A mechanistic multi-centre, parallel group, randomised placebo controlled trial of Mesalazine for treatment of irritable bowel syndrome with diarrhoea (IBS-D)

Introduction: Immune activation has been reported in the mucosa of irritable bowel syndrome patients with diarrhoea (IBS-D) and some small studies have suggested that Mesalazine may reduce symptoms. We performed a double blind, randomised placebo controlled trial of 2g Mesalazine twice daily versus placebo for 3 months in Rome III criteria IBS-D patients. Primary outcome was daily average stool frequency during weeks 11-12; secondary outcomes were abdominal pain, stool consistency, urgency and satisfactory relief of IBS symptoms. Methods: Participants were randomised after a 2-week baseline stool diary. All participants completed a 12-week stool diary and at the end of each week recorded the presence of “satisfactory relief of IBS symptoms”. Results: 136 patients with IBS-D (82 F, 54 M) were randomised, 10 patients withdrew from each group. Analysis by intention to treat showed the daily average stool frequency during weeks 11 and 12 were mean (SD), 2.8 (1.2) in Mesalazine and 2.7 (1.9) in placebo group with no significant group difference (95% confidence interval) 0.1 (-0.33,0.53); p=0.66. Mesalazine did not improve abdominal pain, stool consistency nor percentage with satisfactory relief compared to placebo during the last 2 weeks follow up. Conclusion: This study does not support any clinically meaningful benefit or harm of Mesalazine compared with placebo in unselected IBS with diarrhoea. More precise subtyping based on underlying disease mechanisms is needed to allow more effective targeting of treatment in IBS. (ClinicalTrials.gov number NCT01316718

Health-related quality of life in young adults with symptoms of constipation continuing from childhood into adulthood

<p>Abstract</p> <p>Background</p> <p>Children with functional constipation report impaired Health-related Quality of Life (HRQoL) in relation to physical complaints and long duration of symptoms. In about one third of children with constipation, symptoms continue into adulthood. Knowledge on HRQoL in adults with constipation persisting from childhood is lacking.</p> <p>Objectives</p> <p>To assess HRQoL in adults with constipation from early childhood in comparison to that of their peers. Furthermore to gain insight into the specific social consequences related to continuing symptoms of constipation and/or fecal incontinence at adult age.</p> <p>Methods</p> <p>One HRQoL questionnaire and one self-developed questionnaire focusing on specific consequences of symptoms of constipation continuing into adulthood were administrated to 182 adults with a history of childhood constipation. Successful clinical outcome was defined as a defecation frequency three or more times per week with less than two episodes of fecal incontinence per month, irrespective of laxative use. HRQoL of both adults with unsuccessful and successful clinical outcome were compared to a control group of 361 peers from the general Dutch population.</p> <p>Results</p> <p>No differences in HRQoL were found between the whole study population and healthy peers, nor between adults with successful clinical outcome (n = 139) and the control group. Adults with an unsuccessful clinical outcome (n = 43) reported significantly lower HRQoL compared to the control group with respect to scores on bodily pain (mean ± SD 77.4 ± 19.6 versus 85.7 ± 19.5, p = 0.01) and general health (67.6 ± 18.8 versus 74.0 ± 18.1, p = 0.04). Adults with an unsuccessful clinical outcome reported difficulties with social contact and intimacy (20% and 12.5%, respectively), related to their current symptoms. Current therapy in these adults was more often self-administered treatment (e.g. diet modifications) (60.4%) than laxatives (20.9%).</p> <p>Conclusion</p> <p>Overall, young adults with constipation in childhood report a good quality of life, as HRQoL of adults with successful clinical outcome was comparable to that of their peers. However, when childhood constipation continues into adulthood, it influences HRQoL negatively with social consequences in 20% of these adults.</p

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Les instruments aratoires dans la Grèce archaïque

Amouretti Marie-Claire. Les instruments aratoires dans la Grèce archaïque. In: Dialogues d'histoire ancienne, vol. 2, 1976. pp. 25-52

Rousset (Paul-Louis). — Au Pays de la Meije : La Grave, Villar-d'Arène. La vie et l'histoire du Haut Oisans 1977

Amouretti Bernard. Rousset (Paul-Louis). — Au Pays de la Meije : La Grave, Villar-d'Arène. La vie et l'histoire du Haut Oisans 1977. In: Le Monde alpin et rhodanien. Revue régionale d'ethnologie, n°1-2/1978. pp. 275-276

Naissance de l'agronomie. La place des anciens Grecs

Amouretti Marie-Claire. Naissance de l'agronomie. La place des anciens Grecs. In: Histoire & Sociétés Rurales, n°3, 1er semestre 1995. L'histoire rurale en France. Actes du colloque de Rennes (6-7-8 octobre 1994) pp. 215-223

Exploration du diagramme de phase de l'hématite Fe2O3 par compression dynamique laser

The study of Fe2O3 under extreme conditions is important to better understand the interiors of planets, such as the Earth or super-Earths, and meteorite impacts which are fundamental processes of planetary accretion. In order to study these phenomena, we have used the technique of dynamic compression by laser shock, coupled with time-resolved diagnostics: VISAR (interferometer allowing measurements of surface and interface velocities), and X-ray diffraction and absorption during the shocks and releases. We have accurately measured, for the first time, the equation of state of Fe2O3 at very high pressure, up to 700 GPa, and determined that Fe2O3 melting occurs under shock at 135 GPa and 3000 K. This measurement led us to question the calculated temperature of the currently available SESAME equation of state table for Fe2O3. The measurements also showed that the high pressure phases observed in static compression are not identical to those revealed by dynamic compression. Thus the spin transition (high spin to low spin) of Fe3+ in Fe2O3 is, under dynamic compression, isostructural with volume reduction, while it is probably accompanied by a structural change in static compression. Such differences indicate a kinetic limitation of the use of laser shocks for the study of planetary interiors and conversely of static techniques for that of fast phenomena (ns). Finally, we have highlighted the reduction of iron from Fe3+ to a medium redox state Fe2.2+ in Fe2O3 upon release after a shock at 120 GPa, over a characteristic time of the order of nanoseconds. This observation highlights the rapidity of the redox mechanism, suggesting a probable reduction of Fe3+ during meteorite impacts, which explains some observations made in tektites.L'étude de Fe2O3 en conditions extrêmes est importante pour mieux comprendre les intérieurs de planètes, telles que la Terre ou les super-Terres, et les impacts de météorites, processus fondamentaux de l'accrétion planétaire. Afin d'étudier ces phénomènes, nous avons utilisé la technique de compression dynamique par choc laser, couplée à des diagnostics résolus en temps : le VISAR (interféromètre permettant des mesures de vitesses de surfaces et interfaces), et la diffraction et l'absorption X pendant les chocs et détentes. Nous avons mesuré avec précision, pour la première fois, l'équation d'état de Fe2O3 à très haute pression, jusqu'à 700 GPa et avons déterminé que la fusion de Fe2O3 se produisait sous choc à 135 GPa et 3000 K. Cette mesure nous a conduits à remettre en question la température calculée de la table d'équation d'état SESAME actuellement disponible pour Fe2O3. Les mesures ont en outre montrées que les phases haute pression observées en compression statique ne sont pas identiques à celles mises en évidence par compression dynamique. Ainsi la transition de spin (haut spin vers bas spin) du Fe3+ dans Fe2O3 est, en compression dynamique, isostructurale avec réduction de volume, alors qu'elle s'accompagne probablement d'un changement structural en statique. De telles différences indiquent une limitation cinétique de l'utilisation des chocs laser pour l'étude des intérieurs planétaires et inversement des techniques statiques pour celle des phénomènes rapides (ns). Enfin, nous avons mis en évidence la réduction du fer, de Fe3+ à un état redox moyen Fe2.2+, dans Fe2O3 en détente après un choc à 120 GPa, sur un temps caractéristique de l'ordre de la nanoseconde. Cette observation met en lumière la rapidité du mécanisme redox, suggérant une réduction probable du Fe3+ lors d'un impact de météorite permettant d'expliquer certaines observations faite dans les tectites

Chauvet (Pierre) et Pons (Paul). — Les Hautes-Alpes : hier, aujourd'hui, demain... 1975

Amouretti Bernard. Chauvet (Pierre) et Pons (Paul). — Les Hautes-Alpes : hier, aujourd'hui, demain... 1975. In: Le Monde alpin et rhodanien. Revue régionale d'ethnologie, n°1-2/1978. pp. 274-275