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Est-ce que Cro-Magnon 1 avait une neurofibromatose de type 1 ?
31 mars 2018

Did Cro-Magnon 1 have neurofibromatosis type 1 ?

Le squelette de Cro-Magnon 1 correspond à un homo homo sapiens de 28 000 avant notre ère découvert en 1868 dans un abri sous-terrain des Eyzies en France. Depuis sa découverte, différents diagnostics ont été proposés concernant une lésion ostéolytique polycyclique sur l’os frontal droit, mesurant 37 mm x 27 mm (appendice) : altération post-mortem due au sol, rachitisme, actinomycose, et histiocytose à cellules de Langerhans.

Récemment, [les auteurs ont] fait un CT scan, suivi d’un CT scan sur la lésion. Les résultats ont montré l’aspect osseux exact de la zone pathologique et des limites périphériques (figure A) : une résorption limitée de l’os cortical externe, d’aspect granuleux, sans sclérose périphérique dans la table interne, ce qui exclut une transformation maligne. Cet aspect concorde avec la morphologie radiologique d’un schwannome sous-cutané avec érosion osseuse progressive dans le contexte de la neurofibromatose de type 1, confirmée par la littérature biomédicale, et de la comparaison directe avec des collections de référence paléopathologiques (par exemple, le crâne 101 de la collection Tessier, à Amiens, France).

(...)

Selon ce diagnostic rétrospectif, une nouvelle reconstruction faciale de cet individu peut être proposée, avec l’aspect macroscopique de la maladie (figure B). Une analyse plus poussée du reste du squelette pourrait être intéressante pour rechercher d’autres lésions osseuses présentant des caractéristiques de faible taux de croissance.

En clair pour les non spécialistes... et pour ce que j’ai compris de cette partie de l’article... regardez la photographie ci-dessous.

▻http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30495-1/abstract

http://www.thelancet.com/cms/attachment/2119160419/2089962680/gr1.jpg

#Préhistoire #cro-magnon #28000BP #Philippe_Charlier #Université_de_Versailles_Saint_Quentin_en_Yvelines #Nadia_Benmoussa #Philippe_Froesch #Isabelle_Huynh-Charlier #Antoine_Balzeau #Musée_de_l'_Homme_Paris

Percutaneous coronary intervention in stable angina (ORBITA) : a double-blind, randomised controlled trial - The Lancet
▻http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32714-9/abstract

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Insuffisance coronaire : le #stent pas plus efficace qu’un placebo ?
▻https://www.pourquoidocteur.fr/Articles/Question-d-actu/23350-Angine-poitrine-stent-efficace-qu-un-placebo

https://www.pourquoidocteur.fr/media/article/lamentation-saint-pierre-1509822927.jpg

Les chercheurs ont employé une méthode d’habitude réservée aux études de médicaments : comparer l’intervention réelle à une intervention #placebo en tous points similaire. Autrement dit, une moitié des 230 patientss étaient endormis en salle de cathétérisme et se voyait introduire une sonde… pour rien. L’étude étant en double aveugle, les médecins eux-mêmes ignoraient si leurs patients avaient suivi la procédure réelle ou factice.

« De façon surprenante, même si la pose de stent a amélioré la circulation sanguine, elle n’a pas amélioré les symptômes par rapport aux médicaments », explique le Dr Rasha Al-Lamee, cardiologue à l’Imperial College London et premier auteur de l’étude. Or, du fait de la pathologie précise des patients sélectionnés – une coronaropathie sévère stable –, le contrôle de la douleur est la principale justification de la pose de stent…

[...]

Une nouvelle démonstration de la puissance de l’effet placebo ? Sans doute, encore que plusieurs praticiens appellent à attendre les résultats de plus long terme (le suivi n’ayant été que d’un mois et demi après l’intervention) avant de se prononcer.

Heart Stents Are Useless for Most Stable Patients. They’re Still Widely Used. - The New York Times
▻https://www.nytimes.com/2018/02/12/upshot/heart-stents-are-useless-for-most-stable-patients-theyre-still-widely-used.

Some caveats: All the patients were treated rigorously with medication before getting their procedures, so many had improved significantly before getting (or not getting) a stent. Some patients in the real world won’t stick to the intensive medical therapies, so there may be a benefit from stents for those patients (we don’t know). The follow-up was only at six weeks, so longer-term outcomes aren’t known. These results also apply only to those with stable angina. There may be more of a place for stents in patients who are sicker, who have disease in more than one blood vessel, or who fail to respond to medical therapy.

#santé

The world’s biggest threats are environmental risks - The Lancet Planetary Health
▻http://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(17)30164-X/abstract

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Monitoring universal health coverage within the Sustainable Development Goals: development and baseline data for an index of essential health services - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30472-2/abstract

#datasource #santé_mondiale

Association of air particulate #pollution with bone loss over time and bone fracture risk : analysis of data from two independent studies - The Lancet Planetary Health
▻http://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(17)30136-5/abstract

http://www.thelancet.com/cms/attachment/2115815307/2084830589/gr1.jpg

Research in context

Evidence before this study
Exposure to particulate matter induces oxidative damage and inflammation, which might affect bone health, particularly of older populations. Smoking, which contains several components of particulate matter, has been consistently associated with bone damage. However, whether ambient particulate matter concentrations affect calcium metabolism, bone damage, and risk of fractures is uncertain.

Added value of this study
We demonstrate for the first time higher rates of hospital admissions for bone fractures in communities with higher ambient concentrations of particulate matter less than 2·5 μm in aerodynamic diameter. Participants living at addresses with higher concentrations of traffic-derived particulate matter exhibit lower serum parathyroid hormone concentrations and higher decreases in bone mineral density over an 8-year follow-up.

Implications of all the available evidence
This study provides evidence that long-term exposure to particulate matter—a persistent environmental issue in Europe and globally—is an independent risk factor for bone fractures, possibly involving changes in parathyroid hormone concentrations. These associations might disproportionately affect under-privileged communities. We found the association of particulate matter well below the annual average limits set by the US Environmental Protection Agency and the European Union. Improvements in particulate air pollution concentrations might ameliorate bone health, prevent bone fractures, and reduce the health cost burden associated with fractures in older individuals.

#Ostéoporose : un lien établi entre pollution atmosphérique et risque de fracture – Portail de la communauté guinéenne
▻http://kababachir.com/osteoporose-un-lien-etabli-entre-pollution-atmospherique-et-risque-de-fr

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Au-delà du risque cardiovasculaire et respiratoire ou même de cancer, vivre longtemps dans une zone très polluée pourrait augmenter le risque de fracture liée à l’ostéoporose, surtout chez les seniors, indiquent deux nouvelles études américaines publiées dans la revueThe Lancet Planetary Health.

#particules_fines #pauvreté

Threats to human health by great ocean garbage patches
The Lancet Planetary Health
▻http://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(17)30140-7/fulltext

The medical relevance of environmental topics can be blurred by politicised debates and the global scale of the environmental impact of human life. However, a seemingly remote serious health threat is currently floating in our oceans and needs to trigger the attention of the medical community, as its clinical manifestation is only a matter of time.

[...]

Via the intake of microplastics or their chemical compounds, which are set free in various decomposition processes, ocean garbage has become a latent threat to the health of future generations, and already affects human health on a global scale. Human biomonitoring shows that compounds used for plastic production are already ubiquitous in human blood and cell.

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La pollution, responsable de 9 millions de morts dans le monde par an
▻http://www.lemonde.fr/pollution/article/2017/10/20/la-pollution-responsable-de-9-millions-de-morts-dans-le-monde-par-an_5203511

Les études se suivent et les chiffres sont de plus en plus vertigineux. Dans son rapport 2017 sur la qualité de l’air publié le 11 octobre, l’Agence européenne pour l’environnement estimait que la pollution de l’air était à l’origine de plus de 500 000 décès prématurés (avant 65 ans) en Europe par an. Celle publiée vendredi 20 octobre dans la très respectée revue médicale The Lancet porte ce décompte macabre à 6,5 millions à l’échelle de la planète pour la seule année 2015 et à un total estimé à 9 millions en ajoutant les morts liées à la pollution de l’eau et des sols (1,8 million) et en milieu professionnel (0,8 million).

#pollution #air #décès
►http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32345-0/abstract

Mapping under-5 and neonatal mortality in Africa, 2000–15: a baseline analysis for the Sustainable Development Goals - The Lancet
▻http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31758-0/abstract

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Under-5 mortality rates at the 5 × 5 km resolution in 2000, 2005, 2010, and 2015

Data are at 5 × 5 km resolution. All pixels with an under-5 mortality rate equal to or fewer than 25 deaths per 1000 livebirths (the Sustainable Development Goal 3.2 target for under-5 mortality) are coloured purple. Pixels with fewer than ten people and classified as barren or sparsely vegetated are coloured in grey. Grey areas with diagonal lines are not included in this analysis. km=kilometre.

#infographie #santé

Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015 - The Lancet

▻http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30818-8/fulltext

http://www.thelancet.com/cms/attachment/2094714513/2077254598/gr2a.jpg

The Trauma of Facing Deportation

In Sweden, hundreds of refugee children have fallen unconscious after being informed that their families will be expelled from the country.

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Trump’s “global gag rule”: implications for human rights and global health - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30084-0/fulltext?

This executive order could have great human rights and ethics implications. South Africa is an example of a country that stands to be adversely affected. The country bears the world’s largest burden of HIV and is a major recipient of US federal funding.10 The country’s constitution enshrines the right to reproductive decision-making and the right to health,11 while its laws on termination of pregnancy places a legal obligation on health-care providers to provide or refer abortion-seekers to relevant facilities, when qualifying criteria are met.12 Compliance with Trump’s order will potentially require clinicians in NGOs and international agencies that operate in South Africa and receive US federal funding to violate their professional codes of ethics,13 the country’s abortion laws, and the country’s bill of rights.

#planning_familial #avortement #santé_reproductive #trump #gag_rule

Future life expectancy in 35 industrialised countries: projections with a Bayesian model ensemble
▻http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32381-9/fulltext

Vivre près des axes routiers accroît le risque de démence
▻http://www.lemonde.fr/planete/article/2017/01/05/la-pollution-accroit-le-risque-de-demence_5058034_3244.html

Le fait de vivre à moins de 50 m d’une voie de circulation importante augmenterait de 7 % le risque de développer une démence. Le risque serait accru de 4 % pour un rayon de 50 à 100 m. C’est l’une des principales conclusions d’une étude menée par une équipe nord-américaine dont le premier auteur est le docteur Hong Chen (Public Health Ontario, Canada). Selon cette enquête qui a pris en compte les données d’une population de plus de 6 millions de résidents de l’Ontario sur une période de onze ans, entre 7 % et 11 % des cas de démence pourraient être attribués à un domicile situé à moins de 50 m d’un axe routier majeur. L’étude est publiée jeudi 5 janvier sur le site de la revue The Lancet.

Les chercheurs ont également trouvé une association entre la survenue d’une démence et une exposition à long terme à deux polluants liés au trafic routier bien connus, le dioxyde d’azote (NO2) et les particules fines (dont une bonne partie émane des gaz d’échappement, notamment ceux des moteurs diesel). Cependant, ces deux facteurs ne sauraient expliquer à eux seuls l’élévation du risque, selon le docteur Hong Chen et ses collègues.

Les chercheurs canadiens et américains auteurs de cette étude sont partis des préoccupations croissantes sur les possibilités que « les expositions associées au trafic routier telles que la pollution de l’air et le bruit contribuent aux maladies neurodégénératives ». Des recherches ont montré que les polluants atmosphériques et les gaz d’échappement des moteurs diesel induisent un stress oxydatif et une neuro-inflammation des cellules du cerveau constituant la première défense immunitaire active du système nerveux central.

▻http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32399-6/fulltext
#route #transports #polutions #santé

New #ebola vaccine shows 100% effectiveness in a study of nearly 6000 patients (p-value 0.0033)
▻http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32621-6/fulltext #vaccin

The Lancet Countdown: tracking progress on health and climate change
▻http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32124-9/fulltext

Proposed #indicators and indicator domains for the Lancet Countdown on #health and #climate_change

The proposed indicator domains are heterogeneous: some reflect outcomes (greenhouse gas emissions or health), whereas others reflect process indicators with both direct and indirect links to climate change. Additionally, some can be modelled at a global or national level, whereas others reflect location-specific issues and would depend on data collection at sentinel sites.

1: Health impacts of climate hazards
1.1 Exposure to temperature change
1.2 Exposure to heatwaves
1.3 Changes in labour productivity
1.4 Exposure to flood
1.5 Exposure to drought
1.6 Changes in the incidence and geographical range of climate-sensitive infectious diseases across sentinel sites
1.7 Food security and undernutrition

2: Health resilience and adaptation
2.1 Integration of health into national adaptation plans
2.2 Climate services for health
2.3 Adaptation of finance for health

3: Health co-benefits of climate change mitigation
3.1 Coal phase-out
3.2 Growth in renewable energy
3.3 Access to clean energy
3.4 Energy access for health facilities
3.5 Exposure to ambient air pollution
3.6 Deployment of low-emission vehicles and access to public transport
3.7 Active travel infrastructure and uptake
3.8 Greenhouse gas emissions from the food system and healthy diets
3.9 Greenhouse gas emissions of health-care systems

4: Economics and finance
4.1 Change in annual investment in renewable energy
4.2 Change in annual investment in energy efficiency
4.3 Low-carbon technology patent generation and innovation
4.4 Valuing the health co-benefits of climate change mitigation
4.5 Direct and indirect fossil fuel subsidies
4.6 Coverage and strength of carbon pricing
4.7 Equity of the low-carbon transition

5: Political and broader engagement
5.1 Public engagement with health and climate change
5.2 Academic publications on health and climate change
5.3 Inclusion of health and climate change within medical and public health curricula
5.4 Health and climate change in high-level statements of the UNFCCC and UNGA
5.5 Implementation and estimated health benefits of the nationally determined contributions (NDCs)

#climat #santé_publique

The global burden of women’s cancers: a grand challenge in global health - The Lancet
▻http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31392-7/fulltext

Every year, more than 2 million women worldwide are diagnosed with breast or cervical cancer, yet where a woman lives, her socioeconomic status, and agency largely determines whether she will develop one of these cancers and will ultimately survive. In regions with scarce resources, fragile or fragmented health systems, cancer contributes to the cycle of poverty. Proven and cost-effective interventions are available for both these common cancers, yet for so many women access to these is beyond reach.

▻http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31392-7.pdf

#cancer #femmes #santé #inégalités

Do Activity Trackers Like Fitbit Boost Health? | Health Care | US News
▻http://health.usnews.com/health-care/articles/2016-10-04/do-activity-trackers-boost-health

Fitness trackers may be trendy, but there’s no evidence these devices raise activity levels enough to improve health, even with financial rewards, a new study suggests.

Many U.S. employers have incorporated wearable devices into their employee wellness programs, although rigorous evidence on their long-term health impact is lacking.

Now researchers have reported results of a controlled trial to test activity trackers. They compared full-time employees using the devices under various conditions with a control group.

And the news is “not good,” said study lead author Eric Finkelstein, a professor at Duke-National University of Singapore Medical School.

People want to see evidence that these fitness trackers boost activity, leading to health improvements that reduce chronic disease risk, he explained.

“Our study calls into question all of it: We don’t really find evidence of step increases in the short term, and there’s no evidence that there’s any health effects in the intermediate term,” Finkelstein said.
[…]
At six months, the cash group was more active than the control group. It was also the only group with an increase in daily steps compared with baseline measurements.

What’s more, 88 percent of the cash group continued to use the Fitbit at six months, versus 62 percent of the Fitbit-only and charity groups.

But when incentives were discontinued, only 10 percent of participants from all groups were still using the device.

People abandoned the devices because they didn’t glean new information, Finkelstein explained.

“If you’re inactive, you know you’re inactive. You don’t need to see the screen,” he said.

By the end of the 12-month study period, the incentive group’s activity levels “not only went back to baseline, they actually did a little worse,” Finkelstein said.

Mortality trends and differentials in South Africa from 1997 to 2012: second National Burden of Disease Study - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30113-9/fulltext

#afrique_du_sud #santé #mortalité

#Sci-Hub and medical practice: an ethical dilemma in Peru - The Lancet Global Health
▻http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30188-7/fulltext

#santé #inégalités #recherche #copyright

The UN is finally going to declassify transgender as a mental illness - ScienceAlert
▻http://www.sciencealert.com/the-un-is-finally-going-to-declassify-transgender-as-a-mental-illness

The World Health Organisation (WHO) is moving to declassify transgender identity as a mental disorder, as it updates its category of mental illnesses for the first time in decades.

The body, which is the public health agency of the United Nations (UN), is considering making the change in a revised categorisation of mental and behavioural disorders to be released in 2018.
[…]
In their study, the researchers interviewed 250 transgender people aged 18–65 and found that while many had experienced distress in their lives, most of this stemmed from experiences of social rejection and violence directed at them from others – not confusion or negative feelings over their transgender identity.