Anorexia nervosa and nutritional assessment: contribution of body composition measurements

The psychiatric condition of patients suffering from anorexia nervosa (AN) is affected by their nutritional status. An optimal assessment of the nutritional status of patients is fundamental in understanding the relationship between malnutrition and the psychological symptoms. The present review evaluates some of the available methods for measuring body composition in patients with AN. We searched literature in Medline using several key terms relevant to the present review in order to identify papers. Only articles in English or French were reviewed. A brief description is provided for each body composition technique, with its applicability in AN as well as its limitation. All methods of measuring body composition are not yet validated and/or feasible in patients with AN. The present review article proposes a practical approach for selecting the most appropriate methods depending on the setting, (i.e. clinical v. research) and the goal of the assessment (initial v. follow-up) in order to have a more personalised treatment for patients suffering from A

Anorexia nervosa and nutritional assessment: contribution of body composition measurements

article aims at reviewing present knowledge on these topics in order to determine energy requirements for maintaining a neutral energy balance in ALS patients. Maintaining a neutral energy balance prevents malnutrition and its complications and may improve physical functioning, quality of life and survival. Prevalence of malnutrition varies between 16 and 55% in ALS patients. Energy intakes are below recommended dietary allowances in 70% of ALS patients at least. These elements suggest a chronic negative energy balance with an imbalance between requirements and intakes. While insufficient intakes can be compensated with nutritional support, the energy requirements are unclear. Studies generally report hypermetabolism in ALS patients. Estimation of total energy expenditure and as a corollary energy needs, necessitates taking into account this hypermetabolism, physical activity and possibly mechanical ventilation. The review suggests a flow chart for optimal nutritional follow-up in clinics. Further studies are required to assess whether optimal nutritional follow-up improves outcome

Austérité versus protection sociale : comment garantir l’accès aux soins en Europe ?

Maria MelchiorMédecins du Monde agit en Europe depuis 1986, et actuellement dans 14 pays différents à travers 160 programmes qui visent à aider des personnes vulnérables à accéder à des soins et à leurs droits. Depuis 2004, l’association développe un plaidoyer spécifique auprès de divers acteurs européens – le Parlement européen, la Commission européenne, l’Agence de surveillance sanitaire européenne ainsi que le Conseil de l’Europe – pour promouvoir l’accès aux soins de toutes les personnes ..

CLASH: Complete Lensing Analysis of the Largest Cosmic Lens MACS J0717.5+3745 and Surrounding Structures

The galaxy cluster MACS J0717.5+3745 (z=0.55) is the largest known cosmic lens, with complex internal structures seen in deep X-ray, Sunyaev-Zel'dovich effect and dynamical observations. We perform a combined weak and strong lensing analysis with wide-field BVRi'z' Subaru/Suprime-Cam observations and 16-band Hubble Space Telescope observations taken as part of the Cluster Lensing And Supernova survey with Hubble (CLASH). We find consistent weak distortion and magnification measurements of background galaxies, and combine these signals to construct an optimally estimated radial mass profile of the cluster and its surrounding large-scale structure out to 5 Mpc/h. We find consistency between strong-lensing and weak-lensing in the region where these independent data overlap, <500 kpc/h. The two-dimensional weak-lensing map reveals a clear filamentary structure traced by distinct mass halos. We model the lensing shear field with 9 halos, including the main cluster, corresponding to mass peaks detected above 2.5\sigma_\kappa. The total mass of the cluster as determined by the different methods is M_{vir}=(2.8\pm0.4) \times 10^15 M_sun. Although this is the most massive cluster known at z>0.5, in terms of extreme value statistics we conclude that the mass of MACS J0717.5+3745 by itself is not in serious tension with LambdaCDM, representing only a ~2{\sigma} departure above the maximum simulated halo mass at this redshift.Comment: 24 pages, 16 pages, 6 tables; matches version accepted for publication in Ap

Os mártires e a cristianização do território na América portuguesa, séculos XVI e XVII

O artigo investiga um grupo de atores sociais bastante relevante para viabilizar a cristianização na América portuguesa: os mártires cristãos, indivíduos muito especiais, dispostos a regar a terra com seu próprio sangue, de forma a tornar definitiva e irreversível a ocupação cristã do território. Os mártires - e principalmente a narrativa em torno deles - parecem ter sido bastante acionados para integrar a América portuguesa e seus habitantes nativos à temporalidade e territorialidade cristã. Os mártires dos séculos XVI e XVII, principalmente missionários, reeditavam os martírios do início da cristandade, que espalharam o cristianismo rumo a diversas partes do mundo na antiguidade. Dessa forma, viabilizaram a cristianização das novas fronteiras, consagrando o solo com seu sangue divino e viabilizando posteriores processos de urbanização. Além da função estratégica dos mártires para os cristãos, o texto mostra que eles também tiveram significado peculiar na interlocução com as culturas ameríndias, que tinha como um de seus principais personagens o grande guerreiro, disposto a perder seu sangue em prol de seu grupo.This paper looks into a group of social agents who played a significant role in the Christianization of Portuguese America, namely, the Christian martyrs - very special individuals who were ready to wet the land with their own blood in order to make possible a definitive and irreversible occupation of the territory by Christian settlers. The martyrs, and above all the stories told about them, seem to have been called upon to integrate Portuguese America and its native inhabitants into the temporalities and territory of Christendom. Mostly made up of missionaries, this group of 16th and 17th-century martyrs reedited the martyrdom of early Christians, who spread their creed across numerous parts of the Ancient World. They enabled the Christianization of new frontiers by consecrating the soil with their divine blood and paving the way for subsequent processes of urban development. In addition to their strategic significance for Christianity, the text also shows that their martyrdom played a specific role in the Christian settlers' interaction with Amerindian culture, whose main cults included the figure of the great warrior, ever ready to shed his own blood for his group

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Evaluation des connaissances sur l'obésité d'un échantillon de population consultant en médecine générale

L'obésité est une pathologie multi-factorielle, dont la prévalence s'accroît si rapidement actuellement que l'on parle d'une véritable épidémie internationale. En France, actuellement près de 10% de la population présente une obésité, et près de 30% un surpoids. Face à ces chiffres alarmants, une véritable politique de santé publique a été mise en place dans notre pays, afin de mener des actions de prévention. Il s'agit principalement du Programme National Nutrition Santé (P.N.N.S.). Il nous a parut intéressant d'évaluer les connaissances des patients des médecins généralistes, sur l'obésité. Pour cela, nous avons réalisé une enquête, auprès de 150 personnes, dans 8 cabinets de médecins généralistes de la région parisienne. Les résultats de cette étude nous ont montrés, que les patients, quel que soit leur indice de masse corporel (I.M.C.) avaient de nombreuses lacunes concernant ce sujet, et qu'il était important de poursuivre des campagnes d'information et de prévention, pour sensibiliser les français sur l'obésité.ST QUENTIN EN YVELINES-BU (782972101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Anorexia nervosa and nutritional assessment: contribution of body composition measurements

article aims at reviewing present knowledge on these topics in order to determine energy requirements for maintaining a neutral energy balance in ALS patients. Maintaining a neutral energy balance prevents malnutrition and its complications and may improve physical functioning, quality of life and survival. Prevalence of malnutrition varies between 16 and 55% in ALS patients. Energy intakes are below recommended dietary allowances in 70% of ALS patients at least. These elements suggest a chronic negative energy balance with an imbalance between requirements and intakes. While insufficient intakes can be compensated with nutritional support, the energy requirements are unclear. Studies generally report hypermetabolism in ALS patients. Estimation of total energy expenditure and as a corollary energy needs, necessitates taking into account this hypermetabolism, physical activity and possibly mechanical ventilation. The review suggests a flow chart for optimal nutritional follow-up in clinics. Further studies are required to assess whether optimal nutritional follow-up improves outcome

Heart and anorexia nervosa

International audienceAnorexia nervosa, one of the more frequent and severe eating disorders, is a chronic psychiatric disease with potentially serious somatic consequences. This behavioral symptomatology leads to weight loss, undernutrition, and more or less severe-potentially life-threatening-somatic complications including respiratory, hepatic, digestive and cardiac features, electrolyte disturbances, endocrine and bone impairment, immunodepression, and related opportunistic infections. In this review, the authors report an overview of cardiac diseases in this disease