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Résumé: L’article présente les grandes lignes de la réforme des structures dédiées au handicap. C’est ainsi que les commissions des droits et de l’autonomie des personnes handicapées et les maisons du handicap issues de la loi du 11 février 2005 voient leur fonctionnement détaillé. [Copyright &y& Elsevier]

OBJECTIVES: Aortic valve replacement (AVR) using a bioprosthesis remains controversial for patients aged 50-65 years. This cohort study reports the very long-term outcomes of AVR using Carpentier-Edwards Perimount pericardial bioprosthesis in this age group. METHODS: From 1984 to 2008, 522 Carpentier-Edwards Perimount pericardial aortic bioprostheses were implanted in 516 patients aged 50-65 years (mean age, 60 ± 4 years; 19% female). Multiple valve replacements were excluded fro m our cohort. Baseline demographic, perioperative and follow-up data were recorded prospectively. Mean follow-up was 9 ± 6 years, for a total of 4428 valve-years. Follow-up was complete for 97% of patients included. RESULTS: Operative mortality rate was 2%. One hundred and forty-six late deaths occurred for a linearized rate of 3%/valve-year. Actuarial survival rates averaged 73 ± 2, 59 ± 3 and 35 ± 5% after 10, 15 and 20 years of follow-up, respectively. Mortality rate associated with reoperation was 2%. Actuarial freedom from reoperation rates due to structural valve deterioration (SVD) at 10, 15 and 20 years was respectively of 91 ± 2, 76 ± 3 and 50 ± 6%. Competing risk analysis demonstrated an actual risk of explantation secondary to SVD at 20 years of 30 ± 3%. Expected valve durability was 19 years for this age group. Age was not a significant risk factor for SVD in this middle-aged population. CONCLUSIONS: In patients aged 50-65 years undergoing AVR with the Carpentier-Edwards Perimount bioprosthesis, the expected valve durability was 19 years. Age was not a significant risk factor for SVD within this age group. Patient selection and attention to timing of reintervention may be determinants of long-term outcomes. [ABSTRACT FROM AUTHOR]

Present experiment was conducted to assess the ameliorative effects of soil and foliar application of potash fertilizers, i.e., sulfate of potash (SOP) and muriate of potash (MOP) on five wheat cultivars (‘Sitta’, ‘Sehar’, ‘Bhakkar-2006’, ‘PFAU#VEE’, ‘S-24’), subjected to salt stress created by applying sodium chloride (NaCl; 10 dS m−1) to the growth medium. Different treatments of potash fertilizers used included: control, SOP (100 kg ha−1) in soil, foliar spray of 1% solution of SOP, MOP (100 kg ha−1) in soil and foliar spray of 1% solution of MOP. Experiment was carried out in completely randomized design with three replications. Imposition of salt stress reduced growth, yield, and related yield attributes, photosynthetic attributes, ionic contents and biochemical activities in all wheat cultivars. However, application of potash fertilizers in soil as well as in foliar spray counteracted the adverse effects of salt stress on all wheat cultivars and the application of SOP in soil and as a foliar spray proved to be more effective in inducing salt stress tolerance. No adverse effect of chloride on plant growth was observed. Among the cultivars, ‘S-24’ and ‘Sehar’ showed the maximum growth, yield and biochemical contents and thus could be used in future for obtaining better yield under saline conditions. [ABSTRACT FROM PUBLISHER]

It is well known today that mechanical forces are one of the important factors that induce a variety of cellular responses including morphological changes, protein synthesis, and gene expression and which are involve in tissue remodelling. We studied the effect of uniaxial cyclic stretching on the proliferation, collagens, and tenascin C mRNA expression of fibroblasts under different concentrations of foetal bovine serum. Proliferation was studied by cell cycle analysis, mRNA expression of collagen and tenascin C was studied by RT-PCR. Human fibroblasts were grown in silicon sheet coated with 1% gelatin. Cyclic stretching (5% elongation) was applied at 0.5 Hz (30 cycle/min), for 24 h with two concentrations of the serum (0.5%, 10% FBS). We showed that stretching enhances the synthesis of collagen and tenascin C, but do not act on the proliferation. In contrast, higher concentration of serum enhances the proliferation. These findings suggest that both mechanical stretching and serum concentration can modulate proliferation and extra cellular matrix synthesis in human fibroblasts. [ABSTRACT FROM AUTHOR]

Cardiopulmonary bypass (CPB) induces the release of platelet factor 4 (PF4) and patients are at risk of heparin-induced thrombocytopenia (HIT). This study was aimed to determine whether an abnormal evolution in platelet count (PC) after CPB is predictive of the development of HIT antibodies. Two abnormal PC patterns were defined: pattern P1, characterized by a decrease in PC following previous correction of thrombocytopenia occurring during CPB, and pattern P2, defined as a persistent low PC in the days following CPB. PC was evaluated for 10 d in 305 consecutive patients before and after CPB. Serotonin release assay (SRA) was carried out between days 8 and 10 to detect pathogenic heparin-dependent antibodies. Moreover, antibodies to heparin–PF4 (H–PF4) complexes were assayed by enzyme-linked immunosorbent assay. PC evolution after CPB was normal in 300 patients although antibodies to H–PF4 were frequently present (53·4%). Changes in PC were abnormal in five patients with pattern P1 (n = 4) or P2 (n = 1). As SRA was positive in four of the five cases, the positive predictive value of abnormal PC pattern for pathogenic HIT antibodies was 80%. Careful follow-up of PC after CPB makes it possible to predict with high specificity (99%) for those patients who develop pathogenic HIT antibodies. [ABSTRACT FROM AUTHOR]

Presents a case report of a newborn with strawberry hemangioma. Percentage of newborns affected with hemangioma; Association of hemangiomas with congenital malformations and vascular abnormalities; Localization of the hemangioma.