake and thus energy balance and weight change. We aimed to compare relationships between ED and macronutrient content in individual food and beverage items as well as population diet in a typical Western country. Design: Nutrient data for 3673 food items and 247 beverage items came from the Australian Food and Nutrient database (AusNut). Food and beverage intake data came from the 1995 Australian National Nutrition Survey (a 24-h dietary recall survey in 13 858 people over the age of 2). Relationships between ED and macronutrient and water content were analysed by linear regression with 95% prediction bands. Results: For both individual food items and population food intake, there was a positive relationship between ED and percent energy as fat and negative relationships between ED and percent energy as carbohydrate and percent water by weight. In all cases, there was close agreement between the slopes of the regression lines between food items and dietary intake. There were no clear relationships between ED and macronutrient content for beverage items. Carbohydrate (mostly sucrose) contributed 91, 47, and 25% of total energy for sugar-based, fat-based, and alcohol-based beverages respectively. Conclusions: The relationship between ED and fat content of foods holds true across both population diets and individual food items available in the food supply in a typical Western country such as Australia. As high-fat diets are associated with a high BMI, population measures with an overall aim of reducing the ED of diets may be effective in mediating the growing problem of overweight and obesity.

Longitudinal relationships among overweight, life satisfaction, and aspirations in young women

Objective: This study investigated associations of overweight status and changes in overweight status over time with life satisfaction and future aspirations among a community sample of young women.
Research Methods and Procedures: A total of 7865 young women, initially 18 to 23 years of age, completed two surveys that were 4 years apart. These women provided data on their future life aspirations in the areas of further education, work/career, marital status, and children, as well as their satisfaction with achievements to date in a number of life domains. Women reported their height and weight and their sociodemographic characteristics, including current socioeconomic status (occupation).
Results: Young women's aspirations were cross-sectionally related to BMI category, such that obese women were less likely to aspire to further education, although this relationship seemed explained largely by current occupation. Even after adjusting for current occupation, young women who were obese were more dissatisfied with work/career/study, family relationships, partner relationships, and social activities. Weight status was also longitudinally associated with aspirations and life satisfaction. Women who were overweight or obese at both surveys were more likely than other women to aspire to "other" types of employment (including self-employed and unpaid work in the home) as opposed to full-time employment. They were also less likely to be satisfied with study or partner relationships. Women who resolved their overweight/obesity status were more likely to aspire to being childless than other women.
Discussion: These results suggest that being overweight/obese may have a lasting effect on young women's life satisfaction and their future life aspirations.

Whose socioeconomic status influences a women's obesity risk: her mother's, her father's, or her own?

Background Evidence on the relative influence of childhood vs adulthood socioeconomic conditions on obesity risk is limited and equivocal. The objective of this study was to investigate associations of several indicators of mothers', fathers', and own socioeconomic status, and intergenerational social mobility, with body mass index (BMI) and weight change in young women.

Methods This population-based cohort study used survey data provided by 8756 women in the young cohort (aged 18–23 years at baseline) of the Australian Longitudinal Study on Women's Health. In 1996 and 2000, women completed mailed surveys in which they reported their height and weight, and their own, mother's, and father's education and occupation.

Results Multiple linear regression models showed that both childhood and adulthood socioeconomic status were associated with women's BMI and weight change, generally in the hypothesized (inverse) direction, but the associations varied according to socioeconomic status and weight indicator. Social mobility was associated with BMI (based on father's socioeconomic status) and weight change (based on mother's socioeconomic status), but results were slightly less consistent.

Conclusions Results suggest lasting effects of childhood socioeconomic status on young women's weight status, independent of adult socioeconomic status, although the effect may be attenuated among those who are upwardly socially mobile. While the mechanisms underlying these associations require further investigation, public health strategies aimed at preventing obesity may need to target families of low socioeconomic status early in children's lives.

Preliminary investigation of the costs of incubation in the Australasian Gannet (Morus serrator) breeding in Port Phillip Bay, Victoria

To optimise lifetime reproductive success, individuals must balance current reproductive effort against future reproductive prospects. In birds, incubation and chick-rearing must involve costs, and manipulation of the length of incubation offers an insight into some costs affecting adults. An experiment was conducted at a colony of Australasian Gannets in Port Phillip Bay, Victoria, in which length of incubation was manipulated so that some adults experienced short (10–20 days duration), long (70–80 days) or normal (~45 days) incubation periods. Adults with a manipulated incubation period did not show significant differences in weight change (taken here to reflect cost) during incubation or chick-rearing compared with controls. Manipulation of length of incubation did not significantly affect the hatching success or the growth rate of chicks involved and is not, therefore considered to impose an increased reproductive cost. This suggests that the Australasian Gannet has the capacity to maintain body condition and successfully rear young despite modified duration of incubation.

Current knowledge of the environmental influences on Australian cashmere production and quality

Goat fibre production is affected to a similar extent by genetic and environmental influences. Environmental influences include bio-geophysical factors (photoperiod, climate-herbage system and soil-plant trace nutrient composition), country of origin, nutrition factors (live weight, growth patterns) and management factors (farm, herd age and sex structure). Nutrition and management influences discussed include rate of stocking, energy nutrition, live weight change, parturition and management during shearing. The nutritional variation within and among years is the most important climatic factor influencing cashmere production, fibre diameter and fibre curvature (crimp). With productive cashmere goats, large responses to energy supplementation have been measured with optimum nutritional management. The effects and importance of management and hygiene during fibre harvesting (shearing) in producing quality fibre are emphasised.

Effect of Jersey type on thermoregulatory responses during exercise in a warm humid environment

The thermoregulatory responses of subjects wearing two different forms of rugby league jersey, one with plastic sponsorship recognition and numbering (trial Gl) and one without (trial G2), and a lightweight alternative (trial G3), were compared with a trial without any form of upper body garment (trial GO). Ten male volunteers, mean age 20.9 (±2.3) years, height 179.8 (±4.7) cm, weight 80.2 (±8.9) kg, and body surface area 1.99 (±0.13) m2, participated in this study. Subjects had a mean maximal oxygen uptake capacity of 56.0 (±6.3) ml.kg.min-1 and a sum of 8 skinfolds of 80.6 (±23.8) mm. Subjects were exercised at approximately 50% of maximal oxygen uptake in a warm humid environment for 50 minutes. Mean ambient temperature was 27.6°C (±0.32) with a relative humidity of 64.7% (±1.44). Measurements of core and skin (7 sites) temperature, heart rate, oxygen uptake, plasma volume, peak lactate concentration, and pre- and post-trial body weight, hematocrit and garment weight were recorded. The statistical results showed that all subjects experienced significant (p ≤.0001) decreases in body weight representing a percentage decrease ranging from 1.2-1.3%. No significant difference was found between trials with respect to body weight change. No significant effect of garment type was found on pre- and post-trial hematocrit, plasma volume changes or peak blood lactic acid concentration. However, mean peak lactate was highest for trial Gl (5.6 mmol.L-1 ±2.2) and lowest for trial G3 (4.6 mmol.L-1 ±1.27). Post-trial core temperature was significantly (p≤ .0001) higher than the resting value; no significant difference was found between trials. The mean absolute increase for all experimental trials was 0.9°C. A significant (p≤.005) difference between mean total (7 sites) skin temperature was found with a post-hoc test revealing that trials Gl and G2 were significantly higher than trial GO; no significant difference was found when comparing trial G3 with trial GO or when comparing the garments between each other. Mean skin temperature under the garment (4 sites) was found to be significantly (p≤.05) higher for all trials involving a garment when compared with mean skin temperature outside (3 sites) the garment; no significant difference was found between trials. Mean oxygen uptake was significantly different between trials (p≤.005), with trial Gl and G3 found to be significantly lower than trial GO; no difference was found when comparing the garments with each other. Post-trial garment weights were significantly (p≤.001) heavier than pre-trial and were significantly (p≤.0001) different when compared with each other. There was no significant effect on heart rate, haematocrit, plasma volume changes, peak blood lactic acid concentration, or core temperature due to garment type. However, differences in skin temperature suggest that the garment used in trial G3 may have a benefit. Further research should consider the impact of increased exercise intensity and/or environmental temperature and humidity on the measured parameters while wearing the garments described in this study.

Sociocultural influences of body image among Australian and Fijian girls

Despite a traditional emphasis on a large body size in Fiji, both Australian and Fijian girls' had relatively similar body image attitudes and weight change behaviours. However, in comparison to Australian girls, Fijian girls experienced conflicting messages about losing and gaining weight.

Nutritional status, nutrition practices and post-operative complications in patients with gastrointestinal cancer

Background: Malnutrition and its associated complications are a considerable issue for surgical patients with upper gastrointestinal and colorectal cancer.The present study aimed to determine whether specific perioperative nutritional practices and protocols are associated with improved patient outcomes in this group.
Methods: Patients admitted for elective upper gastrointestinal or colorectal cancer surgery (n = 95) over a 19-month period underwent a medical history audit assessing weight changes, nutritional intake, biochemistry, post-operative complications and length of stay. A subset of patients (n = 25) underwent nutritional assessment by subjective global assessment prior to surgery in addition to assessment of post-operative medical outcomes, nutritional intake and timing of dietetic intervention.
Results: Mean (SD) length of stay for patients was 14.0 (12.2) days, with complication rates at 35%. Length of stay was significantly longer in patients who experienced significant preoperative weight loss compared to those who did not [17.0 (15.8) days versus 10.0 (6.8) days, respectively; P < 0.05]. Low albumin and post-operative weight loss were also predictive of increased length of stay. Of patients who underwent nutritional assessment, 32% were classified as mild–moderately malnourished and 16% severely malnourished. Malnourished patients were hospitalised twice as long as well-nourished patients [15.8 (12.8) days versus 7.6 (3.5) days; P < 0.05]. Time taken [6.9 (3.6) days] to achieve adequate nutrition post surgery was a factor in post-operative outcomes, with a positive correlation with length of stay (r = 0.493; P < 0.01), a negative correlation with post-operative weight change (r = —0.417; P < 0.05) and a greater risk of complications (52% versus 13%; P < 0.01).
Conclusions: Malnutrition is prevalent among surgical patients with gastrointestinal cancer. Poor nutritional status coupled with delayed and inadequate post-operative nutrition practices are associated with worse clinical outcomes.