Comparison of the Effectiveness of Four Bariatric Surgery Procedures in Obese Patients with Type 2 Diabetes: A Retrospective Study

Aim. The aim of the present retrospective study was to evaluate the efficacy of four bariatric surgical procedures to induce diabetes remission and lower cardiovascular risk factors in diabetic obese patients. Moreover, the influence of surgery on weight evolution in the diabetic population was compared with that observed in a nondiabetic matched population. Methods. Among 970 patients who were operated on in our center since 2001, 81 patients were identified as type 2 diabetes. Laparoscopic adjustable gastric banding (GB), intervention type Mason (MA), gastric bypass (RYGB), and sleeve gastrectomy (SG) were performed, respectively, in 25%, 17%, 28%, and 30% of this diabetic population. Results. The resolution rate of diabetes one year after surgery was significantly higher after SG than GB (62.5% versus 20%, P < 0.01), but not significantly different between SG and RYGB. In terms of LDL-cholesterol reduction, RYGB was equivalent to SG and superior to CGMA or GB. Considering the other cardiovascular risk factors, there was no significant difference according to surgical procedures. The weight loss was not statistically different between diabetic and nondiabetic matched patients regardless of the surgical procedures used. Conclusion. Our data confirm that the efficacy of surgery to treat diabetes is variable among the diverse procedures and SG might be an interesting option in this context

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

RECHERCHE D'UN EFFET PROTECTEUR DE LA BETA-STIMULATION SUR LE COEUR ISOLE DE RAT TRAVAILLANT EN ISOVOLUMETRIE (IMPLICATION DES RECEPTEURS BETA-1 ET BETA-2-ADRENERGIQUES (DOCTORAT : PHARMACOLOGIE))

REIMS-BU Santé (514542104) / SudocPARIS-BIUM (751062103) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF

Sélection et caractérisation de souches de Carnobacterium pour la biopréservation du saumon fumé

Afin de développer une stratégie de biopréservation du saumon fumé envers Listeria monocytogenes, la capacité d'inhibition de 3 souches de Carnobacterium isolées de poisson et productrices de bactériocine a été testée. C. divergens V41 maintient le niveau de Listeria à moins de 50 UFC/g dans le saumon fumé stérile pendant 28 jours à 4 et 8C grâce à l'action de la divercine V41. Pour son utilisation dans le produit, la culture de la souche a été optimisée sur un milieu sans protéine animale. Sur saumon fumé commercial, la souche inhibe légèrement les flores endogènes et n'altère pas la qualité sensorielle mais elle produit une amine biogène, la tyramine. Un mutant tyramine négatif a été obtenu par mutagenèse chimique. Sa caractérisation a montré qu'il ne possède pas d'activité enzymatique du fait de la présence d'une mutation stable dans le gène de structure de la tyrosine décarboxylase (1863 pb). Le mutant C. divergens V41A8 a les caractéristiques d'un bon agent de biopréservation.In order to develop a biopreservation strategy in cold-smoked salmon, the inhibitory capacity of 3 bacteriocin-producing Carnobacterium strains isolated from fish have been tested towards Listeria monocytogenes strains. C. divergens V41 maintains the level of Listeria below 50 CFU/g in sterile cold-smoked salmon during the 28 days of vacuum storage at 4 and 8C, thanks to the divercin V41 action. For its use in the product, the culture of the strain was optimized in a growth medium without animal protein. On commercial cold-smoked salmon slices, the strain inhibits slightly the endogenous microflora and doesn't modify the sensorial quality, but it produces tyramine, a biogenic amine. A non-producing tyramine mutant was obtained by chemical mutagenesis. This mutant was characterized and showed no enzymatic activity due to a stable mutation in the structural gene of tyrosine decarboxylase (1863 bp). The mutant C. divergens V41A8 has the characteristics of a good biopreservation agent.NANTES-BU Sciences (441092104) / SudocSudocFranceF

La divercine V41, une bactériocine de classe IIa produite par Carnobacterium divergens V41 (développement d'outils moléculaires et expression hétérologue chez E. coli)

Carnobacterium divergens V41, qui inhibe Listeria monocytogenes dans le saumon fumé, produit la divercine V41. Dans l'objectif d'étudier cette bactériocine de classe IIa, différents outils ont été mis en place. La production d'anticorps polyclonaux contre la divercine V41 a permis sa détection spécifique et sensible ainsi que sa purification par immunoaffinité. L'isolement d'une souche mutante de C. divergens V41 (C. divergens V41C9) a permis de démontrer que l'inhibition de L. monocytogenes dans le saumon fumé par C. divergens V41 était due à la divercine V41. L'analyse statistique du spectre d'action des bactériocines de classe IIa a mis en évidence la corrélation entre leur nombre de ponts disulfures et leur spectre d'activité. Un système d'expression hétérologue de la divercine V41 dans E. coli à partir d'un gène synthétique a été développé avec succès. La divercine V41 recombinante dont les deux ponts disulfures sont reformés est pure, soluble et active contre Listeria.Carnobacterium divergens V41 which inhibits Listeria monocytogenes in smoked salmon, produces divercine V41. To study this class IIa bacteriocin, various tools were set up. Polyclonal antibodies generated against divercin V41 allowed its specific and significant detection and its purification by immunoaffinity. A mutant strain of C. divergens V41 (C. divergens V41C9) showed that L. monocytogenes inhibition in salmon smoked by C. divergens V41 was due to divercin V41. Statistical analysis of inhibition spectrum of class IIa bacteriocins highlighted important correlation between their number of disulfide bridges and their spectrum. Heterologous expression of divercin V41 in E. coli with a synthetic gene was successfully developed. The recombinant divercin V41 whose two disulfide bridges, were reformed, was pure, soluble and active against Listeria.NANTES-BU Sciences (441092104) / SudocSudocFranceF

Caractérisation de bactéries lactiques psychrotrophes en vue de leur utilisation dans la biopréservation des aliments (étude physiologique et moléculaire des mécanismes d'adaptation au froid)

Des souches de bactéries lactiques ont été isolées à partir de produits de la mer et regroupées en fonction de leur pouvoir inhibiteur contre 14 bactéries appartenant à la flore d'altération ou pathogène de ces produits, dans le but de développer des applications en biopréservation. Elles ont été identifiées majoritairement comme leuconostoc gelidum et Lactococcus piscium. L'identification approfondie d'une souche de Lc. piscium montre qu'il s'agit d'une nouvelle espèce de Lactococcus. Des analyses sensorielles ont permis de montrer que 2 souches appartenant à l'espèce Leuconostoc gelidum permettait de prolonger la durée de vie de crevettes cuites emballées sous vide et qu'une souche de Lactococcus sp. avait le même effet sur du saumon fumé. Un test d'inhibition de bactéries pathogènes (Listeria monocytogenes, Staphylococcus aureus et Vibrio cholerae) a été effectué sur du saumon fumé. La souche de Lc.sp.EU2241 (non productrice de bactériocine) s'est révélée plus efficace que la souche de Ln. Gelidum EU 2247 (productrice de bactériocine) pour inhiber ces pathogènes, avec une inhibition atteignant 2 log par rapport au temoin non biopréservé. Les caractéristiques de croissance de la souche Lc sp. EU2241 à différentes températures ont montré un optimum de croissance à 26C et aucune croissance à 29C ou au dessus. L'analyse du protéome a révélé la surproduction d'une protéine de choc froid lors de la croissance à 5C, et le gène correspondant a pu être identifié et séquencé. Il s'agit de la première mise en évidence de la surproduction d'une protéine de choc froid lors de la croissance à température suboptimale pour une bactérie lactique.Lactic acid bacteria strains were isolated from seafood products and clustered according to their inhibiting capacities against 14 food borne spoiling and pathogenic strains in order to develop applications in biopreservation. Most of the strains were identified as Leuconostoc gelidum and Lactococcus piscium. Detailed identification of one strain of the Lactococcus piscium strains suggests that it is a new specie. According to sensory analysis results, 2 strains belonging to the Leuconostoc gelidum specie were the most efficient for the enhancement of the shelf life of vacuum packed peeled and cooked shrimps. Similar results were obtained in cold smoked salmon with one strains of Lactococcus sp. A challenge test against three pathogenic strains (Listeria monocytogenes, Staphylococcus aureus and Vibrio cholerae) was performed in cold smoked salmon. The Lc. sp. EU2241 strain (non bacteriocinogenic) enabled a more efficient inhibition of the pathogens than the Ln. gelidum EU2247 strain (bacteriocinogenic). The maximum recorded inhibition was 2 logs compared to the uninoculated samples. Growth characteristics of strain Lc. sp. EU2241 were determined at different temperatures showed an optimal growth at 26C and no growth at 29C or above. Proteomic analysis showed a cold shock protein overproduction during growth at 5C. The gene coding for this protein was identified and sequenced. Overproduction of a cold shock protein during growth at suboptimal temperature has never been described in a lactic acid bacterium before.NANTES-BU Sciences (441092104) / SudocSudocFranceF

Étude physiologique et caractérisation génétique préliminaire de la production de tyramine par Carnobacterium divergens V41, souche au potentiel bioprotecteur dans le saumon fumé

NANTES-BU Sciences (441092104) / SudocSudocFranceF

Étude de mécanismes moléculaires impliqués dans la résistance des cellules sensibles à la divercine V41, une bactériocine de classe IIa

Les bactériocines de classe IIa telle que la divercine V41 sont des peptides antimicrobiens sécrétées par certaines bactéries et présentent une activité anti-listeria. Ces peptides sont très étudiés afin de développer de nouveaux outils de bio-préservation et des compléments thérapeutiques. Le problème qui se pose actuellement est l apparition de résistants chez les bactéries pathogènes comme Listeria monocytogenes et Enterococcus faecalis. Différents travaux ont mis en évidence l importance de l inactivation des gènes rpoN, un des ces activateurs associés et l opéron mpt dans l acquisition de cette résistance. Au cours de ces travaux de thèse, nous avons pu identifier deux nouveaux gènes dont l inactivation aboutit à une résistance chez E. faecalis vis-à-vis de la divercine V41, les gènes glpQ et pde. La résistance observée par l inactivation du gène glpQ est liée à une modification de la composition en acide gras de la membrane plasmique tandis que celle observée par l inactivation de pde n est pas encore élucidée.Bacteriocins of class IIa, like divercin V41, are small peptide secreted by some lactic acid bacteria and show anti-listeria activity. Last decade, these bacteriocins are studied for develop new system of bio preservation and therapeutic use but matter is apparition of resistant pathogenic strains like Listeria monocytogenes and Enterococcus faecalis. Studies have showed that inactivation of rpoN gene, rpoN associate activator and mpt operon lead to resistance mechanisms in these pathogenic strains. In this work, we identified two new genes, pde and glpQ, their inactivation involved resistance of E. faecalis toward divercin V41. Resistance observed for glpQ inactivation is collaborating with bacterial membrane modification and for this observed for pde inactivation mechanisms are not elucidated. These news targets seem to be E. faecalis specific because genes are not involved in resistance of L. monocytogenesNANTES-BU Sciences (441092104) / SudocSudocFranceF

Preliminary study of the cecal bacterical flora in the pony : quantification

National audienc

MECHANISMS IN ENDOCRINOLOGY: Autocrine/paracrine regulatory mechanisms in adrenocortical neoplasms responsible for primary adrenal hypercorticism

International audienceA wide variety of autocrine/paracrine bioactive signals are able to modulate corticosteroid secretion in the human adrenal gland. These regulatory factors, released in the vicinity of adrenocortical cells by diverse cell types comprising chromaffin cells, nerve terminals, cells of the immune system, endothelial cells, and adipocytes, include neuropeptides, biogenic amines, and cytokines. A growing body of evidence now suggests that paracrine mechanisms may also play an important role in the physiopathology of adrenocortical hyperplasias and tumors responsible for primary adrenal steroid excess. These intra-adrenal regulatory systems, although globally involving the same actors as those observed in the normal gland, display alterations at different levels, which reinforce the capacity of paracrine factors to stimulate the activity of adrenocortical cells. The main modifications in the adrenal local control systems reported by now include hyperplasia of cells producing the paracrine factors and abnormal expression of the latter and their receptors. Because steroid-secreting adrenal neoplasms are independent of the classical endocrine regulatory factors angiotensin II and ACTH, which are respectively suppressed by hyperaldosteronism and hypercortisolism, these lesions have long been considered as autonomous tissues. However, the presence of stimulatory substances within the neoplastic tissues suggests that steroid hypersecretion is driven by autocrine/paracrine loops that should be regarded as promising targets for pharmacological treatments of primary adrenal disorders. This new potential therapeutic approach may constitute an alternative to surgical removal of the lesions that is classically recommended in order to cure steroid excess