AEDs availability and professional practices in delivery outlets in a city center in southern Vietnam

In developing countries, from 80 to 90% of the people with active epilepsy do not have access to treatment. A multitude of factors such as nonavailability of antiepileptic drugs (AEDs) contributes to the treatment gap in epilepsy. Our study carried out in 2003 in southern Vietnam showed that 57% of pharmacies had AEDs. A majority of these pharmacies were located in specific areas like market area or hospital area. The pharmacist in charge was present in only 24% of the pharmacies. The different kinds of AEDs available were carbamazepine (94%), phenytoin (61%), valproate (56%) and diazepam (16%). The maximum stock of a drug was two box. The availability of AEDs in southern Vietnam can be regarded as sufficient but does not allow an adequate treatment for a long time. An effort must be made to sensitize professional health workers to decrease the treatment gap in epilepsy.     

The DATEL (diagnosis for territorial action environment and longevity), a territorial diagnosis for a future with our elders

The territorial structure is such that it is necessary to go through a step of diagnosis. Ageing must be apprehended in all its aspects, but the multiplicity of actors involved prevents the local powers from getting a comprehensive vision of the stakes and from implementing the adequate policies. The gerontop?le of "Pays de Loire" has developed an original method of diagnosis consisting in a comprehensive approach so called DATEL (diagnosis for territorial action environment and longevity). It is based on three aspects: an analysis of the geographical areas, a diagnosis shared by citizens and local councilors according to the Vancouver method, and a prospective review of the medico-social and health situation which integrates all services and forces at work and their potential demographic evolution. This DATEL aims to give local politicians the means to take well-informed decisions that will sustain the rapid demographic evolution of the ageing population and will maintain a good quality of life for our elders.     

Infection of Mice with Mycobacterium avium Primes CD8 Lymphocytes for Apoptosis upon Exposure to Macrophages

Mycobacterial infection is associated with granuloma formation in which the presence of apoptosis has been recognized. The role of CD4⁺ T and CD8⁺ T cells in host protection against mycobacterial infections has been demonstrated. Previous studies, however, have shown that CD8⁺ T cells have a limited role in host defense against Mycobacterium avium infection, and we hypothesize that M. avium infection could lead to T cell apoptosis. To investigate this hypothesis, C57BL/6 mice were infected with M. avium strain 101, and the rate of apoptosis of splenic lymphocytes cultured ex vivo with peritoneal macrophages was determined and compared with that of controls. When exposed to infected macrophages ex vivo, splenic lymphocytes from M. avium-infected mice underwent apoptosis, as determined by the TUNEL assay. This increased T cell apoptosis above the control level was observed after 3 weeks but not after only 1 week of infection in mice. No splenic T cell apoptosis was observed when lymphocytes from Mycobacterium smegmatis-infected mice were cultured in the presence of M. smegmatis-infected peritoneal macrophages. Likewise, macrophages infected in vitro with heat-killed M. avium did not trigger T cell apoptosis. Culture of macrophages in different chamber from lymphocytes, separated by a transwell membrane, was not associated with increase of apoptosis compared with uninfected control, suggesting a requirement for direct cell–cell interactions to trigger lymphocyte apoptosis. Using a double staining TUNEL followed by anti-mouse CD4 or anti-mouse CD8 monoclonal antibodies, it was observed that only CD8⁺ T cells but not CD4⁺ T cells underwent apoptosis at 3 weeks of infection. In conclusion, M. avium infection in C57/BL6 mice for 3 weeks renders CD8⁺ T cells prone to apoptosis when exposed ex vivo to macrophages infected with M. avium.     

Antiproliferative and receptor binding properties of α- and β-casomorphins in the T47D human breast cancer cell line

In previous studies, we have shown that opioid agonists ([ -Ala², -Leu⁵]enkephalin (DADLE), [ -Ser²,Leu⁵]enkephalin-Thr⁶ (DSLET), ethylketocyclazocine and etorphine) bind to opioid binding sites and decrease cell proliferation of human T47D breast cancer cells. Furthermore, we provided evidence about a cross-reaction, also in the T47D human breast cancer cell line, of μ-acting opioids with type-II somatostatin receptors. Since a potential source of opioid activity in the breast might be casomorphin peptides (produced by the enzymatic degradation of α-casein and β-casein), we investigated the antiproliferative action of five different casomorphin peptides: α-casein-(90-95), α-casein-(90-96), β-casomorphin, β-casomorphin-(1-5) and morphiceptin. We show that all five peptides decreased, in a dose-dependent manner, cell proliferation. The general antagonist diprenorphine produced only a partial reversal of their action. Furthermore, we provide evidence that all peptides (except for morphiceptin) bind to δ- and κ-opioid binding sites of T47D cells with different selectivity. Finally, we show that these peptides are also partial competitors at the somatostatin receptors present in the same cell line.     

No Evidence of Metabolic Disorders 10 to 22 Years After Camey Type I Ileal Enterocystoplasty

Purpose

Resection of ileal segments may result in malabsorption and a decrease in intestinal uptake of different substances. The use of intestinal segments in the urinary tract may also cause metabolic disorders. We studied long-term metabolic consequences of enterocystoplasty after radical cystoprostatectomy for bladder cancer.

Materials and Methods

We reviewed 17 patients with a Camey type I enterocystoplasty for a mean of 12.9 years (range 10 to 22) after radical cystoprostatectomy. The enterocystoplasty was constructed with a 35 cm. ileal segment resected 20 cm. proximal to the ileocecal valve. All patients underwent complete physical and radiological examinations, including renal ultrasonography and excretory urography. Laboratory studies included blood count with mean corpuscular volume and packed cell volume. Serum was analyzed for electrolytes, hepatic function, cholesterol, triglycerides, albumin, protein, vitamins B12 and B9, iron, ferritin, calcium, phosphate, vitamin D, parathyroid hormone, urea, creatinine, creatinine clearance and prostate specific antigen. In addition urine calcium, protein, creatinine and pH were measured, and a midstream urine specimen was obtained.

Results

There was no evidence of metabolic acidosis, impairment of phosphorus and calcium metabolism, vitamin D deficiency or parathyroid hormone disturbance. All other laboratory tests were within the normal range. Mean creatinine was 106 micro mol./l., mean creatinine clearance was 1.5 ml. per second per m.² and mean prostate specific antigen was 0.2 ng./ml. No patient had post-void residual urine or a dilated upper urinary tract.

Conclusions

This ileal bladder substitute does not induce long-term metabolic anomalies. However, these results may be due to the short ileal length used in the Camey type I technique and the absence of post-void residual urine obtained by good urinary training (that is sustained voiding function).     

Evaluation of the phytotoxicity of polycontaminated industrial effluents using the lettuce plant (Lactuca sativa) as a bioindicator

Industrial wastewater containing heavy metals is generally decontaminated by physicochemical treatment consisting in insolublizing the contaminants and separating the two phases, water and sludge, by a physical process (filtration, settling or flotation). However, chemical precipitation does not usually remove the whole pollution load and the effluent discharged into the environment can be toxic even if it comes up to regulatory standards. To assess the impact of industrial effluent from 4 different surface treatment companies, we performed standardized bioassays using seeds of the lettuce Lactuca sativa. We measured the rate of germination, and the length and mass of the lettuce plantlet. The results were used to compare the overall toxicity of the different effluents: effluents containing copper and nickel had a much higher impact than those containing zinc or aluminum. In addition, germination tests conducted using synthetic solutions confirmed that mixtures of metals have higher toxicity than the sum of their separate constituents. These biological tests are cheap, easy to implement, reproducible and highlight the effects caused by effluent treated with the methods commonly applied in industry today. They could be routinely used to check the impact of industrial discharges, even when they meet regulatory requirements for the individual metals.     

Influence of pravastatin on carotid artery structure and function in dyslipidemic HIV-infected patients receiving antiretroviral therapy

Forty-two pravastatin-treated HIV-positive patients and 42 sex, age, and smoking status-matched hypercholesterolemic HIV-positive patients not under lipid-lowering treatment were compared for differences in intima-media thickness (IMT) of the common carotid artery (CCA) and aortic stiffness. Pravastatin had no influence on carotid artery structure and function, or aortic stiffness. Age and body mass index were independent determinants of IMT of the CCA. Mean arterial pressure, age, duration of HIV infection and protease inhibitor exposure determined aortic stiffness.     

Fatal varicella hepatitis in an asthmatic adult after short-term corticosteroid treatment

A 28-year-old male patient, treated with prednisone for bronchitis with sibilant rales, developed fever with abdominal pain and generalized vesicular rash after coming in contact with varicella-infected children. He was hospitalized after having a seizure. Laboratory values revealed hepatitis and rapidly fulminant hepatic insufficiency with disseminated intravascular coagulation. Despite acyclovir treatment, the patient died 4 days after admission. Clinical presentation could evoke a Reye's syndrome, but liver biopsy showed massive coagulative necrosis. This report demonstrates the increased risk of complicated varicella associated with the use of corticosteroids, even for a short period of time.