Apolipoprotein B is regulated by gonadotropins and constitutes a predictive biomarker of IVF outcomes

International audienceAbstractBackgroundFollicular fluid (FF) is an important micro-environment influencing oocyte growth, its development competence, and embryo viability. The FF content analysis allows to identify new relevant biomarkers, which could be predictive of in vitro fertilization (IVF) outcomes. Inside ovarian follicle, the amount of FF components from granulosa cells (GC) secretion, could be regulated by gonadotropins, which play a major role in follicle development.MethodsThis prospective study included 61 female undergoing IVF or Intra-cytoplasmic sperm injection (ICSI) procedure. Apolipoprotein B (APOB) concentrations in follicular fluid and APOB gene and protein expression in granulosa cells from reproductively aged women undergoing an in vitro fertilization program were measured. The statistical analyses were performed according to a quartile model based on the amount of APOB level found in FF.ResultsAmounts of APOB were detected in human FF samples (mean ± SD: 244.6 ± 185.9 ng/ml). The odds of obtaining an oocyte in the follicle and a fertilized oocyte increased significantly when APOB level in FF was higher than 112 ng/ml [i.e., including in Quartile Q 2, Q3 and Q4] (p = 0.001; p < 0.001, respectively). The probabilities of obtaining an embryo and a top quality embryo on day 2, were significantly higher if APOB levels were within the ranges of 112 and 330 ng/ml (i.e. in Q2 and Q3) or 112 and 230 ng/ml (i.e. in Q2), respectively (p < 0.001; p = 0.047, respectively). In addition, our experiments in vitro indicated that APOB gene and protein expression, along with APOB content into culture were significantly under-expressed in GC upon stimulation with gonadotropins (follicular stimulating hormone: FSH and/or human chorionic gonadotropin: hCG).ConclusionWe are reporting a positive and statistically significant associations between APOB and oocyte retrieval, oocyte fertilization, and embryo quality. Using an experimental study component, the authors report significant reduced APOB expression and content for luteinized granulosa cells cultured in the presence of gonadotropins

Le tabagisme chez les étudiants de la faculté de médecine et de pharmacie de Dijon

DIJON-BU Médecine Pharmacie (212312103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

External validation of the modified Ottawa score for risk stratification of recurrent cancer-associated thrombosis.

International audienc

Comment on: Influence of empirical double-active combination antimicrobial therapy compared with active monotherapy on mortality in patients with septic shock: a propensity score-adjusted and matched analysis

Lettre à l'éditeur ("Journal of Antimicrobial Chemotherapy" vol. 73, n°6)https://academic.oup.com/jac/article/73/6/1731/486611

Effectiveness of a mobile diabetic retinopathy screening campaign to encourage diabetics to undergo regular ophthalmic follow-up

Aim: To evaluate the effectiveness of a mobile diabetic retinopathy (DR) screening campaign with a non-mydriatic camera to encourage diabetics to undergo a subsequent ophthalmic follow-up. Methods: Diabetic patients who underwent free DR screening with a non-nnydriatic fundus camera were given the recommendation to have an ophthalmic visit, in a time frame suited to the DR stage or in case abnormalities in the macula, the optic nerve or intra-ocular pressure were detected. The photographs were performed by a trained orthoptist. The date of the visit to their ophthalmologist and the report of this consultation were recorded. Results: During 5 annual campaigns, 4,699 diabetics were screened. Of the 1,573 ophthalmic examinations recommended at the screening, 1,241 (79%) were actually conducted. A total of 623 new cases of DR were found in the course of this screening campaign, with a fair concordance between the diagnosis suggested at screening and the examination by the ophthalmologist (K = 0.48). Conclusion: Information and recommendations given during DR screening helped to reintroduce patients to a regular ophthalmic follow-up, at least in the short term. (C) 2014 S. Karger AG, Base

What is epidemiology? Changing definitions of epidemiology 1978-2017.

ContextEpidemiology is a discipline which has evolved with the changes taking place in society and the emergence of new diseases and new discipline related to epidemiology. With these evolutions, it is important to understand epidemiology and to analyse the evolution of content of definitions of epidemiology.ObjectivesThe main objective of this paper was to identify new definitions of epidemiology available since 1978. Secondary objectives were to analyse the content of these definitions, to compare them with those used by Lilienfeld and to determine whether changes have taken place over the last forty years.MethodsA review of grey literature and published literature was conducted to find the definitions of epidemiology written between 1978 and 2017.Results102 definitions of epidemiology were retained. They helped to highlight 20 terms and concepts related to epidemiology. Most of them were already used in the definitions used by Lilienfeld. Five terms were present in more than 50% of definitions from the period 1978 to 2017: "population", "study", "disease", "health" and "distribution". Several developments have occurred: strengthening of the terms "control" and "health" already used, the concept of "disease" was less frequently encountered whereas the concepts "infectious diseases", "mass phenomenon" are no longer used in definitions from 1978 to 2017.ConclusionThis evolution of content of definition of epidemiology is absent from books on epidemiology. A thematic analysis of definitions of epidemiology could be conducted in order to improve our understanding of changes observed

Balance Sheet of Screening for Diabetic Retinopathy With a Mobile Non-Mydriatic Digital Camera in Burgundy, France

Purpose: To assess the economic balance-sheet of screening for diabetic retinopathy (DR) with a mobile non-mydriatic digital camera in Burgundy, France, in a public health and economic perspective.Methods: The 72 lowest medicalised areas of Burgundy were visited. Retinal images were obtained with a non-mydriatic camera. To construct an economic model, we used available data on the prevalence of diabetes in Burgundy, the efficiency of the screening, the number of screened DR, blindness probability according to DR grading, the efficiency of laser therapy, the diabetic characteristics (gender, age, income, professional status and life expectancy) and medical costs induced by our campaign.Results: 3363 diabetics (mean age: 70±11 years) have had an ocular examination for more than 2 years and only 2547 patients were declared eligible (previous medical examination by an ophthalmologist more than 2 years and no RD previously known according to the patient). Among the 3363 patients, only 3 treatable DR and 25 macular oedemas were found. Among eligible patients, neither treatable DR nor macular oedema was found. If we consider only the financial analysis, results showed a cost overrun per patient from Social Security perspective (cost: 97±248 euros; saving i.e. avoided contributions: 49±580 euros) and from societal perspective (cost: 112±57 euros; saving, i.e. avoided loss of income: 6±177 euros).Conclusions: Our study showed the unfavourable balance-sheet of our DR screening sessions. However these results need to be considered in an overall improvement of the quality of life

Detection of temporal clusters of health care-associated infections or colonizations with Pseudomonas aeruginosa.

International audienceWe investigated temporal clusters of Pseudomonas aeruginosa cases between 2005 and 2014 in 1 French university hospital, overall and by ward, using the Kulldorff method. Clusters of positive water samples were also investigated at the whole hospital level. Our results suggest that water outlets are not closely involved in the occurrence of clusters of P aeruginosa cases

Singleton fetal growth kinetics depend on the mode of conception

IF 4.803 (2017)International audienceObjectiveTo study the impact of in vitro fertilization, with or without intracytoplasmic sperm injection (IVF/ICSI), frozen-embryo transfer (FET), and intrauterine insemination (IUI) on fetal growth kinetics throughout pregnancy and to compare the different modes of conception.DesignRetrospective cohort study.Setting University.Patient(s)A total of 560 singleton pregnancies were included (96 IVF, 210 ICSI, 121 FET, and 133 IUI).Intervention(s)None.Main Outcome Measure(s)We compared crown-rump length (CRL) at the first trimester (T1: 11–13 weeks of gestation [WG] + 6 days), estimated fetal weight (EFW) at the second (T2: 21–23 WG + 6 days) and third (T3: 31–33 WG + 6 days) trimesters, and birth weight (BW) z-scores with those in the reference curves (Papageorghiou for T1, and Ego M2 for T2, T3, and birth). Multivariate analyses were performed.Result(s)For T1, the CRL was longer than the reference curve whatever the assisted reproductive technique (ART). For T2, EFW was significantly greater for all groups compared with the reference curve, and for T3 only FET singletons had a greater EFW. ICSI, IVF, and IUI singletons had a significantly lower BW compared with reference curves. For all ART fetuses, growth kinetics differed from T2. Only FET fetuses maintained their significantly above-reference growth values. The proportion of fetuses for which at least one period of growth loss was observed from T2 to birth was higher after IVF, ICSI, and IUI than after FET.Conclusion(s)For the first time, we have highlighted that fetal growth kinetics differed from T2 depending on the ART protocols used. They could have an impact on trophoblastic invasiveness and might lead to long-term health effects