VARDA (VARved sediments DAtabase) – providing and connecting proxy data from annually laminated lake sediments

Varved lake sediments provide long climatic records with high temporal resolution and low associated age uncertainty. Robust and detailed comparison of well-dated and annually laminated sediment records is crucial for reconstructing abrupt and regionally time-transgressive changes as well as validation of spatial and temporal trajectories of past climatic changes. The VARved sediments DAtabase (VARDA) presented here is the first data compilation for varve chronologies and associated palaeoclimatic proxy records. The current version 1.0 allows detailed comparison of published varve records from 95 lakes. VARDA is freely accessible and was created to assess outputs from climate models with high-resolution terrestrial palaeoclimatic proxies. VARDA additionally provides a technical environment that enables to explore the database of varved lake sediments using a connected data-model and can generate a state-of-the-art graphic representation of multi-site comparison. This allows to reassess existing chronologies and tephra events to synchronize and compare even distant varved lake records. Furthermore, the present version of VARDA permits to explore varve thickness data. In this paper, we report in detail on the data mining and compilation strategies for the identification of varved lakes and assimilation of high-resolution chronologies as well as the technical infrastructure of the database. Additional paleoclimate proxy data will be provided in forthcoming updates. The VARDA graph-database and user interface can be accessed online at https://varve.gfz-potsdam.de, all datasets of version 1.0 are available at http://doi.org/10.5880/GFZ.4.3.2019.003 (Ramisch et al., 2019)

COLECTOMIE LAPAROSCOPIQUE POUR MALADIE DIVERTICULAIRE COLIQUE (ETUDE D'UNE SERIE DE 107 PATIENTS)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Leiomyoma of the lower esophagus treated by videolaparoscopy

This report describes a leiomyoma of the inferior third section of the esophagus removed during laparoscopic cholecystectomy. The patient is a woman 55-years-age, carrying esophageal myoma of 40 mm in diameter wide, situated in the posterior wall of the lower esophagus. Indications for surgery were based mainly on the growth of the mass (6 mm when discovered 7 years previously, increased to 40 mm). Recently the patient returned suffering from pain, which could be attributed to his litiasic cholecystopaty. A small degree of low disphagia could also be observed. Radiologic imaging, direct endoscopic examination and endoscopic ultrasound showed that the mioma protruded on to the oesophagic lumen, discreetly diminishing there. A laparoscopic esophageal myomectomy was indicated at the same session of the laparoscopic cholecystectomy. Once the pneunoperitoneum was installed, five ports were placed as if for a hiatus hernia surgery. The cholecystectomy was uneventful. Next, an esophagoscopy was performed so as to determine the precise area covering the base of the tumour; at the right-lateral site. Longitudinal and circular fibres of the esophagus was severed over the lesion and the enucleation of the tumour was performed alternating the monopolar dissection, bipolar and hidrodisection. Control-endoscopy was carried out to verify mucosa integrity. Four suture points with poliglactine 3-0 string so as to close the musculature followed this. One suture was placed in for diminution of the size of the esophagean hiatus. Total time of intervention: two hours (30m for the cholecystectomy and one hour and thirty minutes for the myomectomy). Postoperative period: uneventful. Disappearance of the disphagia was observed. Radiologic transit control with water-soluble contrast at 4th post-operative day: good passage. Diagnosis from laboratory of pathology: conjunctive tumour formed by muscle non-striated cells: leiomyoma. The patient was re-examined on the two-month postoperative follow-up. General conditions were good and there were no complain of dysphagia. Neither there were any symptoms of gastro-esophageal reflux

Region 2 of 8q24 is associated with the risk of aggressive prostate cancer in Caribbean men of African descent from Guadeloupe (French West Indies).

International audienceMultiple regions of the genome have been associated with the risk of prostate cancer in Caucasians, particularly including several polymorphisms located at 8q24. Region 2 of 8q24 has been repeatedly found to be associated with the risk of prostate cancer among men of African descent, although one study performed in the Caribbean island of Jamaica did not report this finding. In this study, the single nucleotide polymorphism rs16901979, located in region 2 of 8q24, was genotyped in 498 cases of histologically confirmed prostate cancer and 541 controls from the French Caribbean islands of Guadeloupe, where the population is largely of African descent. The AA genotype and the A allele at rs16901979 were associated with elevated risks of prostate cancer (odds ratios [ORs] = 1.84, 95% confidence interval [95% CI] = 1.26-2.69, P = 0.002 and OR = 1.36, 95% CI = 1.13-1.64, P = 0.001, respectively). Following stratification of the patients by disease aggressiveness, as defined by the Gleason score, the pooled genotypes AC + AA were associated with a higher risk of a Gleason score ≥7 at diagnosis (OR = 1.79, 95% CI = 1.17-2.73, P = 0.007). In summary, the A allele at rs16901979 was associated with the risk of prostate cancer in the Caribbean population of Guadeloupe, confirming its involvement in populations of African descent. Moreover, our study provides the first evidence of an association between this variant and the risk of aggressive prostate cancer

Terrigenous input response to glacial/interglacial climatic variations over southern Baja California: a rock magnetic approach

International audienceThe sediments deposited off south-western Baja California have recorded millennial-scale fluctuations in biogenic compounds and trace metals accumulation during the last glacial period [Ortiz, J.D., O'Connell, S.B., DelViscio, J., Dean, I W.E., Carriquiry, J.D., Marchitto, T., Zheng, Y., van Geen, A., 2004. Enhanced marine productivity off western North America during warm climate intervals of the past 52 ky. Geology 32, 521-524; Dean, W.E., Zheng, Y., Ortiz, J.D., van Geen, A., 2006. Sediment Cd and Mo accumulation in the oxygen-minimum zone off western Baja California linked to global climate over the past 52 ka. Paleoceanography 21, PA4209]. Since the variations in trace metals concentration appear to result from dilution with nonbiogenic matter, the variability of the terrigenous sedimentation needs to be addressed. Therefore, we performed rock magnetic and geochemical analysis on a 38m-long sediment core collected from the slope off Baja California. The temporal framework provided by 14 C dating and identification of palaeoclimatic transitions allows assigning the sequence to the last glacial-interglacial cycle (similar to last 120 ka). The comparison of magnetic and geochemical properties led to retain the hypothesis of a primary modulation of iron oxides quantity and quality by terrigenous input variations, with a secondary diagenetic amplification. Two magnetic mineral input regimes are distinguished: (i) magnetic susceptibility variations reveal changes in titano-magnetite concentration related to fluvial transport of the terrigenous fraction; (ii) coercivity changes allow detecting variations of hematite or goethite concentrations, minerals generally issued from aeolian deflation of weathered rock surfaces. These two regimes are paced by two distinct climatic forcing: the millennial-scale changes in titano-magnetite input are related to the northern hemisphere climatic variability whilst the record of wind-blown magnetic mineral input contains its major power in the precessional frequency band, with higher input during low insolation periods (and conversely). This record highlights the great sensibility of this region to high and low latitudes climatic regimes. (c) 2007 Elsevier Ltd. All rights reserved

Should ambulatory appendectomy become the standard treatment for acute appendicitis?

Abstract Background Appendectomy is increasingly performed as a ‘short stay’ or ‘ambulatory’ procedure, yet there is no consensus for selection of patients with acute appendicitis for ambulatory surgery (AS). We aimed to compare characteristics and outcomes of complicated and uncomplicated appendectomies performed in ambulatory vs. conventional settings, and to determine factors associated with unexpected re-consultations and re-hospitalizations. Methods The authors reviewed a consecutive series of 185 laparoscopic appendectomies. Whenever possible, patients were offered AS, defined as ‘discharge on the same working day.’ Multivariable regressions were performed to determine associations of unexpected re-consultations and re-hospitalizations with surgery type (ambulatory or conventional) and patient characteristics (age, gender, obesity, symptoms, appendicolith, perforations, appendix diameter, serologic results, American Society of Anesthesiologists score, and Saint-Antoine score). Results From the initial cohort, 117 patients (63.2%) were eligible for AS, of which 8 had peri- or post-operative contraindications. Therefore, 109 patients (58.9%) were operated by AS, with median length of stay 8.5 h (range, 3.3–20.5). Ambulatory cases had a lower incidence of complications (11.9%) than conventional cases (25.0%) (p = 0.029). Uni- and multi-variable regressions revealed that unexpected re-consultations were not significantly associated with any of the pre- or peri-operative variables but that unexpected re-hospitalizations were 4 times more likely for patients with appendicolith (OR, 4.32; p = 0.04). Conclusions Ambulatory surgery could be considered as a standard procedure for both complicated and uncomplicated acute appendicitis. Appendicolith was found to be an independent risk factor for unexpected re-hospitalization and should therefore trigger closer monitoring

Short-term Outcomes of Ambulatory Colectomy for 157 Consecutive Patients

International audienceTo evaluate short-term outcomes of laparoscopic colectomy for selected consecutive patients in an ambulatory setting at two institutions.BACKGROUND:Several studies showed that an enhanced recovery protocol for colorectal surgery reduces postoperative morbidity and mortality, and shortens the length of hospital stay. The development of such a program has allowed us to gradually reduce the length of stay for colorectal surgery, until ambulatory management.METHODS:Between February, 2013 and December, 2016, all patients scheduled for elective laparoscopic colectomy and meeting rigorous criteria for ambulatory surgery were included. Outcome was prospectively studied.RESULTS:One hundred fifty-seven patients (70 women) with a median age of 61 years (range 25-82 years) were included. The ambulatory rate for colectomy was 30.5%. Median operative time and length of in-hospital stay were 95 minutes (range 45-232 minutes) and 10.0 hours (range 7-14.7 hours), respectively. The admission rate was 7.0% due to operative difficulties (4 patients), medical reasons (4 patients), and social reasons (3 patients). Outcomes for these patients were uneventful and the median length of hospital stay was 3.1 days (range 1-14 days). An unscheduled consultation was necessary for 30 patients (20.5%). Nine patients required readmission (6.1%), of whom 6 required reoperation (3.8%). The overall 30-day morbidity rate was 24.8%. The mortality rate was 0%.CONCLUSIONS:This is the first case of consecutive patients undergoing ambulatory colectomy for malignant or benign disease. We demonstrated the feasibility, safety, and reproducibility of outpatient colectomy for selected patients. In our experience, 30% of patients scheduled for elective colectomy can be managed in an ambulatory setting