Chronic nitric oxide synthase inhibition and carotid artery distensibility in renal hypertensive rats.

The goal of the present study was to examine the viscoelastic properties of the carotid artery in genetically identical rats exposed to similar levels of blood pressure sustained by different mechanisms. Eight-week old male Wistar rats were examined 2 weeks after renal artery clipping (two-kidney, one clip [2K1C] Goldblatt rats, n = 53) or sham operation (n = 49). One half of the 2K1C and sham rats received the nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME, 1.48 mmol/L) in their drinking water for 2 weeks after the surgical procedure. Mean blood pressure increased significantly in the 2K1C-water (182 mm Hg), 2K1C-L-NAME (197 mm Hg), and sham-L-NAME (170 mm Hg) rats compared with the sham-water rats (127 mm Hg). Plasma renin activity was not altered by L-NAME but significantly enhanced after renal artery clipping. A significant and similar increase in the cross-sectional area of the carotid artery was observed in L-NAME and vehicle-treated 2K1C rats. L-NAME per se did not modify cross-sectional area in the sham rats. There was a significant upward shift of the distensibility-pressure curve in the L-NAME- and vehicle-treated 2K1C rats compared with the sham-L-NAME rats. L-NAME treatment did not alter the distensibility-pressure curve in the 2K1C rats. These results demonstrate that the mechanisms responsible for artery wall hypertrophy in renovascular hypertension are accompanied by an increase in arterial distensibility that is not dependent on the synthesis of nitric oxide.

Portuguese migrants in Switzerland: healthcare and health status compared to portuguese residents.

BACKGROUND: Most migrant studies have compared health characteristics between migrants and nationals of the host country. We aimed at comparing health characteristics of migrants with nationals from their home country. METHODS: Portuguese national health survey (2005-6; 30,173 participants aged 18-75 years) and four national health surveys conducted in Switzerland (2002, 2004, 2007 and 2011, totalling 1,170 Portuguese migrants of the same age range). Self-reported data on length of stay, cardiovascular risk factors, healthcare use and health status were collected. RESULTS: Resident Portuguese were significantly older and more educated than migrants. Resident Portuguese had a higher mean BMI and prevalence of obesity than migrants. Resident Portuguese also reported more frequently being hypertensive and having their blood pressure screened within the last year. On the contrary, migrant Portuguese were more frequently smokers, had a medical visit in the previous year more frequently and self-rated their health higher than resident Portuguese. After adjustment for age, gender, marital status and education, migrants had a higher likelihood of smoking, of having a medical visit the previous year, and of self-rating their current health as good or very good than resident Portuguese. Compared to Portuguese residents, cholesterol screening in the previous year was more common only among migrants living in Switzerland for more than 17 years. CONCLUSION: Portuguese migrants in Switzerland do not differ substantially from resident Portuguese regarding most cardiovascular risk factors. Migrants consider themselves healthier than Portuguese residents and more often had a recent medical visit.

Clinical and epidemiological profiles of individuals with drug-resistant tuberculosis

Drug-resistant tuberculosis (TB) is a growing global threat. Approximately 450,000 people developed multidrug-resistant TB worldwide in 2012 and an estimated 170,000 people died from the disease. This paper describes the sociodemographic, clinical-epidemiological and bacteriological aspects of TB and correlates these features with the distribution of anti-TB drug resistance. Mycobacterium tuberculosis (MT) cultures and drug susceptibility testing were performed according to the BACTEC MGIT 960 method. The results demonstrated that MT strains from individuals who received treatment for TB and people who were infected with human immunodeficiency virus were more resistant to TB drugs compared to other individuals (p < 0.05). Approximately half of the individuals received supervised treatment, but most drug-resistant cases were positive for pulmonary TB and exhibited positive acid-fast bacilli smears, which are complicating factors for TB control programs. Primary healthcare is the ideal level for early disease detection, but tertiary healthcare is the most common entry point for patients into the system. These factors require special attention from healthcare managers and professionals to effectively control and monitor the spread of TB drug-resistant cases.

Superficial Acral Fibromyxoma involving the nail's apparatus. Case report and literature review.

Superficial Acral Fibromyxoma is a rare tumor of soft tissues. It is a relatively new entity described in 2001 by Fetsch et al. It probably represents a fibrohistiocytic tumor with less than 170 described cases. We bring a new case of SAF on the 5th toe of the right foot, in a 43-year-old woman. After surgical excision with safety margins which included the nail apparatus, it has not recurred (22 months of follow up). We carried out a review of the location of all SAF published up to the present day.

[44 phot. de Norvège, de Bergen au Varanger fjord, par P.C.J. Villié Moriamez, prises en mai-juin 1881, don G. Pouchet en 1886]

Donateur : Pouchet, H. Ch. Georges (1833-1894)

Increased epidermal expression and absence of mutations in CARD14 in a series of patients with sporadic pityriasis rubra pilaris.

Pityriasis rubra pilaris (PRP; MIM 173200) encompasses a spectrum of rare chronic papulosquamous inflammatory disorders, which have been classified into 6 subtypes(1) . Clinical features include palmoplantar keratoderma and follicular hyperkeratotic papules which coalesce into large, scaly, erythematous plaques, with frequent progression to exfoliative erythroderma. This article is protected by copyright. All rights reserved.

Detección de violencia contra la mujer en la consulta del médico de familia.

Objectives. To find out the magnitude of violence against female partners among patients who visit their family doctor. To study frequency and acceptance of its investigation by the family doctor and to assess the effectiveness of a screening question on abuse. Design. Descriptive, cross-sectional study. Setting. Primary care, 4 samples from 2 urban health centres in Jaén, Spain. Participants. Who participated 170 women randomly selected from the female consulting population. Measurements. Interviews by means of the Bradley modified test and the anxiety and depression Goldberg scales. Perceived health, frequency of detection of domestic violence, by the family doctor, and female opinions were also studied. Results. During the last year, abuse against women was detected in 22.9% of the female population consulting their family doctor (95% confidence interval [95% CI], 16.6-29.2). Abused women had a worse perception of health (odds ratio [OR] =4.2; 95% CI, 1.02-17.5) and a higher probability of depression (OR=4.7; 95% CI, 1.8-12.5) independently from the rest of variables. The question "How are the things going with your partner?" as a screening of abuse does obtain a positive probability quotient of 6.23 (95% CI, 3.6-10.9), a specificity of 89% and a negative predictive value of 90%. Of those interviewed, 96.5% would not mind if their family doctor approached the couple's relationships, a situation that occurs in 24.7% of cases. Conclusions. Some degree of abuse was detected in almost a quarter of women who consult their family doctor. Family doctors do not usually ask about family and partner relationships and environment, although for almost all women it is well appreciated and the item has an increased likelihood ratio and high negative predictive value in detecting abuse.

Gregorius IX, papa, Decretales, libri I-II.

Cet exemplaire de la Lectura d’Henri de Suso sur les Décrétales, dont il ne reste que le premier volume, présente la particularité de contenir aussi le texte des Décrétales, chacune d’elles étant suivie par le commentaire correspondant. Certaines anomalies de la copie permettent de préciser que les copistes avaient comme modèle deux manuscrits différents, un pour la Lectura et l’autre pour les Décrétales dans une édition augmentée des Novelles d'Innocent IV, qui devaient être insérées à la suite des titres correspondants, selon la prescription pontificale de 1245. Le texte même des Novelles qui n’était pas commenté dans la Lectura n’a pas été repris dans la copie, sauf l’Extravagante Quia frequenter, au f. 37v, et Sext. I, 13, 1, au f. 133. F. 1-360v. F. 1-177v. "Apparatus [HENRICI de SEGUSIO cardinalis] Ostiensis super textum Decretalium". [Prooemium:] "[A]d Dei omnipotentis gloriam et universalis ecclesie decus et decorem necnon rei publice et maxime scolasticorum utilitatem... - ...emendate"; — [In epistola dedicatoria Gregorii IX:] "Vicarius regis pacifici ad communem utilitatem et maxime studencium quinque compilationes... - ...et punit" (éd.Venise, I, 3-3v). — "Incipit liber primus Decretalium". [GREGORIUS IX papa, Epistola dedicatoria, salutatio] ; suivi de [HENRICUS DE SEGUSIO, Lectura :] "Gregorius episcopus. Omnes sunt episcopi licet vocentur archiepiscopi, primates vel patriarche... de manu apud eum"; — [GREGORIUS IX papa, Epistola dedicatoria] terminée par l'inscription rubriquée de la première Décrétale; suivi de: [HENRICUS DE SEGUSIO, Lectura in epistola dedicatoria :] "Rex. Regum et omnium potestatum. VIII di. que contra mores... - ...super verbo hac tantum"; et de [ID., Lectura in prima rubrica : ]"Quoniam omne quod non est in fine... - ...de fide catholica" (éd.Venise, I, 3v-5) (1-2v). — Extra 1, 1, 1 ; suivi de [ID., Lectura : ] "Firmiter credimus. Bene dicit nam dubius in fine... - ...Extra 1, 37, 1 ; suivi de [ID., Lectura : ] "Clerici... Et si beneficio etc. careant... de foro compe.", incomplet de la fin par lacune matérielle (éd.Venise, I, 5-182, § 10) (2v-177v). A noter: var. de plusieurs lignes à l'explicit des commentaires sur Extra 1, 1, 2 et 1, 3, 11. A noter les anomalies suivantes :L’inscription de chaque Décrétale, à quelques exceptions près, a été inscrite à la fin du texte de la Décrétale précédente. Le libellé: "Innocentius IIIIus" ou bien "Innocentius IIIIus in concil. Lugdun", qui a été inscrit à la fin des titres I, 3 (25v), 6, (85), 10 (103), 28 (132v), 29 (153), 30 (155v), 31 (164) correspond, en fait, à l'inscription des Novelles d'Innocent IV éditées dans le Sexte, livre I, en tête des titres 3, 6, 8, 13, 14, 15, 16.Au f. 37v, à la suite d'Extra 1, 6, 6, le texte de la constitution d'Innocent IV Quia frequenter a été copié, puis exponctué en marge par un correcteur avec la mention "vacat": "Quia frequenter in electione summorum pontificum colupna Dei... - ...minime computato" avec l'inscription: "Idem" écrite à la fin de la Décrétale précédente qui renvoie à Alexandre III. Sur ce texte qui n’a pas été repris dans le Sexte ; cf. H. Singer, Zeitschrift der Savigny-Stiftung für Rechtesgeschichte, Kan. Abt., VI (1916), 1-140 (éd. Friedberg, 946, Sext. 1, 6, 3, note c). Autres manuscrits recensés : Londres, B.L. ms. Add. 18368, f. 8v ; Paris, BNF ms. latin 14324, f. 234 ; Paris, Bibl. Sainte-Geneviève ms. 339, f. 90 ; Prague, I-B4, f. ? (renseignement aimablement communiqué par Michèle Bégou-Davia).Au f. 133, le titre I, 28 est suivi du texte de Sext. I, 13, 1.Au f.114v, le texte d’Extra 1, 15, 1 §1-6 a été copié une première fois dans le module de la glose à la fin d'un cahier, puis exponctué en marge avec la mention "vacat" et recopié dans le gros module habituel sur un feuillet additionnel (115).Aux ff. 133v-134, les Décrétales 1, 29, 3 et 4, suivies de leurs commentaires, ont été interverties ; de même que les Décrétales 1, 29, 42 et 43, aux ff. 152v-153v. F. 178-360v. "Incipit liber secundus". Extra 2, 1, 1 ; suivi de [HENRICUS DE SEGUSIO, Lectura:] "[D]e Quovultdeo etc. Supple ita statutum est d. n. sed propter hoc plene non subvenitur constronccioni [sic].." - ... Extra 2, 30, 6 "... archid. c. fi. § fi". "Explicit liber secundus. Benedictus sit Deus." (éd.Venise, II, 2-209v). Comme dans le livre I, le libellé inscrit à la fin des titres II, 1 (187), 2 (196v), 5 (202), 13 (240), 14 (247), 15 (249), 18 (252v), 25 (312v), 27 (329v), 28 (357v) correspond à l'inscription des Novelles d'Innocent IV éditées dans le Sexte, livre II, en tête des titres 1-3, 5-7, 9, 12, 14, 15.Au f. 196v, le copiste a copié à la suite les commentaire sur Extra 2, 2, 19 et 20, omettant le texte de Extra 2, 20 qu'il a dû ajouter ensuite dans la marge. Au f. 205, le copiste a mal apprécié l’espace réservé pour Extra 6, 2, le texte commencé normalement en gros module d'écriture, se poursuit en petit module et se termine dans la marge inférieure. De même, au f. 227, les dernières lignes d’ Extra 12, 7 ont dû être écrites dans la marge, avec un signe de renvoi. F. 360v-362. Commentaire anonyme sur Extra 2, 28, 59 De appellationibus: "Ut debitus honor etc. More solito dominus Innocencius premittit causam constitutionis exprimens duas causas motivas: qualiter hec constitutio promulgatur antipophornando... - ... se scit et c. arguta". A noter, f. 1-72v, en marge. PETRUS DE SAMPSONA, Distinctiones super Decretalibus 1, 1, 1-1, 6, 44, excerpta; cf. M. Bertram, "Pierre de Sampson et Bernard de Montmirat...", dans L'Eglise et le droit dans le Midi (XIIIe-XIVe s.) (Cahiers de Fanjeaux, 29), Toulouse, 1994, 37-74 et part. 66, parmi les mss recensés. En marge de l'inscription de l'épitre de Grégoire IX: "Greg. ep. etc. Dominus papa Christi universitatis vicarius set episcopus dicitur singularis quare dominus papa dicatur servus... - ...a papa"; en marge de l'épitre dédicatoire: "Rex pacificus quarum alique propter nimiam similitudinem quedam propter contrarietatem sed numquid in hac compilacione... - ...per totum", incipit A de M. Bertram, art. cit., 64 (1) ; — en marge de la Lectura sur l'épitre dédicatoire: Rex pacificus dicitur esse pacificus et Christus pacem diligit temporalem... - ...approbatur" (1v). — Dernière glose en marge d'Extra 1, 6, 44: "Itaque interim etc. Hii etiam qui pape... - ... et similibus" (72v). A noter, au f. 55v, à la fin de la glose, la signature "P. Sampsone" et au f. 67, "P. Samp.". F. 1-69v, passim et 124v-125. Gloses marginales ajoutées par une main cursive anglaise, contemporaine de la copie. « Doctoribus. Qui faciunt universitatem... - ...dilectus. [signé] Abb(at)is" (Bernardus de Montmirat, Lectura in Decretales, ed. Venise, 1588, I, 2) (1). —En marge de la Lecture sur Extra 1, 6, 42: "B. in apostillis suis dicit quod si aliquis potestatem... - ...commento Hostiensis" (69v).

Fragments de divers manuscrits.

Contient : I ; II

"Comment. Boetii in periermenias librum Aristotelis.

N° 22 des mss envoyés à Paris par Maugerard en octobre 1802; cf. B.n.F., département des Manuscrits, Archives Modernes 497; — abbaye d'Echternach (dioc. de Trèves), cf. titre "Continet"; 1789. Le patrimoine libéré, 152 et n° 96

When should clinicians search for GLUT1 deficiency syndrome in childhood generalized epilepsies?

UNLABELLED: GLUT1 deficiency (GLUT1D) has recently been identified as an important cause of generalized epilepsies in childhood. As it is a treatable condition, it is crucial to determine which patients should be investigated. METHODS: We analyzed SLC2A1 for mutations in a group of 93 unrelated children with generalized epilepsies. Fasting lumbar puncture was performed following the identification of a mutation. We compared our results with a systematic review of 7 publications of series of patients with generalized epilepsies screened for SLC2A1 mutations. RESULTS: We found 2/93 (2.1%) patients with a SLC2A1 mutation. One, carrying a novel de novo deletion had epilepsy with myoclonic-atonic seizures (MAE), mild slowing of head growth, choreiform movements and developmental delay. The other, with a paternally inherited missense mutation, had childhood absence epilepsy with atypical EEG features and paroxysmal exercise-induced dyskinesia (PED) initially misdiagnosed as myoclonic seizures. Out of a total of 1110 screened patients with generalized epilepsies from 7 studies, 2.4% (29/1110) had GLUT1D. This rate was higher (5.6%) among 303 patients with early onset absence epilepsy (EOAE) from 4 studies. About 50% of GLUT1D patients had abnormal movements and 41% a family history of seizures, abnormal movements or both. CONCLUSION: GLUT1D is most likely to be found in MAE and in EOAE. The probability of finding GLUT1D in the classical idiopathic generalized epilepsies is very low. Pointers to GLUT1D include an increase in seizures before meals, cognitive impairment, or PED which can easily be overlooked.

Large gangliocytic paraganglioma of the duodenum: A rare entity.

Gangliocytic paragangliomas are rare tumors that almost exclusively occur within the second portion of the duodenum. Although these tumors generally have a benign clinical course, they have the potential to recur or metastasize to regional lymph nodes. The case report presented here describes a 57-year-old female patient with melena, progressive asthenia, anemia, and a mass in the second-third portion of the duodenum that was treated by local excision. The patient was diagnosed with a friable bleeding tumor. The histologic analysis showed that the tumor was a 4 cm gangliocytic paraganglioma without a malignant cell pattern. In the absence of local invasion or distant metastasis, endoscopic resection represents a feasible, curative therapy. Although endoscopic polypectomy is currently considered the treatment of choice, it is not recommended if the size of the tumor is > 3 cm and/or there is active or recent bleeding. Patients diagnosed with a gangliocytic paraganglioma should be closely followed-up for possible local recurrence.

Effect of high-intensity interval exercise on lipid oxidation during postexercise recovery.

PURPOSE: The aim of this study was to examine whether lipid oxidation predominates during 3 h of postexercise recovery in high-intensity interval exercise as compared with moderate-intensity continuous exercise on a cycle ergometer in fit young men (n = 12; 24.6 +/- 0.6 yr). METHODS: The energy substrate partitioning was evaluated during and after high-intensity submaximal interval exercise (INT, 1-min intervals at 80% of maximal aerobic power output [Wmax] with an intervening 1 min of active recovery at 40% Wmax) and 60-min moderate-intensity continuous exercise at 45% of maximal oxygen uptake (C45%) as well as a time-matched resting control trial (CON). Exercise bouts were matched for mechanical work output. RESULTS: During exercise, a significantly greater contribution of CHO and a lower contribution of lipid to energy expenditure were found in INT (512.7 +/- 26.6 and 41.0 +/- 14.0 kcal, respectively) than in C45% (406.3 +/- 21.2 and 170.3 +/- 24.0 kcal, respectively; P < 0.001) despite similar overall energy expenditure in both exercise trials (P = 0.13). During recovery, there were no significant differences between INT and C45% in substrate turnover and oxidation (P > 0.05). On the other hand, the mean contribution of lipids to energy yield was significantly higher after exercise trials (C45% = 61.3 +/- 4.2 kcal; INT = 66.7 +/- 4.7 kcal) than after CON (51.5 +/- 3.4 kcal; P < 0.05). CONCLUSIONS: These findings show that lipid oxidation during postexercise recovery was increased by a similar amount on two isoenergetic exercise bouts of different forms and intensities compared with the time-matched no-exercise control trial.

Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism.

BACKGROUND: The Pulmonary Embolism Severity Index (PESI) estimates the risk of 30-day mortality in patients with acute pulmonary embolism (PE). We constructed a simplified version of the PESI. METHODS: The study retrospectively developed a simplified PESI clinical prediction rule for estimating the risk of 30-day mortality in a derivation cohort of Spanish outpatients. Simplified and original PESI performances were compared in the derivation cohort. The simplified PESI underwent retrospective external validation in an independent multinational cohort (Registro Informatizado de la Enfermedad Tromboembólica [RIETE] cohort) of outpatients. RESULTS: In the derivation data set, univariate logistic regression of the original 11 PESI variables led to the removal of variables that did not reach statistical significance and subsequently produced the simplified PESI that contained the variables of age, cancer, chronic cardiopulmonary disease, heart rate, systolic blood pressure, and oxyhemoglobin saturation levels. The prognostic accuracy of the original and simplified PESI scores did not differ (area under the curve, 0.75 [95% confidence interval (CI), 0.69-0.80]). The 305 of 995 patients (30.7%) who were classified as low risk by the simplified PESI had a 30-day mortality of 1.0% (95% CI, 0.0%-2.1%) compared with 10.9% (8.5%-13.2%) in the high-risk group. In the RIETE validation cohort, 2569 of 7106 patients (36.2%) who were classified as low risk by the simplified PESI had a 30-day mortality of 1.1% (95% CI, 0.7%-1.5%) compared with 8.9% (8.1%-9.8%) in the high-risk group. CONCLUSION: The simplified PESI has similar prognostic accuracy and clinical utility and greater ease of use compared with the original PESI.