Un mode de conduite biologique et un niveau élevé d'herbe améliorent la qualité nutritionelle des acides gras de la viande chez l'agneau engraisse au pâturage

This study aimed at comparing the nutritional quality of meat fatty acids (FA) of pasture-fed lambs reared organically or conventionally and offered two levels of herbage availability. Forty eight castrated male lambs of Limousine breed were used in a 2 x 2 experimental design, i.e. production system (Organic –O- vs. Conventional –C-) x level of herbage availability (High vs. Low). The O and C pastures differed in the level of on-pasture mineral N fertilization (0 vs. 100 U. ha-1. year-1) since 10 years. The level of pasture availability was managed to obtain a mean lamb age at slaughter of 5 vs. 6 months in the High and the Low level respectively. GLC analysis of fatty acids from the Longissimus thoracis muscle showed that organic farming system improved the health value of lamb meat by decreasing the level of saturated FA and especially 16:0, thus leading to a higher value of polyunsaturated FA (PUFA) to saturated FA ratio (+15%, P<0.03) and increasing the level of CLA (+18.2%, P< 0.002). The high level of herbage availability led to a better nutritional and health value of meat FA by increasing significantly deposition of n-6 PUFA (+16.3%), n-3 PUFA (+15%) and CLA (+20.2%) in LT muscle to the detriment of saturated FA (-3.4%). In conclusion, the present study confirmed the general interest of pasture-feeding on the nutritional quality of the lamb meat. It showed, for the first time, the beneficial impact of organic farming on the health value of lamb meat FA by favouring deposition of PUFA (compared to saturated FA) and CLA, this effect being reinforced by a high level of pasture availability

Evaluation et prise en charge de l’envahissement mandibulaire dans les carcinomes epidermoïdes de la cavite orale et de l’oropharynx

Objectif : Le but de notre étude est l’évaluation de l’atteinte mandibulaire dans les carcinomes épidermoïdes de la cavité orale et de l’oropharynx. Matériel et méthodes : Il s’agit d’une étude rétrospective à propos de 34 patients colligés sur 6 ans (1999-2004) et ayant un carcinome épidermoïde de la cavité orale et/ou de l’oropharynx avec envahissement mandibulaire confirmé à l’anatomopathologie. L’atteinte mandibulaire a été évaluée par l’examen clinique,  l’orthopantomographie, la tomodensitométrie, et par les constatations peropératoires du chirurgien. Tous les patients ont eu un évidement ganglionnaire, une exérèse tumorale associée à une mandibulectomie segmentaire interruptrice ou conservatrice. Résultats : L’envahissement mandibulaire a été suspecté cliniquement chez 70,5% des patients devant l’adhérence de la tumeur à l’os. Après examen clinique et imagerie, cette atteinte a été diagnostiquée chez 88,2% des patients. Dans 11,8% des cas, l’atteinte n’a été suspectée qu’en peropératoire. L’examen histologique a confirmé l’atteinte osseuse chez tous les patients. La mandibulectomie segmentaire a été pratiquée chez 17 patients devant l’atteinte du canal mandibulaire. Vingt-huit patients ont eu une radiothérapie postopératoire à la dose moyenne de 64 Gy. Les taux de récidive, de métastase et de décès étaient respectivement de 11,7%, 17,6% et 17,6% pour les patients qui ont eu une mandibulectomie segmentaire, et de 23,5%, 17,6% et 23,5% pour ceux qui ont eu une mandibulectomie conservatrice. Par ailleurs, 76,5% et 29,5% des patients ayant eu respectivement une mandibulectomie segmentaire et une mandibulectomie conservatrice avaient une gêne fonctionnelle importante lors de l’alimentation. Conclusion : L’examen clinique, l’imagerie et l’examen peropératoire sont d’un apport capital dans l’évaluation de l’atteinte mandibulaire. Une atteinte épargnant le canal mandibulaire justifie une mandibulectomie conservatrice permettant d’avoir de meilleurs résultats esthétiques et fonctionnels tout en assurant un contrôle carcinologiquement satisfaisant.Mots clés : envahissement mandibulaire, carcinome épidermoïde, cavité orale, oropharynx, mandibulectomie segmentaire, mandibulectomie conservatric

Les cancers de l’orbite etude retrospective à propos de 31 cas

locorégionale rendant le traitement difficile et mutilant. Dans ce travail, nous rapportons notre expérience dans la prise en charge diagnostique et thérapeutique de ces tumeurs. Matériels et méthodes : Notre étude rétrospective a concerné 31 cas de cancers de l’orbite colligés sur 13 ans (1993- 2005). Tous les patients ont bénéficié d’un examen clinique complet, d’une imagerie du massif facial (TDM et/ou IRM) et d’une biopsie de la tumeur. Le traitement a été basé sur la chirurgie, la radiothérapie et/ou la chimiothérapie. Résultats : La symptomatologie clinique était dominée par les signes ophtalmologiques et les algies faciales. L’imagerie a montré dans tous les cas un processus expansif tissulaire à point de départ orbitaire, avec lyse osseuse orbitaire chez 16 patients (51,6%), une extension au massif facial chez 7 patients (22,6%), endocrâniennes chez 6 patients (19,4%) et des formes bilatérales atteignant les deux orbites dans 3 cas (9,7%) l’anatomopathologie montrait une prédominance des lymphomes malins non hodgkiniens (32,3%) et des carcinomes épidermoïdes (32,3%), suivis des rhabdomyosarcomes embryonnaires (19,4 %). Douze patients ont été traités par chirurgie et radiothérapie postopératoire, dix patients par une association radio-chimiothérapie, et neuf autres par une chimiothérapie néo-adjuvante. La survie globale était de 67,8% à 3 ans, 48,4% à 5 ans et 22,6% à 10 ans. Conclusion : Les cancers de l’orbite sont de mauvais pronostic. Un diagnostic précoce et un traitement radical et adapté au type histologique permet d’améliorer la survie et la qualité de vie chez les patients atteints de ces tumeurs.Mots-clés : Orbite, cancer, lymphome, carcinome épidermoïde, rhabdomyosarcom

Prevalence and associated risk factors of Shigella flexneri isolated from drinking water and retail raw foods in Peshawar, Pakistan

This study was designed to investigate the prevalence and associated risk factors of Shigella flexneri isolated from drinking water and retail raw food samples in Peshawar, Pakistan. A total of 1,020 different samples were collected from various areas of Peshawar between January 2016 and May 2017, followed by identification of S. flexneri through biochemical, serological, and 16S rRNA gene sequencing. Potential risk factors associated with the development and spreading of S. flexneri infection were also investigated. Overall, 45 (4.41%) samples were positive for Shigella species. Among these samples, the predominant species was S. flexneri (n = 44) followed by S. boydii (n = 1). Interestingly, S. sonnei and S. dysenteriae isolates were not found in any sample. The isolation rate of S. flexneri in drinking water samples, market raw milk, and fruits/vegetables from Peshawar were 6.47%, 3.5%, and 2.9%, respectively. The phylogenetic reconstruction showed genetic diversity among three clades, as clades I and II have isolates of S. flexneri that were circulating within the drinking water, milk, fruits/vegetables, while clade III isolates were recovered from milk samples. Most of S. flexneri were detected in June to September. Potential risk factors of S. flexneri were water sources contaminated by toilet wastes (p = 0.04), surface water drainage (p = 0.0002), hospital wastes (p = 0.01), unhygienic handling (p < 0.05), and transportation of raw food (p = 0.04). In conclusion, S. flexneri isolates of closely related lineage originating from non-clinical samples might be associated with an increased human risk to shigellosis in Pakistan, as significant numbers of S. flexneri were observed in the drinking water and retail raw food samples. PRACTICAL APPLICATION: This study demonstrated the presence of S. flexneri in drinking water and retail raw food samples which seem to possess a serious threat to public health. Potential sources of food and water contamination should properly be monitored by public health authorities to reduce cases of shigellosis

Circulating adrenomedullin estimates survival and reversibility of organ failure in sepsis: the prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock-1 (AdrenOSS-1) study

Background: Adrenomedullin (ADM) regulates vascular tone and endothelial permeability during sepsis. Levels of circulating biologically active ADM (bio-ADM) show an inverse relationship with blood pressure and a direct relationship with vasopressor requirement. In the present prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock 1 (, AdrenOSS-1) study, we assessed relationships between circulating bio-ADM during the initial intensive care unit (ICU) stay and short-term outcome in order to eventually design a biomarker-guided randomized controlled trial. Methods: AdrenOSS-1 was a prospective observational multinational study. The primary outcome was 28-day mortality. Secondary outcomes included organ failure as defined by Sequential Organ Failure Assessment (SOFA) score, organ support with focus on vasopressor/inotropic use, and need for renal replacement therapy. AdrenOSS-1 included 583 patients admitted to the ICU with sepsis or septic shock. Results: Circulating bio-ADM levels were measured upon admission and at day 2. Median bio-ADM concentration upon admission was 80.5 pg/ml [IQR 41.5-148.1 pg/ml]. Initial SOFA score was 7 [IQR 5-10], and 28-day mortality was 22%. We found marked associations between bio-ADM upon admission and 28-day mortality (unadjusted standardized HR 2.3 [CI 1.9-2.9]; adjusted HR 1.6 [CI 1.1-2.5]) and between bio-ADM levels and SOFA score (p &lt; 0.0001). Need of vasopressor/inotrope, renal replacement therapy, and positive fluid balance were more prevalent in patients with a bio-ADM &gt; 70 pg/ml upon admission than in those with bio-ADM ≤ 70 pg/ml. In patients with bio-ADM &gt; 70 pg/ml upon admission, decrease in bio-ADM below 70 pg/ml at day 2 was associated with recovery of organ function at day 7 and better 28-day outcome (9.5% mortality). By contrast, persistently elevated bio-ADM at day 2 was associated with prolonged organ dysfunction and high 28-day mortality (38.1% mortality, HR 4.9, 95% CI 2.5-9.8). Conclusions: AdrenOSS-1 shows that early levels and rapid changes in bio-ADM estimate short-term outcome in sepsis and septic shock. These data are the backbone of the design of the biomarker-guided AdrenOSS-2 trial. Trial registration: ClinicalTrials.gov, NCT02393781. Registered on March 19, 2015