Changes in plasma gonadotropin after ovariectomy and estradiol supplementation at different stages at the end of the reproductive cycle in the rainbow trout (Salmo gairdneri R.)

International audienceTo determine the effect of gonadal feedback on plasma GTH level, female rainbow trout were ovariectomized at three stages at the end of the reproductive cycle : at the end of vitellogenesis, during germinal vesicle migration and during the post-ovulatory period. A group of controls and one of castrates in each experiment were given an injection of physiological salt solution, and a third group of castrates was supplemented with estradiol- 17β (E2) twice a week (200 μg/kg) from the day of surgery. The blood was sampled twice a week, and the GTH measured by RIA. At the end of vitellogenesis, castration induced a significant rise in the gonadotropic hormone level (P < 0.001 from post-surgical day 5), and that response, unimpeded by E2 was homogeneous in all the fish. During germinal vesicle migration, the response to castration and to supplementary E2 varied with the individual. Ovariectomy induced a significant increase in GTH (P < 0.005 from day 3), but that increase was immediate in 5 females and delayed in the other 4 ; E2 prevented GTH rise in only 6 females. At the post-ovulatory period we found no significant difference between the control fish and the castrates and E2, at least temporarily, prevented the post-ovulatory rise in GTH which is usually found in trout

The natural history of postoperative Crohn's disease recurrence

International audienceBackground Surgical resection of the diseased bowel in Crohn's disease is unfortunately not curative, and postoperative recurrence remains a problem in these patients. Aim To review the rates of and risk factors for clinical and endoscopic recurrence in population-based studies, referral centres and randomised controlled trials. Methods We searched MEDLINE (source PUBMED, 1966 to September, 2011). Results In randomised controlled trials, clinical recurrence in the first year after surgery occurred in 10-38% of patients, whereas endoscopic recurrence in the first year was reported in 35-85% of patients. In population-based studies, approximately half of patients experienced clinical recurrence at 10 years. In referral centres, 48-93% of the patients had endoscopic lesions (Rutgeerts' score >= 1) in the neoterminal ileum within 1 year after surgery, whereas 20 -37% had symptoms suggestive of clinical recurrence. Three years after surgery, the endoscopic postoperative recurrence rate increased to 85-100%, and symptomatic recurrence occurred in 34-86% of patients. Smoking is the strongest risk factor for postoperative recurrence, increasing by twofold, the risk of clinical recurrence. Prior intestinal resection, penetrating behaviour, perianal disease and extensive bowel disease (> 50 cm) are established risk factors for postoperative recurrence. Risk factors for postoperative recurrence remain poorly defined in population-based cohorts. Conclusion Endoscopic and clinical postoperative recurrence remains common in patients with Crohn's disease, and the identification of risk factors may allow targeted strategies to reduce this recurrence rate

Effets compares de deux sources azotees en nutrition enterale sur le metabolisme proteique "corps entier" chez l'homme a l'aide de la leucine marquee aux isotopes stables

National audienc

Diffusion-weighted magnetic resonance imaging is effective to detect ileocolonic ulcerations in Crohn's disease

International audienceBackgroundMagnetic resonance entero-colonography enables accurate assessment of ileocolonic Crohn's disease, but the need for bowel cleansing and rectal enema limits considerably its use in daily practice. AimWe evaluated the accuracy of diffusion-weighted magnetic resonance entero-colonography with neither bowel cleansing nor rectal enema to assess endoscopic activity. MethodsForty-four Crohn's disease patients underwent prospectively and consecutively diffusion-weighted magnetic resonance entero-colonography [with apparent diffusion coefficient (ADC) and Clermont score calculation] and ileocolonoscopy [with Crohn's Disease Endoscopic Index of Severity (CDEIS) and Simplified Endoscopic score for Crohn's Disease (SES-CD) calculation]. ResultsMean ADC was inversely correlated with total CDEIS (=-0.40; P=0.0067) and total SES-CD (=-0.33; P=0.032). Considering the 194 segments, ADC was inversely correlated with segmental CDEIS (-0.48; P18.9 detected ulcerations with sensitivity=0.79 and specificity=0.73. ConclusionDiffusion-weighted magnetic resonance entero-colonography using apparent diffusion coefficient and Clermont score was effective to indirectly detect endoscopic ulcerations in ileocolonic Crohn's disease

Leucine kinetics are different during feeding with whole protein or oligopeptides

International audienc

Protein metabolism during enteral nutrition with a high protein or peptide diet in healthy subjects

Supplément 2International audienc

Protein metabolism during enteral nutrition with a high protein or peptide diet in healthy subjects

International audienc

Anti-TNF therapy in refractory pouchitis and Crohn's disease-like complications of the pouch after ileal pouch-anal anastomosis following colectomy for ulcerative colitis: a systematic review and meta-analysis

International audienceBackground: Pouchitis and secondary Crohn's disease (CD)-like complication of the pouch are the most common complications after ileal pouch-anal anastomosis following colectomy for ulcerative colitis. Data about the effectiveness of anti-TNF agents in these two entities remains sparse. We aimed to perform a systematic review and meta-analysis to evaluate the efficacy of anti-TNF therapy in differentiating patients with chronic refractory pouchitis and CD-like complications. Methods: Systematic literature search was performed in MEDLINE and from international meetings abstracts. The search process, selection of manuscripts, and data extraction were performed independently by two physicians according to PRISMA statements. Prevalence and 95% confidence interval (CI) were estimated using random-effects models assuming between and within study variability. Statistical heterogeneity between results was assessed by examining forest plots, CIand using I2 and sensitivity analyses were conducted. CD-like complications of the pouch were defined as the presence of non-anastomotic fistula and/or non-anastomotic stenosis and/or prepouch ileitis. Chronic refractory pouchitis was defined as inflammation limited to the pouch. The short term and the long term responses were evaluated at 8 weeks and 12 months, respectively. Results: We identified 21 articles and three abstracts including 313 patients treated either with infliximab (IFX) (n=194) or adalimumab (ADA) (n=119) for inflammatory complications of the pouch. The rate of complete response (CR) after anti-TNF induction therapy for inflammatory complications of the pouch was 0.51 (95% CI [0.39–0.64]; I2=0.56). The rate of short-term CR was 0.57 (95% CI [0.38–0.75]; I2=0.36) for IFX-treated patients compared to 0.38 (95% CI [0.08–0.72]; I2=0.50) for ADA-treated patients (p=0.20). The long-term rate of CR in patients treated with anti-TNF therapy was 0.52 (95% CI [0.39–0.65]; I2=0.59), with 0.59 (95% CI [0.45–0.72]; I2=0.30) for IFX-treated patients compared to 0.30 (95% CI [0.15–0.46]; I2=0.00) for ADA-treated patients (p=0.19). The rate of CR after anti-TNF induction therapy seemed to be higher for CD-like complications of the pouch 0.64 (95% CI [0.5–0.77]; I2=0.18), compared to refractory pouchitis 0.10 (95% CI [0.08–0.35]; I2=0.00) (p=0.06). The rate of long-term CR in patients treated with anti-TNF was 0.57 (95% CI [0.43–0.71]; I2=0.32) for CD-like complications of the pouch compared to refractory pouchitis 0.37 (95% CI [0.14–0.62]; I2=0.47) (p=0.57). Conclusions: Despite wide heterogeneity of the data, anti-TNF agents have a clear trend to have higher and faster efficacy in CD-like complications of the pouch compared to refractory pouchitis, highlighting the need to differentiate these two entities in clinical practice