GDF15 Provides an Endocrine Signal of Nutritional Stress in Mice and Humans.

GDF15 is an established biomarker of cellular stress. The fact that it signals via a specific hindbrain receptor, GFRAL, and that mice lacking GDF15 manifest diet-induced obesity suggest that GDF15 may play a physiological role in energy balance. We performed experiments in humans, mice, and cells to determine if and how nutritional perturbations modify GDF15 expression. Circulating GDF15 levels manifest very modest changes in response to moderate caloric surpluses or deficits in mice or humans, differentiating it from classical intestinally derived satiety hormones and leptin. However, GDF15 levels do increase following sustained high-fat feeding or dietary amino acid imbalance in mice. We demonstrate that GDF15 expression is regulated by the integrated stress response and is induced in selected tissues in mice in these settings. Finally, we show that pharmacological GDF15 administration to mice can trigger conditioned taste aversion, suggesting that GDF15 may induce an aversive response to nutritional stress.This work and authors were funded by the NIHR Cambridge Biomedical Research Centre; NIHR Rare Disease Translational Research Collaboration; Medical Research Council [MC_UU_12012/2 and MRC_MC_UU_12012/3]; MRC Metabolic Diseases Unit [MRC_MC_UU_12012/5 and MRC_MC_UU_12012.1]; Wellcome Trust Strategic Award [100574/Z/12/Z and 100140]; Wellcome Trust [107064 , 095515/Z/11/Z , 098497/Z/12/Z, 106262/Z/14/Z and 106263/Z/14/Z]; British Heart Foundation [RG/12/13/29853]; Addenbrooke’s Charitable Trust / Evelyn Trust Cambridge Clinical Research Fellowship [16-69] US Department of Agriculture: 2010-34323-21052; EFSD project grant and a Royal College of Surgeons Research Fellowship, Diabetes UK Harry Keen intermediate clinical fellowship (17/0005712). European Research Council, Bernard Wolfe Health Neuroscience Endowment, Experimental Medicine Training Initiative/AstraZeneca and Medimmune

Bloc ilioinguinal iliohypogastrique versus transverse abdominis plane bloc échoguidés dans la chirurgie herniaire de l'enfant (une étude prospective randomisée)

Le Transverse Abdominis Plane bloc (TAPB) est proposé comme alternative au Bloc Ilioinguinal (BII). L'objectif principal de ce travail était de comparer leur taux d'échec. Notre étude prospective monocentrique randomisée a inclus des enfants âgés de 6 mois à 10 ans après consentement éclairé des parents. Le critère de jugement principal étai la variation de 10% de la fréquence cardiaque à l'incision. La douleur postopératoire, la consommation d'antalgiques, l'incidence de NVPO et la satisfaction des parents étaient répertoriés. Les tests du Chi2 et de Student ont été utilisés. 70 patients ont été inclus. Les taux d'échec étaient de 11% pour le groupe BII et de 38% pour le groupe TAPB (p=0,021). La consommation d'alfentanil était de 11% dans le groupe BII versus 50% dans le groupe TAPB (p=0,001). Aucune différence significative n'a été retrouvée sur les critères postopératoires. Le BII a montré une meilleure efficacité sur l'analgésie peropératoire que le TAPB.Transverse Abdominis Plane Block (TAPB) may offer an interesting alternativeto the Ilioinguinal Block (BII). The primary aim of this study was to compare their failure rate. After receiving written parental informed consent children aged between 6 months and 10 years were included. Block failure was defined as a heart rate variation within 10% at the surgical incision. Postoperative pain, analgesic consumption, vomiting and parental satisfaction were recorded. Statistical analysis used chi scare or Student's test. 70 patients were included. Failure rates were 11% for the BII and 38% for the TAPB (p=0,021). Alfentanil consumption was higher in the TAPB group: 50% versus 11% (p=0.001). No differences were found on the postoperative outcomes. The ultrasound-guided ilioinguinal iliohypogastric block was associated with better analgesia in the peroperative period compared to a Transverse Abdominis Plane Block.RENNES1-BU Santé (352382103) / SudocSudocFranceF

Transversus Abdominis Plane Block for Anterior Lumbar Interbody Fusion: a randomized controlled trial

International audienceBACKGROUND CONTEXT: ALIF (Anterior Lumbar Interbody Fusion) is a lumbar arthrodesis technique via an anterior approach that is less invasive than the posterior approaches. However, it is associated with specific pain in the abdominal wall. PURPOSE: The objective of this study was to determine whether performing a bilateral ultrasound-guided TAP (Transversus Abdominis Plane) block allows a reduction in morphine consumption in the first 24 hours after surgery. STUDY DESIGN: This study is a prospective single-centre, randomized, double-blind study. PATIENT SAMPLE: Patients undergoing ALIF surgery were included and randomized into two groups. Both groups received a TAP block performed at the end of surgery with either ropivacaine or placebo. OUTCOME MEASURES: The primary outcome measure was morphine consumption in the first 24 hours. The main secondary outcomes were immediate postoperative pain and opioid-related side effects METHODS: Intra- and postoperative anaesthesia and analgesia protocols where standardized. A bilateral ultrasound-guided TAP block was performed with 75 mg (in 15 ml) of ropivacaine per side or isotonic saline serum depending on their assignment group. RESULTS: Forty-two patients were included in the study (21 per group). Morphine consumption at 24 hours (28 mg [18 - 35] in the ropivacaine group vs 25 mg [19 - 37] in the placebo group (p=0.503)) were not significantly different between the 2 groups. CONCLUSION: TAP block with ropivacaine or placebo provided a similar postoperative analgesia when associated with a multimodal analgesia protocol for ALIF

Multicentre, prospective, double-blind, randomised controlled clinical trial comparing different non-opioid analgesic combinations with morphine for postoperative analgesia: the OCTOPUS study

International audienceBackground: Head-to-head comparisons of combinations of more than one non-opioid analgesic (NOA) with morphine alone, for postoperative analgesia, are lacking. The objective of this multicentre, randomised, double-blind controlled trial was to compare the morphine-sparing effects of different combinations of three NOAs-paracetamol (P), nefopam (N), and ketoprofen (K)-for postoperative analgesia. Methods: Patients from 10 hospitals were randomised to one of eight groups: control (C) received saline as placebo, P, N, K, PN, PK, NK, and PNK. Treatments were given intravenously four times a day during the first 48 h after surgery, and morphine patient-controlled analgesia was used as rescue analgesia. The outcome measures were morphine consumption, pain scores, and morphine-related side-effects evaluated 24 and 48 h after surgery. Results: Two hundred and thirty-seven patients undergoing a major surgical procedure were included between July 2013 and November 2016. Despite a failure to reach a calculated sample size, 24 h morphine consumption [median (interquartile range)] was significantly reduced in the PNK group [5 (1-11) mg] compared with either the C group [27 (11-42) mg; P<0.05] or the N group [21 (12-29) mg; P<0.05]. Results were similar 48 h after surgery. Patients experienced less pain in the PNK group compared with the C, N, and P groups. No difference was observed in the incidence of morphine-related side-effects. Conclusions: Combining three NOAs with morphine allows a significant morphine sparing for 48 h after surgery associated with superior analgesia the first 24 h when compared with morphine alone

Humanités numériques, corpus et sens

Ce Dossier s’attache aux humanités numériques et au sens en lien avec des corpus textuels. Les Échanges prolongent la discussion sur la narratologie et en ouvrent une nouvelle sur les valeurs. Les Notes de recherche traitent l’analyse informatisée de la critique de cinéma, la médiatisation du burn out, le traitement romanesque de la réalité historiographique, le témoignage dans la publicité et la transidentité dans la littérature érotique. En VO, Hartmut Rosa montre les facteurs structurels poussant les sociétés vers la croissance, l’innovation et l’accélération et présente une conception du bien-être, fondée sur la résonance. Les Notes de lecture rendent compte de publications dans le domaine de l’information-communication. This Issue studies the digital humanities and the meaning in relation to textual corpora. The Exchanges pursue the discussion on the narratology and open a new one on the values. The Research Notes cover the computerized analysis of movie review, the burn out’s mediatization, how the novels deal with the historical reality, the testimony in advertising and the transidentity in erotica. In Original Version (here, in English), Hartmut Rosa shows the structural features which lead the societies into growth, innovation and acceleration. He presents also an alternative conception of the good life, based on the concept of resonance. The Book Reviews offer succinct overviews and analyses of publications in the field of information and communication

Humanités numériques, corpus et sens

Ce Dossier s’attache aux humanités numériques et au sens en lien avec des corpus textuels. Les Échanges prolongent la discussion sur la narratologie et en ouvrent une nouvelle sur les valeurs. Les Notes de recherche traitent l’analyse informatisée de la critique de cinéma, la médiatisation du burn out, le traitement romanesque de la réalité historiographique, le témoignage dans la publicité et la transidentité dans la littérature érotique. En VO, Hartmut Rosa montre les facteurs structurels poussant les sociétés vers la croissance, l’innovation et l’accélération et présente une conception du bien-être, fondée sur la résonance. Les Notes de lecture rendent compte de publications dans le domaine de l’information-communication. This Issue studies the digital humanities and the meaning in relation to textual corpora. The Exchanges pursue the discussion on the narratology and open a new one on the values. The Research Notes cover the computerized analysis of movie review, the burn out’s mediatization, how the novels deal with the historical reality, the testimony in advertising and the transidentity in erotica. In Original Version (here, in English), Hartmut Rosa shows the structural features which lead the societies into growth, innovation and acceleration. He presents also an alternative conception of the good life, based on the concept of resonance. The Book Reviews offer succinct overviews and analyses of publications in the field of information and communication