Nouveau test ultrarapide pour la détection de bactéries

Introduction

Bacteriological testing is aimed to reduce the risk of transmission of infections. However, the detection of Bacteria by culture requires from 18 hours to 14 days and may produce erroneous results for fastidious species. The goal of this work was to design and validate a new tool for bacterial testing.

Methods

The test is based on the fast real-time PCR (frt PCR). The DNA extracted from samples containing internal controls are introduced into four tubes containing primers and probes for the frt PCR. The cycling program consists in 1 × at 95 °C for 10 min and 45 × (15 s at 95 °C, 8 s) at 52 °C and 10 s at 72 °C.

Results

The frt PCR detects 0,01 CFU/μl of Bacteria and identifies eight Genera without interferences from the environment or from fungi and with no need for melting curve analysis or additional sequencing.

Discussion

The frt PCR detects and quantifies Bacteria identifying and assessing the load of Staphylococci, Streptococci, Haemophilus, Pseudomonas, Enterobacteria, Acinetobacter, Propionibacteriacae and Corynebacteria.

Conclusion

Cultures require at least 24 hours but the new frt PCR reduces the time to 90 minutes. Larger series of samples are necessary to confirm the usefulness of this new test for routine bacterial sterility controls.     

IL-17 induces myocardial fibrosis and enhances RANKL/OPG and MMP/TIMP signaling in isoproterenol-induced heart failure

Objective

This study was designed to investigate whether IL-17 can regulate the expression of the MMP/TIMP system, the OPG/RANK/RANKL system, or type-I and type-III collagen fibers in a rat model of isoproterenol-induced heart failure (HF). We also investigated the effect of IL-17 on myocardial fibrosis in this model.

Methods

HF was induced in Wistar–Kyoto rats by hypodermic injection of isoproterenol (ISO) twice every 24 h. After 2 months, the surviving rats were divided into three groups: monoclonal Anti-IL-17 Ab (100 μg/day), IgG (100 μg/day) or PBS were injected five times every 48 h (i.p.). One day after the last injection, all of the rats were sacrificed. H&E and Masson staining were used to evaluate myocardial fibrosis, and immunohistochemistry was used to measure the levels of MMP-1, TIMP-1, TIMP-4, OPG, RANKL, type-I and type-III collagen fibers. We also treated adult rat cardiac fibroblasts with IL-17 (10 ng/ml), IL-17 (10 ng/ml) + OPG (10 ng/ml), IL-17 (10 ng/ml) + anti-RANKL Ab (100 ng/ml), or PBS for 24 h, realtime RT-PCR was used to measure the expressions of MMP-1.

Results

The expressions of MMP-1, RANKL, and type-I and -III collagen fibers decreased, and the expressions of TIMP-1, TIMP-4, and OPG increased in the Anti-IL-17 group compared to controls. H&E and Masson staining revealed that blockade of IL-17 can improve myocardial fibrosis in HF. IL-17 increased the expression of MMP-1 in cardiac fibroblasts, and OPG and anti-IL-17 Ab could inhibit this function partly. Thus, IL-17 was dependent on the RANKL/OPG system to induce MMP-1 partly.

Conclusion

Our study demonstrates the contribution of IL-17 to myocardial fibrosis in isoproterenol-induced HF. IL-17 can regulate the RANKL/OPG and MMP/TIMP systems in this model. The RANKL/OPG system is one of intermediaries between IL-17 and MMP-1 in cardiac fibroblasts. As a harmful cytokine, anti-IL-17 treatment is a potential therapeutic strategy in HF.     

Activité du doripénème sur les bactéries anaérobies strictes

Aims of the study

This study examines the activity of doripenem, a new carbapenem compound compared with amoxicillin-clavulanic acid, piperacillin + tazobactam, imipenem, clindamycin and metronidazole against 316 anaerobes.

Methods

Inoculum preparation and agar dilution method were performed according to the CLSI method for anaerobes (M11A7).

Results

At a concentration of 4 μg/ml doripenem and imipenem (IMP) inhibited 122 (96 %) and 126 (99 %) strains of the Bacteroides fragilis group, respectively. In contrast, doripenem appeared more potent than IMP against Gram-positive anaerobes inhibiting at the same concentration of 4 μg/ml 145/145 strains (100 %) versus 115/145 for IMP (79.3 %). Against 316 anaerobic strains, the carbapenem doripenem had an MIC₅₀ of 0.25 μg/ml and an MIC₉₀ of 2 μg/ml. Results were similar to those for imipenem (MIC₅₀ of 0.125 μg/ml and MIC₉₀ of 4 μg/ml). If we consider the resistant breakpoints of the two carbapenems as defined by EUCAST, the resistance rate for doripenem (MIC > 4 μg/ml) 1.6 % is similar to that of imipenem (MIC > 8 μg/ml) 1.3 %.

Conclusion

Thus independently of the PK/PD parameters the two carbapenems demonstrated very close activity; doripenem was more potent on Gram-positive anaerobes and slightly less potent against Gram-negative anaerobes mainly the B. fragilis group. Further clinical studies are needed to assess its usefulness in patients.     

Concentraciones de interleucina-18 en preeclámpticas y embarazadas normotensas sanas

Objective

To compare concentrations of interleukin-18 in pre-eclampsia patients and healthy normotensive pregnant women.

Method

A total of 100 patients were selected. Fifty pre-eclamptic patients were selected as cases (group A) and a control group selected by having the same age and body mass index to study group, consisting of 50 healthy normotensive pregnant women. Blood samples were collected in all patients before labour and immediately after diagnosis in group B to determine interleukin-18 concentrations.

Results

There were no significant differences in relation to maternal age, gestation age and body mass index at the time of taking the sample (P = ns). There was a statistically significant difference in interleukin-18 concentrations between patients in cases group (group A; 38.6 ± 6.5 pg/ml) and patients in control group (group B; 32.2 ± 8.5 pg/ml; P < .05). There was a moderate, positive and significant correlation with systolic blood pressure values (r = 0.341; P < .05) and with diastolic blood pressure values (r = 0.408; P < .05).

Conclusions

Pre-eclampsia patients had significantly higher concentrations of interleukin-18 when compared with healthy normotensive pregnant women.     

Computerized self-monitoring and technology-assisted feedback for weight loss with and without an enhanced behavioral component

Objective

The purpose of this study was to develop and evaluate a 12-week weight management intervention involving computerized self-monitoring and technology-assisted feedback with and without an enhanced behavioral component.

Methods

120 overweight (30.5 ± 2.6 kg/m²) adults (45.0 ± 10.3 years) were randomized to one of three groups: computerized self-monitoring with Basic feedback (n = 45), Enhanced behavioral feedback (n = 45), or wait-list control (n = 30). Intervention participants used a computer software program to record dietary and physical activity information. Weekly e-mail feedback was based on computer-generated reports, and participants attended monthly measurement visits.

Results

The Basic and Enhanced groups experienced significant weight reduction (−2.7 ± 3.3 kg and −2.5 ± 3.1 kg) in comparison to the Control group (0.3 ± 2.2; p < 0.05). Waist circumference and systolic blood pressure also decreased in intervention groups compared to Control (p < 0.01).

Conclusions

A program using computerized self-monitoring, technology-assisted feedback, and monthly measurement visits produced significant weight loss after 12 weeks. However, the addition of an enhanced behavioral component did not improve the effectiveness of the program.

Practice implications

This study suggests that healthcare professionals can effectively deliver a weight management intervention using technology-assisted strategies in a format that may complement and reduce face-to-face sessions.     

The variation of AkT/TSC1-TSC1/mTOR signal pathway in hepatocytes after partial hepatectomy in rats

Objective

The aim of this study was to investigate the role and regulatory mechanisms of Akt/TSC1-TSC2/mTOR signal pathway on the hepatocyte growth and proliferation after partial hepatectomy in rats.

Methods

We used the animal model of 70% hepatectomy, separated and cultivated hepatocytes. According to the different time points after partial hepatectomy, it could be grouped into 0 h, 2 h, 6 h, 24 h and 72 h. According to the different kinds of specific inhibitor in the nutritive medium after the separation of hepatocytes, it could be grouped into Triciribine (TR), Rapamycin (RA) and Control (CO). We investigated ³H-Leucine incorporation into protein, the cross section areas of hepatocytes, and detected cell cycle through FCM. The expressions of phosphorylated protein TSC2 and mTOR were observed.

Results

(1) The content of phosphorylated protein TSC2 in group CO began to increase at 2 h and got to the peak at 6 h but declined at 24 h. The content of phosphorylated protein TSC2 in group RA had the same variation with that of phosphorylated protein TSC2 in group CO. (2) At the time point of 0 h, 2 h, 6 h and 24 h after operation, the incorporation efficiency of ³H-Leucine in groups RA and TR was different from that in group CO in statistics (P < 0.01). (3) It could be seen that the cross section areas of hepatocytes in groups RA and TR were different from that in group CO in statistics at 2 h and 6 h after operation (P < 0.05). (4) Comparing with the other two inhibitor groups (TR and RA), the number of cells during the period of G₀/G₁ in group CO became fewer, while the number of cells during the period of S and G₂/M grew obviously (referring to Fig. 8). After operation, each time point was different from the inhibitor groups obviously (P < 0.05 or P < 0.01). The peak declined greatly at 24 h and 72 h after operation.

Conclusions

These data strongly suggest the effects of Akt/TSC1-TSC2/mTOR signal pathway on hepatocyte growth, protein synthesis and cell cycle, and prove its contribution to liver regeneration.     

Portage digestif d’entérobactéries résistantes aux céphalosporines de troisième génération dans une population d’adultes jeunes asymptomatiques : évolution entre 1999 et 2009

Objectives

The aim of this work was to evaluate the fecal carriage of third generation cephalosporins resistant Enterobacteriaceae in nonhospitalized asymptomatic young adults.

Methods

A total of 517 normal fecal samples were spread onto plates agar containing cefotaxime. Isolated strains were identified and studied with agar disk diffusion antibiogram, minimal inhibition concentration in liquid medium and phenotypic and molecular study. Data were compared with a previous study realised in the same conditions in 1999.

Results

In 2009, the prevalence of cefotaxime resistant enterobacteria was 4.2%. Of these 22 Enterobacteriaceae, 11 harboured overexpressed cephalosporinase and 11 produced extended-spectrum-betalactamase (ESBL). Among ESBL, six E. coli produced CTX-M from group 1 (n = 6), group 2 (n = 1), group 9 (n = 2), one E. coli produced SHV-12 and one Klebsiella pneumoniae produced CTX-M from group 1. All ESBL were multiresistant. In 1999, all the CTX resistant isolates recovered produced a cephalosporinase and no ESBL was found.

Conclusions

This study highlights the increasing prevalence of fecal carriage of ESBL-producing enterobacteria in asymptomatic young patients in the community (0% in 1999 versus 2.1% in 2009; P < 0.001). E. Coli with CTX-M from group 1 was the most frequent ESBL identified, while fecal carriage of Enterobacteteriaceae overproducing cephalosporinase was similar (2.1%).     

Dietary trans-fat combined with monosodium glutamate induces dyslipidemia and impairs spatial memory

Aims

Recent evidence suggests that intake of excessive dietary fat, particularly saturated fat and trans-hydrogenated oils (trans-fatty acids: TFA) can impair learning and memory. Central obesity, which can be induced by neonatal injections of monosodium Glutamate (MSG), also impairs learning and memory. To further clarify the effects of dietary fat and MSG, we treated C57BL/6 J mice with either a TFA-enriched diet, dietary MSG, or a combination of both and examined serum lipid profile and spatial memory compared to mice fed standard chow. Spatial learning was assessed at 6, 16 and 32 weeks of age in a Morris Water Maze (MWM). The subjects were given four days of training to find a hidden platform and a fifth day of reversal learning, in which the platform was moved to a new location.

Results

The TFA + MSG combination caused a central adiposity that was accompanied by impairment in locating the hidden platform in the MWM. Females in the TFA + MSG group showed a greater impairment compared to the other diet groups, and also showed elevated levels of fasting serum LDL-C and T-CHOL:HDL-C ratio, together with the lowest levels of HDL-C. Similarly, males in the TFA + MSG diet group were less successful than control mice at locating the hidden platform and had the highest level of abdominal adiposity and elevated levels of fasting serum LDL-C.

Conclusion

Dietary trans-fat combined with MSG increased central adiposity, promoted dyslipidemia and impaired spatial learning.     

Immune cell profile in invasive cholesteatomas: Preliminary findings

Background

Cholesteatoma consists of keratinizing squamous epithelium, granulation tissue and keratin plugs. The pathogenesis of cholesteatoma may be related to alterations in the stromal immune cell infiltrate.

Objective

To examine the immunophenotypic characteristics of the immune cell infiltrate in invasive cholesteatomas.

Materials and methods

This study included 12 patients with invasive cholesteatomas causing wide bone erosion of the mastoid, middle ear structures, and the bony plates of middle ear cleft. Diagnosis of invasiveness was based on the clinical, radiological and intraoperative findings. Canal wall-down surgical approach was done in all cases to control the disease process. We used the cholesteatomatous tissue specimens to perform immunohistochemical stains for B cells (CD20), T cells (CD3), histiocytes (CD68) and Langerhans' cells (CD1a). Mouse monoclonal antibodies and immunoperoxidase staining methods were used. The results of immunohistology were scored as mean values of positively stained immune cells. The data were compared with findings in 10 specimens of external ear skin (control group).

Results

Immunohistochemistry showed highly significant (p < 0.00) counts of immune cells in invasive cholesteatomas (CD3: 4.7 ± 0.4, CD68:4.6 ± 0.5, CD20: 0.8 ± 0.1 and CD1a: 0.8  ± 0.1) compared to those in external canal skin (control group: CD3:0.8 ± 0.3, CD68: 1.0 ± 0.4, CD20: 0.2 ± 0.1 and CD1a: 0.1 ± 0.1). In cholesteatomas, the predominant of CD3⁺ T lymphocytes and CD68⁺ cells (histiocytes). Rare CD20⁺ cells and CD1a⁺ cells (Langerhans' cells) were also observed.

Conclusions

This preliminary study describes the profile of the immune cell infiltrate in invasive cholesteatomas. The numeric dominance of CD3⁺ cells and CD68⁺ cells suggests that cell-mediated immunity has important role in the development of cholesteatoma and in its autodestructive properties. Further studies are recommended to categorize the T cell subsets in different stages of cholesteatomas.     

Étude des polymorphismes des gènes de l’interleukine-1 et de l’antagoniste du récepteur de l’interleukine-1 chez des patients atteints de polyarthrite rhumatoïde

Objectives

One of the most important pro-inflammatory cytokines in the pathophysiology of rheumatoid arthritis (RA) is interleukin 1 (IL-1). The purpose of this study is to evaluate the association between IL-1B (-511), IL-1 (+3953), IL-1 RN variable number of tandem repeat (VNTR) polymorphisms and the occurrence in Algerian patients with rheumatoid arthritis. We also analyze their correlations with clinical and biological phenotypes.

Patients and methods

One hundred and forty-seven patients with RA (119 women, 28 men) and 127 controls (70 women, 57 men) were included in the study. The analysis of two polymorphisms of IL-1B-511 and IL-1B+3953 was done by PCR-RFLP. Analysis of IL1-RN VNTR polymorphism was performed by PCR.

Results

No significant difference in genotype, allelic and haplotype distribution at the three polymorphisms was observed between RA patients and controls. However, the genotype (T/T) polymorphism of IL-1B-511 is more frequent in the group of patients with positive ACPA compared with negative ACPA group (Pc = 0.01, OR = 4.65). Moreover, we noted that the haplotype (IL-1RN* 1/IL-1B-511T/IL-1B+3953C) was more frequent (Pc = 0.03, OR = 2.05) in the positive ACPA group.

Conclusion

The association between the allele 1 of IL-1 RN VNTR, T allele of IL1B-511 and C allele of IL1-B +3953 polymorphisms seems to predispose to the synthesis of ACPA and therefore to the occurrence of ACPA positive RA. Further studies with a larger number of patients are needed to define the real role of IL-1 in the susceptibility to or severity of RA.     

Autonomic dysfunction and arterial stiffness in female overactive bladder patients and antimuscarinics related effects

Objectives

To investigate the characteristics of autonomic function and arterial stiffness of OAB women, their relations with urodynamic parameters, and the impact of antimuscarinics on the above parameters.

Study design

A total of 85 OAB women and another 65 women without OAB were selected. Forty-two OAB women who enrolled before March 2009 were treated with tolterodine for 12 weeks, and another 43 OAB women who enrolled thereafter were treated with solifenacin.

Main outcome measures

The differences of the heart rate variability, cardio-ankle vascular index (CAVI) and ankle-brachial pressure index (ABI) between OAB and asymptomatic women, and their changes after 12 weeks’ antimuscarinics for OAB women.

Results

OAB women had higher low frequency/high frequency ratios (LF/HF) (OAB: 1.5 ± 1.1 vs. the control: 1.1 ± 0.7, P = 0.04). Nonetheless, CAVI and ABI did not differ between OAB and the control group. The square root of the mean squared differences of successive NN intervals (RMSSD) is associated with nocturia (Spearman's ρ = 0.23, P = 0.049), LF is associated with urgency episodes (Spearman's ρ = 0.28, P = 0.01), and maximum urethral closure pressure is negatively associated with CAVI (Spearman's ρ = −0.26, P = 0.02). After 12 weeks’ treatment, a decrease of RMSSD, HF, CAVI and an increase of LF/HF were found in the tolterodine group but not in the solifenacin group.

Conclusions

OAB women have higher severity of autonomic dysfunction with sympathetic predominance. Tolterodine may improve arterial stiffness but may deteriorate autonomic dysfunction to more sympathetic predominance. Thus, tolteridine should be used for OAB with caution in women with preexisting symptoms of autonomic dysfunction.     

Innovative program to increase physical activity following an acute coronary syndrome: randomized controlled trial

Objective

To evaluate the impact of a socio-cognitive intervention associated with a pedometer-based program on physical activity, cardiovascular risk factors and self-efficacy expectation during one year following an acute coronary syndrome.

Methods

Sixty-five subjects were randomized during hospitalization in an experimental or a usual care group. Average steps/day was measured every 3 months until one year following discharge. Other dependent variables were measured at baseline, 6 and 12 months follow-up.

Results

There were 32 patients in the experimental group and 33 patients in the usual care group. Group characteristics were comparable. At baseline, averages steps/day were similar between groups (5845 ± 3246 vs. 6097 ± 3055 steps/day; p = 0.812). At 3-month follow-up, both groups increased their averages steps/day (p < 0.05). This increase was higher in the experimental group (3388 ± 844 vs. 1934 ± 889 steps/day; p < 0.001). At 12-month, interaction effects (group × time) in physical activity and waist circumference were different between groups (p < 0.05), whereas self-efficacy expectation increased in both groups similarly (p < 0.05).

Conclusion

The intervention is useful to improve average steps/day and waist circumference during the first year following an acute coronary syndrome.

Practice implications

This study supports development of the home-based cardiac rehabilitation program using socio-cognitive intervention associated with a pedometer after an acute coronary syndrome.     

Perception of empathy in the therapeutic encounter: effects on the common cold

Objective

To evaluate the effects of patient-practitioner interaction on the severity and duration of the common cold.

Methods

We conducted a randomized controlled trial of 719 patients with new cold onset. Participants were randomized to three groups: no patient-practitioner interaction, “standard” interaction or an “enhanced” interaction. Cold severity was assessed twice daily. Patients randomized to practitioner visits used the Consultation and Relational Empathy (CARE) measure to rate clinician empathy. Interleukin-8 (IL-8) and neutrophil counts were obtained from nasal wash at baseline and 48 h later.

Results

Patients’ perceptions of the clinical encounter were associated with reduced cold severity and duration. Encounters rated perfect on the CARE score had reduced severity (perfect: 223, sub-perfect: 271, p = 0.04) and duration (perfect: 5.89 days, sub-perfect: 7.00 days, p = 0.003). CARE scores were also associated with a more significant change in IL-8 (perfect: mean IL-8 change 1586, sub-perfect: 72, p = 0.02) and neutrophil count (perfect: 49, sub-perfect: 12, p = 0.09).

Conclusions

When patients perceive clinicians as empathetic, rating them perfect on the CARE tool, the severity, duration and objective measures (IL-8 and neutrophils) of the common cold significantly change.

Practice implications

This study helps us to understand the importance of the perception of empathy in a therapeutic encounter.     

Role of hepatic HCV-RNA level on the severity of chronic hepatitis C and response to antiviral therapy

Background

Correlation between hepatic HCV-RNA and serum HCV-RNA, severity of liver disease and response to therapy is poorly known.

Objectives

To assess the influence of hepatic HCV-RNA level on severity of liver disease and response to therapy in a large cohort of chronic hepatitis C (CHC) patients.

Study Design

HCV-RNA was measured in frozen liver biopsies and serum samples from 130 CHC patients the day of liver biopsy prior to treatment. Liver fibrosis was assessed by Ishaq scoring. A Sustained Virological Response (SVR) was observed in 52% of the patients, non-response (NR) in 34%.

Results

Mean ± standard deviation hepatic HCV-RNA level was 7.69 ± 0.67 log₁₀ copies/mg of liver. Mean serum HCV-RNA level was 6.21 ± 0.72 log₁₀ copies/ml. There was a correlation between hepatic and serum HCV-RNA in genotype 1 and 4 (p = 0.008 and p = 0.03) and age (p = 0.006). Mean hepatic HCV-RNA was 7.70 ± 0.69 vs 7.67 ± 0.68 log₁₀ copies/mg of liver, in patients with significant fibrosis vs those with mild fibrosis, respectively (p = 0.7); 8.04 ± 0.68; 7.44 ± 0.47; 7.43 ± 0.49 and 7.44 ± 0.71 log₁₀ copies/mg of liver in genotypes 1, 2, 3 and 4, respectively (p = 0.0001); higher in women than in men (p = 0.04); 7.60 ± 0.63, 7.71 ± 0.54 and 7.96 ± 0.73 log₁₀ copies/mg in SVR, relapsers and NR, respectively (p = 0.1). Multivariate analysis showed that high hepatic HCV-RNA level was independently associated with genotype and response to therapy was associated with genotype independently from hepatic HCV-RNA level.

Conclusions

Hepatic HCV-RNA level was not associated with severity of liver disease. High level was strongly associated with HCV genotype independently from response to therapy.     

HCV core antigen testing in HIV- and HBV-coinfected patients, and in HCV-infected patients on hemodialysis

Background

A quantitative HCV core antigen (HCVcoreAg) immunoassay has been developed for the confirmation of viremia in patients with hepatitis C.

Objectives

We evaluated the correlation of HCV RNA and HCVcoreAg in different patient populations without HCV-specific treatment: HIV/HCV-coinfection, HBV/HCV-coinfection, and patients with end-stage renal disease.

Study design

HCVcoreAg was quantified by a fully-automated immunoassay. Correlation of HCVcoreAg with HCV RNA was studied cross-sectionally in HIV/HCV- and HBV/HCV-coinfected patients, as well as before and after hemodialysis in patients with end-stage renal disease.

Results

A concordant positive or negative test result for both HCV RNA and HCVcoreAg was observed in 68 of 71 (96%), 55 of 57 (96%), and in 109 of 109 (100%) samples of patients with HIV- or HBV/HCV-coinfection, and patients undergoing hemodialysis, respectively. HCVcoreAg showed high correlation with HCV RNA in samples from HIV/HCV-coinfected patients and HCV-infected patients undergoing hemodialysis (r = 0.97 and r = 0.94, p < 0.001). There was no overall correlation between HCVcoreAg and HCV RNA in HBV/HCV-coinfected individuals (r = 0.04, p = 0.822). Excluding patients with HCV RNA to HCVcoreAg ratios below 100 and above 10,000 kIU/fmol led to improved correlation (r = 0.53; p = 0.02), but remained worse than for the other cohorts. Overall, HCV RNA to HCVcoreAg ratios did not differ significantly between the different patient populations, though variation tended to be higher in HBV/HCV-coinfected patients. Patients with lower HCV RNA levels tend to have lower HCV RNA/HCVcoreAg ratios.

Conclusions

HCVcoreAg represents a reliable marker of viral replication showing a good correlation with HCV RNA in various patient populations, with some limitations in HBV/HCV-coinfection.     

Changes in body fat percentage during body weight stable conditions of increased daily protein intake vs. control

Objective

The objective of this study was to examine if increased protein intake vs. control influences body fat percentage during stable body weight.

Design

Body composition was assessed before and after a 3-month isoenergetic dietary intervention of 2MJ/d supplements exchanged with 2MJ/d of habitual ad libitum energy intake. The parallel design consisted of protein-rich supplements in the protein group (n = 12) and an isoenergetic combination of carbohydrate and fat supplements in the control group (n = 12). Daily protein intake was calculated from a 24 h urinary nitrogen. Body composition was measured by a combination of underwater-weighing technique, deuterium-dilution technique and whole-body dual-energy X-ray absorptiometry (DXA), a method that allows for estimation of 4-body compartments (fat and lean; water, bone and rest).

Results

Subjects were weight stable and did not change their habitual physical activity. Daily protein intake increased in the protein group during the intervention compared to baseline with + 11 ± 14 g (P < 0.05) vs. the control group that did not change their protein intake − 1 ± 15 g. This resulted in a significant difference in protein intake during the intervention of 80 ± 21 g of the protein group vs. 59 ± 11 g of the control group (P < 0.01). Change in body fat percentage showed a significant group × time interaction of decreased body fat percentage of − 1.0 ± 1.1% of the protein group vs. 0.1 ± 0.6% of the control group (P < 0.05). The group × time interaction of change in fat mass was significant (P < 0.05), and change in fat-free mass was a trend (P = 0.05). Fat-free mass of the protein group had increased with + 0.9 ± 0.6 kg (P < 0.01), and fat mass had decreased with − 0.6 ± 0.8 kg (P < 0.05), while the control group had not changed.

Conclusion

During increased daily protein intake vs. control body fat percentage decreased with unchanged physical activity during 3 months of stable body weight.     

Endogenous oxidative stress prevents telomerase-dependent immortalization of human endothelial cells

Introduction

With aging, oxidative stress accelerates vascular endothelial cell (EC) telomere shortening-induced senescence, and may promote atherosclerosis in humans. Our aim was to investigate whether an antioxidant treatment combined with telomerase (hTERT) over-expression would prevent senescence of EC isolated from patients with severe atherosclerosis.

Methods

Cells were isolated from internal mammary arteries (n = 11 donors), cultured until senescence with or without N-acetylcystein (NAC) and infected, or not, with a lentivirus over-expressing hTERT.

Results

Compared to control EC, hTERT-NAC cells had increased telomerase activity, longer telomeres and underwent more cell divisions. According to the donor, hTERT-NAC either delayed (n = 5) or prevented (n = 4) EC senescence, the latter leading to cell immortalization. Lack of cell immortalization by hTERT-NAC was accompanied by an absence of beneficial effect of NAC alone in paired EC. Accordingly, lack of EC immortalization by hTERT-NAC was associated with high endogenous susceptibility to oxidation. In EC where hTERT-NAC did not immortalize EC, p53, p21 and p16 expression increased with senescence, while oxidative-dependent DNA damage associated with senescence was not prevented.

Conclusion

Our data suggest that irreversible oxidative stress-dependent damages associated with cardiovascular risk factors are responsible for senescence of EC from atherosclerotic patients.     

Disease-specific education in the primary care setting increases the knowledge of people with chronic obstructive pulmonary disease: A randomized controlled trial

Objective

To examine the effect of brief disease-specific education delivered in primary care on objective measures of knowledge in individuals recently diagnosed with chronic obstructive pulmonary disease (COPD).

Methods

A randomized control trial was undertaken during which an experimental group received 2 h of education delivered by a certified COPD educator and a control group received usual care. The Bristol COPD Knowledge Questionnaire (BCKQ) was self-administered at the time of randomization and approximately three months later.

Results

Of the 93 individuals that completed the study, 50 (forced expiratory volume in 1 s [FEV₁] = 60.0 ± 14.3% predicted; 22 males) and 43 (FEV₁ = 58.2 ± 14.4% predicted; 20 males) participants were randomized to the experimental and control groups, respectively. The BCKQ increased from 27.6 ± 8.7 to 36.5 ± 7.7 points (p < 0.001) in the experimental group, which was greater than any seen in the control group (between-group difference 8.3, 95% confidence interval 5.5-11.2 points).

Conclusion

As little as 2 h of education delivered in primary care was effective at increasing objective measures of disease-specific knowledge.

Practice implications

A program of brief education delivered in the primary care setting, represents an important approach for many individuals with COPD who are unlikely to access pulmonary rehabilitation.     

Circulating vascular endothelial growth factor is independently and negatively associated with trait anxiety and depressive mood in healthy Japanese university students

Objective

Anxiety and depressive mood are sometimes accompanied by modulation of neuroendocrine and immune functions. The aim of this study was to identify circulating immune mediators reflecting anxiety and depressive mood in healthy young adults.

Methods

Anxiety and depressive mood in 209 healthy medical students (125 males and 84 females, aged 20.7 ± 2.7 years (mean ± SD)) were assessed by the Spielberger state-trait anxiety inventory (STAI) and the Zung self-rating depression scale (Zung-SDS), respectively. Cortisol and chromogranin A (CgA) levels in saliva were measured using enzyme immunoassay kits, and 50 different mediators in sera were measured by a multiplex-suspension array system. The level of statistical significance was set at α = 0.05.

Results

Forty-four mediators were measurable in sera, and each mediator showed substantial individual variations. After determining Pearson correlation coefficients, we selected candidate cytokines whose levels were associated with STAI-state (2 cytokines), STAI-trait (8 cytokines), or SDS scores (8 cytokines). The candidate cytokines plus interleukin (IL)-1β, IL-6, tumor necrosis factor-α, and macrophage migration inhibitory factor were then subjected to multiple regression analysis adjusted for gender, BMI, and salivary concentrations of cortisol and CgA. Vascular endothelial growth factor (VEGF) was independently and negatively associated with both trait anxiety (p < 0.05) and depressive mood (p < 0.01). IL-1β showed independently positive association with depressive mood (p < 0.05). Interactions between these two cytokines and gender or BMI were not observed.

Conclusion

Besides IL-1β, circulating VEGF may be a potential biomarker for negative mood states in healthy young adults.