Single polymorphism nucleotide rs1333049 on chromosome 9p21 is associated with carotid plaques but not with common carotid intima-media thickness in older adults. A combined analysis of the Three-City and the EVA studies

ObjectivesTo address the relationship of rs1333049, the 9p21 variant showing the strongest association with coronary heart disease (CHD), with carotid plaques and plaque-free common carotid artery intima-media thickness (CCA-IMT) in older adults from 2 French population-based cohorts.MethodsWe genotyped for rs1333049, 4097 CHD-free participants including 3191 aged 65–86 years from the Three-City (3C) Study and 906 aged 59–71 years from the Vascular Aging Study (EVA). Plaque-free mean CCA-IMT and the presence of carotid plaques were assessed.ResultsIn multivariate analysis, each C allele copy of rs1333049 was associated with baseline carotid plaques (odds ratio (OR) = 1.24; 95% confidence interval (CI) = 1.13–1.36; p < 0.001) but not with baseline CCA-IMT (p = 0.19). Among the EVA participants, the C allele was associated with 4-year plaques progression (p = 0.04) but not with CCA-IMT progression.ConclusionThe chromosome 9p21 locus might influence CHD risk through carotid plaques development.     

Diversity-Oriented Synthesis Yields a New Drug Lead for Treatment of Chagas Disease

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Induced membrane for treatment of critical sized bone defect: a review of experimental and clinical experiences

Purpose

The purpose of this study was to review experimental and clinical experiences about the use of an induced membrane to address critical bone size defect of the limbs.

Methods

From a review of published experimental and clinical data and from our clinical experience, we present the key data about the use of an induced membrane to address critical bone size defect of the limbs.

Results

After reviewing the concept of critical sized bone defect, we present the different indications of an induced membrane, the key points of the surgical technique and the strategy of bone grafting given the indication, localization and importance of the critical sized bone defect. Finally, we discuss the perspective of the use of an induced membrane with various bone substitutes.

Conclusions

The use of an induced membrane to treat critical sized bone defects of the limbs is a simple, reliable and reproducible technique. Certain technical steps should be pointed out and observed with great caution in order to avoid any pitfalls. This technique will probably be a key step for facilitating bone inclusion of new bone substitutes proposed by recent bioengineering.     

Lipid peroxidation in all-in-one admixtures for preterm neonates: impact of amount of lipid, type of lipid emulsion and delivery condition

Aim: To evaluate the effect of lipid emulsion composition and delivery condition on lipid peroxidation in typical all‐in‐one parenteral admixtures for preterm neonates. Methods: Malonedialdehyde (MDA) concentrations were assessed in different all‐in‐one admixtures. We evaluated the effects of fat blend (three lipid emulsions) and the amount of lipids, as well as the effects of protecting bags and/or tubing from ambient light and storage for 72 h. MDA was measured by liquid chromatography/mass spectrometry. Results: Three hundred and sixty samples were collected from 114 admixtures. Neither the type of lipid (p = 0.43) nor the interaction between light and type of lipid (p = 0.49) had any influence on final MDA concentrations, but the increase in MDA concentration at 24 h (T₂₄) was related to light exposure (p < 0.001). The increase in MDA concentration was related to the increase in lipid amount in the admixture at T₀ (r = 0.77) and T₂₄ (r = 0.86). MDA concentrations in solutions stored for 72 h showed no significant increase, with no difference between the three lipid emulsions (p = 0.69). Conclusion: All‐in‐one admixtures may be interesting for the parenteral nutrition of preterm neonates. Protection from light and restricting the amount of lipid to what is required for appropriate energy provision are essential to limit lipid peroxidation.     

Pertinence of the self-report mother-to-infant bonding scale in the neonatal unit of a maternity ward

Objective

To assess the relevance of the self-report Mother-to-Infant Bonding Scale (MIBS) to evaluate mother-infant bonding in the neonatal unit of a maternity ward.

Material and methods

Forty-eight hours after delivery, 78 mothers responded to the MIBS, the Edinburgh Postnatal Depression Scale (EPDS), the Adult Attachment Questionnaire (AAQ), and the Mother's Assessment of the Behavior of her Infant (MABI) questionnaire. They were then interviewed 24 h later by a pediatric psychiatrist, who assessed the mother-infant relationship. The neonatology nurses also filled out the MIBS, imagining the mothers' responses, and responded anonymously to questionnaires on the use of the MIBS in their daily practice.

Results

MIBS satisfactorily detected difficulties in mother-child bonding: the area under the ROC curve was 0.93, with a sensitivity of 0.9 and a specificity of 0.8 for a threshold score ≥ 2. MIBS was independent of EPDS (r = 0.11, p = 0.29) and AAQ (r = 0.05, p = 0.63). However, it was influenced by the infant's behavioral characteristics (r = 0.3, p = 0.01). MIBS scores of the mothers and nurses showed low correlation (r = 0.31, p = 0.004) and the item-by-item responses were rarely concordant. Fully 100% of the nurses stated that the MIBS was helpful in evaluating mother-child bonding and 85% of the mothers found it beneficial.

Conclusion

New mothers need to express their feelings about their babies, as hospital staff observation of mother-infant interactions is not sufficiently reliable for assessing the attachment process. The self-report MIBS is a useful tool for detecting difficulties in early mother-infant bonding.     

Prevention of deformational plagiocephaly in neonates

Background

Since the early 90s a striking rise in deformational plagiocephaly (DP) has been reported, and a causal link between the “back to sleep” position recommended to reduce the risk of sudden infant death syndrome. Recent data suggested that supine position is a risk factor only when combined with other environmental factors

Objective

To evaluate the impact of early intervention in the newborn environment on the prevalence of DP at 4 months of life.

Methods

A multicentric, prospective, controlled study in healthy term neonates. Within 72 h of birth, all parents received the usual recommendations for positioning their infants to prevent sudden infant death syndrome. In the Intervention group, recommendations were also given to encourage spontaneous and unhindered physical movement. At 1, 2 and 4 months, we looked for plagiocephaly and collected information on the infants' environment.

Results

The environment of the Intervention group (n = 88) was significantly more favorable to unhindered movement than in the control group (n = 51) (lower immobility score, p < 0.01). The prevalence of DP was significantly lower in the Intervention group than in the control group (13% vs. 31%, p < 0.001). For each supplementary hour of immobility during the third and fourth months of life, the risk of DP at four months doubled (OR:2.1[1.4-3.2]).

Conclusion

Early postnatal intervention on the maternity ward reduces the prevalence of DP. The recent rise in the incidence of DP could be related to a lack of stimulation and encouragement to physical movement rather than to supine positioning proposed for prevention of sudden infant death syndrome.     

Open source challenges for hospital information system (HIS) in developing countries: a pilot project in Mali

Background  

We are currently witnessing a significant increase in use of Open Source tools in the field of health. Our study aims to research the potential of these software packages for developing countries. Our experiment was conducted at the Centre Hospitalier Mere Enfant in Mali.