Éditeur(s) : HAL CCSD
Résumé : International audience
In French Guiana, the prevalence of HIV among pregnant women along the Maroni river, has risen from 0 to over 1% in the 1990's. Despite this sharp increase, no behavioural surveillance study has ever taken place in this border region. The present study showed that an important proportion of boatmen have risky sexual behaviour. These results underline the importance of targeting prevention interventions on this population that is not currently receiving specific HIV prevention messages.
J AIDS Clinic Res

Droits : info:eu-repo/semantics/OpenAccess
inserm-00915224
http://www.hal.inserm.fr/inserm-00915224
http://www.hal.inserm.fr/inserm-00915224/document
http://www.hal.inserm.fr/inserm-00915224/file/2012_Gaubert_-_KABP_on_HIV_among_Boatmen_on_the_Maroni_river_a_neglected_bridging_group.pdf
DOI : 10.4172/2155-6113.1000181

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
ISSN: 0003-4975

hal-01563338
http://hal.univ-brest.fr/hal-01563338
DOI : 10.1016/j.athoracsur.2016.03.093
PUBMED : 27262916

Éditeur(s) : HAL CCSD
Résumé : International audience
Society of tribologist and lubrication Engineers annual Meeting and exhib
Las vegas, United States

hal-01682115
https://hal.univ-antilles.fr/hal-01682115

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Purpose: Active surveillance is a treatment option for favorable risk prostate cancer. However, data are missing on populations of African descent. We evaluated the safety and benefit of active surveillance in an African Caribbean cohort with favorable risk prostate cancer. Materials and Methods: Between 2005 and 2016, a single center, prospective cohort study was performed in Guadeloupe, French West Indies, including patients on active surveillance who had low risk prostate cancer (prostate specific antigen 10 ng/ml or less and Gleason score 6 or less) or favorable intermediate risk prostate cancer (prostate specific antigen 10 to 20 ng/ml, Gleason score 3 + 4 or less and life expectancy less than 10 years). Treatment was recommended in case of grade progression, increased tumor volume, prostate cancer doubling time less than 36 months or patient wish. Overall survival, disease specific survival and duration of active surveillance were calculated with the KaplanMeier method. Multivariate analysis was performed using the Cox proportional hazards model to identify predictors of active surveillance termination. Results: A total of 234 patients with a median age of 64 years were enrolled in study. Median followup was 4 years (IQR 2.3-5.5). Overall survival at 30 months, 5 years and 10 years was 99.5%, 98.5% and 90.7%, respectively. Disease specific survival at 30 months, and 5 and 10 years was 100%. At 30 months, 5 years and 10 years 72.7%, 52.6% and 40.4% of patients, respectively, remained untreated and on active surveillance. Age (HR 0.96 per additional year, 95% CI 0.93-0.99) and prostate specific antigen density (HR 1.52 per additional 0.1 ng/ml, 95% CI 1.20-1.89) were found to be independent predictors of active surveillance termination. Conclusions: Active surveillance is safe and beneficial for highly selected African Caribbean patients. It seems to be feasible for patients at low risk and intermediate favorable risk. Prostate specific antigen density could help better select these patients.
ISSN: 0022-5347

hal-01519251
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01519251
DOI : 10.1016/j.juro.2016.12.047
PUBMED : 27993665

Éditeur(s) : HAL CCSD
Résumé : National audience
Introduction Streptococcus pneumoniae est le microorganisme le plus fréquemment responsable de méningites bactériennes communautaires. Notre objectif était de décrire leur présentation, leur prise en charge et leur pronostic à partir des données de la Cohorte nationale Observationnelle des Méningites Bactériennes communautaires de l’AdulTe (COMBAT).
17es Journées Nationales d’Infectiologie
Lille, France

Droits : info:eu-repo/semantics/OpenAccess
inserm-01413456
http://www.hal.inserm.fr/inserm-01413456
http://www.hal.inserm.fr/inserm-01413456/document
http://www.hal.inserm.fr/inserm-01413456/file/2016%2C%20Tubiana%20-%20NEURO06.pdf
PUBMED : 27495605

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Background: Influenza is an important cause of serious illness and death, particularly in elderly and high-risk groups. Objectives Aim of this study was to identify factors associated with poor outcomes among adults hospitalized in France for laboratory-confirmed seasonal influenza. Study design Patients hospitalized for influenza were identified in a prospective, multicenter study carried out in French hospitals during three consecutive influenza seasons (2012–2015). Influenza virus infection was confirmed by reverse transcription polymerase chain reaction. Sociodemographic and clinical variables were compared according to the virus type and subtype. Risk factors for complications, intensive care unit (ICU) admission and death were analyzed by backward stepwise logistic regression. Results The study population consisted of 566 patients, of whom 56% were older than 65 years and 82% had underlying chronic illnesses. Type A influenza viruses infected 422 patients (75%), including subtype H3N2 in 239 patients (57%). The prior vaccine coverage rate was 38%. Complications occurred in 255 patients (45%), consisting mainly of pneumonia (n = 143, 30%) and respiratory failure (n = 116, 20%). Eighty-three patients (15%) were admitted to an ICU, and the in-hospital mortality rate was 4% (n = 21). Sixty-six patients (12%) received oseltamivir. Age over 65 years was the only identified risk factor for complications. Risk factors for ICU admission were an absence of vaccination, no oseltamivir administration before admission, pre-existing chronic respiratory disease, and current smoking. Age over 65 years and ICU admission were risk factors for death. Conclusions Older individuals and patients with underlying conditions are most at risk of influenza complications. Vaccination and early oseltamivir administration, both of which are recommended for these patients, appear to reduce ICU admissions
ISSN: 1386-6532

hal-01302409
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01302409
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01302409/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01302409/file/Factors%20associated%20with%20poor%20outcomes.pdf
DOI : 10.1016/j.jcv.2016.04.005

Éditeur(s) : HAL CCSD Nature Publishing Group
Résumé : International audience
Cancer cells display alterations in many cellular processes. One core hallmark of cancer is the Warburg effect which is a glycolytic reprogramming that allows cells to survive and proliferate. Although the contributions of environmental contaminants to cancer development are widely accepted, the underlying mechanisms have to be clarified. Benzo[a]pyrene (B[a]P), the prototype of polycyclic aromatic hydrocarbons, exhibits genotoxic and carcinogenic effects, and it is a human carcinogen according to the International Agency for Research on Cancer. In addition to triggering apoptotic signals, B[a]P may induce survival signals, both of which are likely to be involved in cancer promotion. We previously suggested that B[a]P-induced mitochondrial dysfunctions, especially membrane hyperpolarization, might trigger cell survival signaling in rat hepatic epithelial F258 cells. Here, we further characterized these dysfunctions by focusing on energy metabolism. We found that B[a]P promoted a metabolic reprogramming. Cell respiration decreased and lactate production increased. These changes were associated with alterations in the tricarboxylic acid cycle which likely involve a dysfunction of the mitochondrial complex II. The glycolytic shift relied on activation of the Na+/H+ exchanger 1 (NHE1) and appeared to be a key feature in B[a]P-induced cell survival related to changes in cell phenotype (epithelial-to-mesenchymal transition and cell migration).
ISSN: 2045-2322

Droits : http://creativecommons.org/licenses/by/
hal-01359569
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01359569
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01359569/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01359569/file/The%20environmental%20carcinogen-CCBY%20%281%29.pdf
DOI : 10.1038/srep30776

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
Résumé : International audience
OBJECTIVE: To analyze complications of endoscopic transsphenoidal surgery (ETS) for nonfunctioning pituitary macroadenomas (NFPAs).ăMETHODS: A retrospective study of 300 NFPAs was performed. Complications and factors that could influence these complications were analyzed.ăRESULTS: Visual and pituitary functions worsened in 2.4% and 13.7% of cases, respectively. Postoperative diabetes insipidus was permanent in 6.2% of cases. Postoperative meningitis occurred in 3.3% of patients. Meningitis was strongly associated with intraoperative cerebrospinal fluid (CSF) leaks (P = 0.01), postoperative CSF leaks (P = 0.0001), and operation times longer than 1 hour (P = 0.023). Detection of Staphylococcus aureus and preoperative treatment with mupirocin in the nostrils did not impact the occurrence of meningitis. Two patients with meningitis died (unique causes of death). Postoperative CSF leaks occurred in 2.7% of cases and were associated with intraoperative CSF leaks (P = 0.007) and permanent diabetes insipidus (P = 0.028). The rate of CSF leak decreased from 4% to 0.8% (P = 0.048) after we moved from a soft to hard reconstruction of the sella. The rate of postoperative epistaxis decreased from 6.7% to 1.25% after we stopped using monopolar coagulation (P = 0.013).ăCONCLUSIONS: ETS permits a wide view, allowing good conditions for a satisfactory resection in the majority of NFPAs. Some pitfalls of endoscopy can lead to complications that improve with modification of the operative technique (i.e., CSF leak and postoperative epistaxis). This study confirms an acceptable rate of complications associated with ETS.
World Neurosurgery

hal-01474296
https://hal.archives-ouvertes.fr/hal-01474296
DOI : 10.1016/j.wneu.2016.02.059
PUBMED : 26902781

Éditeur(s) : HAL CCSD Impact journals
Résumé : International audience
TNF-Related Apoptosis-Inducing Ligand (TRAIL) is a well-known apoptosis inducer, which activates the extrinsic death pathway. TRAIL is pro-apoptotic on colon cancer cells, while not cytotoxic towards normal healthy cells. However, its clinical use is limited by cell resistance to cell death which occurs in approximately 50% of cancer cells. Short Chain Fatty Acids (SCFA) are also known to specifically induce apoptosis of cancer cells. In accordance, we have shown that food grade dairy propionibacteria induce intrinsic apoptosis of colon cancer cells, via the production and release of SCFA (propionate and acetate) acting on mitochondria. Here, we investigated possible synergistic effect between Propionibacterium freudenreichii and TRAIL. Indeed, we hypothesized that acting on both extrinsic and intrinsic death pathways may exert a synergistic pro-apoptotic effect. Whole transcriptomic analysis demonstrated that propionibacterial supernatant or propionibacterial metabolites (propionate and acetate), in combination with TRAIL, increased pro-apoptotic gene expression (TRAIL-R2/DR5) and decreased anti-apoptotic gene expression (FLIP, XIAP) in HT29 human colon cancer cells. The revealed synergistic pro-apoptotic effect, depending on both death receptors (TRAIL-R1/DR4, TRAIL-R2/DR5) and caspases (caspase-8,-9 and-3) activation, was lethal on cancer cells but not on normal human intestinal epithelial cells (HIEC), and was inhibited by Bcl-2 expression. Finally, milk fermented by P. freudenreichii induced HT29 cells apoptosis and enhanced TRAIL cytotoxic activity, as did P. freudenreichii DMEM culture supernatants or its SCFA metabolites. These results open new perspectives for food grade P. freudenreichii-containing products in order to potentiate TRAIL-based cancer therapy in colorectal cancer.
ISSN: 1949-2553

hal-01404971
https://hal.inria.fr/hal-01404971
https://hal.inria.fr/hal-01404971/document
https://hal.inria.fr/hal-01404971/file/2016%20Oncotarget_The%20probiotic%20Propionibacterium%20freudenreichii%20as%20a%20new%20adjuvant%20for%20TRAIL-based%20therapy%20in%20colorectal%20cancer..pdf
DOI : 10.18632/oncotarget.6881

Éditeur(s) : HAL CCSD
Résumé : ABSTRACT Infectious complications are a leading cause of morbidity and mortality in patients with sickle cell disease. The exact reasons of the propensity of sickle cell patients to infection are not clear and are matter of debate. Besides, there is a striking variability of the clinical course of the disease between patients. This drew many scientists' attention. Genetic factors have been investigated as potential factor risks for infection in sickle cell patients, for example: HLA system; genes encoding Fc Human Immunoglobulin G receptor IIA, mannose-binding protein, and myeloperoxidase. Associations have been found, but all scientists agree that investigations have to be furthered. We investigated an association between HLA DRB1 and DQB1 polymorphism and infectious complications in sickle cell patients. Genotype frequencies were different between cases and controls for DRB1 locus. Indeed, HLA-DRB1*11 frequency was significantly higher in patients without infections than in patients with infections (χ² = 5.02; p = 0.025).
https://hal.archives-ouvertes.fr/hal-00387082

hal-00387082
https://hal.archives-ouvertes.fr/hal-00387082
https://hal.archives-ouvertes.fr/hal-00387082/document
https://hal.archives-ouvertes.fr/hal-00387082/file/MO_JOANNES_et_al_HLA_and_SCD.pdf

Éditeur(s) : HAL CCSD Oxford University Press (OUP): Policy B
Résumé : International audience
AIMS: Indications for surgery in acute infective endocarditis (IE) are detailed in guidelines, but their application is not well known. We analysed the agreement between the patient's attending physicians and European Society of Cardiology guidelines regarding indications for surgery. We also assessed whether surgery was performed in patients who had an indication. METHODS AND RESULTS: From the 2008 prospective population-based French survey on IE, 303 patients with definite left-sided native IE were identified. For each case, we prospectively recorded (i) indication for surgery according to the attending physicians and (ii) indication for surgery according to guidelines. Surgery was indicated in 194 (65%) patients according to attending physicians and in 221 (73%) according to guidelines, while 139 (46%) underwent surgery. Agreement was moderate between attending physicians and guidelines (kappa 0.41-0.59) and between indication according to guidelines and the performance of surgery (kappa 0.38). Of the 90 (30%) patients not operated despite indication, contraindication to surgery was reported by the attending physicians in 42 (47%), and indication was not identified in 48 (53%). One-year survival was 76% in patients with indication and surgery performed (n = 131), 69% in patients without indication and no surgery (n = 74), 56% in patients with identified indication and contraindication to surgery (n = 42), and 60% in patients with no identified indication (n = 48; P = 0.059). CONCLUSION: Cardiac surgery during acute IE was recommended in almost three out of four patients, although fewer than half were actually operated. Indication was not acknowledged by the attending physicians in one out of six patients
ISSN: 0195-668X

hal-01255874
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01255874
DOI : 10.1093/eurheartj/ehv650
PUBMED : 26685134

Éditeur(s) : HAL CCSD American Public Health Association
Résumé : International audience
Sickle cell disease (SCD) is a significant problem in the Caribbean, where many individuals have African and Asian forebears. However, reliable prevalence data and specific health care programs for SCD are often missing in this region. Closer collaboration between Caribbean territories initiated in 2006 to set up strategies to promote better equity in the health care system for SCD patients led to the formation of CAREST: the Caribbean Network of Researchers on Sickle Cell Disease and Thalassemia. We present the effectiveness of collaborations established by CAREST to promote SCD newborn screening programs and early childhood care, to facilitate health worker training and approaches for prevention and treatment of SCD complications, and to carry out inter-Caribbean research studies.
ISSN: 0090-0036

hal-01668331
https://hal.univ-antilles.fr/hal-01668331
DOI : 10.2105/AJPH.2016.303078

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : National audience
ISSN: 0755-4982

hal-01128003
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01128003
DOI : 10.1016/j.lpm.2014.06.042
PUBMED : 25639624

Éditeur(s) : HAL CCSD
Résumé : International audience

Background. Projections of medical demography show a decrease of number of doctors who practice in a rural setting and a low amount of general practitioners’ facilities.

Aim. To explore residents’ career choices and to determine their terms to settle in rural areas.
Methods. Qualitative study by groups interviews in five French cities with total of 33 residents. Thematic analysis was performed using the NVivo® software.
Results. Personal life strongly influenced residents’ career choices with a strong desire of free time. Residents considered working among a team rather than in a traditional group practice. They were interested by a practice in rural setting but countryside perceived as too far from urban centres and lacking of access to services. They also imagined the practice conditions as difficult and solitary. Many residents intended practicing in a “semi-rural” setting, the description of which could match with a significant part of the rural area.
Conclusion. If this declared craze for practice in “semi-rural” setting was confirmed, forecasts for some rural areas could be relativized. Public authorities’ attention should then be focused on rural areas far from urban centres and on territories characterized by lonesome medical practice.

Contexte. Les projections en termes de démographie médicale montrent une diminution du nombre de médecins exerçant en zone rurale, avec un faible nombre d’installations.
Objectif. Explorer les souhaits d’exercice des internes et recueillir leurs conditions pour exercer en zone rurale.
Méthode. Étude qualitative par entretiens collectifs dans cinq villes de France auprès de 33 internes. L’analyse thématique a été réalisée à l’aide du logiciel NVivo®.
Résultats. La vie personnelle influençait fortement les souhaits d’exercice, avec un désir de préserver du temps libre. Les internes envisageaient un exercice en équipe, au-delà de l’exercice de groupe traditionnel. Ils étaient intéressés par l’exercice en milieu rural, mais le territoire rural leur apparaissait sans accès aux services et très éloigné des pôles urbains. Ils se représentaient également des conditions d’exercice difficiles et solitaires. De nombreux internes se projetaient dans un exercice en « semi-rural », dont la description pourrait correspondre à une partie non négligeable de l’espace rural.
Conclusion. Si cet engouement déclaré pour l’exercice en semi-rural venait à se confirmer, ces projections concernant certaines zones rurales pourraient être relativisées. L’attention des pouvoirs publics devrait alors se concentrer sur les zones rurales éloignées des pôles urbains et les territoires marqués par un exercice médical solitaire prédominant.

ISSN: 0998-3953

hal-01654623
https://hal.archives-ouvertes.fr/hal-01654623
OKINA : ua16504

Éditeur(s) : HAL CCSD
Résumé : ABSTRACT Infectious complications are a leading cause of morbidity and mortality in patients with sickle cell disease. Several mechanisms are supposed to contribute to this susceptibility. The exact reasons of the propensity of sickle cell patients to infection are not clear and are still matter of debate. Interferon gamma is a key cytokine involved namely in the defence against intracellular pathogens. We investigated a possible association of +874 T/A IFNγ polymorphism and infectious complications in sickle cell patients. Seventy-two sickle cell patients were typed for +874 T/A IFNγ polymorphism. Genotype frequencies were different between cases and controls. Indeed, T allele frequency was significantly higher in patients with infections than in patients without infections (χ² = 6.23 ; p = 0.013). Our results suggest that +874 T/A IFNγ polymorphism is associated with infectious complications in sickle cell patients. The T allele could be involved in infections in sickle cell patients.
https://hal.archives-ouvertes.fr/hal-00387081

hal-00387081
https://hal.archives-ouvertes.fr/hal-00387081
https://hal.archives-ouvertes.fr/hal-00387081/document
https://hal.archives-ouvertes.fr/hal-00387081/file/MO_Joannes_et_al._IFNG_polymorphism_and_sickle_cell_disease.pdf