Assessing chronic fish health: An application to a case of an acute exposure to chemically treated crude oil

Human alteration of marine ecosystems is substantial and growing. Yet, no adequate methodology exists that provides reliable predictions of how environmental degradation will affect these ecosystems at a relevant level of biological organization. The primary objective of this study was to develop a methodology to evaluate a fish's capacity to face a well-established environmental challenge, an exposure to chemically dispersed oil, and characterize the long-term consequences. Therefore, we applied high-throughput, non-lethal challenge tests to assess hypoxia tolerance, temperature susceptibility and maximal swimming speed as proxies for a fish's functional integrity. These whole animal challenge tests were implemented before (1 month) and after (1 month) juvenile European sea bass (Dicentrarchus labrax) had been acutely exposed (48h) to a mixture containing 0.08gL(-1) of weathered Arabian light crude oil plus 4% dispersant (Corexit© EC9500A), a realistic exposure concentration during an oil spill. In addition, experimental populations were then transferred into semi-natural tidal mesocosm ponds and correlates of Darwinian fitness (growth and survival) were monitored over a period of 4 months. Our results revealed that fish acutely exposed to chemically dispersed oil remained impaired in terms of their hypoxia tolerance and swimming performance, but not in temperature susceptibility for 1 month post-exposure. Nevertheless, these functional impairments had no subsequent ecological consequences under mildly selective environmental conditions since growth and survival were not impacted during the mesocosm pond study. Furthermore, the earlier effects on fish performance were presumably temporary because re-testing the fish 10 months post-exposure revealed no significant residual effects on hypoxia tolerance, temperature susceptibility and maximal swimming speed. We propose that the functional proxies and correlates of Darwinian fitness used here provide a useful assessment tool for fish health in the marine environment.

Management of burn wounds of the head and neck region

Management of burn wounds of the head and neck region. Management of the severely burned patient is ery often a challenge, not only due to major disturbances in anatomy and physiological processes, but also because the relatively low incidence of this pathology in both civilian and military practice results in care providers'lack of experience. The purpose of this educational document is to provide doctors confronted with these formidable trauma patients with basic management guidelines as well as some practical tips. In summary, and most importantly, these patients should be reated as any other multitrauma patient. First aid is essential and can be provided by non-medical staff. Initial medical nanagement should focus on the usual, familiar trauma algorithms of ABCDEF from the emergency management of evere burns (EMSB) manual' or the ABCDEs of the manual of advanced trauma life support (ATLS)2 or advanced burn life support (ABLS). Medical care should proceed through the following steps - Step one: establish a reliable intravenous nfusion; step two: protect the airway; step three: establish and maintain a haemodynamic state compatible with sufficient organ perfusion in order to reduce aggravation of the burn wounds and increase overall survival likelihood; step four: provide analgesia with adequate sedation and provide anaesthesia for escharotomy, fasciotomy or other surgical injuries; step five: maintain normothermia; step six: feed the patient by starting enteral nutrition as early as possible; step seven: prevent infection using antiseptic wound management, systemic antibiotics and tetanus prophylaxis. All of these intricate steps require continuous reassessment and adjustment, but the existence of other wounds (blast injuries, penetrating and blunt trauma) even further complicates the management of burn casualties.

Evolutionary Pathways to Break Down the Resistance of Allelic Versions of the PVY Resistance Gene va

Emergence of viral genotypes can make control strategies based on resistance genes ineffective. A few years after the deployment of tobacco genotypes carrying alleles of the Potato virus Y (PVY) recessive resistance gene va, virulent PVY isolates have been reported, suggesting the low durability of va. To have a broader view of the evolutionary processes involved in PVY adaptation to va, we studied mutational pathways leading to the emergence of PVY resistance-breaking populations. The viral genome-linked protein (VPg) has been described to be potentially involved in va adaptation. Analyses of the VPg sequence of PVY isolates sampled from susceptible and resistant tobacco allowed us to identify mutations in the central part of the VPg. Analysis of the virulence of wild-type isolates with known VPg sequences and of mutated versions of PVY infectious clones allowed us to (i) validate VPg as the PVY virulence factor corresponding to va, (ii) highlight the fact that virulence gain in PVY occurs rapidly and preferentially by substitution at position AA₁₀₅ in the VPg, and (iii) show that the 101G substitution in the VPg of a PVY^C isolate is responsible for cross-virulence toward two resistance sources. Moreover, it appears that the evolutionary pathway of PVY adaptation to va depends on both virus and host genetic backgrounds.

A selection of reference genes and early-warning mRNA biomarkers for environmental monitoring using Mytilus spp. as sentinel species

mRNA biomarkers are promising tools for environmental health assessment and reference genes are needed to perform relevant qPCR analyses in tissue samples of sentinel species. In the present study, potential reference genes and mRNA biomarkers were tested in the gills and digestive glands of native and caged mussels (Mytilus spp.) exposed to harbor pollution. Results highlighted the difficulty to find stable reference genes in wild, non-model species and suggested the use of normalization indices instead of single genes as they exhibit a higher stability. Several target genes were found differentially expressed between mussel groups, especially in gills where cyp32, π-gst and CuZn-sod mRNA levels could be biomarker candidates. Multivariate analyses confirmed the ability of mRNA levels to highlight site-effects and suggested the use of several combined markers instead of individual ones. These findings support the use of qPCR technology and mRNA levels as early-warning biomarkers in marine monitoring programs.

Surgical management of an epithelioid hemangioendothelioma of the superior vena cava protruding into the right atrium

Epithelioid hemangioendothelioma (EH) is a rare malignant tumor of vascular origin that often involves soft tissues and visceral organs, and less commonly, large veins. We report a case of EH of the superior vena cava protruding into the right atrium and its surgical management.

Interplay between spin-glass clusters and geometrical frustration

The presence of spin-glass (SG) order in highly geometrically frustrated systems is analyzed in a cluster SG model. The model considers infinite-range disordered interactions among cluster magnetic moments and the J(1)-J(2) model couplings between Ising spins of the same cluster. This model can introduce two sources of frustration: one coming from the disordered interactions and another coming from the J(1)-J(2) intracluster interactions (intrinsic frustration). The framework of one-step replica symmetry breaking is adopted to obtain a one-cluster problem that is exactly solved. As a main result we create phase diagrams of the temperature T versus intensity of the disorder J, where the paramagnetic-SG phase transition occurs at T(f) when T decreases for high-J values. For low-J values, the SG order is absent for antiferromagnetic clusters without intrinsic frustration. However, the SG order can be observed within the intracluster intrinsic frustration regime even for lower intensity of disorder. In particular, the results indicate that the presence of small clusters in geometrically frustrated antiferromagnetic systems can help stabilize the SG order within a weak disorder.

Methemoglobinemie consecutive a l'abus de gel de lidocaïne visqueuse

Lidocaine use may lead to methemoglobinemia. Lidocaine is clinically widely used as an anaesthesic drug, however its toxic effect is rare. We report a high methemoglobinemia level of 31.1 % following repeated Xylocaine® gel oral applications. New metabolic pathways of lidocaine have been reported leading to dimethylphenylhydroxylamine in humans. This metabolism is very similar to the aniline derivative ones, and may explain lidocaine methemoglobinemia effect.

Outpatient hemithyroidectomy

Outpatient surgery consists of performing an elective surgical procedure in the context of a day-only admission. This type of management is the result of sociological changes and allows a reduction of the cost. Hemithyroidectomy is a well-defined surgical procedure with known complications. The authors assessed the feasibility, patient satisfaction and cost of outpatient hemithyroidectomy.

MATERIAL AND METHODS

One hundred and forty-six hemithyroidectomies were performed between August 2011 and September 2012. Inclusion criteria for outpatient surgery were surgical, anaesthetic and patient-dependent. Exclusion criteria were related to the bleeding risk, socio-economic conditions and the patient's understanding of the procedure. Preoperative information and the modalities of anaesthesia, surgery, postoperative surveillance and follow-up were standardized. Patient satisfaction was evaluated by questionnaire and cost was evaluated on the basis of medical information department data.

RESULTS

Forty patients were eligible and 34 patients agreed to outpatient surgery (M/F sex ratio: 1/4; mean age: 46 ± 6.3 years), but only 32 operations were performed on an outpatient basis. Two conversions to conventional hospitalisation were required, one because of preoperative initiation of platelet anti-aggregants and the other because of nausea. One patient remained in hospital on the day after the operation because of severe asthenia and nausea.

CONCLUSION

Patients were satisfied with this type of management and 100% of them reported that they would repeat the experience. The economy for our establishment was €711 per patient. This procedure improves patient comfort without increasing the risks and allows a reduction of management costs.

Reversibility of acquired amyloid polyneuropathy after liver retransplantation

Domino liver transplantation (DLT) has become an accepted procedure designed to address problems with organ limited supply. However, cases of acquired amyloid neuropathy are increasingly being recognized following this procedure. Until now, only one patient had undergone liver retransplantation and follow-up findings were not reported. We describe the case of a 72-year-old patient with partial recovery from acquired amyloid neuropathy following retransplantation with a deceased donor 7 years after DLT performed for end-stage liver disease. His clinical and paraclinical improvement is described, and the impact of this case on the indication for a domino procedure and the challenges linked to retransplantation are discussed.

Fast screening of Bifidobacterium longum sublethal stress conditions in a novel two-stage continuous culture strategy

A central issue in the application of probiotics as food additives is their fastidious production and their sensitivity to many environmental stresses. The importance of inducible cell-protective mechanisms triggered by application of sublethal stresses for survival under stress conditions has been demonstrated. Continuous cultures could be a suitable and more efficient method to test stress factors on one culture instead of several repeated batch cultures. In this study, the application of a two-stage continuous culture of Bifidobacterium longum NCC2705 was investigated. The first reactor was operated under fixed conditions at 37 °C and pH 6.0 and used to produce cells with controlled physiology, mimicking cells in the late exponential growth phase. Stress pretreatment combinations of pH (6.0, 5.0 and 4.0), temperature (37, 45 and 47 °C) and NaCl (0, 5 and 10%) were tested in the second reactor. Of all tested combinations, only those of pH 4.0 significantly decreased cell viability in the second reactor compared to control conditions (37 °C, pH 6.0, 0% NaCl) and, therefore, could not be considered as sublethal stresses. Pretreatments with 5 or 10% NaCl had a negative effect on cell viability after gastric lethal stress. A significant improvement in cell resistance to heat lethal stress (56 °C, 5 min) was observed for cells pretreated at 47 °C. In contrast, heat pretreatment negatively affected cell viability after freeze drying and osmotic lethal stresses. The two-stage continuous culture allowed for efficient screening of several stress pretreatments during the same experiment with up to four different conditions tested per day. Optimal sublethal stress conditions can also be applied for producing cells with traditional batch cultures.

Effect on disability and safety of Tafamidis in late onset of Met30 transthyretin familial amyloid polyneuropathy

BACKGROUND AND PURPOSE

The aim of this study was to assess the effect of Tafamidis, which slows the progression of early stages of Met30 transthyretin (TTR) familial amyloidosis polyneuropathy (FAP) in more advanced cases.

METHODS

The study was a prospective, non-randomized controlled trial carried out at the French national reference centre for FAP with follow-up at 1 year. Thirty-seven consecutive Met30-TTR-FAP patients were enrolled between December 2009 and July 2011, with NIS-LL (Neuropathy Impairment Score-lower limbs) > 10 and Karnofsky score > 60. Their mean (SD) age was 56.4 (19) years. Seventy-seven per cent of patients had a walking disability. Seven patients (19%) were withdrawn for adverse effects. The primary study outcome measurements, planned before data collection began, were NIS-LL and NIS-UL (upper limbs) scores and disability scores.

RESULTS

Of the 37 patients entered into the study, 29 were evaluated at 6 months and 13 at 12 months. During the first 6 months of treatment, the mean progression of NIS-LL score was 4.8 and was similar to that during the period before treatment. Among the 45% of patients without NIS-LL progression, the NIS-UL score worsened in 55%. During the first year, 55% deteriorated with respect to disability and 38% with respect to NIS only; only two patients (7%) remained stable. Four (out of 20; 20%) patients who were previously stage 1 reached stage 2 (walking with aid) after this period. Two out of nine patients who were initially normotensive developed orthostatic hypotension. There were a total of 19 adverse events, including four febrile urinary tract infections and three severe diarrhoeas, with faecal incontinence in two.

CONCLUSION

In most patients with advanced Met30 TTR-FAP, Tafamidis is not able to stop disease progression, in respect of both NIS-LL and disability. Other anti-amyloid medicines should be assessed in this context.

Transcriptome analysis and physiology of Bifidobacterium longum NCC2705 cells under continuous culture conditions

A central issue in the use of probiotics in food and food supplements is their sensitivity to many environmental stress factors. The resistance of probiotic cells to lethal stress can be improved by application of homologous or heterologous sub-lethal stress during culture. This screening procedure is generally performed using batch cultures. Continuous cultures could be a suitable and more efficient method to test different stress factors on one culture instead of repeating several batch cultures. However, before testing stresses using continuous cultures, the physiological stability of continuously produced cells over a considered time period must be first evaluated. A continuous culture of Bifidobacterium longum NCC2705 was maintained for 211 h at a dilution rate of 0.1 per h, mimicking a deceleration growth phase culture. Stable viable cell counts were measured over the culture period, decreasing only moderately from 8.8 to 8.6 log10 cfu/ml. A slight shift in metabolite production, characterized by increased lactate and decreased acetate, formate and ethanol concentrations was observed. Susceptibilities to antibiotics and stress conditions were stable (cefotaxim, ampicillin, ceftazidime) or moderately affected (simulated gastric juices, heat, bile salts, tetracycline, chloramphenicol, penicillin, vancomycin and neomycin) over culturing time. Comparison of gene transcription profiles between samples collected after 31 h of continuous culture and samples collected after 134 and 211 h revealed only limited changes in expression of 1.0 and 3.8% of total genes, respectively. Based on these results, we propose that continuous culture can be used to produce bacterial cells with stable physiological properties suitable for fast and efficient screening of sub-lethal stress conditions.

Inverse freezing in a cluster Ising spin-glass model with antiferromagnetic interactions

Inverse freezing is analyzed in a cluster spin-glass (SG) model that considers infinite-range disordered interactions between magnetic moments of different clusters (intercluster interaction) and short-range antiferromagnetic coupling J(1) between Ising spins of the same cluster (intracluster interaction). The intercluster disorder J is treated within a mean-field theory by using a framework of one-step replica symmetry breaking. The effective model obtained by this treatment is computed by means of an exact diagonalization method. With the results we build phase diagrams of temperature T/J versus J(1)/J for several sizes of clusters n(s) (number of spins in the cluster). The phase diagrams show a second-order transition from the paramagnetic phase to the SG order at the freezing temperature T(f) when J(1)/J is small. The increase in J(1)/J can then destroy the SG phase. It decreases T(f)/J and introduces a first-order transition. In addition, inverse freezing can arise at a certain range of J(1)/J and large enough n(s). Therefore, the nontrivial frustration generated by disorder and short-range antiferromagnetic coupling can introduce inverse freezing spontaneously.

Gut microbial adaptation to dietary consumption of fructose, artificial sweeteners and sugar alcohols: implications for host-microbe interactions contributing to obesity

The Western diet, comprised of highly refined carbohydrates and fat but reduced complex plant polysaccharides, has been attributed to the prevalence of obesity. A concomitant rise in the consumption of fructose and sugar substitutes such as sugar alcohols, artificial sweeteners, even rare sugars, has mirrored this trend, as both probable contributor and solution to the epidemic. Acknowledgement of the gut microbiota as a factor involved in obesity has sparked much controversy as to the cause and consequence of this relationship. Dietary intakes are a known modulator of gut microbial phylogeny and metabolic activity, frequently exploited to stimulate beneficial bacteria, promoting health benefits. Comparably little research exists on the impact of 'unconscious' dietary modulation on the resident commensal community mediated by increased fructose and sugar substitute consumption. This review highlights mechanisms of potential host and gut microbial fructose and sugar substitute metabolism. Evidence is presented suggesting these sugar compounds, particularly fructose, condition the microbiota, resulting in acquisition of a westernized microbiome with altered metabolic capacity. Disturbances in host-microbe interactions resulting from fructose consumption are also explored.

Importance of interplane coupling on the magnetic phases of quasi-two-dimensional tantalites

We propose a three-dimensional model to describe magnetic interactions in a class of tantalite compounds of compositions A(x)A'(1-x)Ta(2)O(6), with A,A' = Fe, Co or Ni. Due to the quasi-two-dimensional nature of the magnetism in these compounds, experimental data have been previously interpreted using two-dimensional models. These are anisotropic Heisenberg models or Ising models and include competing exchange interactions from different neighbors. Taking into account all the relevant exchange terms, which include interplane interactions, we show that the latter allows us to understand the various low-temperature magnetic phases observed by neutron diffraction in this family of compounds. This is done by studying the eigenvalues of the exchange-interaction matrix in wavevector space for different sets of coupling parameters, of which those relative to in-plane interactions have been obtained from high-temperature series analysis of the magnetic susceptibility. This approach is rather general and the model presented here is directly applicable to isostructural compounds like ASb(2)O(6).

Mucormycosis after allogeneic haematopoietic stem cell transplantation: a French Multicentre Cohort Study (2003-2008)

We conducted a nationwide retrospective study to evaluate clinical characteristics and outcome of mucormycosis among allogeneic haematopoietic stem cell transplant recipients. Twenty-nine patients were diagnosed between 2003 and 2008. Mucormycosis occurred at a median of 225 days after allogeneic haematopoietic stem cell transplant, and as a breakthrough infection in 23 cases. Twenty-six patients were receiving steroids, mainly for graft-versus-host disease treatment, while ten had experienced a prior post-transplant invasive fungal infection. Twenty-six patients received an antifungal treatment; surgery was performed in 12. Overall survival was 34% at 3 months and 17% at 1 year.