Search

International audience

International audience; SCOPE: Post-infarct left ventricular dysfunction and cardiac remodeling are the primary causes of chronic heart failure in industrialized countries. In the present study, we examined the influence of dietary selenium intake on cardiac remodeling after reperfused myocardial infarction and explored one of the possible mechanisms. METHODS AND RESULTS: Rats were fed a diet containing either 0.05 mg/kg (Low-Se, group of rats receiving the low-selenium diet) or 1.50 mg/kg (group of rats receiving the high-selenium diet) selenium. At the end of the 5th week of the diet, rats were subjected to transient (1 h) coronary ligation followed by 8 days of reperfusion. Infarct size and cardiac passive compliance were increased in the Low-Se group compared with group of rats receiving the high-selenium diet. Similarly, indices of cardiac remodeling (thinning index and expansion index) were more altered in Low-Se hearts. These adverse effects of the Low-Se diet on cardiac remodeling were accompanied by an increase in cardiac TNF-α content, a decreased activity of antioxidant seleno-enzymes and an increase in connexin-43 dephosphorylation. CONCLUSION: Dietary selenium intake influences post-infarct cardiac remodeling even when provided within the range of physiological values. Our data suggest that the cardioprotective effect of selenium might be mediated by a reduced oxidative stress, a lower connexin-43 dephosphorylation, and a decreased TNF-α expression.

Notre recherche vise à comprendre quand, comment et pourquoi la notion d’observance et ses corollaires pénètrent le champ de la pratique soignante. Le moyen de conduire cet objectif fut de procéder à une analyse des écrits sur la notion d’observance/compliance apparue dans les années 1980 dans les services de santé français et qui s’est répandue très largement depuis. Cette recension inclut les travaux francophones et anglo-saxons en sciences humaines et sociales. Nous en avons fait une lecture critique visant à mettre à jour les éléments suivants : 1) les conditions d’émergence de cette notion et son évolution relative à des notions connexes (adhésion/adherence, concordance, éducation thérapeutique, fidélité/fidelity, etc.) ; 2) les enjeux sous-jacents à son émergence et à sa large diffusion dans les milieux de pratique ; 3) les définitions et les mesures produites dans le cadre d’études cliniques ; 4) les différents facteurs mis en avant pour expliquer les attitudes des patients vis-à-vis des prescriptions et recommandations soignantes.Une attention est portée à situer l’émergence et la diffusion de la notion d’observance/compliance dans une visée comparative à partir des documents produits en langue anglaise et en langue française pour faire ressortir les différences ou les similitudes entre les pays (et systèmes de santé), les pathologies et les spécialités médicales.

Notre recherche vise à comprendre quand, comment et pourquoi la notion d’observance et ses corollaires pénètrent le champ de la pratique soignante. Le moyen de conduire cet objectif fut de procéder à une analyse des écrits sur la notion d’observance/compliance apparue dans les années 1980 dans les services de santé français et qui s’est répandue très largement depuis. Cette recension inclut les travaux francophones et anglo-saxons en sciences humaines et sociales. Nous en avons fait une lecture critique visant à mettre à jour les éléments suivants : 1) les conditions d’émergence de cette notion et son évolution relative à des notions connexes (adhésion/adherence, concordance, éducation thérapeutique, fidélité/fidelity, etc.) ; 2) les enjeux sous-jacents à son émergence et à sa large diffusion dans les milieux de pratique ; 3) les définitions et les mesures produites dans le cadre d’études cliniques ; 4) les différents facteurs mis en avant pour expliquer les attitudes des patients vis-à-vis des prescriptions et recommandations soignantes.Une attention est portée à situer l’émergence et la diffusion de la notion d’observance/compliance dans une visée comparative à partir des documents produits en langue anglaise et en langue française pour faire ressortir les différences ou les similitudes entre les pays (et systèmes de santé), les pathologies et les spécialités médicales.

Notre recherche vise à comprendre quand, comment et pourquoi la notion d’observance et ses corollaires pénètrent le champ de la pratique soignante. Le moyen de conduire cet objectif fut de procéder à une analyse des écrits sur la notion d’observance/compliance apparue dans les années 1980 dans les services de santé français et qui s’est répandue très largement depuis. Cette recension inclut les travaux francophones et anglo-saxons en sciences humaines et sociales. Nous en avons fait une lecture critique visant à mettre à jour les éléments suivants : 1) les conditions d’émergence de cette notion et son évolution relative à des notions connexes (adhésion/adherence, concordance, éducation thérapeutique, fidélité/fidelity, etc.) ; 2) les enjeux sous-jacents à son émergence et à sa large diffusion dans les milieux de pratique ; 3) les définitions et les mesures produites dans le cadre d’études cliniques ; 4) les différents facteurs mis en avant pour expliquer les attitudes des patients vis-à-vis des prescriptions et recommandations soignantes.Une attention est portée à situer l’émergence et la diffusion de la notion d’observance/compliance dans une visée comparative à partir des documents produits en langue anglaise et en langue française pour faire ressortir les différences ou les similitudes entre les pays (et systèmes de santé), les pathologies et les spécialités médicales.

Notre recherche vise à comprendre quand, comment et pourquoi la notion d’observance et ses corollaires pénètrent le champ de la pratique soignante. Le moyen de conduire cet objectif fut de procéder à une analyse des écrits sur la notion d’observance/compliance apparue dans les années 1980 dans les services de santé français et qui s’est répandue très largement depuis. Cette recension inclut les travaux francophones et anglo-saxons en sciences humaines et sociales. Nous en avons fait une lecture critique visant à mettre à jour les éléments suivants : 1) les conditions d’émergence de cette notion et son évolution relative à des notions connexes (adhésion/adherence, concordance, éducation thérapeutique, fidélité/fidelity, etc.) ; 2) les enjeux sous-jacents à son émergence et à sa large diffusion dans les milieux de pratique ; 3) les définitions et les mesures produites dans le cadre d’études cliniques ; 4) les différents facteurs mis en avant pour expliquer les attitudes des patients vis-à-vis des prescriptions et recommandations soignantes.Une attention est portée à situer l’émergence et la diffusion de la notion d’observance/compliance dans une visée comparative à partir des documents produits en langue anglaise et en langue française pour faire ressortir les différences ou les similitudes entre les pays (et systèmes de santé), les pathologies et les spécialités médicales.

International audience; Usual imaging after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) consists of AAA diameter monitoring and endoleak detection. Among additional predictor parameters previously proposed to help clinicians in better identifying subgroups of AAA still at risk of rupture, AAA wall motion after EVAR has been studied, but its value was not clearly established. Tissue Doppler imaging (TDI) is an ultrasonographic modality which allows wall motion measurements along an arterial segment. The aim of the current study was to analyze AAA wall motion with TDI before and after EVAR and to describe its evolution in patients with more than 1 month of follow-up. Twenty-five consecutive patients undergoing EVAR between February 2005 and June 2007 gave informed consent to be prospectively investigated with the TDI system before EVAR and at each visit during follow-up. The mean (SD) follow-up was 13.7 (9.7) months. Maximum mean segmental dilation (MMSD), segmental compliance, dilation at maximum diameter, pressure strain elastic modulus (Ep), and stiffness were compared between three periods (before stenting, before discharge, and at last follow-up), and their relation with AAA diameter was analyzed. A significant decrease in AAA compliance was immediately observed after successful EVAR and remained stable during later follow-up. On the other hand, AAA diameter progressively decreased along time and was statistically lower at the last control compared to the initial value. MMSD, segmental compliance, and dilation at maximum diameter were positively related to AAA diameter. This means that the larger the AAA diameter after stenting, the higher the value for these parameters can be expected. On the contrary, percentage of AAA diameter decrease and percentage of MMSD decrease were not related after successful EVAR. There was no parallelism between loss in compliance and diameter decrease along time, and there is not a unique pattern of AAA diameter and compliance evolution after EVAR. Even if comparison between patients without and with endoleak was weak due to the small sample of the latter group (five patients with endoleak), compliance tended to be greater in case of endoleak. AAA wall motion after successful EVAR reflects complex interactions between all the components of the stented aneurysm which evolve over time, including true compliance of the aneurysm wall itself; intra-aneurysm sac pressure with possible different effects for peak, mean, and pulse pressures; remodeling of the thrombus; stiffness characteristics of the graft; and systemic pressure. Combining simultaneous MMSD records with actual intrasaccular pressure measurements in patients with and without endoleak would improve our understanding of the clinical pulsatility mechanism within AAA after EVAR.

International audience; Tegaserod relieves overall and multiple individual constipation-predominant irritable bowel syndrome (IBS-C) symptoms. However, mechanisms for the relief of abdominal pain/discomfort are not well understood. The effects of tegaserod on rectal sensitivity to distension were measured by the nociceptive flexion RIII reflex, as evidenced by spinal hyperexcitability (i.e. increase or facilitation of the RIII reflex), in IBS-C patients. A randomized, double-blind, placebo-controlled, parallel study was performed in 30 women with IBS-C. The effects of slow ramp rectal distension on the RIII reflex, recorded from the lower limb, were measured before [first experimental day (D1)] and after 7 days [day 8 (D8)] of placebo (n=15) or 6 mg tegaserod bid (n=15). Pressure-volume and sensation-volume relationships were measured during distension, and patients reported their IBS symptoms daily. On D1, rectal distension facilitated the RIII reflex in both treatment groups. On D8 vs D1 these facilitatory effects were significantly lower (P

The present study was designed to assess the cardiac changes induced by cold water immersion compared with dry conditions during a prolonged hyperbaric and hyperoxic exposure (ambient pressure between 1.6 and 3 ATA and PiO(2) between 1.2 and 2.8 ATA). Ten healthy volunteers were studied during a 6 h compression in a hyperbaric chamber with immersion up to the neck in cold water while wearing wet suits. Results were compared with measurements obtained in dry conditions. Echocardiography and Doppler examinations were performed after 15 min and 5 h. Stroke volume, left atrial and left ventricular (LV) diameters remained unchanged during immersion, whereas they significantly fell during the dry session. As an index of LV contractility, percentage fractional shortening remained unchanged, in contrast to a decrease during dry experiment. Heart rate (HR) significantly decreased after 5 h, although it had not changed during the dry session. The changes in the total arterial compliance were similar during the immersed and dry sessions, with a significant decrease after 5 h. In immersed and dry conditions, cardiac output was unchanged after 15 min but decreased by almost 20% after 5 h. This decrease was related to a decrease in HR during immersion and to a decrease in stroke volume in dry conditions. The hydrostatic pressure exerted by water immersion on the systemic vessels could explain these differences. Indeed, the redistribution of blood volume towards the compliant thoracic bed may conceal a part of hypovolaemia that developed in the course of the session.

Background Left ventricular diastolic dysfunction, with secondary atrial pressure elevation, is a well-known concept. On the contrary, effect of left atrial compliance on pulmonary pressure is rarely considered. Case presentation We report the echocardiographic case of a 9-year-old child who presented severe rheumatic mitral valve regurgitation with a giant left atrium, in contrast to a normal artery pulmonary pressure, testifying of the high left atrial compliance. Conclusion Left atrial compliance is an important determinant of symptoms and pulmonary artery pressure in mitral valve disease.

This study focused on the architectural changes in the muscle-tendon complex during the immediate and secondary (delayed) reductions of performance (bimodal recovery) caused by an exhaustive rebound type stretch-shortening cycle (SSC) exercise. The isometric plantar flexor torque during maximum voluntary contraction (MVC) was measured together with recording of electromyography (EMG) and ultrasonography from the soleus muscle before (BEF), after (AFT), 2 h (2H), 2 and 8 days (2D, 8D) after the SSC exercise (n=8). The performance variables (MVC torque and EMG activation) followed the bimodal recovery patterns. This was not the case in the changes of the fascicle length and muscle thickness. The relative torque changes in MVC correlated positively (R=0.78, P=0.02) to the corresponding averaged EMG changes between BEF and 2H (BEF-->2H); the significance disappeared in the comparison between 2H and 2D (2H-->2D), during which period MVC showed a secondary reduction. The relative torque changes in MVC showed no correlation with the changes in muscle thickness between BEF-2H. However, this correlation between 2H-2D was negative (R=-0.85, P

International audience; Tegaserod relieves overall and multiple individual constipation-predominant irritable bowel syndrome (IBS-C) symptoms. However, mechanisms for the relief of abdominal pain/discomfort are not well understood. The effects of tegaserod on rectal sensitivity to distension were measured by the nociceptive flexion RIII reflex, as evidenced by spinal hyperexcitability (i.e. increase or facilitation of the RIII reflex), in IBS-C patients. A randomized, double-blind, placebo-controlled, parallel study was performed in 30 women with IBS-C. The effects of slow ramp rectal distension on the RIII reflex, recorded from the lower limb, were measured before [first experimental day (D1)] and after 7 days [day 8 (D8)] of placebo (n=15) or 6 mg tegaserod bid (n=15). Pressure-volume and sensation-volume relationships were measured during distension, and patients reported their IBS symptoms daily. On D1, rectal distension facilitated the RIII reflex in both treatment groups. On D8 vs D1 these facilitatory effects were significantly lower (P