Évaluation d’un score prédictif de complications postopératoires chez la personne âgée en chirurgie orthopédique programmée‎ : intérêt de l’outil ABCDEF

Le vieillissement de la population française entraîne un accroissement constant du nombre de personnes âgées. Compte tenu de la forte proportion d’interventions chirurgicales aux âges avancés, repérer les patients âgés fragiles qui sont plus à risque de complications postopératoires est devenu un enjeu majeur de santé publique. L’outil ABCDEF a été créé pour dépister la fragilité gériatrique, afin d’anticiper ses complications. Objectif principal et secondaires : Évaluer le taux de complications en postopératoire de chirurgie orthopédique programmée, ainsi que les performances de l’outil ABCDEF pour dépister les patients âgés à risque de complications postopératoires. Type d’étude : Étude de cohorte prospective monocentrique de février 2015 à février 2017. Patients & méthodes : Tous les patients âgés > 75 ans devant bénéficier d’une chirurgie prothétique programmée de hanche ou de genou ont été inclus. Chaque patient a bénéficié en préopératoire d’une évaluation de la fragilité selon le score ABCDEF. Toute complication majeure survenant durant les 7 jours postopératoires a été recueillie. Résultats : Sur la période de l’étude, 103 patients ont été inclus. On observe un taux de complications postopératoires de 29,1%, dont 16,5% de confusion. La prévalence de la fragilité de la population était de 36,9%, pour un seuil du score ABCDEF > 2. La performance du score ABCDEF était correcte au seuil de 2/6 pour le dépistage des patients âgés fragiles susceptibles de se compliquer en postopératoire (Se 63% ; Spe 74% ; Vpp 50% ; Vpn 83%). Conclusion : Notre étude a pu mettre en évidence un taux de complications postopératoires élevé, évitable grâce au dépistage des patients âgés fragiles par l’outil ABCDEF. L’utilisation d’un tel score au quotidien permettrait de stratifier le risque, afin de mieux orienter le patient fragile pour une prise en charge optimale. Une stratégie de prévention efficace pourrait reposer sur une consultation gériatrique préopératoire

Les macroinvertébrés dans l’évaluation du fonctionnement trophique lacustre : mesures isotopiques et analyse des communautés

National audienc

Les macroinvertébrés dans l’évaluation du fonctionnement trophique lacustre : mesures isotopiques et analyse des communautés

National audienc

Biological quality assessment of three French Alpine lakes (Lake Annecy, Lake Crop, Lake Grand Domenon) using the Lake Biotic Index (LBI)

International audienc

Carbon isotope ratios (δ13C) of macro-invertebrates in assessing lake trophic functioning

International audienceThe European Water Framework Directive (WFD) (2000/60 EC) requires, for all members, an assessment of the ecological status of aquatic ecosystems. This status has been defined as a result of the structure and the functioning of aquatic systems. Currently, most of the biological methods for lake monitoring are based on their trophic level and not on their functioning. Therefore, the aim of this study is to contribute to a better knowledge of lake trophic functioning i.e. the lake’s ability to transfer the organic matter up to consumers. Two approaches based on the macro-invertebrate communities have been applied on 12 French lakes: The Lake Biotic Index (LBI) (Verneaux & al., 2004), a new lake biological quality assessment method, comprising two indices, each of them giving rise to a peculiar interpretation: the Bl index reflecting a trophic potential and the Df index, interpreted as the trophic functioning result i.e. the efficiency of the organic matter transfer. The carbon isotope ratios (δ13C) of macro-invertebrates sampled according to the LBI method. These ratios have been analysed to test relationships of the LBI interpretations (in term of trophic potential and organic matter transfer) with carbon sources and organic matter recycling. The LBI obtained, from 12 French lakes, showed that systems greatly differed through both their trophic potential and their organic matter transfer. The results, concerning the LBI, showed also that all combinations between high/low trophic potential and efficient/no efficient organic matter transfer exist. The results of carbon isotope ratios, from 7 lakes, revealed great differences between mean δ13C values, standard deviations and the depth related δ13C variations. Based on the macro-invertebrate δ13C results obtained from 7 lakes, preliminary interpretations could be proposed: The littoral δ13C standard deviations would be related to the lake trophic potential; despite none correlation between Bl index and 13C have been obtained, two groups of lakes appeared: lakes with weak trophic potential and standard deviation of δ13C values less than or equal to 1 and lakes with high trophic potential and standard deviation of δ13C values superior to 1. The variations in 13C values between littoral and deep zones, correlated to the Df index, could reflect the trophic functioning. Through the 7 lakes, two types of trophic functioning have been defined: one type based on a high heterotrophic organic matter recycling activity and another based on direct organic matter consumption without recycling

Phylou : une première expérience de co-construction de modèle avec les acteurs locaux de la gestion de l'eau

The risk of superficial and subterranean waters contamination by pesticide is an increasing problem, at the interface between agriculture and water resources. That issue fits in with different scales and implicates actors within several organisation levels. In order to make information exchanges easier, we propose to make a model for weed-killer transfers in vineyards cases. That model should be a qualitative one for sharing knowledge and should answer to two main aims: (i) to conceptualise weedkiller transfers from the parcel to the active hydrological network, by being focused on the analyse of the landscape structure which is the explicative factor of transfers and on experts knowledge ; (ii) to be a sufficiently flexible modelling able to evolve quickly and to make exchanges easier. The aim of this study is to present a participatory modelling experiment giving an integrated vision between hydrological modellers and sociologists. First of all, we present modelling process it-self : the conditions of realization, the issues, and the impacts/constraints on the technical aspects. Secondly, we present the model it-self focusing on the landscape representation and biophysical processes that we conceptualised and implemented. During the 6-month modelling process, three versions of Phylou model were realized taking account stakeholder expectations, notably, on scale issues. The last scale of modelling is a group of parcels, which permits to integrate transfer processes, interactions between actors and which is understood by the wine growers. Phylou model is ready to simulate landscaped patchwork. Such disposable and simple model still questions technical and social evaluations

Evaluation du fonctionnement trophique de 4 lacs français par analyse de l'Indice Biologique Lacustre (IBL) et des signatures isotopiques en carbone des macroinvertébrés

National audienc

Influence des activités humaines des bassins versants sur les ratios d’isotopes stables d’azote et de carbone des poissons dans neuf lacs français

International audienceThe relationships between fish community δ15N and δ13C values and land use in watersheds and in buffer zones of nine French lakes were studied. The results showed inter-lakes variability of mean δ15N and δ13C values for different fish species. The study of correlations between fish δ15N and δ13C values and the proportions from different land use categories in watersheds showed a land use effect on fish δ15N values but not on δ13C values. The results underlined the great impact of manure spreading on grasslands as a nitrate source in our lakes. Nevertheless, the best correlations between fish δ15N values and land use were obtained when the entire fish community (i.e. the whole fish community mean δ15N values in each lake) and all anthropogenic activities (residential lands, camp sites and grasslands for our systems) were considered in either watersheds or in buffer zones. Thus, for our sites, the fish δ15N values are useful to evaluate nitrogen inputs from human and animal wastes at the watershed-scale as well as at the buffer zone-scale. The absence of land use effect on the fish community δ13C values could be at least partly explained by the small size of these lakes in which it has been shown that consumers, namely macroinvertebrates, have δ13C values largely influenced by organic matter recycling activity.Les relations entre les valeurs de δ15N et δ13C des communautés pisciaires, l’occupation des bassins versants et des zones tampon de neuf lacs français ont été étudiées. Les résultats montrent une variablilité inter-lac des valeurs moyennes de δ15N et δ13C pour les différentes espèces. L’étude des relations entre les valeurs isotopiques des poissons et les proportions des différentes catégories d’usage des bassins versants montre une corrélation entre l’occupation des sols et les valeurs de δ15N des poissons alors qu’aucune corrélation n’apparaît si l’on considère les valeurs de δ13C. Les résultats obtenus mettent en évidence l’impact important de l’utilisation des lisiers sur prairies comme source de nitrate dans ces lacs. Les meilleures corrélations entre les valeurs de δ15N des poissons et l’occupation de l’espace sont obtenues quand la communauté de poissons dans son ensemble (c'est-à-dire les valeurs moyennes de δ15N pour toutes les espèces dans chaque lac) et toutes les activités anthropiques (zones d’habitation, camping et prairies) sont prises en compte aussi bien au niveau du bassin versant que de la zone tampon. Pour les lacs étudiés, les valeurs de δ15N des poissons permettent d’évaluer l’impact des apports d’azote dus aux déchets humains et animaux, aussi bien au niveau du bassin versant que de la zone tampon. L’absence de corrélation entre l’occupation des sols et les signatures en carbone des poissons peut être expliquée, au moins partiellement, par la petite taille de ces lacs dans lesquels il a été montré que les consommateurs, dont les macroinvertébrés, ont des valeurs de δ13C largement influencées par le recyclage interne de la matière organique

Influence of watershed’s anthropogenic activities on fish nitrogen and carbon stable isotope ratios in nine French lakes

The relationships between fish community δ15N and δ13C values and land use in watersheds and in buffer zones of nine French lakes were studied. The results showed inter-lakes variability of mean δ15N and δ13C values for different fish species. The study of correlations between fish δ15N and δ13C values and the proportions from different land use categories in watersheds showed a land use effect on fish δ15N values but not on δ13C values. The results underlined the great impact of manure spreading on grasslands as a nitrate source in our lakes. Nevertheless, the best correlations between fish δ15N values and land use were obtained when the entire fish community (i.e. the whole fish community mean δ15N values in each lake) and all anthropogenic activities (residential lands, camp sites and grasslands for our systems) were considered in either watersheds or in buffer zones. Thus, for our sites, the fish δ15N values are useful to evaluate nitrogen inputs from human and animal wastes at the watershed-scale as well as at the buffer zone-scale. The absence of land use effect on the fish community δ13C values could be at least partly explained by the small size of these lakes in which it has been shown that consumers, namely macroinvertebrates, have δ13C values largely influenced by organic matter recycling activity

Macroinvertebrate delta 13C variability analysis for the assessment of lake trophic functioning

International audienceThe aim of this study was to better understand the relationships of within-and among-lake variability of macroinvertebrate carbon stable-isotope ratios with both lake trophic potential and lake trophic functioning