Bobinage à faible impact environnemental

L'étude d'un nouveau fil émaillé dont le procédé d'élaboration réduit fortement son impact environnemental est présentée. Cette étude est associée à celle d'un vernis dont la quantité de Composés Organiques Volatiles (COV) est très faible. Les nombreux essais tant mécaniques qu'électriques montrent que ce fil est aussi performant que le fil émaillé classique. Sur certaine caractéristique comme le PDIV il est même meilleur. Enfin la problématique de l'imprégnation, souvent faite sous vide et pression pour être performante, est abordée. L'emploi d'un vernis monomère réactif et d'une pré-gélification par lampe UV, permet de réduire fortement la perte de masse et d'améliorer toutes tes caractéristiques mécaniques exigée pour le fonctionnement des moteurs en milieu hostile

Mediastinal parathyroid carcinoma: a case report

Chora w wieku 72 lat była operowana z powodu zagrażającego przełomu przytarczycowego w przebiegu pierwotnej nadczynności przytarczyc. Przedoperacyjne stężenie PTH w surowicy krwi wynosiło 808 pg/ml. Śródoperacyjnie zlokalizowano jedynie dwie przytarczyce górne — jedną prawidłową i jedną w stanie rozrostu. Pooperacyjne stężenie PTH w surowicy krwi wynosiło 726,5 pg/ml. W badaniu TK w przednim śródpiersiu stwierdzono obecność heterogennego guza. Chorą operowano ponownie. Wykonano sternotomię pośrodkową górną, usuwając zmienioną ektopowo przytarczycę. W badaniu histopatologicznym rozpoznano raka przytarczycy. Uzyskano spadek stężenia PTH do wartości 5,74 pg/ml. Badanie cytofluorometryczne wykazało diploidę przytarczyc górnych, podczas gdy rak przytarczycy miał charakter aneuploidalny. Chora została wypisana z kliniki po 27 dniach od operacji; pozostaje pod kontrolą ambulatoryjną bez cech wznowy procesu nowotworowego i jest poddana substytucji preparatami wapnia. (Endokrynol Pol 2012; 63 (2): 143–146)A 72 year-old woman with primary hyperparathyroidism was operated for parathyroid crisis. PTH serum level was 808 pg/mL. During the operation, only two superior parathyroid glands were found. One was normal, and hypertrophy was revealed in the other. After the surgical procedure, PTH serum level was 726.5 pg/mL. Helical computer tomography examination showed a heterogeneous mass in the anterior mediastinum. The tumour was removed via a sternotomy approach. Histopathological examination revealed parathyroid carcinoma. PTH level dropped to 5.74 pg/mL. Cytofluorometric examination revealed diploidy (DI = 1) in both the hypertrophic and the unchanged upper glands, whereas parathyroid cancer was aneuploid. After the initial operation, the woman was discharged from the hospital on the 27th postoperative day. One year after surgical procedures, she is well. She has to take calcium. (Pol J Endocrinol 2012; 63 (2): 143–146

In vivo

The effect of aqueous extract of Spondias mombin leaves extract on lipid peroxidation and antioxidant activity in alloxan induced diabetes was studied. Forty male albino Wistar rats (100-150 g body weight) were used. The rats were randomly selected into four groups containing 10 rats each. Group 1 was the control group and it was placed on normal rat chow. Group 2 was the Spondias mombin (spm) group placed on normal rat chow and given 250 mg/kg extract orally. Group 3 was the alloxan-induced diabetic (150 mg/kg) group (DM) and Group 4 was the diabetic group treated with 250 mg/kg extracts (Dm+spm). At the end of 30 days blood samples were collected by cardiac puncture and used for biochemical analysis. Results obtained revealed that blood glucose level in group 3 (Dm) was significantly higher (p<0.05) than control but the administration of Spondias mombin leaves extract significantly reduced the blood glucose level (p<0.05). Total cholesterol (TC), triglycerides (TG) and Low Density Lipoprotein (LDL) were significantly raised in the diabetic group while High Density Lipoprotein (HDL) was significantly reduced (p<0.05). Treatment with extract decreased TC, TG, LDL but significantly increased the HDL level (p<0.05). Lipid peroxidation was increased in the diabetic group and treatment with extract significantly reduced (p<0.05) the level of lipid peroxidation. Superoxide dismutase (SOD) and catalase (CAT) activities were decreased significantly in the diabetic group. Administration of extracts increased the antioxidant enzymes activities. The result suggests that aqueous extracts of Spondias mombin leaves possess hypoglycemic effects and improve lipid profile of diabetic rats. This effect may be secondary to its ability to reduce oxidative stress.© 2016 International Formulae Group. All rights reserved.Keywords: Diabetes, SOD, CAT, Lipid peroxidation, hypolipidemic, hypoglycemic, Spondias mombi

Therapeutical inertia in hypertension treatment

Nadciśnienie tętnicze jest uznawane za chorobę cywilizacyjną.Według najnowszych badań populacyjnychdotyczy ono około 9,5 miliona osób w Polsce, awśród mieszkańców całej kuli ziemskiej liczbę tęszacuje się na ponad miliard . Występowanie nadciśnieniatętniczego jest związane ze zwiększonym ryzykiempowstania wielu powikłań, takich jak chorobaniedokrwienna serca, udar mózgu, przewlekłachoroba nerek czy siatkówki oka.Leczenie nadciśnienia tętniczego pochłania poważnączęść środków przeznaczonych na ochronęzdrowia w różnych krajach. Jednak, pomimo stałegopostępu odbywającego się w zakresie diagnostykii leczenia nadciśnienia tętniczego oraz zwiększaniasum wydawanych przez rządy i fundusze ochronyzdrowia uzyskiwane wyniki leczenia są niezadawalające.Niestety, u części pacjentów, mimo stosowanegoleczenia hipotensyjnego, nie osiąga się założonychprzez wytyczne celów, czyli wartości ciśnienia< 140/90 mm Hg. W badaniu WOBASZ, w którymoceniono wiele parametrów związanych z występowaniemi leczeniem nadciśnienia tętniczego wewszystkich województwach w Polsce, określono, żeodsetek pacjentów z prawidłowo kontrolowanymnadciśnieniem tętniczym wynosi 10% u mężczyzni 16% u kobiet. Natomiast według badaniu NATPOL2011 skuteczność kontroli ciśnienia u pacjentówz nadciśnieniem tętniczym w Polsce wynosi 26%.Jedną z przyczyn niskiej skuteczności leczenia nadciśnieniatętniczego jest zjawisko nazywane inercjąterapeutyczną. Określa się je jako niepowodzenie lekarza w osiąganiu założonych celów terapeutycznych,związane z brakiem podwyższania dawki jużstosowanego leku i/lub dodania kolejnego preparatu.Inercja terapeutyczna dotyczy nie tylko leczenianadciśnienia tętniczego, ale również leczenia innychprzewlekłych chorób, na przykład dyslipidemii czycukrzycy. Cele, które należy osiągnąć w leczeniu tychschorzeń, zostały dokładnie określone, a skuteczneleczenie jest powszechnie dostępne.Arterial hypertension is a civilization disease. According tothe recent studies it concerns about 9.5 million people inPoland, and among people throughout the world thisnumber is estimated to be more than a billion. Prevalenceof hypertension is associated with an increased risk of complications,such as heart disease, stroke, chronic kidneydisease or ophthalmic complications. The treatment of hypertensionabsorbs a serious part of the appropriations intendedfor health protection in different countries. However,despite the continued progress taking place in thediagnosis and treatment of hypertension and increasingthe sums that are spent by governments and the funds ofthe health protection, treatment results are unsatisfactory.The WOBASZ study evaluated several parameters relatedto the occurrence and treatment of arterial hypertension inall provinces in Poland determined that the percentage ofpatients with well-controlled hypertension was 10% in menand 16% in women, while according to NATPOL 2011survey effectiveness of blood pressure control among hypertensivepatients in Poland is 26%.One of the reasons of low blood pressure control is phenomenon,called therapeutical inertia (TI). It is definedas the treating physician failure in achieving the goals ofmanagement, related to the lack of action to increase thedose of already used medication and/or to add anotherpreparation. TI concerns not only the treatment of hypertension,but also dyslipidemia or diabetes treatment.The goals to be achieved in the treatment of these diseases have been exactly defined and effective treatment iswidely available

Therapeutical inertia in hypertension patients treated by general practitioners and cardiologists in Poland

Wstęp W Polsce realizowane były dotychczas 3 dużeprogramy populacyjne mające na celu scharakteryzowanieproblemu nadciśnienia tętniczego: Pol-MONICA, NATPOL i WOBASZ. Pozwoliło to naoszacowanie odsetka pacjentów z prawidłowo leczonymnadciśnieniem, który wynosił 12% w 2002 rokui wzrósł do 26% w 2011 roku.Materiał i metody Badanie dotyczące problemuinercji terapeutycznej w leczeniu nadciśnienia tętniczegowśród lekarzy rodzinnych i kardiologóww Polsce prowadzone było w latach 2009–2010. Uczestniczyłow nim 4195 osób w wieku 18–92 lat (śr. 47,9± 11,01 lat), w tym 42,4% kobiet i 57,6% mężczyzn.U każdego pacjenta przeprowadzono 3 wizyty.W badaniu wzięło udział 246 lekarzy. Odsetek osóbz dobrze kontrolowanym nadciśnieniem tętniczymzdefiniowano jako stosunek osób aktualnie leczonychz powodu nadciśnienia, u których uzyskanonormalizację ciśnienia tętniczego (<140/90 mm Hg),do ogółu osób, u których w czasie badania stwierdzononadciśnienie tętnicze.Wyniki Odsetek pacjentów z wartościami ciśnienia skurczowego powyżej górnej granicy normy, to znaczypowyżej 140 mm Hg wynosił w kolejnych trzechwizytach odpowiednio 84,4%, 57,5% i 38,6%, a z wartościamiciśnienia rozkurczowego powyżej górnejgranicy normy, to znaczy 90 mm Hg, odpowiednio74,6%, 43,0% i 30,5%. W odniesieniu do tych pacjentówterapia uległa zmianie podczas kolejnych wizyt,odpowiednio w 82,4%, 58% i 40,3% przypadków.Wnioski Do czynników mogących pozytywnie wpłynąćna zjawisko inercji terapeutycznej należą: poprawawykształcenia lekarzy w zakresie leczenianadciśnienia tętniczego i znajomości obowiązującychzaleceń, stosowanie preparatów złożonych,ograniczona liczba wizyt lekarskich w danej jednostceczasu, współistnienie innych chorób układu sercowo-naczyniowego oraz możliwość telefonicznegolub radiowego raportowania zmierzonych wartościciśnienia przez pacjentów.Background There were three large population-based programscarried out in Poland to characterize the problem ofarterial hypertension- Pol-MONICA, NATPOL andWOBASZ. It was possible to estimate the percentage ofproperly treated hypertension patients, which increasedfrom 12% in 2002 to 26% in 2011.Material and methods Study concerning therapeutic inertiain hypertension treatment among general practitionersand cardiologists in Poland was carried out in 2009-10. Itwas attended by 4195 people aged 18-92 years (mean47.9±11.01 years), including 42.4% women and 57.6%men. Every patient had three visits. In the study took part246 physicians. The percentage of patients with well-controlledhypertension was defined as the ratio of patientscurrently treated for hypertension who achieved a goalblood pressure (< 140/90 mmHg) and the total number ofparticipating hypertension patients.Results The percentage of patients with systolic blood pressurevalues above 140 mm Hg was during following threevisits, respectively 84.4%, 53.9% and 26.8%, and withdiastolic blood pressure values above 90 mm Hg, respectively74.1%, 38.1% and 19.1%. In these patients, treatmentwas changed during subsequent visits, respectively in82.4%, 58% and 40.3% of cases.Conclusions The factors that can positively influencetherapeutical inertia are: improvement of physician educationconcerning arterial hypertension treatment and currentguidelines knowledge, hypertension treatment usingcombination drugs, coexistence of other cardiovascular system’sdiseases, patient’s possibility to do phone or radioreports of his blood pressure value

Increased risk of the abdominal aortic aneurysm in carriers of the MTHFR 677T allele

Abstract. Abdominal aortic aneurysm (AAA) presents itself as a progressive dilation of the abdominal aorta, leading -if untreated -to rupture. It is a common disease of the elderly, with a complex etiology. Several genetic, biochemical and environmental factors are recognized as relevant for the pathogenesis of AAA. We determined the polymorphism of the MTHFR (methylenetetrahydrofolate reductase) gene within the fourth exon (C677T) in 63 patients with AAA and compared it to that in 75 subjects of the population sample. The frequencies of the C/C, C/T and T/T genotypes were 65%, 27%, and 8% in the population sample and 33%, 60%, and 6% in the patients. This corresponds to a 4.4-fold greater risk of AAA in subjects who have the 677C/T variant of MTHFR, as compared with those who are 677C/C (p<0.0001; 95% CI=2.11-9.34). The frequency of allele MTHFR 677T in patients (0.37) was higher than in the population sample (0.21; p < 0.007). This association between the common allele of the MTHFR gene -MTHFR 677T -and the development of AAA suggests that elevated homocysteine (Hcy) may disturb the function of the aortic wall. The disturbance may involve enhancement of elastin degradation, the process enhanced by mild hyperhomocysteinemia in minipigs. The magnitude of this effect, which refers to the AAA patients unselected for familial occurrence, indicates that the disturbance of aortic wall physiology caused by the presence of the MTHFR 677T allele is greater than the effect of the earlier described allele disequilibrium at the polymorphic alleles of the PAI1 (plasminogen activator inhibitor 1) gene seen only in familial cases of AAA

Imipramine influences body distribution of supplemental zinc which may enhance antidepressant action

Zinc (Zn) was found to enhance the antidepressant efficacy of imipramine (IMI) in human depression and animal tests/models of depression. However, the underlying mechanism for this effect remains unknown. We measured the effect of intragastric (p.o.) combined administration of IMI (60 mg/kg) and Zn (40 mg Zn/kg) in the forced swim test (FST) in mice. The effect of Zn + IMI on serum, brain, and intestinal Zn concentrations; Zn transporter (ZnT, ZIP) protein levels in the intestine and ZnT in the brain; including BDNF (brain-derived neurotrophic factor) and CREB (cAMP response element-binding protein) protein levels in the brain were evaluated. Finally, the effect of IMI on Zn permeability was measured in vitro in colon epithelial Caco-2 cells. The co-administration of IMI and Zn induced antidepressant-like activity in the FST in mice compared to controls and Zn or IMI given alone. This effect correlated with increased BDNF and the ratio of pCREB/CREB protein levels in the prefrontal cortex (PFC) compared to the control group. Zn + IMI co-treatment increased Zn concentrations in the serum and brain compared to the control group. However, in serum, co-administration of IMI and Zn decreased Zn concentration compared to Zn alone treatment. Also, there was a reduction in the Zn-induced enhancement of ZnT1 protein level in the small intestine. Zn + IMI also induced an increase in the ZnT4 protein level in the PFC compared to the control group and normalized the Zn-induced decrease in the ZnT1 protein level in the hippocampus (Hp). The in vitro studies revealed enhanced Zn permeability (observed as the increased transfer of Zn through the intestinal cell membrane) after IMI treatment. Our data indicate that IMI enhances Zn transfer through the intestinal tract and influences the redistribution of Zn between the blood and brain. These mechanisms might explain the enhanced antidepressant efficacy of combined IMI/Zn treatment observed in the FST in mice

Effect of natalizumab on disease progression in secondary progressive multiple sclerosis (ASCEND). a phase 3, randomised, double-blind, placebo-controlled trial with an open-label extension

Background: Although several disease-modifying treatments are available for relapsing multiple sclerosis, treatment effects have been more modest in progressive multiple sclerosis and have been observed particularly in actively relapsing subgroups or those with lesion activity on imaging. We sought to assess whether natalizumab slows disease progression in secondary progressive multiple sclerosis, independent of relapses. Methods: ASCEND was a phase 3, randomised, double-blind, placebo-controlled trial (part 1) with an optional 2 year open-label extension (part 2). Enrolled patients aged 18–58 years were natalizumab-naive and had secondary progressive multiple sclerosis for 2 years or more, disability progression unrelated to relapses in the previous year, and Expanded Disability Status Scale (EDSS) scores of 3·0–6·5. In part 1, patients from 163 sites in 17 countries were randomly assigned (1:1) to receive 300 mg intravenous natalizumab or placebo every 4 weeks for 2 years. Patients were stratified by site and by EDSS score (3·0–5·5 vs 6·0–6·5). Patients completing part 1 could enrol in part 2, in which all patients received natalizumab every 4 weeks until the end of the study. Throughout both parts, patients and staff were masked to the treatment received in part 1. The primary outcome in part 1 was the proportion of patients with sustained disability progression, assessed by one or more of three measures: the EDSS, Timed 25-Foot Walk (T25FW), and 9-Hole Peg Test (9HPT). The primary outcome in part 2 was the incidence of adverse events and serious adverse events. Efficacy and safety analyses were done in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01416181. Findings: Between Sept 13, 2011, and July 16, 2015, 889 patients were randomly assigned (n=440 to the natalizumab group, n=449 to the placebo group). In part 1, 195 (44%) of 439 natalizumab-treated patients and 214 (48%) of 448 placebo-treated patients had confirmed disability progression (odds ratio [OR] 0·86; 95% CI 0·66–1·13; p=0·287). No treatment effect was observed on the EDSS (OR 1·06, 95% CI 0·74–1·53; nominal p=0·753) or the T25FW (0·98, 0·74–1·30; nominal p=0·914) components of the primary outcome. However, natalizumab treatment reduced 9HPT progression (OR 0·56, 95% CI 0·40–0·80; nominal p=0·001). In part 1, 100 (22%) placebo-treated and 90 (20%) natalizumab-treated patients had serious adverse events. In part 2, 291 natalizumab-continuing patients and 274 natalizumab-naive patients received natalizumab (median follow-up 160 weeks [range 108–221]). Serious adverse events occurred in 39 (13%) patients continuing natalizumab and in 24 (9%) patients initiating natalizumab. Two deaths occurred in part 1, neither of which was considered related to study treatment. No progressive multifocal leukoencephalopathy occurred. Interpretation: Natalizumab treatment for secondary progressive multiple sclerosis did not reduce progression on the primary multicomponent disability endpoint in part 1, but it did reduce progression on its upper-limb component. Longer-term trials are needed to assess whether treatment of secondary progressive multiple sclerosis might produce benefits on additional disability components. Funding: Biogen