Le traitement pulpaire des dents permanentes immatures

Chez l'enfant, il est courant de rencontrer des lésions carieuses ou traumatiques sur les dents permanentes immatures. Leur conservation sur l'arcade est alors un enjeu primordial pour le chirurgien-dentiste. Deux cas de figures se présentent : soit la dent présente une pulpe vivante, auquel cas l'objectif principal est d'obtenir une édification radiculaire physiologique avec fermeture complexe de l'apex. Le recours aux thérapeutiques d'apexogénèse est alors nécessaire. Soit la dent présente une pulpe nécrosée, l'édification radiculaire non physiologique est obtenue grâce à des techniques d'apexification. Plus récemment, l'approche de la pulpe nécrosée par une technique de revascularisation permet d'obtenir un développement radiculaire physiologique. Cet ouvrage à visée pédagogique est le résultat d'une longue recherche faisant la synthèse des données actuelles présentes dans la littérature

Registration of phase contrast images in propagation-based X-ray phase tomography

International audienceX-ray phase tomography aims at reconstructing the 3D electron density distribution of an object. It offers enhanced sensitivity compared to attenuation-based X-ray absorption tomography. In propagation-based methods, phase contrast is achieved by letting the beam propagate after interaction with the object. The phase shift is then retrieved at each projection angle, and subsequently used in tomographic reconstruction to obtain the refractive index decrement distribution, which is proportional to the electron density. Accurate phase retrieval is achieved by combining images at different propagation distances. For reconstructions of good quality, the phase-contrast images recorded at different distances need to be accurately aligned. In this work, we characterise the artefacts related to misalignment of the phase-contrast images, and investigate the use of different registration algorithms for aligning in-line phase-contrast images. The characterisation of artefacts is done by a simulation study and comparison with experimental data. Loss in resolution due to vibrations is found to be comparable to attenuation-based computed tomography. Further, it is shown that registration of phase-contrast images is nontrivial due to the difference in contrast between the different images, and the often periodical artefacts present in the phase-contrast images if multilayer X-ray optics are used. To address this, we compared two registration algorithms for aligning phase-contrast images acquired by magnified X-ray nanotomography: one based on cross-correlation and one based on mutual information. We found that the mutual information-based registration algorithm was more robust than a correlation-based method

Response of Phytoplankton Communities to Variation in Salinity in a Small Mediterranean Coastal Lagoon: Future Management and Foreseen Climate Change Consequences

Mediterranean coastal lagoons are particularly vulnerable to increasing direct anthropogenic threats and climate change. Understanding their potential responses to global and local changes is essential to develop management strategies adapted to these ecosystems. Salinity is a fundamental structuring factor for phytoplankton communities; however, its role under climate change is understudied. We hypothesized that salinity variations imposed by climate change and/or management actions could disturb Mediterranean lagoons’ phytoplankton communities. To test our hypothesis, we performed two 5-day microcosm experiments in which natural phytoplankton assemblages from the Santa Giulia lagoon (Corsica Island) were subjected to three increasing (53–63–73) and decreasing (33–26–20) levels of salinity, to mimic strong evaporation and flash flooding, respectively. Results indicate that over-salinization inhibited growth and modified the assemblages’ composition. Freshening, on the contrary, showed feeble effects, mainly boosting microphytoplankton abundance and depleting diversity at lowest salinity. In both experiments and under freshening in particular, initially rare species emerged, while photosynthetic activity was degraded by salinity increase only. We demonstrated that phytoplankton communities’ structure and metabolism are strongly altered by the predicted implications of climate change. Such impacts have to be considered for future management of coastal lagoons (control of sea exchanges and watershed fluxes). This work constitutes a priority step towards the proactive adapted management and conservation of such as-yet-neglected ecosystems in the context of climate change

Distinct clades of TELOMERE REPEAT BINDING transcriptional regulators interplay to regulate plant development

Abstract TELOMERE REPEAT BINDING proteins (TRBs) are plant-specific transcriptional regulators that combine two DNA-binding domains, the GH1 domain shared with H1 histones that binds to linker DNA and the Myb/SANT domain that specifically recognizes the telobox DNA binding site motif. TRB1, TRB2 and TRB3 proteins recruit the Polycomb group complex 2 (PRC2) to deposit H3K27me3 and JMJ14 to remove H3K4me3 at target genes containing telobox motifs in their promoters to repress transcription. Here, we characterize the function of TRB4 and TRB5, which belong to a separate TRB clade conserved in spermatophytes. TRB4 and TRB5 affect the transcriptional control of several hundred genes involved in developmental responses to environmental cues, the majority of which differ from differentially regulated genes in trb1 trb2 trb3, suggesting distinct modes of action at the chromatin level. Indeed, TRB4 binds to several thousand sites in the genome, mainly at TSS and promoter regions of transcriptionally active and H3K4me3-marked genes but is not enriched at H3K27me3-marked gene bodies. TRB4 physically interacts with the PRC2 component CURLY LEAF (CLF), but, unexpectedly, loss of TRB4 and TRB5 partially suppresses the developmental defects of clf mutant plants, by acting as transcriptional activators of the key flowering genes SOC1 and FT. We further show that TRB4 and TRB1 share multiple target genes and reveal physical and genetic interactions between TRBs of the two distinct clades, collectively unveiling that TRB proteins engage in both positive and negative interactions with other members of the family to regulate plant development through PRC2-dependent and independent mechanisms

Real-world evidence of tofacitinib effectiveness and safety in patients with refractory ulcerative colitis

International audienc

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used