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Biomedical subjects

C Mercier

Publications and source records attributed to C Mercier.

At least 73 records · Page 4Linked to original sources

Mutagenicity of nitro- and amino-substituted carbazoles in Salmonella typhimurium. III. Methylated derivatives of 9H-carbazole.

The mutagenic potency of nine methylnitrocarbazoles, four methylaminocarbazoles and the methylcarbazole parent compounds was evaluated in Salmonella typhimurium TA98 and TA100, in the absence and presence of S9 isolated from Aroclor-induced rat liver. Nitro derivatives were additionally tested in TA98NR and TA98/1,8DNP6, and mutagenicity of nitrocarbazoles bearing methyl groups in positions 1 and 4 was also determined in TA1537 and TA1977, with and without S9. The addition of methyl groups on non-mutagenic carbazole can induce a mutagenic response where the intensity and nature of the effect depends on the position of the substitution: base-pair substitutions were only observed for N-methylated carbazoles, whereas 1,4-dimethylated compounds exhibited frameshift mutagenicity. All these activities depended on the presence of S9. From its dependence on classical nitroreductases, direct mutagenicity of methylnitro derivatives should be attributed to bacterial reduction of nitro groups. The influence of the methyl groups (and other additional substituents) on mutagenicity of these derivatives is discussed through their effects on life-time and reactivity of the intermediates (i.e., hydroxylamines and nitrenium ions), taking into account the nature, the position and the number of substituted sites Mutagenic activity of methylnitrocarbazoles was also tentatively correlated with various molecular descriptors. Among them hydrophobicity was found to be strongly correlated with the mutagenicity of the 1,4diMe3NC isomers. On the other hand, mutagenic potency of the nitrated and aminated methylcarbazoles varied independently of parameters linked to their oxidoreduction properties (i.e., reduction and oxidation potentials, LUMO and HOMO energies).

Amines↗

[Relations between anesthetists and general practitioners or pediatricians. Results of a cross sectional study among 2281 physicians with private practice].

OBJECTIVE: To assess the relationship of anaesthetiologists (Anaes) with general practitioners (GP) and paediatricians (Paed), possessors of the medical files of children scheduled to undergo ambulatory anaesthesia and participating in postoperative surveillance. STUDY DESIGN: Cross-sectional prospective survey. PERSONS: GP and Paed treating children admitted in September 1994 at the paediatric clinic of the University hospital of Tours for ambulatory surgery. METHOD: Questionnaire including 11 items circulated to 2,181 GP and 100 Paed of the centre of France. RESULTS AND DISCUSSION: Replies were obtained from 1,053 GP (48%) and 64 Paed (64%). The experience of Anaesth in paediatric anaesthesia was the least important criterion for the choice of the clinic (for 67% of Paed and 44% of GP). The rate of contacts of Anaesth with GP and Paed was low (23% of GP and 38% of Paed). Informations concerning anaesthesia (26% of GP and 42% of Paed), or its complications (8% of GP and 8% of Paed) were scarce. The rules of ambulatory anaesthesia were better known by Paed (56%) than by GP (34%), unlike those for autotransfusion (45% of GP and 23% of Paed). A majority of GP (82%) and Paed (73%) would appreciate an anaesthetic report. Most of GP (86%) and Paed (83%) were in favour of more informations, mainly through continuing medical education, on these problems.

Ambulatory Care↗

Pre-hospital and hospital time delays in thrombolytic treatment in patients with suspected acute myocardial infarction. Analysis of data from the EMIP study. European Myocardial Infarction Project.

OBJECTIVES: To compare the components of the time delay involved in pre-hospital and hospital thrombolytic therapy in patients presenting with suspected acute myocardial infarction. MATERIAL AND METHODS: From October 1988 to January 1992 a total of 198 mobile emergency units in 15 European countries and Canada randomized 5469 patients to receive either pre-hospital thrombolytic treatment, followed by placebo in hospital (pre-hospital group), or pre-hospital (hospital group) in the European Myocardial Infarction Project trial. We performed a post hoc analysis of these data to correlate components of the interval between symptom onset and treatment with baseline patient characteristics. RESULTS: The delay between onset of symptoms and calling for an ambulance was significantly longer for female patients (P = 0.0001), older patients (> 65 years old; P = 0.0001), those who had experienced pain within the previous 24 h (P = 0.0001), and those with pulmonary oedema (P = 0.04). This delay was significantly shorter in patients with previous myocardial infarction (P = 0.02), those with ventricular fibrillation (P = 0.0001), and those in shock (P = 0.0001). The delay between the two injections was significantly longer for older patients (> 65 years old; P = 0.02), those with previous myocardial infarction (P = 0.03), and those in shock (P = 0.003). CONCLUSIONS: Action undertaken to reduce delays between symptom onset and treatment should focus on modifiable factors such as patients who are likely to be late callers i.e. women and those over 65 years of age.

Aged↗

Expression of Toxoplasma gondii genes in the closely-related apicomplexan parasite Neospora caninum.

We have established the feasibility of using Neospora caninum as a heterologous system for the expression of genes from the closely-related parasite Toxoplasma gondii. Plasmid construct containing the lacZ gene from Escherichia coli driven by T. gondii promoters were electroporated into N. caninum parasites, and expression of beta-galactosidase (beta-Gal) activity was assayed enzymatically. In transient assays, expression of beta-Gal driven by the GRA1 promoter was approximately 10-fold higher than the expression obtained with the SAG1 promoter. Enzyme activity was not detected when N. caninum parasites were transfected with a promoterless lacZ construct. Transfection of N. caninum with complete genomic clones of SAG1 or GRA2 from T. gondii yielded parasites that transiently expressed the respective gene products, as detected by immunofluorescence and Western blot. Additionally, these transiently expressed T. gondii proteins appeared by immunofluorescence localization and Triton X-114 partitioning to be correctly targeted in both extracellular and intracellular N. caninum parasites. Heterologous gene expression should be useful for studying the function of specific gene products and may facilitate the identification of genes responsible for the phenotypic differences observed between these two closely-related apicomplexan parasites.

Animals↗

Quality of life and social integration of severely mentally ill patients: a longitudinal study.

The quality of life concept serves to measure functional changes and program outcome. Patients with schizophrenia have an improved prognosis. Is quality of life improving over time, and if so, over what period? These questions were addressed in a longitudinal study where subjective quality of life (SQOL) was rated by severely mentally ill patients living in the community and using support services located in an outlying area of Quebec. The Satisfaction for Life Domains Scale (SLDS) (Baker and Intagliata 1982) measuring SQOL as a whole and in specific domains (for example, housing, finances, social relationships) was repeated over a period of 7 y. Results show that SQOL ratings received the same scores after 7 y. Functional status was decreased, while social integration improved and more services were used. The results could be due to sample characteristics or to the ambiguity of the SQOL construct. In our opinion, extensive community-based support services may have played a key role in the maintenance of patient's quality of life.

Adult↗

[Validation of Satisfaction with Life Domains Scale in Quebec].

This article presents the results of the Quebec validation of the Satisfaction With Life Domains Scale: This scale was developed in the United States for the general population and adapted for severely mentally ill individuals. Two hundred and sixty six individuals from the general population and 245 severely mentally ill persons participated in this study. Factor analysis allowed the identification of four sub-scales for the clinical population and five for the general population. The scale (alpha = 0.90) and the sub-scales (alpha between 0.60 et 0.84) show excellent internal consistencies and the test-retest reliability was good (r = 0.73). Moreover, analysis of the variance and the discriminant analysis allow to acknowledge that the sub-scales have a high discriminating power; they allow to distinguish the general population from welfare recipient and people suffering from psychosis. The overall results suggest that l'Echelle de satisfaction des domaines de vie have good psychometric properties and can be considered as a valid instrument for assessing subjective quality of life in descriptive or evaluative studies.

Analysis of Variance↗

No season-of-birth effect in schizophrenic patients from a tropical island in the Southern Hemisphere.

The distribution of birth rates was examined in 668 schizophrenic patients born in Réunion, a tropical French island in the Southern Hemisphere, and compared with that in the general local population. We failed to observe a significant season-of-birth effect, either in the total sample of schizophrenic patients or in subgroups categorized by gender, age, or family history of schizophrenia. Seasonal factors do not appear to affect the yearly distribution of births among schizophrenic patients on Réunion Island. It is nevertheless possible that environmental factors which are seasonal in countries with more contrasting climates have a continuous effect, throughout the whole year, in subtropical areas. Conversely, these findings provide some evidence against the hypothesis that there is an age-incidence artifact in seasonal studies from countries in the Northern Hemisphere.

Adult↗

Type III-IV laryngotracheoesophageal cleft: report of a successfully treated case.

This report presents a case of Stage III laryngotracheoesophageal cleft (LTEC). It is, to our knowledge, the fourth case in which the patient is still alive twenty months after surgery. We herein describe an initial symptomatology dominated by a bubbling hypersalivation, our surgical technique using a pleural shred of interposition and an endoscopic check during the operation and, finally, the clinical development dominated by a food intake refusal which was progressively improved through psychiatric help.

Cleft Palate↗

Epidemiological survey of childhood burn injuries in France.

Among domestic injuries in children, skin burns deserve special attention because they can lead to severe residual lesions. Their frequency has been reported to range from 3 to 8 per cent of all childhood injuries, but few epidemiological data have been collected in France. This study was undertaken to improve our knowledge of this public-health problem. A 20-item epidemiological questionnaire developed by the SFETB was used to collect prospective data on childhood burn injuries managed over a 12-month period in 14 burn centres and 18 paediatric surgery units in France. Of the 937 patients included in the study, 606 were contributed by burn centres and 331 by paediatric surgery units. Descriptive analysis and tests for correlations between several parameters showed that the typical burn-injury patient was a boy (61.6 per cent) with a mean age of 47 months, who suffered a scald burn (64.1 per cent) in the kitchen (56.2 per cent). The bathroom (13.6 per cent) was found to be an especially dangerous room because of the presence of hot water taps (shower, bathtub) and the high risk of an immersion injury. Burns due to ignition of volatile substances (16.95 per cent) were less common, but caused seven of the 11 deaths recorded in this survey. Most burn injuries were superficial lesions (59 per cent) covering less than 10 per cent of the body surface (56.2 per cent). However, grafting was required in 35 per cent of patients. Epidemiological surveys provide objective information on hazardous agents and on the settings in which burns are most likely to occur. They are essential for the development of appropriate preventive strategies, which are still receiving insufficient emphasis in the European Economic Community (EEC).

Accidents, Home↗

Common cis-acting elements critical for the expression of several genes of Toxoplasma gondii.

Transient transformation of Toxoplasma using the CAT (chloramphenicol acetyl transferase) reporter gene has been used to map promoter elements of four genes encoding dense granule proteins (GRA1, GRA2, GRA5 and GRA6). Intense CAT activities (GRA1 > GRA5 > GRA2 > GRA6) are detected for constructs containing 379bp, 276bp, 209bp and 265bp upstream of the transcription start site of the GRA1, GRA2, GRA5 and GRA6 genes, respectively. Deletion analysis shows that optimal promoter activity of each gene is contained in the proximal region of the transcription start site: -129 to -47 for GRA1, -87 to -37 for GRA2, -156 to -30 for GRA5 and -146 to -27 for GRA6. Quantitative CAT assay and mutation analysis show that repeated motifs (A/TGAGACG) found in either orientation with respect to transcription are critical elements of these defined promoter regions. We have found such sequence elements in the upstream region of other Toxoplasma genes such as Tub1 and within the stretch of 27bp repeats of the SAG1 promoter.

Animals↗

Ventricular fibrillation following administration of thrombolytic treatment. The EMIP experience. European Myocardial Infarction Project.

Reperfusion-induced ventricular fibrillation has been demonstrated in animal models of myocardial ischaemia, but no evidence exists for this in humans. The European Myocardial Infarction Project compared the efficacy and safety of pre-hospital thrombolytic therapy with that of hospital therapy. The objective of this study was to investigate the occurrence of reperfusion-induced ventricular fibrillation in acute myocardial infarction patients following thrombolytic therapy. In a double-blind multicentre trial, eligible patients were randomized to receive anistreplase at home followed by placebo in the hospital (A/P group), or placebo followed by anistreplase (P/A group). The occurrence of ventricular fibrillation, and other adverse events were recorded on specific study forms and could be attributed to defined time intervals. The incidence of ventricular fibrillation in the A/P group was significantly higher following the pre-hospital injection than in the P/A group (2.5% vs 1.6%; P = 0.021); the situation was reversed following the hospital injection (3.6% vs 5.3%; P = 0.002). No relationship was found between this excess of ventricular fibrillation and the patients' condition, with the exception of the site of the infarct. These results suggest the existence of reperfusion-induced ventricular fibrillation in patients developing myocardial infarction who receive thrombolytic treatment.

Anistreplase↗

Lidocaine plasma concentrations in pediatric patients after providing airway topical anesthesia from a calibrated device.

The aim of this prospective study was to evaluate plasma lidocaine concentrations in infants and children after laryngeal spray using a calibrated device. Twenty-one patients aged 3 to 24 mo requiring laryngoscopy or bronchoscopy were included in the study. Anesthesia was induced via a mask with halothane up to 2% in 100% O2. Lidocaine was administered using a 5% lidocaine spray. For patients weighing less than 10 kg, one spray (8 mg of lidocaine) was administered. For those weighing from 10 to 20 kg, two sprays (16 mg) were given. The dose of lidocaine administered ranged between 0.9 and 2.6 mg/kg. Maximum plasma lidocaine concentration (Cmax) was 1.05 +/- 0.55 micrograms/mL (mean +/- SD; range 0.24-2.29 micrograms/mL). With this procedure, we demonstrated the safety of administering lidocaine to children by laryngeal spraying using a 5% sprayer.

Aerosols↗

Perfusion-MVO2 mismatch during inotropic stress in CAD patients with normal contractile function.

With the use of[11C]acetate, positron emission tomography (PET) permits exploration of myocardial blood flow (MBF) and oxidative metabolism (MVo2) coupling. PET imaging was performed at rest and under dobutamine infusion in 8 normal subjects and 10 coronary artery disease (CAD) patients with significant single-vessel left anterior descending (LAD) stenosis (> 70%) and normal regional left contractile function at rest. Resting MBF and MVo2 were similar in remote and LAD regions of normal subjects and patients. During dobutamine infusion, MBF and myocardial flow reserve were lower in LAD regions of patients compared with remote regions (MBF: 1.49 +/- 0.42 and 2.06 +/- 0.57 ml.g-1.min-1, P < 0.01; reserve: 1.73 +/- 0.59 and 2.14 +/- 0.47, P < 0.01, respectively), whereas MVo2 expressed as kmono (an index of MVo2) and metabolic reserve were similar (kmono: 0.106 +/- 0.021 vs. 0.107 +/- 0.017 min-1; reserve: 1.88 +/- 0.32 vs. 1.98 +/- 0.37, respectively). This is the first human study showing that, in normal contractile regions at rest but perfused by stenosed artery, a disparate rise in MVo2 relative to the rise in myocardial perfusion occurs during increased cardiac work induced by dobutamine. This flow-metabolism uncoupling probably reflects an increase in O2 extraction.

Adult↗

Direct intraoperative sclerotherapy of an aneurysmal bone cyst of the sphenoid.

A young boy presented with a symptomatic aneurysmal bone cyst of the left great wing of the sphenoid bone. Arterial embolization had failed to produce thrombosis, and the lesion could not be resected surgically. Direct intraoperative sclerotherapy resulted in immediate thrombosis of 80% of the volume of the vascular malformation with no progression of symptoms. Two years later, the symptoms had completely resolved, and CT scans showed total ossification of the lesion.

Arteriovenous Malformations↗

Stable DNA transformation of Toxoplasma gondii using phleomycin selection.

Toxoplasma gondii (Tg) is an obligate intracellular protozoan parasite that is an important opportunistic pathogen in humans. To provide additional tools for molecular genetic analysis, we have developed a set of vectors for DNA transformation in Tg based on selection with the antibiotic phleomycin (Ph). These new vectors rely on the flanking sequences from the parasite genes GRA1, GRA2 or SAG1 to drive expression of the Tn5 ble gene encoding resistance to the DNA intercalating drug Ph (PhR). Treatment of extracellular parasites was used to select stable PhR transformants by plaque formation on host cell monolayers. Transfection of linear or circular forms of the pGRA1/ble, pGRA2/ble or pSAG1/ble vectors by electroporation resulted in stable transformation with an efficiency of approx. 10(-4)/micrograms DNA. Stable transformants contained 1-5 copies of ble that were integrated at non-homologous sites in the parasite nuclear genome. Ble provides a new dominant selectable marker for safe, efficient and rapid isolation of stable DNA transformants in Tg.

Acetyltransferases↗

Case management with homeless women: a descriptive study.

This article presents the results of a three-year survey of the activities of two case managers following 25 homeless women with substance abuse problems. The case managers' activity record indicated that a great deal of the case managers' energy was devoted to providing direct, concrete services. More than half the clients received four weekly contacts, for an average total of two hours/client/week. Furthermore, direct support accounted for 42.2% of all contacts reported by the case managers, suggesting that, although case managers fill many different functions, establishing and maintaining a significant relationship with the participants constituted a major part of their work. The study confirms that a high staff-to-client ratio is required to respond to the multiple needs of this population.

Adult↗