Éditeur(s) : HAL CCSD
Résumé : International audience
To assess prognostic factors for survival and describe Model for End-Stage liver disease (MELD) dynamics in human immunodeficiency virus+/hepatitis C virus+ (HIV+/HCV+) patients after an initial episode of hepatic decompensation.An HIV+/HCV+ cohort of patients experiencing an initial decompensation episode within the year preceding enrollment were followed prospectively. Clinical and biological data were collected every 3 months. Predictors for survival were identified using Kaplan-Meier curves and Cox models. A 2-slope-mixed linear model was used to estimate MELD score changes as a function of survival.Sixty seven patients were included in 32 centers between 2009 and 2012 (72% male; median age: 48 years [interquartile ratio (IQR):45-52], median follow-up: 22.4 months [range: 0.5-65.3]). Overall survival rates were 86%, 78%, and 59% at 6, 12, and 24 months, respectively. Under multivariate analysis, the MELD score at initial decompensation was predictive of survival, adjusted for age, type of decompensation, baseline CD4 counts, and further decompensation during follow-up as a time-dependent variable. The adjusted hazard ratio of death was 1.32 for a score 3 points higher (95% CI: [1.06-1.63], P = 0.012). MELD score kinetics within the 6 months after initial decompensation differed significantly between non-deceased and deceased patients, with a decreased (-0.49/month; P = 0.016), versus a flat (+0.06/month, P = 0.753) mean change in score.MELD is an effective tool to predict survival in HIV+/HCV+ patients with decompensated cirrhosis. A non-decreasing MELD score within 6 months following this initial decompensation episode may benefit from privileged access to liver transplantation in this poor prognosis population
Medicine

hal-01205351
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01205351
DOI : 10.1097/MD.0000000000001239
PUBMED : 26222860

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Despite the dramatic reductions in children's blood lead levels (BLLs), there is considerable evidence that low-level lead exposure is associated with intellectual deficits and behavioral problems, without apparent threshold. There are limited data, however, about the contribution of residential sources of lead to contemporary children's blood lead levels. The aim of this study is to calculate the contributions of residential sources of lead to assess the potential impact of setting new standards for lead levels in residential dust, soil and water. We enrolled 484 French children aged from 6 months to 6 years, and collected data on social, housing and individual characteristics. Lead concentrations in blood and environmental samples (water, soils, and dusts) were measured using inductively coupled plasma mass spectrometry. Data were analyzed using a multivariate generalized additive model accounting for the sampling design and the sampling weights. We found that exceedingly low concentrations of lead in dust, soil and water were significant predictors of children's BLLs, after adjustment for potential confounding variables. Lead-contaminated floor dust was the main source of lead in blood. BLLs (GM: 14μg/L) increased by 65%, 13%, 25%, and 5% when lead content in floor dust, loose soil, hard soil and water increased from their 25th percentile to their 95th percentile, respectively. We also observed that the steepest increase in BLLs occurred at the lowest levels of lead-contaminated floor dust, which indicates that lead contamination should be kept as low as possible. Impact of different possible standards on children's BLLs was also tabulated and indicated that unless standards are set low, they will only benefit a small proportion of children who have the highest exposures.
ISSN: 1438-4639

inserm-00821999
http://www.hal.inserm.fr/inserm-00821999
DOI : 10.1016/j.ijheh.2013.02.007
PUBMED : 23528234

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
The distribution of the lagoon cockle Cerastoderma glaucum is strongly fragmented and usually restricted to isolated, shallow and nontidal lagoons. A high level of genetic structuring was found among the European populations of this species based on mtDNA (COI) sequences, as well as allozymic and microsatellite markers. However, the strengths and geographic locations of the major divisions differed among markers. In the present study we characterized the diversity of a new, potentially universal exon-primed intron-crossing marker, i34, for 17 C. glaucum populations. Allele frequency data at the i34 locus were informative and relevant with respect to geography. Multivariate analyses of new data together with previously published microsatellites confirmed the divergent character of the Ionian Sea and the Aegean-Ponto-Caspian populations, but also revealed the existence of a genetic cline from the Bay of Biscay to the Baltic Sea. Some noncongruent patterns among loci were detected, which may reflect either differential introgression along the genome at the hypothetical contact zone, or selective sweeps. This strong genetic differentiation, and the occurrence of private alleles, may hint at the presence of cryptic species within C. glaucum.
ISSN: 0260-1230

hal-01444646
https://hal.archives-ouvertes.fr/hal-01444646
DOI : 10.1093/mollus/eyw019

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
BACKGROUND: Dengue and malaria are two major public health concerns in tropical settings. Although the pathogeneses of these two arthropod-borne diseases differ, their clinical and biological presentations are unspecific. During dengue epidemics, several hundred patients with fever and diffuse pain are weekly admitted at the emergency room. It is difficult to discriminate them from patients presenting malaria attacks. Furthermore, it may be impossible to provide a parasitological microscopic examination for all patients. This study aimed to establish a diagnostic algorithm for communities where dengue fever and malaria occur at some frequency in adults. METHODOLOGY/PRINCIPAL FINDINGS: A sub-study using the control groups of a case-control study in French Guiana - originally designed to compare dengue and malaria co-infected cases to single infected cases - was performed between 2004 and 2010. In brief, 208 patients with malaria matched to 208 patients with dengue fever were compared in the present study. A predictive score of malaria versus dengue was established using .632 bootstrap procedures. Multivariate analysis showed that male gender, age, tachycardia, anemia, thrombocytopenia, and CRP>5 mg/l were independently associated with malaria. The predictive score using those variables had an AUC of 0.86 (95%CI: 0.82-0.89), and the CRP was the preponderant predictive factor. The sensitivity and specificity of CRP>5 mg/L to discriminate malaria from dengue were of 0.995 (95%CI: 0.991-1) and 0.35 (95%CI 0.32-0.39), respectively. CONCLUSIONS/SIGNIFICANCE: The clinical and biological score performed relatively well for discriminating cases of dengue versus malaria. Moreover, using only the CRP level turned to be a useful biomarker to discriminate feverish patients at low risk of malaria in an area where both infections exist. It would avoid more than 33% of unnecessary parasitological examinations with a very low risk of missing a malaria attack.
ISSN: 1935-2727

inserm-00872353
http://www.hal.inserm.fr/inserm-00872353
http://www.hal.inserm.fr/inserm-00872353/document
http://www.hal.inserm.fr/inserm-00872353/file/journal.pntd.0002420.pdf
DOI : 10.1371/journal.pntd.0002420

Éditeur(s) : Elsevier
Résumé : The discovery of deep-sea hydrothermal vent fauna, kilometres deep in the oceans, is a great achievement of 20th-century marine biology. The deep-sea hydrothermal food web does not directly depend on the sun's energy. Vent communities rely primarily on trophic associations between chemoautotrophic bacteria and consumers A small. number of endemic taxa are adapted to the inhospitable vent environments that are distributed along ridge crests. Where these vent communities originated and how they dispersed are among the important questions ecologists must answer. Here, by statistical analysis of the most comprehensive database ever assembled about deep-sea hydrothermal fauna, we delineate six major hydrothermal provinces in the world ocean and identify seven possible dispersal pathways between adjacent provinces. Our model suggests that the East-Pacific Rise may have played a pivotal role as a centre of dispersal for the hydrothermal fauna. Our data-driven conclusion will have to be tested by phylogenetic studies and completed by surveys of less-explored fields.
Deep Sea Research Part I: Oceanographic Research Papers (0967-0637) (Elsevier), 2009-08 , Vol. 56 , N. 8 , P. 1371-1378

Droits : 2009 Elsevier Ltd All rights reserved.
http://archimer.ifremer.fr/doc/2009/publication-6936.pdf
http://archimer.ifremer.fr/doc/2009/sup-6936.xls
DOI:10.1016/j.dsr.2009.01.009
http://archimer.ifremer.fr/doc/00000/6936/