Le théâtre antique d’Orange : un immense chantier au service de la connaissance

International audienc

Effets de l’environnement de vie sur les associations entre déterminants individuels et santé périnatale en Wallonie (Belgique)

Résumé L’association entre les caractéristiques individuelles des mères et la prématurité ou le faible poids à la naissance, tout comme l’effet de l’environnement de vie sur la santé périnatale ont fait l’objet de nombreux travaux. Plus rares sont les études qui se sont penchées sur l’effet que l’environnement de vie pouvait avoir sur l’association entre ces caractéristiques individuelles et la santé périnatale. Dans cet article, nous adoptons une perspective multi-niveaux pour prendre en compte conjointement l’effet de l’environnement de vie et les déterminants individuels des mères sur deux indicateurs de santé périnatale, la prématurité et le faible poids à la naissance en Wallonie. Les analyses portent sur 147 718 naissances vivantes uniques issues de mères qui résidaient en Wallonie de 2010 à 2013. Les variables indépendantes principales sont le niveau d’instruction, le statut professionnel et l’état de cohabitation des mères. Les variables dépendantes sont la prématurité et le faible poids à la naissance. Un indice synthétique des conditions de bien-être (ICBE) est utilisé pour décrire l’environnement de vie et mis en relation avec la prématurité et le faible poids à la naissance grâce à des modèles de régression logistique multivariables à un et plusieurs niveaux. La fréquence de la prématurité et du faible poids s’avère plus élevée dans les communes avec un environnement de vie défavorisé. Les mères ayant un faible niveau d’instruction, n’ayant pas d’activité professionnelle ou déclarant vivre seule courent par ailleurs un risque plus élevé d’accoucher prématurément ou d’avoir un enfant de faible poids à la naissance. Dans les analyses multi-niveaux, les mesures d’association entre les variables socio-économiques de la mère et les deux variables dépendantes restent identiques aux mesures d’association observées dans les régressions classiques. Les conditions de bien-être dans une commune, mesurées par l’ICBE, n’ont pas d’effet additionnel sur les associations entre les caractéristiques socio-économiques de la mère et la prématurité ou le faible poids à la naissance. Abstract The association between the individual characteristics of mothers, preterm birth or low birth weight and the impact of the living environment on perinatal health have been widely studied. Far fewer studies have examined the way the living environment can influence the association between characteristics and perinatal health. In this paper, we adopt a multi-level analysis to simultaneously study the effects of the living environment and the individual characteristics of the mothers on preterm birth and low-birth weight in Wallonia. The study population consists of 147’718 single live births to mothers who resided in Wallonia and delivered between 2010 and 2013. The main independent variables are the mothers’s level of education, their occupational and cohabitation status. The dependent variables are preterm birth and low birth weight. A synthetic index of Well-being condition (ICBE) is used to describe living conditions. The association between these conditions, preterm birth and low birth weight is quantified through multilevel logistic regression models adjusted for mothers’ characteristics. Preterm birth and low birth weight rates are higher in municipalities with a poor living environment. Non-working, single mothers or with low levels of education are at higher risk of delivering a preterm or low birth weight baby. In the multilevel analyses, the association between the socio-economic variables and the two dependent variables is similar to the one observed in the classical regressions (one level-analysis). Well-Being conditions, measured through ICBE, have no additional effect on the association between individual socio-economic characteristics of the mother, preterm birth or low birth weight.&nbsp

Clinical and molecular characterization of 17q21.31 microdeletion syndrome in 14 French patients with mental retardation.

International audienceChromosome 17q21.31 microdeletion was one of the first genomic disorders identified by chromosome microarrays. We report here the clinical and molecular characterization of a new series of 14 French patients with this microdeletion syndrome. The most frequent clinical features were hypotonia, developmental delay and facial dysmorphism, but scaphocephaly, prenatal ischemic infarction and perception deafness were also described. Genotyping of the parents showed that the parent from which the abnormality was inherited carried the H2 inversion polymorphism, confirming that the H2 allele is necessary, but not sufficient to generate the 17q21.31 microdeletion. Previously reported molecular analyses of patients with 17q21.31 microdeletion syndrome defined a 493 kb genomic fragment that was deleted in most patients after taking into account frequent copy number variations in normal controls, but the deleted interval was significantly smaller (205 kb) in one of our patients, encompassing only the MAPT, STH and KIAA1267 genes. As this patient presents the classical phenotype of 17q21.31 syndrome, these data make it possible to define a new minimal critical region of 160.8 kb, strengthening the evidence for involvement of the MAPT gene in this syndrome

Race-free estimated glomerular filtration rate equation in kidney transplant recipients:development and validation study

OBJECTIVE: To compare the performance of a newly developed race-free kidney recipient specific glomerular filtration rate (GFR) equation with the three current main equations for measuring GFR in kidney transplant recipients.DESIGN: Development and validation study SETTING: 17 cohorts in Europe, the United States, and Australia (14 transplant centres, three clinical trials).PARTICIPANTS: 15 489 adults (3622 in development cohort (Necker, Saint Louis, and Toulouse hospitals, France), 11 867 in multiple external validation cohorts) who received kidney transplants between 1 January 2000 and 1 January 2021.MAIN OUTCOME MEASURE: The main outcome measure was GFR, measured according to local practice. Performance of the GFR equations was assessed using P 30 (proportion of estimated GFR (eGFR) within 30% of measured GFR (mGFR)) and correct classification (agreement between eGFR and mGFR according to GFR stages). The race-free equation, based on creatinine level, age, and sex, was developed using additive and multiplicative linear regressions, and its performance was compared with the three current main GFR equations: Modification of Diet in Renal Disease (MDRD) equation, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2009 equation, and race-free CKD-EPI 2021 equation. RESULTS: The study included 15 489 participants, with 50 464 mGFR and eGFR values. The mean GFR was 53.18 mL/min/1.73m 2 (SD 17.23) in the development cohort and 55.90 mL/min/1.73m 2 (19.69) in the external validation cohorts. Among the current GFR equations, the race-free CKD-EPI 2021 equation showed the lowest performance compared with the MDRD and CKD-EPI 2009 equations. When race was included in the kidney recipient specific GFR equation, performance did not increase. The race-free kidney recipient specific GFR equation showed significantly improved performance compared with the race-free CKD-EPI 2021 equation and performed well in the external validation cohorts (P 30 ranging from 73.0% to 91.3%). The race-free kidney recipient specific GFR equation performed well in several subpopulations of kidney transplant recipients stratified by race (P 30 73.0-91.3%), sex (72.7-91.4%), age (70.3-92.0%), body mass index (64.5-100%), donor type (58.5-92.9%), donor age (68.3-94.3%), treatment (78.5-85.2%), creatinine level (72.8-91.3%), GFR measurement method (73.0-91.3%), and timing of GFR measurement post-transplant (72.9-95.5%). An online application was developed that estimates GFR based on recipient's creatinine level, age, and sex (https://transplant-prediction-system.shinyapps.io/eGFR_equation_KTX/). CONCLUSION: A new race-free kidney recipient specific GFR equation was developed and validated using multiple, large, international cohorts of kidney transplant recipients. The equation showed high accuracy and outperformed the race-free CKD-EPI 2021 equation that was developed in individuals with native kidneys.TRIAL REGISTRATION: ClinicalTrials.gov NCT05229939.</p

ORANGE « PCR Architecture, technique et décor du théâtre antique »

International audienc

Analyse des comorbidités chez les patients hospitalisés pour un accident vasculaire cérébral ischémique et leurs influences sur la létalité

Objectives: The aim of the study consists of analyzing the comorbidities of acute ischemic stroke and those influencing its hospital lethality. Methods: We considered patients from Wallonia aged 25 years or more and admitted to a Belgian hospital for an acute ischemic stroke in 2013 and 2014. The analyzed medico-administrative data are taken from the Minimum Hospital Summary. A factorial correspondence analysis (FCA) was used to demonstrate the comorbidities profiles. A logistic regression was used to analyse the comorbidities influencing hospital lethality by ischemic stroke. Results: The stroke risk factors vary according to the age. Cardiac problems are more common in older people aged 85 years or more. High blood pressure, hypercholesterolemia and diabetes are more present between 65- and 84-year-olds. Overweight is more present between 55 and 74-year-olds. People who are addicted to alcohol or tobacco are often 65 years or younger. The logistic regression showed that age and heart problems are the risk factors that increase lethality. However there is a lethality diminution in the presence of high blood pressure, hypercholesterolemia, overweight and addiction to alcohol or tobacco. Conclusion: This study demonstrates that medico-administrative databases and factorial statistical methods are perfectly adapted to confirm the ischemic stroke risk factors. This type of study will allow to target with more precision the secondary and tertiary prevention actions of stroke.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

ORANGE « PCR Architecture, technique et décor du théâtre antique »

International audienc

ORANGE PCR « Théâtre antique »

International audienc