Les dimensions spatiales du maintien de l’ordre. Introduction

Ce numéro consacré aux dimensions spatiales du maintien de l’ordre s’est construit au cours d’une période fortement marquée par des événements médiatisés, relançant des débats sur les pratiques policières et notamment la relation police-citoyen·ne. Dans ce contexte, le cadre légal et la doctrine du maintien de l’ordre ont fait l’objet de concertations et de différents projets de réformes en France. Le Ministère de l’intérieur a par exemple publié le Schéma national du maintien de l’ordre (SNM..

Les debuts de la thrombolyse intraveineuse par le rt-pa a la phase aigue des avc ischemiques a Abidjan, Cote d’Ivoire: a propos de 10 patients

Introduction: La thrombolyse intraveineuse est un traitement efficace et validé à la phase aigue de l’AVC ischémique. Elle est pratiquée depuis environ 20 ans dans les pays occidentaux, mais elle tarde à se développer en Afrique subsaharienne.Objectif: Rapporter les premiers cas de thrombolyse intraveineuse en Côte d’ivoire.Résultats: Après une première expérience isolée en avril 2013, 10 autres patients ont bénéficié d’une thrombolyse IV en 18 mois, entre octobre 2017 et avril 2019. L’âge médian était de 50 ans (28 à 73 ans) et un sex-ratio de 1,5. La moitié des patients avaient une HTA. Les délais moyens d’admission et de réalisation de l’imagerie étaient respectivement de 83 et 61 minutes. La thrombolyse a été réalisée dans un délai moyen de 192 minutes et le « door to needle time » était de 110 minutes. Le NIHSS médian était de 8 à l’admission et de 3 à H24. Cependant, 5 des 10 patients avaient une récupération totale à H24 (NIHSS=0) et 6 patients ont eu une amélioration significative (> 4 points) de leur score NIH. Sept patients avaient un score de Rankin modifié à 0 ou 1 à 3 mois. Un patient est resté grabataire (mRS 5) et un patient est décédé. Aucune hémorragie symptomatique n’a été notée.Conclusion: Nous n’avons pas retrouvé de données publiées de thrombolyse intraveineuse en Afrique subsaharienne en dehors de l’Afrique du Sud et de quelques cas cliniques isolés, et cette série, bien que très faible, reste la plus large réalisée dans cette région. Elle démontre la faisabilité de la thrombolyse intraveineuse en Afrique subsaharienne, avec une efficacité.Mots clefs: Afrique subsaharienne – AVC ischémique – ThrombolyseEnglish Title: The beginning of intravenous thrombolysis with rt-pa in acute ischemic stroke in Abidjan, Côte d'Ivoire: about 10 patientsEnglish AbstractIntroduction: Intravenous thrombolysis is an effective and validated treatment for the acute phase of ischemic stroke. It has been practiced for about 20 years in western countries, but it is slow to develop in sub-Saharan Africa.Objective: To report the first cases of intravenous thrombolysis in Côte d’Ivoire.Results: After a first isolated experience in April 2013, 10 other patients underwent IV thrombolysis in 18 months, between October 2017 and April 2019. The median age was 47 years (28 to 73 years) and sex- ratio of 1.5. Half of the patients had hypertension. The average onset to admission and admission to imaging time was 83 and 61 minutes, respectively. Thrombolysis was performed within an average of 192 minutes and the « door to needle time » was 110 minutes. The median NIHSS was 8 on admission and 3 on H24. However, 5 of the 10 patients had a complete recovery at H24 (NIHSS = 0) and 6 patients had a significant improvement (> 4 points) in their NIH score. Seven patients had a modified Rankin score at 0 or 1 to 3 months. One patient remained bedridden (mRS 5), and one patient died. No symptomatic haemorrhage was noted.Conclusion: We did not find published intravenous thrombolysis data in sub-Saharan Africa outside of South Africa and some isolated clinical cases, and this series, although very low, remains the largest in this region. It demonstrates the feasibility of intravenous thrombolysis in sub-Saharan Africa, with good efficacy and tolerance that are within international standards, despite limited accessibility.Keywords: Sub-Saharan Africa – Ischemic stroke – Thrombolysi

Connaissances, perceptions et attitudes face aux Accidents Vasculaires Cerebraux (AVC) : Etude chez les aidants des patients victimes d’avc hospitalisés au service de neurologie du chu de Cocody

Introduction: Notre étude avait pour objectif de déterminer le niveau de connaissance sur les AVC des aidants de patients hospitalisés pour AVC au service de neurologie du CHU de Cocody.Méthode: Il s‘agissait d‘une étude transversale à visée descriptive. Elle s‘est déroulée sur une période de trois mois, s‘étendait du 2 avril au 2 juillet 2018. A travers un questionnaire, il s‘agissait d‘évaluer les connaissances, de déterminer les perceptions et attitudes des aidants face aux AVC. Elle visait également à déterminer leur niveau de connaissance des facteurs de risques et des signes ou symptômes de l‘AVC.Résultats: Nous avons inclus 106 aidants, membres de l‘entourage des patients victimes d‘AVC séjournant en milieu hospitalier. L‘âge moyen des aidants était de 40,18 ± 13,09 ans 20,8% des aidants étaient non scolarisés. Le sigle AVC a été correctement défini par 12 aidants (11,3%) et 50,9% des participants estimaient que l‘AVC pouvait avoir une origine mystique, et 57,5% identifiaient les « sortilèges » comme facteurs de risque d‘AVC. L‘Hypertension artérielle (HTA) était le principal facteur de risque de l‘AVC spontanément cité par 40,6 % des aidants. Les signes d‘AVC les plus cités spontanément étaient l‘hémiplégie et les troubles du langage, rapportés par respectivement 78,3% et 37,7% des aidants.Conclusion: Il ressort de notre étude que les connaissances de facteurs de risque, des symptômes et des moyens de prévention des AVC demeurent insuffisantes.   English title: Knowledge, perceptions and attitudes in front of  strokes : Study among caregivers stroke patients hospitalized in neurology at Universitary Hospital of Cocody Introduction: The aim of the study was to determine the level of knowledge about stroke among caregivers of patients hospitalized for stroke at the Cocody‘s university hospital (Abidjan).Method: It was a cross-sectional study, carried out during a three months period, from 2nd April to 2nd July 2018 at the Cocody‘s university hospital. Through a questionnaire, we assessed knowledges, perceptions and behaviors of stroke patients‘s caregivers. We also intended to determine their knowledge level of risk factors and signs or symptoms of stroke.Results: The study included 106 caregivers, from the entourage of stroke patients staying in hospital. The caregivers mean age was 40.18 ± 13.09 years. The percentage of unschooled caregivers was 20.80%. The acronym « AVC » was correctly defined by 12 caregivers (11.30%). Half of participants estimated that stroke had a mystical origin, and 57.50% identified « spells » as risk factors for stroke. Hypertension was the main risk factor of stroke spontaneously cited by 40.57% of caregivers. The most commonly reported signs of stroke were hemiplegia and language impairment, reported by 78.30% and 37.74% of caregivers, respectively.Conclusion: Our study found that knowledge of risk factors, symptoms, and ways to prevent stroke are inadequate

Metabolic analysis of S. cerevisiae strains engineered for malolactic fermentation

International audienc

Characterization of Schizosaccharomyces pombe Malate Permease by Expression in Saccharomyces cerevisiae

In Saccharomyces cerevisiae, l-malic acid transport is not carrier mediated and is limited to slow, simple diffusion of the undissociated acid. Expression in S. cerevisiae of the MAE1 gene, encoding Schizosaccharomyces pombe malate permease, markedly increased l-malic acid uptake in this yeast. In this strain, at pH 3.5 (encountered in industrial processes), l-malic acid uptake involves Mae1p-mediated transport of the monoanionic form of the acid (apparent kinetic parameters: V(max) = 8.7 nmol/mg/min; K(m) = 1.6 mM) and some simple diffusion of the undissociated l-malic acid (K(d) = 0.057 min(−1)). As total l-malic acid transport involved only low levels of diffusion, the Mae1p permease was further characterized in the recombinant strain. l-Malic acid transport was reversible and accumulative and depended on both the transmembrane gradient of the monoanionic acid form and the ΔpH component of the proton motive force. Dicarboxylic acids with stearic occupation closely related to l-malic acid, such as maleic, oxaloacetic, malonic, succinic and fumaric acids, inhibited l-malic acid uptake, suggesting that these compounds use the same carrier. We found that increasing external pH directly inhibited malate uptake, resulting in a lower initial rate of uptake and a lower level of substrate accumulation. In S. pombe, proton movements, as shown by internal acidification, accompanied malate uptake, consistent with the proton/dicarboxylate mechanism previously proposed. Surprisingly, no proton fluxes were observed during Mae1p-mediated l-malic acid import in S. cerevisiae, and intracellular pH remained constant. This suggests that, in S. cerevisiae, either there is a proton counterflow or the Mae1p permease functions differently from a proton/dicarboxylate symport

Management of adolescents with very poorly controlled type 1 diabetes by nurses: a parallel group randomized controlled trial

International audienceBACKGROUNDS: Fluctuation in glycemia due to hormonal changes, growth periods, physical activity, and emotions make diabetes management difficult during adolescence. Our objective was to show that a close control of patients' self-management of diabetes by nurse-counseling could probably improve metabolic control in adolescents with type 1 diabetes. METHODS: We designed a multicenter, randomized controlled, parallel group, clinical trial. Seventy seven adolescents aged 12-17 years with A1C \textgreater8% were assigned to either an intervention group (pediatrician visit every 3 months + nurse visit and phone calls) or to the control group (pediatrician visit every 3 months). The primary outcome was the evolution of the rate of A1C during the 12 months of follow-up. Secondary outcomes include patient's acceptance of the disease (evaluated by visual analog scale), the number of hypoglycemic or ketoacidosis episodes requiring hospitalization, and evaluation of A1C rate over time in each group. RESULTS: Seventy-seven patients were enrolled by 10 clinical centers. Seventy (89.6%) completed the study, the evolution of A1C and participants satisfaction over the follow-up period was not significantly influenced by the nurse intervention. CONCLUSION: Nurse-led intervention to improve A1C did not show a significant benefit in adolescents with type 1 diabetes because of lack of power. Only psychological management and continuous glucose monitoring have shown, so far, a slight but significant benefit on A1C. We did not show improvements in A1C control in teenagers by nurse-led intervention. TRIAL REGISTRATION: Clinical Trials.gov registration number: NCT00308256, 28 March 2006

Duplication and Specialization of NUDX1 in Rosaceae Led to Geraniol Production in Rose Petals

Nudix hydrolases are conserved enzymes ubiquitously present in all kingdoms of life. Recent research revealed that several Nudix hydrolases are involved in terpenoid metabolism in plants. In modern roses, RhNUDX1 is responsible for formation of geraniol, a major compound of rose scent. Nevertheless, this compound is produced by monoterpene synthases in many geraniol-producing plants. As a consequence, this raised the question about the origin of RhNUDX1 function and the NUDX1 gene evolution in Rosaceae, in wild roses or/and during the domestication process. Here, we showed that three distinct clades of NUDX1 emerged in the Rosoidae subfamily (Nudx1-1 to Nudx1-3 clades), and two subclades evolved in the Rosa genus (Nudx1-1a and Nudx1-1b subclades). We also showed that the Nudx1-1b subclade was more ancient than the Nudx1-1a subclade, and that the NUDX1-1a gene emerged by a trans-duplication of the more ancient NUDX1-1b gene. After the transposition, NUDX1-1a was cis-duplicated, leading to a gene dosage effect on the production of geraniol in different species. Furthermore, the NUDX1-1a appearance was accompanied by the evolution of its promoter, most likely from a Copia retrotransposon origin, leading to its petal-specific expression. Thus, our data strongly suggest that the unique function of NUDX1-1a in geraniol formation was evolved naturally in the genus Rosa before domestication

Increasing knowledge in IGF1R defects: lessons from 35 new patients

International audienceBACKGROUND: The type 1 insulin-like growth factor receptor (IGF1R) is a keystone of fetal growth regulation by mediating the effects of IGF-I and IGF-II. Recently, a cohort of patients carrying an IGF1R defect was described, from which a clinical score was established for diagnosis. We assessed this score in a large cohort of patients with identified IGF1R defects, as no external validation was available. Furthermore, we aimed to develop a functional test to allow the classification of variants of unknown significance (VUS) in vitro.METHODS: DNA was tested for either deletions or single nucleotide variant (SNV) and the phosphorylation of downstream pathways studied after stimulation with IGF-I by western blot analysis of fibroblast of nine patients.RESULTS: We detected 21 IGF1R defects in 35 patients, including 8 deletions and 10 heterozygous, 1 homozygous and 1 compound-heterozygous SNVs. The main clinical characteristics of these patients were being born small for gestational age (90.9%), short stature (88.2%) and microcephaly (74.1%). Feeding difficulties and varying degrees of developmental delay were highly prevalent (54.5%). There were no differences in phenotypes between patients with deletions and SNVs of IGF1R. Functional studies showed that the SNVs tested were associated with decreased AKT phosphorylation.CONCLUSION: We report eight new pathogenic variants of IGF1R and an original case with a homozygous SNV. We found the recently proposed clinical score to be accurate for the diagnosis of IGF1R defects with a sensitivity of 95.2%. We developed an efficient functional test to assess the pathogenicity of SNVs, which is useful, especially for VUS