Selon le Centre international de recherche sur le cancer (CIRC) on peut estimer que dans l’Union Européenne, 13 000 cas de cancer du sein (CDS) pourraient être évités annuellement par un maintien à ...la normale du poids corporel. Cette revue a pour objectif d’analyser la relation entre l’Activité physique (AP) et le CDS, cette dernière étant une maladie associée au surpoids et à l’obésité.
L’AP est impliquée dans la relation liant le surpoids et l’obésité au CDS, notamment en ce qui concerne la perte de masse grasse et ses modifications physiologiques : l’AP est susceptible de réguler les dysfonctions au niveau des hormones sexuelles, des hormones régulatrices du métabolisme, au niveau inflammatoire, des adipokines, ainsi que du stress oxydatif. La littérature montre que des AP aérobies, telles que la marche, avec des volumes élevés (e.g. 200–300min/semaine) et des intensités modérées, ont une efficacité bien établie.
According to the International Agency for Research on Cancer (IARC), in the European Union, 13,000 cases of breast cancer (BC) could be annually prevented by maintaining a normal body weight. The purpose of this review is to analyze the relationships between Physical Activity (PA) and BC, the latter being a disease associated with overweight and obesity.
PA is involved in the relationship linking overweight and obesity to the BC, because it can induce a fat mass loss, resulting into a host of beneficial physiological alterations. PA may modify circulating levels of sex hormones, fuel-regulating hormones, markers of systemic inflammation, adipokines and oxidative stress. Data suggest that the most significant effects are found with aerobic AP, as walking, with high volume (ie, 200–300min/week) and moderate intensities.
L’activité physique (AP) est un élément très important de la prise en charge du cancer du sein (CDS) en complément de l’approche carcinologique. Elle diminue la mortalité, toutes causes confondues, ...de ces patientes. L’AP modérée s’est avérée tout particulièrement intéressante dans ce contexte, ce qui peut suggérer que le ciblage au LIPOXmax peut trouver une indication dans ce contexte. Nous avons donc voulu déterminer le profil d’oxydation des lipides et des glucides à l’exercice chez ces patientes. Quinze patientes (âge 56,8±1,8 ; IMC 32,7±1,3kg/m2) réalisent une calorimétrie d’effort et sont comparées à 182 femmes témoins appariées pour l’âge et l’anthropométrie. Les patientes ont une aptitude aérobie plus basse de −12 % (p=0,01) leur LIPOXmax survient à une puissance plus basse (p=0,01), de même que leur point de croisement (p=0,01) et le niveau où les glucides deviennent le substrat exclusif (p=0,009). Le coût glucidique du watt, qui quantifie la relation linéaire entre l’oxydation des glucides et la puissance, est également plus élevé chez les patientes (0,32±0,03 vs. 0,26±0,02mg/min/kg/watt ; p=0,02). Ces données montrent que les patientes, pour des raisons probablement liées à la fois au terrain prédisposant (adiposité et sédentarité) et au parcours thérapeutique (inflammation de bas grade, fonte musculaire, déconditionnement à l’exercice) ont un profil de calorimétrie d’effort caractérisé par une utilisation majoritaire des glucides et une faible utilisation des lipides, plus encore que des patientes appariées pour l’âge et la corpulence. Il reste à déterminer si un réentraînement ciblé au LIPOXmax, facile à mettre en place chez ces patientes souvent asthéniques, rééquilibre ce profil et améliore la composition corporelle et l’inflammation de bas grade comme montré dans d’autres populations.
Physical activity (PA) is a very important component of breast cancer management in complement of the purely carcinologic approach, since it decreases mortality from all causes in these patients. Endurance PA targeted at low to moderate intensity has proved its efficacy and usefulness in this context. Since the efficacy of low intensity PA is explained by its lipid-oxidizing effect, we thus aimed at determining the balance of lipids and carbohydrate oxidation during exercise in these patients. Fifteen patients (age 56.8+1.8; BMI 32.7+1.3kg/m2) realize an exercise calorimetry test and are compared to 182 women matched by age and anthropometry. The patients have a lower aerobic capacity (−12%; P=0.01), their level of maximal lipid oxidation (LIPOXmax) occurs at a lower power intensity (P=0.01) as well as their crossover point (P=0.01) and the level where carbohydrates become the exclusive substrate (P=0.009). The carbohydrate cost of the watt, which quantifies the linear relation between carbohydrates oxidation and power, is also higher in patients (0.32±0.03 vs. 0.26±0.02mg/min/kg/watt; P=0.02). These data show that patients, for reasons probably related to their clinical background (sedentary lifestyle, obesity) as well as therapeutic procedure (low-grade inflammation, muscular weakness, deconditioning), exhibit a calorimetric profile at exercise characterized by a higher use of carbohydrates and a lower use of lipids, even more than matched women who have the same adiposity and the same age and are also to some extent ‘glucodependent’. This provides a rationale for targeting more closely on lipid oxidation (LIPOXmax) low endurance training, which has already been found on the average to improve life expectancy and quality of life in these patients.
Humulus lupulus
L. (Cannabaceae), commonly named hop, is widely grown around the world for its use in the brewing industry. Its female inflorescences (hops) are particularly prized by brewers because ...they produce some secondary metabolites that confer bitterness, aromas and antiseptic properties to the beer. These sought-after metabolites include terpenes and sesquiterpenes, found in essential oil, but also prenylated phenolic compounds, mainly acylphloroglucinols (bitter acids) from the series of
α
-acids (humulone derivatives). These metabolites have shown numerous biological activities, including among others, antimicrobial, sedative and estrogenic properties. This review provides an inventory of hop’s chemistry, with an emphasis on the secondary metabolites and their biological activities. These compounds of biological interest are essentially produced in female inflorescences, while other parts of the plant only synthetize low quantities of them. Lastly, our article provides an overview of the research in plant biotechnology that could bring alternatives for hops metabolites production.
Summary
Background
In horses, the only established method for reinnervation of the larynx is the nerve‐muscle pedicle implantation, whereas in human medicine, direct nerve implantation is a standard ...surgical technique for selective laryngeal reinnervation in human patients suffering from bilateral vocal fold paralysis.
Objectives
(1) To describe a modified first or second cervical nerve transplantation technique for the treatment of recurrent laryngeal neuropathy (RLN) in horses and (2) evaluate the outcomes of reinnervation using direct nerve needle‐stimulation of the first cervical nerve and exercising endoscopy before and after surgery.
Study design
Case series.
Methods
Nerve transplantation surgery, in which the first or second cervical nerve is tunnelled through the atrophied left cricoarytenoideus dorsalis muscle, was performed in combination with ipsilateral laser ventriculocordectomy. Ultrasound‐guided stimulation of the first cervical nerve at the level of the alar foramen was used to confirm successful reinnervation post‐operatively. Exercising endoscopy was performed before and after surgery. The exercising RLN grade of the left arytenoid was blindly determined at the highest stride frequency for each examination.
Results
Surgery was performed in 17 client‐owned animals with RLN. Reinnervation was confirmed by nerve stimulation and subsequent arytenoid abduction observed in 11 out of 12 cases between 4 and 12 months post‐operatively. Fourteen horses had exercising endoscopy before and after surgery. Nine horses had an improved exercising RLN grade, four horses had the same exercising grade and one horse had a worse exercising grade after surgery.
Main limitations
A sham‐operated control group was not included and follow‐up beyond 12 months and objective performance data were not obtained.
Conclusions
The modified first or second cervical nerve transplantation technique, using tunnelling and direct implantation of the donor nerve into the cricoarytenoideus dorsalis muscle, resulted in reinnervation in 11 out of 12 cases and improved exercising grade in 9 out of 14 horses within 12 months after surgery.
Adeno-associated viral (AAV) vectors promote long-term gene transfer into muscle in many animal species. Increased expression levels may be obtained by using alternative serotypes in combination with ...repeated administrations. Here we compared AAV vectors based on serotypes 1, 2 and 5 in immunocompetent mice and assessed the feasibility of multiple administrations of either identical (readministration) or different (cross-administration) serotype-based vectors. A 1-year-long dose-response study confirmed the superiority of recombinant (r)AAV1, achieving transduction levels 5 to 10-fold higher than rAAV2 and rAAV5 in mouse skeletal muscle, respectively. Repeated administration demonstrated that increased gene transfer level was achieved with a second injection of rAAV1 following the first administration of rAAV2 or rAAV5. A readministration study with a vector encoding a different gene allowed the evaluation of gene expression from the second vector only. All three rAAVs were inhibited when the animals were previously exposed to the same serotype. In contrast, no significant change in gene expression from the second vector was observed in cross-administration. A humoral immune response was elicited against the viral capsid for all three serotypes following the initial exposure. Neutralizing antibody (NAB) levels correlated with the vector dose injected. No significant cross-reactivity of NAB from a given serotype toward another was observed in vitro. These data provide the first direct comparative evaluation of re- and cross-administration of rAAV1, rAAV2 and rAAV5 in muscle, and further indicate that rAAV1 is capable of transducing muscle tissue when cross-administered.
Résumé
Objectif
Évaluer et améliorer le délai de réalisation de la TDM cérébrale initiale des patients traités par anticoagulants et victimes d’un traumatisme crânien.
Matériels et méthode
Nous avons ...réalisé une évaluation des pratiques professionnelles. Elle s’est déroulée en trois phases : une période d’audit clinique, puis une phase de formation, avant la réévaluation. Les patients de plus de 18 ans traités par anticoagulants et victimes d’un traumatisme crânien étaient inclus. Nous avons mesuré le délai entre la prise en charge par l’infirmière organisatrice de l’accueil et la réalisation de la TDM cérébrale sans injection. La phase de formation a consisté en une présentation des recommandations de la SFMU. Un algorithme de prise en charge a également été édité.
Résultats
À la phase « avant », 40 patients étaient inclus entre le 5 mars et le 25 avril 2013. Quarante et un patients ont été inclus entre le 16 juillet et le 22 août 2013 lors de la phase « après ». La proportion de patients ayant bénéficié d’une TDM en moins d’une heure est passée de 40 % (
n
= 16) à 71 % (
n
= 29)
p
= 0,007. La médiane de délai était améliorée, passant de 89 minutes (IQR : 35–125) à 43 minutes (IQR : 26–66)
p
= 0,01. Nous avons amélioré la proportion de patients sans saignement intracrânien à la TDM initiale, ayant bénéficié d’une TDM de contrôle à 24 heures du traumatisme. Elle passait de 21 (7/34) à 65 % (24/37) (
p
< 0,001).
Conclusion
À l’issue d’une période de formation, nous avons amélioré la prise en charge des patients traités par anticoagulants victimes d’un traumatisme crânien.
In spite of improvements in implant designs and surgical precision, functional outcomes of mechanically aligned total knee arthroplasty (MA TKA) have plateaued. This suggests probable technical ...intrinsic limitations that few alternate more anatomical recently promoted surgical techniques are trying to solve. This review aims at (1) classifying the different options to frontally align TKA implants, (2) at comparing their safety and efficacy with the one from MA TKAs, therefore answering the following questions: does alternative techniques to position TKA improve functional outcomes of TKA (question 1)? Is there any pathoanatomy not suitable for kinematic implantation of a TKA (question 2)? A systematic review of the existing literature utilizing PubMed and Google Scholar search engines was performed in February 2017. Only studies published in peer-reviewed journals over the last ten years in either English or French were reviewed. We identified 569 reports, of which 13 met our eligibility criteria. Four alternative techniques to position a TKA are challenging the traditional MA technique: anatomic (AA), adjusted mechanical (aMA), kinematic (KA), and restricted kinematic (rKA) alignment techniques. Regarding osteoarthritic patients with slight to mid constitutional knee frontal deformity, the KA technique enables a faster recovery and generally generates higher functional TKA outcomes than the MA technique. Kinematic alignment for TKA is a new attractive technique for TKA at early to mid-term, but need longer follow-up in order to assess its true value. It is probable that some forms of pathoanatomy might affect longer-term clinical outcomes of KA TKA and make the rKA technique or additional surgical corrections (realignment osteotomy, retinacular ligament reconstruction etc.) relevant for this sub-group of patients. Longer follow-up is needed to define the best indication of each alternative surgical technique for TKA. Level I for question 1 (systematic review of Level I studies), level 4 for question 2.
Background: Malignant melanoma of dogs is a highly aggressive neoplasm and is the 2nd most common digit tumor. Metastatic disease is a common sequela for which few effective treatment options exist. ...Studies show that xenogeneic tyrosinase DNA vaccination yields immune responses and prolongation of survival in dogs with oral malignant melanoma.
Objectives/Hypothesis: Describe clinical findings and tumor characteristics of a cohort of dogs with digit malignant melanoma, and evaluate the prognostic utility of a proposed staging system. Determine if a novel xenogeneic DNA vaccine is safe and potentially effective for treatment of dogs with digit melanoma.
Animals: Fifty‐eight dogs with digit malignant melanoma treated at the Animal Medical Center between 2004 and 2007.
Methods: Retrospective, medical records review of dogs with digit melanoma treated with xenogeneic DNA vaccine.
Results: Overall median survival time (MST) for dogs treated with loco‐regional control and xenogeneic DNA vaccine was 476 days with a 1‐year survival rate of 63%. MST for dogs presenting with metastasis was 105 days versus 533 days for dogs presenting without metastasis (P < .0001). Forty‐eight percent of the dogs in the latter group were alive at 2 and 3 years. A proposed staging system proved prognostic with stages I–IV dogs surviving >952, >1,093, 321, and 76 days, respectively.
Conclusions and Clinical Importance: The xenogeneic murine tyrosinase DNA vaccine was safe and appears effective when used in conjunction with local and regional disease control. The proposed staging system was prognostic in this study and future studies might benefit from utilizing this staging system.
Abstract Sagittal pelvic kinematics along with spino-pelvic angular parameters have recently been studied by numerous investigators for their effect on total hip replacement (THR) clinical outcomes, ...but many issue of spine-hip relations (SHR) are currently unexplored. Therefore, our review aims at clarifying the following questions: is there any evidence of a relationship between articular impingement/dislocation risk in primary THR and (1) certain sagittal pelvic kinematics patterns, (2) pelvic incidence, and (3) types of SHRs? A systematic review of the existing literature utilising PubMed and Google search engines was performed in January 2017. Only clinical or computational studies published in peer-reviewed journals over the last five years in either English or French were reviewed. We identified 769 reports, of which 12 met our eligibility criteria. A review of literature shows that sagittal pelvic kinematics, but not the pelvic incidence, influences the risk of prosthetic impingement/dislocation. We found no study having assessed the relationship between this risk and the types of SHRs. Sagittal pelvic kinematics is highly variable among individuals and certain kinematic patterns substantially influences the risk of prosthetic impingement/dislocation. Recommendations for cup positioning are therefore switching from a systematic to a patient-specific approach, with the standing cup orientation Lewinneck safe zone progressively giving way to a new parameter of interest: the functional orientation of the cup. Based on a recently published classification for SHRs, We propose a new concept of “kinematically aligned THR” for the purposes of THR planning. Further studies are needed to investigate the relevance of such a classification towards the assumptions and hypothesis we have made. Level of evidence ,- Level IV, systematic review of level III and IV studies.
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