Benzodiazepine use and risk of dementia: prospective population based study

Producción CientíficaObjective To evaluate the association between use of benzodiazepines and incident dementia. Design Prospective, population based study. Setting PAQUID study, France. Participants 1063 men and women (mean age 78.2 years) who were free of dementia and did not start taking benzodiazepines until at least the third year of follow-up. Main outcome measures Incident dementia, confirmed by a neurologist. Results During a 15 year follow-up, 253 incident cases of dementia were confirmed. New use of benzodiazepines was associated with an increased risk of dementia (multivariable adjusted hazard ratio 1.60, 95% confidence interval 1.08 to 2.38). Sensitivity analysis considering the existence of depressive symptoms showed a similar association (hazard ratio 1.62, 1.08 to 2.43). A secondary analysis pooled cohorts of participants who started benzodiazepines during follow-up and evaluated the association with incident dementia. The pooled hazard ratio across the five cohorts of new benzodiazepine users was 1.46 (1.10 to 1.94). Results of a complementary nested case-control study showed that ever use of benzodiazepines was associated with an approximately 50% increase in the risk of dementia (adjusted odds ratio 1.55, 1.24 to 1.95) compared with never users. The results were similar in past users (odds ratio 1.56, 1.23 to 1.98) and recent users (1.48, 0.83 to 2.63) but reached significance only for past users. Conclusions In this prospective population based study, new use of benzodiazepines was associated with increased risk of dementia. The result was robust in pooled analyses across cohorts of new users of benzodiazepines throughout the study and in a complementary case-control study. Considering the extent to which benzodiazepines are prescribed and the number of potential adverse effects of this drugclass in the general population, indiscriminate widespread use should be cautioned against

Deficits of psychomotor and mnesic functions across aging in mouse lemur primates

International audienceOwing to a similar cerebral neuro-anatomy, non-human primates are viewed as the most valid models for understanding cognitive deficits. This study evaluated psychomotor and mnesic functions of 41 young to old mouse lemurs (Microcebus murinus). Psychomotor capacities and anxiety-related behaviors decreased abruptly from middle to late adulthood. However, mnesic functions were not affected in the same way with increasing age. While results of the spontaneous alternation task point to a progressive and widespread age-related decline of spatial working memory, both spatial reference and novel object recognition (NOR) memory tasks did not reveal any tendency due to large inter-individual variability in the middle-aged and old animals. Indeed, some of the aged animals performed as well as younger ones, whereas some others had bad performances in the Barnes maze and in the object recognition test. Hierarchical cluster analysis revealed that declarative-like memory was strongly impaired only in 7 out of 25 middle-aged/old animals. These results suggest that this analysis allows to distinguish elder populations of good and bad performers in this non-human primate model and to closely compare this to human aging

Deficits of psychomotor and mnesic functions across aging in mouse lemur primates.

Owing to a similar cerebral neuro-anatomy, non-human primates are viewed as the most valid models for understanding cognitive deficits. This study evaluated psychomotor and mnesic functions of 41 young to old mouse lemurs (Microcebus murinus). Psychomotor capacities and anxiety-related behaviors decreased abruptly from middle to late adulthood. However, mnesic functions were not affected in the same way with increasing age. While results of the spontaneous alternation task point to a progressive and widespread age-related decline of spatial working memory, both spatial reference and novel object recognition (NOR) memory tasks did not reveal any tendency due to large inter-individual variability in the middle-aged and old animals. Indeed, some of the aged animals performed as well as younger ones, whereas some others had bad performances in the Barnes maze and in the object recognition test. Hierarchical cluster analysis revealed that declarative-like memory was strongly impaired only in 7 out of 25 middle-aged/old animals. These results suggest that this analysis allows to distinguish elder populations of good and bad performers in this non-human primate model and to closely compare this to human aging.journal article20142015 01 09importe

Study Design and Baseline Characteristics for the Reflect Gene Therapy Trial ofm.11778g\u3eA/ND4-LHON

Objective REFLECT is the first randomised, double-masked, placebo-controlled multicentre phase 3 clinical trial that evaluated the efficacy and safety of bilateral intravitreal (IVT) injection of lenadogene nolparvovec in subjects with Leber hereditary optic neuropathy carrying the m.11778G\u3eA mutation. Methods and analysis A total of 98 subjects were enrolled with vision loss of ≤12 months. The subjects were randomised to one of two treatment arms with all subjects receiving an intravitreal (IVT) injection of lenadogene nolparvovec in their first affected eye and the second-affected eye randomised to receive IVT of either lenadogene nolparvovec or placebo. Results The majority of subjects were male with a mean duration of vision loss of 8.3 months. All but one subject experienced bilateral loss of vision at the time of injection. The mean best-corrected visual acuity of first-affected eyes was worse compared with second/not-yet-affected eyes. Analysis of retinal anatomical parameters showed increased thinning in the first-affected eyes when compared with the second/not-yet-affected eyes with both treatment arms showing significant changes compared with unaffected individuals. Conclusion The REFLECT trial is the third and the largest phase 3 clinical study evaluating lenadogene nolparvovec in m.11778G\u3eA Leber hereditary optic neuropathy (LHON) subjects. The observed demographics in REFLECT are consistent with previous reports in LHON subjects in the acute and dynamic phases of LHON disease. Combined with the visual function and anatomical parameters obtained in the previous RESCUE and REVERSE trials, REFLECT has provided a uniformly collected data set that should help direct future LHON clinical trials

L'oeuvre poétique d'Elizabeth Barrett Browning (héritage, palimpseste et transition)

La poésie d'Elizabeth Barrett Browning trouve ses origines dans la tradition de la poésie sentimentale romantique dont elle s'inspire et s'écarte dans ses choix poétiques novateurs. Sa poésie-charnière remanie les textes antérieurs et les figures tutélaires inscrites en palimpseste permettant la génération et la validation de voix traditionnellement mises à l'écart. Cette poésie polyphonique remet en question l'idéologie victorienne car les genres, les normes poétiques et les images traditionnelles sont transposés et manipulés à des fins personnelles et politiques. L'instant de passage symbolisé par l'apparition et la disparition de ces voix montre que sa poésie hésite encore entre dénonciation et renoncement mais fait de cet instant éphémère intermédiaire le lieu privilégié de la création poétique. Les décentrements de cette voix et la fugacité du motif du cri indiquent que c'est l'esthétique de la transmission et de la transition qui forge de nouvelles modalités poétiques féminines.The origins of Elizabeth Barrett Browning's works lie in the tradition of sentimental Romantic poetry in which she fends inspiration but from which she distances herself, choosing her own innovative style. Her reshaped poetry hinges on revised former texts and guardian figures that lie beneath the surface, allowing her to produce and empower voices traditionally set apart. This polyphonic poetry challenges Victorian ideology by manipulating poetical genres, norms and conventional images in order to meet personal and political ends. The transitory moment symbolized by these emerging and fading voices shows that her poetry continually hesitates between denunciation and renunciation, but transforms this moment of transience into the favourite locus of poetical creation. The displacement of this voice and the transient pattern of the cry reveal that the aesthetics of transmission and transition creates new feminine poetical forms.NANTERRE-BU PARIS10 (920502102) / SudocSudocFranceF

Les déterminants psychosociaux du recours aux soins

Les inégalités sociales de santé ne se réduisent pas spontanément grâce au progrès médical et à l augmentation quantitative et qualitative de l offre de soins, y compris dans les Etats providence où le système de santé permet en théorie un accès équitable aux soins. Un nombre grandissant d épidémiologistes soulignent l intérêt de travailler sur de nouvelles approches telles que les déterminants psychosociaux de la santé afin de progresser dans la compréhension des mécanismes sous jacents aux inégalités sociales de santé. C est dans ce contexte que s inscrit cette thèse dont l objectif était d étudier les associations entre certains facteurs psychosociaux et les comportements de recours aux soins. Nos travaux soulignent que la question du renoncement aux soins ne saurait être comprise sans porter une attention particulière à la manière dont les personnes perçoivent et vivent à la fois leurs besoins en matière de santé et leur situation sociale et financière.PARIS-BIUSJ-Thèses (751052125) / SudocPARIS-BIUSJ-Physique recherche (751052113) / SudocSudocFranceF

Microbiological composition of raw milk from selected farms in the Camembert region of Normandy.

International audienceRaw milk from 27 farms was sampled over 6 months for listerias, salmonellas, Yersinia enterocolitica and campylobacters. Total bacterial counts and somatic cell counts were measured. Lactococci, lactobacilli, dextran-producing leuconostocs, Brevibacterium linens, yeasts and moulds, Staphylococcus aureus and other Micrococcaceae, Pseudomonas, coliforms, Escherichia coli, enterococci, Clostridium perfringens and spores of anaerobic lactate-fermenting bacteria were also counted. Pseudomonas (2000 cfu ml-1), lactococci (760 cfu ml-1) and Micrococcaceae (720 cfu ml-1) were the most numerous groups. Lactic acid bacteria were detected in all samples. Coliforms were present in most samples, but 84% of samples had counts < 100 cfu ml-1. Staphylococcus aureus was detected in 62% of milks, the average count was 410 cfu ml-1. About 80% of supplies had < or = 10 E. coli cfu ml-1 and all samples had < or = 1 Cl. perfringens cfu ml-1. Two of the tested milks were positive for salmonellas (2.9%), four were positive for Listeria monocytogenes (5.8%), 25 for Yersinia enterocolitica (36%) and one for campylobacters (1.4%)

Déterminants psychosociaux du renoncement aux soins pour raisons financières dans cinq zones urbaines sensibles de la Région parisienne en 2001

Psychosocial determinants of the renouncing healthcare for financial reasons in five underprivileged urban areas of the Paris region in 2001 In France, thanks to its social security System, access to care is guaranteed for ail. However, the IRDES national surveys on health and social protection reveal that approximately one person out of five questioned states not having sought care for financial reasons. Our objective was to show that beyond the classically studied socio-economic factors, other factors, such as living conditions, social ruptures and integrations, representations of health and psychological characteristics, are associated with not seeking care. This survey, undertaken in 2001, studied a random sample of 525 people living in five underprivileged urban areas in the Paris region. The associations between not seeking care for financial reasons and psychosocial factors were studied by logistic régression adjusted for age, gender, size of household, presence of chronic diseases, health coverage, level of income, and employment situation. The estimation of the model's adequacy was based on Pearson residues and deviance residues. The model's stability was estimated by a bootstrap method. Not seeking care for financial reasons is more frequently reported by people having suffered from difficult childhood events, financial difficulties in adulthood, sexual, physical or psychological abuse; people with a poor acceptance of disease, and those who award high priority to their health. Finally, the lower the level of self-esteem the more people déclare not having sought care having renounced.Résumé. L'accès aux soins est garanti pour tous en France grâce à son système de sécurité sociale. Cependant, les enquêtes nationales sur la santé et la protection sociale de l'IRDES estiment qu'environ une personne interrogée sur cinq déclare avoir déjà renoncé à des soins pour raisons financières. Notre objectif était de montrer que, au-delà des facteurs socio-économiques classiquement étudiés, d'autres facteurs, de l'ordre des conditions de vie, des ruptures et intégrations sociales, des représentations de santé et des caractéristiques psychologiques, sont associés à un tel renoncement. L'enquête, réalisée en 2001, porte sur un échantillon aléatoire de 525 personnes vivant dans cinq zones urbaines sensibles d'Ile-de-France. Les associations entre le renoncement aux soins pour raisons financières et des facteurs psychosociaux ont été étudiées par une régression logistique ajustée sur l'âge, le sexe, la taille du ménage, la présence de maladies chroniques, la couverture maladie, le niveau de revenu et la situation à l'égard de l'emploi. L'adéquation du modèle a été réalisée à partir des résidus de Pearson et des résidus de la déviance. La stabilité du modèle a été estimée par une méthode de bootstrap. La déclaration d'un renoncement aux soins pour raisons financières est plus fréquente chez les personnes ayant vécu des événements difficiles dans la jeunesse, des difficultés financières à l'âge adulte, des expériences d'abus sexuels, physiques ou psychologiques, les personnes ayant une faible acceptation de la maladie et celles qui portent une forte priorité à leur santé. Enfin, plus le niveau d'estime de soi est bas plus les personnes déclarent un tel renoncement.Determinantes psicosociales de la renuncia a la atención medica por razones financieras en cinco zonas urbanas desfavorecidas de la región de Paris en 2001 En Francia el acceso a la atención medica esta garantizados portodos, gracias al sistema de Seguridad Social. Sin embargo, las encuestas nacionales del IRDES sobre la salud y la protección social revelan que aproximadamente una persona de cada cinco interrogadas declara haber renunciado a utilizar los recursos sanitarios por razones financieras. Nuestro objetivo era demostrar que más allá de los factures socioeconómicos clásicamente estudiados, otros factores taies como las condiciones de vida, las rupturas y integraciones sociales, las representaciones de la salud y las características psicológicas, están asociadas a tal renuncia. Este estudio fue realizado en el 2001 con una muestra aleatoria de 525 personas viviendo en cinco zonas urbanas desfavorecidas de la región de Paris. Las asociaciones entre renunciar a los recursos sanitarios por razones financieras y factores psicosociales fueron estudiadas por una regresión logística ajustada por la edad, el sexo, el tamaño del hogar, la presencia de enfermedades crónicas, la cobertura medica, el nivel de ingresos, y la situación de empleo. La adecuación del modelo fue realizada en base de los residuos de Pearson y de los residuos de la desviación. La estabilidad del modelo ha sido estimada por un método bootstrap. El declarar haber renunciado a los recursos sanitarios por razones financieras es más frecuente entre las personas habiendo vivido acontecimientos difíciles en la niñez, dificultades financieras en la edad adulta, abusos sexuales, físicos o psicológicos; las personas con menor aceptación de la enfermedad, y las que conceden una gran prioridad a su salud. Finalmente, cuanto más bajo el nivel de autoestima mayor es la probabilidad de renunciar a los recursos sanitarios.Bazin Fabienne, Parizot Isabelle, Chauvin Pierre. Déterminants psychosociaux du renoncement aux soins pour raisons financières dans cinq zones urbaines sensibles de la Région parisienne en 2001. In: Sciences sociales et santé. Volume 24, n°3, 2006. Déterminants socio-économiques des inégalités de santé. pp. 11-31

Mise en évidence d’un bonnet décoré de lamelles d’or dans la sépulture d’un nourrisson mérovingien de l’église Saint-Martin-au-Val. Restitution par l’analyse des restes organiques textiles et par l’archéo-thanatologie (Chartres, 28)

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