Le programme RNPC®, une thérapeutique non-médicamenteuse pour la prise en charge des patients atteints de surcharge pondérale

Ces dernières années, de nombreux travaux de recherche ont montré que la répartition des graisses au niveau du corps, plus que leur quantité totale, permettait d’estimer de façon plus fiable les risques liés à l’excès de poids. Les graisses localisées dans la cavité abdominale sont notamment particulièrement néfastes pour la santé. En effet, le tissu adipeux intra-abdominal (ou viscéral) est aujourd’hui reconnu comme un véritable tissu paracrine et endocrine qui secrète de façon continue des molécules potentiellement toxiques pour notre organisme car impliquées dans la genèse de nombreuses pathologies chroniques telles que les maladies cardiovasculaires, le diabète de type 2 et le cancer. La circonférence abdominale est fortement corrélée à la proportion de tissu adipeux viscéral. Le fait que même des personnes ayant un indice de masse corporelle (IMC) normal voient leur risque de mortalité accru à cause d’un périmètre abdominal élevé devrait fortement encourager les médecins à mesurer le tour de taille de tous leurs patients en plus de calculer leur IMC.These last years, many research studies have shown that the distribution of body fat, more than the total amount, enabled to undertake a more reliable assessment of overweight-associated risks. risks. Fats located in the abdominal cavity are particularly detrimental to health. In fact, intraabdominal (or visceral) adipose tissue is today recognized as a true paracrine and endocrine tissue that continuously secretes molecules potentially toxic for our organism because involved in the genesis of many chronic pathologies such as cardiovascular diseases, type 2 diabetes and cancer. Abdominal circumference is highly correlated with the proportion of visceral adipose tissue. The fact that even people with normal body mass index (BMI). Have an increased mortality risk due to their high abdominal perimeter should strongly encourage physicians to measure waist circumference in all their patients in addition to calculating their BMI. Regarding overweight management, French physicians admit lacking time during a consultation as well as expertise in dietetics. The RNPC® centers fully meet physicians’ needs by offering them the alternative to recommend the RNPC® program, specifically designed for patients that their overweight or obesity expose to a major cardiometabolic risk

Plasmodium falciparum Malaria and Atovaquone-Proguanil Treatment Failure

We noticed overrepresentation of atovaquone-proguanil therapeutic failures among Plasmodium falciparum–infected travelers weighing >100 kg. We report here 1 of these cases, which was not due to resistant parasites or impaired drug bioavailability. The follow-up of such patients should be strengthened

Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study.

INTRODUCTION: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. METHODS: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. RESULTS: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. CONCLUSION: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches

Evolution of dispersal strategies and dispersal syndromes in fragmented landscapes

Funded by ERA-Net BiodivERsAPeer reviewedPostprin

Variation in neurosurgical management of traumatic brain injury

Background: Neurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe. Methods: A survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP). Results: The survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30 min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25 mmHg, 18% 30 mmHg, and 17% 20 mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions. Conclusion: Despite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care

Microbiological alteration of egg products during their production process: discovery of early prediction biomarkers

International audienc

Découverte de marqueurs précoces de l'altération microbiologique des ovoproduits par des approches de métabolomique croisée (RMN-spectrométrie de masse)

National audienc

Microbiological alteration of egg products during their production process: discovery of early prediction biomarkers

International audienc

Two scales of inflation at Lastarria-Cordon del Azufre volcanic complex, central Andes, revealed from ASAR-ENVISAT interferometric data

ASAR-ENVISAT Interferometric Synthetic Aperture Radar (InSAR) data collected over the Lastarria-Cordon del Azufre complex (Chile-Argentina) between March 2003 and May 2005 show the persistence of the large wavelength ground inflation revealed by Pritchard and Simons in 2002 from the analysis of ERS InSAR data [Nature 418 (2002) 167-170]. After reducing the tropospheric contribution in the interferograms using a combination of data network adjustment and analysis of MODIS images, we produced an accurate interferometric time series showing a 2 yr long temporal evolution of the ground displacements patterns. Two distinct inflating signals are detected. The main signal covers an elliptical area with a 45 km NNE-SSW major axis and a 37 km minor axis. It is correlated with a regional topographic dome. We estimated its maximum inflation rate to similar to 2.5 cm yr(-1). We inverted the InSAR data for a range of source geometries (spherical, prolate ellipsoids, penny-shaped cracks). The inferred source parameters for 2003-2005 period are consistent with an over-pressured reservoir at shallow to intermediate crustal depths (7-15 km), with an average volumetric rate of inflation of about 14 x 10(6) m(3) yr(-1). In addition to this main signal a new feature highlighted by the ASAR data is short wavelength inflation (6 km wide) at the location of Lastarria volcano on the northern margin of the large wavelength signal. We explain this short wavelength signal by a spherical over-pressured source lying 1000 m below the summit of Lastarria volcano. We estimate the average volumetric rate of inflation during the observation period to be similar to 35 x 10(3) m(3) yr(-1). It is remarkable that both volumetric variations for the large and small inflations exhibit the same evolution during the 2003-2005 period, suggesting that both processes could be related. On the basis of the inversion results and of arguments provided by field evidences and a morpho-structural analysis of the Digital Elevation Model of the area, we propose that the deep source have a magmatic origin while the shallow source is most likely related to hydrothermal fluids. In our interpretation, the on-going deformation processes observed at Lastarria-Cordon del Azufre volcanic complex could represent an evolving pre-caldera silicic system. Further field geological and geophysical investigations will be required to confirm these hypotheses and refine the proposed model, mostly based on satellite observations