Dénutrition et affections neuromusculaires de l''adulte et de l''adolescent

Patients with neuromuscular diseases have protein malnutrition related to the muscle mass decrease. When associated with a decrease in food intake below requirements, patients become cachectic. Respiratory complications are then frequent and severe. In case of respiratory distress, the acute stress might aggravate the protein loss which will be particularly difficult to restore if the muscular activity is reduced. Although there are no curative therapies for neuromuscular diseases but all symptomatic treatments are useful in maintaining function and quality of life; therefore the prevention of malnutrition is essential. Nutritional care is difficult because of the lack of norms for body composition and protein and energy requirements. The nutritional support must take into account the swallowing difficulties, the digestive and polyvisceral involvement and the natural history of the disease. The nutritional support is usually enteral. Feeding through a gastrostomy tube, feasable at home, has improved the quality of life of the patient. Parenteral nutrition is prescribed for limited periods for surgery or acute respiratory failure.     

A multi-perspective survey of mental health consumer needs

Conclusions There is extensive evidence that perspectives on mental health consumer needs vary widely between consumers and other stakeholders-administrators, practitioners, and family members. Traditional methods of determining mental health consumer needs, based on professional input only, have inhibited program development. While progress has been achieved when shared goals have been identified, it has also been inhibited by a lack of known areas of consensus between stakeholder groups.Surveys provide a cost-effective step toward documenting shared views from stakeholders who have the greatest stake in influencing the size and direction of the mental health service system. Identifying shared views is necessary to coordinate stakeholder efforts. The most encouraging result of the surveys is that there are many areas of consensus and thus the potential exists for the stakeholders to coordinate their efforts toward shared goals to better meet important consumer needs by prioritizing services, improving practitioner training, and coordinating advocacy.     

The HGAR1 familial hypercholesterolemia pedigree

Data on 232 members of a single pedigree, descended from two pairs of original parents, were made available to the participants of Genetic Analysis Workshop 8 (GAW8). In addition to information concerning age and sex, measurements for 10 quantitative traits and genotypes at 22 polymorphic marker loci were also provided for a subset of 193 of these family members. © 1993 Wiley-Liss, Inc.     

General Anesthetics Do Not Affect Release of the Neuropeptide Cholecystokinin from Isolated Rat Cortical Nerve Terminals

Background: General anesthetics inhibit evoked release of classic neurotransmitters. However, their actions on neuropeptide release in the central nervous system have not been well characterized.

Methods: The effects of representative intravenous and volatile anesthetics were studied on the release of sulfated cholecystokinin 8 (CCK8s), a representative excitatory neuropeptide, from isolated rat cerebrocortical nerve terminals (synaptosomes). Basal, elevated KCl depolarization-evoked and veratridine-evoked release of CCK8s from synaptosomes purified from rat cerebral cortex was evaluated at 35[degrees]C in the absence or presence of extracellular Ca2+. CCK8s released into the incubation medium was determined by enzyme-linked immunoassay after filtration.

Results: Elevation of extracellular KCl concentration (to 15-30 mm) or veratridine (10-20 [mu]m) stimulated Ca2+-dependent CCK8s release. Basal, elevated KCl- or veratridine-evoked CCK8s release was not affected significantly by propofol (12.5-50 [mu]m), pentobarbital (50 and 100 [mu]m), thiopental (20 [mu]m), etomidate (20 [mu]m), ketamine (20 [mu]m), isoflurane (0.6-0.8 mm), or halothane (0.6-0.8 mm).     

Cor triatriatum associated with partial anomalous pulmonary venous connection to the coronary sinus: Echocardiographic and angiocardiographic features

Summary An infant girl is described who had cor triatriatum and partial anomalous pulmonary venous connection of the left pulmonary veins to the coronary sinus, the first report of this combination of lesions. The infant also had a Dandy-Walker malformation and multiple facial and intrathoracic hemangiomas. The cardiac diagnosis was made by two-dimensional echocardiography. Cardiac catheterization and angiography confirmed the findings and also demonstrated a persistent left superior vena cava draining to the coronary sinus. The infant underwent successful surgical repair. Partial anomalous pulmonary venous connection and left superior vena cava not infrequently are associated with cor triatriatum. Although two-dimensional echocardiography is sensitive for the detection of cor triatriatum, preoperative cardiac catheterization is necessary to identify unequivocally systemic and pulmonary venous connections.     

Antibodies to interleukin-1 inhibit cytokine-induced proliferation of neonatal rat Schwann cells in vitro

Unfractionated cytokines have been shown to induce in vitro proliferation of neonatal rat Schwann cells but the nature of the mitogen(s) is not known. A mixture of rabbit antibodies specific for recombinant interleukin-1α (IL-1α) and interleukin-1β (IL-1β) inhibited Schwann cell proliferation induced by unfractionated human cytokines whereas antibodies to interleukin-2 (IL-2) and control IgG did not. However, purified human IL-1 and recombinant human IL-1α or β did not induce Schwann cell proliferation on their own.