La fermentation de matières premières végétales

Les produits fermentés sont consommés dans le monde entier depuis des siècles.Les végétaux fermentés font l’objet d’un regain d’intérêt, suivant les tendances du végétarisme, de la recherche de naturalité et du développement durable.Le CTCPA et le pôle de compétitivité VEGEPOLYS vous proposent ce séminaire de formation, au cours duquel leurs intervenants feront le point sur les tendances de ce marché, sur l’état de l’art et les limites des connaissances techniques et scientifiques sur le sujet

3 præsentationer fra Økologisk-Kongres 2017

3 præsentationer fra pEcoSystem projektet til Økologi-Kongress 2017 1)Bedre grisemiljø versus lavere klima- og miljøpåvirkning? Eller både og? 2)10 ugers fravænning 3)Træer i folde fordele og ulempe

Caractérisation et conservation de la diversité bactérienne d’un lait fermenté traditionnel breton, le Gwell en lien avec la préservation d’une race locale de vache, la Bretonne Pie Noir

Le Gwell est un lait fermenté traditionnel spécifique de la Bretagne. Il est obtenu à partir de lait de vaches de race Bretonne Pie Noir, inoculé avec une portion de la fabrication précédente (appelé ferment) sans aucun recours à des levains commerciaux. Les productions de Gwell partagent une texture ferme et onctueuse et un gout frais et acidulé, avec des caractéristiques organoleptiques propres à chaque producteur. Les producteurs sont malheureusement parfois confrontés à la perte de leur ferment et doivent alors avoir recours à la solidarité d’autres producteurs pour réacquérir un ferment opérationnel. Ces pertes de ferments sont un frein au développement de la production de Gwell et donc à la valorisation de lait issu de vaches Bretonne Pie Noir. Cette race emblématique de la Bretagne, caractérisée par une rusticité hors du commun et un lait très riche en matière grasse totalisait au milieu du 19ème siècle près de 900 000 têtes. La modernisation des pratiques agricoles alliée à une orientation productiviste forte a conduit à une quasi extinction de l’espèce, ce qui a conduit à initier en 1976 un programme de sauvegarde de l’espèce. Le nombre de vaches s’élève ainsi aujourd’hui à près de 2500 femelles. La transformation du lait en Gwell est, pour les éleveurs, un moyen de valoriser la qualité du lait de Bretonne Pie Noir en conservant sa valeur ajoutée. Les éleveurs qui transforment le lait en Gwell œuvrent ainsi à la sauvegarde de l’espèce Bretonne Pie Noir, mais aussi à la préservation de la diversité microbienne, du patrimoine et des savoir-faire paysans associés. La caractérisation de l’écosystème microbien du ferment Gwell, pour mieux maitriser sa conservation et sécuriser ainsi la production de Gwell, participe de ce fait au maintien de la race Bretonne Pie Noir. Dans ce contexte notre étude visait à caractériser l’écosystème microbien du Gwell pour sécuriser les souches à l’origine de la typicité du produit. Nous avons ainsi montré que toutes les productions de Gwell avaient une flore bactérienne dominante similaire, composée de deux sous-espèces de la bactérie lactique Lactococcus lactis (subsp. lactis et subsp. cremoris). En fonction des producteurs, le nombre de souches de chaque sous-espèce peut varier avec dans certain cas la présence de Streptococcus thermophilus. De plus, nous avons identifié et caractérisé des souches spécifiques à chaque producteur et montré une forte résilience de l’écosystème pouvant expliquer en partie les différences organoleptiques observées entre les Gwell de différents producteurs

Mycobacterium tuberculosis bloodstream infection prevalence, diagnosis, and mortality risk in seriously ill adults with HIV: a systematic review and meta-analysis of individual patient data.

BACKGROUND: The clinical and epidemiological significance of HIV-associated Mycobacterium tuberculosis bloodstream infection (BSI) is incompletely understood. We hypothesised that M tuberculosis BSI prevalence has been underestimated, that it independently predicts death, and that sputum Xpert MTB/RIF has suboptimal diagnostic yield for M tuberculosis BSI. METHODS: We did a systematic review and individual patient data (IPD) meta-analysis of studies performing routine mycobacterial blood culture in a prospectively defined patient population of people with HIV aged 13 years or older. Studies were identified through searching PubMed and Scopus up to Nov 10, 2018, without language or date restrictions and through manual review of reference lists. Risk of bias in the included studies was assessed with an adapted QUADAS-2 framework. IPD were requested for all identified studies and subject to harmonised inclusion criteria: age 13 years or older, HIV positivity, available CD4 cell count, a valid mycobacterial blood culture result (excluding patients with missing data from lost or contaminated blood cultures), and meeting WHO definitions for suspected tuberculosis (presence of screening symptom). Predicted probabilities of M tuberculosis BSI from mixed-effects modelling were used to estimate prevalence. Estimates of diagnostic yield of sputum testing with Xpert (or culture if Xpert was unavailable) and of urine lipoarabinomannan (LAM) testing for M tuberculosis BSI were obtained by two-level random-effect meta-analysis. Estimates of mortality associated with M tuberculosis BSI were obtained by mixed-effect Cox proportional-hazard modelling and of effect of treatment delay on mortality by propensity-score analysis. This study is registered with PROSPERO, number 42016050022. FINDINGS: We identified 23 datasets for inclusion (20 published and three unpublished at time of search) and obtained IPD from 20, representing 96·2% of eligible IPD. Risk of bias for the included studies was assessed to be generally low except for on the patient selection domain, which was moderate in most studies. 5751 patients met harmonised IPD-level inclusion criteria. Technical factors such as number of blood cultures done, timing of blood cultures relative to blood sampling, and patient factors such as inpatient setting and CD4 cell count, explained significant heterogeneity between primary studies. The predicted probability of M tuberculosis BSI in hospital inpatients with HIV-associated tuberculosis, WHO danger signs, and a CD4 count of 76 cells per μL (the median for the cohort) was 45% (95% CI 38-52). The diagnostic yield of sputum in patients with M tuberculosis BSI was 77% (95% CI 63-87), increasing to 89% (80-94) when combined with urine LAM testing. Presence of M tuberculosis BSI compared with its absence in patients with HIV-associated tuberculosis increased risk of death before 30 days (adjusted hazard ratio 2·48, 95% CI 2·05-3·08) but not after 30 days (1·25, 0·84-2·49). In a propensity-score matched cohort of participants with HIV-associated tuberculosis (n=630), mortality increased in patients with M tuberculosis BSI who had a delay in anti-tuberculosis treatment of longer than 4 days compared with those who had no delay (odds ratio 3·15, 95% CI 1·16-8·84). INTERPRETATION: In critically ill adults with HIV-tuberculosis, M tuberculosis BSI is a frequent manifestation of tuberculosis and predicts mortality within 30 days. Improved diagnostic yield in patients with M tuberculosis BSI could be achieved through combined use of sputum Xpert and urine LAM. Anti-tuberculosis treatment delay might increase the risk of mortality in these patients. FUNDING: This study was supported by Wellcome fellowships 109105Z/15/A and 105165/Z/14/A

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570