: Gender differences in STEMI

International audienceBACKGROUND: Gender differences in presentation, management and outcome in patients with ST-segment elevation myocardial infarction (STEMI) have been reported. AIM: To determine whether female gender is associated with higher inhospital mortality. METHODS: Data from ORBI, a regional STEMI registry of 5 years' standing, were analysed. The main data on presentation, management, inhospital outcome and prescription at discharge were compared between genders. Various adjusted hazard ratios were then calculated for inhospital mortality (women versus men). RESULTS: The analysis included 5000 patients (mean age 62.6±13 years), with 1174 women (23.5%). Women were on average 8 years older than men, with more frequent co-morbidities. Median ischaemia time was 215 minutes (26 minutes longer in women; P<0.05). Reperfusion strategies in women less frequently involved fibrinolysis, coronary angiography, radial access and thrombo-aspiration. Female gender, especially in patients aged<60 years, was associated with poorer inhospital prognosis (including higher inhospital mortality: 9% vs. 4% in men; P<0.0001), and underutilization of recommended treatments at discharge. Moreover, excess female inhospital mortality was independent of presentation, revascularization time and reperfusion strategy (hazard ratio for women 1.33, 95% confidence interval 1.01-1.76; P=0.04). CONCLUSIONS: One in four patients admitted for STEMI was female, with significant differences in presentation. Female gender was associated with less-optimal treatment, both in the acute-phase and at discharge. Efforts should be made to reduce these differences, especially as female gender was independently associated with an elevated risk of inhospital mortality

TIS et attractif contre Bactrocera dorsalis à La Réunion

International audienceLa mouche orientale des fruits, Bactrocera dorsalis, est un ravageur invasif qui s'est rapidement propagé en Afrique subsaharienne et dans les îles du Sud-Ouest de l'océan Indien, notamment en 2017 à la Réunion, causant des dégâts significatifs sur diverses cultures fruitières.Pour contrer cette menace, des projets de recherche testant plusieurs leviers agroécologiques ont été initiés. Parmi ceux-ci, la technique de l'insecte stérile (TIS) est un des leviers considérés comme prometteurs. Cette approche nécessite des études approfondies avant sa mise en œuvre à la Réunion. Notamment, le projet consiste à acquérir un certain nombre de données et de connaissances sur la bioécologie de B. dorsalis afin de développer et calibrer des modèles mathématiques, dont l’analyse et la simulation sont des facteurs-clés pour adapter au mieux les stratégies de lutte et maximiser leurs efficacités. En parallèle, un programme de recherche complémentaire cherche de nouveaux attractifs spécifiques aux femelles de B. dorsalis et susceptibles de les piéger. Une enquête minutieuse associant analyses chimiques des odeurs de fruits et neurophysiologie de l’olfaction des mouches a déjà permis d’identifier près d’un millier de composés chimiques volatils, et de sélectionner les plus prometteurs pour des tests comportementaux qui seront réalisés à partir de 2024

TIS et attractif contre Bactrocera dorsalis à La Réunion

International audienceLa mouche orientale des fruits, Bactrocera dorsalis, est un ravageur invasif qui s'est rapidement propagé en Afrique subsaharienne et dans les îles du Sud-Ouest de l'océan Indien, notamment en 2017 à la Réunion, causant des dégâts significatifs sur diverses cultures fruitières.Pour contrer cette menace, des projets de recherche testant plusieurs leviers agroécologiques ont été initiés. Parmi ceux-ci, la technique de l'insecte stérile (TIS) est un des leviers considérés comme prometteurs. Cette approche nécessite des études approfondies avant sa mise en œuvre à la Réunion. Notamment, le projet consiste à acquérir un certain nombre de données et de connaissances sur la bioécologie de B. dorsalis afin de développer et calibrer des modèles mathématiques, dont l’analyse et la simulation sont des facteurs-clés pour adapter au mieux les stratégies de lutte et maximiser leurs efficacités. En parallèle, un programme de recherche complémentaire cherche de nouveaux attractifs spécifiques aux femelles de B. dorsalis et susceptibles de les piéger. Une enquête minutieuse associant analyses chimiques des odeurs de fruits et neurophysiologie de l’olfaction des mouches a déjà permis d’identifier près d’un millier de composés chimiques volatils, et de sélectionner les plus prometteurs pour des tests comportementaux qui seront réalisés à partir de 2024

A single substitution in Vacuolar protein sorting 4 is responsible for resistance to Watermelon mosaic virus in melon

International audienceIn plants, introgression of genetic resistance is a proven strategy for developing new resistant lines. While host proteins involved in genome replication and cell to cell movement are widely studied, other cell mechanisms responsible for virus infection remain under investigated. Endosomal sorting complexes required for transport (ESCRT) play a key role in membrane trafficking in plants and are involved in the replication of several plant RNA viruses. In this work, we describe the role of the ESCRT protein CmVPS4 as a new susceptibility factor to the Potyvirus Watermelon mosaic virus (WMV) in melon. Using a worldwide collection of melons, we identified three different alleles carrying non-synonymous substitutions in CmVps4. Two of these alleles were shown to be associated with WMV resistance. Using a complementation approach, we demonstrated that resistance is due to a single non-synonymous substitution in the allele CmVps4P30R. This work opens up new avenues of research on a new family of host factors required for virus infection and new targets for resistance

[Acquired uterine arteriovenous malformations].

International audienceUterine arteriovenous malformations (AVM) may be responsible for vaginal bleeding potentially life-threatening. They are most often acquired following uterine trauma (curettage, cesarean section, artificial delivery/uterus examination) in association with pregnancy or gestational trophoblastic disease. We report three cases of patients having uterine AVM after curettage. The diagnostic management is important to avoid differential diagnoses (intra-uterine retention, hemangioma, gestational trophoblastic disease). It is based on serum hCG measurement and Doppler ultrasound, then confirmed on dynamic angio-MRI, which tends to replace angiography as first-line. The therapeutic management in cases of symptomatic AVMs is mostly embolization which offers the possibility for childbearing. Current data on subsequent pregnancies is reassuring even if they remain limited

Surgical management of isthmocele symptom relief and fertility

International audienceObjective: To describe symptoms and fertility and quality of life outcomes after isthmocele surgery.Study design: We conducted a retrospective study on from January 2012 to December 2017 in two tertiary referral centers in Rennes (France). All the patients diagnosed with isthmocele and operated were included. They all underwent isthmocele surgery by hysteroscopy, vaginal way or laparotomy.Results: The following data were collected: surgical procedure, symptoms and fertility before and after surgery, patient satisfaction about the surgery, and quality of life after surgery. Eighteen patients were included. The mean duration of follow-up was 15 months. Surgical procedures consisted of hysteroscopy (n = 5/18, 27.8%), vaginal surgery(n = 8/18, 44.4%) and laparotomy (n = 5/18, 27.8%). Surgical indications were: secondary infertility (n = 10/18, 55 %), pelvic pain (n = 5/18, 28%) and abnormal uterine bleeding (n = 3/18, 17%). Among patients with abnormal uterine bleeding, improvement was obtained after hysteroscopy, laparotomy and vaginal surgery for 83.3%, 75% and 50%, respectively. Among those with pelvic pain, improvement was obtained after hysteroscopy, laparotomy and vaginal surgery for 80%, 81% and 66%, respectively. One patient (1/18, 5.5%) had post-operative complication. Of the 12 patients who wished to conceive eleven pregnancies were obtained (91.7%). Of the 10 patients with secondary infertility, six became pregnant (60%). Five pregnancies (5/11, 45.4%) were carried to full term, including four in patients whose surgical indication was infertility. Among these, one patient had a vaginal delivery (after vaginal surgery) without obstetric complication. All patients operated on by hysteroscopy would recommend this surgery versus 75% of patients with vaginal surgery and 60% of patients with laparotomy (p = 0.24). Pain and quality-of-life scores were comparable between the three groups.Conclusion: Isthmocele surgery is effective for abnormal uterine bleeding, pain and infertility regardless of the surgical route

Hysteroscopic Metroplasty: Ultrasound Parameters to Optimize Fertility Benefits?

International audienceIntroduction: Metroplasty is a procedure used by some teams to correct certain uterine anomalies to improve fertility outcomes. Our goal was to evaluate hysteroscopic metroplasty in the management of nulliparous and infertile patients with a uterine anomalies.Material and methods: We conducted a single-center, retrospective, observational study of women who underwent hysteroscopic metroplasty for infertility between January 1, 2015 and December 31, 2019. The primary endpoint was the occurrence of a live birth at 18 months post-surgery. The secondary endpoint was to identify predictive factors for the success of the procedure, in particular ultrasound criteria, and live-birth rate during total follow up.Results: We included 43 nulliparous patients with an average of 5.2±-2.4 years of primary infertility, including 84.2 % patients who had at least one IVF cycle prior to the surgery. The mean age was 37±5 years. The post-surgery live-birth rate was 27.9 % at 18 months and 53.5 % during the total postoperative follow-up (mean follow-up 4.5 ± 1 years). Pregnancies were obtained spontaneously after surgery for 8/28 (28.6 %) patients who were undergoing assisted reproduction technology before surgery. No intra- or postoperative complications were recorded. We did not identify any predictive ultrasound factors, pre- or postoperatively, for a live birth at 18 months post-surgery.Discussion: Hysteroscopic metroplasty appears to improve the chances of a live birth in a population of nulliparous and infertile patients with at least one uterine pathology. Spontaneous pregnancy can occur after hysteroscopic metroplasty. The Congenital-Ultrasound-Malformation-by-Expert ultrasound criteria do not appear to be predictive of post-surgery outcomes

Supply-limited weathering regime in a tropical shields basin (Ogooué River basin, Gabon)

International audienceAt the global scale and on geological time scales, mechanical erosion and chemical weathering budgets are linked. Together, these processes contribute to the formation and the degradation of the Earth's critical zone and to the biogeochemical cycles of elements. While the weathering of hot and humid shields areas exhibit low weathering rates because of the depth of the mature depleted soil mantle there, shields areas dominate the continents areas over intertropical regions and, therefore, represent a significant proportion of the global delivery of dissolved matter to the oceans. In addition, these environments are under supply-limited conditions (the weathering rate is limited by the low rates of the erosion) and thus particularly sensitive to long-term variability erosion rates. Despite this importance, weathering-erosion budgets and rates estimation in these environments is sparse, and generally performed at a local scale (soil profiles) or, when performed at a larger catchment scale, the intra cratonic characteristics variabilities (e. g. the diversity of mechanical erosional regimes) are usually not singled out.In the present study, we explored the variability of the weathering intensity of the Ogooué sub-basins (Western central Africa, Gabon) as a function of their geomorphologic, tectonic and lithological setting variability. We analyzed major and trace elements concentration and the strontium and neodymium isotopes of water, suspended matter sediments and bedload sampled in 24 Ogooué tributaries (September 2017 campaign). Our results show that shield areas exhibit a high variability of chemical weathering intensity, which follows the erosional regime characteristics of the studied sub-basins, likely related to their tectonic activity. Three regions can be distinguished: The Bateke plateau (East sub-basins - PB), is composed of pure sandstones (quartz) and is inert in term of tectonic activity and therefore in term of erosion and weathering budget; the northern sub-basins (NB) are subjected to low tectonic activity and exhibit slightly higher erosion and weathering intensity than PB region and, by comparison, southern sub-basins (SB) exhibits uplift activity which is traduced by more intensive erosion and weathering processes.The annual dissolved solid budget of the Ogooué basin is ~2.52 t.yr-1 for a rate of 11.7 t.km-2.yr-1. According to the source discrimination method performed based on the geochemical analysis, the atmospheric inputs contributes to around 20% to the TDS, the silicate weathering contribution dominates the dissolved exports throughout 70% of its production while the carbonates weathering lowly contributes to the TDS production.By comparison to the other large shields rivers, this basin exhibit a lower range of chemical silicate weathering rate than most of the world's large rivers, with values similar to those of the Congo River. This new dataset provides a key information to complete the World River chemistry database, which is limited for inter-tropical regions, especially in tectonically quiescent environments. Moreover, this study provides new data for tropical shields contexts allowing for the exploration of the interactions between erosion rates and climate in the control of continental weathering rates, and their relationships with long-term carbon cycle and short-term biogeochemical cycles