Pharmacogenomic studies have shown that ADCY9 genotype determines the effects of the cholesteryl ester transfer protein (CETP) inhibitor dalcetrapib on cardiovascular events, atherosclerosis imaging and body weight variation. The underlying mechanisms responsible for the interactions between ADCY9 and CETP have not yet been determined. Adcy9 -inactivated ( Adcy9 Gt/Gt ) and wild-type (WT) mice, that were or not transgenic for the CETP gene (CETP Gt and CETP WT ), were submitted to an atherogenic protocol (injection of an AAV8 expressing a PCSK9 gain-of-function variant and 0.75% cholesterol diet for 16 weeks). Atherosclerosis, cell adhesion, vasorelaxation, telemetry and adipose tissue MRI were evaluated. Adcy9 Gt/Gt mice had a 65% reduction in aortic atherosclerosis compared to WT ( P <0.01). CD68-positive macrophage accumulation and proliferation in plaques were reduced in Adcy9 Gt/Gt mice compared to WT animals ( P <0.05 for both). Adcy9 inactivation did not change counts of blood monocytes and their subsets. Splenocytes showed reduced adhesion to native aortic endothelium from Adcy9 Gt/Gt mice ( P <0.05 vs WT). Femoral artery endothelial-dependent vasorelaxation was improved in Adcy9 Gt/Gt mice (versus WT, P <0.01). Selective pharmacological blockade showed that the nitric oxide, cyclooxygenase and endothelial-dependent hyperpolarization pathways all contributed to the improvement of vasodilatation in Adcy9 Gt/Gt versus WT ( P <0.01 for all). Adcy9 Gt/Gt mice gained more weight than WT with the atherogenic diet, and this was associated with an increase in whole body adipose tissue volume ( P <0.05 for both). Feed efficiency was increased in Adcy9 Gt/Gt compared to WT mice ( P <0.05), which was accompanied by improved nocturnal heart rate variability ( P =0.0572) and prolonged cardiac RR interval ( P <0.05). Adcy9 inactivation-induced effects on atherosclerosis, endothelium-dependent vasodilation, weight gain and feed efficiency were lost in CETP Gt mice ( P >0.05 vs CETP WT ). Adcy9 inactivation protects against atherosclerosis, but only in the absence of CETP activity. This atheroprotection may be explained by decreased macrophage accumulation and proliferation in the arterial wall, improved endothelial function and autonomic tone.
La littérature empirique et militante de même que certaines lois dans le domaine de la périnatalité démontrent des faits éloquents : plusieurs femmes vivent des expériences de violence lorsqu’elles accouchent dans des établissements de soins de santé. Cependant, un survol de la littérature permet de constater l’emploi de termes différents pour désigner ces violences. Dans le but de définir les attributs liés au concept de la violence obstétricale, d’en améliorer la compréhension et de contribuer à son opérationnalisation dans les domaines de la recherche et de la pratique clinique, les auteures ont réalisé une analyse conceptuelle inspirée par la démarche méthodologique de Lorraine Olszewski Walker et Kay Coalson Avant et éclairée par l’approche féministe proposée par Judith Wuest. Leur démarche d’analyse permet d’abord d’exposer les différentes utilisations du concept de la violence obstétricale, les attributs qui le définissent, ses antécédents et ses conséquences. Les auteures proposent, par la suite, un cas modèle pour l’illustration de ce concept et une définition s’appuyant sur les éléments centraux qui le composent.
La présence de violence intime lors de la grossesse à l’adolescence est une problématique relativement nouvelle en termes d’intérêt scientifique et de préoccupations cliniques. Cette problématique est préoccupante pour la santé publique puisque 1) sa prévalence varie entre 5 % et 67 % selon les études recensées ; 2) les conséquences pour la santé des mères et des bébés sont nombreuses, tant sur le plan de la santé physique que psychologique et sexuelle et 3) les connaissances théoriques et empiriques spécifiques à cette problématique sont peu développées, ce qui limite le développement d’interventions pertinentes et efficaces. Il apparaît donc pertinent et nécessaire d’améliorer l’état des connaissances à différents niveaux écologiques afin de mettre sur pied des interventions préventives adaptées, qui permettront aux jeunes mères de surmonter les conditions adverses dans lesquelles elles se trouvent et d’offrir, à elles et leurs enfants, un environnement favorable et sécurisant.
L'objectif de cet article est de présenter une mise à jour sur l'utilisation des méthodes contraceptives, y compris la contraception d'urgence, chez les femmes sexuellement actives qui fréquentent les cégeps et les universités du Québec. Cet article puise dans deux études sur la santé sexuelle menées en milieu collégial et universitaire (ESS-UQAM et PIXEL). Les principaux constats de ces études réalisées auprès d'un échantillon de 1812 universitaires (ESS-UQAM) et d'un échantillon de 921 étudiantes recrutées dans 17 cégeps et 7 universités (PIXEL) révèlent que, globalement, la proportion d'étudiantes québécoises utilisant des méthodes contraceptives efficaces est élevée et que la non-utilisation de contraception est faible (entre 2,9 % et 6 %). L'utilisation de méthodes contraceptives semble varier selon le parcours migratoire et l'orientation sexuelle des étudiantes. Ces résultats sont discutés dans la perspective de faire émerger certains des enjeux actuels en matière de contraception et d'orienter la prise de décision à l'égard d'interventions préventives.
Background Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) provide similar biologic effects in model systems and similar clinical impacts in humans. The changes in the cardiac angiotensin system signaling pathways in the human heart in response to ACE inhibitors versus ARBs have been incompletely studied. Objective To investigate the effects of ACE inhibitors versus valsartan on the angiotensin II signal transduction pathways in the transplanted human heart. Methods Twenty-seven stable cardiac transplant recipients were randomized to remain on ACE inhibitor therapy (n = 8) or to receive valsartan (n = 19). Two additional endomyocardial biopsy samples were obtained at baseline and after 9 months of therapy. The expression of cardiac angiotensin type I and II receptors and atrial natriuretic factor (ANF) was measured by quantitative polymerase chain reaction. The expression and phosphorylation levels of selected signal transduction pathways were analyzed by immunoblotting. Results The mean dose of valsartan was 114 ± 41 mg/day. The use of valsartan resulted in a similar impact on blood pressure and biochemistry profile. There were no significant changes in the expression of angiotensin type I and II receptors and ANF with valsartan. Similarly, no significant changes in the expression and phosphorylation of Jun N-terminal kinase, extracellular signal–regulated kinase 1 and 2, and p38 mitogen-activated protein kinases or AKT, and mammalian target of rapamycin was observed in the valsartan-treated group. Conclusions Valsartan use is associated with similar clinical and molecular cardiac effects as ACE inhibitor therapy in stable long-term cardiac transplant recipients.
Reproductive coercion and abuse (RCA) is a form of violence that affects sexual and reproductive health. Women and individuals who experienced RCA in an intimate relationship frequently consult service providers (SPs), such as health professionals or violence counselors. The objective of this article, which is the result of a participative action research project targeting RCA perpetrated by in an intimate partner, is twofold: (1) to better understand the practices as well as the barriers and facilitators encountered by SPs and (2) to develop information and awareness tools with them that meet their needs. To this end, we first held focus groups with 31 SPs. The use of thematic analysis revealed intervention strategies that focus on caring and listening, identifying signs of RCA, and creating a safe environment for disclosure. Their practices also focused on harm-reduction strategies and effective referrals. Despite the importance they gave to this issue, lack of time, inappropriate settings, and inadequate training hindered them from intervening effectively with individuals who were victims of RCA. They also indicated the need for easy-to-follow practice guidelines and patient education tools. Based on these findings and the best practices identified in the grey and scientific literature, we developed a practice guide for SPs and a booklet on RCA. The development of these guide and booklets involved a lot of back and forth to meet the needs expressed by the community and health professionals.
Amid adolescence, youth are developing the relational skills necessary to form and maintain positive intimate relationships. Sexual assertiveness is a key skill that could be related to couples’ sexual outcomes (i.e. sexual satisfaction, sexual concerns, and sexual function). However, dyadic studies are lacking, and associations between sexual assertiveness and adolescents’ sexual health and well-being remain underexplored. This cross-sectional dyadic study examined associations between dimensions of sexual assertiveness and sexual outcomes in adolescent romantic relationships. The Actor-Partner Interdependence Model guided analyses of self-reported questionnaires from 110 romantic dyads (aged 14–19 years; M = 16.51). Participants’ gender was considered in the models, and gender differences emerged in the associations between study variables. Path analyses revealed that sexual needs and desires communication, refusal of unwanted sex, sexual intimacy initiation, and comfort talking about sex have significant actor and partner effects on adolescents’ sexual outcomes in mixed-gender dyads. These findings suggest that authentically expressing one’s own sexual needs, desires, and limits in adolescence may influence not only one’s own sexual satisfaction, sexual concerns, and sexual function, but also their partner’s. The aforementioned dimensions of sexual assertiveness could be important targets for research-based interventions to promote sexual health and well-being in adolescent romantic relationships.
