PubMed Health⌕ Search

Biomedical subjects

S Dubois

Publications and source records attributed to S Dubois.

At least 19 recordsLinked to original sources
PubMed2006

[Maternal-fetal staphylococcal toxic shock syndrome with chorioamniotitis].

We report a rare case of mother-infant pair with Staphylococcal Toxic Shock Syndrome (TSS). A term neonate was born by caesarean section for maternal septic syndrome during per-partum. He presented with respiratory distress complicated by pulmonary hypertension, skin rash, and multiple organ system involvement. Staphylococcus aureus was isolated from placenta, surface swabs and gastric aspirate. He received adapted antibiotics, respiratory support by high frequency ventilation and NO. The mother had shock, skin rash and inflammatory syndrome. Outcome was good in both cases. The isolate produced enterotoxin C and L. Shock, exanthematous disease and multi-organ involvement complicating a staphylococcal infection in neonate must lead to suspect a TSS.

Anti-Bacterial Agents↗
PubMed2006

Effects of feed restriction and subsequent refeeding on energy utilization in growing pigs.

An experiment was carried out to evaluate the metabolic utilization of energy in crossbred barrows during feed restriction and subsequent refeeding. Ten pigs, initially weighing 52 kg, were used in 5 blocks of 2 littermates each. A 7-d adaptation period (P1) was used in which pigs were offered feed at 2.60 MJ of ME.kg of BW(-0.60).d(-1). This adaptation period was followed by a 7-d period (P2), in which 1 pig of each block continued to receive feed at the same level of feeding, whereas for its littermate a 40% reduction in feed intake was imposed (i.e., 1.55 MJ of ME.kg of BW(-0.60).d(-1)). During the subsequent 7-d period (P3), both pigs were offered feed at 2.60 MJ of ME.kg of BW(-0.60).d(-1). After P3, pigs were fasted for 1 d. Heat production (HP) was measured for all pigs during the last 3 d of P1 and on all days for P2 and P3. Heat production was measured using an open-circuit respiration chamber. Energy and N balances were determined for P1, P2, and P3. The HP was partitioned into HP due to physical activity, the short-term thermic effect of feeding, and resting HP. Feed restriction during P2 decreased (P < 0.01) total HP, resting HP, short-term thermic effect of feeding, and retained energy, whereas HP due to physical activity was not affected by feed restriction (P = 0.50). Likewise, fecal and urinary N loss, protein gain, lipid gain, and ADG were reduced during feed restriction (P < 0.01). There were no differences in components of HP and metabolic utilization of energy between the 2 groups during P1 and P3. Nevertheless, urinary N loss was decreased (P < 0.05) and ADG increased (P < 0.01) during P3 for pigs that were restricted in P2. Compensatory growth after a period of feed restriction does not seem to be related to a change in the metabolic utilization of energy for gain but more likely is due to gain in water and gut contents.

Animal Feed↗
PubMed2005

[Global HIV care in general/family practice].

Dealing with HIV/AIDS in primary care encompasses preventive, curative, social and psychological aspects within a framework of a person-centred approach. Antiretroviral treatments enable the control of HIV infection, prevent opportunistic infections and allow patients to "live their life" with an increased life expectancy, active sexuality and need to procreate. The holistic care of patients should always be the primary concern. An increased involvement of GP's in HIV care can raise the quality of care, reduce the stigma and prejudice surrounding HIV Medical care providers can substantially affect HIV transmission by positively reinforcing changes to safe behavior, by referring patients for specialized services and working in direct collaboration with them, by facilitating partner counseling and testing. However, providers must interweave the "half-baked "science about drug therapies, side effects and drug interactions with the psychosocial and lifestyle factors of the patient. Sometimes it's not easy to find adequate and relevant information about HIV in primary care. This document will provide primary care givers the keys for improvement, increase their basic HIV-related skills (and strengthen their role in HIV/AIDS prevention and follow-up) and make them more confident in their assessments.

Acquired Immunodeficiency Syndrome↗
PubMed2004

The self-perceived role and educational needs of pharmaceutical representatives: a survey.

INTRODUCTION: Despite considerable debate in the medical literature about the educational utility of pharmaceutical representatives (PR), little is known about their attitudes towards their role as marketers and/or educators, their ability to provide comprehensive information about products and their learning needs. DESIGN: A survey. SUBJECTS AND METHOD: Questionnaires were mailed to 606 PRs from five Canadian pharmaceutical companies. RESULTS: Of 309 (51%) respondents, 98% strongly agreed or agreed they had a role in educating doctors, while 52% strongly disagreed or disagreed their main goal was marketing. Overall, 92% agreed they had received adequate training to perform a well-informed detail, and 96% reported the information they provide is accurate. The majority (66%) felt a university-accredited program would improve the quality of their detailing. CONCLUSION: Most PRs believe their main goal is education. Despite most reporting that they had received adequate training, they felt that a university-accredited educational program would improve the quality of detailing. The number of years that a PR spent in the industry appears to have an effect on how they perceive their role.

Canada↗
PubMed2004

Angiogenesis and extracellular matrix remodelling in bronchioloalveolar carcinomas: distinctive patterns in mucinous and non-mucinous tumours.

AIM: Bronchioloalveolar carcinomas (BACs) are rare primitive lung adenocarcinomas growing along the alveolar septum without stromal, vascular or pleural invasion. We report an immunohistochemical study of their vascular microenvironment. METHODS AND RESULTS: In three mucinous BACs (M-BAC) and three non-mucinous BACs (NM-BAC) we examined the following parameters in comparison with the normal lung: (i) constituents of the alveolar extracellular matrix; (ii) qualitative and quantitative changes of alveolar capillaries; and (iii) expression of vascular endothelial growth factor (VEGF) by tumour cells. In M-BAC, the alveolar matrix was unchanged compared with the normal parenchyma. Capillaries expressed normal alveolar endothelial markers and their average surface was calculated, as in normal lung, as 8%. VEGF was negative in tumour cells. In NM-BAC, the alveolar wall was thickened by deposits of fibronectin and type III collagen containing myofibroblasts and the basement membrane was disrupted. Capillaries did not retain alveolar endothelial markers and their surface was calculated as 19%. Tumour cells expressed high levels of VEGF. CONCLUSIONS: In contrast to NM-BAC, M-BAC do not modify the alveolar structure and seem to exploit the normal alveolar vascular bed to grow, without inducing neoangiogenesis. A better understanding of the mechanisms of growth of lung cancers may have implications for future anti-angiogenic therapeutic strategies.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed2004

Comparison of health care professionals' self-assessments of standards of care and patients' opinions on the care they received in hospital: observational study.

OBJECTIVES: To compare the views of healthcare professionals and patients regarding compliance with standards of care concerning patient information. DESIGN: Self-rated questionnaire survey. SETTING: Nine wards in short stay French hospitals. PARTICIPANTS: 939 patients and 359 healthcare professionals (physicians, nurses, assistants and other professionals). MAIN OUTCOME MEASURE: Patients' and healthcare professionals' views of compliance with 20 standards of patient care described in the French accreditation manual. Comparison of the rank order of the standards within the two samples. RESULTS: The response rate was 61.5% in the patient group and 85.8% in the healthcare professionals. The rank orders for the 20 items were similar in both groups (Spearman rank order correlation 0.6, p = 0.004). The two items ranked highest by healthcare professionals ("consent request for a surgical procedure" and "the doctors ask the visitors to leave the room before examining a patient") were also the two ranked highest by the patients. Three items were ranked low by both groups: "consent request for students to be present", "health education given to patients", and "possibility to express satisfaction during discharge". Patients were more satisfied with their pain management than were healthcare providers. Professionals were more satisfied with the social services than the patients. CONCLUSION: There are both similarities and differences between patients' and healthcare professionals' views of care. Accurate assessments of quality performed during the accreditation procedure require that both patients' and professionals' views be taken into account.

Accreditation↗
PubMed2002

Digestibility and metabolic utilisation of dietary energy in adult sows: influence of addition and origin of dietary fibre.

According to a 4 x 4 Latin square design, four adult ovariectomised sows fed at a similar energy level (516 kJ ME/kg body weight (BW)0.75 per d) received one of four diets successively: a control low-dietary-fibre (DF) diet (diet C, 100 g total DF/kg DM) and three fibre-rich diets (200g total DF/kg DM) that corresponded to a combination of diet C and maize bran (diet MB), wheat bran (diet WB), or sugar-beet pulp (diet SBP). Sows were adapted to the diet for 12 d before an 8 d measurement period. Digestibility of energy and nutrients in the diets, and total heat production (HP) and its components (fasting HP, activity HP and thermic effect of feeding (TEF), were measured. The TEF was partitioned between a short-term component (TEF(st)) and a long-term component (TEF(lt)). Total tract digestibility of nutrients and energy was greater for diet C; among the three other diets, the digestibility coefficients were higher for diet SBP than for diets MB and WB. Energy losses from CH4 were linearly related to the digestible total DF intake (+1.4kJ/g). Fasting HP at zero activity averaged 260 kJ/kg BW(0.75) per d. Activity HP represented 20% total HP, or 83 kJ/kg BW(0.75) per d on average. Total TEF and TEF(lt) were higher (P<0.05) for diet WB than for the other diets. However, total HP (406kJ/kg BW(0.75 per d) was not significantly affected by diet characteristics. Our results suggest that metabolic utilisation of dietary energy is little affected by the addition and origin of DF, at least under the conditions of the present study.

Animals↗
PubMed2001

Interleukin-15 expression in cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome).

BACKGROUND: Cytokines are of potential importance in the pathogenesis of cutaneous T-cell mediated disorders, including cutaneous T-cell lymphoma (CTCL). OBJECTIVES: To compare interleukin (IL)-15 expression in certain inflammatory cutaneous diseases, with that in CTCL (mycosis fungoides and Sézary syndrome). METHODS: IL-15 mRNA and protein expression were examined by in situ hybridization and immunohistochemistry, respectively, on formalin-fixed, paraffin-embedded biopsies of normal human skin, atopic dermatitis, psoriasis, parapsoriasis and CTCL. RESULTS: Despite similar expression of IL-15 mRNA, we found differences in IL-15 protein expression between normal human skin, atopic dermatitis and psoriasis on the one hand, and parapsoriasis and CTCL on the other. IL-15 protein expression was not detected in normal human skin, atopic dermatitis or psoriasis, but was detected, mainly at low levels but in a few patients at higher levels, in epidermal keratinocytes in parapsoriasis, mycosis fungoides and Sézary syndrome. CONCLUSIONS: Induction of keratinocyte IL-15 expression appears to be a feature of CTCL. The factors stimulating such an expression remain unknown.

Antineoplastic Agents↗
PubMed2001

Modelling heat production and energy balance in group-housed growing pigs exposed to low or high ambient temperatures.

The effects of ambient temperature (T; 12-29 degrees C), body weight (BW; 30-90 kg) and metabolisable energy intake (ME) on components of energy balance were studied in seven groups of Piétrain x Large White barrows kept in a respiratory chamber. In Expt 1 (groups 1, 2 and 3), T varied in a cyclic way from 22 degrees C to 12 degrees C and then from 12 degrees C to 22 degrees C with three or four consecutive days at each of 22, 19, 16, 14 and 12 degrees C. Similarly, in Expt 2 (groups 4, 5 and 6), T varied from 19 to 29 degrees C and then from 29 to 19 degrees C with three or four consecutive days at each of 19, 22, 25, 27 and 29 degrees C. In both experiments, pigs were offered feed ad libitum. In Expt 3, pigs (group 7) were exposed to the thermic conditions of Expt 1 but their feed allowance was adjusted on a BW basis to the ad libitum intake recorded at 19 and 22 degrees C in Expt 1. Groups 1, 2, 4, 5 and 7 were used over two successive cycles with initial average BW of 37 kg at cycle 1 (four pigs per group) and 63 kg at cycle 2 (three pigs per group). Groups 3 and 6 were studied at an intermediary stage of growth; their initial BW was 45 kg. The O2 and CO2 concentrations, physical activity and feed intake were continuously and simultaneously measured and used to calculate total heat production (HP; HPtot), HP due to physical activity (HPact), activity-free HP (HP0), and thermic effect of feed. HP was modelled as a non-linear function with T, BW and ME as predictors. Results indicate that all components of HP were proportional to BW(0.60). Physical activity was minimal between 19 and 27 degrees C (8 % ME). The estimated lower critical temperature was 24 degrees C. Between 24 and 12 degrees C, total thermic effect of feed decreased from 31 to 16 % ME, but the short-term thermic effect of feed (5.1 % ME) remained constant. Equations for prediction of HPtot, HPact and HP0 according to BW, T and ME are proposed and evaluated according to literature values; values for the feed cost of thermoregulation in pigs are proposed.

Animal Feed↗
PubMed2001

Effect of high temperature on feeding behaviour and heat production in group-housed young pigs.

To assess the acclimation of pigs to heat stress, the effects of high (33 degrees C) or thermoneutral (23 degrees C) constant temperatures on feeding behaviour and components of energy balance were studied in group-housed young pigs. Three groups of five pigs were used at each temperature. After 1 week of adaptation, voluntary feed intake (VFI) and heat production (HP) were recorded for thirteen consecutive days. Animals were fed ad libitum. Fasting HP was measured on the last day. Average initial body weights (BW) were 21.4 and 20.9 kg at 23 and 33 degrees C respectively. Feeding behaviour was measured individually and rate of feed intake and characteristics of feeding behaviour were calculated. The O(2) consumption, CO(2) production and physical activity of the group were used to calculate total HP (HP(tot)) and its components, i.e. fasting HP (HP(fas)), HP due to physical activity (HP(act)) and thermic effect of feed (TEF). The BW gain and VFI were reduced by 37 and 30 % respectively at 33 degrees C. The decrease in VFI corresponded to reduced consumption time (-34 %) and size of the meals (-32 %). Feeding behaviour was mostly diurnal (66 % of the VFI), and the rate of feed intake (28 g/min) was not affected by temperature. Daily HP(tot), HP(fas) and TEF, expressed per kg metabolic weight (BW(0.60)), were significantly decreased at 33 degrees C by 22, 18 and 35 % respectively, whereas HP(act) was not affected; TEF expressed per g feed was not affected (2 kJ/g). The decrease in HP(tot) at 33 degrees C was caused by a reduction in TEF and HP(fas) (kJ/d per/kg BW(0.60)), which are both related to reduction in VFI.

Adaptation, Physiological↗
PubMed2001

The Zarit Burden Interview: a new short version and screening version.

PURPOSE: The purpose of the study was to develop a short and a screening version of the Zarit Burden Interview (ZBI) that would be suitable across diagnostic groups of cognitively impaired older adults, and that could be used for cross-sectional, longitudinal, and intervention studies. DESIGN AND METHODS: We used data from 413 caregivers of cognitively impaired older adults referred to a memory clinic. We collected information on caregiver burden with the 22-item ZBI, and information about dependence in activities of daily living (ADLs) and the frequency of problem behaviors among care recipients. We used factor analysis and item-total correlations to reduce the number of items while taking into consideration diagnosis and change scores. RESULTS: We produced a 12-item version (short) and a 4-item version (screening) of the ZBI. Correlations between the short and the full version ranged from 0.92 to 0.97, and from 0.83 to 0.93 for the screening version. Correlations between the three versions and ADL and problem behaviors were similar. We further investigated the behavior of the short version with a two-way analysis of variance and found that it produced identical results to the full version. IMPLICATIONS: The short and screening versions of the ZBI produced results comparable to those of the full version. Reducing the number of items did not affect the properties of the ZBI, and it may lead to easier administration of the instrument.

Activities of Daily Living↗
PubMed2001

Energetic efficiency of starch, protein and lipid utilization in growing pigs.

Mathematical models are increasingly used to predict the response of an animal to a changing nutrient supply. The objective of this experiment was to provide data that can be used in model development or evaluation and concerns the energetic efficiency with which nutrients are used for protein and lipid deposition. A basal diet (D1), limiting in lysine supply, was fed at 1.7 MJ metabolizable energy (ME)/(kg BW(0.60) x d1) to growing pigs that weighed approximately 60 kg. Four additional diets were formulated: the basal diet and a dietary supplement that consisted of starch (D2), starch and corn gluten meal (D3), starch and casein (D4) or starch and lipid (D5). The latter four diets were fed at 2.55 MJ ME/(kg BW(0.60) x d1) and ensured the same intake of the basal diet across treatments; the difference was supplied by the supplement. Metabolic utilization of the basal diet and supplements was determined using nitrogen and energy balances (indirect calorimetry). The N retention was similar in pigs fed diets D1, D2, D3 and D5 but considerably higher in those fed D4. A data analysis model was developed to account for differences in ME utilization between nutrients. The ME not deposited as protein entered a common pool of energy, which was used for adenosine triphosphate synthesis or lipid deposition. The energetic efficiencies of ME utilization were 0.842, 0.520 and 0.883 for starch, protein and lipid, respectively. Due to the energy cost of protein deposition (or protein turnover), the energetic efficiencies of depositing dietary protein as protein or lipid were similar.

Aging↗
PubMed2001

Primary liver carcinoma in genetic hemochromatosis reveals a broad histologic spectrum.

Hepatocellular carcinoma (HCC) is a well-known complication of genetic hemochromatosis (GH). However, the frequency of primary liver carcinoma (PLC) with biliary differentiation, such as cholangiocarcinoma (CC) and combined hepatocholangiocarcinoma (CHCC), in GH remains unclear We analyzed the histologic type of 20 PLCs occurring in the background of GH; all patients were homozygotic for the C282Y mutation. Ten were depleted of iron by successive phlebotomies, while the remaining 10 were untreated. Histologically, 13 cases were classified as HCC, 3 as CC, and 4 as CHCC. Immunohistochemical detection of Hep Par 1, cytokeratin 19 (CK19), and MUC1 supported this classification; PLC with biliary differentiation was immunoreactive for MUC1 in 86% (6/7) of cases and for CK19 in 100% (7/7) of cases. The nontumoral liver exhibited no cirrhosis or extensive fibrosis in 6 cases. Von Meyenburg complexes were present in 11 cases and intraparenchymal bile duct adenomas in 3. These data suggest that PLCs in patients with GH present a wide histologic spectrum, with tumors showing frequent biliary differentiation; may arise on a nonfibrotic or a cirrhotic liver; and often are associated with Von Meyenburg complexes and to a lesser extent with bile duct adenomas.

Adenoma, Bile Duct↗
PubMed2001

Energy utilization of low-protein diets in growing pigs.

Three trials were conducted to measure the effects of reducing the dietary CP content on digestive and metabolic utilization of N and energy in growing pigs. Sixty barrows weighing about 65 kg were used. In Trial 1, four semisynthetic diets with CP content decreasing from 18.9 to 12.3% were formulated. In Trials 2 and 3, two diets with 17.4 and 13.9% CP were formulated using conventional ingredients. In the three trials, diets were supplemented with variable amounts of industrial AA in order to maintain a constant standardized digestible lysine/NE ratio (0.76 g/MJ) and ratios between essential AA relative to lysine of at least 60, 65, 20, 60, and 70% for methionine + cystine, threonine, tryptophan, isoleucine, and valine, respectively. In Trials 1 and 2, feed was given in four meals per day, whereas, in Trial 3, two feeding frequencies (two and seven meals per day) were compared. Five or six N and energy balance (indirect calorimetry) measurements were conducted for each treatment, and components of heat production were estimated. Results of Trial 3 showed no effect of meal frequency on either N or energy utilization. Reduction of dietary CP content had no effect on N retention or animal performance but markedly decreased N excretion (-40% in Trials 2 and 3, and -58% in Trial 1). In the three trials, the lower N excretion with low-CP diets was accompanied by a reduction in urinary energy loss equivalent to 3.5 kJ/g of decrease in protein intake. Data of the three trials indicated that heat production was lower when CP was reduced (-7 kJ/g decrease in protein intake). This lower heat production was attributed to a reduction of the thermic effect of feed, whereas heat production associated with physical activity and maintenance were not affected. Reduction of dietary CP was associated with higher energy gain, mainly as fat. But, this effect was no longer significant when data were adjusted for similar NE intakes. These results confirm the possibility of limiting N excretion, while maintaining a high level of performance, by reducing CP level in the feed with adequate AA supplementation. This study also confirms the superiority of the NE system (in comparison with DE or ME systems) for predicting performance and energy gain of pigs and controlling carcass adiposity, especially in situations of feeds with variable CP contents.

Animals↗
PubMed2001

Effect of high temperature and feeding level on energy utilization in piglets.

The effect of temperature (23 or 33 degrees C) and feeding level on components of energy balance was studied in seven groups of individually reared Piétrain x (Landrace x Large White) littermate piglets. Within each litter, one pig was reared at 23 degrees C and given a predefined feeding level close to ad libitum (23AL pigs), one was reared at 33 degrees C and also fed close to ad libitum (33AL), and one was reared at 23 degrees C and pair-fed to the 33AL pig (23PF). Piglets of one litter were acclimated during 2 to 4 wk to their experimental temperature in temperature-controlled rooms before being transferred (one per week) to a respiration chamber for measurement of nitrogen and energy balances. The average initial BW was 22.4 kg. The data on O2 consumption, CO2 production, and physical activity were collected over seven consecutive days and used to calculate total heat production (HPtot) and its components: fasting heat production (FHP), heat production due to physical activity (HPact), and thermic effect of feed (TEF). A preliminary trial was conducted in which heat production was measured in three piglets according to a Latin square design at 23, 25, and 27 degrees C. Total heat production was, but activity-free heat production was not, affected by temperature, and no firm conclusions could be drawn as to whether 23 degrees C was within the thermoneutral zone of fed piglets. In Trial 2, the combination of increased temperature and reduced feed intake resulted in a 20% lesser heat production in 33AL than in 23AL pigs. This was due to a reduction in both TEF (-39%) and FHP (0.642 vs 0.808 MJ x d(-1) x kg BW-0.60). Despite the shorter duration of standing activity, HPact was slightly higher at 33 degrees C, probably due to hyperventilation at this temperature. With similar feeding levels (23PF vs 33AL), HPtot and activity-free heat production were less at 33 degrees C and energy retention as protein (+6%) and fat (+31%) was increased. Because HPact was similar for both treatments, the greater energy retention for 33AL seemed to be due to a greater utilization of feed energy or to a reduced maintenance requirement (i.e., reduced FHP). However, the type of stress imposed on 23PF and 33AL pigs was different and may have affected energy metabolism. The results suggest that the reduction in heat production of piglets at high ambient temperatures is caused by a reduction in voluntary feed intake and differences in energetic efficiency. The mechanisms for the lesser efficiency at 23 degrees C compared to 33 degrees C (at the same level of feed intake) remain unclear.

Animal Feed↗