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Clermont-Ferrand, France

Macaire J.-J.,University of Tours | Fourmont A.,University of Tours | Argant J.,University of Lyon | Breheret J.-G.,University of Tours | And 2 more authors.
Holocene | Year: 2010

Minimum rates of solid (SSY) and dissolved (DSY) sediment yield (SY) were evaluated in t/km2 per yr from sediments stored in the Sarliève palaeolake (French Massif Central) for seven phases of the Lateglacial and Holocene up to the seventeenth century. The catchment (29 km2), mainly formed of limestones and marls, is located in an area rich in archaeological sites in the Massif Central. The respective impacts of human activities and climate on SY were compared by quantification of human settlements through archaeological survey and palynological data. During the Lateglacial and early Holocene up to about 7500 yr cal. BP, variations in SSY and DSY rates were mainly related to climate change with higher rates during colder periods (Younger Dryas and Preboreal) and lower rates during warmer periods (Bölling-Alleröd and Boreal). However, CF1 tephra fallout induced a sharp increase in SY during the Alleröd. During the middle and late Holocene after 7500 yr cal. BP, SSY and DSY greatly increased (by factors of 6.5 and 2.8, respectively), particularly during the Final Neolithic at about 5300 yr cal. BP when the climate became cooler and more humid. After this date, at least 75% of the SSY increase and more than 90% of the DSY increase resulted from human activities, but SSY rates showed little variation during Protohistoric and Historic Times up to the seventeenth century. SSY and DSY rates and DSY/SSY ratio indicate that catchment soils began to form during the Lateglacial and Preboreal, thickened considerably during the Boreal and Atlantic, finally thinning (rejuvenation) mainly as the result of human-induced erosion during the sub-Boreal and sub-Atlantic. Increased mechanical erosion during the late Holocene also induced an increase in chemical erosion. © The Author(s) 2010.

Costedoat-Chalumeau N.,University of Paris Descartes | Pouchot J.,University of Paris Descartes | Guettrot-Imbert G.,University Of Clermont Ferrand | Leroux G.,University of Paris 13 | And 2 more authors.
Best Practice and Research: Clinical Rheumatology | Year: 2013

Adherence is defined as "the extent to which a person's behaviour coincides with medical or health advice." Poor adherence to therapeutic regimens is a common and expensive problem in patients with chronic diseases including systemic lupus erythematosus (SLE) and is associated with a higher risk of flares, morbidity, hospitalisations and poor renal outcome. Non-adherence to the treatment is multifactorial for most patients and varies according to unintentional or intentional patterns. The rates of non-adherence in SLE patients range from 3% to 76% depending on the assessment methods, which are all subject to limitations. Indeed, poor adherence to therapeutic regimens is difficult to evaluate. Two studies have shown that undetectable blood hydroxychloroquine (HCQ) concentration may be a simple, objective and reliable marker of non-adherence in SLE patients. The accurate diagnosis of non-adherence may prevent one from incorrectly interpreting disease manifestations as a lack of response. It may then avoid an unnecessary or even dangerous treatment escalation. © 2013 Elsevier Ltd. All rights reserved.

Pugazhendhi S.,Wellcome Trust Research Laboratory | Santhanam S.,Wellcome Trust Research Laboratory | Venkataraman J.,Government Stanley Medical College | Creveaux I.,University Of Clermont Ferrand | Ramakrishna B.S.,Wellcome Trust Research Laboratory
Gene | Year: 2013

Background: Three mutations (two missense and one frameshift) in the NOD2 gene are associated with Crohn's disease (CD) in a proportion of patients with Crohn's disease in North America, Europe and Australia. These three mutations are not found in Indian patients with CD. We undertook new studies to identify polymorphisms in the NOD2 gene in the Indian population and to detect whether any of these were associated with inflammatory bowel disease (IBD) in this population. Methods: Individual exons of the NOD2 gene were amplified by PCR and subjected to denaturing high performance liquid chromatography (DHPLC) to detect heteroduplex formation. All 12 exons of the NOD2 gene were amplified and Sanger-sequenced to detect polymorphisms in the NOD2 gene. 310 patients with CD, 318 patients with ulcerative colitis (UC) and 442 healthy controls (HC) were recruited for association studies. DNA from these participants was evaluated for the identified eight polymorphisms by Sequenom analysis. Results: Heteroduplex formation was noted by DHPLC in exons 2 and 4 of the NOD2 gene. Sequencing of the entire NOD2 gene data revealed eight polymorphisms - rs2067085, rs2066842, rs2066843, rs1861759, rs2111235, rs5743266, rs2076753, and rs5743291 - of which the latter four were described for the first time in Indians. None of these polymorphisms was associated with CD. The SNPs rs2066842 and rs2066843 were in significant linkage disequilibrium. Both SNPs showed a significant association with UC (P = 0.03 and 0.04 respectively; odds ratio 1.44 and 1.41 respectively). Conclusion: Four NOD2 polymorphisms were identified for the first time in the Indian population. Of 8 NOD2 polymorphisms, none were associated with CD but two were weakly associated with UC. NOD2 polymorphisms do not play a major role in CD genesis in India. © 2012 Elsevier B.V.

Gremeaux V.,Pole Reeducation Readaptation | Benaim C.,Pole Reeducation Readaptation | Poiraudeau S.,Service de Reeducation et Readaptation | Herisson C.,Montpellier University Hospital Center | And 2 more authors.
Joint Bone Spine | Year: 2013

Objectives: To evaluate the medium-term impact of education workshops on low back pain (LBP) in the setting of a thermal spa on: fear-avoidance beliefs, disability, pain, and satisfaction. Methods: Randomized prospective alternate-month design-type study including 360 individuals having thermal spa therapy for LBP: 188 in the intervention group (three standardized education workshops lasting 1. h. 30 each and usual thermal therapy for 3. weeks), 172 in the control group (usual thermal therapy and non-standardized verbal information). The principal analysis criterion was the difference in the fear-avoidance beliefs (physical FABQ) score between baseline and 6. months after the therapy; secondary criteria were: evolution of disability (Quebec Scale) and pain intensity (Visual Analogue Scale), and satisfaction with the information received. Results: There was a significant reduction in the physical FABQ score at 6. months (. P<. 0.05), and this reduction was more marked in the intervention group (-5.8. ±. 0.7 vs. -2. ±. 0.72. points out of 24; P<. 0.0001). Disability and pain significantly decreased in both groups (. P<. 0.05), with no difference between groups. These workshops also had a significant effect on satisfaction with the information received. Conclusion: Standardized education workshops have a beneficial impact on LBP and contribute to an improvement in the medical services provided during spa therapy by reducing the effect of fear-avoidance beliefs as well as relieving pain. Extending the use of such workshops could contribute to enhance the positive impact of spa therapy in the management of chronic disabling diseases. © 2012 Société française de rhumatologie.

Leger J.-M.,University Hospital Pitie Salpetriere | Viala K.,University Hospital Pitie Salpetriere | Nicolas G.,University of Angers | Creange A.,University Hospital Henri Mondor | And 7 more authors.
Neurology | Year: 2013

Objective: To determine whether rituximab 375 mg/m2 was efficacious in patients with immunoglobulin M (IgM) anti-myelin-associated glycoprotein antibody demyelinating neuropathy (IgM anti-MAG demyelinating neuropathy). Methods: Fifty-four patients with IgM anti-MAG demyelinating neuropathy were enrolled in this randomized, double-blind, placebo-controlled trial. The inclusion criteria were inflammatory neuropathy cause and treatment (INCAT) sensory score (ISS) $4 and visual analog pain scale >4 or ataxia score $2. The primary outcome was mean change in ISS at 12 months. Results: Twenty-six patients were randomized to a group receiving 4 weekly infusions of 375 mg/m2 rituximab, and 28 patients to placebo. Intention-to-treat analysis, with imputation of missing ISS values by the last observation carried forward method, showed a lack of mean change in ISS at 12 months, 1.0 ± 2.7 in the rituximab group, and 1.0 ± 2.8 in the placebo group. However, changes were observed, in per protocol analysis at 12 months, for the number of patients with an improvement of at least 2 points in the INCAT disability scale (p = 0.027), the self-evaluation scale (p 5 0.016), and 2 subscores of the Short Form-36 questionnaire. Conclusions: Although primary outcome measures provide no evidence to support the use of rituximab in IgM anti-MAG demyelinating neuropathy, there were improvements in several secondary outcomes in per protocol analysis. Level of evidence: This study provides Class I evidence that rituximab is ineffective in improving ISS in patients with IgM anti-MAG demyelinating neuropathy. © 2013 American Academy of Neurology.

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