The increased intramuscular fat promoted by dietary lysine restriction in lean but not in fatty pig genotypes improves pork sensory attributes

Sixty entire male pigs from 2 distinct genotypes (30 Alentejano purebred, an autochthonous fatty genotype, and 30 commercial crossbred pigs, a lean genotype) were used to investigate the effects of dietary CP reduction and low-Lys levels on growth performance, carcass traits, and meat quality. Pigs with 59.9 ± 2.0 kg BW were randomly assigned within each genotype to 1 of 3 diets [normal CP diet (control), reduced CP diet adjusted for Lys (RPDL), and reduced CP diet not adjusted for Lys (RPD)] as a 2 × 3 factorial arrangement of treatments with 10 individually fed pigs per treatment. Pigs were slaughtered at 93.4 ± 2.4 kg BW. The results showed that intramuscular fat (IMF) content of longissimus lumborum muscle was greater in Alentejano than crossbred pigs (5.0 vs. 2.4%). The RPDL had no effect on IMF content, ADG, backfat thickness, and loin weight in both genotypes. The RPD promoted the increase (P < 0.05) in IMF content in crossbred (∼50%) but not Alentejano pigs, which indicates that Lys restriction can mediate the effect of RPD. Within crossbred pigs, meat obtained from pigs fed RPD had an increased IMF content (+1.3%) and a tendency for greater sensory scores (tenderness, juiciness, flavor, and acceptability) than those fed the control. The IMF content was positively correlated to flavor in Alentejano genotype (P < 0.05) but not in crossbred pigs. Alentejano and crossbred pigs had a greater tendency to deposit 18:1c9 and SFA, respectively. Despite the contribution of fatty acid composition to flavor, its influence on pork acceptability was more noticeable in crossbred than Alentejano pigs. In conclusion, the increased IMF promoted by dietary CP reduction in lean but not in fatty pig genotypes during the growing-finishing period is likely due to Lys limitation, which seems to enhance eating quality of pork.

[Functional MRI by general radiologists in prediction of side-specific extracapsular extension after radical prostatectomy: what value in daily practice?]

OBJECTIVE

To evaluate the performance of functional MRI (FMRI) performed by general radiologists (GR) in detection of side-specific extracapsular extension (SSECE) prostate cancer (PCa).

METHODS

We retrospectively analyzed 79 patients who underwent FMRI with pelvic phased array coil before radical prostatectomy (RP) performed at University Hospital (UH) of Nîmes. Twelve GR (including three from UH) interpreted the images during their daily practice. FMRI results were dichotomized as positive or negative and confronted to pathological reports for SSECE and side-specific seminal vesicle invasion (SSSVI), with calculation of diagnostic values. The influence of interval between biopsy and FMRI, diffusion-weighted sequence (DWS) and intensity of FMRI, on the diagnostic performance were assessed by Fisher's exact test.

RESULTS

A SSECE and a SSSVI were observed at FMRI and pathology respectively on 14 (8.8%) and 38 (24.1%) prostate lobes, and on six (3.8%) and seven (4.4%) prostate lobes. The sensitivity, specificity, positive and negative predictive values of FMRI for SSECE were respectively 24%, 96%, 64% and 80%; and for SSSVI were 14%, 97%, 17% and 96% respectively. The time between biopsy and FMRI, intensity of FMRI and DWS, did not influence the sensitivity and specificity of fMRI at Fisher test.

CONCLUSION

This study found that preoperative prostate FMRI performed by GR has good specificity but poor sensitivity in predicting SSECE on pathological reports.

[Sexual function before surgery for pelvic organ prolapse]

AIM

The aim of our study was to assess the link between pelvic organ prolapse (POP) characteristics and sexual well-being using validated tools.

MATERIAL

A prospective analysis was carried out in 148 women with a POP. The degree of prolapse was measured by using the Pelvic Organ Prolapse Quantification (POPQ). Pelvic Floor Distress Inventory (PFDI-20) questionnaire score was used to estimate the severity of symptoms. Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire short form (PISQ-12) scores determined sexual function level.

RESULTS

No correlation was found concerning the global sexual function score and the POP stage (P=0.24). Pelvic and urinary symptoms were associated with a decrease in sexual function score (P=0.04 and P=0.002). Defecation symptoms were correlated with decreased sexual satisfaction (P ≤ 0.05) and were associated with premature ejaculation (P ≤ 0.05). Urinary symptoms were associated with dyspareunia (P ≤ 0.01), avoidance of sexual activities (P ≤ 0.05), negative emotions during intercourse (P ≤ 0.01) and decreased sexual excitement (P ≤ 0.05). Pelvic symptoms were significantly tied to avoidance of sexual activities (P ≤ 0.01), dyspareunia (P ≤ 0.05) and a poorer orgasm quality (P ≤ 0.05).

CONCLUSION

The degree of pelvic organ prolapse was not statistically associated with sexual function. However, urinary, pelvic and defecatory (ano-rectal) symptoms were associated with a decrease in the couple's sexual well-being.

[Influence of aging on male sexual health]

INTRODUCTION

With the increase in life expectancy, men's sexual health has become a major concern for elderly couples. Erectile dysfunction (ED) is responsible for a 50 % decrease of sexually active men between 60 and 85. The aim of this study was to identify objective elements to evaluate the influence of age on male sexual health.

MATERIALS AND METHOD

Data on the effects of aging on men's sexual health have been explored in Medline and Embase using the MeSH keywords: prostate; sexuality and erectile dysfunction; aging. The articles were selected based on their methodology, relevance, date and language of publication.

RESULTS

ED concerns 64 % of 70 years old patients and up to 77.5 % after 75 years. The screening of this pathology is based on standardized diagnostic tools. The most used of them remains the "International Index of Erectile function" which, in its simplified version with 5 items (IIEF-5 or SHIM), presents at the cutoff score of 21, a sensitivity of 98 %, a specificity of 88 % and a kappa index of 0.82. The ED is often responsible for a decrease in the quality of life for 60 % of elderly couples wishing to pursue sexual activity. Some diagnostic tools, such as the "Self-Esteem And Relationship" (SEAR) questionnaire or the "Sexual Experience Questionnaire" (SEX-Q) assess individual and couple satisfaction. Physiological aging seems to favor erection disorders by the development of an Androgen Deficiency of the Aging Male (ADAM) but pathological aging appears to be primarily responsible. Cardiovascular or neurological diseases and lower urinary tract symptoms (LUTS) are, with the polymedication, modifiable risk factors of ED to systematically screen in elderly subjects.

CONCLUSION

Many diagnostic tools allow to detect ED and assess the impact on the quality of life of elderly men. The fundamental element of the management of ED is the research of modifiable risk factors including cardiovascular.

Transforming growth factor β signaling perturbation in the Loeys-Dietz syndrome

The transforming growth factor β (TGFβ) superfamily consists of multipotential secreting cytokines that mediate many key events in normal cellular growth and development, including differentiation, proliferation, motility, organization and death. TGFβs act as ligand for 3 classes of cell surface receptors, the transmembrane serine-threonine kinase receptors, TGFβ receptor type I (TGFβRI) and type 2 (TGFβRII), and TGFβRIII receptors which include an ubiquitous extracellular β-glycan and the membrane glycoprotein endoglin (CD105). Binding of TGFβs to their receptors initiates diverse cellular responses resulting in the phosphorilation of Smad proteins, which then translocate to the nucleus and regulate the transcription of target genes. Perturbation of TGFβ signaling has been implicated in various human disorders including cancer, fibrosis and auto-immune diseases. Recently, mutations in TGFβR1 and TGFβR2 genes have been found in association with a continuum of clinical features with widespread vascular involvement. The extreme of clinical severity is represented by the Loeys-Dietz syndrome (LDS), an autosomal dominant disorder characterized by hypertelorism, bifid uvula, and/or cleft palate, and aggressive arteriopathy causing arterial tortuosity as well as life-threatening complications such as vascular aneurysms and dissections. Elastin disarray, loss of elastic fibre architecture and increased collagen expression in the arterial wall are the pathologic hallmark of LDS. In the present review article we will provide details on the activation of TGFβ cascade, on the clinical features of LDS, as well as on the mechanisms of TGFβ signaling perturbation leading to this condition and the potential role of the antagonism of TGFβ activity in disease management.

Aortic debranching from the ascending aorta: a novel surgical approach for extended TAAA and chronic type B dissections in high risk patients

AIM

Extend thoraco-abdominal aortic aneurysms (TAAA) involving arch vessels and the visceral arteries remains a challenging operation when affecting high risk patients (HRP). Recently, hybrid surgery has gained popularity for HRP. The conventional surgical repair is the gold standard for low risk patients with previous mortality from 6% to 15% in thoracic aneurysms up to 30% in thoracic type B dissections. The risk of paraplegia is 3% to 15%. Without repair the outcome is poor with only 35% of patient's survival at two years after diagnosis. The total endovascular technique is not widespread used because of its very time-consuming, needs training, and procedure planning with high radiation exposure. Only few centers in the world perform it. In order to reduce the morbidity a novel approach is proposed, with an aortic debranching from the ascending aorta.

METHODS

Nine patients (two females) aged between 53 and 81 years, with high risk factors for surgery, were offered this hybrid technique from March 2004 to July 2009. Eight patients presented with a TAAA and one type a B chronic dissection. A staged hybrid operation started by a debranching of the aorta from a median sternotomy to supra-aortic vessels and visceral arteries, followed by the second stage one-two weeks later, with an extended stent grafting. This attitude avoids CPB and aortic cross clamping. The surgical approach is a median sternotomy combined to mid upper laparotomy associated to pericardial and diaphragm division. It is well tolerated even in elderly patients and allows easy access to celiac axis (CA), superior mesenteric artery (SMA), right renal artery (RRA). Access to the left renal artery is more difficult and may be benefit from a combinated stent grafting and bypass according to the VORTEC technique described by Lachat M, or an extra-anatomic bypass. Rerouting the visceral arteries is done from the ascending aorta with a partial clamping on an undiseased implantation site, offering à good anterograde high flow. Combined bypass to supraaortic vessels is associated when needed.

RESULTS

There was no intraoperative mortality. One patient died during 30D period from cardiac failure and another on the early follow up from a pancreatic fistula. The complications: one stroke (11.1%); one cardiac failure (11.1%); one renal failure (11.1%), one pancreatic fistula (11.1%), one non-infected retrostrenal collection (11.1%). No paraplegia, limb ischemia or aortic fistula were detected. No stent-graft related complication was retrieved, the bypass patency was 77.7 at four-year survival.

CONCLUSION

Our early and mid term results are promising and similarly to other series. This new approach for rerouting the supraaortic and visceral arteries before stent grafting in extended TAAA, lowers the surgical injury and is particularly designed for HRP who cannot benefit from conventional surgery under CPB. Larger series and longer follow-up are needed.

Concordance between personality disorder assessment methods

BACKGROUND

Studies have criticized the low level of agreement between the various methods of personality disorder (PD) assessment. This is an important issue for research and clinical purposes.

METHOD

Seven hundred and forty-two participants in the Hopkins Epidemiology of Personality Disorders Study (HEPS) were assessed on two occasions using the Personality Disorder Schedule (PDS) and the International Personality Disorder Examination (IPDE). The concordance between the two diagnostic methods for all DSM-IV PDs was assessed using standard methods and also two item response analytic approaches designed to take account of measurement error: a latent trait-based approach and a generalized estimating equations (GEE)-based approach, with post-hoc adjustment.

RESULTS

Raw criteria counts, using the intraclass correlation coefficient (ICC), κ and odds ratio (OR), showed poor concordance. The more refined statistical methods showed a moderate to moderately high level of concordance between the methods for most PDs studied. Overall, the PDS produced lower prevalences of traits but higher precision of measurement than the IPDE. Specific criteria within each PD showed varying endorsement thresholds and precision for ascertaining the disorder.

CONCLUSIONS

Concordance in the raw measurement of the individual PD criteria between the two clinical methods is lacking. However, based on two statistical methods that adjust for differential endorsement thresholds and measurement error in the assessments, we deduce that the PD constructs themselves can be measured with a moderate degree of confidence regardless of the clinical approach used. This may suggest that the individual criteria for each PD are, in and of themselves, less specific for diagnosis, but as a group the criteria for each PD usefully identify specific PD constructs.

Gold nanoprobe assay for the identification of mycobacteria of the Mycobacterium tuberculosis complex

Members of the Mycobacterium tuberculosis complex (MTC) are causative agents of human and animal tuberculosis. This complex encompasses several phylogenetically related species, including M. tuberculosis, the main aetiological agent of human tuberculosis, and Mycobacterium bovis, the causative agent of bovine tuberculosis, a relevant worldwide zoonosis. Clear epidemiological evaluation of appropriate and effective treatment requires unambiguous differentiation between MTC members. Routine diagnosis has been increasingly relying on the molecular identification of MTC members. In the present study, we report the use of a gold nanoparticle-based approach for the sensitive, specific and fast identification of MTC and for the differentiation of M. bovis and M. tuberculosis using the gyrB locus as target. This gold nanoprobe strategy relies on the colorimetric differentiation of specific DNA sequences based on differential aggregation profiles in the presence or absence of specific target hybridization. Three nanoprobes were designed and successfully used for the specific identification of members of MTC, M. bovis and M. tuberculosis.