Fitness versus fatness: Respective cardiometabolic impacts in children/adolescents and in elderly people

peer reviewedLe sujet adulte d’âge moyen en surpoids ou obèse est caractérisé par une adiposité exagérée, généralement combinée à une aptitude physique cardio-respiratoire déficiente. La pratique régulière d’une activité physique d’endurance améliore le profil de risque cardio-métabolique dans cette tranche d’âge. Le manque d’activité physique chez les adolescents contribue à augmenter leur masse grasse et à induire des anomalies métaboliques, tandis que la sédentarité marquée des sujets âgés peut conduire à un excès de graisse combiné à une fonte musculaire (obésité sarcopénique). Dans ces deux tranches d’âge, les effets néfastes d’un excès de masse grasse (fatness) pourraient être contrecarrés, voire annulés, par la pratique régulière d’exercices musculaires conduisant à une meilleure aptitude physique (fitness). Cet article décrit les relations entre fitness et fatness, et les impacts cardio-métaboliques respectifs de ces deux composantes, d’une part, dans la population jeune ( 60 ans)

Metabolically healthy, but obese subjects. First part: definition, pathophysiology and prevalence

peer reviewedAround 30 to 50% of obese subjects are “metabolically normal” (MHO) whereas numerous nonobese subjects are “metabolically abnormal”. The distribution and function of adipose deposits seem to play a crucial role in explaining this apparent paradox. The aim of this first article is to describe the clinical and biological characteristics that lead to the diagnosis of MHO, attempt to discover the etiopathogenesis of this syndrome and analyze the underlying pathophysiological mechanisms and, finally, to assess the prevalence of the MHO phenotype, which may vary according to the definition used and the population studied.Environ 30 à 50 % des sujets obèses sont « métaboliquement normaux » (MHO metabolically healthy, but obese) alors qu’inversement, nombre de sujets non obèses sont « métaboliquement anormaux ». La topographie et la fonction des dépôts graisseux semblent jouer un rôle déterminant pour expliquer cet apparent paradoxe. Ce premier article vise à présenter les éléments conduisant au diagnostic du phénotype MHO, à tenter d’en cerner l’étiopathogénie et de mieux comprendre sa physiopathologie et, enfin, à analyser la prévalence de ce syndrome, quelque peu différente en fonction de la définition retenue et de la population étudiée

Don't neglect metabolic syndrome.

editorial reviewedThe concept of «metabolic syndrome» was brought to the forefront in the early 2000s in international literature, but this interest seems to have faded somewhat in recent years. However, this constellation of cardiovascular risk factors should not be neglected. Taken individually, they hardly seem problematic, but when they are present within the same individual, they significantly increase the risk of cardiovascular morbidity and mortality. This clinical vignette aims to draw attention to the usefulness of the search for metabolic syndrome in clinical practic.Le concept de «syndrome métabolique» a été mis en avant de la scène au début des années 2000 dans la littérature internationale, mais cet intérêt semble s’être quelque peu estompé au cours des dernières années. Il convient cependant de ne pas négliger cette constellation de facteurs de risque cardiovasculaire qui, pris individuellement, ne paraissent guère problématiques, mais qui, lorsqu’ils co-existent chez une même personne, augmentent sensiblement le risque de morbi-mortalité. Cette vignette clinique a pour but d’attirer l’attention sur l’importance de la recherche d’un syndrome métabolique dans la pratique clinique

Microbiome variation in corals with distinct depth distribution ranges across a shallow-mesophotic gradient (15-85 m)

Mesophotic coral ecosystems (MCEs) are generally poorly studied, and our knowledge of lower MCEs (below 60 m depth) is largely limited to visual surveys. Here, we provide a first detailed assessment of the prokaryotic community associated with scleractinian corals over a depth gradient to the lower mesophotic realm (15-85 m). Specimens of three Caribbean coral species exhibiting differences in their depth distribution ranges (Agaricia grahamae, Madracis pharensis and Stephanocoenia intersepta) were collected with a manned submersible on the island of Cura double dagger ao, and their prokaryotic communities assessed using 16S rRNA gene sequencing analysis. Corals with narrower depth distribution ranges (depth-specialists) were associated with a stable prokaryotic community, whereas corals with a broader niche range (depth-generalists) revealed a higher variability in their prokaryotic community. The observed depth effects match previously described patterns in Symbiodinium depth zonation. This highlights the contribution of structured microbial communities over depth to the coral's ability to colonize a broader depth range.Austrian Science Fund (FWF); Catlin Group Limited; Global Change Institute; Eddie Bauer Grant for Expeditions by The Explorers Club; Marie Curie Fellowship [FP7-299320]; Lise Meitner Program of the Austrian Science Fund (FWF) [M1363-B20]info:eu-repo/semantics/publishedVersio

The F4/AS01B HIV-1 Vaccine Candidate Is Safe and Immunogenic, But Does Not Show Viral Efficacy in Antiretroviral Therapy-Naive, HIV-1-Infected Adults: A Randomized Controlled Trial

The impact of the investigational human immunodeficiency virus type 1 (HIV-1) F4/AS01(B) vaccine on HIV-1 viral load (VL) was evaluated in antiretroviral therapy (ART)-naive HIV-1 infected adults.This phase IIb, observer-blind study (NCT01218113), included ART-naive HIV-1 infected adults aged 18 to 55 years. Participants were randomized to receive 2 (F4/AS01(B)_2 group, N=64) or 3 (F4/AS01(B)_3 group, N=62) doses of F4/AS01(B) or placebo (control group, N=64) at weeks 0, 4, and 28. Efficacy (HIV-1 VL, CD4(+) T-cell count, ART initiation, and HIV-related clinical events), safety, and immunogenicity (antibody and T-cell responses) were evaluated during 48 weeks.At week 48, based on a mixed model, no statistically significant difference in HIV-1 VL change from baseline was demonstrated between F4/AS01(B)_2 and control group (0.073 log(10)copies/mL [97.5% confidence interval (CI): -0.088; 0.235]), or F4/AS01(B)_3 and control group (-0.096 log(10)copies/mL [97.5% CI: -0.257; 0.065]). No differences between groups were observed in HIV-1 VL change, CD4(+) T-cell count, ART initiation, or HIV-related clinical events at intermediate timepoints. Among F4/AS01(B) recipients, the most frequent solicited symptoms were pain at injection site (252/300 doses), fatigue (137/300 doses), myalgia (105/300 doses), and headache (90/300 doses). Twelve serious adverse events were reported in 6 participants; 1 was considered vaccine-related (F4/AS01(B)_2 group: angioedema). F4/AS01(B) induced polyfunctional F4-specific CD4(+) T-cells, but had no significant impact on F4-specific CD8(+) T-cell and anti-F4 antibody levels.F4/AS01(B) had a clinically acceptable safety profile, induced F4-specific CD4(+) T-cell responses, but did not reduce HIV-1 VL, impact CD4(+) T-cells count, delay ART initiation, or prevent HIV-1 related clinical events

EuReCa ONE—27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe

AbstractIntroductionThe aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.MethodsThis was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries.ResultsData on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge.ConclusionThe results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe.EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events

Metabolically healthy, but obese subjects. Second part : prognosis and management

Around 30 to 50 % of obese subjects are « metabolically normal » (MHO) whereas numerous non obese subjects are « metabolically abnormal ». The distribution and the function of adipose depots seem to play a crucial role to explain this apparent discrepancy. In a first paper, we described the clinical and biological characteristics of these MHO individuals, analyzed the underlying pathophysiological mechanisms, and reported the prevalence of this syndrome in the adult population. This second paper aims at assessing the prognosis, especially regarding the risk of diabetes and cardiovascular disease, and at discussing the advantages and disadvantages of a classical therapeutic strategy of obesity among MHO individuals.Environ 30 à 50 % des sujets sont « métaboliquement sains » bien qu’ils soient obèses (MHO pour « Metabolically Healthy, but Obese ») alors qu’inversement, nombre de sujets non obèses sont « métaboliquement anormaux ». La topographie et la fonction des dépôts graisseux semblent jouer un rôle déterminant pour expliquer cette apparente discordance. Nous avons décrit dans un premier article les caractéristiques cliniques, les mécanismes physiopathologiques et la prévalence du syndrome MHO dans la population adulte. Ce second article a pour objectifs d’évaluer le pronostic, notamment en termes de diabète et de risque cardio-vasculaire, et de discuter les avantages et inconvénients d’une prise en charge classique de l’obésité chez ces patients MH

Fitness versus fatness: Pathophysiological aspects and metabolic consequences in non-diabetic adults

peer reviewedL’excès de masse grasse (adiposité), surtout abdominale, induit des effets cardio-métaboliques néfastes, alors que l’exercice musculaire et une bonne aptitude physique exercent globalement une influence favorable. Les effets délétères d’un excès de masse grasse (fatness) pourraient donc être contrecarrés par la pratique régulière d’exercices aboutissant à une bonne forme physique (fitness). Cet article analyse d’abord les différents mécanismes physiopathologiques par lesquels l’exercice physique produit des effets bénéfiques chez la personne avec excès pondéral et fait le distinguo entre la pratique d’une activité physique (exercice musculaire) stricto sensu et aptitude physique (fitness). Ensuite, il décrit les études les plus importantes ayant analysé les relations entre le niveau d’aptitude physique et le degré d’adiposité chez le sujet adulte en surpoids ou obèse non diabétique et leurs influences respectives sur le risque de survenue de troubles métaboliques (syndrome métabolique) et sur la mortalité, en particulier cardiovasculaire