Primary liver cancer is more aggressive in HIV-HCV coinfection than in HCV infection. A prospective study (ANRS CO13 Hepavih and CO12 Cirvir)

OBJECTIVE: Since HAART, primary liver cancer has emerged as an increasing cause of morbidity and mortality in patients with HIV infection. Our aim was to compare characteristics and outcome of primary liver cancer according to HIV status in HCV cirrhotic patients submitted to periodic ultrasonographic surveillance. METHODS: All patients with primary liver cancer and cirrhosis were selected from two prospective cohorts (ANRS CO12 Cirvir, viral cirrhosis, n=1081; ANRS CO13 Hepavih, HIV-HCV coinfection, n=1175). Cirrhosis was diagnosed by liver biopsy in monoHCV group and biopsy and/or non-invasive tests in HIV-HCV group. Ultrasonographic surveillance was performed every 6 months. Diagnosis of primary liver cancer was established according to EASL-AASLD guidelines. RESULTS: Primary liver cancer was diagnosed in 32 patients, 16 in each group, and corresponded to hepatocellular carcinoma in all except for two cholangiocarcinomas in HIV-HCV patients. Ultrasonographic follow-up was similar (median time since last ultrasonographic without focal lesion: 237 days in HIV-HCV group (n=12) versus 208 days in HCV group, NS). At primary liver cancer diagnosis HIV-HCV patients were markedly younger (48 vs. 60 yrs, P<0.001), primary liver cancer was more advanced in HIV-HCV patients (single nodule: 43% vs. 75%, P=0.07; mean diameter of main nodule: 24 vs. 16 mm, P=0.006; portal obstruction: 3 vs. 0). Curative treatment was performed in four HIV-HCV patients versus 11 HCV patients (P=0.017). During follow-up, 10 HIV-HCV patients died versus only one HCV patient (P=0.0005). CONCLUSIONS: This result suggests more aggressiveness for tumors in HIV infected patients and, if confirmed, could result in shortening the length between ultrasonographic examinations

Natural History of Cardiac and Respiratory Involvement, Prognosis and Predictive Factors for Long-Term Survival in Adult Patients with Limb Girdle Muscular Dystrophies Type 2C and 2D

International audienceBackgroundType 2C and 2D limb girdle muscular dystrophies (LGMD) are a group of autosomal recessive limb girdle muscular dystrophies manifested by proximal myopathy, impaired respiratory muscle function and cardiomyopathy. The correlation and the prognostic impact of respiratory and heart impairment are poorly described. We aimed to describe the long-term cardiac and respiratory follow-up of these patients and to determine predictive factors of cardio-respiratory events and mortality in LGMD 2C and 2D.MethodsWe reviewed the charts of 34 LGMD patients, followed from 2005 to 2015, to obtain echocardiographic, respiratory function and sleep recording data. We considered respiratory events (acute respiratory failure, pulmonary sepsis, atelectasis or pneumothorax), cardiac events (acute heart failure, significant cardiac arrhythmia or conduction block, ischemic stroke) and mortality as outcomes of interest for the present analysis.ResultsA total of 21 patients had type 2C LGMD and 13 patients had type 2D. Median age was 30 years [IQR 24–38]. At baseline, median pulmonary vital capacity (VC) was 31% of predicted value [20–40]. Median maximal inspiratory pressure (MIP) was 31 cmH2O [IQR 20.25–39.75]. Median maximal expiratory pressure (MEP) was 30 cm H2O [20–36]. Median left ventricular ejection fraction (LVEF) was 55% [45–64] with 38% of patients with LVEF <50%. Over a median follow-up of 6 years, we observed 38% respiratory events, 14% cardiac events and 20% mortality. Among baseline characteristics, LVEF and left ventricular end diastolic diameter (LVEDD) were associated with mortality, whilst respiratory parameters (VC, MIP, MEP) and the need for home mechanical ventilation (HMV) were associated with respiratory events.ConclusionIn our cohort of severely respiratory impaired type 2C and 2D LGMD, respiratory morbidity was high. Cardiac dysfunction was frequent in particular in LGMD 2C and had an impact on long-term mortality

Alpine Corsica Metamorphic Core Complex

International audienceAlpine Corsica is an example where superficial nonmetamorphic allochtonous units rest upon a highly strained metamorphic complex. Early ductile deformation under high pressure-low temperature (HP-LT) conditions is due to the westward thrusting of oceanic material onto a continental basement as shown by previous studies. New thermobarometric estimates yield minimal peak HP-LT metamorphism conditions of 11 kbar at 400°C. The early deformation is overprinted by a ductile deformation with an eastward sense of shear postdating or contemporaneous with mineral recrystallizations in the greenschist facies conditions. Early compressive thrust contacts are reworked as east dipping ductile normal faults and the less competent units display only eastward shear criteria. The upper units are affected by an extensional brittle deformation, and east dipping brittle normal faults bound to the west the early to middle Miocene Saint-Florent half-graben. The greenschist metamorphic event lasted until 33 Ma, which is contemporaneous with the beginning of the extension in the Liguro-Provençal basin. We interpret the second deformation stage as the result of a ductile extension following the overthickening of the crust due to the westward thrusting. Extension reduces the thickness of the crust so that upper units free from early P-T conditions are brought into close contact with a HP-LT metamorphic core complex. The geometry of the late extension is controlled by that of the early compressive thrust

Gravimétrie hybride : application à l'étude du fonctionnement hydrologique du bassin versant du Strengbach

Mountain hydrosystems contribute to the water supply of populations and ecosystems. The water storage dynamics within such hydrosystems is complex, due to a high variability of water stocks in space and time. The deployment of in situ measurement networks is therefore essential to characterize their hydrological functioning. Gravimetry allows a direct monitoring of water storage variations at an intermediate measurement scale. We have implemented such hybrid gravimetric monitoring combining: (i) a continuous monitoring of gravity variations and (ii) relative measurements on a network of 16 stations over a period covering two hydrological cycles in the Strengbach watershed (Vosges). The observed temporal gravity variations are interpreted using a homogeneous hydro-gravimetric model and a physically based distributed hydrological model. It shows that water storage variations are spatially heterogeneous, and that hybrid gravimetry provides distributed measurements allowing to better constrain physically based distributed hydrological models.Les hydrosystèmes de montagne contribuent à l’approvisionnement en eau des populations et des écosystèmes. La dynamique des stocks d’eau au sein de tels hydrosystèmes est complexe, du fait d’une grande variabilité des stocks d’eau dans l’espace et dans le temps. Le déploiement de réseaux de mesures in situ est donc indispensable pour caractériser leur fonctionnement hydrologique. La gravimétrie permet un suivi direct des variations de stock d’eau à une échelle de mesure intermédiaire. Nous avons mis en oeuvre un tel suivi gravimétrique hybride combinant : (i) un suivi continu des variations de gravité et (ii) des mesures relatives sur un réseau de 16 stations sur une période couvrant deux cycles hydrologiques sur le bassin versant du Strengbach (Vosges). On interprète les variations temporelles de gravité observées à l’aide d’un modèle hydro-gravimétrique homogène, et d’un modèle hydrologique distribué à base physique. On montre ainsi que les variations de stock d’eau sont hétérogènes spatialement, et que la gravimétrie hybride fournie des mesures distribuées permettant de mieux contraindre les modèles hydrologiques distribués à base physique

Gravimétrie hybride : application à l'étude du fonctionnement hydrologique du bassin versant du Strengbach

Mountain hydrosystems contribute to the water supply of populations and ecosystems. The water storage dynamics within such hydrosystems is complex, due to a high variability of water stocks in space and time. The deployment of in situ measurement networks is therefore essential to characterize their hydrological functioning. Gravimetry allows a direct monitoring of water storage variations at an intermediate measurement scale. We have implemented such hybrid gravimetric monitoring combining: (i) a continuous monitoring of gravity variations and (ii) relative measurements on a network of 16 stations over a period covering two hydrological cycles in the Strengbach watershed (Vosges). The observed temporal gravity variations are interpreted using a homogeneous hydro-gravimetric model and a physically based distributed hydrological model. It shows that water storage variations are spatially heterogeneous, and that hybrid gravimetry provides distributed measurements allowing to better constrain physically based distributed hydrological models.Les hydrosystèmes de montagne contribuent à l’approvisionnement en eau des populations et des écosystèmes. La dynamique des stocks d’eau au sein de tels hydrosystèmes est complexe, du fait d’une grande variabilité des stocks d’eau dans l’espace et dans le temps. Le déploiement de réseaux de mesures in situ est donc indispensable pour caractériser leur fonctionnement hydrologique. La gravimétrie permet un suivi direct des variations de stock d’eau à une échelle de mesure intermédiaire. Nous avons mis en oeuvre un tel suivi gravimétrique hybride combinant : (i) un suivi continu des variations de gravité et (ii) des mesures relatives sur un réseau de 16 stations sur une période couvrant deux cycles hydrologiques sur le bassin versant du Strengbach (Vosges). On interprète les variations temporelles de gravité observées à l’aide d’un modèle hydro-gravimétrique homogène, et d’un modèle hydrologique distribué à base physique. On montre ainsi que les variations de stock d’eau sont hétérogènes spatialement, et que la gravimétrie hybride fournie des mesures distribuées permettant de mieux contraindre les modèles hydrologiques distribués à base physique

Hybrid gravimetry : application to the study of the hydrological functionning of the Strengbach catchment

Les hydrosystèmes de montagne contribuent à l’approvisionnement en eau des populations et des écosystèmes. La dynamique des stocks d’eau au sein de tels hydrosystèmes est complexe, du fait d’une grande variabilité des stocks d’eau dans l’espace et dans le temps. Le déploiement de réseaux de mesures in situ est donc indispensable pour caractériser leur fonctionnement hydrologique. La gravimétrie permet un suivi direct des variations de stock d’eau à une échelle de mesure intermédiaire. Nous avons mis en oeuvre un tel suivi gravimétrique hybride combinant : (i) un suivi continu des variations de gravité et (ii) des mesures relatives sur un réseau de 16 stations sur une période couvrant deux cycles hydrologiques sur le bassin versant du Strengbach (Vosges). On interprète les variations temporelles de gravité observées à l’aide d’un modèle hydro-gravimétrique homogène, et d’un modèle hydrologique distribué à base physique. On montre ainsi que les variations de stock d’eau sont hétérogènes spatialement, et que la gravimétrie hybride fournie des mesures distribuées permettant de mieux contraindre les modèles hydrologiques distribués à base physique.Mountain hydrosystems contribute to the water supply of populations and ecosystems. The water storage dynamics within such hydrosystems is complex, due to a high variability of water stocks in space and time. The deployment of in situ measurement networks is therefore essential to characterize their hydrological functioning. Gravimetry allows a direct monitoring of water storage variations at an intermediate measurement scale. We have implemented such hybrid gravimetric monitoring combining: (i) a continuous monitoring of gravity variations and (ii) relative measurements on a network of 16 stations over a period covering two hydrological cycles in the Strengbach watershed (Vosges). The observed temporal gravity variations are interpreted using a homogeneous hydro-gravimetric model and a physically based distributed hydrological model. It shows that water storage variations are spatially heterogeneous, and that hybrid gravimetry provides distributed measurements allowing to better constrain physically based distributed hydrological models

Projet GEOSUD : EQUIPEX GEOSUD Infrastructure d'information spatiale sur les Territoires et l'Environnement

International audiencePrésentation du Projet GEOSUD, Infrastructure d'Information spatiale sur les territoires et l'environnement

UMR TETIS "Territoires, Environnement, Télédétection et Information Spatiale"

International audienc