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Leger D.,University of Paris Descartes | Bayon V.,University of Paris Descartes | Ohayon M.M.,University of Paris Descartes | Ohayon M.M.,Stanford University | And 6 more authors.
Journal of Sleep Research | Year: 2014

Summary: The link between sleepiness and the risk of motor vehicle accidents is well known, but little is understood regarding the risk of home, work and car accidents of subjects with insomnia. An international cross-sectional survey was conducted across 10 countries in a population of subjects with sleep disturbances. Primary care physicians administered a questionnaire that included assessment of sociodemographic characteristics, sleep disturbance and accidents (motor vehicle, work and home) related to sleep problems to each subject. Insomnia was defined using the International Classification of Sleep Disorders (ICSD-10) criteria. A total of 5293 subjects were included in the study, of whom 20.9% reported having had at least one home accident within the past 12 months, 10.1% at least one work accident, 9% reported having fallen asleep while driving at least once and 4.1% reported having had at least one car accident related to their sleepiness. All types of accident were reported more commonly by subjects living in urban compared to other residential areas. Car accidents were reported more commonly by employed subjects, whereas home injuries were reported more frequently by the unemployed. Car accidents were reported more frequently by males than by females, whereas home accidents were reported more commonly by females. Patients with insomnia have high rates of home accidents, car accidents and work accidents related to sleep disturbances independently of any adverse effects of hypnotic treatments. Reduced total sleep time may be one factor explaining the high risk of accidents in individuals who complain of insomnia. © 2013 European Sleep Research Society. Source


Mathieu J.,Institute Of Recherche Biomedicale Des Armees Irba | Mathieu J.,Institute Pasteur Paris
Toxins | Year: 2015

Autophagy is a physiological process involved in defense mechanisms for clearing intracellular bacteria. The autophagic pathway is finely regulated and bacterial toxins interact with this process in a complex manner. Bacterial toxins also interact significantly with many biochemical processes. Evaluations of the effects of bacterial toxins, such as endotoxins, pore-forming toxins and adenylate cyclases, on autophagy could support the development of new strategies for counteracting bacterial pathogenicity. Treatment strategies could focus on drugs that enhance autophagic processes to improve the clearance of intracellular bacteria. However, further in vivo studies are required to decipher the upregulation of autophagy and potential side effects limiting such approaches. The capacity of autophagy activation strategies to improve the outcome of antibiotic treatment should be investigated in the future. © 2015 by the authors; licensee MDPI, Basel, Switzerland. Source


Blatteau J.-E.,Institute Of Recherche Biomedicale Des Armees Irba | Gempp E.,Expertise Plongee SMHEP | Constantin P.,Expertise Plongee SMHEP | Louge P.,Expertise Plongee SMHEP
Diving and Hyperbaric Medicine | Year: 2011

Background: This study was designed to examine the influence of short delay to recompression and other risk factors associated with the development of severe neurological decompression sickness (DCS) in military divers. Methods: Fifty-nine divers with DCS treated in less than 6 hours from onset of symptoms to hyperbaric recompression were included retrospectively. Diving parameters, Symptom latency and recompression delay were analysed. Clinical symptoms were evaluated for both the acute event and one month later. Results: Median delay to hyperbaric treatment was 35 min (2-350 min). Resolution was incomplete after one month in 25.4% of divers with DCS. Multivariate analysis demonstrated that severe symptoms, classifiedas sensory and motor deficits or the presence of bladder dysfunction, were predictors of poor recovery with adjusted odds ratios (OR) of 4.1 (1.12 to and 9.99 (1.5 to 66.34) respectively. There was a relationship between a longer delay to treatment and incomplete recovery, but the increased risk appeared negligible with an adjusted OR of 1.01 (1-1.02). Conclusion: Our results suggest that neurological severity upon occurrence is the main independent risk factor associated with a poor outcome in military divers with DCS. Clinical recovery was not dramatically improved in this series when recompression treatment was performed promptly. Source


Leger D.,University of Paris Pantheon Sorbonne | Beck F.,University of Paris Pantheon Sorbonne | Richard J.-B.,University of Paris Pantheon Sorbonne | Sauvet F.,University of Paris Pantheon Sorbonne | And 2 more authors.
PLoS ONE | Year: 2014

Background: A significant U-shaped association between sleep duration and several morbidity (obesity, diabetes or cardiovascular disease) and mortality risks has been regularly reported. However, although the physiological pathways and risks associated with "too short sleep" (<5 hours/day) have been well demonstrated, little is known about "too much sleeping".Purpose: To explore socio-demographic characteristics and comorbidities of "long sleepers" (over 10 hours/day) from a nationally representative sample of adults.Methods: A cross-sectional nationally representative sample of 24,671 subjects from 15 to 85-year-old. An estimated total sleep time (TST) on non-leisure days was calculated based on a specifically designed sleep log which allows to distinguish "long sleepers" from "short sleepers" (<5 hours/day). Insomnia was assessed according to the International classification of sleep disorders (ICSD-2).Results: The average TST was 7 hours and 13 minutes (+/-17 minutes). Six hundred and twelve subjects were "long sleepers" (2.7%) and 1969 "short sleepers" (7.5%). Compared to the whole group, "long sleepers" were more often female, younger (15-25 year-old) or older (above 65 year-old), with no academic degree, mostly clerks and blue collar workers. "Long sleepers" were significantly more likely to have psychiatric diseases and a greater body mass index (BMI). However, long sleep was not significantly associated with the presence of any other chronic medical disease assessed. Conversely, short sleep duration was significantly associated with almost all the other chronic diseases assessed.Conclusions: In the general population, sleeping too much was associated with psychiatric diseases and higher BMI, but not with other chronic medical diseases. © 2014 Léger et al. Source


Drouet J.-B.,Institute Of Recherche Biomedicale Des Armees Irba | Fauvelle F.,Institute Of Recherche Biomedicale Des Armees Irba | Maunoir-Regimbal S.,Institute Of Recherche Biomedicale Des Armees Irba | Fidier N.,Institute Of Recherche Biomedicale Des Armees Irba | And 5 more authors.
Neuroscience | Year: 2015

In patients suffering from stress-related pathologies and depression, frontal cortex GABA and glutamate contents are reported to decrease and increase, respectively. This suggests that the GABA and/or glutamate content may participate in pathological phenotype expression. Whether differences in frontal cortex GABA and glutamate contents would be associated with specific behavioral and neurobiological patterns remains unclear, especially in the event of exposure to moderate stress. We hypothesized that an increase in prefrontal cortex GABA/glutamate ratio would be associated with a blunted prefrontal cortex activation, an enhanced hypothalamo-pituitary-adrenocortical (HPA) axis activation and changes in behavior. Rats being restrained for 1-h were then tested in an open-field test in order to assess their behavior while under stress, and were sacrificed immediately afterward. The GABA/glutamate ratio was assessed by 1H high-resolution magic angle spinning magnetic resonance spectroscopy (1H-HRMAS-MRS). The neurobiological response was evaluated through prefrontal cortex mRNA expression and plasma corticosterone levels. The stressed rats were distributed into two subgroups according to their high (H-G/g) or low (L-G/g) GABA/glutamate ratio. Compared to the L-G/g rats, the H-G/g rats exhibited a decrease in c-fos, Arc, Npas4, Nr4a2 mRNA expression suggesting blunted prefrontal cortex activation. They also showed a more pronounced stress with an enhanced rise in corticosterone, alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT), creatine kinase (CK) and lactate dehydrogenase (LDH) levels, as well as behavioral disturbances with decreased locomotion speed. These changes were independent from prefrontal cortex energetic status as mammalian target of rapamycin (mTOR) and adenosine monophosphate-activated protein kinase (AMPK) pathway activities were similar in both subpopulations. The differences in GABA/glutamate ratio in the frontal cortex observed in the stressed animals may participate in shaping individual differences in psychophysiological reactions. © 2014 IBRO. Source

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