Impact du confinement sur le suivi des immunothérapies orales alimentaires : étude multicentrique dans 3 centres d’Île-de-France

But de l’étude

Plusieurs études ont confirmé l’impact du confinement sur la population, entraînant une rupture de soins, des effets somatiques et psychologiques. Notre étude s’intéresse aux effets indésirables et aux problèmes d’observance au cours d’immunothérapie orale (ITO) alimentaires pendant le confinement.

Patients et méthodes

Au total, 132 patients, majoritairement des enfants (95 %), avec un antécédent atopique (60 %) suivis pour une ITO ont été inclus dans 3 centres d’allergologie en Île-de-France, pendant le confinement lié à la pandémie SARS-Cov-2 du 16/03 au 11/05/20. Les aliments des ITO étaient principalement l’arachide (38 %), le lait de vache (24 %), la noisette (14 %), l’œuf (9 %), la noix de cajou et la pistache (8 %).

Résultats

Des effets indésirables ont été retrouvés chez 13 patients soit 10 % des cas. Ces réactions étaient principalement de grade 1 et 2 selon la classification de Ring et Messmer. Trois patients ont présenté des réactions de grade 3 et six patients ont utilisé l’adrénaline au domicile. L’observance était correcte dans 81 % des cas sans aucun oubli. Trois patients ont augmenté leur dose quotidienne sans avis médical. Nous n’avons pas retrouvé de différence significative dans l’analyse en sous-groupe comparant des enfants appariés en âge suivis en ITO en 2019 et en 2020 sur la même période dans le même hôpital.

Conclusion

Il n’y a pas eu d’augmentation des effets indésirables au cours d’ITO pendant la période du confinement. L’éducation thérapeutique au cours de l’ITO est primordiale et participe à réduire la survenue d’effets indésirables.

Assessment of clogging of managed aquifer recharge in a semi-arid region

To overcome water scarcity issues in arid and semi-arid regions, Managed Aquifer Recharge (MAR) remains a viable and suitable solution to manage and restore aquifers. However, clogging represents a major issue that can affect the durability and efficiency of MAR structures. The aim of this study was to evaluate the extent of clogging in MAR sites (Berrechid, Morocco). To achieve this objective, two field-based studies were undertaken: the first one consists of implantation of sand-filled columns in the recharge sites to evaluate the surface and subsurface clogging. The second one consists of the implantation of pickets over a 750 m² area in each recharge site to measure the extent of deposit thickness on the surface of the wadi bed. Results show that, despite the low rainfall (<1.4 mm/day) and the short period (91 days) of the study, the deposits thickness exceeds 3 cm in a large part of the MAR. The suspended solids concentrations measured in recharge sites ranged from 1.1 to 1.4 g/L. Due to the particles retention, the estimation of the saturated hydraulic conductivity (k) of the sand declines over 90% in the immediate entrance of the columns. The k values measured in situ during the drying period ranged from 10^-5 to 10^-6 m/s. The k values of the cake formed, without cracks, was about 10^-8 m/s. The presence of cracks drives the entire infiltration. However, due to the high plasticity index of the MAR soil, a slight reduction of cracks opening during wetting cycles is observed. In addition, particles deposited in these cracks, would contribute actively to the reduction of infiltration. The results of this study clearly showed the MAR sites vulnerability in semi-arid regions due to physical clogging.

Leech therapeutic applications

Hematophagous animals including leeches have been known to possess biologically active compounds in their secretions, especially in their saliva. The blood-sucking annelids, leeches have been used for therapeutic purposes since the beginning of civilization. Ancient Egyptian, Indian, Greek and Arab physicians used leeches for a wide range of diseases starting from the conventional use for bleeding to systemic ailments, such as skin diseases, nervous system abnormalities, urinary and reproductive system problems, inflammation, and dental problems. Recently, extensive researches on leech saliva unveiled the presence of a variety of bioactive peptides and proteins involving antithrombin (hirudin, bufrudin), antiplatelet (calin, saratin), factor Xa inhibitors (lefaxin), antibacterial (theromacin, theromyzin) and others. Consequently, leech has made a comeback as a new remedy for many chronic and life-threatening abnormalities, such as cardiovascular problems, cancer, metastasis, and infectious diseases. In the 20(th) century, leech therapy has established itself in plastic and microsurgery as a protective tool against venous congestion and served to salvage the replanted digits and flaps. Many clinics for plastic surgery all over the world started to use leeches for cosmetic purposes. Despite the efficacious properties of leech therapy, the safety, and complications of leeching are still controversial.

Are there differences in performance, metabolism, and quadriceps muscle activity in black African and Caucasian athletes during brief intermittent and intense exercise?

The purpose of the present study was to determine whether there are any differences in power output (PO) and/or quadriceps muscle (Quad) activity between black African and Caucasian football players during a force-velocity (fv) exercise test, which consisted of performing maximal 6-s sprints against an increasing load. Each subject started the test with a load of 2 kg and then recovered for 5 min before repeating the same test with a load increased by 2 kg. When the pedal frequency did not exceed 130 rev x min(-1), the load was increased by only 1 kg. Each subject attained the load corresponding to his maximal power if an additional increase in load (+1 kg) induced a power decrease. Nine black Africans (mean age 24.2 +/- 3.3 years) and nine Caucasians (24.7 +/- 4.2 years) (matched for stature and aerobic fitness) participated in the fv exercise test. During the test, PO, blood lactate, and the quadriceps electromyography (EMG) root mean square (Quad RMS) were assessed. Higher blood lactate was observed in Caucasians than in black Africans for POs over the load range from 4 kg up to the maximal power. However, PO and Quad RMS values were similar in Caucasians and black Africans. They also had similar lean leg volume (LLV) and consequently produced similar PO/LLV and Quad RMS/LLV values. Overall, our results suggest that Caucasians and black Africans matched for stature, VO(2max), and training background have similar PO and Quad RMS values, but different blood lactate concentrations during brief, intermittent, intense exercise performed on a cycloergometer.

Effects of Prior Exercise on Force-Velocity Test Performance and Quadriceps EMG

This study investigated the effects of prior exercise on performance during a subsequent force-velocity (FV) exercise test. After determination of the individual maximal aerobic power (MAP) during maximal graded exercise testing, fifteen trained male subjects (age: 25 +/- 3 y) were randomly assigned to perform the FV exercise test without prior exercise (NPE) or preceded by prior exercise (PE) (10 min at 60 % of MAP, followed after 1-min rest interval by four intervals of 30-s cycling at 100 % MAP with 15-s rest intervals, then 10 min recovery). Blood samples were drawn at rest, and then for each work load at the 3rd minute of recovery. Skin temperature (T (sk)) from the rectus femoris and heart rate (HR) were measured continuously during prior exercise, the FV test, and during the 5-min recovery period at the end of each FV test. The Root Mean Square (RMS) of the surface electromyogram (EMG) signals obtained from the vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) were calculated during each sprint for each FV test. The lactate increase for each load (deltaLa) during the FV test was significantly less following PE than NPE. However, the lactate concentration (La) was significantly higher in the FV test following PE than NPE. There was an improvement in power output during the first two sprints (2 and 4 kg) following PE compared to NPE. There was also a more pronounced decrease in VL, VM, and RF RMS in PE compared to NPE. Our results showed that the first few sprints may provide sufficient prior exercise for the FV test. The higher lactate concentration following PE than NPE, despite no difference in maximum power, suggests that a large lactate accumulation may not be detrimental to FV test performance. However, a greater lactate concentration and T(sk) may be associated with a decrease in RMS.

Aerobic capacity and peripheral skeletal muscle function in coronary artery disease male patients

The aim of this study was to determine if the diminished aerobic capacity of coronary artery disease male (CAD) patients is accompanied by an impaired skeletal muscle function compared to healthy control subjects. Thirteen CAD patients and 9 healthy subjects performed both a maximal laboratory exercise testing and an assessment of the peripheral skeletal muscle function on an isokinetic apparatus. The cardiorespiratory and mechanical parameters were measured at ventilatory threshold and at maximal effort during a maximal exercise testing. The peripheral skeletal muscle function of the quadriceps was assessed from the maximal voluntary isometric force (MVIF) and from the static endurance time (SET) at an intensity of 50 % of the MVIF. The CAD patients showed a diminished aerobic capacity compared to healthy control subjects at maximal effort (maximal VO(2) uptake: p < 0.0001, maximal ventilation: p < 0.01; maximal heart rate: p < 0.0001, maximal power: p < 0.001) but also at VT (VO(2) uptake VT: p < 0.0001, Power VT: p < 0.001). No difference was found on the MVIF (p < 0.90) between the CAD patients and the control subjects whereas the SET was lower in the CAD patients (p < 0.01). The CAD patients had a lower aerobic capacity and an impaired skeletal muscle endurance compared to healthy subjects.

Effects of aging on cardiorespiratory responses to brief and intense intermittent exercise in endurance-trained athletes

The aim of this study was to investigate the effects of aging on athletes' cardiorespiratory responses to a brief intense intermittent effort, using the force-velocity test as an exercise model. Twelve young athletes (24.8 +/- 1.3 years) and twelve master athletes (65.1 +/- 1.2 years) with similar heights, body masses, and endurance training schedules participated in this study. They performed both a maximal graded exercise and the force-velocity tests. The force-velocity test consisted of the repetition of 6-second sprints against increasing braking forces with 5-minute recovery periods. None of the subjects presented abnormal electrocardiogram responses to the tests. During the force-velocity test, the heart rate magnitudes of response in all subjects were correlated to the corresponding sprint power output (p < .001), with higher values for the young athletes (p < .001). Both groups had similar systolic blood pressure peaks of response during the force-velocity test. Both groups had similar preexercise and end-of-recovery oxygen consumption (VO2), but the young athletes had higher peaks of response (p < .001). The VO2 magnitudes of response increased during the test (p < .01) in all subjects, with higher values for the young athletes (p < .001). There was a positive correlation between the VO2 magnitude of response and (1) the corresponding sprint power output (R = .58,p < .001) and (2) the corresponding number of sprint repetitions (R = .29, p < .02). The young athletes had higher end-of-recovery and peak carbon dioxide production (VCO2) responses than the master athletes (p < .001). Pulmonary ventilation (V(E)) peaks of response to the sprints were higher in the young athletes (p < .001). There was a positive relation between the V(E) and VCO2 peaks of response (R = 84,p < .001). In both groups the peak heart rate, VO2, VCO2, and V(E) values attained during the force-velocity test represented similar percentages of the maximal values reached at exhaustion of maximal graded exercise. These results showed that aging does not alter the percentage of the cardiorespiratory response to a brief intense intermittent exercise such as the force-velocity test. Moreover, the arterial blood pressure response is not significantly altered, whereas the vasodilatatory response is.