Intérêt des statines dans la prévention cardiovasculaire selon l'âge (revue de la littérature)

Les statines ont révolutionné la prévention et le traitement de la maladie athéromatheuse. Leur efficacité est démontrée chez le sujet de moins de 65 ans dans la prévention primaire et secondaire, cardiovasculaire mais aussi cérébrovasculaire. Le bénéfice est net, aussi bien chez la femme que l'homme, ainsi que chez les patients diabétiques. C'est ce que démontrent les grandes études prospectives réalisées avec différentes statines sur des populations avec des niveaux de cholestérol et de facteurs de risque cardiovasculaire variés. Cela est dû à l'abaissement important du LDL-Cholestérol, facteur de risque cardiovasculaire indéniable, mais probablement aussi aux effets indépendants du cholestérol des statines, leurs effets pléiotropes. Il en découle une stratégie et des recommandations en constante évolution. Cependant, les études prospectives s'attachant plus spécifiquement aux sujets de plus de 65 ans sont peu nombreuses et encore assez peu concordantes. Il en ressort néanmoins que le bénéfice est toujours réel et important en prévention secondaire cardiovasculaire. Il est mitigé en ce qui concerne la prévention primaire cardiovasculaire et la prévention cérébrovasculaire en général. Enfin, le rapport coût bénéfice est lui sujet à caution suivant les critères observés. De nouvelles études sont donc requises dans cette populationPARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Enjeux et mutations à l'ère du numérique : le cas du projet de numérisation des manuscrits de Tombouctou

International audienc

Enjeux et mutations à l'ère du numérique : le cas du projet de numérisation des manuscrits de Tombouctou

International audienc

Histogram of structure tensors: application to pattern clustering

Pattern clustering is an important data analysis process useful in a wide spectrum of computer vision applications. In addition to choosing the appropriate clustering methods, particular attention should be paid to the choice of the features describing patterns in order to improve the clustering performance. This paper presents a novel feature descriptor, referred as Histogram of Structure Tensors (HoST), allowing to capture the local information of an image. The basic idea is that a local pattern could be described by the distribution of the structure tensors orientations and shapes. The proposed HoST descriptor has two major advantages. On the first hand, it captures the dominant orientations in a local spatial region taking into account of the local shape of the edges structure. In fact, it is based on the structure tensor that represents a very interesting concept for characterizing the local shape. On the other hand, the use of the histogram concept makes the proposed descriptor so effective and useful when a reduced feature representation is required. In this paper, the proposed HoST descriptor is addressed to the pattern clustering task. An extensive experimental validation demonstrates its performance when compared to other existing feature descriptors such as Local Binary Patterns and Histogram of Oriented Gradients. In addition, the proposed descriptor succeeds in improving the performance of clustering based resolution enhancement approaches

Results of the 2017 inspection campaign of French phase I/II research sites in Île-de-France following the BIA 10-2474 accident: Medical vs. regulatory relevance

International audienceAimsFollowing the serious adverse events that occurred in January 2016 during the BIA 10-2474 First-in-Human study, the French Ministry of Health asked the Regional Health Agencies to inspect operations at all research sites conducting phase I/II clinical trials of experimental drugs. The aim of this study was to assess the medical relevance of the inspections made in Île-de-France (Paris region) in 2017.MethodsAll 30 sites of Île-de-France region fully authorized to perform phase I/II trials were inspected by a public health physician and a public health pharmacist. Their reported list of observations was submitted to three physicians with longstanding experience of early pharmacology studies performed in academic or private research facilities. These physicians were asked to adjudicate each observation according to their perceived medical importance regarding safety. Adjudications were first performed separately and disagreements were later settled during a final adjudication meeting.ResultsAt least one disagreement occurred initially among the 3 adjudicators for 84 of the 120 observations (70%) reported by the inspectors. Following reconciliation, the 3 physicians agreed that 20% of the observations were likely to have potentially serious medical consequences. These observations mainly concerned the management of emergencies and of serious adverse events and the continuity of care.ConclusionsMaintenance of on-site inspections periodically carried out by regulatory authorities granting authorisations to perform phase I/II trials are justified. However, the medical relevance of these inspections can be improved with more emphasis on factors affecting the safety of research participants than on administrative or purely regulatory issues

Bayesian networks classifiers applied to documents

This paper discusses the use of the bayesian network model for a classification problem related to the document image understanding field. Our application is focused on logical labeling in documents, which consists in assigning logical labels to text blocks. The objective is to map a set of logical tags, composing the document logical structure, to the physical text components. We build a bayesian network model that allows this mapping using supervised learning, and without imposing a priori constraints on the document structure. The learning strategy is based partly on genetic programming tools. A prototype has been implemented, and tested on tables of contents found in periodicals and magazines.

Outcome of SARS-CoV-2 infection is linked to MAIT cell activation and cytotoxicity

International audienceImmune system dysfunction is paramount in coronavirus disease 2019 (COVID-19) severity and fatality rate. Mucosal-associated invariant T (MAIT) cells are innate-like T cells involved in mucosal immunity and protection against viral infections. Here, we studied the immune cell landscape, with emphasis on MAIT cells, in cohorts totaling 208 patients with various stages of disease. MAIT cell frequency is strongly reduced in blood. They display a strong activated and cytotoxic phenotype that is more pronounced in lungs. Blood MAIT cell alterations positively correlate with the activation of other innate cells, proinflammatory cytokines, notably interleukin (IL)-18, and with the severity and mortality of severe acute respiratory syndrome coronavirus 2 infection. We also identified a monocyte/macrophage interferon (IFN)-α-IL-18 cytokine shift and the ability of infected macrophages to induce the cytotoxicity of MAIT cells in an MR1-dependent manner. Together, our results suggest that altered MAIT cell functions due to IFN-α-IL-18 imbalance contribute to disease severity, and their therapeutic manipulation may prevent deleterious inflammation in COVID-19 aggravation