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Oral Postdialysis Cholecalciferol Supplementation in Patients on Maintenance Hemodialysis: A Dose-Response Approach
Eric Descombes,Benoit Fellay,Ould Maouloud Hemett,Jean-Luc Magnin,Gilbert Fellay
International Journal of Nephrology , 2014, DOI: 10.1155/2014/597429
Abstract: The aim of the present study was to evaluate the dose of postdialysis cholecalciferol needed to maintain the 25-hydroxyvitamin D [25(OH)D] levels in the optimal range of 75–150?nmol/L. Twenty-six patients who had low baseline 25(OH)D levels (mean ?nmol/L) were studied. The 25(OH)D levels were measured every 2 months for one year. During the first two months, all the patients received 2000?IU of cholecalciferol after each hemodialysis (=6000?IU/wk). Thereafter, the dose was individualized and adapted every 2 months by administering 1 to 6 cholecalciferol tablets (2000?IU each) per week (total weekly dose = 2000–12000?IU/wk). During cholecalciferol supplementation, the 25(OH)D concentrations rapidly increased from baseline to ?nmol/L at month 6 and ?nmol/L at month 12. At month twelve, 86% of the patients had 25(OH)D levels within the target range with a mean dose of ?IU/wk of cholecalciferol; however, the amount needed to maintain these levels varied widely from 0 ( ) to 12000?IU/wk ( ). In conclusion, postdialysis cholecalciferol prescription is quite effective in correcting vitamin D deficiency/insufficiency, but the amount of cholecalciferol needed to maintain the 25(OH)D levels within the optimal range over the long-term varies widely among patients and must be individualized. 1. Introduction Recent important advances have been made in understanding vitamin D physiology, beyond its classic role in mineral and bone metabolism [1–11]. Indeed, recent studies have shown that several tissues, in addition to the kidneys, express the enzyme CYP27B1, which catalyzes the 1 -hydroxylation of 25(OH)D, and that the vitamin D receptor (VDR) is expressed ubiquitously [1–11]. It is now known that a conversion of 25(OH)D to 1 ,25-dihydroxyvitamin D (calcitriol, the active form of vitamin D) occurs in several extrarenal cells and may be associated with significant biological roles beyond those traditionally attributed to vitamin D [1–11]. As a consequence, there has been a great deal of interest in the study of these nonclassical autocrine/intracrine effects of vitamin D during the past few years and a significant body of information in the medical literature has shown that vitamin D deficiency/insufficiency is associated with several abnormalities such as an increased risk of cardiovascular, musculoskeletal and autoimmune diseases, cancer, infections, diabetes, and mortality [1–6, 12–27]. As a result, the possible benefits of vitamin D supplementation in patients with low levels became the focus of interest of the scientific community and studies have even reported
Host Genetics and HIV-1: The Final Phase?
Jacques Fellay ,Kevin V. Shianna,Amalio Telenti,David B. Goldstein
PLOS Pathogens , 2010, DOI: 10.1371/journal.ppat.1001033
Abstract: This is a crucial transition time for human genetics in general, and for HIV host genetics in particular. After years of equivocal results from candidate gene analyses, several genome-wide association studies have been published that looked at plasma viral load or disease progression. Results from other studies that used various large-scale approaches (siRNA screens, transcriptome or proteome analysis, comparative genomics) have also shed new light on retroviral pathogenesis. However, most of the inter-individual variability in response to HIV-1 infection remains to be explained: genome resequencing and systems biology approaches are now required to progress toward a better understanding of the complex interactions between HIV-1 and its human host.
Recent Advances in Neural Recording Microsystems
Benoit Gosselin
Sensors , 2011, DOI: 10.3390/s110504572
Abstract: The accelerating pace of research in neuroscience has created a considerable demand for neural interfacing microsystems capable of monitoring the activity of large groups of neurons. These emerging tools have revealed a tremendous potential for the advancement of knowledge in brain research and for the development of useful clinical applications. They can extract the relevant control signals directly from the brain enabling individuals with severe disabilities to communicate their intentions to other devices, like computers or various prostheses. Such microsystems are self-contained devices composed of a neural probe attached with an integrated circuit for extracting neural signals from multiple channels, and transferring the data outside the body. The greatest challenge facing development of such emerging devices into viable clinical systems involves addressing their small form factor and low-power consumption constraints, while providing superior resolution. In this paper, we survey the recent progress in the design and the implementation of multi-channel neural recording Microsystems, with particular emphasis on the design of recording and telemetry electronics. An overview of the numerous neural signal modalities is given and the existing microsystem topologies are covered. We present energy-efficient sensory circuits to retrieve weak signals from neural probes and we compare them. We cover data management and smart power scheduling approaches, and we review advances in low-power telemetry. Finally, we conclude by summarizing the remaining challenges and by highlighting the emerging trends in the field.
Influence of flow on mucosal-to-arterial carbon dioxide difference
Benoit Vallet
Critical Care , 2002, DOI: 10.1186/cc1845
Abstract: In the present issue of Critical Care, Dubin and collaborators [1] report the results of a study in which they tested the hypothesis that intramucosal-to-arterial carbon dioxide difference (the so-called PCO2 [partial carbon dioxide tension] gap) may remain unaltered during dysoxia (a state in which oxygen delivery [DO2] is insufficient to sustain oxygen demand) because DO2 is reduced when flow is maintained. In order to achieve this and to avoid the confounding effects of low flow, they produced hypoxaemia with preserved intestinal flow. The PCO2 gap obtained in this condition (hypoxic hypoxia [HH]) was compared with that obtained in ischaemic hypoxia (IH).This work conducted in sheep is an important confirmatory study of our previous studies that dealt with differential effects of IH and HH on PCO2 gap [2,3]. In those earlier reports, we clearly demonstrated that dog limb venous-to-arterial carbon dioxide gap [2] increased greatly in IH (approximately 17 mmHg at critical DO2 and approximately 27 mmHg at maximal DO2) and remained almost unaltered in HH (10 mmHg) [2]; and that pig gastrointestinal mucosal-to-arterial carbon dioxide gap increased to a greater extent in IH (maximal value approximately 50 mmHg) than in HH (maximal value approximately 30 mmHg) [3]. In the range of DO2 values below the critical level, increases in PCO2 gap were smaller in HH than in IH, although similar decreases in DO2 were achieved. Dependency on oxygen supply may therefore develop in the absence of large increases in tissue PCO2 during hypoxia. We concluded that these experimental findings were important in interpreting moderate increases in intestinal mucosal PCO2, because mucosal-to-arterial carbon dixoide difference (ΔPCO2) may underestimate the extent of oxygen supply limitation [3].It is important to emphasize that, if studies are to be valid, those investigating oxygen supply dependency must consider important experimental conditions, which were clearly present in our previous s
Gut oxygenation in sepsis: Still a matter of controversy?
Benoit Vallet
Critical Care , 2002, DOI: 10.1186/cc1508
Abstract: In his review paper published in the present issue of Critical Care, Stephan Jakob [1] deals with the difficult and broad topic of splanchnic ischaemia in critical care. The presentation is exhaustive, including the still controversial issue of inadequate gastrointestinal flow in septic states. As mentioned in that review, several lines of evidence support the notion that cellular energetics are deranged in sepsis, in terms not only of inadequate tissue perfusion but also of impaired mitochondrial respiration and/or coupling (i.e. organ dysfunction in sepsis may occur as a result of 'cytopathic hypoxia') [2]. If this is correct then the therapeutic implications might be enormous. It would imply that efforts to improve outcome in septic patients by monitoring and manipulating cardiac output, systemic oxygen delivery (DO2) and regional blood flow are doomed to failure, and that the focus should rather be on developing pharmacological strategies to restore normal mitochondrial function and cellular energetics. This is largely speculative, however, and the controversy remains regarding whether there is a deficit in regional DO2 or whether the deficit resides in the inability of tissue cells to utilize available oxygen adequately.A deficiency in the ability of tissues to extract oxygen is a prominent feature of the pathology of sepsis, and this is especially true at the level of the gut [3]. This deficiency manifests as a condition in which, despite apparent correction of global variables of DO2, signs of regional dysoxia are present (e.g. elevated lactate levels and enhanced gastric carbon dioxide level – a surrogate marker for decreased perfusion that is determined tonometrically). Several investigators have reported that tissue oxygenation is impaired in experimental models of sepsis. For example, we investigated the effects of acute endotoxaemia on tissue partial oxygen tension (PO2) [4]. We took sequential measurements in a single group of dogs at baseline during a
Formas de transformación del conocimiento de la medicina tradicional en los pueblos nahuas del municipio de Hueyapan, Sierra Norte de Puebla
Jorand, Benoit;
Cuicuilco , 2008,
Abstract: in this work a summary of the study of the processes of transformation that occur within the knowledge of traditional medicine possessed by the nahua communities of the municipality of hueyapan, in the northern sierra of puebla, is presented. this knowledge is based mainly on the use and conservation of traditional herbolary, as well as in the ancestral concepts of illness and medicine. the study is synchronic and aims to understand the current state of local knowledge, through the evaluation of the impacts of the official health system on the conceptualization of the relationship between health-illness and medical practice held by indigenous groups. it was possible to verify that traditional medicine is still important in the region. however, there is a tendency for the specialized knowledge of the curanderas and other traditional specialists to disappear. the transformation of traditional knowledge takes place at the level of domestic groups, in particular through women who have a key role in the processes of reproduction, transmission and redefinition of the knowledge of traditional medicine. they also play an essential role in the conservation and revival of medicinal plants through the cultivation of them in home gardens.
Assessing Brazilian educational inequalities
Lorel, Benoit;
Revista Brasileira de Economia , 2008, DOI: 10.1590/S0034-71402008000100002
Abstract: this paper provides an evaluation of schooling inequality in brazil using different indicators such as the education gini coefficient, the education standard deviation and the average number of years of schooling. we draw up a statistical description of brazilian human capital dispersion in time over the last half century, across regions and states. our analysis suggests several conclusions: 1) strong reduction of educational inequalities measured by education gini index. 2) a three parts picture of brazil seems to emerge, reflecting initial conditions. 3) high increase of the average number of years of schooling. 4) a significant link between education gini and the average education length. 5) education standard deviation leads to inverted results compared to education gini. 6) brazilian data are consistent with an education kuznets curve if we consider education standard deviation.
Da mi-carême ao carnabeach: história da(s) micareta(s)
Gaudin, Benoit;
Tempo Social , 2000, DOI: 10.1590/S0103-20702000000100004
Abstract: the purpose of this paper is to provide insights into the history of the micareta in brazil, from its origin as a mi-carême (mid-lent celebration) to its current expression. although this research is in part a synthesis of the rare publications on the subject, most of the data comes from extensive historical archive research, carried out mainly in the brazilian national and local press. the micareta is an old festival (started in 1908) and its history is closely linked to the carnival in salvador. it resulted from an evolution of the trio elétrico and from the bahian trio bands. tied in with the successive waves of expansion of the micareta throughout brazil, five distinct developmental stages are discussed. their salient features reflect the gradual commercialization of the micareta.
Des enfants dessinent la carte de France à main levée d’après leur souvenir des informations météo à la télévision
M. Benoit
Mappemonde , 1990,
Abstract: à un moment où l’image est reine, où la télévision est considérée comme un média para-scolaire à qui l’on attribue un pouvoir éducatif qui pourrait se substituer à l’école, 230 enfants ont été testés pour conna tre leur capacité à dessiner, à main levée et de mémoire, la carte de France, diffusée tous les jours et plusieurs fois par jour lors des informations météorologiques. Seulement 56 ont dessiné une carte plus ou moins ressemblante et seuls les CM2 en sont capables… Ce qui prouverait que seule l’école structure les connaissances et que les supports imprimés et permanents sont supérieurs aux supports fugaces.
La gestion territoriale de l'activité agricole dans un village lorrain
M. Benoit
Mappemonde , 1990,
Abstract: Les relations que les agriculteurs d’un village lorrain entretiennent avec leur territoire sont dynamiques. En un siècle, la répartition des cultures est devenue concentrique, centrée sur le bati villageois, et la sortie des batiments agricoles de leur gangue villageoise a été un facteur décisif de cette dynamique. Les conséquences de cette actuelle gestion territoriale de l’activité agricole sont multiples et concernent le fonctionnement interne aux exploitations du village, les transferts de fertilité, donc les risques de pollution des eaux souterraines, et la création d’un paysage.
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