Fatal evolution of a dilated cardiomyopathy during a primary Epstein-Barr virus infection

We report the observation of a 2-year-old child who developed an acute heart failure during a primary EBV infection. The viral serological diagnosis showed CMV and EBV IgM positivity. The detection of EBV genome by PCR and the characteristic evolution of EBV serological response confirmed a primary EBV infection.     

Allaitement maternel et pratiques à l’officine : intérêt d’une formation pour les pharmaciens et préparateurs en pharmacie

Objectives

Breastfeeding rates in France remain low compared to those in other European countries. Encouragement of breastfeeding and education by healthcare providers improve breastfeeding initiation and duration. This study evaluated the impact of a breastfeeding educational intervention on the knowledge of pharmacists and pharmacy technicians.

Methods

A before and after study was conducted in March 2012. Pharmacists and pharmacy technicians from the Nord department in France, on a voluntary basis, attended the conference. The topics were based on the specific needs of mothers and pharmacists and had been defined in an earlier study: use of a breast pump, preservation and reheating of breast milk, insufficient milk supply, cracked nipples, engorgement and mastitis, breastfeeding and medication, and effective breastfeeding. Baseline knowledge and change in knowledge were assessed by pretest and immediate posttest questionnaires.

Results

Of the 311 pharmacists and pharmacy technicians invited, 107 attended the conference. Ninety-five people completed the pretest questionnaire and 83 completed the posttest questionnaire. The knowledge of the pharmacists and pharmacy technicians on breastfeeding significantly increased after the intervention: 55.1/100 (95% CI: [51.6–58.7]) before the intervention and 84.4 (95% CI: [83.2–85.7]) after the intervention (P < 0.001). Their knowledge significantly improved on all topics (P < 0.0005). The mean score of pharmacy technicians was significantly lower than that of the pharmacists before and after the intervention (P = 0.02). Seventeen participants who underwent prior training in breastfeeding had higher baseline knowledge (64.4, 95% CI: [56.5–72.3]) than the rest of the group (P = 0.02) and they improved significantly after the intervention (87.3, 95% CI: [83.7–90.9]) (P < 0.001). Sixty-three participants (76%) had a posttest score of at least 80/100.

Conclusion

An educational intervention on breastfeeding significantly improved the knowledge of pharmacists and pharmacy technicians. Increasing the knowledge of healthcare providers is the first step in improving clinical practice that is necessary for the management of breastfeeding women.

     

Myocardial uptake and clearance of T1-201 in healthy subjects: comparison of adenosine-induced hyperemia and exercise stress

Pharmacologic stress testing with dipyridamole is useful in patients undergoing thallium-201 myocardial perfusion scintigraphy who cannot adequately exercise. Because dipyridamole increases coronary blood flow by reducing the metabolism of adenosine, the authors compared the uptake and clearance of T1-201 following exercise stress testing (EST) and resting intravenous infusion of adenosine (AI) in crossover fashion in 20 healthy men. No perfusion defects or areas of redistribution were noted in any of the scans. Mean absolute myocardial T1-201 uptake was 1.3 times greater with AI than with EST. Mean absolute extracardiac uptake was 2.0 times greater with AI. Mean T1-201 myocardial clearance was virtually the same in all AI and EST views. During AI, 70% of the subjects experienced subjective side effects, mean arterial blood pressure decreased by 15%, and heart rate increased by 48%. The effects of adenosine on T1-201 kinetics in the myocardium are similar to those of EST. Adenosine may be useful as a pharmacologic stress agent in patients undergoing T1-201 myocardial perfusion scintigraphy.     

穴位坦线配合中药治疗银屑病疗效观察

０　引言　银屑病是一原因不明的常见皮肤病,临床以慢性、复发性,表面覆盖有多层的银白色鳞屑,境界清楚的红斑、丘疹为特征．３ａ来我们采用穴拉埋线配合自拟中药验方治疗银屑病４６例,取得较好疗效．１　对象和方法１．１　对象　本组４６（男２１,女２５）例,年龄...     

Automated sequencing detects all mutations in Northern Irish patients with phenylketonuria and mild hyperphenylalaninaemia

In the first phase of the Northern Ireland PKU Study, we used automated sequencing to identify the spectrum of mutations in a random group of 32 unrelated phenylketonuria (PKU) families. We also investigated 7 Northern Irish patients with mild hyperphenylalaninaemia not requiring dietary intervention (MHP, previously referred to as non-PKU HPA). Disease-causing mutations were identified on all 78 investigated chromosomes. We found 23 different mutations, including 20 missense, 1 nonsense and 2 splice site mutations. All mutations were located within exons or at intronexon boundaries of the phenylalanine hydroxylase gene. Seven mutations occurred at CpG sites, confirming these sites as mutation hot-spots in PKU. Mutations R408W and I65T are the two commonest PKU mutations in the Northern Irish population. Two mutations (T380M and V245A) can be characterized as MHP mutations; they are quasi dominant markers for MHP since they cause mild hyperphenylalaninaemia even when occurring in conjunction with the most severe PKU mutations. The results have proven valuable for the development of a routine PKU mutation analysis system in Northern Ireland.