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Quel contenu pour le formulaire de consentement en génétique pédiatrique ?: Etude comparative des formulaires de consentement en France
No full textInternational audienceL'étude examine les formulaires de consentement utilisés pour les tests génétiques en oncologie pédiatrique en France, en mettant l'accent sur la place accordée aux mineurs dans le processus d'information et de consentement. Les auteurs ont analysé 26 formulaires provenant de divers établissements de santé, en se concentrant sur les aspects éthiques et juridiques. Les résultats montrent une grande hétérogénéité dans le vocabulaire utilisé pour désigner les protagonistes (parents, mineurs, etc.) et dans la définition des informations génétiques incidentes. Certains formulaires incluent des informations spécifiques pour les mineurs, tandis que d'autres se concentrent uniquement sur les parents. La majorité des formulaires requièrent la signature des titulaires de l'autorité parentale, mais peu d'entre eux demandent celle du mineur. L'étude souligne l'importance d'harmoniser les formulaires de consentement pour garantir une protection égale des droits des patients mineurs sur tout le territoire. Les auteurs recommandent de simplifier les formulaires et de fournir des notices d'information adaptées à l'âge et à la maturité des enfants. Ils suggèrent également de renforcer la capacité des équipes de soins à recontacter les patients devenus majeurs pour qu'ils puissent réévaluer leur consentement. En conclusion, l'article met en lumière la nécessité d'améliorer les pratiques de consentement en génétique pédiatrique pour mieux respecter l'autonomie des patients mineurs et assurer une information claire et adaptée
Réussite et attractivité au département GEII de l'IUT de Rennes après les réformes du BUT et du lycée
No full textInternational audienceIn 2021, IUTs had to implement the BUT reform, just after Covid and at the same time as the first new general baccalaureates were introduced. I wanted to take advantage of this edition of CETSIS to try to answer several questions. What impact has the BUT reform had? Has the general baccalaureate reform had an impact? Has the Covid period changed things? Is the BUT GEII still attractive? To complete this work, I will also present various actions implemented in our department to help our students succeed and/or enhance the attractiveness of our program.En 2021, les IUT ont dû mettre en place la réforme du BUT, juste après le Covid et en même temps que sortaient les premiers nouveaux bacs généraux. J’ai voulu profiter de cette édition du CETSIS pour tenter de répondre à plusieurs questions. Quel impact a eu la réforme du BUT ? Y a-t-il un impact de la réforme du baccalauréat général ? Est-ce que la période du Covid a modifié les choses ? Le BUT GEII est-il toujours attractif ? Pour compléter ce travail, je présenterai aussi différentes actions mises en place dans notre département pour aider à la réussite de nos étudiants et/ou renforcer l’attractivité de notre formation
Similarity of the effects of reverberation on speech intelligibility in noise for hearing-impaired and normal-hearing listeners
No full textInternational audienceHearing-impaired (HI) listeners experience difficulties to understand speech in noisy environments. The aim of this study was to determine whether they are more affected by the detrimental effects of reverberation than normal-hearing (NH) listeners. Intelligibility tests were done for NH listeners and HI listeners with various degrees of hearing loss, using headphones and real-room binaural impulse responses to simulate several spatial configurations. This allowed us to investigate different effects of reverberation on speech intelligibility in noise: the temporal smearing of the target speech impairing its intelligibility, the temporal smearing of modulated noise maskers reducing the opportunity for dip listening, and the detrimental effects of reverberation on spatial release from masking (SRM). The results indicate that the HI and NH listeners were similarly affected by reverberation. The tested conditions did not reveal any effect of hearing loss asymmetry on SRM, potentially because the main asymmetries were partly compensated for by the linear amplification applied to the stimuli for the HI listeners. Finally, the data could be described reasonably well using a binaural speech intelligibility model
Prostate Cancer: A Journey Through Its History and Recent Developments
No full textInternational audienceProstate cancer is one of the most common diseases among men worldwide and continues to pose a serious threat to health. This review shows the history and the new developments in the management of prostate cancer, with an emphasis on a range of therapeutic approaches, such as hormone therapy, radiation therapy, surgery, and innovative targeted therapeutics. The evolution of these treatments is examined in light of clinical outcomes, patient quality of life, and emerging resistance mechanisms, such as the recently shown vitamin D-based strategies. New developments that have the potential to increase survival rates and reduce side effects are also discussed, including PARP inhibitors (PARPis), immunotherapy, and tailored medication. Additionally, the use of biomarkers and sophisticated imaging methods in therapeutic decision-making is explored, with a focus on how these tools might improve patient care. The absolute necessity for a multidisciplinary approach for improving treatment strategies is becoming more and more apparent as our understanding of the biology of prostate cancer deepens. This approach ensures that patients receive customized medicines that fit their unique profiles. Future avenues of investigation will focus on resolving issues dealing with treatment efficacy and resistance to improve treatment results, ultimately leading to disease cure for prostate cancer patients
What are the expectations of patients regarding the communication of nuclear imaging results? Insights from a French national survey of 723 patients
No full textInternational audienceObjectives There are still some controversies regarding the role of nuclear medicine practitioners in delivering imaging findings to the patients as well as content and magnitude of information to be delivered. The aim of the study was to identify the expectations of patients regarding the communication of results from a nuclear imaging examination. Design A national survey was conducted among patients who underwent a nuclear imaging examination. In each participating centre, a questionnaire was administered to the patients. Setting Primary care in France. Participants The study involved 723 patients from 12 French Nuclear Medicine departments (university hospitals, general hospitals, comprehensive cancer centres and private centres). Outcome measure The primary endpoint was to determine the proportion of patients expressing a wish to consult a nuclear medicine physician at the end of the imaging session and to assess the rationale underlying this preference. Results Our results indicate that a significant majority (73.2%) of patients prefer to meet primarily with the nuclear medicine physician to receive an explanation of the imaging findings. Concerning the disclosure of these results, 66.1% of the patients prefer to receive an explanation from the nuclear medicine physician, either alongside or instead of the requesting physician alone. Furthermore, nearly all patients (96.1%) who wish to meet with the nuclear medicine physician also indicate their willingness to receive the examination results, even if they are unfavourable. Conclusions This study underscores the clear preference of patients to interact with nuclear medicine specialists and benefit from their expertise, irrespective of whether the results are positive or negative. This emphasises the critical need for implementing standardised recommendations across countries and ensuring adequate training for nuclear physicians to actually meet this demand. This aspect is likely to distinguish a nuclear medicine physician from a scan interpreter
Évaluation de la consommation en psychotropes depuis la pandémie de Covid-19 chez les résidents de sept Ehpad, en Ille-et-Vilaine
No full textInternational audienceThis study aimed to determine the course of psychotropic drugs use since the Covid-19 pandemic onset among nursing homes (NH) residents in Brittany, France. We conducted a retrospective, observational, descriptive study, including 7 NH. We collected the data about antipsychotic, antianxiety, hypnotic and antidepressant drugs dispensed from January 2016 to June 2021, and compared their consumptions over 3 periods (1: January 2016 to December 2019; 2: January to December 2020; 3: January to June 2021) using the unit of measurement DDD. In the whole NH population, no significant changes were found. At a NH level, the results between periods 1 and 2 were very different, depending on the NH. For NH with a single nursing home-employed physician, there was an increase of antipsychotic drugs use between periods 1 and 2, and 1 and 3. During periods 2 and 3, the consumption of antipsychotic drugs was higher for NH with a single nursing home-employed physician. The course of psychotropic drugs use since the onset of the Covid-19 pandemic changed depending on the NH organization. Further studies are needed to identify the factors explaining differences between NH.Introduction :Nous avons analysé l’évolution de la consommation en psychotropes depuis le début de l’épidémie de Covid-19 chez des résidents d’Ehpad en région Bretagne, France.Méthode :Nous avons réalisé une étude rétrospective, observationnelle, descriptive, incluant sept Ehpad hospitaliers. Nous avons recueilli les quantités délivrées en antipsychotiques, anxiolytiques, hypnotiques et antidépresseurs de janvier 2016 à juin 2021, et comparé leurs consommations sur trois périodes (1 : janvier 2016 à décembre 2019 ; 2 : janvier à décembre 2020 ; 3 : janvier à juin 2021) en utilisant l’unité de mesure DDD.Résultats :Tous Ehpad confondus, il n’était pas retrouvé de différences significatives. Les résultats étaient très hétérogènes entre les périodes 1 et 2 selon les Ehpad. Pour les Ehpad avec un seul médecin prescripteur, il existait une augmentation de la consommation en antipsychotiques entre les périodes 1 et 2, et 1 et 3. Durant les périodes 2 et 3, la consommation d’antipsychotiques était plus importante pour les Ehpad avec un seul médecin prescripteur.Conclusion :L’évolution de la consommation en psychotropes depuis le début de la pandémie Covid-19 était très variable d’un Ehpad à l’autre. Des études complémentaires sont nécessaires pour identifier les facteurs expliquant ces différences
Developmental plasticity of hermaphrodite sperm production across environments in Caenorhabditis elegans
No full textInternational audienceMany organisms show flexible resource allocation to adjust for optimal reproductive investment across different environments. How such reproductive plasticity occurs in hermaphroditic organisms—allocating resources to both oocytes and sperm—are central questions of sex allocation research. Self-fertilizing hermaphrodites of the androdioecious nematode Caenorhabditis elegans exhibit a sequential transition from spermatogenesis to oogenesis, so the extent of self-sperm production determines both fertilization onset and lifetime reproductive potential under selfing. Despite this key role, it remains largely unclear whether such sequential hermaphrodites flexibly adjust sperm production to optimize self-fertilization across different environments. Here we directly quantified plasticity in C. elegans hermaphrodite self-sperm production in diverse experimental environments. We found that: (a) Sperm production was developmentally plastic, but such changes did not consistently translate into changes in self-progeny number, suggesting C. elegans self-fecundity is likely often oocyte-limited rather than sperm-limited; (b) Contrary to expectations, plastically increased sperm production did not delay the onset of fertilization across various environments; (c) Subtle environmental challenges, such as mild dietary restriction, did not affect sperm production but had a significant impact on developmental time, age at reproductive maturity, and germline proliferation. This emphasizes the relative environmental insensitivity of sperm production compared to other reproductive traits in hermaphrodites. (d) Plasticity in sperm and germline traits varied by genetic background, with notable differences between the laboratory strain N2 and wild strains. These findings contribute to our understanding of reproductive plasticity in C. elegans and the developmental plasticity of sex allocation in sequential hermaphrodites
Quantification of Staphylococcal Enterotoxins by Coupling Laser-Induced Dissociation and Mass Spectrometry
No full textInternational audienceStaphylococcal enterotoxins (SEs) are a superfamily of virulence factors that make Staphylococcus aureus a major cause of food poisoning. The amount of SEs produced by a strain may correlate with its virulence; however, their accurate quantification remains a major challenge. This difficulty arises from two main factors: SEs exhibit emetic activity at nanogram levels, and they are secreted into complex biological matrices during bacterial growth, which typically requires immunoaffinity enrichment before multiplex mass spectrometry (MS) analysis. This study presents an innovative method combining Laser-Induced Dissociation (LID) with mass spectrometry to detect and quantify low-abundance SEs without prior immunoenrichment. To enhance detection specificity based on optical properties, a 473 nm laser was used to selectively fragment chromophore-derivatized cysteine peptides from SEs via LID-MS/MS. The derivatization strategy was first validated on synthetic peptides from five major SEs. Sample preparation was then optimized using purified toxins spiked into biological matrices. The method linearity was assessed by spiking SE synthetic peptides into the matrix across a wide concentration range. Finally, the full analytical protocol was validated by the detection and quantification of endogenous SEs produced by S. aureus strains. This LID-MS/MS approach offers a promising alternative to antibody-based methods for the precise quantification of staphylococcal enterotoxins in complex samples
International real-world study of combination immunotherapy sequences in metastatic melanoma
No full textInternational audienceBackground Immune checkpoint inhibitors (ICIs) have revolutionized melanoma treatment, with programmed cell death protein 1 (PD-1) inhibitors—alone or in combination with cytotoxic T-lymphocyte–associated protein 4 or lymphocyte-activation gene 3 inhibitors—demonstrating significant efficacy. However, there is a critical lack of robust data to determine the optimal sequencing of these therapies for individual patients. In particular, the role of relatlimab+nivolumab (rela/nivo) within treatment sequences remains poorly defined. Choosing the right sequence is strategic, as an inappropriate order may compromise the effectiveness of subsequent treatments and limit long-term benefits. Methods This multicenter retrospective and prospective study evaluated 190 patients across three treatment arms: rela/nivo followed by ipilimumab+nivolumab (ipi/nivo) (arm A, N=40), ipi/nivo followed by rela/nivo (arm B, N=71), and anti-PD-1 followed by rela/nivo (arm C, N=79). The study assessed the impact of treatment sequencing on outcomes including response rate, progression-free survival, and overall survival (OS). Results The overall response rate to second treatment was highest in arm C (30.4%), followed by arm B (28.1%) and arm A (17.5%). Patients with secondary resistance to first-treatment ICIs had better responses to second-treatment ICIs than those with primary resistance, particularly in arm B (p=0026). Median OS from date of first ICI treatment was significantly longer in arms B (40.9 months) and C (42.5 months) compared with arm A (16.3 months). Conclusions Our findings indicate that rela/nivo may remain active following anti-PD-1 or ipi/nivo therapy. Additionally, our results suggest that sequencing ipi/nivo before rela/nivo may yield better outcomes than starting with rela/nivo. Patients who respond to the first combination regimen appear to derive greater benefit from the second. Further efforts are needed to optimize sequencing strategies in advanced melanoma, and future studies should consider the impact of prior treatment outcomes
Association between serum interleukin 8 levels and cardiovascular events in patients with chronic kidney disease
No full textInternational audienceIntroduction Chronic kidney disease (CKD) is associated with systemic inflammation and elevated pro-inflammatory cytokines. While interleukin (IL)-8 has shown harmful cardiovascular effects in preclinical studies, its role in CKD remains underexplored. The study aimed to (i) determine serum IL-8 concentrations across CKD stages, (ii) identify factors associated with IL-8 concentrations, and (iii) evaluate its association with major adverse cardiovascular events (MACEs) and all-cause mortality. Methods The Chronic Kidney Disease–Renal Epidemiology and Information Network (CKD-REIN) prospective cohort includes CKD patients with an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m² not on kidney replacement therapy. Baseline serum IL-8 concentrations were centrally measured. MACE was defined as any cardiovascular death, myocardial infarction, stroke and hospital admission for heart failure. Multivariable linear regression was used to identify factors associated with IL-8 concentrations. Adjusted cause-specific Cox proportional hazard models were used to estimate hazard ratios [hazard ratio (HR) (95% confidence interval)] for the first MACE and for mortality. Results Among 2389 included patients (66% men; median age 68 years; mean eGFR 34.8 mL/min/1.73 m²), median serum IL-8 concentration was 12.2 pg/mL. Higher IL-8 levels correlated with more advanced CKD (P < .001), and were independently associated with lower eGFR, diabetes, prior cardiovascular disease, anemia, elevated C-reactive protein, more medications and lower serum albumin. Elevated baseline IL-8 was associated with a greater adjusted hazard of MACEs in women [HR for 1-unit change in log(IL-8): 1.75 (1.26; 2.43)] but not in men [HR 1.16 (0.93; 1.45)]. The adjusted HR for all-cause mortality was 1.70 (1.40; 2.06), with no difference between men and women. Conclusion In a large cohort of patients with moderate-to-advanced CKD, higher IL-8 levels were associated with a greater risk of MACEs in women (but not in men) and higher mortality in both sexes. Further research is needed to assess the potential of IL-8 as a cardiovascular risk biomarker, clarify the clinical significance of the sex difference observed here and determine whether targeting IL-8 could reduce cardiovascular risk in CKD