Skeletal muscle IL-6 regulates muscle substrate utilization and adipose tissue metabolism during recovery from an acute bout of exercise

An acute bout of exercise imposes a major challenge on whole-body metabolism and metabolic adjustments are needed in multiple tissues during recovery to reestablish metabolic homeostasis. It is currently unresolved how this regulation is orchestrated between tissues. This study was undertaken to clarify the role of skeletal muscle derived interleukin 6 (IL-6) in the coordination of the metabolic responses during recovery from acute exercise. Skeletal muscle specific IL-6 knockout (IL-6 MKO) and littermate Control mice were rested or ran on a treadmill for 2h. Plasma, skeletal muscle, liver and adipose tissue were obtained after 6 and 10h of recovery. Non-exercised IL-6 MKO mice had higher plasma lactate and lower plasma non-esterified fatty acids than Controls. The activity of pyruvate dehydrogenase in the active form was, in skeletal muscle, higher in IL-6 MKO mice than Controls in non-exercised mice and 6h after exercise. IL-6 MKO mice had lower glucose transporter 4 protein content in inguinal adipose tissue (WAT) than Control in non-exercised mice and 10h after treadmill running. Epididymal WAT hormone sensitive lipase phosphorylation and inguinal WAT mitogen activated kinase P38 phosphorylation were higher in IL-6 MKO than Control mice 6h after exercise. These findings indicate that skeletal muscle IL-6 may play an important role in the regulation of substrate utilization in skeletal muscle, basal and exercise-induced adaptations in adipose tissue glucose uptake and lipolysis during recovery from exercise. Together this indicates that skeletal muscle IL-6 contributes to reestablishing metabolic homeostasis during recovery from exercise by regulating WAT and skeletal muscle metabolism

Maternal and neonatal outcomes in planned versus emergency cesarean delivery for placenta accreta spectrum: A multinational database study

Introduction: Placenta accreta spectrum (PAS) is a condition often resulting in severe maternal morbidity. Scheduled delivery by an experienced team has been shown to improve maternal outcomes; however, the benefits must be weighed against the risk of iatrogenic prematurity. The aim of this study is to investigate the rates of emergency delivery seen for antenatally suspected PAS and compare the resulting outcomes in the 15 referral centers of the International Society for PAS (IS-PAS). Material and methods: Fifteen centers provided cases between 2008 and 2019. The women included were divided into two groups according to whether they had a planned or an emergency cesarean delivery. Delivery was defined as "planned" when performed at a time and date to suit the team. All the remaining cases were classified as "emergency". Maternal characteristics and neonatal outcomes were compared between the two groups according to gestation at delivery. Results: In all, 356 women were included. Of these, 239 (67%) underwent a planned delivery and 117 (33%) an emergency delivery. Vaginal bleeding was the indication for emergency delivery in 41 of the 117 women (41%). There were no significant differences in terms of blood loss, transfusion rates or major maternal morbidity between planned and emergency deliveries. However, the rate of maternal intensive therapy unit admission was increased with emergency delivery (45% vs 33%, P = .02). Antepartum hemorrhage was the only independent predictor of emergency delivery (aOR: 4.3, 95% confidence interval 2.4-7.7). Emergency delivery due to vaginal bleeding was more frequent with false-positive cases (antenatally suspected but not confirmed as PAS at delivery) and the milder grades of PAS (accreta/increta). The rate of infants experiencing any major neonatal morbidity was 25% at 34+1 to 36+0 weeks and 19% at >36+0 weeks. Conclusions: Emergency delivery in centers of excellence did not increase blood loss, transfusion rates or maternal morbidity. The single greatest risk factor for emergency delivery was antenatal hemorrhage. When adequate expertise and resources are available, to defer delivery in women with no significant antenatal bleeding and no risk factors for pre-term birth until >36+0 weeks can be considered to improve fetal outcomes. Further studies are needed to investigate this fully

Placenta Imaging Workshop 2018 report:Multiscale and multimodal approaches

The Centre for Medical Image Computing (CMIC) at University College London (UCL) hosted a two-day workshop on placenta imaging on April 12th and 13th 2018. The workshop consisted of 10 invited talks, 3 contributed talks, a poster session, a public interaction session and a panel discussion about the future direction of placental imaging. With approximately 50 placental researchers in attendance, the workshop was a platform for engineers, clinicians and medical experts in the field to network and exchange ideas. Attendees had the chance to explore over 20 posters with subjects ranging from the movement of blood within the placenta to the efficient segmentation of fetal MRI using deep learning tools. UCL public engagement specialists also presented a poster, encouraging attendees to learn more about how to engage patients and the public with their research, creating spaces for mutual learning and dialogue

Republication de : Risque périnéal et mesures de protection obstétricale : enquête auprès des professionnels de la naissance

International audienceObjectivesThe main objective was to evaluate the practices declared by birth professionals in the Lorraine region about perineal obstetric protection (any perineal tear combined). The secondary objective was to evaluate prevention measures performed in practice by birth professionals according to the perineal risk subjectively estimated for each obstetric situation.MethodsThis is a practice survey conducted through an anonymous questionnaire distributed to birth professionals (gynecologists, interns, midwife and midwife student) in October 2016. Topics covered concerned maternal, obstetric and fetal risk factors associated with perineal (1st to 4th degrees) lesions and the associated protective measures. A descriptive analysis of the data collected was conducted.ResultsOne hundred and five professionals answered the questionnaire. The identified risk factors were consistent with those highlighted in the literature. Other factors, not known as associated with perineal risk, were cited by professionals (smoking, phototype). If the professional perceived a significant perineal risk, they more frequently practiced an episiotomy (15% vs. 0%, P < 0.001) or considered that the delivery should be performed by an obstetrician (34% vs 8%, P < 0.001).ConclusionThis evaluation shows that birth professionals know the main risk factors for perineal injury. On the other hand, they easily use perineal protection maneuvers (episiotomy for example) without real demonstrated effectiveness.ObjectifsL’objectif de notre étude était de réaliser une évaluation des pratiques déclarées par les professionnels de la naissance de la région Lorraine à propos de la protection périnéale obstétricale (toute déchirure périnéale confondue). L’objectif secondaire était d’évaluer les mesures de prévention réalisées en pratique par les professionnels de la naissance en fonction du risque périnéal subjectivement estimé pour chaque situation obstétricale.MéthodesIl s’agit d’une enquête de pratique réalisée grâce à un questionnaire anonyme distribué aux professionnels de la naissance (gynécologues-obstétriciens, internes de spécialité, sage-femme, étudiants sage-femme) en octobre 2016. Les thèmes abordés concernaient les facteurs de risque maternels, obstétricaux et fœtaux associés aux lésions périnéales (du 1er au 4e degrés) et les mesures de protection associées. Il a été réalisé une analyse descriptive des données recueillies.RésultatsCent cinq professionnels ont répondu au questionnaire. Les facteurs de risque identifiés étaient en accord avec ceux mis en évidence dans la littérature. D’autres facteurs, non connus comme associés à un risque périnéal, étaient cités par les professionnels (tabagisme, phototype). En cas de perception, subjective, par le professionnel d’un risque périnéal important, ils pratiquaient plus fréquemment une épisiotomie (15 % vs 0 %, p < 0,001) ou considéraient que l’accouchement devaient être réalisé par un obstétricien (34 % vs 8 %, p < 0,001).ConclusionCette évaluation montre que les professionnels de la naissance connaissent les principaux facteurs de risque de lésion périnéale. En revanche, ils utilisent facilement des manœuvres de protection périnéale (épisiotomie par exemple) sans réelle efficacité démontrée

Risque périnéal et mesures de protection obstétricale : enquête auprès des professionnels de la naissance

International audienc

Place de l’antibiothérapie en première intention en cas de bartholinite aiguë : à propos d’une série de 33 cas

International audienc

Les complications respiratoires de la drépanocytose chez les enfants: le syndrome thoracique aigu.

The acute chest syndrome (ACS) is one of the most frequent complications of sickle cell disease. It affects mostly young children and counts for one quarter of mortality in the young sickle cell disease (SCD) population. This retrospective study evaluates the impact of ACS among hospitalizations for other complications of SCD in patients at the University Childrens' Hospital Reine Fabiola (Brussels, Belgium) in order to isolate clinical conditions associated with a high risk of ACS development. The medical records of all SCD patients aged up to 18 years admitted for all SCD related acute complications over a period of 13 month have been reviewed. Two patient groups have been formed based on the presence of an ACS within the study period. Epidemiologic data, medical history, the clinical presentation at admission but also blood counts in steady state, at admission and along the hospital stay were compared for a total of 96 hospital stays. There is no difference for age or hemoglobin phenotype between the two major patient groups. Male sex and having had a previous ACS episode in the past were significantly more important in the group of patients hospitalized for ACS. Thoracic pain in an SCD patient who doesn't show typical ACS symptoms should be interpreted as a risk factor for ACS. In conclusion, male sex, medical history of at least one ACS and thoracic pain at hospital admission are associated with high risk of developing ACS.English AbstractJournal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Skeletal muscle IL-6 regulates muscle substrate utilization and adipose tissue metabolism during recovery from an acute bout of exercise - Table 3

<p>Skeletal muscle IL-6 regulates muscle substrate utilization and adipose tissue metabolism during recovery from an acute bout of exercise</p> - Table

PDHa activity (a), PDH^Ser300 phosphorylation (b) PDK4 protein content (c), ACC^Ser212 phosphorylation (d) protein content representative blots of, PDH^Ser232 phosphorylation, PDH^Ser293 phosphorylation, PDH E1α, AMPK^Thr172 phosphorylation, AMPK (e) and HKII, GLUT4, LDHa protein content and ACC2 protein content (f).

<p>in non-exercised mice as well as 6h or 10h after 2h of treadmill running in IL-6 MKO and Control mice. Values are mean ± SE;(n = 9–10). *: significantly different from non-exercised within given genotype (p<0.05), ¤: significantly different from 6h within given genotype (p<0.05), #: significantly different from Control within given time point (p<0.05).</p

iWAT HSL^Ser660 phosphorylation (a), eWAT HSL^Ser660 phosphorylation (b), iWAT P38^Tyr180/182 phosphorylation (c), eWAT P38^Tyr180/182 phosphorylation (d), iWAT GLUT4 protein content (e), iWAT GLUT4 protein content (f), iWAT (g) and eWAT in non-exercised mice as well as 6h or 10h after 2h of treadmill running in d IL-6 MKO and Control mice.

<p>(h) Representative blots of HSL⁵⁶⁵ phosphorylation, HSL, UCP1 and P38 protein content. Values are mean ± SE; (n = 9–10). *: significantly different from non-exercised within given genotype (p<0.05), ¤: significantly different from 6h within given genotype (p<0.05), #: significantly different from Control within given time point (p<0.05).</p