Is the neutrophil-to-lymphocyte ratio more correlated than C-reactive protein with postoperative complications after major abdominal surgery?

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Optimisation des conditions de régénération de plantes fertiles à partir de suspensions cellulaires issues de cals embryogenèse d’apex caulinaire de mil (Pennisetum glaucum (L.) R.)

Ce travail a pour objectif d’établir les conditions optimales de régénération de plantes fertiles à partir de suspensions cellulaires embryogènes en vue de leur utilisation pour une transformation génétique par bombardements de protoplastes. Ce travail réalisé sur des variétés de Pennisetum glaucum de Côte d’Ivoire a permis de mettre en évidence les facteurs qui influent (taille et âge des cals, milieu de conditonnement, et âge de la suspension cellulaire) sur la régénération de plantes fertiles. Il ressort de cette étude que la taille des cals et les milieux de conditionnement utilisés n’ont aucun effet sur le taux de régénération de plantes fertiles. Cependant, l’âge de la suspension cellulaire obtenue à partir de cals embryogènes et l’âge du cal initiateur de la suspension cellulaire influent sur le taux de régénération. Le taux de plantes normales régénérées est élevé durant les deux premiers mois de culture de la suspension cellulaire initiée à partir des cals de 2-3 mois (60 à 70%). Les plantes régénérées présentent les mêmes caractéristiques de croissance végétative (taille, longueur de la chandelle, nombre de barres, longueur de l’épi) que les plantes témoins. Pour le rendement, les plantes régénérées portent moins de grains (412) que les plantes témoins (715).Mots clés : Plantes fertiles, suspension cellulaire, cal embryogène, Pennisetum glaucum, Côte d’Ivoire

Optimisation des conditions d’etablissement de suspensions cellulaires embryogenes a partir de cals d’apex caulinaire de mil (Pennisetum glaucum (L.) R.)

L’isolement de protoplastes en vue de la régénération de plantes transgéniques chez les monocotylédones dépend de la qualité des suspensions cellulaires embryogènes. Ce travail a pour objectif d’établir les conditions optimales d’établissement de suspensions cellulaires embryogènes régénérables en plantes pour permettre une transformation génétique ultérieure. Ce travail réalisé, pour la première fois, sur des variétés de Pennisetum glaucum de Côte d’Ivoire, a révélé les facteurs qui influent sur l’établissement et la croissance des suspensions cellulaires embryogènes à partir de cals d’apex caulinaires. En effet, l’établissement de suspensions cellulaires embryogènes a été obtenu au bout de 8 semaines, lorsque la première filtration a été faite après 2 semaines et que les amas de cals ont été broyés à chaque filtration. En début de culture, lorsque le volume du milieu de culture a été faible (30 ml), la croissance de la suspension cellulaire embryogène a été d’autant meilleure que l’intervalle de temps entre les subcultures a été plus court (3 jours). Inversement, un intervalle de temps plus long (6 jours) entre les subcultures s’est montré meilleur pour de grands volumes de milieu de culture (60 ml). La croissance de la suspension cellulaire embryogène a été comparable sur les deux milieux de culture utilisés (MS et N6).Mots clés : In vitro, suspension cellulaire, cal embryogène, Pennisetum glaucum, Côte d’Ivoire.EFFICIENT CONDITIONS FOR ESTABLISHING EMBRYOGENIC CELL SUSPENSIONS DERIVED FROM STEMAPEX CALLUS IN PEARL MILLET (Pennisetum glaucum (L.) R.)Isolation of protoplasts for the regeneration of transgenic monocotyledonous plants depends on the quality of embryogenic cell suspensions. This work aims to establish the optimal conditions for the establishment of regenerable embryogenic cell suspensions of plants to enable further genetic transformation. This work released for the first time, on varieties of Pennisetum glaucum from Côte d’Ivoire revealed the factors that influence the establishment (the date of the first filtration and the grinding of the callus) and the growth (the mass of the initial heap of callus, the volume of the culture medium and the time interval between subcultures) of embryogenic cell suspensions derived from stem apex callus. It appears that the establishment of embryogenic cell suspension is obtained after 8 weeks when the first filtration takes place after two weeks and heaps of callus are ground at each filtration. During the first days of culture, when the volume of the culture medium is low (30 ml), the growth of embryogenic cell suspension is better if the time interval between the subcultures is shorter (3 days). Conversely, a longer period of time (6 days) between subcultures is needed for larger volumes of culture medium (60 ml). The growth of embryogenic cell suspension is similar on both culture media used (MS and N6).Keywords : Tissue culture, embryogenic cell suspension, callus, Pennisetum glaucum, Côte d’Ivoire

Hypothermic in situ perfusion of the porcine liver using Celsior or Ringer-lactate solution

BACKGROUND: Hypothermic perfusion (HP) of the liver is applied during total vascular exclusion (TVE) to reduce ischemic injury during liver resection. No studies have been performed comparing different perfusion solutions for HP. The aim of this experimental study was to compare Ringer-lactate solution (RL) with Celsior solution (Cs) for HP in a pig model of 60-min TVE. METHOD: Twenty pigs underwent 60-min TVE of the liver. Groups were TVE without HP (no-HP, n = 9), TVE with HP using RL (n = 6), and TVE with HP using Cs (n = 5). Blood and liver tissue samples were taken before TVE and during 24-h reperfusion. RESULTS: In the no-HP group, plasma aspartate aminotransferase values were significantly increased during reperfusion (p <0.05), while liver tissue pO(2) levels (p <0.01) were decreased when compared to the HP groups. After 24-h reperfusion, bile production and liver tissue glutathione content were significantly higher (p <0.05) in the Cs group (42.0 +/- 1.7 mL/h and 44.9 +/- 2.2 nmol/mg, respectively) as compared to the RL group (31.5 +/- 3.5 mL/h and 19.6 +/- 1.8 nmol/mg, respectively). CONCLUSION: The protective effect of HP during TVE was confirmed in this study. HP with Cs was more effective in reducing ischemic injury as compared to HP with R

Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial

Objective To assess the effect of general practitioner testing for C reactive protein (disease approach) and receiving training in enhanced communication skills (illness approach) on antibiotic prescribing for lower respiratory tract infection

Improving management of patients with acute cough by C-reactive protein point of care testing and communication training (IMPAC(3)T): study protocol of a cluster randomised controlled trial

BACKGROUND: Most antibiotic prescriptions for acute cough due to lower respiratory tract infections (LRTI) in primary care are not warranted. Diagnostic uncertainty and patient expectations and worries are major drivers of unnecessary antibiotic prescribing. A C-reactive protein (CRP) point of care test may help GPs to better guide antibiotic treatment by ruling out pneumonia in cases of low test results. Alternatively, enhanced communication skills training to help clinicians address patients' expectations and worries could lead to a decrease in antibiotic prescribing, without compromising clinical recovery, while enhancing patient enablement. The aim of this paper is to describe the design and methods of a study to assess two interventions for improving LRTI management in general practice. METHODS/DESIGN: This cluster randomised controlled, factorial trial will introduce two interventions in general practice; point of care CRP testing and enhanced communication skills training for LRTI. Twenty general practices with two participating GPs per practice will recruit 400 patients with LRTI during two winter periods. Patients will be followed up for at least 28 days. The primary outcome measure is the antibiotic prescribing rate. Secondary outcomes are clinical recovery, cost-effectiveness, use of other diagnostic tests and medical services (including reconsultation), and patient enablement. DISCUSSION: This trial is the first cluster randomised trial to evaluate the influence of point of care CRP testing in the hands of the general practitioner and enhanced communication skills, on the management of LRTI in primary care. The pragmatic nature of the study, which leaves treatment decisions up to the responsible clinicians, will enhance the applicability and generalisability of findings. The factorial design will allow conclusion to be made about the value of CRP testing on its own, communication skills training on its own, and the two combined. Evaluating a biomedical and communication based intervention ('hard' and 'soft' technologies) together in this way makes this trial unique in its field

Applying the InterVA-4 model to determine causes of death in rural Ethiopia

BACKGROUND: In Ethiopia, most deaths take place at home and routine certification of cause of death by physicians is lacking. As a result, reliable cause of death (CoD) data are often not available. Recently, a computerized method for interpretation of verbal autopsy (VA) data, called InterVA, has been developed and used. It calculates the probability of a set of CoD given the presence of circumstances, signs, and symptoms reported during VA interviews. We applied the InterVA model to describe CoD in a rural population of Ethiopia. OBJECTIVE: VA data for 436/599 (72.7%) deaths that occurred during 2010-2011 were included. InterVA-4 was used to interpret the VA data into probable cause of death. Cause-specific mortality fraction was used to describe frequency of occurrence of death from specific causes. RESULTS: InterVA-4 was able to give likely cause(s) of death for 401/436 of the cases (92.0%). Overall, 35.0% of the total deaths were attributed to communicable diseases, and 30.7% to chronic non-communicable diseases. Tuberculosis (12.5%) and acute respiratory tract infections (10.4%) were the most frequent causes followed by neoplasms (9.6%) and diseases of circulatory system (7.2%). CONCLUSION: InterVA-4 can produce plausible estimates of the major public health problems that can guide public health interventions. We encourage further validation studies, in local settings, so that InterVA can be integrated into national health surveys.Berhe Weldearegawi, Yohannes Adama Melaku, Mark Spigt, and Geert Jan Dinan

Influence of the live cell DNA marker DRAQ5 on chromatin-associated processes

In the last decade, live cell fluorescence microscopy experiments have revolutionized cellular and molecular biology, enabling the localization of proteins within cellular compartments to be analysed and to determine kinetic parameters of enzymatic reactions in living nuclei to be measured. Recently, in vivo DNA labelling by DNA-stains such as DRAQ5, has provided the opportunity to measure kinetic reactions of GFP-fused proteins in targeted areas of the nucleus with different chromatin compaction levels. To verify the suitability of combining DRAQ5-staining with protein dynamic measurements, we have tested the cellular consequences of DRAQ5 DNA intercalation. We show that DRAQ5 intercalation rapidly modifies both the localization and the mobility properties of several DNA-binding proteins such as histones, DNA repair, replication and transcription factors, by stimulating a release of these proteins from their substrate. Most importantly, the effect of DRAQ5 on the mobility of essential cellular enzymes results in a potent inhibition of the corresponding cellular functions. From these observations, we suggest that great caution must be used when interpreting live cell data obtained using DRAQ5

An illness-focused interactive booklet to optimise management and medication for childhood fever and infections in out-of-hours primary care: study protocol for a cluster randomised trial

Background Fever is the most common reason for a child to be taken to a general practitioner (GP), especially during out-of-hours care. It is mostly caused by self-limiting infections. However, antibiotic prescription rates remain high, especially during out-of-hours care. Anxiety and lack of knowledge among parents, and perceived pressure to prescribe antibiotics amongst GPs, are important determinants of excessive antibiotic prescriptions. An illness-focused interactive booklet has the potential to improve this by providing parents with information about fever self-management strategies. The aim of this study is to develop and determine the effectiveness of an interactive booklet on management of children presenting with fever at Dutch GP out-of-hours cooperatives. Methods/design We are conducting a cluster randomised controlled trial (RCT) with 20 GP out-of-hours cooperatives randomised to 1 of 2 arms: GP access to the illness-focused interactive booklet or care as usual. GPs working at intervention sites will have access to the booklet, which was developed in a multistage process. It consists of a traffic light system for parents on how to respond to fever-related symptoms, as well as information on natural course of infections, benefits and harms of (antibiotic) medications, self-management strategies and ‘safety net’ instructions. Children < 12 years of age with parent-reported or physician-measured fever are eligible for inclusion. The primary outcome is antibiotic prescribing during the initial consultation. Secondary outcomes are (intention to) (re)consult, antibiotic prescriptions during re-consultations, referrals, parental satisfaction and reassurance. In 6 months, 20,000 children will be recruited to find a difference in antibiotic prescribing rates of 25% in the control group and 19% in the intervention group. Statistical analysis will be performed using descriptive statistics and by fitting two-level (GP out-of-hours cooperative and patient) random intercept logistic regression models. Discussion This will be the first and largest cluster RCT evaluating the effectiveness of an illness-focused interactive booklet during GP out-of-hours consultations with febrile children receiving antibiotic prescriptions. It is hypothesised that use of the booklet will result in a reduced number of antibiotic prescriptions, improved parental satisfaction and reduced intention to re-consult

A Clinical Perspective on the Criteria for Liver Resection and the Use of Liver Function Tests

Ó The Author(s) 2009. This article is published with open access at Springerlink.com To the Editor, In a recently published survey of 100 liver centers, Breitenstein et al. [1] reported that on a global scale, (1) the average minimal remnant liver volume for resection is 25% (range = 15-40%) for normal liver parenchyma and 50% (range = 25–90%) for cirrhotic livers, (2) portal vein occlusion is employed in 89 % of the centers for purposes of augmenting liver volume before surgery, and that (3) 38 % of the centers employed liver function tests as part of their clinical routine, of which 76 % used the ICG clearance test. The interesting survey provoked a few issues that we feel obliged to address. The authors contend that ‘‘below a certain volume, a remnant liver cannot sustain metabolic, synthetic, and detoxifying functions’ ’ [1]—a statement that is unequivocal and uncontested. However, it should be born in mind that liver volume is not a directly proportional measure of liver function. We have demonstrated a few fundamental aspects of the volume-function relationship that support this notion: (i) Whereas liver function correlates with volume in uncompromised livers [2], there is significantly less correlation between liver volume an