Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : National audience
Introduction Les télomérases sont les enzymes assurant la synthèse des télomères, séquences d’ADN essentiels dans la protection des chromosomes. Les mutations des télomérases sont responsables, entre autres, d’anomalies hématologiques, pulmonaires (fibrose pulmonaire idiopathique) et hépatiques. Il n’y a que peu de données dans la littérature concernant les résultats des transplantations pulmonaires chez ces patients mutés. Cas clinique Nous rapportons le cas d’un jeune homme de 39 ans, souffrant de syndrome myélodysplasique associé à une fibrose pulmonaire, permettant de poser le diagnostic de téloméropathie (mutation de la sous-unité ARN ou TERC ; r.182delG, pseudoknot area). L’insuffisance médullaire est sévère : leucopénie à 1,3 G/L dont 0,54 G/L de PNN, anémie macrocytaire (Hb à 10,3 g/dL ; VGM à 120 fL) et thombopénie à 27 G/L. Le syndrome restrictif est également sévère avec une CPT à 60 % et une CVF à 82 % de la valeur prédite (% pred). Il s’associe à une altération de la membrane alvéolo-capillaire (DLCO corrigée sur l’hémoglobine à 31 % pred). Le patient a été récusé à la fois pour la transplantation médullaire et pour la transplantation pulmonaire malgré son jeune âge. La prise en charge est donc palliative : réhabilitation respiratoire, oxygénothérapie, puis nintedanib. Discussion Dans la littérature, les transplantations médullaires chez les patients présentant une mutation des télomérases s’associent à une dégradation de la fonction respiratoire, en lien avec la toxicité des traitements immunosuppresseurs, même en l’absence d’atteinte pulmonaire initiale. Par ailleurs, les complications infectieuses et hématologiques post-transplantations pulmonaires chez ces patients mutés semblent plus fréquentes et nécessitent souvent une adaptation des traitements anti-rejets. Ces risques post-transplantations paraissent plus importants en présence d’une thrombopénie sévère préopératoire. Ces données sont cependant limitées à trois études rétrospectives de petites tailles. Au total, ce jeune patient a été jugé inéligible à la transplantation médullaire et à la transplantation pulmonaire, respectivement à cause de l’insuffisance respiratoire et de l’insuffisance médullaire. Il est émis l’hypothèse que l’allègement de la thérapie immunosuppressive pourrait améliorer le devenir des patients mutés transplantés, sans majorer le risque de rejet, illustrant le concept d’immunosénescence. Mais cette hypothèse reste à être validée. Ce cas clinique souligne l’importance de reconnaître les signes évocateurs de téloméropathie, dans la mesure où le diagnostic impacte la prise en charge de la fibrose pulmonaire
ISSN: 0761-8425

hal-01334065
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01334065
DOI : 10.1016/j.rmr.2016.04.018

Éditeur(s) : HAL CCSD SAGE Publications
Résumé : International audience
In Western French Guiana there was a dramatic increase in HIV-prevalence between 1990 and 2000. The present study describes the causes of fever among HIV patients hospitalized in the medical ward of the only hospital in the western part of French Guiana. A retrospective descriptive study was conducted between January 1st 2008 and June 30th 2010 in the department of medicine of Saint Laurent du Maroni Hospital. The main characteristics of 67 patients having presented with fever in the first 48 hours of hospitalization were described. Among patients with CD4<200/mm3 the main febrile opportunistic infection was disseminated histoplasmosis (41.1%). Among patients with CD4 counts <50/mm3 and fever without focal points 85.7% had disseminated histoplasmosis. Three patients died and all had disseminated histoplasmosis. Disseminated histoplasmosis is the most common febrile opportunistic infection in western French Guiana. Primary prophylaxis with itraconazole among immunocompromised patients seems warranted.
ISSN: 0956-4624

inserm-01082409
http://www.hal.inserm.fr/inserm-01082409
http://www.hal.inserm.fr/inserm-01082409/document
http://www.hal.inserm.fr/inserm-01082409/file/2014%2C%20Vantilcke%20-%20Fever%20and%20HIV.pdf
http://www.hal.inserm.fr/inserm-01082409/file/Histoplasmosis_tab_2%5B1%5D%20revised.pdf

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: End-Stage renal disease (ESRD) causes considerable morbidity and mortality, and significantly alterspatients’ quality of life. There are very few published data on this problem in the French Overseas territories. Thedevelopment of a registry on end stage renal disease in French Guiana in 2011 allowed to describe the magnitudeof this problem in the region for the first time.Methods: Using data from the French Renal Epidemiology and Information Network registry (R.E.I.N). Descriptivestatistics on quantitative and qualitative variables in the registry were performed on prevalent cases and incidentcases in 2011, 2012 and 2013.Results: French Guiana has one of the highest ESRD prevalence and incidence in France. The two main causes ofESRD were hypertensive and diabetic nephropathies. The French Guianese population had a different demographicprofile (younger, more women, more migrants) than in mainland France. Most patients had at least one comorbidity,predominantly (95.3%) hypertension. In French Guiana dialysis was initiated in emergency for 71.3% of patients versus33% in France (p < 0.001).Conclusion: These first results give important public health information: i) End stage renal disease has a very highprevalence relative to mainland France ii) Patients have a different demographic profile and enter care late in thecourse of their renal disease. These data are closer to what is observed in the Caribbean or in Latin America than inMainland France.
ISSN: 1471-2369

inserm-01567222
http://www.hal.inserm.fr/inserm-01567222
http://www.hal.inserm.fr/inserm-01567222/document
http://www.hal.inserm.fr/inserm-01567222/file/2017%2C%20Rochemont%20-%20End%20stage%20renal%20disease.pdf
DOI : 10.1186/s12882-017-0614-6

Éditeur(s) : HAL CCSD EDP Sciences
Résumé : The physiological ageing, the chronic conditions and the psycho-social environment are source of vulnerability to the old subject. These factors impact on the oral pathologies while the oral affections can deteriorate them on the contrary and lead the patient in the spiral of the decompensation. The clinical examination has to consist of a global approach of the eldely person, what confers it a specific character. Within the framework of this article, we propose a methodology of diagnostic survey bringing to light the necessity of interdisciplinary collaboration between the medical participants
Le vieillissement physiologique, les pathologies chroniques et l’environnement psychosocial sont source de vulnérabilité chez le sujet âgé. Ces facteurs impactent les pathologies bucco-dentaires alors que les affections orales peuvent à l’inverse les aggraver et conduire le patient dans la spirale de la décompensation. L’examen clinique doit consister en une approche globale de la personne âgée, ce qui lui confère son caractère spécifique. Dans le cadre de cet article, nous proposons une méthodologie d’enquête diagnostique mettant en évidence la nécessité de collaboration interdisciplinaire entre les intervenants médicaux
ISSN: 1760-611X

hal-01136939
https://hal.archives-ouvertes.fr/hal-01136939
DOI : 10.1 0 5 1 / a o s / 2 0 1 2 1 0 9

Éditeur(s) : HAL CCSD
Résumé : International audience
Despite the recent interest in psychiatric illness in prison, the psychopathology of the Remire-Montjoly prison population remains largely unknown. Subject to significant population movements, French Guiana and its prison houses a very mixed population in which recent history has left a strong mark (earthquake in Haïti, civil war in Suriname, violence related to gold mining population and drug trafficking). These negative life events appear as potential vectors of psychological trauma. Additionally, strong links have been established in the literature between post-traumatic stress disorder (PTSD) and many other psychiatric disorders, including suicidal behavior and addictions. Under these conditions, we felt it essential to focus on the identification of PTSD in this sensitive population.Through adapted reception interviews, we tried to identify the PTSD, to describe by means of socio-demographic factors the studied population and to detect psychiatric comorbidities. The screening tool was the M.I.N.I. 5.0, which identifies 17 psychiatric disorders including the PTSD, based on the DSM IV definition. The target population was the prison incomers, agreeing to participate in the study, aged more than 18 years old and imprisoned between 18 January 2013 and 31 December 2013. To this date, 549 inmates were included in the study.The main result of this study was a prevalence of PTSD of 17% for incomers in detention. We found that the PTSD+ population is more likely to be female (15% against 7% p = 0.0246), which is consistent with the literature data. The M.I.N.I. 5.0 showed a higher prevalence of psychiatric disorders in the PTSD+ group. This association was confirmed in several types of pathology like mood disorders including: major depressive episode and manic or hypomanic episode, suicidal risk, some anxiety disorders including: panic disorder, obsessive-compulsive disorder and generalized anxiety disorder. Strong association was found for current major depressive episode, current manic or hypomanic episode and suicidal risk (p < 0.005).The prevalence of PTSD is very high in this study, about 24 times higher than in a general population survey using the same screening tool.A large number of comorbidities have been identified, which corresponds to those described in the literature. The specific issues of psychiatry in prison lead us to examine more specifically the significance of the results about suicide risk. A comprehensive suicide risk (sum of medium and high risk screened by the M.I.N.I.) was found in significantly more PTSD+ inmates (17% versus 7%, p = 0.005). This study supports the need for routine screening of PTSD among incomers in detention. This disease is both worrying and common in this population but the real issues are the comorbidities. Suicidal potential is among the most important issues in detention. Its evaluation should be completed by an early recognition of a PTSD.
Soumis à des mouvements de population importants, la Guyane Française et son centre pénitentiaire abritentune population métissée chez qui l’histoire récente a laissé une empreinte forte (tremblement de terre en Haïti,guerre civile au Suriname, violence liée à l’orpaillage et au trafic de stupéfiants). Ces événements de vienégatifs apparaissent comme autant de vecteurs potentiels de psychotraumatismes. Dans ces conditions, il nous a paru essentiel de mettre l’accent sur le repérage du TSPT (Trouble de Stress Post-traumatique) dans cette population sensible. A l'aide d’entretiens d’accueil dédiés nous nous sommes proposé de repérer les TSPT, de décrire sur un plan sociodémographique la population étudiée et de rechercher les comorbidités psychiatriques. Le résultat principal de cette étude était une prévalence du TSPT de 17% chez les arrivants en détention. Le MINI 5.0 a montré une prévalence plus élevée des pathologies psychiatriques dans le groupe présentant un TSPT avec un lien très fort (p<0.005) pour l’épisode dépressif majeur actuel, l’épisode (hypo)maniaque actuel et le risque suicidaire. Cette étude appuie la nécessité d’avoir un dépistage systématique du TSPT chez les arrivants en détention. Cette pathologie est à la fois fréquente dans cette population et invalidante mais ce sont ses comorbidités, dont le potentiel suicidaire, qui font tout l’enjeu d’un repérage précoce.
ISSN: 0383-6320

inserm-01421075
http://www.hal.inserm.fr/inserm-01421075
http://www.hal.inserm.fr/inserm-01421075/document
http://www.hal.inserm.fr/inserm-01421075/file/2016%2C%20Arnal%20-%20Post-Traumatic%20Stress%20Disorder%20among%20Incomers%20in%20Remire-Montjoly%20Prison%2C%20French%20Guiana.pdf
PUBMED : 27570960

Éditeur(s) : HAL CCSD Publisher : Paris : Baillière [1980-. Latest Publisher : Paris : Elsevier
Résumé : National audience
Introduction L’atteinte œsophagienne est fréquente chez les patients présentant une sclérodermie systémique. Le diagnostic est confirmé par la manométrie œsophagienne. La sensibilité et la spécificité de la manométrie œsophagienne ont été améliorées par l’avènement de la manométrie de haute résolution. L’objectif principal de cette étude observationnelle est de caractériser les troubles moteurs œsophagiens par manométrie de haute résolution, à la lumière de la troisième version de la classification de Chicago, chez des patients présentant une sclérodermie systémique selon les critères de l’EULAR/ACR 2013. Patients et méthodes Trente-six patients répondant au diagnostic de sclérodermie systémique selon les critères EULAR/ACR 2013 et ayant bénéficié d’une manométrie de haute résolution dans un centre de compétence français ont été inclus de manière consécutive. Les résultats de la manométrie de haute résolution ont été interprétés selon la troisième version de la classification de Chicago. Les caractéristiques cliniques, biologiques et les atteintes viscérales des patients ont également été relevées et confrontées aux données manométriques. L’atteinte pulmonaire était évaluée selon la méthode de Goh et al. en aveugle des données manométriques. Résultats L’âge moyen à l’inclusion était de 58,4 ans (SD = 14,2 ans) ; 83,3 % des patients étaient de sexe féminin. 22,2 % des patients avaient une sclérodermie systémique avec atteinte cutanée diffuse selon la classification de LeRoy ; 67 % des patients avaient un pyrosis, 30,6 % une dysphagie, 33,3 % une dyspepsie. 11 % des patients avaient des épisodes de fausses routes. D’après les résultats de la manométrie de haute résolution, 55,6 % des patients avaient un apéristaltisme, 33,3 % une hypotonie du sphincter inférieur de l’œsophage et 19,4 % une hypotonie du sphincter supérieur de l’œsophage. En analyse univariée, il n’était pas retrouvé d’association significative entre la présence d’une hypotonie du sphincter inférieur de l’œsophage et les caractéristiques cliniques ou biologiques quelles qu’elles soient. La présence d’un apéristaltisme était associée avec une symptomatologie de pyrosis (p = 0,004). L’apéristaltisme était associé de manière significative avec la présence de télangiectasies (p = 0,007) et d’anticorps anti-centromères (p = 0,038). La présence de calcinose ou d’une sclérodactylie n’était pas spécifiquement associée à une atteinte sphinctérienne ou motrice œsophagienne. Vingt-neuf patients (80,6 %) avaient bénéficié d’une TDM thoracique dans l’année de la réalisation de la manométrie de haute résolution. Parmi eux, 7 patients étaient atteints d’une pneumopathie interstitielle diffuse sévère (atteinte interstitielle de plus de 20 % du parenchyme pulmonaire évaluée sur 5 coupes standardisées). Il existait une association significative entre la présence d’un apéristaltisme et la présence d’une dilatation œsophagienne en TDM (p = 0,002) et la présence d’une atteinte pulmonaire sévère (p = 0,005, OR = 6,85 IC95 % (1,12–41,82)). Discussion L’association retrouvée entre apéristaltisme en manométrie de haute résolution et sévérité de la PID est confirmée par ce travail. Néanmoins un lien de causalité n’est pas certain. Une étude prospective évaluant la mise en évidence d’une atteinte œsophagienne par manométrie de haute résolution au moment du diagnostic de sclérodermie systémique et l’atteinte pulmonaire par TDM à distance serait nécessaire. L’entité nosologique représentée par le syndrome CREST n’est pas retrouvée dans cette cohorte de patients atteints de sclérodermie systémique selon les critères EULAR/ACR 2013, où 2 des critères diagnostiques (présence de calcinose et sclérodactylie) ne sont pas associés de manière significative à l’atteinte œsophagienne d’après les résultats de la manométrie de haute résolution. Conclusions Dans cette série, chez plus de la moitié des patients atteints de sclérodermie systémique la manométrie de haute résolution permet de détecter un apéristaltisme. La présence de troubles moteurs œsophagiens est associée à une atteinte pulmonaire plus sévère en TDM
ISSN: 0248-8663

hal-01321854
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01321854
DOI : 10.1016/j.revmed.2016.04.267

Éditeur(s) : HAL CCSD Springer Verlag
Résumé : International audience
Bronchoalveolar lavage (BAL) is a major diagnostic tool in lung diseases, including viral respiratory infections. We aimed to better define the situations where viral tests should be performed on BAL fluid (BALF). We retrospectively studied all cases where viral tests [immunofluorescence, immunocytochemistry, viral culture, and/or polymerase chain reaction (PCR)] were performed on BALF during a period of 1 year (2008) in our institution. We compared the characteristics of patients with virus-positive versus virus-negative BALF. Of the 636 BALF samples sent to the microbiology laboratory, 232 underwent viral tests. Of these, 70 (30 %) were positive and identified 85 viruses: herpes simplex virus (HSV)-1 (n = 27), cytomegalovirus (CMV, n = 23), Epstein-Barr virus (EBV, n = 18), human herpesvirus (HHV)-6 (n = 12), respiratory syncytial virus (RSV, n = 3), rhinovirus (n = 1), and adenovirus (n = 1). The variables associated with positive viral tests on univariate analysis were immunosuppression [human immunodeficiency virus (HIV), corticosteroids >10 mg/day for ≥3 weeks, or other immunosuppressive therapy], ground-glass attenuations on computed tomography (CT) scanning, late-onset ventilator-associated pneumonia (VAP), and durations of (i) hospital stay, (ii) intensive care unit (ICU) stay, and (iii) mechanical ventilation before BAL (p < 0.01 for each comparison). On multivariate analysis, only immunosuppression [odds ratio (OR) 6.4, 95 % confidence interval (CI) [2.8-14.3], p < 0.0001] and ground-glass attenuations (OR 3.7, 95 % CI [1.8-7.7], p = 0.0004) remained associated with virus-positive BAL. None of the viral tests performed on BALF for the initial assessment of diffuse infiltrative lung disease (n = 15) was positive. PCR improved the diagnostic yield of viral tests on BALF by 50 %. Testing for viruses on BALF should be mostly restricted to immunocompromised patients with acute respiratory diseases and/or patients with unexplained ground-glass attenuations on CT scanning.
ISSN: 0934-9723

hal-00873158
https://hal.archives-ouvertes.fr/hal-00873158
DOI : 10.1007/s10096-012-1791-7
PUBMED : 23238685

Éditeur(s) : HAL CCSD Springer Verlag
Résumé : International audience
The objective of this study is to assess the association of clinical manifestations of systemic sclerosis (SSc) with the absolute count of circulating blood monocyte subpopulations according to their membrane expression of CD16. Forty-eight consecutive patients fulfilling the 2013 ACR/EULAR classification criteria for SSc were included in this cross-sectional study. CD16+ monocyte absolute count was defined by flow cytometry and confronted to the clinical characteristics of SSc patients. Twenty-three healthy donors (HD) were randomly selected for comparison. SSc patients had an increased number of total circulating blood monocytes compared to HD (p < 0.001). The CD16- subpopulation absolute count was increased in SSc patients compared to HD (p < 0.001) but was similar in limited SSc (lSSc) and diffuse SSc (dSSc). On the contrary, the CD16+ population absolute count was increased in dSSc compared to both HD and lSSc patients (dSSc 0.071 Giga/L (+/- 0.034) vs HD 0.039 Giga/L (+/- 0.030), p < 0.01, and dSSc 0.071 Giga/L (+/- 0.034) vs lSSc 0.048 Giga/L (+/- 0.024), p < 0.05). The CD16+ monocyte subpopulation absolute count was significantly correlated with the severity of skin fibrosis evaluated by the modified Rodnan skin score (p < 0.001). The CD16+ monocyte subpopulation was also associated with pulmonary fibrosis (p < 0.05), with the severity of the restrictive ventilatory defect evaluated by total lung capacity (p < 0.05) and with the pulmonary function impairment reflected by diffusing capacity of the lungs for carbon monoxyde measures (p < 0.01). These results suggest that CD16+ monocytes are associated with the main fibrotic manifestations of SSc and their role in the pathogenesis of fibrosis in this autoimmune disorder should therefore be further considered.
ISSN: 0770-3198

hal-01560150
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01560150
DOI : 10.1007/s10067-017-3597-6
PUBMED : 28293753

Éditeur(s) : 11th Pacific Science Inter-Congress / 2nd Symposium on French Research in the Pacific, Tahiti
Résumé : In order to have a standardised database gathering most information on New Caledonian prawn farms a software, called “Stylog-module ferme”, was developed and implemented by Ifremer with the help of shrimp farmers. Data recording results in more than 2 million data from 250 crops since the beginning of the project (2003). The main objective is to help the researchers in understanding the processes taking place in a cultured pond. It also provides a follow-up of the prawn farming industry (evolution of management practices, health surveillance system…) and to facilitate sharing of information between the different partners of the industry (prawn farmers, research and local authorities). Finally, this decision-making tool also helps shrimp farmers for routine crop management. This poster presents the method and tools used to create this database, from the definition of specifications, in close relation with end users, to the implementation of a real project structure, including all partners (users committee and steering committee, agreement of confidentiality). It also shows some examples resulting from the analysis of these data (investigating good management practices indicators, publishing technical bulletins or specific data analysis for research…). Finally, the networking (Extranet) of this base seems to present real perspectives in sharing information, and analysis capacity.
Afin de disposer d'une base de données regroupant un maximum d'informations collectées sur les fermes de grossissement de crevettes de Nouvelle-Calédonie, dans un format informatisé et standardisé, un logiciel nommé « Stylog – module ferme » a été développé par l'Ifremer en lien avec les aquaculteurs. L'archivage des données a permis de collecter depuis le début de sa conception (2003) plus de 2 millions de données représentant près de 250 élevages. Les objectifs principaux de cette base sont d'aider les chercheurs dans la compréhension de phénomènes pouvant survenir dans un bassin d'élevage, d'assurer un suivi de la filière (évolution des pratiques zootechniques, veille clinique…) et de faciliter les échanges d'informations entre les différents partenaires de la filière (aquaculteurs privés, recherche, institutions). Enfin, cet outil d'aide à la décision permet aux aquaculteurs de gérer leurs élevages au quotidien. Ce poster explique d'une part, la méthode et les outils utilisés pour créer cette base de données, de la réalisation du cahier des charges, en lien étroit avec les utilisateurs finaux, à la mise en place d'une réelle structure projet regroupant les différents partenaires (comité des utilisateurs et comité de pilotage, convention de confidentialité). D'autre part, il présente quelques exemples de résultats en termes d'utilisation de ces données (recherche d'indicateurs de qualité d'élevage, édition de bulletins techniques, analyses de données spécifiques à la recherche…). Enfin, la mise en réseau (Extranet) de cette base semble présenter de réelles perspectives en termes de partage de l'information et de capacité d'analyses.

Droits : 2009 Ifremer
http://archimer.ifremer.fr/doc/00065/17659/15189.pdf
http://archimer.ifremer.fr/doc/00065/17659/

Éditeur(s) : HAL CCSD
Résumé : International audience
A prospective study on randomized patients was conducted to determine how morphokinetic parameters are altered in embryos grown in sequential versus global culture media. Eleven morphokinetic parameters of 160 single embryos transferred were analyzed by time lapse imaging involving two University-affiliated in vitro fertilization (IVF) centers. We found that the fading of the two pronuclei occurred earlier in global (22.56±2.15 hpi) versus sequential media (23.63±2.71 hpi; p=0.0297). Likewise, the first cleavage started earlier at 24.52±2.33 hpi vs 25.76±2.95 hpi (p=0.0158). Also, the first cytokinesis was shorter in global medium, lasting 18±10.2 minutes in global versus 36±37.8 minutes in sequential culture medium (p <0.0001). We also observed a significant shortening in the duration of the 2-cell stage in sequential medium: 10.64 h±2.75 versus 11.66 h±1.11 in global medium (p=0.0225) which suggested a faster progression of the embryos through their first mitotic cell cycle. In conclusion, morphokinetic analysis of human embryos by Time lapse imaging reveals significant differences in five kinetic variables according to culture medium. Our study highlights the need to adapt morphokinetic analysis accordingly to the type of media used to best support human early embryo development.
Annales de Biologie Clinique

hal-01579406
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01579406
DOI : 10.1684/abc.2017.1259
PUBMED : 28751285

Éditeur(s) : HAL CCSD ACSM
Résumé : International audience
The aim of this study was to examine the effects of the cycle-run and run-cycle successions of the triathlon and duathlon, respectively, on respiratory muscle strength and endurance. Methods: Respiratory muscle strength was assessed by measuring maximal inspiratory (P1max) and expiratory {PEmax) pressures. Respiratory muscle endurance was assessed by measuring the time limit (Tlim). Twelve triathleles participated in a three-trial protocol. The first trial consisted of an incremental cycle test to assess the maximal oxygen uptake (VO2max) of triathletes. Trial 2 consisted of 20 min of cycling followed by 20 min of running (C-R), and trial 3 consisted of 20 min of running followed by 20 min of cycling (R-C). Trials 2 and 3 were performed at the same metabolic intensity (% VO2max). P1max and P1max were measured before and 10 min after C-R and R-C, and I min after the post-C-R and post-R-C Tlim measurements (P1max l'). Tlim was measured I d before and 30 min after C-R and R-C. Results: The results showed a significant decrease in P1max after C-R (126.7 ± 4.3 cmH2O, P < 0.05) and R-C (123.7 ± 4.9 cmH2O, P < 0.05) compared with the baseline values (130 ± 3.8 and 129.6 ± 4.3 cmH2O, respectively). P1max 1' showed a significantly greater decrease after R-C versus C-R(111.2 ± 5.5 cmH2O vs 121.2 ± 3.9 cmH2O,respectively, P < 0.001). Tlim after C-R (3.3 ± 0.3 min) decreased significantly compared with baseline values (4.19 ± 0.3min and 4.02 ± 0.3 min, respectively). However, the Tlim decrease after R-C was significantly greater than after C-R (P < 0.001). Conclusion: We concluded that respiratory muscle strength and endurance were less decreased after the cycle-run succession and that cycling induced a greater decrease in respiratory muscle endurance than running.
Medicine & Science in Sports & exercise

hal-00720796
https://hal.univ-antilles.fr/hal-00720796

Éditeur(s) : HAL CCSD Taylor & Francis (Routledge)
Résumé : International audience
The French Antilles (Martinique, Saint Martin and Guadeloupe) and French Guiana are the French territories most affected by the HIV epidemic. Some population groups such as men who have sex with men (MSM), especially those involved in transactional sex, are thought to be particularly vulnerable to HIV but few data exist to help characterize their health-related needs and thus implement relevant prevention interventions. To fill this knowledge gap, we used data collected from an HIV/AIDS Knowledge, Attitudes, Behaviours and Practices survey conducted in 2012 among MSM living in the French Antilles and French Guiana and recruited through snowball sampling. Our objectives were to compare social and demographic characteristics and sexual behaviours between MSM engaging in transactional sex and MSM not engaging in transactional sex and to identify factors associated with transactional sex involvement using a logistic regression model. A total of 733 MSM were interviewed, 21% of whom reported to undergo transactional sex. Their behaviour and social and demographic characteristics were different from other MSMs’ and they were more exposed to factors that are recognized to potentiate HIVvulnerability, at the individual, community, network and structural levels. The variables positively associated with sex trade involvement were having ever consumed drug (OR = 2.84 [1.23–6.52]; p = .002), having a greater number of sex partners than the median (OR = 8.31 [4.84–14.30]; p < .001), having experienced intimate partner violence (OR = 1.72 [0.99–3.00]; p = .053) and having undergone physical aggression because of sexual orientation (OR = 2.84 [1.23–6.52];p = .014). Variables negatively associated with sex trade involvement were being older (OR = 0.93 [0.90–0.97] per year; p = .001), having a stable administrative situation (OR = 0.10 [0.06–0.19]; p < .001), having a stable housing (OR = 0.29 [0.15–0.55]; p < .001) and being employed full-time (OR = 0.29 [1.23–6.52]; p = .002).
ISSN: 0954-0121

inserm-01407263
http://www.hal.inserm.fr/inserm-01407263
http://www.hal.inserm.fr/inserm-01407263/document
http://www.hal.inserm.fr/inserm-01407263/file/AIDS%20Care%20final%20version.pdf
DOI : 10.1080/09540121.2016.1234680

Éditeur(s) : HAL CCSD
Résumé : International audience
BACKGROUND AND AIM: The impact of basal core promoter (BCP) and precore (PC) mutants of the hepatitis B virus (HBV) on liver disease severity remains controversial. The aim of the present study was to screen BCP and PC mutations in 252 HBV surface antigen (HBsAg) positive carriers in France and to assess relationships between these mutations and severe fibrosis. METHODS: Direct sequencing of the precore/core gene was used to detect A1762T/G1764A and G1757A mutations in the BCP and G1896A and G1899A mutations in the PC region. RESULTS: The prevalences of A1762T/G1764A, G1757A, G1896A, and G1899A mutations were 34.1%, 38.7%, 54.9%, and 29.3% (P < 0.001), respectively. The independent predictors of severe fibrosis (>/=F3 Metavir) were older age (P < 0.001), male gender (P = 0.012), elevated alanine aminotransferase (P < 0.001), and the double A1762T/G1764A mutant with no other mutations (P = 0.011). Interestingly, the association of the G1899A mutation with the double A1762T/G1764A mutant significantly counteracted the deleterious effect of the sole double A1762T/G1764A mutant (odds ratio [OR] = 0.28 vs. OR = 3.55, respectively, P = 0.028). CONCLUSIONS: Patients with the A1762T/G1764A mutation have a higher risk of severe fibrosis. The G1899A mutation is a protective factor against severe fibrosis that counteracted the deleterious effect of the A1762T/G1764A mutation. Finally, host phenotypic and HBV genotypic markers independently predict fibrosis severity.
Journal of gastroenterology and hepatology

hal-01477209
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01477209
DOI : 10.1111/jgh.13338
PUBMED : 26992056

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Patients with sickle cell anemia (SCA) have usually lower diastolic, systolic and mean blood pressure (BP) than the general population. However, BP values ≥120/70 mmHg considerably increase the risk for acute and chronic complications in SCA. The aim of this study was to identify biological factors associated with relative hypertension in adults with SCA. We compared the hematological, lipid and hemolytic profiles, as well as blood viscosity, between SCA patients with normal BP (<120/70 mmHg, n = 54) and those with relative hypertension (BP≥120/70 mmHg, n = 43). Our results demonstrated that male gender (OR: 3.49; 95%CI 1.20 to 10.16, p<0.05), triglycerides (OR: 9.19; 95% CI 2.29 to 36.95, p<0.01), blood viscosity (OR: 1.35; 95% CI 1.01 to 1.81, p<0.05) and body mass index (OR: 1.37; 95% CI 1.14 to 1.64, p<0.01) were independent risks factors for relative hypertension in SCA. No association was found between the BP status and the positive history of painful vaso-occlusive crisis or acute chest syndrome. An association between triglycerides level and the occurrence of these two major acute complications was detected. Our study suggests that male gender, increased triglycerides level, BMI and blood viscosity could increase the risk for developing relative hypertension in SCA. In addition, our results support a role of moderately elevated triglycerides in the pathophysiology of vaso-occlusive events.
ISSN: 1932-6203

inserm-00838991
http://www.hal.inserm.fr/inserm-00838991
http://www.hal.inserm.fr/inserm-00838991/document
http://www.hal.inserm.fr/inserm-00838991/file/Lamarre_et_al._2013_PloS_ONE_.pdf
DOI : 10.1371/journal.pone.0066004

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BACKGROUND: In Guadeloupe and Martinique, two French Overseas Departments, colorectal cancer (CRC) has become an essential public health issue. However, little is known about CRC characteristics and the p53 status in these populations, particularly in Guadeloupe, whereas certification of a cancer registry has been recently validated. METHODS: This was a descriptive retrospective study of 201 patients who, between 1995 and 2000, underwent surgery for CRC in the Guadeloupe Teaching Hospital (GlpeTH; 83 patients) and in the Martinique Teaching Hospital (MqueTH; 118 patients). The clinicopathological features and the p53 expression, evaluated with immunohistochemistry, were compared at the time of diagnosis. A relationship between these parameters and the p53 expression was also studied. Data were analysed, using the SPSS computer software version 17.0. RESULTS: No statistical difference was found between the two groups of patients regarding age (p = 0.60), percentage of young patients (<=50 years; p = 0.94)), sex (p = 0.47), histological type (p = 0.073) and tumour sites (p = 0.65), although the GlpeTH patients were diagnosed with more distal colon cancers (54.2%) than the Mque TH patients (47.4%). By contrast, a significant difference was found regarding the tumour grade (p < 0.0001), the pTNM stage (p = 0.045) and the pT stage (p < 0.0001). Regarding p53 expression, solely for the MqueTH patients, nuclear expression was associated with pTNM, the percentage of p53 negative tumours increasing with the progression of the pTNM stages (p = 0.029). CONCLUSIONS: For the first time, this study reveals discrepancies in clinicopathological features and in the p53 status between the two groups of patients. The GlpeTH patients were diagnosed with more moderated CRCs but with few CRCs at pTNM IV stage. By contrast, the MqueTH patients were diagnosed with more differentiated tumours, but with many more CRCs at pTNM IV stage. This paradox may be due to differences in tumour location (distal vs proximal), multiplicity of the genetic profiles of patients, or patients getting treatment elsewhere. Although our study is limited due to its small size, it emphasizes the originality of our results.
ISSN: 1472-6890

inserm-00971313
http://www.hal.inserm.fr/inserm-00971313
http://www.hal.inserm.fr/inserm-00971313/document
http://www.hal.inserm.fr/inserm-00971313/file/1472-6890-14-12.pdf
DOI : 10.1186/1472-6890-14-12

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
BACKGROUND: Dengue fever is the most important arboviral infection that affects humans, particularly in tropical and subtropical regions. Here, we provide the first comprehensive overview of the severity of dengue epidemics in French Guiana. METHODOLOGY/PRINCIPAL FINDINGS: We monitored hospitalized cases between 2008 and 2013. Detailed clinical features and biological parameters were collected on a daily basis from all cases. Among the 1,356 cases, 216 (16%) were classified according to the WHO 2009 classification as dengue without warning signs (WS), 926 (68%) were classified as dengue with WS and 214 (16%) were classified as severe dengue. The severity rates were similar between the three major epidemics that occurred during the study period, whereas the hospitalization rate was highest in 2013. Fluid accumulation, aspartate aminotransferase (ASAT) counts>193 IU/L and platelet counts<75,000 cells/mm3 were associated with dengue severity. CONCLUSIONS/SIGNIFICANCE: Our findings provide a recent epidemiological description of the severity of dengue epidemics in French Guiana. These results highlight the potential impacts and consequences of implementing the WHO 2009 classification on hospital activity. Future studies should include virological and immunological investigations of well-documented serum samples.
ISSN: 1932-6203

hal-01477201
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01477201
DOI : 10.1371/journal.pone.0172267
PUBMED : 28196111

Éditeur(s) : HAL CCSD MDPI
Résumé : International audience
Malaria remains one of the most common vector-borne diseases in the world and the definition of novel control strategies can benefit from the modeling of transmission processes. However, data-driven models are often difficult to build, as data are very often incomplete, heterogeneous in nature and in quality, and/or biased. In this context, a knowledge-based approach is proposed to build a robust and general landscape-based hazard index for malaria transmission that is tailored to the Amazonian region. A partial knowledge-based model of the risk of malaria transmission in the Amazonian region, based on landscape features and extracted from a systematic literature review, was used. Spatialization of the model was obtained by generating land use and land cover maps of the cross-border area between French Guiana and Brazil, followed by computing and combining landscape metrics to build a set of normalized landscape-based hazard indices. An empirical selection of the best index was performed by comparing the indices in terms of adequacy with the knowledge-based model, intelligibility and correlation with P. falciparum incidence rates. The selected index is easy to interpret and successfully represents the current knowledge about the role played by landscape patterns in malaria transmission within the study area. It was significantly associated with P. falciparum incidence rates, using the Pearson and Spearman correlation coefficients (up to 0.79 and 0.75, respectively; p-value < 0.001), and the linear regression coefficient of determination (reaching 0.63; p-values < 0.001). This study establishes a spatial knowledge-driven, landscape-based hazard malaria index using remote sensing that can be easily produced on a regular basis and might be useful for malaria prediction, surveillance, and control. Keywords: remote sensing; land use and land cover; landscape metric; knowledge-based hazard modeling; malaria; cross-border area between French Guiana and Brazil
ISSN: 2072-4292

hal-01355255
https://hal.archives-ouvertes.fr/hal-01355255
https://hal.archives-ouvertes.fr/hal-01355255/document
https://hal.archives-ouvertes.fr/hal-01355255/file/010066865.pdf
IRD : fdi:010066865

Éditeur(s) : HAL CCSD
Résumé : International audience
Background: The aim of this study was to identify the predictive factors of HIV disclosure to the sex partner in HIV pregnant women in Cayenne (French Guiana). Methods: A case control study was conducted including all deliveries in Cayenne from 2003 to 2010. For each case, a standardized questionnaire including epidemiological, clinical, and biological data was administered. Thirty-four women in the first group and 95 in the control group were included in the study. Results: The logistic regression showed that the variables that independently predicted HIV disclosure to the sex partner were the existence of a profession (OR=5.62, IC95% =1.3-24.26, p=0.021), disclosure to the doctor (OR=12.65, IC95% =2.87-55.8, p<0.001), the negative representations of HIV (OR=5.99, IC95% =1.17-30.69, p=0.032). The partner's HIV status was also linked to the outcome (OR=0.01, IC95% =0.001-0.07, p<0.001). Conclusion: These predictive factors should be considered in positive prevention programs and prevention of mother to child transmission.
Epidemiol

inserm-00915113
http://www.hal.inserm.fr/inserm-00915113
http://www.hal.inserm.fr/inserm-00915113/document
http://www.hal.inserm.fr/inserm-00915113/file/2012_Elenga_-_Predictive_Factorssur HIV_Status_Disclosure_to_Sex_Partner_in_Pregnant_women_in_cayenne_french_guiana.pdf
DOI : 10.4172/2161-1165.1000116

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
BACKGROUND: Histoplasmosis is an endemic fungal infection in French Guiana. It is the most common AIDS-defining illness and the leading cause of AIDS-related deaths. Diagnosis is difficult, but in the past 2 decades, it has improved in this French overseas territory which offers an interesting model of Amazonian pathogen ecology. The objectives of the present study were to describe the temporal trends of incidence and mortality indicators for HIV-associated histoplasmosis in French Guiana. METHODS: A retrospective study was conducted to describe early mortality rates observed in persons diagnosed with incident cases of HIV-associated Histoplasma capsulatum var. capsulatum histoplasmosis admitted in one of the three main hospitals in French Guiana between 1992 and 2011. Early mortality was defined by death occurring within 30 days after antifungal treatment initiation. Data were collected on standardized case report forms and analysed using standard statistical methods. RESULTS: There were 124 deaths (45.3%) and 46 early deaths (16.8%) among 274 patients. Three time periods of particular interest were identified: 1992-1997, 1998-2004 and 2005-2011. The two main temporal trends were: the proportion of early deaths among annual incident histoplasmosis cases significantly declined four fold (χ2, p<0.0001) and the number of annual incident histoplasmosis cases increased three fold between 1992-1997 and 1998-2004, and subsequently stabilized. CONCLUSION: From an occasional exotic diagnosis, AIDS-related histoplasmosis became the top AIDS-defining event in French Guiana. This was accompanied by a spectacular decrease of early mortality related to histoplasmosis, consistent with North American reference center mortality rates. The present example testifies that rapid progress could be at reach if awareness increases and leads to clinical and laboratory capacity building in order to diagnose and treat this curable disease.
ISSN: 1935-2727

inserm-01065109
http://www.hal.inserm.fr/inserm-01065109
http://www.hal.inserm.fr/inserm-01065109/document
http://www.hal.inserm.fr/inserm-01065109/file/PLOS_Neglected_Tropical_Dis_2014.pdf
http://www.hal.inserm.fr/inserm-01065109/file/2014_Adenis_-_HIV-associated_histoplasmosis_early_mor.pdf

Éditeur(s) : HAL CCSD Springer Verlag
Résumé : International audience
Pituitary adenomas are currently classified by histological, immunocytochemical and numerous ultrastructural characteristics lacking unequivocal prognostic correlations. We investigated the prognostic value of a new clinicopathological classification with grades based on invasion and proliferation. This retrospective multicentric case-control study comprised 410 patients who had surgery for a pituitary tumour with long-term follow-up. Using pituitary magnetic resonance imaging for diagnosis of cavernous or sphenoid sinus invasion, immunocytochemistry, markers of the cell cycle (Ki-67, mitoses) and p53, tumours were classified according to size (micro, macro and giant), type (PRL, GH, FSH/LH, ACTH and TSH) and grade (grade 1a: non-invasive, 1b: non-invasive and proliferative, 2a: invasive, 2b: invasive and proliferative, and 3: metastatic). The association between patient status at 8-year follow-up and age, sex, and classification was evaluated by two multivariate analyses assessing disease- or recurrence/progression-free status. At 8 years after surgery, 195 patients were disease-free (controls) and 215 patients were not (cases). In 125 of the cases the tumours had recurred or progressed. Analyses of disease-free and recurrence/progression-free status revealed the significant prognostic value (p < 0.001; p < 0.05) of age, tumour type, and grade across all tumour types and for each tumour type. Invasive and proliferative tumours (grade 2b) had a poor prognosis with an increased probability of tumour persistence or progression of 25- or 12-fold, respectively, as compared to non-invasive tumours (grade 1a). This new, easy to use clinicopathological classification of pituitary endocrine tumours has demonstrated its prognostic worth by strongly predicting the probability of post-operative complete remission or tumour progression and so could help clinicians choose the best post-operative therapy.
ISSN: 0001-6322

hal-00875723
https://hal.archives-ouvertes.fr/hal-00875723
DOI : 10.1007/s00401-013-1084-y
PUBMED : 23400299