High propionic acid fermentations and mineral accumulation in the cecum of rats adapted to different levels of inulin

The digestive and metabolic effects of inulin (from chicory) were studied in rats adapted to semipurified diets containing 0, 5, 10 or 20% inulin (wt/wt). Moderate levels of inulin (5-10%) did not significantly affect food intake or body weight gain. Dietary inulin resulted in considerably greater cecal fermentation and a significantly greater intraluminal concentration of propionate (peaking at 58.4 mmol/L). A lower concentration of acetate (42.6 mmol/L) was observed in rats fed 20% inulin. Lactic fermentations were observed in rats fed the 10 or 20% inulin diets. The cecal pool of volatile fatty acids tended to reach a plateau in rats fed diets containing more than 10% inulin (up to 600-700 mumol), but volatile fatty acid absorption was a slightly hyperbolic function of the dietary inulin level. Butyrate absorption was proportionally lower than that of propionate. Inulin-containing diets induced an enlargement of the cecal pool of calcium, phosphate and (to a lesser extent) magnesium. There was also an enhanced absorption of these divalent cations. The cecal pool of bile acids was greater in rats fed inulin, and this oligosaccharide displayed a slight hypocholesterolemic effect, even in rats fed the 5% inulin diet. However, plasma triglycerides were depressed only in rats fed the 20% inulin diet. In conclusion, inulin seems very effective in promoting propionic fermentation and in enhancing the calcium content of the large intestine. However, high levels of inulin (greater than 10%) may affect growth in rats and lead to acidic (pH 5.65) cecal fermentation.     

Adverse events in phase one studies: a study in 430 healthy volunteers

Summary All the clinical, laboratory and electrocardiographic adverse events detected during 24 Phase I studies in the same unit over a 5 y period are reported here. 430 healthy male volunteers were involved, corresponding to 5488 days of follow-up.The overall incidence of adverse events was 13.5%, with a significant difference between active drug (15.3%) and placebo (7.4%) treatments. There were 69 distinct types of adverse events. Headache was the most frequent symptom (2%). There were severe adverse events in 20 cases (0.36%), with an incidence of 20/430 per subject (4.6%). There were no deaths or life-threatening events.Although the main objective of Phase I studies is to determine the maximum dose tolerated, cause-effect relationships with adverse events are hard to establish, because of the frequency of adverse events with placebo, and because of the limited number of subjects included such studies.     

Severe gestational hypertriglyceridemia: related complications and management

We present two cases of severe hypertriglyceridemia (HTG>10g/l) in pregnancy. The first reports the case of a primigravida with mild HTG before conception. Triglycerides (TG) increased thereafter (20.9g/l) during pregnancy causing pancreatitis and in utero fetal death at 24 weeks' gestation (WG). The second deals with the de novo occurrence of a severe HTG (19g/l) diagnosed incidentally at 34 WG and complicated by acute renal failure. Severe HTG in pregnancy threatens maternal and fetal prognosis. We have summarized the curative and preventive management of gravidic HTG.     

Modélisation fonctionnelle adaptée à l’analyse des risques en radiothérapie

PurposeThis document presents a systematic and structured approach for functional modeling for risk analysis in radiotherapy, aiming to reconcile the need, on one hand, for a method that can be applied generally and, on the other hand, for a method that provides a highly precise model.Materials and methodsThe approach relies on new functional structuring patterns and flux analysis, derived from system engineering and knowledge engineering.ResultsThe method affords strong support for the development of detailed models of the patient's process through a department of radiotherapy. Lack of structure of the actual process in a particular department may be easily identified leading to the development of specific procedures for the improvement of security.ConclusionModeling approach derived from engineering may be used for functional modeling for risk analysis in radiotherapy.     

Démarche systématique d’analyse dysfonctionnelle en radiothérapie

PurposeWe previously presented a systematic and structured approach to acquire an accurate functional model of the patient's process in radiotherapy. This approach relied on new functional structuring patterns, derived from system engineering and knowledge engineering. Additionally, we propose a complementary methodical process for the dysfunctional analysis of the obtained functional model.Materials and methodsThe procedure is based on joint implementation of two qualitative methods named “Failure modes and effects analysis” (FMEA) and “Hazard and operability” (HazOp).ResultsAll the technical, the human and the organizational dimensions of the patient's process are pooled in a unique, exhaustive and detailed dysfunctional analysis. The application of this systematic approach within a particular institution can precisely identify the risks incurred by patients in care, but also highlight the logical sequence between precursor events and incidents.ConclusionThe dysfunctional analysis presented in this document will be used for the development still in process of quantified risk models.     

Etiologic factors in 500 cases of bleeding peptic ulcer

Summary In a series of 500 cases of G.I. bleeding collected from 1791 cases of peptic ulcer hospitalized in the same service, we have analyzed six factors related to the bleeding ulcer.We have considered the role of the site of the ulcer, of the patient's sex, age and race, the temporal relation of the hemorrhage to the ulcer history and, finally, the mortality rate.Above all, we have emphasized the role of associated disease and drugs in relation to causation of the hemorrhage and to prognosis. Of these, alcoholism and acetylsalicylic acid are the most important factors.