Éditeur(s) : UNDP Guyana UNDP Guyana ( Guyana )
Résumé : (Funding) Support for the development of the technical infrastructure and partner training provided by the United States Department of Education TICFIA program.
While the global response to HIV and AIDS has realized several successes in achieving universal access to prevention, care and treatment to date, challenges persist in ensuring equal access to these services for most at risk populations. The epidemiology of HIV reflects a stark disparity in access to prevention and treatment services for neglected most-at risk populations, such as men who have sex with men (MSM). World-wide, MSM often experience higher rates of HIV relative to the total population. The reasons for this dynamic are multi-faceted and include high risk behaviors, and cultural as well as structural barriers. For MSM in developing countries, for example, basic services for prevention and treatment of HIV infection have yet to reach the large majority of men. Homophobia and discrimination limit access of MSM to prevention services and markedly increase vulnerability, as do criminalization of same-sex behavior. Decriminalization of same-sex behavior is a structural intervention for prevention of HIV infection and has recently been embraced by a nonbinding statement from the United Nations (Beyrer C,Clin Infect Dis. 2010 May 15;50 Suppl 3:S108-13) In the Caribbean, all of the above mentioned barriers exist. In fact, recent evidence demonstrates that there is a correlation between the decriminalization of homosexuality and lower rates of HIV (UNAIDS). This correlation is attributed to improved access to services. Therefore, The United Nations Development Program (UNDP) has recently launched an initiative to address the current situation regarding men who have sex with men in Guyana where the HIV prevalence in this population is 19.4% in contrast to 1.8% in the total population. This rapid assessment has been commissioned to supplement two previous studies that were conducted in Guyana in informing the design of upcoming activities to support local capacity building to enhance access to services and respect for the human rights protections for MSM. Unfortunately, in Guyana, like much of the Caribbean, MSM tend to be a hard to reach population, perhaps due to elevated levels of stigma and discrimination and difficulty in accessing men who might participate in high risk same sex behaviors yet do not self-identify as an MSM. As a result, there is a relative paucity of data concerning the knowledge, attitudes and behaviors of this total population in Guyana. (i.e. those who self –identify and those who do not) The baseline report is organized as follows: the methodology is explained followed by the study limitations, the review (literature and desk). The report then proceeds with describing the reality of work and working with sexual and gender minorities in Guyana, the status quo and entry points. The main findings of the capacity assessment and focus groups are then discussed. Issues relating to the uniformed forces and health services providers are then presented followed by discussions and conclusions.

Droits : All rights reserved by the source institution.

Éditeur(s) : INRA : Institut National de la Recherche Agronomique Université des Antilles. Service commun de la documentation University of Suriname
Extrait de : 52e congrès annuel de la Société caribéenne des plantes alimentaires / 52nd annual meeting of the Caribbean food crops society (CFCS), du 10 au 16 juillet 2016. INRA, CFCS
Description : Many rural areas in Suriname are lacking information on technology from extension agents from the government extension agency, and research institutes. Communication and informal voices of farmers are shared by media. As part of a baseline study conducted for the sixth operational strategic plan of the Small Grants Programme in Suriname, four communities were selected: Moengo, Pokigron, Nickerie, Sipaliwini and Para. The purpose of this study was to collect data from communities regarding problems related to climate change, agricultural innovation and landscape management. This qualitative study was done through the focus group method. Eight focus group meetings were organized and consisted of 8-15 participants each. The key questions were extracted from the SEPLS method (Socio-ecological Production Landscapes and Seascapes). The data was analyzed through the SWOT method. Based on the results, the communities have a good level of awareness about management of their landscapes. Improvement of agriculture management will be possible by access to innovative and new knowledge developed in and outside the community. Climate change is an important issue that the community already is aware of, they developed their own local strategy in resilience to this issue. Beaucoup de zones rurales au Surinam manquent d'information sur la technologie des agents de vulgarisation de l'agence d'extension de gouvernement, et des instituts de recherche. La communication et les voix informelles des agriculteurs sont partagées par media. En tant qu'élément d'une étude de ligne de base entreprise pour le sixième plan stratégique opérationnel du petit programme de concessions au Surinam, les quatre communautés ont été sélectionnées : Moengo, Pokigron, Nickerie, Sipaliwini et paragraphe. Le but de cette étude était de rassembler des données de communautés concernant des problèmes liés au changement climatique, à l'innovation agricole et à la gestion de paysage. Cette étude qualitative a été faite par la méthode de groupe cible. Huit réunions de groupe cible ont été organisées et se sont composées de 8-15 participants chacun. Les questions clé ont été extraites à partir de la méthode de SEPLS (des paysages et des paysages marins Socio-écologiques de production). Les données ont été analysées par la méthode de BÛCHEUR. Basé sur les résultats, les communautés ont un bon niveau de conscience au sujet de la gestion de leurs paysages. L'amélioration de la gestion d'agriculture sera possible par l'accès aux connaissances innovatrices et nouvelles développées à l'intérieur et à l'extérieur de la communauté. Le changement climatique est une question importante que la communauté a pris en compte et développé sa propre stratégie locale dans la résilience.
Siècle(s) traité(s) : 21
Droits : CC-BY-NC-ND - Attribution - Pas d'utilisation commerciale - Pas de modification
Permalien : http://www.manioc.org/fichiers/V16256
V16256

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Ethnopharmacological relevancePsidium acutangulum Mart. ex DC is a small tree used by the Wayana Amerindians from the Upper-Maroni in French Guiana for the treatment of malaria.Aim of the studyIn a previous study, we highlighted the in vitro antiplasmodial, antioxidant and anti-inflammatory potential of the traditional decoction of P. acutangulum aerial parts. Our goal was then to investigate on the origin of the biological activity of the traditional remedy, and eventually characterize active constituents.Materials and methodsLiquid-liquid extractions were performed on the decoction, and the antiplasmodial activity evaluated against chloroquine-resistant FcB1 ([3H]-hypoxanthine bioassay) and 7G8 (pLDH bioassay) P. falciparum strains, and on a chloroquine sensitive NF54 ([3H]-hypoxanthine bioassay) P. falciparum strain. The ethyl acetate fraction (D) was active and underwent bioguided fractionation. All the isolated compounds were tested on P. falciparum FcB1 strain. In vitro anti-inflammatory activity (IL-1β, IL-6, IL-8, TNFα) of the ethyl acetate fraction and of an anti-Plasmodium active compound, was concurrently assessed on LPS-stimulated human PBMC and NO secretion inhibition was measured on LPS stimulated RAW murine macrophages. Cytotoxicity of the fractions and pure compounds was measured on VERO cells, L6 mammalian cells, PBMCs, and RAW cells.ResultsFractionation of the ethyl acetate soluble fraction (IC50 ranging from 3.4 to <1 µg/mL depending on the parasite strain) led to the isolation of six pure compounds: catechin and five glycosylated quercetin derivatives. These compounds have never been isolated from this plant species. Two of these compounds (wayanin and guaijaverin) were found to be moderately active against P. falciparum FcB1 in vitro (IC50 5.5 and 6.9 µM respectively). We proposed the name wayanin during public meetings organized in June 2015 in the Upper-Maroni villages, in homage to the medicinal knowledge of the Wayana population. At 50 µg/mL, the ethyl acetate fraction (D) significantly inhibited IL-1β secretion (−46%) and NO production (−21%), as previously observed for the decoction. The effects of D and guiajaverin (4) on the secretion of other cytokines or NO production were not significant.ConclusionsThe confirmed antiplasmodial activity of the ethyl acetate soluble fraction of the decoction and of the isolated compounds support the previous results obtained on the P. acutangulum decoction. The antiplasmodial activity might be due to a mixture of moderately active non-toxic flavonoids. The anti-inflammatory activities were less marked for ethyl acetate fraction (D) than for the decoction.
ISSN: 0378-8741

hal-01313006
http://hal.upmc.fr/hal-01313006
http://hal.upmc.fr/hal-01313006/document
http://hal.upmc.fr/hal-01313006/file/Houel_Wayanin_and.pdf
DOI : 10.1016/j.jep.2016.04.053

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
OBJECTIVES: The aims of the study were to assess in patients with advanced HIV disease receiving antiretroviral therapy (ART) intensification with enfuvirtide (i) resistance at virological failure (VF), (ii) impact of baseline tropism on immunovirological response, and (iii) HIV-1 DNA tropism evolution during ART. METHODS: The ANRS 130 APOLLO randomized trial evaluated in naive patients the immunovirological impact of standard ART without (control arm) or with enfuvirtide. Tropism was determined on RNA and DNA by V3-loop sequencing interpreted using the Geno2Pheno algorithm. RESULTS: At baseline the median CD4 cell count was 30 cells/mm(3). Among the 170 patients assessable in this virological substudy, HIV-1 RNA tropism was as follows: 60% of viruses were R5 and 40% were R5X4/X4. HIV-1 DNA tropism was as follows: 54% were R5 and 46% were R5X4/X4. At week 24, 39% and 49% of patients experienced VF in the enfuvirtide and control arms, respectively. In the enfuvirtide arm, only resistance-associated mutations to enfuvirtide were detected. In the control arm, two patients displayed drug-resistant viruses at the time of VF. No impact of baseline tropism was observed on immunovirological response, regardless of the study arm. Among the 25 patients experiencing DNA tropism switch between baseline and week 24, 16 (64%) switched from R5 to R5X4/X4. These latter were mostly successfully suppressed patients receiving enfuvirtide and exhibiting poorer immunological response. CONCLUSIONS: Baseline RNA tropism had no impact on the immunovirological response. Drug resistance mutations were only detected for the fusion inhibitor. Finally, the mechanism of replenishment of the viral cellular reservoir with X4 viruses observed needs to be further analysed.
ISSN: 0305-7453

hal-00875130
https://hal.archives-ouvertes.fr/hal-00875130
DOI : 10.1093/jac/dks455
PUBMED : 23152480

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 Lippincott, Williams & Wilkins
Résumé : International audience
Objective Large-scale prospective studies do not support an association between neuroticism and extroversion with cancer incidence. However, research on other personality constructs is inconclusive. This longitudinal study examined the associations between four personality measures, Type 1, "suppressed emotional expression"; Type 5, "rational/antiemotional"; hostility; and Type A with cancer incidence. Methods Personality measures were available for 13,768 members in the GAZEL cohort study (baseline assessment in 1993). Follow-up for diagnoses of primary cancers was obtained from January 1, 1994 to December 31, 2009. Associations between personality and cancer incidence were evaluated using Cox proportional hazards analyses and adjusted for potential confounders. Results During a median follow-up of 16.0 years (range, 9 days-16 years), 1139 participants were diagnosed as having a primary cancer. The mean duration between baseline and cancer diagnosis was 9.3 years. Type 1 personality was associated with a decreased risk of breast cancer (hazard ratio per standard deviation = 0.81, 95% confidence interval = 0.68-0.97, p = .02). Type 5 personality was not associated with prostate, breast, colorectal, or smoking-related cancers, but was associated with other cancers (hazard ratio per standard deviation = 1.17, 95% confidence interval = 1.04-1.31, p = .01). Hostility was associated with an increased risk of smoking-related cancers, which was explained by smoking habits, and Type A was not associated with any of the cancer endpoints. Conclusions Several personality measures were prospectively associated with the incidence of selected cancers. These links may warrant further epidemiological studies and investigations about potential biobehavioral mechanisms.
ISSN: 0033-3174

inserm-00813178
http://www.hal.inserm.fr/inserm-00813178
http://www.hal.inserm.fr/inserm-00813178/document
http://www.hal.inserm.fr/inserm-00813178/file/PersonalityCancer_Lemogne_Psychosom_Med_2013.pdf
http://www.hal.inserm.fr/inserm-00813178/file/inserm-00813178_edited.pdf

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
This study aimed to identify factors associated with virological response (VR) to raltegravir (RAL)-containing regimens in 468 treatment-experienced but integrase inhibitor-naive HIV-1 patients receiving a RAL-containing regimen. VR was defined at Month 6 (M6) as HIV-1 RNA viral load (VL) <50 copies/mL. The impacts on VR of baseline integrase mutations, VL, CD4 count, genotypic sensitivity score for nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and protease inhibitors, and the number of new antiretrovirals used for the first time associated with RAL were investigated. For patients with VL >50 copies/mL at M6, integrase mutations selected were characterised. Median baseline VL was 4.2 log(10)copies/mL (IQR 3.3-4.9 log(10) copies/mL) and CD4 count was 219 cells/mm(3) (IQR 96-368 cells/mm(3)). At M6, 71% of patients were responders. In multivariate analysis, baseline VL and CD4 count and ≥ 2 new antiretrovirals among darunavir, etravirine, maraviroc and enfuvirtide were associated with VR to RAL. Neither HIV-1 subtype nor baseline integrase polymorphisms were associated with VR to RAL. Among 63 failing patients at M6, selection of ≥ 1 change in the integrase gene was observed in 49 (77.8%), and 27/63 (42.9%) were considered as RAL-associated resistance mutations. Factors independently associated with the occurrence of ≥ 1 RAL-associated resistance mutation were VL at failure >3 log(10) and having no new drugs associated with RAL. RAL showed great potency in treatment-experienced patients. The number of new drugs associated with RAL was an important factor associated with VR. HIV-1 subtype and baseline integrase polymorphisms do not influence the RAL VR.
ISSN: 0924-8579

hal-00875083
https://hal.archives-ouvertes.fr/hal-00875083
DOI : 10.1016/j.ijantimicag.2013.02.016
PUBMED : 23562640

Éditeur(s) : HAL CCSD IOS Press
Résumé : International audience
The aim of the present study was to test the effects of hydroxyurea (HU) therapy on clinical, hematological and hemorheological parameters in adult patients with sickle cell anemia (SCA). Hematological and hemorheological parameters were measured in 28 SCA patients before HU therapy (i.e., baseline) and at 6, 12 and 24 months of treatment. RBC deformability was determined by ektacytometry at 30 Pa. RBC aggregation properties were investigated by light-backscatter method. Blood viscosity was measured at 225 s-1 by a cone-plate viscometer. The rates of vaso-occlusive crises and acute chest syndrome were lower at 1 and 2 years of HU therapy compared to baseline. The proportion of patients with leg ulcers tended to decrease after 2 years of treatment. Hemoglobin oxygen saturation improved with HU therapy. HU therapy induced a decrease of platelet and white blood cell counts and a rise in fetal hemoglobin level and mean cell volume. While hemoglobin concentrations increased under HU, blood viscosity remained unchanged all along the study. RBC deformability increased over baseline values at 6 months of HU therapy and continued to rise until the end of the follow-up period. In conclusion, the improvement in RBC deformability probably compensates the increase of hemoglobin on blood viscosity and participates to the improvement of the clinical status of patients.
ISSN: 1386-0291

hal-01668327
https://hal.univ-antilles.fr/hal-01668327
DOI : 10.3233/CH-170280

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
This study analyses the interactions between deformation and reactive fluid and melt percolation, and their effects on sub-arc mantle seismic properties based on microstructural observations on mantle xenoliths extracted by the Tubaf and Edison seamounts close to the Lihir Island, in the Papua New Guinea archipelago. These xenoliths sample an oceanic lithosphere, which has experienced high-temperature deformation in the presence of fluids or melts. This was followed by metasomatism under static conditions. Syn-kinematic percolation of reactive Si-rich melts or fluids in peridotites has produced pyroxene-enrichment, grain size reduction, and dispersion of olivine crystal preferred orientation (CPO). Fourier transform infrared spectroscopy analyses show that olivine has very low water contents (1-4 wt. ppm H2O), similar to spinel peridotites from other subduction zones. These low values may record both low water solubility in olivine at low pressure and dehydration during transport and exhumation. Water contents in pyroxenes are highly variable and likely result from spatially heterogeneous melt or fluid percolation. Analysis of olivine CPO indicates dominant activation of both (010)[100] and (001)[100] slip systems, which are characteristic of deformation under high temperature, low stress, low pressure and low to moderate hydrous conditions. Fast S-wave polarization and P- and Rayleigh propagation directions are thus parallel to the mantle flow direction. The pyroxene enrichment by melt-rock reactions is accompanied by dispersion of olivine CPO and induces a significant decrease of the maximum S-wave and P-wave anisotropy in the peridotites. The calculated seismic properties also show that the lowest Vp/Vs ratios (< 1.7) mapped in fore-arc mantle may only be explained by taking in consideration the CPO-induced elastic anisotropy of the peridotites.
ISSN: 0040-1951

hal-00950058
https://hal.archives-ouvertes.fr/hal-00950058
DOI : 10.1016/j.tecto.2013.09.024

Éditeur(s) : HAL CCSD Taylor & Francis (Routledge)
Résumé : International audience
Border areas are particular “hot spots” generating high levels of HIV vulnerability and facing great challenges to control epidemics. The objective of this study is to describe the sociodemographic, clinical and biological profiles of newly HIV diagnosed people at the French Guiana - Suriname border, to construct an HIV care cascade and compare it with the Surinamese one. HIV-patients aged over 15 years newly diagnosed in western French Guiana in 2011 and 2012 were included in a retrospective cohort study. Patients were identified using different sources (n=121). The male-to-female ratio was 0.8, 85% of the patients were of foreign origin, 72% were undocumented migrants, 21% were living in Suriname and 48% had baseline CD4 cell counts <200 cells/mm3. After one year, 34% were lost to follow-up, 54% received treatment, 34% had controlled viremia and 6% died. We observed a disappointing HIV cascade, like that of Suriname, requiring to develop a coordinated healthcare offer on both sides of the border. Targeted efforts through a bi-national collaboration are needed to address the specific issues of cross-border patients to reach the 90*3 UNAIDS’s diagnosis, link to care and treatment targets and better control the local epidemic
ISSN: 0954-0121

inserm-01476267
http://www.hal.inserm.fr/inserm-01476267
http://www.hal.inserm.fr/inserm-01476267/document
http://www.hal.inserm.fr/inserm-01476267/file/2017%20Jaries%20-%20Population%20movements%20and%20the%20HIV%20cascade-1.pdf
DOI : 10.1080/09540121.2017.1291899

Éditeur(s) : Elsevier Sci Ltd
Résumé : The aim of this study is to establish a baseline for poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) lifetime prediction in a marine environment, by means of mechanical and physico-chemical characterization of specimens immersed in continuously renewed and filtered natural seawater in the laboratory at different temperatures (4, 25 and 40°C). Samples were also aged at sea in Lorient harbour in order to compare laboratory and natural degradation mechanisms and kinetics. Due to its morphology, hydrolysis of PHBV in natural seawater is quite slow, and samples were observed to undergo preferentially an enzymatic surface degradation. Increasing the aging temperature in the laboratory promotes the water uptake and causes hydrolysis. As two degradation mechanisms occur in parallel, the choice of test conditions is critical, and the lifetime of PHBV in a marine environment is difficult to predict accurately.
Polymer Degradation And Stability (0141-3910) (Elsevier Sci Ltd), 2014-07 , Vol. 105 , P. 237-247

Droits : 2014 Elsevier Ltd. All rights reserved.
http://archimer.ifremer.fr/doc/00188/29972/28425.pdf
DOI:10.1016/j.polymdegradstab.2014.04.026
http://archimer.ifremer.fr/doc/00188/29972/

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
The aim of this study is to assess the availability and quality of data from the International GNSS Service (IGS) Global Positioning System (GPS) network in Africa, especially for retrieving zenith tropospheric delay (ZTD), from which precipitable water vapour (PWV) can be derived, in view of application to the African Monsoon Multidisciplinary Analysis (AMMA) project. Three major error sources for the GPS data analysis evaluating PWV in Africa are the accuracy of the satellite orbits, the correction for the radio delay induced by the ionosphere and the vertical site displacements due to ocean loading. The first part of this study examines these error sources and the validity of GPS data for meteorological applications in Africa in dedicated analyses spanning the year 2001. These analyses were performed using the IGS precise orbits. Weak degradation of baseline precision with increasing baseline lengths suggests that the average orbital error is not limiting the GPS analysis in Africa. The impact of the ionosphere has been evaluated during a maximum of solar activity in 2001. The loss of L2 data has actually been observed. It amounts to 2% on average for 2001, with maxima of 8% during magnetic storm events. A slight decrease in formal accuracy of ZTD seems to be related to the loss of L2 data at the end of the day. This indicates that scintillation effects are present in the GPS observations but however are not a major limitation. The impact of ocean loading is found to be significant on ZTD estimates (up to ±2 mm in equivalent PWV). The use of a proper ocean loading model eliminates this effect. The second aspect of this study concerns the IGS analysis quality for the African stations. The accuracy has been assessed through position dispersion between individual solutions and the most recent version of the IGS combined solution IGb00, and residuals from the transformation of the IGS combined solution into the International Terrestrial Reference Frame 2005. The positioning performance of the IGS analysis is consistent with an accuracy in ZTD of ±6 mm (±1 mm in PWV), as requested for meteorological applications such as planned in AMMA.
ISSN: 1364-6826

insu-00347961
https://hal-insu.archives-ouvertes.fr/insu-00347961
DOI : 10.1016/j.jastp.2007.04.008

Éditeur(s) : HAL CCSD International Medical Press
Résumé : International audience
BACKGROUND: Psychiatric disorders are relatively common among HIV-infected patients. However, there are few studies about their potential risk factors. This analysis aimed to measure the incidence of severe psychiatric events (PE) among patients receiving combination antiretroviral therapy (cART) of the French APROCO-COPILOTE (ANRS CO8) cohort, and to identify the medical and socio-behavioural correlates of their first episode of depression, suicide or suicide attempt (D/S/SA). METHODS: APROCO-COPILOTE is a cohort of patients started on a protease inhibitor regimen between 1997 and 1999, with prospective medical standardized records and self-administered questionnaires collecting socio-demographic and socio-behavioural data. This analysis included all 11-year follow-up visits for 1,095 patients having completed baseline self-administered questionnaires. A proportional hazard Cox model was used to identify the correlates of a first D/S/SA event. RESULTS: The overall prevalence of severe PE remained low: 50 patients experienced 67 events (incidence rate [95% CI] =1.04 [0.82, 1.32] per 100 person-years). Depression (n=16), suicides (n=5) and suicide attempts (n=14) were the most frequently diagnosed PE (0.54 [0.39, 0.76] per 100 person-years) among 25 patients. Multivariate results showed that unemployment, unstable housing, detectable viral load and smoking more than 20 cigarettes/day were independently associated with D/S/SA. CONCLUSIONS: Although the incidence of severe PE remained relatively low among the patients of APROCO-COPILOTE cohort, this study's results underline a clinically important problem in HIV-infected patients receiving cART. Furthermore, our findings not only emphasize the importance of comprehensive care, especially for socially vulnerable patients, but may also help future studies designed to assess the effectiveness of interventions in reducing the risk of PE during cART.
ISSN: 1359-6535

hal-00875183
https://hal.archives-ouvertes.fr/hal-00875183
DOI : 10.3851/IMP2102
PUBMED : 22544079

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: Overweight in Guadeloupe is a public health matter affecting children and adults. In the present study we evaluated the metabolic profile, including serum ghrelin, leptin and adiponectin levels, in normal weight, overweight and obese school children and we analyzed the potential changes in anthropometric and metabolic risk factors after a 1-year lifestyle intervention program. Methods: Parameters were assessed at baseline and at 1 year. Three groups (G) were defined according the International Obesity Task Force reference values, G1: normal weight / G2: overweight / G3: obese. The lifestyle intervention included dietary counseling, regular physical activity and family support. Results: A total of 120 children (G1: n = 44, G2: n = 39, G3: n = 37), aged 11– 15 years and 59 % girls were enrolled. Obese children showed significant lower HDL-C, adiponectin and ghrelin concentrations, higher triglycerides, fasting blood glucose, insulin and leptin levels and also higher frequencies of abdominal obesity (G1: 2.3 %, G2: 28.2 %, G3: 73 %) and insulin resistance (GI: 39 %, G2: 72 %, G3: 89 %) than the other groups. In the overall sample, the linear regressions exploring the associations of ghrelin, adiponectin and leptin with age, gender, BMI z-score, HOMA-IR and tanner stage as independent variables showed strong associations of leptin levels with weight status and insulin resistance at baseline. The models accounted for 58 % of variability in leptin levels compared with 26 and 15 % for adiponectin and ghrelin levels respectively. In 83 children who completed the program, significant decreases in BMI z-score in overweight and obese children were noted. Leptin levels decreased significantly only in the obese group whereas adiponectin concentrations increased significantly in the three groups, In obese children, a significant correlation was found between changes in BMI Z-score, and changes in leptin levels (r = 0.39; P = 0.049) but not with changes in adiponectin levels. Conclusions: Abdominal obesity and insulin resistance were highly prevalent in obese children highlighting their risk of metabolic complications in adulthood. A 1-year long lifestyle intervention was associated with improvement in BMI z-score and metabolic parameters.
ISSN: 1743-7075

Droits : http://creativecommons.org/licenses/by/
hal-01231394
http://hal.upmc.fr/hal-01231394
http://hal.upmc.fr/hal-01231394/document
http://hal.upmc.fr/hal-01231394/file/art_10.1186_s12986-015-0039-9.pdf
DOI : 10.1186/s12986-015-0039-9

Éditeur(s) : HAL CCSD
Résumé : International audience
Au cours de l'année 2014, de nouvelles données publiées dans la BPCO vont nous permettre d'améliorer la prise en charge de nos patients. Le retrait progressif des corticoïdes inhalés (CSI) sous couvert d'une double bronchodilatation en traitement de fond (étude WISDOM) n'a pas été accompagné d'une majoration des exacerbations. Une étude transversale rétrospective canadienne a montré l'intérêt tout particulier des CSI chez les patients de plus de 65 ans. Un travail soulignait l'intérêt probable de la corticothérapie systémique lors des exacerbations traitées par ventilation mécanique, invasive ou non. L'étude COLUMBUS a confirmé l'intérêt des macrolides avec une indication privilégiée de l'azithromycine au long cours chez les patients BPCO présentant des exacerbations fréquentes (≥3/an), ayant un traitement inhalé maximaliste (trithérapie) et sevrés du tabac. Le timing de la réhabilitation respiratoire a été précisé et il semblerait qu'elle ne doive pas être initiée à la phase aiguë (i.e., avant la fin de l'exacerbation chez le patient hospitalisé), ce qui ne remet pas en cause l'intérêt démontré de la réhabilitation respiratoire initiée précocement après exacerbation. Enfin, l'étude STATCOPE retire toute place aux statines dans le traitement de fond des patients atteints de BPCO post-tabagique sans comorbidité cardiovasculaire. Tous ces travaux sont détaillés dans ce manuscrit. , Abstract In 2014 new data on COPD were published that allow us to improve the management of patients. The gradual withdrawal of inhaled corticosteroids (ICS) under the cover of double bronchodilatation in baseline treatment (WISDOM study) was not accompanied by an increase in exacerbations. A Canadian retrospective cross sectional study has shown the particular role of ICS in patients over 65 years old. A study underlined the probable role of systemic corticosteroids during exacerbations treated by mechanical ventilation, invasive or not. The COLUMBUS study confirmed the role of macrolides, in particular azithromycin, in the long term treatment of patients with COPD who have frequent exacerbations (3 or more per year) despite taking maximal inhaled therapy and stopping smoking. The timing of pulmonary rehabilitation has been clarified and it seems that it should not be started in the acute phase (i.e. before the end of the exacerbation in hospitalized patients). This questions the demonstrated role of initiation of pulmonary rehabilitation soon after an exacerbation. Finally, the STATCOPE study removes any place for statins in the baseline treatment of COPD patients without cardiovascular comorbidity. All these studies are detailed in this paper.
Mission CPLF 2015. Congrès de Pneumologie de Langue Française
Denver, United States

hal-01198647
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01198647
DOI : 10.1016/S1877-1203(15)30036-7

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Aims: The aims of this study were to compare short-and long-term outcomes for clinical T2N0 oesophageal cancer with analysis of (i) primary surgery (S) versus neoadjuvant therapy plus surgery (NS), (ii) squamous cell carcinoma and adenocarcinoma subsets; and (iii) neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy.Methods: Data were collected from 30 European centres from 2000 to 2010. Among 2944 included patients, 355 patients (12.1%) had cT2N0 disease; 285 (S) and 70 (NS), were compared in terms of short-and long-term outcomes. Propensity score matching analyses were used to compensate for differences in baseline characteristics.Results: No significant differences between the groups were shown in terms of in hospital morbidity and mortality. Nodal disease was observed in 50% of S-group at the time of surgery, with 20% pN2/N3. Utilisation of neoadjuvant therapy was associated with significant tumour downstaging as reflected by increases in pT0, pN0 and pTNM stage 0 disease, this effect was further enhanced with neoadjuvant chemoradiotherapy. After adjustment on propensity score and confounding factors, for all patients and subset analysis of squamous cell and adenocarcinoma, neoadjuvant therapy had no significant effect upon survival or recurrence (overall, loco-regional, distant or mixed) compared to surgery alone. There were no significant differences between neoadjuvant chemotherapy and chemoradiotherapy in short-or long-term outcomes.Conclusion: The results of this study suggest that a surgery alone treatment approach should be recommended as the primary treatment approach for cT2N0 oesophageal cancer despite 50% of patients having nodal disease at the time of surgery.
ISSN: 0959-8049

hal-01666517
https://hal.univ-lorraine.fr/hal-01666517
DOI : 10.1016/j.ejca.2015.11.024

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Long-term exposure to air pollution (AP) has been shown to have an impact on mortality in numerous countries, but since 2005 no data exists for France. We analyzed the association between long-term exposure to air pollution and mortality at the individual level in a large French cohort followed from 1989 to 2013. The study sample consisted of 20,327 adults working at the French national electricity and gas company EDF-GDF. Annual exposure to PM10, PM10–2.5, PM2.5, NO2, O3, SO2, and benzene was assessed for the place of residence of participants using a chemistry-transport model and taking residential history into account. Hazard ratios were estimated using a Cox proportional-hazards regression model, adjusted for selected individual and contextual risk factors. Hazard ratios were computed for an interquartile range (IQR) increase in air pollutant concentrations. The cohort recorded 1967 non-accidental deaths. Long-term exposures to baseline PM2.5, PM10-25, NO2 and benzene were associated with an increase in non-accidental mortality (Hazard Ratio, HR = 1.09; 95% CI: 0.99, 1.20 per 5.9 μg/m3, PM10-25; HR = 1.09; 95% CI: 1.04, 1.15 per 2.2 μg/m3, NO2: HR = 1.14; 95% CI: 0.99, 1.31 per 19.3 μg/m3 and benzene: HR = 1.10; 95% CI: 1.00, 1.22 per 1.7 μg/m3).The strongest association was found for PM10: HR = 1.14; 95% CI: 1.05, 1.25 per 7.8 μg/m3. PM10, PM10-25 and SO2 were associated with non-accidental mortality when using time varying exposure. No significant associations were observed between air pollution and cardiovascular and respiratory mortality. Long-term exposure to fine particles, nitrogen dioxide, sulfur dioxide and benzene is associated with an increased risk of non-accidental mortality in France. Our results strengthen existing evidence that outdoor air pollution is a significant environmental risk factor for mortality. Due to the limited sample size and the nature of our study (occupational), further investigations are needed in France with a larger representative population sample.
ISSN: 0160-4120

hal-01187145
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01187145
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01187145/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01187145/file/Association%20between%20long-term%20exposure%20to%20air%20pollution%20and%20mortality_accepted.pdf
DOI : 10.1016/j.envint.2015.08.006

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
The natural history of pulmonary Langerhans cell histiocytosis (PLCH) has been unclear due to the absence of prospective studies. The rate of patients who experience an early progression of their disease is unknown. Additionally, conflicting effects of smoking cessation on the outcome of PLCH have been reported. In this prospective, multicentre study, 58 consecutive patients with newly diagnosed PLCH were comprehensively evaluated over a two-year period. Our objectives were to estimate the incidence of early progression of the disease and to evaluate the impact of smoking status on lung function outcomes. Lung function deterioration was defined as a decrease of at least 15% in FEV1 and/or FVC and/or DLCO, compared with baseline values. At each visit, smoking status was recorded based on the patients' self-reports and urinary cotinine measurements that were blinded for the patients. The cumulative incidence of lung function outcomes over time was estimated using the non-parametric Kaplan-Meier method. Multivariate Cox models with time-dependent covariates were used to calculate the hazards ratios of the lung function deterioration associated with smoking status with adjustment for potential confounders. The cumulative incidence of lung function deterioration at 24 months was 38% (22% for FEV1 and DLCO, and 9% for FVC). In the multivariate analysis, smoking status and PaO2 at inclusion were the only factors associated with the risk of lung function deterioration. The patients' smoking statuses markedly changed over time. Only 20% of the patients quit using tobacco for the entire study period. Nevertheless, being a non-smoker was associated with a decreased risk of subsequent lung function deterioration, even after adjustment for baseline predictive factors. By serial lung computed tomography, the extent of cystic lesions increased in only 11% of patients. Serial lung function evaluation on a three- to six-month basis is essential for the follow-up of patients with recently diagnosed PLCH to identify those who experience an early progression of their disease. These patients are highly addicted to tobacco, and robust efforts should be undertaken to include them in smoking cessation programs. ClinicalTrials.gov: No: NCT01225601 .
ISSN: 1750-1172

hal-01146047
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01146047
PUBMED : 25887097
DOI : 10.1186/s13023-015-0249-2

Résumé : Sea fish farms with production of more than 20 tons per year in France must obtain two operating licences: (i) one for Sea Farming (AECM), with the aim of ensuring that the granted site and use of the maritime public domain for exploitation will respect all restrictions of general interest; (ii) one for regulating Facilities Classified for the Protection of the Environment (ICPE). Although the first one requires a relatively simple licence request file, the second one demands a very complete file, which includes, beyond the notice of exploitation information, a complete impact study, as well as a hazards study and a health and safety notice. In this context, petitioners in Corsica (adjustment of status or new exploitation) are faced with the same difficulties, which highlighted the need for a methodological guide adapted to each region's specific situation, assembling in particular the necessary baseline data (legal, zootechnical, geographical, climatic, socio-economic, ecological...) as well as recognised methods for evaluating the potential effects of the farm on the environment. Development of this guide was supported by ADEC and supervised by a steering committee composed of representatives from the administrations concerned, fish farmers and scientific bodies. The significant aspects dealt with the effects of fish farming on Posidonie herbarium, a protected species very present in Corsica and with coordinating the two AECM and ICPE procedures. For each part of the ICPE file, the guide introduces the technical or scientific context and, depending upon the case, the state of the art, sources of available data, acquisition and methods of acquiring measurements and of assessing the potential effects, as well as practical editing recommendations. Finally, the guide is made complete by a model schedule of conditions designed to help petitioners to have a specialist research department incorporate all or part of the file. This guide primarily concerns first-time marine facilities for exploitation in Corsica, conceived of as in the open sea rather than in confined spaces. Nonetheless, any fish farmer or future fish farmer needing to process a request for an exploitation licence may find it useful.
Les piscicultures marines de plus de 20 t/an de production sont soumises en France à l'obtention de deux autorisations d'exploiter : (i) celle au titre des Cultures Marines (AECM), visant à s'assurer que le site concédé et l'usage du domaine public maritime pour l'exploitation permettent de respecter l'ensemble des contraintes d'intérêt général ; (ii) celle au titre de la réglementation des Installations Classées pour la Protection de l'Environnement (ICPE). Si la première nécessite un dossier de demande d'autorisation relativement simple, la seconde requiert un dossier très complet, qui comprend, outre une notice de renseignements sur l'exploitation, une étude d'impact complète, ainsi qu'une étude des dangers et une notice d'hygiène et de sécurité. Dans ce contexte, les demandeurs en Corse (régularisation ou exploitation nouvelle) sont confrontés aux mêmes difficultés, ce qui a mis en évidence le besoin d'un guide méthodologique adapté aux spécificités régionales, rassemblant en particulier les données de base nécessaires (juridiques, zootechniques, géographiques, climatiques, socio-économiques, écologiques...) ainsi que les méthodes reconnues de l'évaluation des effets potentiels de la ferme sur l'environnement. L'élaboration de ce guide a été soutenue par l'ADEC et suivie par un comité de pilotage composé de représentants des administrations concernées, des pisciculteurs et d'organismes scientifiques. Les aspects importants ont porté sur les effets de la pisciculture sur l'herbier de Posidonie, espèce protégée très présente en Corse et sur la coordination entre les deux procédures AECM et ICPE. Pour chaque partie du dossier ICPE, le guide présente le contexte technique ou scientifique et selon le cas, l'état de l'art, les sources de données disponibles, les méthodes d'acquisition des mesures et d'évaluation des effets potentiels, ainsi que des recommandations pratiques de rédaction. Enfin, le guide est complété par un cahier des charges type destiné à aider les demandeurs à confier à un bureau d'étude spécialisé la réalisation de tout ou partie de la constitution du dossier. Ce guide concerne prioritairement les installations marines de nouvelles exploitations en Corse, envisagées en mer ouverte plutôt que dans des espaces confinés. Néanmoins tout pisciculteur ou futur pisciculteur devant instruire une demande d'autorisation d'exploiter peut y trouver intérêt.

Droits : info:eu-repo/semantics/openAccess
http://archimer.ifremer.fr/doc/2004/rapport-2188.pdf
http://archimer.ifremer.fr/doc/00000/2188/

Éditeur(s) : HAL CCSD Elsevier
Résumé : This contribution reports our preliminary work to determine Cu isotope ratios for various granite rocks and examine the Cu isotope systematics within granite suites. A chemical procedure, modified from Marechal [Marechal, C.N., Telouk, R and Albarede, F., 1999. Precise analysis of copper and zinc isotopic compositions by plasma-source mass spectrometry. Chemical Geology, 156(1-4): 251-273.], Was used to separate Cu from rock matrix. Quantitative recovery (100.6 +/- 1.6%), with a low total procedural blank (2.65 +/- 0.66 ng) for Cu, has been achieved, allowing Cu isotopic measurements on samples with as little as 10 ppm Cu. The Cu isotope ratios (delta Cu-65 relative to NIST SRM 976) of 32 rock samples, ranging from mafic to felsic compositions, from 3 batholiths (2 I-type, 1 S-type) from the Lachlan Fold Belt in southeastern Australia. vary from -0.46 parts per thousand to 1.51 parts per thousand. Most of them cluster around zero, With mean values for the I-type and S-type granites of 0.03 +/- 0.15 parts per thousand and - 0.03 +/- 0.42 parts per thousand (2 sigma) respectively. These data, together with Cu isotope ratios of two loess samples, provide preliminary evidence that the baseline Cu isotopic composition of the crystalline part of upper continental crust is close to zero. The tight clustering of Cu isotope ratios of rocks from the I-type suites Suggests that high-temperature magmatic processes do not produce significant Cu isotope fractionation. However, two granites with abnormally heavy Cu isotope signatures (up to 1.51 parts per thousand) appears to be the result of localized hydrothermal alteration. Measurable variation in Cu isotopic composition of the S-type granite may reflect isotopic heterogeneity in the sedimentary Source region as a result of redox processes or may be due to hydrothermal overprinting. Thus, Cu isotope geochemistry may be a useful tracer for studying hydrothermal alteration and Source heterogeneity of granitic rocks.
ISSN: 0009-2541

hal-00413130
https://hal.archives-ouvertes.fr/hal-00413130
DOI : 10.1016/j.chemgeo.2008.06.047