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A little smile...

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Child↗
PubMed2004

["Opération Smile" missions in Mongolia].

We report our experience of plastic surgery of the face, limbs and burns in Mongolia. This country is three times as huge as France and has got 2,4 millions of inhabitants of whom almost one million live in the capital city Oulan-Baator, where sanitary and weather conditions are very tough for a large part of the population. The main observed and treated pathologies were sequellae of nerves and vessels lacerations, sequellae of complex hand injuries, sequellae of leg traumas, face, neck and limb burns, lips and palate clefts and pressure shores. The training of Mongol surgeons is far from good in the fields of skin coverage, digits reconstruction, treatment of nerve and vascular injuries and management of burns. Pedicled radial antebrachial, posterior interosseous, inguinal, sural, saphenous and lower limb muscular flaps were performed and taught. Microsurgery is still starting up. Thus we performed the first second toe transfer to reconstruct an amputated thumb. Some clinical cases are presented. This French-Mongolian cooperation should continue in order to match between both countries the knowledge and use of standard techniques in plastic surgery.

Adult↗
PubMed2004

Life's smile, death's grin: vital functions of apoptosis-executing proteins.

Apoptosis is executed by caspases as well as caspase-independent death effectors. Caspases are expressed as inactive zymogens in virtually all animal cells and are activated in cells destined to undergo apoptosis. However, there are many examples where caspase activation is actually required for cellular processes not related to cell death, namely terminal differentiation, activation, proliferation, and cytoprotection. Several caspase-independent death effectors including apoptosis-inducing factor, endonuclease G and a serine protease (Omi/HtrA2) are released from the mitochondrial intermembrane space upon permeabilization of the outer membrane. Such proteins also have important roles in cellular redox metabolism and/or mitochondrial biogenesis. As a general rule, it thus appears that cell-death-relevant proteins, especially those involved in the core of the executing machinery, have a dual function in life and death. This has important implications for pathophysiology. The fact that the building blocks of the apoptotic machinery have normal functions not related to cell death may mean that essential parts of the apoptotic executioner cannot be lost and thus reduces the possibility of oncogenic mutations that block the apoptotic program. Moreover, therapeutic suppression of unwarranted cell death must be designed to target only the lethal (and not the vital) role of death effectors.

Animals↗
PubMed2005

"Reduced to nods and smiles": experiences of professionals caring for people with cancer from black and ethnic minority groups.

Despite growing research in the UK suggesting that patients from black and ethnic minority groups feel that they do not always receive the best treatment and care, little is known about how care professionals themselves respond to working with this group. The study, involving focus groups with health and social care staff, was undertaken to learn about their views and experiences. The principal finding was the extent to which staff experience difficulties in caring for patients from black and ethnic minority groups. Entailing serious challenges to their own professional practice, these were found to arise at all stages of patients' experience of cancer, including at diagnosis, during treatment and at the palliative phase. Staff were concerned that their inability to communicate with some patients meant that they were not able to provide them a good service, as they could not develop an easy relationship and talk around issues. Yet it could be difficult to work with interpreters, as well as family members, both of who could be reluctant to translate important information. They were also conscious of not being fully sensitive to patients' differing cultures, while noting the importance of not making assumptions about particular beliefs or behaviour. Staff would welcome training to help them to explore their attitudes and assumptions in working with black and ethnic minority patients, but did not seek induction into the detailed practices of different cultures. Some staff felt they would benefit from training in working with interpreters.

Adaptation, Psychological↗
PubMed1996

Effects of the early administration of zofenopril on onset and progression of congestive heart failure in patients with anterior wall acute myocardial infarction. The SMILE Study Investigators. Survival of Myocardial Infarction Long-term Evaluation.

Chronic congestive heart failure (CHF) is a common disease responsible for a high mortality and morbidity whose clinical course can be improved by angiotensin-converting-enzyme (ACE) inhibition. However, limited data are available on the effects of ACE inhibitors on the onset and progression of CHF in patients with acute myocardial infarction (AMI). The present study was performed as a substudy of the Survival of Myocardial Infarction Long-term Evaluation trial and involved 1,146 patients with anterior wall AMI not undergoing thrombolysis with the exclusion of patients with prior history or clinical signs of CHF on admission. Patients were randomly allocated to treatment with zofenopril (7.5 to 30 mg twice daily) or placebo for a cumulative period of 6 weeks. The prevalence of CHF, either mild to moderate or severe, has been the main objective and has been evaluated 6 weeks and 1 year after AMI. The overall prevalence of CHF was not reduced by zofenopril after both 6 weeks and 12 months. Conversely the prevalence of severe CHF (1.6% vs 2.6%: risk reduction 55.5%; 95% confidence interval 9 to 63; p = 0.0325) and the combined occurrence of death or severe CHF (4.8% vs 8.2%: risk reduction 59%; 95% confidence interval 11 to 71; p = 0.024) were reduced after 6 weeks of treatment with zofenopril. Moreover, the percentage of patients experiencing a deterioration to severe CHF after 1 year was significantly reduced with zofenopril (11.0% vs 24.3%; p = 0.001). In conclusion, the early administration of zofenopril to patients with AMI attenuates the progression of the clinical symptoms of CHF and its clinical consequences, suggesting that ACE inhibitors should be regarded as a suitable strategy for the prevention and treatment of CHF in patients with AMI.

Adolescent↗