Le suivi pratique des patients sous pression positive continue

The therapeutic follow-up is a decisive factor of the success of a long course treatment by continuous positive airway pressure (CPAP). The effectiveness of this treatment on both symptoms and complications must be regularly verified. Polysomnography with CPAP could be necessary in order to check out the efficacy of this treatment and/or to find an associated diagnosis when symptoms persist, particularly a diurnal drowsiness, which is the main therapeutic target in obstructive sleep apnea syndrome (OSAS). The secondary effects that are likely to compromise the compliance of CPAP treatment must be resolved, particularly the nasal intolerance, which are enhanced by mask leakages and often corrected by using heated humidity with CPAP delivery systems. The efficacy of CPAP on both diurnal drowsiness and hypertension is related to the compliance of this treatment which must be regularly verified, at the same time that the clinical evaluation. The data obtained from the device\u27s memory give information concerning the number of hours day to day, in which the CPAP device was running at the prescribed pressure. The first months with CPAP are decisive to avoid a failure of the treatment at long term. This period must be closely monitored by both the physician and the home care provider. Patients should use the CPAP at least 3–4 h by night and all possible means should be used to obtain a maximal compliance. Therapeutic educational programs could help to reach this goal

Does Characterizing Global Running Pattern Help to Prescribe Individualized Strength Training in Recreational Runners?

This study aimed to determine if concurrent endurance and strength training that matches the global running pattern would be more effective in increasing running economy (RE) than non-matched training. The global running pattern of 37 recreational runners was determined using the Volodalen <sup>®</sup> method as being aerial (AER) or terrestrial (TER). Strength training consisted of endurance running training and either plyometric (PLY) or dynamic weight training (DWT). Runners were randomly assigned to a matched (n = 18; DWT for TER, PLY for AER) or non-matched (n = 19; DWT for AER, PLY for TER) 8 weeks concurrent training program. RE, maximal oxygen uptake V̇O <sub>2</sub> max) and peak treadmill speed at V̇O <sub>2</sub> max (PTS) were measured before and after the training intervention. None of the tested performance related variables depicted a significant group effect or interaction effect between training and grouping (p ≥ 0.436). However, a significant increase in RE, V̇O <sub>2</sub> max, and PTS (p ≤ 0.003) was found after the training intervention. No difference in number of responders between matched and non-matched groups was observed for any of the performance related variables (p ≥ 0.248). In recreational runners, prescribing PLT or DWT according to the global running pattern of individuals, in addition to endurance training, did not lead to greater improvements in RE

Lack of in vivo blockade of Fas- and TNFR1-mediated hepatocyte apoptosis by the hepatitis C virus.

In vitro data have shown that the hepatitis C virus (HCV) core protein binds to protein members of the tumour necrosis factor receptor (TNFR) superfamily. Since this interaction could be relevant to HCV persistence and oncogenesis, this study assessed whether HCV may interfere with the apoptotic cascade in vivo. Apoptosis (by TUNEL) and Fas and TNFR1 expression (by immunohistochemistry) were scored in the liver of 60 chronic hepatitis C patients. Results were compared with the liver disease grading and staging scores and the HCV replication level in serum and liver. Apoptotic hepatocytes were stained in 29 cases. Fas was expressed in 35 cases and TNFR1 in 21, 15 patients (25%) being negative for both receptors. Overall, the numbers of TUNEL-, Fas- and TNFR-positive hepatocytes did not correlate with the extent of intrahepatic CD8+ T-lymphocyte infiltration, the grading and staging of liver disease, or the serum or liver HCV RNA levels. Furthermore, when patients expressing either Fas or TNFR1 were stratified according to serum HCV RNA levels, cases with detectable hepatocyte apoptosis had higher HCV viraemias. In conclusion, an HCV-mediated, in vivo blockade of hepatocyte apoptosis via the Fas- or TNFR1-dependent pathways seems unlikely

Supramolecular Control over the Structural Organization of a Second-Order NLO-active Organogelator

A study of the structural parameters which govern the supramolecular organization of an organogelator built from the Disperse Red moiety is proposed. In particular, the key balance between intermolecular H-bonding and/or π–π interactions is addressed by comparing the effect of a secondary amide vs. an ester linker within the molecular structure. Solution 1H-NMR studies show the superiority of the former interaction in promoting the nanostructuring process, allowing it to reach a gel state in toluene. The nanostructures obtained from both the amide and the ester derivatives were also studied in the solid state. In particular, the use of second-harmonic generation microscopy demonstrates that an anisotropic organization of the material can even be observed in the case of the ester derivative, which demonstrates the efficiency of the tris(alkoxy)benzene unit in directing the self-assembly process, independently of additional H-bond interactions

Mandibular Advancement for Obstructive Sleep Apnea: Dose Effect on Apnea, Long-Term Use and Tolerance

Background: Previous studies have documented an effect of mandibular advancement (MA) on pharyngeal airway size and collapsibility. Objectives: We aimed to describe the course of the apnea-hypopnea index (AHI) and the snoring index (SI) during progressive MA and to evaluate the long-term efficacy, tolerance and usage of MA therapy after progressive MA titration in sleep apnea patients. Methods: Sixty-six patients with obstructive sleep apnea syndrome underwent sequential sleep recordings during progressive MA titration. Long-term effectiveness, compliance and side effects of oral appliance (OA) in the titrated position were evaluated by questionnaires. Results: OA therapy was started at 80% of the maximum MA. Seventy percent of the patients had only one increment in MA with a marked decrease in mean AHI from 36 to 10. In the remaining cases, further increments in MA were associated with a progressive reduction in AHI and an increase in the number of patients responding to treatment. OA in the titrated position resulted in a 70% decrease in AHI, with 54% of patients showing complete responses, 29% partial responses and 17% no response. Daytime sleepiness and quality of life improved, too. Seventeen months after the start of treatment, 82% of the patients declared that they were still using OA almost all nights. Reported side effects including subjective occlusal changes were frequent but mild. Conclusions: Improvement in AHI during OA is dependent on the amount of MA. Sequential sleep recordings facilitate MA titration. Long-term MA therapy in the titrated position is effective and well tolerated. Reported side effects are frequent but mild

Promoting Spontaneous Second Harmonic Generation through Organogelation

An organogelator based on the Disperse Red NLO-phore was synthesized according to a simple and efficient three-step procedure. The supramolecular gel organization leads to xerogels which display a spontaneous second harmonic generation (SHG) response without any need for pre-processing and this SHG activity appears stable over several months. These findings, based on an intrinsic structural approach are supported by favorable intermolecular supramolecular interactions, which promote a locally non-centrosymmetric NLO-active organization. This is in sharp contrast with most materials designed for SHG purposes, which generally require the use of expensive or heavy-to-handle external techniques for managing the dipoles alignment

Paleoenvironmental and diagenetic evolution of the Aptian Pre-Salt succession in Namibe Basin (Onshore Angola)

The Aptian Pre-Salt sedimentary succession cropping out in Cangulo palaeovalley onshore Namibe Basin (Angola) was studied by a combination of field and analytical techniques to constrain the sedimentary and diagenetic evolution of the uppermost sag sequence of the South Atlantic passive margin. Field observations allows definition of four transgressive-regressive cycles characterised by fluvial to tidal-influenced mixed clastic-carbonate and carbonate-dominated deposits, that locally show evidence of evaporite dissolution; highlighting that evaporite deposition started earlier than deposition of the regional South Atlantic Loeme-Bambata evaporite formations. Two separate pre-salt carbonate units have been differentiated within the Cangulo Fm; i) a lower transitional to marginal marine, and ii) a younger upper non-marine freshwater travertine system, that is documented for the first time in the west African margin. Transgressive-regressive cycles control the early diagenesis of the tidal carbonates that include dolomitization due to mixing fluids during transgressions, and karstification due to evaporite dissolution by meteoric water circulation during regressive events. Clastic supply appears to have been completely shut down during carbonate deposition, suggesting major climatic change associated with carbonate deposition. During the lowstand between the two carbonate units, fluid flow through Cangulo palaeovalley was re-established resulting in extensive karstification and formation of a large-scale erosional unconformity that is interpreted to be time equivalent to an intra Chela-Cuvo Fm. event. The top of the studied succession corresponds to the transgressive deposits of the Bambata evaporites that are not preserved in the Cangulo palaeovalley due to its erosion but are regionally developed. The results of this study can be directly linked to along strike age equivalent Pre-Salt successions cropping out in the Namibe, Benguela and Kwanza basins, and directly offshore Angola and Brazil using well and seismic data. These new data shed important new light and constraints on the depositional and diagenetic evolution of the complex Pre-Salt reservoir systems of the South Atlantic, and the depositional and bathymetric setting at the time of onset of the main south Atlantic evaporite deposition.The geology of Cangulo palaeovalley was characterised through a combination of remote sensing mapping (RSM), fieldwork and laboratory analysis. Remote sensing mapping was performed using Equinor-Digitizer2, software, using very high resolution orthorectified satellite imagery, and a digital elevation model (DEM) with a resolution of 1.0 m. RSM and field mapping were supported by the interpretation of stratal relationships directly onto field photopanoramas.We thank Israel Cruz Orosa and Emilio Casciello for fruitful discussion during the development of the present study. Thanks to Equinor Angola and Rafael's camp staff for logistical support during field work, and all involved in the Equinor-Sonangol onshore field work collaboration program in the Namibe, Benguela and Kwanza basins between 2010 and 2014. Thank you to TGS for permission to use line drawing of seismic in Fig. 2. We thank associate editor Laura Tomassetti, Pierre-Alexandre Teboul and an anonymous reviewer who helped improve the quality of the manuscript. Carbon and oxygen isotopic analyses, and electron microprobe analyses were carried out at the Centre Científics i Tecnològics of the Universitat de Barcelona. XRD analyses were carried out in the laboratories of the Geoscience Barcelona (Geo3BCN–CSIC). This research is a contribution of the Group of Dynamics of the Lithosphere (GDL), Geosciences Barcelona (Geo3Bcn), Consejo Superior de Investigaciones Científicas (CSIC), Spain. The project work was sponsored by Equinor (Norway), ALORBE Project (PIE–CSIC–202030E310), FEIBOB project (PGC2018-093903-B-C22) and ORRI Spanish project (PID2021-122467NB-C22). This research is within the framework of the Grups Consolidats de Recerca “Modelització Geodinàmica de la Litosfera” (2017SGR-847) and “Geologia Sedimentària” (SGR-Cat 2021 349)