Incontinence. Implications for health care policy

The impact of health policies on the delivery of health services to the elderly must be considered a high priority by public policy makers. Incontinence is symptomatic of a major health policy crisis in the care of the elderly.     

Relationship between cytotoxicity,drug accumulation,DNA damage and repair of human ovarian cancer cells treated with doxorubicin: modulation by the tiapamil analog RO11-2933

Summary The effect ofN-(3,4-dimethoxyphenyl)N-methyl-2-(naphthyl)-m-dithiane-2-propylamine hydrochloride (RO11-2933), an analog of the calcium channel blocker tiapamil, on doxorubicin (DOX)-induced cytotoxicity and DNA damage in human ovarian cancer cells sensitive and resistant to DOX was investigated. A2780-DX2, A2780-DX3, and A2780-DX6 cell sublines were characterized by 7-, 26-, and 48-fold resistance after 2 h DOX exposure and 30-, 50-, and 500-fold resistance after 72 h DOX exposure, respectively. Increased drug efflux resulting in a lower intracellular drug accumulation, decreased DOX-induced DNA single-strand breaks (DNA SSBs), and rapid DNA repair correlated with the degree of resistance. In addition, DNA SSBs were rapidly repaired within 8 h in A2780-DX3 cells, whereas no significant repair of DNA SSBs was observed in sensitive cells. In comparison with verapamil, RO11-2933 was found to reverse DOX resistance at lower and nontoxic concentrations (2 M as compared with 10 M verapamil). This reversion was complete in cells with a low degree of resistance (A2780-DX1 and A2780-DX2) but partial in highly resistant cells (A2780-DX3 and A2780-DX6), and continuous exposure to RO11-2933 was essential for optimal reversal of drug resistance. Interestingly, RO11-2933 was found to inhibit the repair of DNA SSBs induced by DOX but not those induced by X-ray. These results suggest that the potentiation of DNA SSBs and the specific inhibition of DNA repair by RO11-2933 in multidrug-resistant cells could be of particular value in overcoming MDR in the clinic.Abbreviations RO11-2933 N-(3,4-dimethoxyphenethyl)-N-methyl-2-(2-naphthyl)-m-dithiane-2-propylamine hydrochloride - DOX doxorubicin-HCl - SSBs single-strand breaks - MDR multidrug resistance This work was supported in part by CA 18420 and CA 21071     

Delayed changes in postprandial lipid in young normolipidemic men after a nocturnal vitamin A oral fat load test.

The oral fat load tests (OFLT) used to study postprandial lipemia are generally conducted during the day. A nocturnal fat load test could be convenient and physiologically more appropriate. We have therefore compared the lipemic responses of 9 normolipidemic young men to OFLT given at 2200 h (nocturnal) and at 0700 h (diurnal). Triglyceride and retinyl palmitate concentrations were measured for 10 h. Peak plasma concentrations or areas under curves (AUC) for triglyceride after the diurnal and nocturnal tests were not significantly different [2.17 +/- 0.78 (diurnal) vs. 2.04 +/- 0.87 mmol/L (nocturnal) and 13.12 +/- 4.45 (diurnal) vs. 13.74 +/- 5.79 mmol/(L. h) (nocturnal)]. Peak plasma concentrations and AUC retinyl palmitate for the two tests were not different [1.71 +/- 0.69 (diurnal) vs. 1.42 +/- 0.66 mg/L (nocturnal) and 7.17 +/- 3.98 (diurnal) vs. 6.63 +/- 4.23 mg/(L. h) (nocturnal)]. The diurnal triglyceride peak occurred significantly earlier (4.3 +/- 1.2 h) than the nocturnal peak (5.8 +/- 1.7 h, P < 0.05). We have developed a model using only three sample time points to predict AUC [triglyceride at 0 h, triglyceride at average peak-time (4 h for diurnal and 6 h for nocturnal tests), and triglyceride at 10 h], thus reducing the number of blood samples. The predicted AUC was well correlated with the total AUC after nocturnal OFLT (r = 0.98, P < 0.0001). The nocturnal test appeared to be well tolerated by the subjects. The three-point simplified protocol may well be suitable for studies on large groups of subjects.     

Vitamin-D Deficiency and Supplementation Altered the Network of the Coronary Arteries in a Rodent Model—In Situ Video Microscopic Technique

The aim of our study was to identify whether vitamin-D deficiency (VDD) can alter the geometry of the coronary-resistance-artery system. Male Wistar rats were divided into vitamin-D-deficient (VD−, n = 10) and vitamin-D-supplemented (VD+, n = 8) groups. After eight weeks, branches and segments of the left-anterior-descending-coronary-artery (LAD) network were analyzed by a video-microscopy technique. Segments were divided into 50 μm-long cylindrical ring units. VDD did not increase the number of morphological abnormalities. The number of segments did not differ between the groups (VD−: 210 and VD+: 224; pooled data of 8 networks). A larger lumen area of branches was found in VD+ group, while 1–4-order branches were lengthier in the VD− group. VD− rats had less rich coronary-resistance-artery networks in terms of 50 µm-long units. (VD−: 6365 vs. VD+: 6602; pooled data of 8 networks). VD+ animals were richer in the 100–350 µm outer diameter range, and VD− animals were richer in the 400–550 µm-diameter units. In VD− rats, 150–200 and 300 µm units were almost missing at higher flow distances from the orifice. Serum vitamin-D alterations caused by dietary changes can affect the geometry of the coronary-artery network, which may contribute to vitamin-D-dependent changes in cardiovascular mortality.     

Fractal Analysis of a Non-Newtonian Fluid Flow in a Rough-Walled Pipe

The fully developed laminar flow of a viscous non-Newtonian fluid in a rough-walled pipe is considered. The fluid rheology is described by the power–law model (covering shear thinning, Newtonian, and shear thickening fluids). The rough surface of the pipe is considered to be fractal, and the surface roughness is measured using surface fractal dimensions. The main focus of this study lies in the theoretical investigation of the influence of the pipe surface roughness on the velocity profile and the Darcy friction factor of an incompressible non-Newtonian fluid. The plotted results demonstrate that shear thinning fluids are the most sensitive to the surface roughness compared with Newtonian and shear thickening fluids. For a particular value of the surface fractal dimension, there exists an intersection point where shear thinning, Newtonian, and shear thickening fluids behave the same way regarding the amplitude of the velocity profile and the friction factor. This approach has a variety of potential applications, for instance fluid dynamics in hydrology, blood flow in the cardiovascular system, and many industrial applications.     

A Comparative Study to Evaluate the Essential Work of Fracture to Measure the Fracture Toughness of Quasi-Brittle Material

In the present work, three different woven composite laminates were fabricated using the hand lay-up method. The woven reinforcement fibres were carbon fibres (CFRP), glass fibres (GFRP-W) and (GFRP-R) in combination with epoxy resin. Then, the central notch specimen tensile test (CNT) was used to measure the fracture toughness and the corresponding surface release energy (GIC). Then, the data were compared with the essential work of fracture (we) values based on the stored energy of the body to obtain a new standard fracture toughness test for composite laminates using relatively simple techniques. In addition to an extended finite element model, XFEM was implemented over a central notch specimen geometry to obtain a satisfactory validation of the essential work of fracture concepts. Therefore, the average values of (GIC) were measured with CNT specimens 25.15 kJ/m², 32.5 kJ/m² and 20.22 kJ/m² for CFRP, GFRP-W and GFRP-R, respectively. The data are very close as the percentage error for the surface release energy measured by the two methods was 0.83, 4.6 and 5.16 for carbon, glass and random fibre composite laminates, respectively. The data for the fracture toughness of XFEM are also very close. The percentage error is 4.6, 5.25 and 2.95 for carbon, glass and random fibre composite laminates, respectively. Therefore, the fundamental work of the fracture concept is highly recommended as a fracture toughness test for composite laminates or quasi-brittle Material.     

Pathophysiology,Diagnosis, and New Therapeutic Approaches for Ischemic Mitral Regurgitation

Ischemic mitral regurgitation (MR) is a valvular complication frequently seen in patients with coronary artery disease and is associated with increased mortality and morbidity. Ischemic mitral regurgitation has a complex, heterogeneous, and still incompletely understood pathophysiology involving both the mitral valve and the left ventricle. The occurrence of valve regurgitation in patients with ischemic cardiomyopathy in return accelerates left ventricular remodelling and dysfunction, ultimately leading to irreversible heart failure. Diagnostic evaluation of ischemic MR is unique and different from the other causes of MR. The severity thresholds associated with outcomes are different from primary MR, and specific imaging characteristics are potentially useful to guide therapy. The use of imaging modalities such as 3-dimensional echocardiography and cardiac magnetic resonance imaging can refine the diagnostic evaluation and help in choosing the correct management. Although multiple treatments are available to improve ischemic MR, each therapeutic option is associated with limitations and incomplete success. Therapy has therefore to be individualised for each patient. Current options include optimal medical therapy, cardiac resynchronisation therapy, percutaneous or surgical revascularisation, surgical mitral repair or replacement, and new percutaneous interventions. This review aims to discuss the latest insights regarding the pathophysiology, diagnosis, and treatment of ischemic MR.     

Whole genome sequencing to decipher the virulence phenotype of hypervirulent Klebsiella pneumoniae responsible for liver abscess,Marseille, France

European Journal of Clinical Microbiology & Infectious Diseases - We described three clinical cases of pyogenic liver abscess caused by hypervirulent Klebsiella pneumoniae (hvKp) successfully...     

New amino group functionalized porous carbon for strong chelation ability towards toxic heavy metals

Herein, ethylenediamine functionalized porous carbon (PC-ED/1.5) was synthesized, then characterized by various methods and finally used as a functional material for Cu(ii) and Pb(ii) ion removal from water. XPS revealed the presence of numerous functionalities within the surface of PC including –NH and C–N–C groups. Furthermore, S_BET, RS, XRD and FTIR analyses confirmed the changes implemented on the PC surface. Thereafter, a systematic study was implemented to analyze the interactions of the PC-ED/1.5 surface with Cu(ii) and Pb(ii) heavy metal ions. Hence, adsorption experiments showed that the PC-ED/1.5 exhibits maximum adsorption capacities of 123.45 mg g⁻¹ and 140.84 mg g⁻¹ for Cu(ii) and Pb(ii), respectively. Moreover, in situ electrostatic interactions occurring between the divalent cation and the PC-ED/1.5 functional groups was investigated. The mechanism involves chelation processes, electrostatic interactions and mechanical trapping of the metal ions in the adsorbent pores. Interestingly, a synergistic effect of the pores and surface active sites was observed. Finally, by using alginate bio-polymer we prepared membrane films of PC-ED/1.5 which showed long-term stability, regeneration capabilities and high mass recovery.

Herein, ethylenediamine functionalized porous carbon (PC-ED/1.5) was synthesized, then characterized by various methods and finally used as a functional material for Cu(ii) and Pb(ii) ion removal from water.     

Deletion of alanine 2201 in the FVIII C2 domain results in mild hemophilia A by impairing FVIII binding to VWF and phospholipids and destroys a major FVIII antigenic determinant involved in inhibitor development

The C2 domain of factor VIII (FVIII) mediates FVIII binding to von Willebrand factor (VWF) and phospholipids (PLs), thereby determining the stability and the activity of FVIII. A deletion of Ala2201 (Del2201) was identified in the FVIII C2 domain of 2 unrelated patients with mild hemophilia A (FVIII:C 11%-33%). This mutation prevents FVIII binding to a human monoclonal antibody recognizing the C2 domain and inhibiting FVIII binding to VWF and phospholipids. By comparison to healthy FVIII, Del2201 FVIII had a significantly reduced binding to VWF, which likely contributes to reduced FVIII levels in plasma. Del2201 FVIII interaction with phospholipids was evaluated in an FXa generation assay, using various concentrations of synthetic phospholipid vesicles mimicking an activated platelet surface. At the lowest phospholipid concentration allowing FXa generation, Del2201 FVIII activity was reduced 3-fold. This is the first report of a mutation altering FVIII binding to phospholipids and occurring in patients with hemophilia A.