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[Risk factors of ciguatera in the French West Indies in Saint-Barthélémy, Saint-Martin and Anguilla].

An epidemiological study on ciguatera fish poisoning in the French West Indies (St-Barthelemy, St-Martin and Anguilla) was conducted during the years 1985-1986. The investigation on intoxications shows a non seasonal significant prevalence. Though it was difficult to list the cases, the morbidity seems to vary between 7 and 30 per thousand. A study of fish toxicity was realised; 46 different species were tested (individually or by pools) by the mosquito bio-test. Observations of intoxications give the following results: High risk species: Caranx bartholomaei, C. lugubris, Seriola dumerili, Lutjanus apodus, L. jocu, Pristipomoides macrophtalmus, Gymnothorax funebris, G. moringa, Scomberomorus cavalla, S. regalis, Mycteroperca venenosa, M. tigris, Epinephelus morio, Sphyraena barracuda. Intermediate species: Caranx latus, C. ruber, Lachnolaimus maximus, Lutjanus analis, L. buccanella, L. griseus, Malacanthus plumieri, Scomberomorus maculatus. Low risk species: Balistes vetula, Alectis ciliaris, Haemulon album, Bodianus rufus, Halichoeres radiatus, Priacanthus arenatus, Alphestes afer. Many species are involved in the toxic food chain. New ones have been identified, but it is difficult to determine the toxic level range. A cartography is presented but no place is free of risk. A research of Gambierdiscus toxicus, the causal agent, on algal surface from dead corals was conducted around St-Barthelemy and St-Martin. The dinoflagellate is found in low or medium populations all around the islands with no difference between North and South. There is a maximal activity during the spring. A model of the epidemiology of the ciguatera in the area is proposed.

Animals↗

The age of saints and the saintliness of age.

The image of the saint as an old person is a familiar one. Does this mental association have any basis in fact? This article reports a study examining the age of saints, and includes a discussion of the saint as a possible model for the old person. The sample of 487 saints (118 females, 369 males) was drawn from reference sources to meet the criteria of a) actual historical person, and b) established dates (years) of birth and death. Those who died as martyrs were analyzed separately. Martyrdom was twice as common among the males. Almost all female martyrs died young; males were more likely to be put to death in their forties. Saints whose lives were not brought to an abrupt end by martyrdom were studied more extensively. Male saints, combining all historical periods, had a mean longevity of 69.9 years: literally the proverbial "three score and ten!" Female saints had a mean longevity of 58.1. A series of quasicomparisons suggests that saints, especially the males, have had a longevity advantage throughout most of history. However, a time trend was noted among the males: the number of very old saints has diminished markedly in recent times, and centenarians, in particular, have been absent for more than seven hundred years. The data suggest that interactions exist between gender and historical period. Four alternative hypotheses about the possible age-saint relationship are examined in light of the present findings, and the saint is explored as a possible model for coping with the burdens and trials of old age, contrasted with current age-based health rationing concepts.

Aged↗

[Long-term results of Carpentier-Edwards and Saint-Jude Medical mitral valve prosthesis].

Between 1980 and 1985, 239 patients underwent mitral valve replacement with a Saint Jude Medical (130) or Carpentier-Edwards (109) prosthesis alone or associated with correction of tricuspid regurgitation. Age, NYHA grade and pulmonary artery pressures were comparable in the two groups. Two hundred and seventeen of the 221 survivors were contacted (98.6% follow-up): the long-term prosthesis-related mortality was 35% in the Saint Jude Medical group and 22.5% in the Carpentier-Edwards group. The global survival at 9 years was 82% in the Saint Jude Medical group but only 63% in the Carpentier-Edwards group. The actuarial thromboembolic-free rate at 9 years was 96% in the Saint Jude Medical and 86% in the Carpentier-Edwards group (not significant). Two Saint Jude Medical and one Carpentier-Edwards bioprosthesis thrombosed--a linear rate of 0.2% PY and 0.1% PY respectively. Furthermore, there was no significant difference in the actuarial rate of haemorrhagic complications between the two groups. Endocarditis and valve degeneration were more common in the Carpentier-Edwards group (1.3% and 1.6% PY respectively). Over the 9 year period, the thromboembolic complications of the Saint Jude Medical and Carpentier-Edwards prostheses were similar in actuarial and linear terms. With respect to long-term mortality and morbidity, the results with the Saint Jude Medical valve seem to be superior to those of the Carpentier-Edwards bioprosthesis.

Actuarial Analysis↗

Saint Marina: the protectress of nephrology.

Saint virgin and martyr Marina (Margarita) of Antioch in Pisidia (255-270) is recognized as the patron saint of kidney sufferers and the protectress of nephrology. Beginning in the 13th century she heals in particular patients suffering from nephropathies, pregnant women having a difficult childbirth, barren women and sickly children. She protects the patients from every side effect and complication. Saint Marina is represented in hagiography as a victor, defeating the dragon satan, holding a hammer or a cross and wearing a belt around her back in the area of kidneys. According to writers, artists and sculptors the belt is the perceivable means of Saint Marina for the miraculous recovery from and healing of kidney diseases. Therefore, kidney sufferers and pregnant women put belts upon her relics for blessing and then wore them. From the Middle Ages and Renaissance and up to the contemporary period Saint Marina (Margarita) was considered the patron saint of kidney sufferers. Justifiably she is recognized by the modern medical world as the protectress of nephrology.

Catholicism↗

Visible saints: social cynosures and dysphoria in the Mediterranean tradition.

"Visible saints" are individuals in the Mediterranean culture area who lead lives of heroic, exemplary and public suffering. This paper offers an analysis of visible saints as social cynosures as a means of exploring critical cultural psychiatric issues. We examine the changing nature of saintly suffering in the culture area and look at the media through which familiarity with the saints and their passions is developed and maintained. A detailed clinical case study is presented of "Madame Lorca," identified by her peers as a "saint." We focus on a particular illness episode which proved to be an amplification of symptoms of long standing. Psychiatric diagnostic instruments were administered and indicated the presence of severe clinical depression. However, our research suggests that Mme. Lorca's symptomatology reflects culturally specific methods of coping with dysphoric affects and chronic illness. The paper concludes with an exploration of the nature of personal illness as it relates to a wider cultural system of meaning. The findings demonstrate that the visible saint and her symptomatology are part of a cultural system which generates, promotes, patterns and frames the experience of dysphoric affect in a cultural complex quite distinct from that of clinical depression.

Adult↗

Differential effects of Saint John's Wort (hypericum perforatum) on the urinary excretion of D-glucaric acid and 6beta-hydroxycortisol in healthy volunteers.

OBJECTIVE: We investigated the effects of treatment with Saint John's wort (hypericum perforatum) extract on the urinary excretion of D-glucaric acid, 6beta-hydroxycortisol, and free cortisol in order to assess the effect of this extract on the activity of hepatic xenobiotic metabolizing enzymes. METHODS: Forty-eight healthy volunteers (25 male and 23 female) received a daily dose of 1800 mg hypericum extract for 14 days. Urinary excretion of D-glucaric acid, 6beta-hydroxycortisol, and free cortisol was measured in 24-h urine samples on the day preceding the initiation of hypericum treatment and after 14 days of treatment. D-Glucaric acid was measured enzymatically. Cortisol and 6beta-hydroxycortisol were quantified using high-performance liquid chromatography with ultraviolet detection. RESULTS: Urinary excretion of D-glucaric acid was unaffected after a 14-day treatment with Saint John's wort extract (26.7 micromol/day vs 27.7 micromol/day; 95% confidence interval of the difference: -1.9 to 3.8). The urinary excretion of 6beta-hydroxycortisol increased from a mean baseline value of 254 microg/day to 369 microg/day (P<0.0001) indicating induction of CYP3A. While the excretion of free cortisol was unaltered, the ratio of 6beta-hydroxycortisol to free cortisol changed significantly from 9.9 at baseline to 14.3 (95% confidence interval of the difference: 2.3-6.5) after Saint John's wort treatment. CONCLUSIONS: High-dose treatment with Saint John's wort extract induced CYP3A activity in healthy volunteers as evidenced by increased 6beta-hydroxycortisol excretion. This enzyme induction most likely contributes to the decreased bioavailability observed upon co-administration of various drugs with Saint John's wort extract. The D-glucuronic acid pathway appeared unaffected by Saint John's wort.

Adult↗

Locomotion and body proportions of the Saint-Césaire 1 Châtelperronian Neandertal.

The initial Upper Paleolithic (Châtelperronian) of western Europe was associated with late European Neandertals, best known through the Saint-Césaire 1 partial skeleton. Biomechanical cross-sectional analysis of the Saint-Césaire 1 femoral diaphysis at the subtrochanteric and midshaft levels, given the plasticity of mammalian diaphyseal cortical bone, provides insights into the habitual levels and patterns of loading on the lower limbs from body mass, proportions, and locomotion. The overall robustnesses of the femoral diaphyses of European Neandertals and early modern humans are similar once contrasts in body proportions are incorporated into the body size scaling. Saint-Césaire 1 matches these samples only if it is provided with Neandertal-like hyperarctic body proportions. And the rounded proximal femoral diaphysis of Saint-Césaire 1 is similar to those of earlier Neandertals, likely also reflecting similar cold-adapted broad pelvic regions. However, although morphologically similar to those of archaic Homo, the Saint-Césaire 1 femoral midshaft exhibits the anteroposterior reinforcement characteristic of early modern humans. Consequently, Saint-Césaire 1 appears as a morphological Neandertal with hyperarctic body proportions who nonetheless had shifted locomotor patterns to more closely resemble those of other Upper Paleolithic humans.

Animals↗