Le Dossier Médical Personnel en 2010 (quelles attentes et quelles perspectives en médecine générale?)

Créé par la loi du 13 août 2004, le Dossier Médical Personnel (DMP) doit proposer à chaque assuré social un dossier médical accessible via internet par les professionnels de santé et le patient.Après de multiples reports et débats tant techniques que juridiques et éthiques, sa mise en place est annoncée pour la fin de l'année 2010.Malgré ce temps passé, le concept du DMP apparaît encore flou pour les médecins qui en seront pourtant les principaux utilisateurs.Notre enquête met en évidence les attentes et les craintes des médecins généralistes face à ce nouvel outil et vérifie que les prérequis techniques nécessaires à son utilisation sont réunis.Puis dans une discussion, nous tentons de déterminer les bénéfices et les limites du DMP pour la médecine générale ainsi que ses conséquences sur l'exercice professionnel.Le DMP apparaît comme un outil potentiellement très utile dans la pratique médicale tant au niveau de la prise en charge du patient et de la coordination des soins qu'en terme de santé publique.Cependant, des questions se posent, notamment au sujet de la sécurité et du respect du secret médical.La mise en place effective du DMP est susceptible de modifier l'exercice de la médecine générale : il apporte de nouvelles obligations d'alimentation et de coordination, qui seront sans doute chronophages, particulièrement au début.Il participe à l'évolution de la médecine devenue collective avec un médecin traitant désormais coordinateur des soins et un patient devenu acteur de sa santéMONTPELLIER-BU Médecine UPM (341722108) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

The [URE3] prion is not conserved among Saccharomyces species.

The [URE3] prion of Saccharomyces cerevisiae is a self-propagating inactive form of the nitrogen catabolism regulator Ure2p. To determine whether the [URE3] prion is conserved in S. cerevisiae-related yeast species, we have developed genetic tools allowing the detection of [URE3] in Saccharomyces paradoxus and Saccharomyces uvarum. We found that [URE3] is conserved in S. uvarum. In contrast, [URE3] was not detected in S. paradoxus. The inability of S. paradoxus Ure2p to switch to a prion isoform results from the primary sequence of the protein and not from the lack of cellular cofactors as heterologous Ure2p can propagate [URE3] in this species. Our data therefore demonstrate that [URE3] is conserved only in a subset of Saccharomyces species. Implications of our finding on the physiological and evolutionary meaning of the yeast [URE3] prion are discussed

Design of a water-soluble chitosan-based polymer with antioxidant and chelating properties for labile iron extraction

AbstractLoosely bound iron, due to its contribution to oxidative stress and inflammation, has become an important therapeutic target for many diseases. A water-soluble chitosan-based polymer exhibiting both antioxidant and chelating properties due to the dual functionalization with DOTAGA and DFO has been developed to extract this iron therefore preventing its catalytic production of reactive oxygen species. This functionalized chitosan was shown to have stronger antioxidant properties compared to conventional chitosan, improved iron chelating properties compared to the clinical therapy, deferiprone, and provided promising results for its application and improved metal extraction within a conventional 4 h hemodialysis session with bovine plasma.</jats:p

Combating lead and cadmium exposure with an orally administered chitosan-based chelating polymer

Abstract Heavy metals present a threat to human health, even at minimal concentrations within the body. One source of exposure is due to the consumption of low-level contaminated foodstuff and water. Lead and cadmium have been shown to be absorbed by and accumulate within organs like the kidneys and liver, and they have also been associated to many diseases including cardiovascular disease and kidney dysfunction as well as developmental disorders and neurodegenerative diseases. Since this contamination of lead and cadmium is found worldwide, limiting the exposure is complicated and novel strategies are required to prevent the absorption and accumulation of these metals by forcing their elimination. In this study, a DOTAGA-functionalized chitosan polymer is evaluated for this preventative strategy. It shows promising results when orally administered in mice to force the elimination and negate the toxic effects of lead and cadmium found within foodstuff

Feasibility study and direct extraction of endogenous free metallic cations combining hemodialysis and chelating polymer

International audienceAbstract In this article, we report the conception and the use of dialysis-based medical device for the extraction of metals. The medical device is obtained by addition in the dialysate of a functionalized chitosan that can chelate endogenous metals like iron or copper. This water-soluble functionalized chitosan is obtained after controlled reacetylation and grafting of DOTAGA. Due to the high mass of chitosan, the polymer cannot cross through the membrane and the metals are trapped in the dialysate during hemodialysis. Copper extraction has been evaluated in vitro using an hemodialysis protocol. Feasibility study has been performed on healthy sheep showing no acute toxicity througout the entire dialysis procedure and first insights of metallic extraction even on healthy animals

Towards the sustainable discovery and development of new antibiotics

International audienceAn ever-increasing demand for novel antimicrobials to treat life-threatening infections caused by the global spread of multidrug-resistant bacterial pathogens stands in stark contrast to the current level of investment in their development, particularly in the fields of natural-product-derived and synthetic small molecules. New agents displaying innovative chemistry and modes of action are desperately needed worldwide to tackle the public health menace posed by antimicrobial resistance. Here, our consortium presents a strategic blueprint to substantially improve our ability to discover and develop new antibiotics. We propose both short-term and long-term solutions to overcome the most urgent limitations in the various sectors of research and funding, aiming to bridge the gap between academic, industrial and political stakeholders, and to unite interdisciplinary expertise in order to efficiently fuel the translational pipeline for the benefit of future generations