Prise en charge des patients douloureux chroniques (analyse de besoins des patients vis-à-vis de leurs médicaments antalgiques)

La douleur chronique et ses conséquences plurielles sur la vie quotidienne des personnes qui en souffrent, nécessitent une prise en charge complexe, personnalisée et adaptée à chaque patient. Une analyse de besoins des patients douloureux chroniques centrée sur leurs médicaments antalgiques a été envisagée à l aide d auto-questionnaires distribués auprès de patients douloureux chroniques (hors douleur cancéreuse) fréquentant différents types d établissements (centres hospitaliers, officines, cabinets médicaux). Le profil des 86 patients ayant répondus à cette enquête est représentatif de la population douloureuse chronique. Les patients expriment un besoin d informations important quant à leurs effets indésirables et à la gestion de leur traitement au quotidien. Ils aimeraient également que les soignants soient plus à l écoute . De plus, ils seraient intéressés par des rencontres entre patients afin d échanger sur les stratégies possibles pour la prise en charge de leur douleur chronique. Plusieurs pistes d actions peuvent être proposées : formations des soignants développant des connaissances professionnelles et des compétences en communication / création d offres éducatives ciblant la problématique des effets indésirables, imaginant des outils d aide à la gestion du traitement au quotidien, associant des séances de groupe et des entretiens individuels, par exemple à l officine / renforcer les offres de soutien et d évaluation des besoins au cours du temps Ces différentes propositions pourraient compléter les offres éducatives existantes. De plus, il semble nécessaire de continuer à renforcer les liens entre les soignants afin d optimiser leur prise en charge.GRENOBLE1-BU Médecine pharm. (385162101) / SudocSudocFranceF

The Cellular Prion Protein PrPc Is Involved in the Proliferation of Epithelial Cells and in the Distribution of Junction-Associated Proteins

BACKGROUND: The physiological function of the ubiquitous cellular prion protein, PrP(c), is still under debate. It was essentially studied in nervous system, but poorly investigated in epithelial cells. We previously reported that PrP(c) is targeted to cell-cell junctions of polarized epithelial cells, where it interacts with c-Src. METHODOLOGY/FINDINGS: We show here that, in cultured human enterocytes and in intestine in vivo, the mature PrP(c) is differentially targeted either to the nucleus in dividing cells or to cell-cell contacts in polarized/differentiated cells. By proteomic analysis, we demonstrate that the junctional PrP(c) interacts with cytoskeleton-associated proteins, such as gamma- and beta-actin, alpha-spectrin, annexin A2, and with the desmosome-associated proteins desmoglein, plakoglobin and desmoplakin. In addition, co-immunoprecipitation experiments revealed complexes associating PrP(c), desmoglein and c-Src in raft domains. Through siRNA strategy, we show that PrP(c) is necessary to complete the process of epithelial cell proliferation and for the sub-cellular distribution of proteins involved in cell architecture and junctions. Moreover, analysis of the architecture of the intestinal epithelium of PrP(c) knock-out mice revealed a net decrease in the size of desmosomal junctions and, without change in the amount of BrdU incorporation, a shortening of the length of intestinal villi. CONCLUSIONS/SIGNIFICANCE: From these results, PrP(c) could be considered as a new partner involved in the balance between proliferation and polarization/differentiation in epithelial cells

Species diversity and biogeography of an ancient frog clade from the Guiana Shield (Anura: Microhylidae: Adelastes, Otophryne, Synapturanus) exhibiting spectacular phenotypic diversification

The outstanding biodiversity of the Guiana Shield has raised many questions about its origins and evolution. Frogs of the genera Adelastes, Otophryne and Synapturanus form an ancient lineage distributed mostly across this region. These genera display strikingly disparate morphologies and life-history traits. Notably, Synapturanus is conspicuously adapted to fossoriality and is the only genus within this group to have dispersed further into Amazonia. Moreover, morphological differences among Synapturanus species suggest different degrees of fossoriality that might be linked to their biogeographical history. Through integrative analysis of genetic, morphometric and acoustic data, we delimited 25 species in this clade, representing a fourfold increase. We found that the entire clade started to diversify ~55 Mya and Synapturanus ~30 Mya. Members of this genus probably dispersed three times out of the Guiana Shield both before and after the Pebas system, a wetland ecosystem occupying most of Western Amazonia during the Miocene. Using a three-dimensional osteological dataset, we characterized a high morphological disparity across the three genera. Within Synapturanus, we further characterized distinct phenotypes that emerged concomitantly with dispersals during the Miocene and possibly represent adaptations to different habitats, such as soils with different physical properties.Peer reviewe

Dietary polyphenol supplementation prevents alterations of spatial navigation in middle-aged mice

Spatial learning and memory deficits associated with hippocampal synaptic plasticity impairments are commonly observed during aging. Besides, the beneficial role of dietary polyphenols has been suggested as potential functional food candidates to prevent this memory decline. Indeed, polyphenols could potentiate the signaling pathways of synaptic plasticity underlying learning and memory. In this study, spatial learning deficits of middle-aged mice were first highlighted and characterized according to their navigation patterns in the Morris water maze task. An eight-week polyphenol-enriched diet, containing a polyphenol-rich extract from grape and blueberry (PEGB; from the Neurophenols Consortium) with high contents of flavonoids, stilbenes and phenolic acids, was then successful in reversing these age-induced effects. The use of spatial strategies was indeed delayed with aging whereas a polyphenol supplementation could promote the occurrence of spatial strategies. These behavioral results were associated with neurobiological changes: while the expression of hippocampal calmodulin kinase II (CaMKII) mRNA levels was reduced in middle-aged animals, the polyphenol-enriched diet could rescue them. Besides, an increased expression of nerve growth neurotrophic factor (NGF) mRNA levels was also observed in supplemented adult and middle-aged mice. Thus these data suggest that supplementation with polyphenols could be an efficient nutritional way to prevent age-induced cognitive decline

Résultats et devenir 10 ans après une transplantation hépatique pour atrésie des voies biliaires (étude unicentrique concernant 280 enfants)

PARIS6-Bibl. St Antoine CHU (751122104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Maladie thromboembolique veineuse familiale et facteur V Leiden hétérozygote (polymorphisme commun ou mutation délétère ?)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

The complete mitochondrial genome of Iphisa elegans (Reptilia: Squamata: Gymnophthalmidae)

International audienc