Efeitos do sulfato de magnésio e da milrinona sobre o vasoespasmo cerebral após hemorragia subaracnoidea por aneurisma: estudo randômico

Background

Aneurysmal subarachnoid hemorrhage is an important cause of premature death and disability worldwide. Magnesium sulphate is shown to have a neuroprotective effect and it reverses cerebral vasospasm. Milrinone is also used in the treatment of cerebral vasospasm. The aim of the present study was to compare the effect of prophylactic magnesium sulphate and milrinone on the incidence of cerebral vasospasm after subarachnoid hemorrhage.

Learning condyle repositioning during orthognathic surgery with a surgical navigation system

Condyle repositioning during bilateral sagittal splint osteotomy (BSSO) is a challenging step for the inexperienced surgeon. We aimed to demonstrate the benefit of navigation for learning the condyle repositioning. We treated 100 patients who underwent a BSSO. A trainee performed the condyle repositioning of one side in two phases. In the first one, the trainee positioned without watching the screen of the Orthopilot Navigation system (ONS). In the second one, the trainee could use the ONS to replace the condyle. Heuristic, anatomical and functional scores of each phase were recorded. Heuristic (17% vs. 75%; p < 0.0001), anatomical (35% vs. 86%; p < 0.0001) and functional (14% vs. 56%; p < 0.0001) scores were significantly greater with the ONS. The ONS is a promising and original intraoperative learning tool for the repositioning of the condyle during BSSO.     

Impact des facteurs psychosociaux sur la santé mentale du personnel de nettoyage

Purpose

To describe the relationship between psychosocial factors and mental health among housekeepers.

Dietary fat intake and metabolic syndrome in adults: A systematic review

Background and aimsThe metabolic syndrome (MetS) is a cluster of coexisting cardiovascular risk factors. The role of specific dietary fats was reemphasized by dietary recommendations. This systematic review aims to assess evidence for the effect of dietary fat intake on MetS occurrence and reversion in adults.Methods and ResultsThe MEDLINE database was used to search the existing literature. We included observational studies that analyzed dietary fat intake in adults with MetS and clinical trials that compared the effects of different dietary fat diets on MetS and/or its components. Thirty articles were selected (14 observational and 16 clinical trials), and we included information of dietary fat and fatty acids as well as MetS, body mass index, cholesterol, hypertension, and diabetes in adults. SFA intake was found to be positively associated with MetS components. Most of the observational reviewed studies found beneficial associations between MUFA and PUFA (including n-3 and n-6 subtypes) intake and MetS components. Clinical trials also supported the benefits of MUFA- or PUFA-enriched diets (including low-fat diets) in reducing MetS.ConclusionsThe effects of dietary SFAs on MetS will be influenced by other specific nutrients. Replacement of SFA by MUFA and PUFA has been associated with a decrease in MetS. Dietary recommendations should emphasize on different qualities of fat intake, not only to reduce total fat intake, to obtain health benefits in adults.     

淫羊藿苷对骨微血管内皮细胞自噬及外泌体产生的影响

目的评估淫羊藿苷对低浓度糖皮质激素诱导的骨微血管内皮细胞（bone microvascular endothelial cells，BMECs）自噬和外泌体分泌的影响。方法从行全髋关节置换术切取的股骨头中分离 BMECs，用一系列低浓度梯度氢化可的松（0、0.03、0.06、0.10 mg/mL）干预（设为 A、B、C、D 组），在此基础上再用 5×10⁻⁵ mol/L 淫羊藿苷干预（设为 A1、B1、C1、D1 组），24 h 后采用 Western blot 检测自噬相关蛋白微管相关蛋白轻链 3B（microtubule-associated protein 1 light chain 3B，LC3B）及死骨片 1（p62）的表达。从经淫羊藿苷处理（干预组）和未经淫羊藿苷处理（未干预组）的 BMECs 中提取外泌体，纳米颗粒跟踪分析技术检测其直径和浓度，BCA 法检测外泌体总蛋白质含量，Western blot 检测外泌体 CD9、CD81、TGF-β₁ 和 VEGFA 蛋白的表达。进一步将 BMECs 分为 3 组，实验组和对照组分别分离经或未经淫羊藿苷处理的 BMECs 分泌的外泌体，与 BMECs 共培养；空白对照组为单纯 BMECs。氢化可的松处理后，采用 Western blot 检测 LC3B 和 p62 表达，划痕实验检测细胞迁移能力，并观察血管生成能力。 结果随氢化可的松浓度升高，各组 LC3B-Ⅱ蛋白相对表达量逐渐增加，p62 蛋白相对表达量减少，各组间差异均有统计学意义（P<0.01）；相同激素浓度下，淫羊藿苷干预后，LC3B-Ⅱ蛋白相对表达量减少，p62 蛋白相对表达量增加（P<0.01）。干预组外泌体浓度显著高于未干预组（t=−10.191，P=0.001）；两组外泌体直径和总蛋白质含量比较差异均无统计学意义（P>0.05）。未干预组和干预组 CD9 和 CD81 蛋白均高度表达；干预组 VEGFA/CD9 和 TGF-β₁/CD9 蛋白相对表达量比值均显著高于未干预组（P<0.01）。外泌体共培养后，空白对照组、对照组和实验组中 p62 蛋白相对表达量呈递增趋势，LC3B-Ⅱ蛋白相对表达量呈递减趋势，各组间比较差异均有统计学意义（P<0.05）。氢化可的松处理 12、24 h 时，对照组和实验组划痕闭合率明显高于空白对照组（P<0.05），实验组明显高于对照组（P<0.05）；氢化可的松处理 4、8 h 时，实验组和对照组管腔数、出芽数和小管分支长度均显著大于空白对照组（P<0.05）；实验组小管分支长度和管腔数显著大于对照组（P<0.05）。 结论淫羊藿苷及 BMECs 产生的外泌体能改善低浓度激素诱导的 BMECs 自噬，对内皮细胞起到保护作用。     

Cardiac Surgery in Patients With Liver Cirrhosis (CASTER) Study: Early and Long-Term Outcomes

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Development of the Depist’HTA® score to predict a rise in blood pressure during a self-testing session: PREDIC-HTA bakery survey

The use of an automatic blood pressure monitor with the help of a protocol given by an e-health application allows self-testing of blood pressure without the help of a health professional.ObjectiveConduct a screening campaign for high blood pressure in artisanal bakeries in France and develop a score to predict the observation of an increase in blood pressure during self-testing.MethodCross-sectional survey conducted in mainland France in 2018 using 1000 screening kits including a tablet, Predic’HTA® application and a connected electronic blood pressure monitor (BP Track, IHealth). Available for one week in 14,000 artisanal bakeries, in turn. Used in the workplace, on a voluntary basis, by bakery employees. Completion of a health questionnaire with an estimate of excessive salt consumption. Self-screening of 3 blood pressure measurements with centralization of data on a secure database for epidemiological analysis. The average of the last 2 measurements characterizes each subject.ResultsFull use of Predic’HTA® was obtained in 62.4% of users or 7502 subjects (44% under 35 years of age, 44% 35 to 54 years of age, 12% 55 years of age and over). Antihypertensive treatment was followed by 27% of those aged 55 and over and 1% of those under 35. Among untreated subjects, the prevalence of BP > 140/90 was 21.1%, increasing with age (13%, 27%, 33%) and higher among men (27.2%) than among women (15.4%). With the parameters age, sex, weight, IMC, family history of high blood pressure, excessive salt consumption, previous intake of an antihypertensive drug, a score is calculated to associate a probability of having an BP >120/80 with self-screening. The ROC curve shows an AUC at 0.723 with a PPV at 91% and a NPV at 41%. The depist’HTA® score is available at www.depisthta.netConclusionSelf-testing of blood pressure is possible with an electronic blood pressure monitor if a dedicated appliance is used at the same time. The development of the prediction score depist’HTA® for a blood pressure level > 120/80 would be useful to target subjects who need to self-test their blood pressure in the short term.