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Bla producing Pseudomonas aeruginosa ST235 is involved in resistance to different β-lactams
No full textInternational audienceMultidrug resistance in Pseudomonas aeruginosa, particularly resistance to carbapenem, represents a major challenge for public health. This study investigated resistance mechanisms in three P. aeruginosa isolates: HU63 (blaGES-6 carbapenemase-positive), HU141 (carbapenem-resistant without carbapenemase), and PAO1 (control). Genomic analysis revealed distinct sequence types (ST235 for HU63, ST253 for HU141) and chromosomal integration of resistance genes. HU63 harbored diverse resistance mechanisms, including beta-lactamases (blaGES-6, blaPDC-35, blaOXA-488) and efflux pumps. Minimum inhibitory concentration assays demonstrated HU63's resistance to all beta-lactams tested (meropenem, imipenem-cilastatin, ceftazidime, piperacillin-tazobactam), while HU141 remained susceptible except to cefoxitin and cloxacillin. Time-kill assays revealed tolerance phenotypes, with HU63 showing regrowth after 8-24 h despite initial reductions in bacterial density. Gene expression varied significantlydepending on the antibiotic and the isolate. The HU63 isolate (GES-6 positive) stands out for its marked induction of blaGES-6 in all the antibiotics tested, contributing to its resistance to carbapenems and broad-spectrum cephalosporins. These expression profiles corroborate the classic molecular mechanisms of resistance: regulation of entry pores (oprD), activation of efflux pumps (mexA) and production of beta-lactamases (blaGES-6, ampC) adapted to each situation. These findings underscore the multifactorial nature of resistance in Carbapenem-resistant Pseudomonas aeruginosa (CRPA), combining enzymatic inactivation, efflux, and genetic adaptability. The study emphasizes the urgent need for genomic surveillance to track high-risk clones and develop therapies targeting tolerance mechanisms alongside traditional resistanc
Examining the roles of body composition, energy expenditure and substrate metabolism in the control of daily energy intake in adolescents with obesity
No full textInternational audienceBACKGROUND: The implication of body composition and energy metabolism in the control of human energy intake (EI) has been well described in adults, remaining however unexplored in adolescents with obesity. The aim of this study was to question the role of body composition, energy expenditure (EE) and substrate metabolism in the control of EI of adolescents with obesity. METHODS: Ad libitum 24-h EI, body composition (Dual X-ray absorptiometry), Resting Metabolic Rate (RMR, indirect calorimeter) where measured and Total EE obtained during a 36-h stay in metabolic chambers in 26 adolescents (14.1 ± 1.5 years; 14 girls) with severe obesity. RESULTS: The mean body weight and Body Mass index were 92.2 ± 17.2 kg and 33.98 ± 4.14 kg.m-2 respectively. 24-h EI was positively correlated with body weight (rho = 0.597, p = 0.014), Fat Free Mass (FFM) kg (rho = 0.576, p = 0.019), 24-h Total EE (TEE (rho =0.675, p < 0.001)), RMR (rho =0.632, p = 0.005), 24-h Carbohydrate (CHO) oxidation rates (rho = 0.716, p < 0.001), and urinary nitrogen excretion (rho =0.28, p < 0.001). According to the path analysis FFM (kg) but not Fat Mass (FM) (kg) was positively correlated with RMR, with direct effects of 0.87 (p < 0.001) and 0.027 (p = 0.74) respectively. The effect of FFM on 24-h EI was mediated by RMR (96% of the effect), while the effect of FM on 24-h EI was also mediated by RMR (67% of the effect). CONCLUSIONS: The present study provides the first evidence regarding the role of RMR as a main tonic signal of appetite control mediating the effect of body composition and mainly FFM (over FM) on daily EI in adolescents with obesity. It also suggests for the first-time relationships between 24-h CHO and protein oxidation and daily EI in this population</div
Long-term kidney complications in childhood leukemia survivors: a study from the Childhood and Adolescent Leukaemia (LEA) project
No full textInternational audienceAcute leukaemias represent the 1st cause of cancer in children. Their prognosis has improved significantly due to remarkable advances in therapeutic management, despite the risk of long-term consequences, especially for patients who underwent allogenic hematopoietic stem cell transplantation (aHSCT). Through the Leukaemia in Children and Adolescents (LEA) long-term follow-up cohort, we conducted a French national multicentre prospective study on the occurrence and risk factors of chronic kidney disease (CKD), differentiating glomerular and tubular dysfunctions, corresponding to the NephroLEA project. Among the 1676 patients included, the median [interquartile range] age at evaluation was 15.8 [11.3-20.5] years, with a median follow-up of 9.2 [5.8-13.9] years. aHSCT was performed on 343 (20.6%) patients, half of whom have undergone the procedure after achieving 2nd or greater remission. A higher percentage of children among transplanted patients had diastolic and systolic blood pressure above 95th, with 13.7% vs 5.2% (P =3x10-3) and 15% vs 6.5% (P = 9x10-2), respectively. A total of 187 patients (11.1%) had a mild CKD (i.e., eGFR between 75 and 90 mL/min/1.73 m2), while 3% (n=50) exhibited mild to severe CKD (eGFR < 75 mL/min/1.73 m2). Notably, no patient reached kidney failure. Twenty-one patients (1.3%) had decreased GFR associated with tubular impairment. The principal risk factors for developing CKD were aHSCT and leukaemia relapse. In conclusion, CKD represents a long-term risk for patients who relapsed and/or underwent aHSCT. These patients could benefit from nephroprotection advice to further improve their long-term outcomes, which is becoming a public health issue
Avis de l'Anses relatif à l’établissement de repères alimentaires destinés aux personnes suivant un régime d’exclusion de tout ou partie des aliments d’origine animale
No full textCitation suggérée : Anses (2025). Avis de l’Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail relatif à l’établissement de repères alimentaires destinés aux personnes suivant un régime d’exclusion de tout ou partie des aliments d’origine animale. Saisine 2019-SA-0118. Maisons-Alfort : Anses, 46 p.L’Anses s’est autosaisie le 28 juin 2019 pour la réalisation de l’expertise suivante : « établissement de repères alimentaires destinés aux personnes suivant un régime d’exclusion de tout ou partie des aliments d’origine animale ».CONTEXTE ET OBJET DE LA SAISINELes repères du Programme National Nutrition Santé (PNNS) pour la population générale adulte ont été actualisés par l’Anses en 2016 sur la base des références nutritionnelles et des données de consommation de la population générale, de composition et de contamination des aliments consommés par cette population. Pour réaliser cette actualisation, l’Anses a utilisé une « méthode d’optimisation linéaire sous contrainte » permettant d’établir des repères spécifiques qui intègrent les données de composition et de consommation des aliments et répondent à un ensemble de contraintes et d’objectifs nutritionnels, épidémiologiques et toxicologiques (Anses 2016a).Par construction, ce travail réalisé en population générale ne couvrait pas certaines ,populations spécifiques, qui ont des particularités physiologiques ou des pratiques alimentaires atypiques. C’est notamment le cas des personnes suivant un régime d’exclusion de tout ou partie des aliments d’origine animale. Pour ces populations dites « végétariennes », une déclinaison des repères établis pour la population générale nécessite ainsi d’être réalisée, sur la base des références nutritionnelles et des différents modes de consommation propres à ces populations.L’objectif général est d’établir des repères de consommation permettant de couvrir les besoins nutritionnels de ces populations, tout en considérant l'association de certains groupes alimentaires avec le risque de maladies chroniques non transmissibles (les maladies cardioneurovasculaires, le diabète de type 2, l’obésité, certains cancers et les maladies liées à la santé osseuse ont été retenus) et l’exposition aux contaminants. Pour atteindre cet objectif, l’approche méthodologique de l’optimisation des régimes alimentaires développée pour la population générale adulte a été adaptée aux caractéristiques des populations végétariennes
Balancing Cohort Size and Variability in Iterative Deep Brain Template Creation
No full textSession: Theme 03: Medical Image Computing - 3. Image Segmentation techniques, Neuroimaging (Poster Session).International audienceThis study investigates the effect of cohort size on the creation of cohort-specific deep brain anatomical templates for movement disorder. Pre-operative MRI data from 70 patients implanted with deep brain stimulation (DBS) systems were used to generate anatomical templates with varying cohort sizes (5 to 67 subjects). An iterative non-linear normalization pipeline was employed to optimize template generation. Template variability was assessed using Dice overlap of anatomical structures. The templates created with 44 subjects achieved optimal balance between variability and accuracy. Tukey’s HSD test confirmed significant differences across iterations and cohort sizes. This study underscores the importance of cohort size and iterative registration methods in creating high-quality anatomical templates
Bulevirtide in Chronic Hepatitis D Patients Awaiting Liver Transplantation Results From a French Multicentric Retrospective Study.
No full textInternational audienceBackground and aims: The impact of bulevirtide in patients awaiting liver transplantation (LT) for decompensated liver disease and/or hepatocellular carcinoma (HCC) is unclear. We assessed clinical, virological, and biochemical responses to bulevirtide in patients with chronic hepatitis delta virus (HDV) awaiting LT and compared outcomes with a cohort of similar untreated patients.Methods: Consecutive HDV-infected patients waiting for LT since bulevirtide approval were included. Patients receiving 2 mg of bulevirtide daily had clinical, biological, and virological data collected at baseline, Week 24, Week 48, at LT, and post-LT. Patients not receiving bulevirtide had data collected at baseline, LT, and post-LT for comparison.Results: Forty-one patients from nine LT centers were included. In the bulevirtide group (20 patients; mean age 52.8 ± 9.98 years; 75% male), 65%, 10% and 25% were Child-Pugh A, B and C, respectively. Fifteen completed 48 weeks of therapy. At 48 weeks, median HDV RNA decreased by 2.56 log IU/mL (p = 0.004). Virological and biochemical responses were obtained in 73.3% and 66.6% of patients. Twelve patients (60%) underwent LT. No serious adverse events occurred. Bulevirtide improved liver function, enabling one (7.1%) HCC patient to undergo chemoembolization while on the WL and leading to delisting of three (15%) other patients. In untreated patients (mean age 42.9 ± 7.9 years; 76.2% Child-Pugh C), none were delisted. Three-month transplant-free survival was 76.9% in the bulevirtide group versus 36.7% (p = 0.007) in the control group.Conclusions: Bulevirtide demonstrates safety and efficacy in HDV-infected patients listed on the LT waiting list and may potentially improve pre-transplant outcomes
Improvement of iron status with elexacaftor tezacaftor ivacaftor therapy is associated with the correction of systemic inflammation and improvement of lung function: a one-year prospective study
No full textInternational audienceIron deficiency (ID) is frequent in adult patients with cystic fibrosis (pwCF). The effect of elexacaftor-tezacaftor-ivacaftor (ETI) on iron metabolism has rarely been reported. We aimed to study the trends and variables associated with iron store modulation under ETI. We conducted a prospective adult cohort in two referral centres for pwCF. Iron supplementation during the follow-up was an exclusion criterion. Clinical, biological data and pulmonary function tests were collected prospectively at ETI initiation (V0) and after 1 year of ETI (V12). The presence of Pseudomonas aeruginosa in forced sputum was assessed at V0 and V12. 220 (87 women) pwCF among the 278 screened were included. At V0, ID prevalence was 58% and was significantly associated with female sex and lower forced expiratory volume (FEV1). At V12, ID prevalence decreased significantly from 58 to 31% (p = 0.001). A significant decrease of C reactive protein and total globulins was found at V12. 60% of patients with ID at V0 achieved normalization of iron status at V12 with a significant association with the increase of FEV1 (moderate size effect: 0.68). A lower decrease of C reactive protein was significantly associated with the onset of ID in a small sample of patients (p < 0.001). The disappearance of Pseudomonas aeruginosa in sputum at V12 was not correlated to the evolution of iron status under ETI. ETI was associated with a decrease of ID prevalence, and improvement of pulmonary function and a correction of systemic inflammation
Epidémiologie et phylogénomique de l'entérovirus A71 en Europe, 2016-2022
No full textInternational audienceContexte général : Les entérovirus (EV) font partie de la famille des Picornaviridae et du genre Enterovirus, comprenant quinze espèces, dont quatre (EV-A à EV-D) regroupent 116 types, dont 102 sont liés à des infections humaines. Ces infections touchent principalement les enfants, souvent de manière asymptomatique. Les complications graves, comme la méningite aseptique et des troubles neurologiques sévères, restent rares mais peuvent être fatales, surtout chez les nourrissons, jeunes enfants et chez les sujets immunodéprimés. Les entérovirus présentent un taux de mutation élevé (entre 10-3 et 10-4), qui, couplé à la recombinaison génétique, influe sur leur évolution. La recombinaison génétique joue un rôle crucial dans l'émergence de souches épidémiques, comme l'illustrent les poliovirus et plus récemment l'entérovirus A71 (EV-A71). Ce dernier a provoqué des épidémies en Europe, avec des cas neurologiques signalés en 2016 et 2019, en particulier en Espagne et en France.Objectifs de l'étude multicentrique européenne : Cette étude vise à suivre l'évolution de l'EV-A71 en Europe, en examinant sa propagation entre les pays européens entre 2016 et 2022. Elle cherche également à analyser les manifestations cliniques associées aux différents lignages de souches du virus.Matériels & méthodes : Une étude collaborative a été lancée dans le cadre du réseau ENPEN (European Non-Polio Enterovirus Network), avec la participation de 18 équipes issues de 14 pays européens. A partir d’échantillons collectés auprès des différents sites, les génomes viraux ont été amplifiés puis séquencé par Illumina et Nanopore. L’évolution des souches virales ont été analyses par des approches phylogénétiques bayésiennes et la propagation par modélisation phylogéographique.Résultats : les résultats montrent une grande diversité génétique au sein des souches d'EV-A71 en Europe, avec des réorganisations dues à des événements de recombinaison génétique, et une augmentation significative de la population virale en lien avec les épidémies. La phylogéographie indique que la France aurait joué un rôle clé dans l’émergence et la diffusion des lignées C1-like, en particulier au sein de l'Europe.Conclusions principales : L'étude met en évidence l'importance de surveiller l'évolution génétique et la propagation de l'EV-A71 à travers l'Europe, ainsi que les implications cliniques des différentes souches virales. Les résultats peuvent contribuer à mieux comprendre les dynamiques des épidémies et à améliorer les stratégies de prévention et de traitement des infections graves dues aux entérovirus
Refeeding syndrome in head and neck cancers: a risk in the prehabilitation of patients?
No full textInternational audienceRefeeding syndrome (RS) is characterized by electrolyte and fluid shifts caused by the rapid reintroduction of nutrition after a period of undernutrition. This study aimed to determine the prevalence of RS in patients with head and neck cancer (HNC) affected by a malnutrition risk. The study involved 69 patients with HNC at the outset of management with one of the following risk factors of RS: BMI ≤ 18.5 kg/m2, weight loss > 5%, significant decrease in oral intake on a visual analog scale (≤ 5), or inability to swallow. RS was defined by serum ionic depletion (phosphorus, potassium, magnesium) within 5 days of refeeding. The study sample comprised 51 males and 18 females with a mean age of 62.80 ± 9.19 SD. Oropharyngeal squamous cell carcinoma (SCC) was the most prevalent histologic type in these patients (42%), predominantly associated with a negative P16 status and a high prevalence of a current or past history of smoking (94.2%) and/or alcoholism (69.6%). RS prevalence was 98% in the patients who had risk factors of malnutrition. No patient had organ failure. No clinical criteria were able to predict the severity of RS. RS is extremely common in malnourished patients with HNC. With adequate supplementation and close laboratory monitoring of refeeding, RS rarely causes clinical complications. The very high prevalence of RS in this study is due to the inclusion of patients with risk factors for malnutrition, this indicates that these factors are highly predictive of RS in patients with HNC
New challenges and perspectives on the organic halo effect on calories estimation: A brief review and Meta-analysis
No full textInternational audienceOrganic certification identifies food produced with more sustainable product methods. However, several studies have pointed out that it is also likely to generate a halo effect on the caloric estimation of food. As a result, unhealthy foods are perceived as containing fewer calories and may lead to increased consumption intentions. The aim of this paper is to quantify the magnitude of this organic halo effect and identify its possible moderators. We address the issue with a systematic review and a meta-analysis of the available literature specifically focused on the organic halo effect on food calorie estimation (i.e., 10 articles, 21 studies). The results highlighted a strong “organic halo effect” on calorie estimation (r = 0.40). Despite these findings, no stable moderator of the organic halo effect has been consistently identified across the literature. This meta-analysis provides a foundation for future research on the organic halo effect, offering a framework to guide upcoming studies on the phenomenon. The discussion outlines research avenues and advocates for a systematic investigation of specific moderators as well as an investigation of the conditions that promote the organic halo effect to facilitate and structured the exploration of the phenomenon