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Benamouzig R.,Service Route
Colon and Rectum | Year: 2017

Colon cancer chemoprevention of cancer involves the use of chemical agents to prevent or inhibit the development carcinogenesis. Among the main well-valued agents some such as aspirin and NSAIDs are effective but their actual interest remains debated. This review presents an updated status of the available results and the practical conclusions that can be drawn from them. © 2017 Lavoisier

Reach G.,Service Route | Reach G.,University of Paris 13
Diabetologia | Year: 2010

In chronic diseases such as diabetes, adherence to therapy aims to preserve health, which is a long-term objective, whereas non-adherence tends to present an immediate 'reward'. We propose that non-adherence, like addiction, is at least in part due to the fact that, for physiological, and maybe genetic reasons described in a new field, neuroeconomics, a number of people have a taste for the present rather than the future. Thus, for 'impatient patients' it is natural not to adhere to therapeutic prescriptions that share the characteristic of being future-oriented. This hypothesis may apply to any disease requiring long-term therapy. © 2010 Springer-Verlag.

De Troyer A.,Laboratory of Cardiorespiratory Physiology | De Troyer A.,Service Route
Journal of Applied Physiology | Year: 2012

The diaphragm acting alone causes a cranial displacement of the lower ribs and a caudal displacement of the upper ribs. The respiratory effect of the lower rib displacement, however, is uncertain. In the present study, two sets of experiments were performed in dogs to assess this effect. In the first, all the inspiratory intercostal muscles were severed, so that the diaphragm was the only muscle active during inspiration, and the normal inspiratory cranial displacement of the lower ribs was suppressed at regular intervals. In the second experiment, the animals were given a muscle relaxant to abolish respiratory muscle activity, and external, cranially oriented forces were applied to the lower rib pairs to simulate the action of the diaphragm on these ribs. The data showed that 1) holding the lower ribs stationary during spontaneous, isolated diaphragm contraction had no effect on the change in lung volume during unimpeded inspiration and no effect on the fall in pleural pressure (Ppl) during occluded breaths; 2) the procedure, however, caused an increase in the caudal displacement of the upper ribs; and 3) pulling the lower rib pairs cranially induced a cranial displacement of the upper ribs and a small fall in Ppl. These observations indicate that the force applied on the lower ribs by the diaphragm during spontaneous contraction, acting through the interdependence of the ribs, is transmitted to the upper ribs and has an inspiratory effect on the lung. However, this effect is very small compared to that of the descent of the dome. Copyright © 2012 the American Physiological Society.

Kirkpatrick C.A.,Service Route
Acta Clinica Belgica | Year: 2010

The HELLP syndrome is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10- 20% of cases with severe preeclampsia. The present review highlights occurrence, diagnosis, complications, surveillance, treatment, mode of delivery and risk of recurrence. Clinical reviews published between 2000 and 2009 were screened using PubMed and Cochrane databases. About 70% of cases develop before delivery, the majority in the third trimester of pregnancy; the remainder within 48 hours after delivery. The HELLP syndrome may be complete or incomplete. The syndrome is a progressive condition and serious complications are frequent. Conservative treatment (≥ 48 hours) is controversial. Delivery is indicated if the HELLP syndrome occurs after the 34th week or the foetal and/or maternal conditions deteriorate. Vaginal delivery is preferable. In gestational ages between 24 and 34 weeks, a single course of corticosteroid for foetal lung maturation is recommended. Standard corticosteroid treatment is, however, of uncertain clinical value in the maternal HELLP syndrome. Close surveillance of the mother should be continued for at least 48 hours after delivery. The recognition of HELLP syndrome and an aggressive multidisciplinary approach and prompt transfer of these women to obstetric centres with expertise in this field are required for the improvement of materno-foetal prognosis.

Engelman E.,Service Route | Maeyens C.,Service Route
Journal of Gastrointestinal Surgery | Year: 2010

Background: Eight clinical trials involving the administration of preoperative i. v. methylprednisolone have been undertaken in order to decrease the considerable inflammatory response to esophageal resection, in an effort to decrease the supposedly associated morbidity and mortalityMethod: A meta-analysis was performed for eight clinical end-points. Due to quality problems in seven of the eight included studies, a Bayesian meta-analysis using a skeptical prior derived from the results of the classical analysis was also performed. Results: The end-points including any organ dysfunction (OR = 0.30), respiratory complication (OR = 0.41), sepsis (OR = 0.37), liver dysfunction (OR = 18), cardiovascular dysfunction (OR = 0.28), and surgical anastomotic leak (OR = 0.42) were significantly decreased by methylprednisolone pretreatment. Following the Bayesian analysis, despite the use of skeptical priors, there is a 95% probability to obtain a relative risk reduction of at least 23% to 54%, depending of the end-point, by methylprednisolone pretreatment. Conclusion: We are in the presence of a potential benefit that cannot be accepted at face value due to the quality problems of the included studies. But in the presence of a remaining potential benefit after a Bayesian analysis starting from a skeptical prior, the best option would be the planning of a large multicenter prospective randomized study. © 2010 The Society for Surgery of the Alimentary Tract.

Ortonne J.-P.,Service Route
Expert Opinion on Pharmacotherapy | Year: 2011

Introduction: Chronic urticaria is characterized by recurring episodes of spontaneous transient dermal wheals and pruritus, with or without angioedema, which can persist for ≥ 6 weeks. Chronic urticaria impairs quality of life, emphasizing the need for effective treatments. Professional societies and clinical experts have issued evidence-based recommendations for the management of chronic urticaria, including recommending the use of second-generation antihistamines as a first-line therapy. Areas covered: A Medline search was conducted from 2000 to 2011 using the following terms, alone or in combination: 'chronic urticaria', 'management guidelines', 'consensus guidelines' and 'expert opinions'. Ten management guidelines/expert opinions met the inclusion criteria. Expert opinion: There was a universal agreement among the articles reviewed, that low-sedating, second-generation antihistamines should be prescribed as a first-line treatment of chronic urticaria. For refractory urticaria, however, recommendations varied and included dose escalation of second-generation antihistamines and adjunctive treatments with other agents of the same class, such as sedating antihistamines or leukotriene receptor antagonists. More research into effective second-line treatments and consistent implementation of current guidelines is needed, to ensure that treatment is based on clinical evidence. © 2011 Informa UK, Ltd.

Grimaldi G.,Service Route | Manto M.,Service Route
Cerebellum | Year: 2012

The cerebellum is a key-piece for information processing and is involved in numerous motor and nonmotor activities, thanks to the anatomical characteristics of the circuitry, the enormous computational capabilities and the high connectivity to other brain areas. Despite its uniform cytoarchitecture, cerebellar circuitry is segregated into functional zones. This functional parcellation is driven by the connectivity and the anatomo-functional heterogeneity of the numerous extra-cerebellar structures linked to the cerebellum, principally brain cortices, precerebellar nuclei and spinal cord. Major insights into cerebellar functions have been gained with a detailed analysis of the cerebellar outputs, with the evidence that fundamental aspects of cerebrocerebellar operations are the closed-loop circuit and the predictions of future states. Cerebellar diseases result in disturbances of accuracy of movements and lack of coordination. The cerebellar syndrome includes combinations of oculomotor disturbances, dysarthria and other speech deficits, ataxia of limbs, ataxia of stance and gait, as well as often more subtle cognitive/behavioral impairments. Our understanding of the corresponding anatomo-functional maps for the human cerebellum is continuously improving. We summarize the topography of the clinical deficits observed in cerebellar patients and the growing evidence of a regional subdivision into motor, sensory, sensorimotor, cognitive and affective domains. The recently described topographic dichotomy motor versus nonmotor cerebellum based upon anatomical, functional and neuropsychological studies is also discussed. ©Springer Science+Business Media, LLC 2011.

Cogan E.,Service Route
Revue Medicale de Bruxelles | Year: 2015

Anti-aging medicine is self defined as a preventive medicine, combining nutritional recommendations, dietary supplements, prescriptions for hormones and various aesthetic techniques. The essential aim is to reduce the risk of aging, both psychically, physically and aesthetically. Although many scientific studies in animals or in vitro models have demonstrated the deleterious role of oxidative stress and of hormonal, vitamin or trace elements deficiencies, the transposition to humans of these findings is marginal and does not justify the therapeutic proposals advocated by the anti aging medicine. These practices are mostly not based on any scientific basis both in the diagnostic and therapeutic fields. These approaches are particularly costly for gullible patients in search of well being and abused by a carefully organized marketing involving tacit complicity of doctors, laboratories and firms producing hormones and dietary supplements and various substances devoted for aesthetic purposes.

Pepersack T.,Service Route
Revue Medicale de Bruxelles | Year: 2013

Potentially inappropriate medications are a preventable cause of negative clinical and economic consequences in older people. A range of educational interventions and the implemention of clinical tools to sensitize physicians to inappropriate prescriptions appear to have positively impacted physicians' awareness and prescribing behaviour, which led to significant reductions in inappropriate drugs exposures and likely translated to significant population health benefits among their older patients. Although the level of evidence is not high, the general practitioner has a central position and its sensitization to inappropriate prescription allow to improve health of the olders.

News Article | March 20, 2015

Taking a "poo bus" to work in Bristol, UK, is about to get a lot easier. A commuter bus that runs on biomethane gas produced by food waste and fecal matter will enter regular service on March 25th, The Guardian reports. This means that people in Bristol will be able to ride the waste-powered bus four days a week, on Service Route 2, of all places. the bus runs on biomethane gas released from food waste and fecal matter Bristol's "poo bus" uses fecal matter and food waste generated by 32,000 local households. Microorganisms break down the waste that's gathered at Bristol Sewage Treatment Works, and produce 600 million cubic feet of biomethane a year, reports Gizmag. The bus itself can travel 186 miles on a full tank of gas. The end result is a vehicle that produces less emissions than traditional diesel-powered buses, according to Geneco, the renewable energy company that makes the buses. "Gas-powered vehicles have an important role to play in improving air quality in UK cities, but the Bio-Bus goes further than that and is actually powered by people living in the local area, including quite possibly those on the bus itself," Geneco general manager Mohammed Saddiq told Gizmag. The Bio-Bus started running in Bristol in November, but it has only been used in the center of the city once before. Its previous route was irregular and easy to miss: it traveled between Bath and Bristol airport — a 17-minute trip, according to Google maps. Now, locals and tourists will be able ride it more often, and for longer periods. If the experiment is successful, Bristol may soon find itself gaining additional "poo buses," according to First West England, the company that operates the bio-bus. If successful, Bristol may soon find itself gaining additional "poo buses" "Since its original unveiling last year, the Bio-Bus has generated worldwide attention and so it’s our great privilege to bring it to the city," James Freeman, managing director at First West of England, told The Guardian. "The very fact that it’s running in the city should help to open up a serious debate about how buses are best fuelled, and what is good for the environment."

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