Activité anti-androgénique de Leptadenia hastata (Pers.) Decne : effet compétitif des extraits aqueux de la plante et du propionate de testostérone sur des rats impubères castrés

Anti-androgenic activity of Leptadenia hastata (Pers.) Decne: competitive effect of the aqueous extracts of the plant and the testosterone propionate on castrated immature rats. The anti-androgenic activity and the evaluation of competitiveness between the extracts of Leptadenia hastata and the testosterone propionate (TP) were studied on Wistar immature castrated rats. The first group received only 0.04; 0.4; 4; 40; 400 and 1,000 µg.kg-1 of TP and the second group received simultaneously these different doses of TP and 200 mg.kg-1 of L. hastata. The various treatments showed a significant increase (p < 0.05) of the weight of androgeno-dependent organs and the level of plasmatic testosterone. At low dosis of TP, the dosis of 200 mg.kg-1 of L. hastata inhibited TP effects, whereas at high doses of TP L. hastata extracts potentiated TP effects. In conclusion, the anti-androgenic effect of the extract of L. hastata is expressed when the TP amounts are weak

Effets oestrogéniques du macéré aqueux des feuilles de Holarrhena floribunda (G. Don) Dur & Schinz chez la rate ovariectomisée

Oestrogenic effects of macerated aqueous extracts of the leaves of Holarrhena fl oribunda (G. Don) Dur & Schinz on ovariectomized rat. Estrogenic effects of aqueous extracts of leaves of Holarrhena fl oribunda have been evaluated by uterotrophic assay. Ovariectomized mice were used and treated subcutaneously during seven days with 50, 100, 200 mg.kg-1 doses of Holarrhena fl oribunda and with 100, 200 mg.kg-1 doses of Holarrhena fl oribunda plus 25 mg.kg-1 of oestradiol 17-β. Estrogenic activity was analysed by uterine dry and wet weight, surrenal gland wet weight, vaginal opening, protein and cholesterol level in uteri horn. Administration of extracts to the doses of 100 and 200 mg.kg-1 exhibits increase of uterine dry and wet weight, surrenal gland wet weight, vaginal opening, protein levels and decrease of level of cholesterol in uterine horn. The results suggest that, aqueous extracts of Holarrhena fl oribunda possesses estrogenic type effect. But when 100 and 200 mg.kg-1 of Holarrhena fl oribunda were given alone with 25 mg.kg-1 of estradiol 17-β, the estrogenic effect was slight. These results supposed that H. fl oribunda is a weak phytoestrogen and the aqueous extracts of the leaves behad as partial agonisti

Pilot Testing and Psychometric Validation of the Nijmegen Professionalism Scale for Spanish Nursing

Background and purpose: Professional commitment is frequently used as a humanistic care indicator. Thus, it is important to design and validate a tool which is able to measure professional commitment of nurses in Spain. In this study we aimed to analyze the psychometric properties of the Nijmegen Professionalism Scale for Spanish (NPS-S) nursing in order to verify its validity and reliability. Methods: We undertook the pilot testing and psychometric validation of the NPS-S. A total sample of 249 nursing professionals from a variety of areas of expertise took part in this study. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) Statement was used for reporting this research. Results: The NPS-S achieved a high degree of content validity, construct validity, internal consistency, temporal stability, and usability; this version is, thus, equivalent to the Nijmegen Professionalism Scale in its original version. Implications for practice: Based on the results obtained from the validation of this tool, it is possible to affirm that the NPS-S is an effective instrument for measuring professional commitment in this population. The NPS-S will evaluate and thus contribute to the promotion of professional commitment in Spanish nursing. Additionally, it will serve to establish correlations between professional commitment and other variables including quality of care and patient satisfaction. Future studies should analyze the evaluation capacity of this tool

The CCG-domain-containing subunit SdhE of succinate:quinone oxidoreductase from Sulfolobus solfataricus P2 binds a [4Fe–4S] cluster

In type E succinate:quinone reductase (SQR), subunit SdhE (formerly SdhC) is thought to function as monotopic membrane anchor of the enzyme. SdhE contains two copies of a cysteine-rich sequence motif (CXnCCGXmCXXC), designated as the CCG domain in the Pfam database and conserved in many proteins. On the basis of the spectroscopic characterization of heterologously produced SdhE from Sulfolobus tokodaii, the protein was proposed in a previous study to contain a labile [2Fe–2S] cluster ligated by cysteine residues of the CCG domains. Using UV/vis, electron paramagnetic resonance (EPR), 57Fe electron–nuclear double resonance (ENDOR) and Mössbauer spectroscopies, we show that after an in vitro cluster reconstitution, SdhE from S. solfataricus P2 contains a [4Fe–4S] cluster in reduced (2+) and oxidized (3+) states. The reduced form of the [4Fe–4S]2+ cluster is diamagnetic. The individual iron sites of the reduced cluster are noticeably heterogeneous and show partial valence localization, which is particularly strong for one unique ferrous site. In contrast, the paramagnetic form of the cluster exhibits a characteristic rhombic EPR signal with gzyx = 2.015, 2.008, and 1.947. This EPR signal is reminiscent of a signal observed previously in intact SQR from S. tokodaii with gzyx = 2.016, 2.00, and 1.957. In addition, zinc K-edge X-ray absorption spectroscopy indicated the presence of an isolated zinc site with an S3(O/N)1 coordination in reconstituted SdhE. Since cysteine residues in SdhE are restricted to the two CCG domains, we conclude that these domains provide the ligands to both the iron–sulfur cluster and the zinc site

Spontaneous Breathing in Early Acute Respiratory Distress Syndrome: Insights From the Large Observational Study to UNderstand the Global Impact of Severe Acute Respiratory FailurE Study

OBJECTIVES: To describe the characteristics and outcomes of patients with acute respiratory distress syndrome with or without spontaneous breathing and to investigate whether the effects of spontaneous breathing on outcome depend on acute respiratory distress syndrome severity. DESIGN: Planned secondary analysis of a prospective, observational, multicentre cohort study. SETTING: International sample of 459 ICUs from 50 countries. PATIENTS: Patients with acute respiratory distress syndrome and at least 2 days of invasive mechanical ventilation and available data for the mode of mechanical ventilation and respiratory rate for the 2 first days. INTERVENTIONS: Analysis of patients with and without spontaneous breathing, defined by the mode of mechanical ventilation and by actual respiratory rate compared with set respiratory rate during the first 48 hours of mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: Spontaneous breathing was present in 67% of patients with mild acute respiratory distress syndrome, 58% of patients with moderate acute respiratory distress syndrome, and 46% of patients with severe acute respiratory distress syndrome. Patients with spontaneous breathing were older and had lower acute respiratory distress syndrome severity, Sequential Organ Failure Assessment scores, ICU and hospital mortality, and were less likely to be diagnosed with acute respiratory distress syndrome by clinicians. In adjusted analysis, spontaneous breathing during the first 2 days was not associated with an effect on ICU or hospital mortality (33% vs 37%; odds ratio, 1.18 [0.92-1.51]; p = 0.19 and 37% vs 41%; odds ratio, 1.18 [0.93-1.50]; p = 0.196, respectively ). Spontaneous breathing was associated with increased ventilator-free days (13 [0-22] vs 8 [0-20]; p = 0.014) and shorter duration of ICU stay (11 [6-20] vs 12 [7-22]; p = 0.04). CONCLUSIONS: Spontaneous breathing is common in patients with acute respiratory distress syndrome during the first 48 hours of mechanical ventilation. Spontaneous breathing is not associated with worse outcomes and may hasten liberation from the ventilator and from ICU. Although these results support the use of spontaneous breathing in patients with acute respiratory distress syndrome independent of acute respiratory distress syndrome severity, the use of controlled ventilation indicates a bias toward use in patients with higher disease severity. In addition, because the lack of reliable data on inspiratory effort in our study, prospective studies incorporating the magnitude of inspiratory effort and adjusting for all potential severity confounders are required

Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis of the LUNG SAFE database

Background: Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). Methods: An ancillary analysis of a global, multi-centre prospective observational study (LUNG SAFE) was undertaken. LUNG SAFE evaluated all patients admitted to an intensive care unit (ICU) over a 4-week period, that required mechanical ventilation and met AHRF criteria. Patients who had their AHRF fully explained by cardiac failure were excluded. Important clinical characteristics were included in a stepwise selection approach (forward and backward selection combined with a significance level of 0.05) to identify a set of independent variables associated with having ARDS at any time, developing ARDS (defined as ARDS occurring after day 2 from meeting AHRF criteria) and with hospital mortality. Furthermore, propensity score analysis was undertaken to account for the differences in baseline characteristics between patients with and without diabetes mellitus, and the association between diabetes mellitus and outcomes of interest was assessed on matched samples. Results: Of the 4107 patients with AHRF included in this study, 3022 (73.6%) patients fulfilled ARDS criteria at admission or developed ARDS during their ICU stay. Diabetes mellitus was a pre-existing co-morbidity in 913 patients (22.2% of patients with AHRF). In multivariable analysis, there was no association between diabetes mellitus and having ARDS (OR 0.93 (0.78-1.11); p = 0.39), developing ARDS late (OR 0.79 (0.54-1.15); p = 0.22), or hospital mortality in patients with ARDS (1.15 (0.93-1.42); p = 0.19). In a matched sample of patients, there was no association between diabetes mellitus and outcomes of interest. Conclusions: In a large, global observational study of patients with AHRF, no association was found between diabetes mellitus and having ARDS, developing ARDS, or outcomes from ARDS. Trial registration: NCT02010073. Registered on 12 December 2013

Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries

Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013