Éditeur(s) : Publ. CNEXO (France) (Actes Colloq.)(no. 9)
Résumé : The coastline of Western Ireland has an hyperoceanic climate. Its complicated geological structure and the Pleistocene glacial remnants explain its diversity. Cliffs have various altitudes (megafalaises, high cliffs, low cliffs). Lowland shores are rocky, sandy or built of morainic deposits. Transverse coasts have steep forelands and narrow embayments.
Les littoraux de l'Irlande occidentale ont un climat hyperocéanique. Ils doivent leur diversité à une structure géologique complexe et à l'héritage de la glaciation pléistocène. Les falaises ont des altitudes variées (mégafalaises, hautes falaises, basses falaises). Les côtes basses sont rocheuses, sableuses ou façonnées dans des matériaux morainiques. Des littoraux transverses opposent des promontoires élevés à de profondes baies en bouteille.

Droits : info:eu-repo/semantics/openAccess
http://archimer.ifremer.fr/doc/1979/publication-6016.pdf
http://archimer.ifremer.fr/doc/00000/6016/

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) : Pergamon-elsevier Science Ltd
Résumé : We tested the applicability of the BIT (branched and isoprenoid tetraether) index as a proxy for palaeoflood events in the river-dominated continental margin of the Gulf of Lions (NW Mediterranean). We compared the concentrations of branched glycerol dialkyl glycerol tetraethers (br GDGTs) and crenarchaeol in suspended particulate matter (SPM) collected downstream in the Rhône River, as well as in surface sediments and a ca. 8m piston core from the Rhône prodelta. The core covered the last 400 yr, with four distinct intervals recording the river influence under natural and man-induced shifts in four main channels of the river mouth (Bras de Fer, Grand Rhône, Pégoulier,and Roustan). The results indicate that there are mixed sources of br GDGTs and crenarchaeol in the prodelta, complicating applicationof the BIT index as an indicator of continental organic carbon input and thus as a palaeoflood proxy. However, the sedimentary BIT record for the period when continental material was delivered by the river more directly to the core site (Roustan phase;1892 to present) mimics the historical palaeoflood record. This shows the potential of the BIT index as a palaeoflood proxy, provided that the delivery route of the continental material by rivers to the core sites remains constant over time. The study also highlights the idea that shifts in river channels should be taken into account for the use of the BIT index as a palaeoflood proxy.
Organic Geochemistry (0146-6380) (Pergamon-elsevier Science Ltd), 2014-10 , Vol. 75 , P. 99-108

Droits : 2014 Elsevier Ltd. All rights reserved.
http://archimer.ifremer.fr/doc/00198/30969/29345.pdf
DOI:10.1016/j.orggeochem.2014.06.011
http://archimer.ifremer.fr/doc/00198/30969/

Éditeur(s) : HAL CCSD Royal Society, The
Résumé : International audience
Many studies have focused on the impacts of climate change on biological assemblages, yet little is known about how climate interacts with other major anthropogenic influences on biodiversity, such as habitat disturbance. Using a unique global database of 1128 local ant assemblages , we examined whether climate mediates the effects of habitat disturbance on assemblage structure at a global scale. Species richness and evenness were associated positively with temperature, and negatively with disturbance. However, the interaction among temperature, precipitation and disturbance shaped species richness and evenness. The effect was manifested through a failure of species richness to increase substantially with temperature in transformed habitats at low precipitation. At low precipitation levels, evenness increased with temperature in undisturbed sites, peaked at medium temperatures in disturbed sites and remained low in transformed sites. In warmer climates with lower rainfall, the effects of increasing disturbance on species richness and evenness were akin to decreases in temperature of up to 98C. Anthropogenic disturbance and ongoing climate change may interact in complicated ways to shape the structure of assemblages, with hot, arid environments likely to be at greatest risk.
ISSN: 0962-8452

hal-01323255
https://hal.archives-ouvertes.fr/hal-01323255
DOI : 10.1098/rspb.2015.0418

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
Advances in groundwater storage monitoring are crucial for water resource management and hydrological processes understanding. The evaluation of water storage changes (WSC) often involve point measurements (observation wells, moisture probes, etc.), which may be inappropriate in heterogeneous media. Over the past few years, there has been an increasing interest in the use of gravimetry for hydrological studies. In the framework of the GHYRAF (Gravity and Hydrology inAfrica) project, 3 yr of repeated absolute gravity measurements using a FG5-type gravimeter have been undertaken at Nalohou, a Sudanian site in northern Benin. Hydrological data are collected within the long-term observing system AMMA-Catch. Once corrected for solid earth tides, ocean loading, air pressure effects, polar motion contribution and non-local hydrology, seasonal gravity variations reach up to 11 μGal, equivalent to a WSC of 260-mm thick infinite layer of water. Absolute temporal gravity data are compared to WSC deduced from neutron probe and water-table variations through a direct modelling approach. First, we use neutronic measurements available for the whole vertical profile where WSC occur (the vadose zone and a shallow unconfined aquifer). The RMSD between observed and modelled gravity variations is 1.61 μGal, which falls within the error bars of the absolute gravity data. Second, to acknowledge for the spatial variability of aquifer properties, we use a 2-D model for specific yield (Sy) derived from resistivity mapping and Magnetic Resonance Soundings (MRS). The latter provides a water content (θMRS) known to be higher than the specific yield. Hence, we scaled the 2-D model of θMRS with a single factor (α). WSC are calculated from water-table monitoring in the aquifer layer and neutronic measurements in the vadose layer. The value of α is obtained with aMonte-Carlo sampling approach, minimizing the RMSD between modelled and observed gravity variations. This leads to α = Sy/θMRS = 0.63 ± 0.15, close to what is found in the literature on the basis of pumping tests experiments, with a RMSD value of 0.94 μGal. This hydrogeophysical experiment is a first step towards the use of time-lapse gravity data as an integrative tool to monitor interannual WSC even in complicated subsurface distribution.
ISSN: 0956-540X

hal-00821181
https://hal.archives-ouvertes.fr/hal-00821181
DOI : 10.1093/gji/ggt146

Éditeur(s) : HAL CCSD
Résumé : International audience
The development of diabetic vascular complications is initiated, at least in part, by mitochondrial reactive oxygen species (ROS) production in endothelial cells. Hyperglycemia induces superoxide production in the mitochondria and initiates changes in the mitochondrial membrane potential that leads to mitochondrial dysfunction. Hydrogen sulfide (H2S) supplementation has been shown to reduce the mitochondrial oxidant production and shows efficacy against diabetic vascular damage in vivo. However, the half-life of H2S is very short and it is not specific for the mitochondria. We have therefore evaluated two novel mitochondria-targeted anethole dithiolethione and hydroxythiobenzamide H2S donors (AP39 and AP123 respectively) at preventing hyperglycemia-induced oxidative stress and metabolic changes in microvascular endothelial cells in vitro. Hyperglycemia (HG) induced significant increase in the activity of the citric acid cycle and led to elevated mitochondrial membrane potential. Mitochondrial oxidant production was increased and the mitochondrial electron transport decreased in hyperglycemic cells. AP39 and AP123 (30–300 nM) decreased HG-induced hyperpolarisation of the mitochondrial membrane and inhibited the mitochondrial oxidant production. Both H2S donors (30–300 nM) increased the electron transport at respiratory complex III and improved the cellular metabolism. Targeting H2S to mitochondria retained the cytoprotective effect of H2S against glucose-induced damage in endothelial cells suggesting that the molecular target of H2S action is within the mitochondria. Mitochondrial targeting of H2S also induced >1000-fold increase in the potency of H2S against hyperglycemia-induced injury. The high potency and long-lasting effect elicited by these H2S donors strongly suggests that these compounds could be useful against diabetic vascular complications. © 2016
Pharmacological Research

hal-01373947
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01373947
DOI : 10.1016/j.phrs.2016.08.019
PUBMED : 27565382

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
RATIONALE: Optimal management of complicated parapneumonic effusions (CPPE) remains controversial. OBJECTIVES: to assess safety and efficacy of iterative therapeutic thoracentesis (ITTC), the first-line treatment of CPPE in Rennes University Hospital. METHODS: Patients with CPPE were identified through our computerized database. We retrospectively studied all cases of CPPE initially managed with ITTC in our institution between 2001 and 2010. ITTC failure was defined by the need for additional treatment (i.e. surgery or percutaneous drainage), or death. RESULTS: Seventy-nine consecutive patients were included. The success rate was 81% (n = 64). Only 3 patients (4%) were referred to thoracic surgery. The one-year survival rate was 88%. On multivariate analysis, microorganisms observed in pleural fluid after Gram staining and first thoracentesis volume ≥450 mL were associated with ITTC failure with adjusted odds-ratios of 7.65 [95% CI, 1.44-40.67] and 6.97 [95% CI, 1.86-26.07], respectively. The main complications of ITTC were iatrogenic pneumothorax (n = 5, 6%) and vasovagal reactions (n = 3, 4%). None of the pneumothoraces required chest tube drainage, and no hemothorax or re-expansion pulmonary edema was observed. CONCLUSIONS: Although not indicated in international recommendations, ITTC is safe and effective as first-line treatment of CPPE, with limited invasiveness.
ISSN: 1932-6203

hal-00945622
https://hal-univ-rennes1.archives-ouvertes.fr/hal-00945622
https://hal-univ-rennes1.archives-ouvertes.fr/hal-00945622/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-00945622/file/fetchObject.pdf
PUBMED : 24400113

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
BACKGROUND:Sickle cell anaemia (SCA) is a severe hereditary haemoglobinopathy characterised by haemorheological abnormalities, which play a role in the occurrence of several acute and chronic clinical complications. While βS -haplotypes and alpha-thalassaemia modulate SCA clinical severity, their effects on blood rheology have been incompletely described. The aim of this study was to test the effects of these genetic modifiers on the haemorheological properties and clinical complication of children with SCA.PROCEDURE:Steady-state haemorheological profile, biological parameters, βS -haplotypes, alpha-globin status, vaso-occlusive crisis (VOC) and acute chest syndrome frequencies were analysed in 128 children (aged 5 to 18 years) with SCA.RESULTS:Patients with alpha-thalassaemia showed increased red blood cell (RBC) deformability and aggregation compared to those without. Median VOC rate was higher in patients with homozygous alpha-thalassaemia compared to those with a normal alpha genotype. Conversely, the haemorheological profile and clinical complications were not influenced by the βS -haplotypes in our study.CONCLUSION:Our results demonstrate that alpha-thalassaemia is associated with higher risk for VOC events in children with SCA, which may be due in part to its effects on RBC deformability and aggregation.
ISSN: 1545-5009

hal-01668317
https://hal.univ-antilles.fr/hal-01668317
DOI : 10.1002/pbc.26455
PUBMED : 28097791

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

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Objectives To investigate the association between priapism in men with sickle cell anemia (SCA) and hemorheological and hemolytical parameters. Materials and Methods Fifty-eight men with SCA (median age: 38 years) were included; 28 who had experienced priapism at least once during their life (priapism group) and 30 who never experienced this complication (control group). Twenty-two patients were treated with hydroxycarbamide, 11 in each group. All patients were at steady state at the time of inclusion. Hematological and biochemical parameters were obtained through routine procedures. The Laser-assisted Optical Rotational Cell Analyzer was used to measure red blood cell (RBC) deformability at 30 Pa (ektacytometry) and RBC aggregation properties (laser backscatter versus time). Blood viscosity was measured at a shear rate of 225 s(-1) using a cone/plate viscometer. A principal component analysis was performed on 4 hemolytic markers (i.e., lactate dehydrogenase (LDH), aspartate aminotransferase (ASAT), total bilirubin (BIL) levels and reticulocyte (RET) percentage) to calculate a hemolytic index. Results Compared to the control group, patients with priapism exhibited higher ASAT (p = 0.01), LDH (p = 0.03), RET (p = 0.03) levels and hemolytic indices (p = 0.02). Higher RBC aggregates strength (p = 0.01) and lower RBC deformability (p = 0.005) were observed in patients with priapism compared to controls. After removing the hydroxycarbamide-treated patients, RBC deformability (p = 0.01) and RBC aggregate strength (p = 0.03) were still different between the two groups, and patients with priapism exhibited significantly higher hemolytic indices (p = 0.01) than controls. Conclusion Our results confirm that priapism in SCA is associated with higher hemolytic rates and show for the first time that this complication is also associated with higher RBC aggregate strength and lower RBC deformability.
ISSN: 1932-6203

hal-01390971
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01390971
DOI : 10.1371/journal.pone.0154866
PUBMED : 27145183

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
Parapneumonic pleural effusions represent the main cause of pleural infections. Their incidence is constantly increasing. Although by definition they are considered to be a “parapneumonic” phenomenon, the microbial epidemiology of these effusions differs from pneumonia with a higher prevalence of anaerobic bacteria. The first thoracentesis is the most important diagnostic stage because it allows for a distinction between complicated and non-complicated parapneumonic effusions. Only complicated parapneumonic effusions need to be drained. Therapeutic evacuation modalities include repeated therapeutic thoracentesis, chest tube drainage or thoracic surgery. The choice of the first-line evacuation treatment is still controversial and there are few prospective controlled studies. The effectiveness of fibrinolytic agents is not established except when they are combined with DNase. Antibiotics are mandatory; they should be initiated as quickly as possible and should be active against anaerobic bacteria except for in the context of pneumococcal infections. There are few data on the use of chest physiotherapy, which remains widely used. Mortality is still high and is influenced by underlying comorbidities.
Les épanchements pleuraux parapneumoniques représentent la principale étiologie des pleurésies infectieuses. Leur incidence est en constante augmentation. Bien qu’ils soient qualifiés de « parapneumoniques », l’épidémiologie microbienne est différente de celle des pneumonies avec notamment une plus grande fréquence des germes anaérobies. La ponction pleurale exploratrice représente l’étape diagnostique centrale qui permet de distinguer les épanchements parapneumoniques compliqués et non compliqués. Seuls les épanchements parapneumoniques compliqués doivent faire l’objet d’un traitement évacuateur reposant sur la mise en œuvre de ponctions pleurales répétées (PPR), d’un drainage thoracique ou d’une prise en charge chirurgicale. Le choix de la technique évacuatrice première reste débattu car il existe peu d’études prospectives comparatives. L’utilisation d’agents fibrinolytiques n’a pas fait la preuve de son efficacité sauf lorsqu’ils sont utilisés en association à la DNAse. L’antibiothérapie doit être systématique, précoce et couvrir les germes anaérobies, sauf en cas d’infection à pneumocoque. Il existe peu de données sur la place de la kinésithérapie qui reste largement utilisée. La mortalité est élevée et directement influencée par les comorbidités sous-jacentes.
ISSN: 0761-8425

hal-01117905
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01117905
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01117905/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01117905/file/Les%20%C3%A9panchements%20pleuraux%20parapneumoniques_accepted.pdf
DOI : 10.1016/j.rmr.2014.12.001

Éditeur(s) : HAL CCSD IOS Press
Résumé : International audience
Sickle cell anemia (SCA or SS homozygous sickle cell disease) is an inherited blood disorder caused by single 12 nucleotide substitution in the ␤-globin gene that renders their hemoglobin (HbS) much less soluble than normal hemoglobin 13 (HbA) when deoxygenated. The polymerization of HbS upon deoxygenation is the basic pathophysiologic event leading to 14 RBC sickling, hemolysis, vasoocclusion and ultimately to chronic organ damage. The metabolic changes imposed by exercise 15 may initiate sickling and vaso-occlusive episodes. Further, in patients with SCA, exercise limitation may be related to anemia 16 or chronic complications such as pulmonary vascular disease, congestive heart failure and chronic parenchymal lung disease. 17 Few studies have investigated the cardiorespiratory responses of patients with SCA during either symptom-limited maximal 18 exercise test on cyclo-ergometer or during a six minute walk test. Therefore, patients are advised to start exercise slowly and 19 progressively, to maintain adequate hydration during and after exercise, to avoid cold exposure or sudden change in temperature, 20 and to avoid sports associated with mechanical trauma. There are, however, lack of evidence to allow practitioners to prescribe 21 an exercise program for patients with SCA, and individuals are usually encouraged to exercise on a symptom-limited basis. 22 Finally, this review will also highlight the basic principles that are often used for exercise practice and could be used for exercise 23 prescription and rehabilitation in patients with sickle cell anemia.
ISSN: 1386-0291

hal-01163966
https://hal.univ-antilles.fr/hal-01163966
DOI : 10.3233/CH-2011-1465

Éditeur(s) : Université des Antilles Études caribéennes
Résumé : L’eau joue un rôle incontournable dans l’Histoire de la Caraïbe. Ainsi que le remarque Aimé Césaire, les premiers colons furent des aventuriers, des pirates qui traversèrent les eaux avec pour mission de violer la terre et ses hommes. L’océan fut ainsi le vecteur qui aboutit au premier génocide de l’histoire. L’eau abonde dans les écrits de Roland Brival qui sont marqués par la mémoire ancestrale liée au « passage du milieu ». Il présente aussi des personnages métis dont la subjectivité est imbibée des composantes de l’eau. Leur corps et leur identité deviennent un prolongement archétypique de l’élément liquide. Ils sont attirés par la mer qui appelle leurs multiples « moi ». L’eau les invite à conjuguer toutes les identités possibles contrairement à la vie terrestre qui leur impose un ancrage identitaire. L’article présente aussi l’eau comme élément complice dans les rencontres Les couples se retrouvent souvent au bord d’une rivière, d’une source, de la mer. L’océanique est ainsi un élément de prédilection pour les héros brivaliens et représente l’espace métis par excellence. L’eau, l’identité et le corps métis partagent la violence de l’histoire, l’entre-deux, le flou, la mouvance et l’impossibilité d’une fin. La métaphore filée de l’eau marque son empreinte dans des textes qui inscrivent la complexité de l’être métis
The water plays an inescapable role in the History of the Caribbean. As Aimé Césaire remarks, the first colons were adventurers, buccaneers who crossed the sea with a mission to rape the earth and its men and women. The ocean was a vector, which lead to the first genocide in history. The imagery of water is abundant in the works of Roland Brival: his novels are infused with the ancestral memory linked to the “middle passage.” He also introduces metis characters whose identity is infused by the components of the liquid element. Their body and identity become an archetypical extension of the water. They are attracted by the sea, which invites the multiplicity of self. The water enables them to “conjugate” all the potential identities unlike the life on earth, which imposes an identitarian anchoring. This article also presents the water as an accomplice in sexual encounters. Characters often meet by the river, the spring water, the sea, and the ocean. The water represents the ideal space par excellence for the metis protagonists. The hybrid body, identity, and the waters share the violence of history, the “third space,” the ever-changing and the unfeasibility of closure. The metaphors of water brand the texts of Roland Brival and reveal the complexity of the hybrid body and identity.
Martinique

Droits : info:eu-repo/semantics/openAccess
urn:doi:10.4000/etudescaribeennes.6348
http://journals.openedition.org/etudescaribeennes/6348

Éditeur(s) : HAL CCSD
Résumé : International audience
INTRODUCTION: There are no French guidelines for the management of complicated parapneumonic effusions. A national observational study was carried out to assess the main features of current clinical practice for this condition. MATERIAL AND METHODS: A questionnaire was sent by email to the 1500 members of the Société de Pneumologie de Langue Française (SPLF) between 15th November and 15th December 2012. RESULTS: There were 92 responders, i.e. a response rate of 6%. Of these, 87 physicians mentioned that they were involved in the management of patients with complicated parapneumonic effusions with a median number of cases of 10 per year (IQR: 5-20). Chest tube drainage was the main approach used for pleural fluid aspiration (n=51/87), followed by repeated thoracentesis (n=29/87) and early surgery (1/87). Five physicians answered both chest tube drainage or repeated thoracentesis and one physician either chest tube drainage or early surgery. Pleural fibrinolytics were never used by 20% of physicians, only in case of loculations by 70% and by 10% of respondents in all cases. Only 3 physicians combined fibrinolytics with DNAse. A double antibiotic dose was used by one third of physicians. All the physicians used respiratory physiotherapy during hospitalization and to aid recovery. Follow-up practices were heterogeneous. CONCLUSIONS: The management of complicated parapneumonic effusions varies significantly in France. National guidelines may be helpful to define best practice and aid in its implementation.
Revue Des Maladies Respiratoires

hal-01146851
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01146851
DOI : 10.1016/j.rmr.2015.01.001
PUBMED : 25725981

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
Alveolar proteinosis (AP) is a rare disease characterized by alveolar accumulation of surfactant components, which impairs gas exchange. AP is classified into three groups: auto-immune AP defined by the presence of plasma autoantibodies anti-GM-CSF, the most frequent form (90 % of all AP); secondary AP, mainly occurring as a consequence of haematological diseases, or following on from toxic inhalation or infections, and genetic AP, which affects almost exclusively children. AP diagnosis is suspected where chest CT-scan demonstrates interstitial lung disease with a crazy paving aspect; and confirmed by bronchoalveolar lavage, which has a milky appearance and contains periodic acid Schiff positive proteinaceous alveolar deposits. The use of surgical lung biopsy to confirm AP is less frequent nowadays. In this context, positive antibodies against GM-CSF indicates an auto-immune etiology of the AP. Concerning management, whole lung lavage is the gold standard therapy. In refractory AP, new treatments are available such as subcutaneous or inhaled GM-CSF supplementation, or rituximab infusions. The clinical course is unpredictable. Spontaneous improvement or even cure can occur, and the 5-year actuarial survival is 95 %. The most frequent complications are infectious etiology.
La protéinose alvéolaire pulmonaire (PAP) est une maladie rare caractérisée par l’accumulation alvéolaire de composants du surfactant qui gêne les échanges gazeux. Les PAP sont séparées en trois groupes : les PAP auto-immunes caractérisées par la présence d’anticorps sériques anti-GM-CSF qui sont les plus fréquentes ; les PAP secondaires à une maladie sous-jacente, le plus souvent hématologique, mais aussi à l’inhalation de toxiques et à des infections ; enfin, les PAP d’origine génétique. Le diagnostic de PAP est évoqué sur le scanner thoracique avec une pneumopathie infiltrante diffuse ayant un aspect classique de crazy paving, puis confirmé par l’aspect laiteux du lavage bronchoalvéolaire, et la présence de matériel lipoprotéinacé PAS positif. La confirmation du diagnostic de PAP par biopsie pulmonaire chirurgicale est désormais rarement nécessaire. La positivité des anticorps sériques anti-GM-CSF signe le caractère auto-immun de la maladie. Le traitement de référence des PAP auto-immunes est le « grand lavage pulmonaire thérapeutique ». En cas de maladie réfractaire, d’autres traitements sont disponibles, tels que le GM-CSF en injection sous-cutanée ou en aérosol et le rituximab. L’évolution de la maladie est imprévisible. Une évolution spontanément favorable ou même une guérison spontanée peuvent survenir et la survie actuarielle à 5 ans est de 95 %. Les principales complications sont infectieuses.
ISSN: 0761-8425

hal-01085907
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01085907
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01085907/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01085907/file/Prot%C3%A9inose%20alv%C3%A9olaire%20pulmonaire_accepted.pdf
DOI : 10.1016/j.rmr.2014.08.009

Éditeur(s) : HAL CCSD
Résumé : This thesis falls within the scope of social and human geography and more exactly of« disability studies ». Understanding the disability like a « social object », the thesis analyzes the societal consideration of disabled people in non-urbanized areas with a high issue of touristic, recreational and patrimonial development. In the first place, it's the recent construction of disability as a social object that is discussed by reminding the history of the societal consideration of the disabled person in our occidental world. The French model and his fundamental rule of global accessibility for ail the domains of the social life are explained and the « Nature and Disability » thematic is more precisely analyzed as a development of an active living ideal for people who are in a disability situation. Secondly, the thesis develops this thematic on the particular field of the Reunion Island and tries to answer to a question which is both simple and complicated: « Today, how we live with a disability on the Reunion Island? ». ln a last time and on the basis of this study of the disability inside a Reunion Island society with accelerated transformations, the thesis specifies the current tendencies with the emergence of new public policies for the welcome of disabled people on natural and touristic areas of the island. To conclude and referring to an original survey, the thesis suggests some tools of evaluation and decision-making aids to these areas.
Cette thèse s'inscrit dans le champ de la géographie humaine et sociale et plus précisément dans celui des « disability studies ». En positionnant le handicap comme une « figure du social », la thèse analyse la prise en compte sociétale des personnes à mobilité réduite (PMR) dans des environnements non urbanisés, à très fort enjeu de développement touristique, récréatif et patrimonial. Dans un premier temps, c'est la construction récente du handicap en tant que figure du social qui est abordée, en rappelant l'historique de la considération de la personne handicapée dans nos sociétés occidentales. Le modèle français et son principe fondamental d'accessibilité généralisée à tous les domaines de la vie sociale sont détaillés et la thématique « Nature et Handicap » est analysée plus précisément, en tant que développement d'un idéal de vie active pour les personnes en situation de handicap. Dans un second temps, la thèse développe cette thématique sur le terrain particulier de l'Île de La Réunion et tente de répondre à une question à la fois simple et complexe : « comment vit-on avec une déficience aujourd'hui à La Réunion ? ». Dans un dernier temps et sur la base de cette analyse du handicap au sein d'une société réunionnaise aux mutations accélérées, la thèse précise les tendances actuelles avec l'apparition de nouvelles politiques publiques d'accueil des PMR dans les espaces naturels et touristiques de l'île. S'appuyant sur une enquête originale, la thèse propose enfin des outils d'évaluation et d'aide à la décision spécifiques à ces espaces.
https://tel.archives-ouvertes.fr/tel-01279042

NNT : 2012LARE0025
tel-01279042
https://tel.archives-ouvertes.fr/tel-01279042
https://tel.archives-ouvertes.fr/tel-01279042/document
https://tel.archives-ouvertes.fr/tel-01279042/file/2012lare0025_AGuenat.pdf

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
BACKGROUND: The timing of cardiac surgery after stroke in infective endocarditis (IE) remains controversial. We examined the relationship between the timing of surgery after stroke and the incidence of in-hospital and 1-year mortalities. METHODS: Data were obtained from the International Collaboration on Endocarditis-Prospective Cohort Study of 4794 patients with definite IE who were admitted to 64 centers from June 2000 through December 2006. Multivariate logistic regression and Cox regression analyses were performed to estimate the impact of early surgery on hospital and 1-year mortality after adjustments for other significant covariates. RESULTS: Of the 857 patients with IE complicated by ischemic stroke syndromes, 198 who underwent valve replacement surgery poststroke were available for analysis. Overall, 58 (29.3%) patients underwent early surgical treatment vs 140 (70.7%) patients who underwent late surgical treatment. After adjustment for other risk factors, early surgery was not significantly associated with increased in-hospital mortality rates (odds ratio, 2.308; 95% confidence interval [CI], .942-5.652). Overall, probability of death after 1-year follow-up did not differ between 2 treatment groups (27.1% in early surgery and 19.2% in late surgery group, P = .328; adjusted hazard ratio, 1.138; 95% CI, .802-1.650). CONCLUSIONS: There is no apparent survival benefit in delaying surgery when indicated in IE patients after ischemic stroke. Further observational analyses that include detailed pre- and postoperative clinical neurologic findings and advanced imaging data (eg, ischemic stroke size), may allow for more refined recommendations on the optimal timing of valvular surgery in patients with IE and recent stroke syndromes.
ISSN: 1058-4838

hal-00875143
https://hal.archives-ouvertes.fr/hal-00875143
DOI : 10.1093/cid/cis878
PUBMED : 23074311

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Few studies have explored the consequences of environmental exposure to organochlorine pesticides for gestational hypertension (GH), preeclampsia (PE) and gestational diabetes mellitus (GDM). Chlordecone is a persistent organochlorine pesticide that was used intensively, and almost exclusively, in the French West Indies until 1993. We investigated the impact of prenatal exposure to chlordecone on the occurrence of GDM, GH and PE by studying 779 pregnant women enrolled in a prospective mother-child cohort (Timoun Study) in Guadeloupe between 2004 and 2007. Chlordecone exposure was determined by assaying maternal plasma and information about pregnancy complications was obtained from midwives, pediatricians and hospital medical records after delivery. The risks of GH (n=65), PE (n=31) and GDM (n=71) were estimated by multiple logistic regression including potential confounders. Levels of chlordecone plasma concentration in the third (OR=0.2; 95% confidence interval (CI): 0.1, 0.5) and fourth quartiles (OR=0.3; 95% CI: 0.2, 0.7) were associated with a statistically significant decrease in the risk of GH. A log10 increase in chlordecone concentration was significantly associated with lower risk of GH (OR=0.4; 95% CI: 0.2, 0.6). No significant associations were observed between the chlordecone exposure and the risk of PE or GDM. This study suggests an inverse association between chlordecone exposure during pregnancy and GH. Further studies are required to determine the underlying mechanism, or the potential unknown confounding factors, resulting in this association.
ISSN: 0160-4120

hal-01061391
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01061391
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01061391/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01061391/file/Saunders_et_al._Final_version_main_manuscript.pdf
DOI : 10.1016/j.envint.2014.03.024

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Mass balances are often used to calculate sediment fluxes in foreland basins and denudation rates in adjacent mountain ranges on intermediate to long timescales (from a few tens of thousand to a million years). Here, we study the simple Quaternary catchment-alluvial fan system of the Kuitun River, in northern Tian Shan, to discuss some ideas about sediment storage, release, and bypass in relatively short (100 km long) sediment routing systems. This study shows that the Kuitun catchment and piedmont areas clearly present evidence of a significant and temporary storage of sediments during the Pleistocene. These sediments were then excavated and delivered farther into the foreland basin during the Holocene. The difference between the volumes of materials released from the catchment and piedmont areas (5.5 ± 1.7 km3) and the volume stored in a contemporaneous fan downstream (2.6 ± 0.6 km3) indicates that the latter did not trap the whole sediment load transported by the river. The alluvial fan was bypassed by 27 to 78% of this load toward its distal alluvial plain. If this value is well estimated, it implies a major volumetric partitioning of the deposits between the fan and the alluvial plain, with a very high sedimentation rate in the fan (1.97 ± 0.52 mm*y− 1) and a much lower one downstream (0.11 ± 0.11 mm*y− 1). However, this volumetric partitioning might only occur during periods with a very specific hydrological regime such as the Holocene deglaciation. Eventually, the peculiar sediment storage and release pattern within the Kuitun catchment and piedmont areas during the Pleistocene and Holocene complicates the calculation of mean paleodenudation rates using either sediment budgets or in situ produced cosmogenic nuclides.
ISSN: 0169-555X

insu-00985283
https://hal-insu.archives-ouvertes.fr/insu-00985283
https://hal-insu.archives-ouvertes.fr/insu-00985283/document
https://hal-insu.archives-ouvertes.fr/insu-00985283/file/jolivet-et_al-2014_HAL.pdf
DOI : 10.1016/j.geomorph.2014.01.024

Éditeur(s) : HAL CCSD IOS Press
Résumé : International audience
Because of the metabolic changes induced by a physical activity, the hemorheological properties of patients with sickle cell anemia could be further impaired and increase the risks for vaso-occlusive complications. However, few studies suggest that moderate physical activity could be beneficial rather than harmful in patients with sickle cell anemia (SCA). However, the definition of what can be considered as a moderate physical activity in SCA patients is imprecise. The present study tested the effects of a short incremental cycling exercise test conducted until the first ventilatory threshold on different biomarkers. Hematological and hemorheological parameters were compared between 8 patients with SCA and 13 healthy subjects (CONT) before, immediately after the end of the exercise and at 12, 36 and 60 hours after the exercise. We observed no significant hematological or hemorheological alteration induced by the exercise in the two groups. However, the exercise resulted in a delayed improvement of the red blood cell disaggregation threshold at 36 and 60 hrs after exercise in the SCA group which was paralleled to the decrease in the platelet count in this group. The present study suggests that such an exercise might be beneficial for microcirculatory blood flow.
ISSN: 1386-0291

hal-01137567
https://hal.univ-antilles.fr/hal-01137567