2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy.

Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI

Molécules antirétrovirales (étude expérimentale de leurs effets sur le métabolisme d'une lignée pré-adipocytaire murine)

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF

Etude de l'évolution du Z-score de l'IMC pendant 5 années après une prise en charge multidisciplinaire institutionnelle d'enfants et d'adolescents obèses (suivi d'une cohorte de 3550 patients pour une période de 17 années d'années d'activité du Centre médical infantile nutritionnel "Les Oiseaux")

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Les Isoformes intestinales et hépatiques des "fatty acid binding proteins" dans le trafic intracellulaire des acides gras et leur expression dans un modèle animal de syndrome métabolique

La consommation excessive de graisses est aujourd hui l une des causes principales de l augmentation de la prévalence des maladies métaboliques. Après leur hydrolyse, les graisses sont absorbées par les entérocytes sous forme d acides gras (AG) et de monoglycérides qui sont pris en charge dans la cellule par de petites protéines cytosoliques, les FABPs. L entérocyte exprime la I- FABP et la L-FABP dont la fonction spécifique dans le trafic intracellulaire des AG est toujours mal connue. Pour appréhender les relations structure-fonction in vivo, la caractérisation immunocytochimique de cellules Cos-1 transfectées exprimant de grandes quantités de FABPs a été réalisée. Ces protéines ciblent l AG vers des sites de métabolisation (mitochondries ou réticulum endoplasmique / appareil de Golgi). Lorsque chaque protéine est exprimée isolément dans la cellule, elle distribue de façon spécifique un analogue fluorescent d AG, suggérant une fonction propre pour chacune. Mais lorsqu elles sont toutes deux présentes, elles coopèrent pour la distribution de l AG dans des régions comparables à celles ciblées par la seule I-FABP suggérant un rôle de sensor pour cette protéine. Ce travail a été poursuivi en montrant que les régulations de l expression de la I-FABP et de la L-FABP différaient dans un modèle de syndrome métabolique induit par un régime riche en fructose chez le rat. Dans ce modèle, nous avons aussi analysé les effets de l apport dans le régime des AG polyinsaturés oméga 3 sur l expression de gènes impliqués dans le métabolisme énergétique et l inflammation. Un rôle spécifique de PPAR delta dans le foie et le cœur a pu être mis en évidence.AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

Effects of omega-3 fatty acids on gene expression in the fructose fed rat, a model of metabolic syndrome

National audienc

Sex-specific association of fatty acid binding protein 2 and microsomal triacylglycerol transfer protein variants with response to dietary lipid changes in the 3-mo Medi-RIVAGE primary intervention study

International audienceBackground: The dietary guidelines targeted at reducing cardiovascular risk lead to largely heterogeneous responses in which genetic determinants are largely involved. Objectives: We evaluated the effect of fatty acid binding protein 2 (FABP2) Ala54Thr and microsomal triacylglycerol transfer protein (MTTP) –493G/T allelic variations on plasma lipid markers, at baseline and on the response to the 3-mo Medi-RIVAGE primary prevention study. Design: Subjects with moderate cardiovascular disease risk (n = 169) were advised to reduce total and saturated dietary fats and to increase intake of monounsaturated and polyunsaturated fats. They were genotyped for FABP2 Ala54Thr and MTTP –493G/T allelic variations, and plasma was processed for cardiovascular risk marker analyses. Results: At baseline, men and women homozygous for Thr54 presented a significant opposite profile for plasma oleic acid (18:1), triacylglycerol-rich lipoprotein (TRL) cholesterol, and TRL phospholipids. In addition, all Thr/Thr men presented higher 18:1 values than did women. For the MTTP –493G/T polymorphism, although all TT subjects presented high apolipoprotein B-48, a genotype x sex interaction was present for palmitic acid, linolenic acid, eicosatrienoic acid, and insulin. The prudent diet clearly improved plasma lipid markers. FABP2 genotype did not interact much with the amplitude of the response. However, for MTTP polymorphism, men homozygous for the T allele displayed a significantly more pronounced response than did men carrying the G allele, which is particularly evident by their larger decrease in the Framingham score. Conclusions: These 2 polymorphic loci are thus differently associated with the baseline lipid markers as well as with the response to nutritional recommendations, but both presented a marked sex-specific profile, with the response to diet being particularly efficient in men homozygous for the MTTP –493T allel

Gender-specific association of FABP2 and MTP variants with response to dietary lipid changes in the 3-mo Medi-RIVAGE primary intervention study

National audienc

Output of liver fatty acid-binding protein (L-FABP) in bile.

International audienceLiver fatty acid-binding protein (L-FABP) is a small cytoplasmic molecule highly expressed in the liver. Since L-FABP exhibits affinities for several biliary components, its presence in bile was explored by Western blotting and competitive ELISA in various mammalian species. A L-FABP-like immunoreactivity was consistently found in both hepatic and gallbladder bile. A close molecular identity between this 14 kDa biliary protein and the purified L-FABP was assessed by immunological analyses and high performance capillary electrophoresis. Pharmacological induction of hepatic L-FABP biosynthesis led to a similar increase in biliary L-FABP levels showing a close relationships between the cytosolic and biliary contents of this protein. Finally, a correlation between the presence of L-FABP in bile and both bile flow and bile acid release was found. These data suggest an output of L-FABP in bile in normal conditions which might be coupled with the physiological release of biliary components

Gender-specific association of FABP2 and MTP variants with response to dietary lipid changes in the 3-mo Medi-RIVAGE primary intervention study

International audienc