Functional abdominal pain disorders and patient- and parent- reported outcomes in children with inflammatory bowel disease in remission

BACKGROUND: Chronic abdominal pain occurs frequently in pediatric patients with inflammatory bowel disease (IBD) in remission. AIMS: To assess the prevalence and factors associated with Functional Abdominal Pain Disorders among IBD children in remission (IBD-FAPD). METHODS: Patients with IBD for > 1 year, in clinical remission for ≥ 3 months were recruited from a National IBD network. IBD-FAPDs were assessed using the Rome III questionnaire criteria. Patient- or parent- reported outcomes were assessed. RESULTS: Among 102 included patients, 57 (56%) were boys, mean age (DS) was 15.0 (± 2.0) years and 75 (74%) had Crohn's disease. Twenty-two patients (22%) had at least one Functional Gastrointestinal Disorder among which 17 had at least one IBD-FAPD. Past severity of disease or treatments received and level of remission were not significantly associated with IBD-FAPD. Patients with IBD-FAPD reported more fatigue (peds-FACIT-F: 35.9 ± 9.8 vs. 43.0 ± 6.9, p = 0.01) and a lower HR-QoL (IMPACT III: 76.5 ± 9.6 vs. 81.6 ± 9.2, p = 0.04) than patients without FAPD, and their parents had higher levels of State and Trait anxiety than the other parents. CONCLUSIONS: Prevalence of IBD-FAPD was 17%. IBD-FAPD was not associated with past severity of disease, but with fatigue and lower HR-QoL

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

La tuberculose neuroméningée de l'enfant en France (analyse rétrospective de 12 observations entre 2001 et 2010)

CAEN-BU Médecine pharmacie (141182102) / SudocSudocFranceF

Stérilité masculine et microdélétions du chromosome Y : bilan de 6 années incluant 258 patients

REIMS-BU Santé (514542104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Cerebral microdialysis and PtiO2 to decide unilateral decompressive craniectomy after brain gunshot

Decompressive craniectomy (DC) following brain injury can induce complications (hemorrhage, infection, and hygroma). It is then considered as a last-tier therapy, and can be deleteriously delayed. Focal neuromonitoring (microdialysis and PtiO2) can help clinicians to decide bedside to perform DC in case of intracranial pressure (ICP) around 20 to 25 mmHg despite maximal medical treatment. This was the case of a hunter, brain injured by gunshot. DC was performed at day 6, because of unstable ICP, ischemic trend of PtiO2, and decreased cerebral glucose but normal lactate/pyruvate ratio. His evolution was good despite left hemiplegia due to initial injury

In vitro, ex vivo and clinical approaches to evaluate the potential effect of Gentiana lutea extract on skin

International audienceAbstract Background Dark circles affect subjects of all ages and in all skin types. They can be treated by various methods, particular by topical solutions. This investigation was directed towards exploring the effect of gentiopicroside (GP) on the skin around the eyes. For this, an extract of Gentiana lutea (GIE) containing GP (65% by dry matter) was evaluated on oxidant and angiogenesis parameters using in vitro and ex‐vivo studies. A clinical experimentation was also realized. Methods The effect of GIE at different concentrations on antioxidant gene was evaluated in vitro by RT‐qPCR after treatment of NHDF. The effect of 2.93 μg mL −1 GIE on the release of VEGF‐A and VEGF‐C by NHDF was also studied. The effect of 87.9 μg mL −1 GIE was also evaluated on pseudotube formation in a coculture system of normal dermal microvascular endothelial cells (HMVEC‐d)‐NHDF stimulated or not with VEGF as pro‐angiogenic factor. Prior to these assays, preliminary cytotoxicity assays were performed using a standard WST‐8 reduction assay. The expressions of carboxymethyl‐lysine and glyoxalase‐1 were quantified on skin explants topically treated with 147 μg mL −1 GIE in basal and UVA‐irradiated conditions. A clinical study was conducted in 22 subjects using topical twice daily for 14 days on eye area (split‐face application: cream containing 147 μg mL −1 GIE versus placebo). 3D image acquisition and skin colour measurement were performed at D0 and D14. Results Treatment of GIE upregulated the gene expression of NFE2L2 and downregulated the expression of CXCL8. GIE targeted AGEs pathways and reduced the formation of pseudotubes. A total of 147 μg mL −1 GIE gel cream significantly reduced significantly the average roughness and relief of the upper eyelid skin as well as the redness of dark circles after 14 days of application. Conclusion By acting on the pathway of AGEs, VEGF‐A and VEFG‐C, GIE seems to allow a rejuvenation of the skin resulting, among others, in a decrease in redness. It now would be interesting to evaluate the efficacy of GIE on skin around eyes microbiota, antibacterial gentiopicroside property being well‐established.Résumé Contexte Le contour des yeux est une zone sensible. Les cernes affectent les sujets de tout âge et de tout type de peau. Différentes solutions peuvent être proposées, dont les solutions topiques. Cette étude visait a explorer l'effet d’un extrait de Gentiana lutea (GIE) riche en gentiopicroside (65% de matière sèche) sur des paramètres d'oxydation et d'angiogenèse au moyen d’études in vitro et ex‐vivo. Une expérimentation clinique a également été réalisée. Méthodes L'effet du GIE a différentes concentrations sur des gènes antioxydants a été évalué in vitro par RT‐qPCR après traitement de fibroblastes (NHDF). L'effet de 2.93 μg mL−1 GIE sur la libération de VEGF‐A et VEGF‐C a également été étudié. Il en est de même pour l'effet de 87.9 μg g mL−1 GIE sur la formation de pseudotubes qui a été évalué dans un système de co‐culture de cellules endothéliales (HMVEC‐d)‐ NHDF stimulées ou non avec du VEGF comme facteur pro‐angiogénique. Les expressions de la carboxymethyl‐lysine et de la glyoxalase‐1 ont été quantifiées sur des explants cutanés traites par voie topique avec 147 μg g mL−1 GIE dans des conditions basales et irradiées par UVA. Une étude clinique a été menée sur vingt‐deux sujets en utilisant un traitement topique deux fois par jour pendant 14 jours sur le contour des yeux (crème contenant 147 μg g mL−1 GIE contre placebo). L'acquisition d'images 3D et la mesure de la couleur de la peau ont été réalisées a J0 et J14. Résultats Le traitement par GIE a augmenté l'expression génétique de NFE2L2 et diminue l'expression de CXCL8. GIE a cible les voies des AGEs et a réduit la formation de pseudotubes. 147 μg g mL−1 GIE gel crème a significativement réduit la rugosité moyenne et le relief de la peau de la paupière supérieure ainsi que la rougeur des cernes après 14 jours d'application. Conclusion En agissant sur la voie des AGEs, du VEGF‐A et du VEFG‐C, GIE semble permettre un rajeunissement de la peau se traduisant, entre autres, par une diminution des rougeurs. Il serait maintenant intéressant d'évaluer l'efficacité du GIE sur le microbiote de la peau du contour des yeux, la propriété antibactérienne du gentiopicroside étant bien établie

Pre-Sleep Low Glycemic Index Modified Starch Does Not Improve Next-Morning Fuel Selection or Running Performance in Male and Female Endurance Athletes

To determine the effects of pre-sleep supplementation with a novel low glycemic index (LGI) carbohydrate (CHO) on next-morning substrate utilization, gastrointestinal distress (GID), and endurance running performance (5-km time-trial, TT). Using a double-blind, randomized, placebo (PLA) controlled, crossover design, trained participants (n = 14; 28 ± 9 years, 8/6 male/female, 55 ± 7 mL/kg/min) consumed a LGI, high glycemic index (HGI), or 0 kcal PLA supplement ≥ 2 h after their last meal and <30 min prior to sleep. Upon arrival, resting energy expenditure (REE), substrate utilization, blood glucose, satiety, and GID were assessed. An incremental exercise test (IET) was performed at 55, 65, and 75% peak volume of oxygen consumption (VO2peak) with GID, rating of perceived exertion (RPE) and substrate utilization recorded each stage. Finally, participants completed the 5-km TT. There were no differences in any baseline measure. During IET, CHO utilization tended to be greater with LGI (PLA, 56 ± 11; HGI, 60 ± 14; LGI, 63 ± 14%, p = 0.16, η2 = 0.14). GID was unaffected by supplementation at any point (p > 0.05). Performance was also unaffected by supplement (PLA, 21.6 ± 9.5; HGI, 23.0 ± 7.8; LGI, 24.1 ± 4.5 min, p = 0.94, η2 = 0.01). Pre-sleep CHO supplementation did not affect next-morning resting metabolism, BG, GID, or 5-km TT performance. The trend towards higher CHO utilization during IET after pre-sleep LGI, suggests that such supplementation increases morning CHO availability

Control of the pH for marine microalgae polycultures: A key point for CO2 fixation improvement in intensive cultures

Recently, CO2 recycling for the production of valuable microalgae has acquired substantial interest. Most studies investigating CO2 conversion efficiency in algal cultures were based on single species, although a stabilising effect of algal diversity on biomass production was recently highlighted. However, addition of CO2 into polyalgal cultures requires a careful control of pH; performance of CO2 conversion, growth and carbon biomass production are affected by pH differently, depending on the species of microalgae. This study investigates the efficiency of CO2 conversion by natural marine algal assemblage cultivated in open, land-based raceways (4.5 m3, 10 m2), working as high rate algal ponds (HRAP). Ponds were enriched with nitrogen and phosphate, pure CO2 was added and algal cultures were grown under three different fixed pH levels: pH 6, 7 and 8. The highest conversion of photosynthetically fixed CO2 into carbon biomass (40 %) was reached at pH 7, an intermediate level, due to the partial CO2 asphyxiation of algal predators (copepods, ciliates), while being under the suboptimal conditions for the development of marine amoebae. Under this pH, the theoretical maximal biological conversion of available CO2 into carbon biomass was estimated to be 60 % in naturally inoculated open ponds

Les Bouches de Bonifacio durant l’Antiquité

International audienc

Les Bouches de Bonifacio durant l’Antiquité

National audienc