Site expérimental forestier ICOS de Salles (33) sur la mesure des échanges de gaz à effet de serre et de vapeur d’eau entre le couvert et l’atmosphère

National audienc

À propos de la nationalité

Si l’on s'accorde à définir la « réforme sociale » (al-islâh al-ijtimâ'i) comme le projet à la fois collectif et global qui s’impose, vers la fin des années 1930, comme une sorte de lieu commun du débat sociétal où s’élaborent les représentations, se dessinent les pratiques et se forgent, les instruments par lesquels s’opère la production-réfection de la société égyptienne comme société en prise sur la « contemporanéité » — pour ne pas parier ici de modernité —, à même de prendre en main par elle-même son propre destin ; si l’on admet, par ailleurs, l’hypothèse — qui constitue l'une des propositions axiologiques du programme de recherche engagé au CEDEJ sur le thème de la réforme — selon laquelle le débat sur la société juste, vertueuse, réformée, tend, dans le contexte colonial, à se structurer, pour tous ses protagonistes, comme débat sur l’identitéde la société égyptienne, on conçoit que la question de la nationalité puisse apparaître comme l’un des enjeux centraux de la problématique de la réforme. […

One-Anastomosis Gastric Bypass Revision for Gastroesophageal Reflux Disease: Long Versus Short Biliopancreatic Limb Roux-en-Y Gastric Bypass

International audienceAbstractPurposeOne-anastomosis gastric bypass (OAGB) may be associated with refractory gastroesophageal reflux disease (GERD). The nature of this GERD remains unclear. This complication can be treated either with an additional enteroenterostomy without shortening of gastric pouch (long biliopancreatic limb Roux-en-Y gastric bypass (L-BPL-RYGB)) or revision to conventional short biliopancreatic limb Roux-en-Y gastric bypass (S-BPL-RYGB). The objective of this study is to compare the aforementioned procedures in terms of efficacy on GERD symptoms.Materials and MethodsRetrospective analysis between October 2012 and June 2020.ResultsFifty-two patients underwent OAGB revision to S-BPL-RYGB (n = 21) or L-BPL-RYGB (n = 31) secondary to GERD. Investigation with pH impedance prior to revision was performed in 15 patients showing biliary reflux (BR) in 7 (46.6%), acid reflux (AR) in 6 (40%), and no confirmation in 2. Patients with AR had a revision to S-BPL-RYGB, whereas patients with BR underwent L-BPL-RYGB. Among the patients without pH metry results (n = 37), S-BPL-RYGB was performed for associated disabling digestive disorders or nutritional deficiencies. GERD was treated in 68% of patients with L-BPL-RYGB versus 95% of patients after S-BPL-RYGB. Patients, whose decision for revisional procedure was based on the results of pH impedance testing, did not reveal refractory GERD.ConclusionL-BPL-RYGB seems appropriate in patients with BR, whereas conversion to S-BPL-RYGB should be preferred if AR is present

150-cm Versus 200-cm Biliopancreatic Limb One-Anastomosis Gastric Bypass: Propensity Score–Matched Analysis

International audienceBackgroundIt has been suggested that shortening the length of the biliopancreatic limb (BPL) to 150 cm in one anastomosis gastric bypass (OAGB) would reduce nutritional complication rates without impairing weight loss outcomes. The aim of this study is to compare patients who underwent OAGB with a 200-cm BPL (OAGB-200) to patients with OAGB with a 150-cm BPL (OAGB-150) in terms of weight loss and late morbidity.MethodsThis is a monocentric retrospective matched cohort study including patients with a body mass index between 35 and 50 kg/m2 who underwent an OAGB-150 or an OAGB-200. Patients were matched 1:1 based on age, sex, and body mass index, prior to bariatric surgery.ResultsIn total, 784 patients who underwent OAGB were included (OAGB-150 n = 392 and OAGB-200 (n = 392). There was no significant difference in terms of early morbidity. Regarding late morbidity in patients with an OAGB-150, significantly lower rates for marginal ulcer (OR = 0.4, CI 95% [0.2; 0.8], p = 0.006), incisional hernia (OR = 0.5, CI 95% [0.3; 1], p = 0.041), and bowel obstruction (OR = 0.3, CI 95% [0.1; 0.9], p = 0.039) were reported. Likewise, regarding late nutritional deficiencies, post-OAGB-150, a significantly lower number of patients with hypoalbuminemia (OR = 0.3, CI 95% [0.2; 0.7], p = 0.006), low vitamin B9 (OR = 0.5, CI 95% [0.2; 1], p = 0.044), and low ferritin (OR = 0.5, CI 95% [0.3; 0.8], p = 0.005) were observed. There was no significant difference in the percentage of excess BMI loss at 1, 2, 3, 4, and 5 years.ConclusionCompared to OAGB-200 in patients with BMI ≤ 50 kg/m2, OAGB-150 results in fewer nutritional deficiency rates long term, without impairing weight loss

Entre réforme sociale et mouvement national

Cet ouvrage est dédié à la mémoire d’Avriel Butovsk