Conseil contraceptif en psychiatrie : impact des facteurs sociodémographiques et médicaux pouvant influencer le conseil contraceptif chez cent patientes suivies en centre médico-psychologique d’Île de France

The contraceptive advice involves regular intervention of a general practitioner or a gynecologist. It is bordered by the recommendations of the HAS (2013) and must be adapted, personalized and chosen by the patient.The aim of our study was to observe the demographic and medical characteristics involved in the choice of a contraception in patients with psychiatric disease and reveal the specifics of contraceptive advice in these patients.Of the 100 patients interviewed, 43 have a contraception (against 90 in the general population).Sociodemographic factors as: eligibility to a Disability Allowance or a measure of legal protection, appear to be related to lower rates of contraception and show impaired autonomy of these patients. Medical factors as suffering from schizophrenia and personality disorders are associated with lower rates of contraception compared to other psychiatric disorders.The most chosen contraceptions are the intrauterine device and the contraceptive implant. They are more used than in the general population and seem suitable for these patients suffering from difficulties with adherence. They are here routinely prescribed by gynecologists, whitch rises questions on the practices of general practitioners.Lack of contraception is often due to a lack of information.Therefore, general practitioners, and gynecologists, must know the medical, demographic and behavioral characteristics of their patients provide an appropriate contraceptive advice whithin dedicated consultations.Le conseil contraceptif implique régulièrement l’intervention d’un médecin généraliste ou d’un gynécologue. Il est encadré par des recommandations de la HAS (2013) et doit être adapté, personnalisé et choisi par la patiente.L’objectif de l’étude est d’observer les caractéristiques sociodémographiques et médicales influençant la contraception chez des patientes atteintes d’une pathologie psychiatrique et de révéler les spécificités du conseil contraceptif chez elles.Sur les 100 patientes interrogées, 43 prennent une contraception (contre 90 en population générale).Les facteurs sociodémographiques comme bénéficier d’une Allocation Adulte Handicapé ou d’une mesure de protection juridiques, semblent liés à un plus faible taux de contraception et témoignent d’une altération de l’autonomie. Les facteurs médicaux comme souffrir de schizophrénie et de trouble de la personnalité sont associés à un taux de contraception plus bas par rapport aux autres pathologies psychiatriques.Les contraceptions les plus souvent choisies sont le dispositif intra utérin et l’implant contraceptif. Ils sont plus utilisés qu’en population générale et semblent adaptés à ces patientes souffrant de difficultés d’observance. Ils sont, ici, systématiquement prescrits par les gynécologues. Cela questionne sur les pratiques des médecins généralistes. L’absence de contraception est souvent liée à un manque d’information.Le médecin généraliste, comme le gynécologue, doit connaître les spécificités médicales, sociodémographiques et comportementales de ses patientes

Apprendre aux étudiants paramédicaux à collaborer : dynamique et continuum de pratiques collaboratives dans un dispositif de formation.

International audienceL'évolution des besoins en santé de la population implique aujourd'hui pour les acteurs du domaine médico-social un changement des pratiques professionnelles tournées vers la collaboration. Cela demande de repenser les formations initiales en santé pour permettre aux jeunes professionnels de s'adapter à ces nouvelles pratiques de terrain. C'est pourquoi, l'Institut de Formation en Pédicurie-podologie, Ergothérapie et Kinésithérapie (IFPEK) de Rennes a mis en place un dispositif de formation à la collaboration interprofessionnelle. Cette recherche analyse l'impact de ce dispositif sur la professionnalité émergente de 181 étudiants pédicure-podologues, ergothérapeutes et kinésithérapeutes, notamment dans leur capacité à mettre en place des interactions dans le cadre d'un travail collaboratif. Dix entretiens semi-directifs auprès de ces étudiants ainsi que des observations directes lors de la formation ont été menés. En s'appuyant sur le modèle canadien du « Continuum des pratiques de collaboration en santé et service sociaux », les résultats montrent qu'une grande majorité des étudiants s'orientent spontanément vers des pratiques collaboratives mais que leurs interactions sont parfois insuffisantes pour répondre aux problématiques de santé les plus complexes

Strictosidine activation in Apocynaceae: towards a "nuclear time bomb"?

<p>Abstract</p> <p>Background</p> <p>The first two enzymatic steps of monoterpene indole alkaloid (MIA) biosynthetic pathway are catalysed by strictosidine synthase (STR) that condensates tryptamine and secologanin to form strictosidine and by strictosidine β-D-glucosidase (SGD) that subsequently hydrolyses the glucose moiety of strictosidine. The resulting unstable aglycon is rapidly converted into a highly reactive dialdehyde, from which more than 2,000 MIAs are derived. Many studies were conducted to elucidate the biosynthesis and regulation of pharmacologically valuable MIAs such as vinblastine and vincristine in <it>Catharanthus roseus </it>or ajmaline in <it>Rauvolfia serpentina</it>. However, very few reports focused on the MIA physiological functions.</p> <p>Results</p> <p>In this study we showed that a strictosidine pool existed <it>in planta </it>and that the strictosidine deglucosylation product(s) was (were) specifically responsible for <it>in vitro </it>protein cross-linking and precipitation suggesting a potential role for strictosidine activation in plant defence. The spatial feasibility of such an activation process was evaluated <it>in planta</it>. On the one hand, <it>in situ </it>hybridisation studies showed that CrSTR and CrSGD were coexpressed in the epidermal first barrier of <it>C. roseus </it>aerial organs. However, a combination of GFP-imaging, bimolecular fluorescence complementation and electromobility shift-zymogram experiments revealed that STR from both <it>C. roseus </it>and <it>R. serpentina </it>were localised to the vacuole whereas SGD from both species were shown to accumulate as highly stable supramolecular aggregates within the nucleus. Deletion and fusion studies allowed us to identify and to demonstrate the functionality of CrSTR and CrSGD targeting sequences.</p> <p>Conclusions</p> <p>A spatial model was drawn to explain the role of the subcellular sequestration of STR and SGD to control the MIA metabolic flux under normal physiological conditions. The model also illustrates the possible mechanism of massive activation of the strictosidine vacuolar pool upon enzyme-substrate reunion occurring during potential herbivore feeding constituting a so-called "nuclear time bomb" in reference to the "mustard oil bomb" commonly used to describe the myrosinase-glucosinolate defence system in Brassicaceae.</p

Cellular and Subcellular Compartmentation of the 2C-Methyl-D-Erythritol 4-Phosphate Pathway in the Madagascar Periwinkle

The Madagascar periwinkle (Catharanthus roseus) synthesizes the highly valuable monoterpene indole alkaloids (MIAs) through a long metabolic route initiated by the 2C-methyl-D-erythritol 4-phosphate (MEP) pathway. In leaves, a complex compartmentation of the MIA biosynthetic pathway occurs at both the cellular and subcellular levels, notably for some gene products of the MEP pathway. To get a complete overview of the pathway organization, we cloned four genes encoding missing enzymes involved in the MEP pathway before conducting a systematic analysis of transcript distribution and protein subcellular localization. RNA in situ hybridization revealed that all MEP pathway genes were coordinately and mainly expressed in internal phloem-associated parenchyma of young leaves, reinforcing the role of this tissue in MIA biosynthesis. At the subcellular level, transient cell transformation and expression of fluorescent protein fusions showed that all MEP pathway enzymes were targeted to plastids. Surprisingly, two isoforms of 1-deoxy-D-xylulose 5-phosphate synthase and 1-deoxy-D-xylulose 5-phosphate reductoisomerase initially exhibited an artifactual aggregated pattern of localization due to high protein accumulation. Immunogold combined with transmission electron microscopy, transient transformations performed with a low amount of transforming DNA and fusion/deletion experiments established that both enzymes were rather diffuse in stroma and stromules of plastids as also observed for the last six enzymes of the pathway. Taken together, these results provide new insights into a potential role of stromules in enhancing MIA precursor exchange with other cell compartments to favor metabolic fluxes towards the MIA biosynthesis

A single gene encodes isopentenyl diphosphate isomerase isoforms targeted to plastids, mitochondria and peroxisomes in Catharanthus roseus

Isopentenyl diphosphate isomerases (IDI) catalyze the interconversion of the two isoprenoid universal C5 units, isopentenyl diphosphate and dimethylally diphosphate, to allow the biosynthesis of the large variety of isoprenoids including both primary and specialized metabolites. This isomerisation is usually performed by two distinct IDI isoforms located either in plastids/peroxisomes or mitochondria/peroxisomes as recently established in Arabidopsis thaliana mainly accumulating primary isoprenoids. By contrast, almost nothing is known in plants accumulating specialized isoprenoids. Here we report the cloning and functional validation of an IDI encoding cDNA (CrIDI1) from Catharanthus roseus that produces high amount of monoterpenoid indole alkaloids. The corresponding gene is expressed in all organs including roots, flowers and young leaves where transcripts have been detected in internal phloem parenchyma and epidermis. The CrIDI1 gene also produces long and short transcripts giving rise to corresponding proteins with and without a N-terminal transit peptide (TP), respectively. Expression of green fluorescent protein fusions revealed that the long isoform is targeted to both plastids and mitochondria with an apparent similar efficiency. Deletion/fusion experiments established that the first 18-residues of the N-terminal TP are solely responsible of the mitochondria targeting while the entire 77-residue long TP is needed for an additional plastid localization. The short isoform is targeted to peroxisomes in agreement with the presence of peroxisome targeting sequence at its C-terminal end. This complex plastid/mitochondria/peroxisomes triple targeting occurring in C. roseus producing specialized isoprenoid secondary metabolites is somehow different from the situation observed in A. thaliana mainly producing housekeeping isoprenoid metabolites.This work was financially supported by the “Ministère de l’Enseignement Supérieur et de la Recherche” (MESR) and by a grant from the University of Tours. Grégory Guirimand and Anthony Guihur were financed by MESR fellowships.Peer reviewe

Triple subcellular targeting of isopentenyl diphosphate isomerases encoded by a single gene

Isopentenyl diphosphate isomerase (IDI) is a key enzyme of the isoprenoid pathway, catalyzing the interconversion of isopentenyl diphosphate and dimethylallyl diphosphate, the universal precursors of all isoprenoids. In plants, several subcellular compartments, including cytosol/ER, peroxisomes, mitochondria and plastids, are involved in isoprenoid biosynthesis. Here, we report on the unique triple targeting of two Catharanthus roseus IDI isoforms encoded by a single gene (CrIDI1). The triple localization of CrIDI1 in mitochondria, plastids and peroxisomes is explained by alternative transcription initiation of CrIDI1, by the specificity of a bifunctional N-terminal mitochondria/plastid transit peptide and by the presence of a C-terminal peroxisomal targeting signal. Moreover, bimolecular fluorescence complementation assays revealed self-interactions suggesting that the IDI likely acts as a multimer in vivo.Peer reviewe

Oncology Section EDGE Task Force on Cancer: Measures of Cancer-Related Fatigue—A Systematic Review

Background: Cancer-related fatigue (CRF) is one of the most common side effects of cancer and cancer treatment. Being able to accurately screen for and assess CRF will improve access to and prescriptions for interventions. Valid and reliable measures to screen for and assess CRF need to be identified. Purpose: To identify and recommend reliable, valid, and clinically useful tools to screen for and assess CRF among those treated for cancer. Methods: A systematic review of the literature was conducted to assess the published psychometric properties and clinical feasibility of each method identified. Task force members independently reviewed each measure using the Cancer EDGE Rating Form. Results: Review of 136 studies resulted in recommendations for 14 questionnaires. Five unidimensional and 9 multidimensional questionnaires are recommended by the Oncology EDGE Task Force. Conclusion: The 10-point Numeric Rating Scale for Fatigue is best as a screening tool, whereas the Multidimensional Fatigue Symptom Inventory is a highly recommended multidimensional tool. Ease of screening can promote referral for interventions, whereas thorough assessment drives appropriate interventions

A perspective on Hypericum perforatum Genetic transformation

Hypericum perforatum (St John's wort) is a reservoir of diverse classes of biologically active and high value secondary metabolites, which captured the interest of both researchers and the pharmaceutical industry alike. Several studies and clinical trials have shown that H. perforatum extracts possess an astounding array of pharmacological properties. These properties include antidepressant, anti-inflammatory, antiviral, anti-cancer, and antibacterial activities; and are largely attributed to the naphtodianthrones and xanthones found in the genus. Hence, improving their production via genetic manipulation is an important strategy. In spite of the presence of contemporary genome editing tools, genetic improvement of this genus remains challenging without robust transformation methods in place. In the recent past, we found that H. perforatum remains recalcitrant to Agrobacterium tumefaciens mediated transformation partly due to the induction of plant defense responses coming into play. However, H. perforatum transformation is possible via a non-biological method, biolistic bombardment. Some research groups have observed the induction of hairy roots in H. perforatum after Agrobacterium rhizogenes co-cultivation. In this review, we aim at updating the available methods for regeneration and transformation of H. perforatum. In addition, we also propose a brief perspective on certain novel strategies to improve transformation efficiency in order to meet the demands of the pharmaceutical industry via metabolic engineering.GF and PS are financed from the BIOTALENT project (GA621321) funded by the European Union Seventh Framework Programme (FP7) ERA Chairs Pilot Call and co-financed by funds allocated for education through project no W26/7.PR/2015 [GA 3413/7.PR/2015/2] for the years 2015-2019. This work was partially supported by Fundacao para a Ciencia e a Tecnologia (FCT) project (PTDC/AGR-GPL/119211/2010). WEE acknowledges the financial support provided by the FCT (SFRH/BD/52561/2014), under the Doctoral Programme "Agricultural Production Chains-from fork to farm" (PD/00122/2012).info:eu-repo/semantics/publishedVersio

Consolidated bioprocessing of corn cob-derived hemicellulose: engineered industrial Saccharomyces cerevisiae as efficient whole cell biocatalysts

Background Consolidated bioprocessing, which combines saccharolytic and fermentative abilities in a single microorganism, is receiving increased attention to decrease environmental and economic costs in lignocellulosic biorefineries. Nevertheless, the economic viability of lignocellulosic ethanol is also dependent of an efficient utilization of the hemicellulosic fraction, which contains xylose as a major component in concentrations that can reach up to 40% of the total biomass in hardwoods and agricultural residues. This major bottleneck is mainly due to the necessity of chemical/enzymatic treatments to hydrolyze hemicellulose into fermentable sugars and to the fact that xylose is not readily consumed by Saccharomyces cerevisiaethe most used organism for large-scale ethanol production. In this work, industrial S. cerevisiae strains, presenting robust traits such as thermotolerance and improved resistance to inhibitors, were evaluated as hosts for the cell-surface display of hemicellulolytic enzymes and optimized xylose assimilation, aiming at the development of whole-cell biocatalysts for consolidated bioprocessing of corn cob-derived hemicellulose. Results These modifications allowed the direct production of ethanol from non-detoxified hemicellulosic liquor obtained by hydrothermal pretreatment of corn cob, reaching an ethanol titer of 11.1 g/L corresponding to a yield of 0.328 g/g of potential xylose and glucose, without the need for external hydrolytic catalysts. Also, consolidated bioprocessing of pretreated corn cob was found to be more efficient for hemicellulosic ethanol production than simultaneous saccharification and fermentation with addition of commercial hemicellulases. Conclusions These results show the potential of industrial S. cerevisiae strains for the design of whole-cell biocatalysts and paves the way for the development of more efficient consolidated bioprocesses for lignocellulosic biomass valorization, further decreasing environmental and economic costs.This work has been carried out at the Biomass and Bioenergy Research Infrastructure (BBRI)-LISBOA-01-0145-FEDER-022059, supported by Operational Programme for Competitiveness and Internationalization (PORTUGAL2020), by Lisbon Portugal Regional Operational Programme (Lisboa 2020) and by North Portugal Regional Operational Programme (Norte 2020) under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) and has been supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UIDB/04469/2020, the “Contrato-Programa” UIDB/04050/2020, the MIT-Portugal Program (Ph.D. Grant PD/BD/128247/2016 to Joana T. Cunha) and through Project FatVal (POCI-01-0145-FEDER-032506) and BioTecNorte operation (NORTE-01-0145-FEDER-000004) funded by the European Regional Development Fund under the scope of Norte2020 - Programa Operacional Regional do Norte.info:eu-repo/semantics/publishedVersio