Ancrage/institutionnalisation des actions de l'OFSP visant à la réduction des problèmes liés à la toxicomanie : l'appréciation des responsables des programmes

[Table des matières] 1. Introduction. 2. Concepts et modèles d'ancrage. 3. Méthode. 4. Analyse de l'ancrage des programmes. 4.1 Programme Prévention des dépendances dans les communes (RADIX). 4.2 Programme Voilà. 4.3 Programme Fil rouge. 4.4 Programme Funtasy Projects. 4.5 Programme-cadre Ecoles et santé / REES-CH. 4.6 La "Formation des médiateurs scolaires de Suisse romande et du Tessin" et le Projet "Médication" (Ecoles et santé). 4.7 Programme "Drogue ou Sport?", Service "Drogues et sport", Programme "Sport et drogues" / LaOla. 4.8 Les projets soutenus par le Bureau suisse pour la réduction des risques liés aux drogues (OSEO). 4.9 Matériel de prévention de la toxicomanie produit par l'ISPA. 5. Conclusions : Les éléments transversaux d'ancrage des programmes. 6. Annexes.

Caldes de Malavella, entre la Selva i el Gironès

Els moviments diaris de personesi productes entre les diferents localitatssón un fet evident i fàcilmentpalpable dins el nostrecontext social actual. Caldes deMalavella, municipi d'uns 3.000habitants situat al sud-est de la comarcade la Selva, limitant amb la delGirones, és una d'aquestes poblacionsque sobresurt especialmenl perquè generabon nombre de fluxos de moviment,ja sigui de persones o de productes,amb l'entorn territorial més proper.Sens dubte, el fet de tenir a l'abast totun ampli ventall de vies de comunicacióde notable importància, com laNacional II, l'autopista A-17, la línia deferrocarril Barcelona-Franga o el mateixaeroport Girona-Costa Brava, ha estatel principal factor que ha propiciataquests fluxos de moviment

Energetic and metabolic cost of growth in Gambian infants.

The aim of the study was to measure the energy used for growth of healthy fullterm and breast-fed Gambian infants. The weight gain (WG) of 14 infants (mean age +/- SEM 17 +/- 1 d, weight 3.581 +/- 0.105 kg) was measured over a 2-week period; the energy intake (EI) from breast milk was assessed for 24 h in the middle of the study period by weighing the infant before and after each breast-feed. On the same day, sleeping energy expenditure (SEE) and respiratory quotient (RQ) were measured for 30 min on five occasions through the 24-h period. EI averaged 502 +/- 25 kJ/kg.d, and SEE 230 +/- 6 kJ/kg.d; thus, an average of 272 kJ/kg.d were available for physical activity and the energy stored for growth. The total energy spent by infants while sleeping and for periods of physical activity was calculated to be 1.7 x SEE. The mean RQ measured on five occasions averaged 0.879 +/- 0.009. SEE was correlated with WG (r = 0.747, P less than 0.005), with a slope of the regression line of 5.5 kJ/g; this value can be considered as an estimate of the energy spent for new tissue synthesis in the resting infant. The efficiency of weight gain was lower in this study (67%) than in studies conducted on fast-growing preterm infants or children recovering from malnutrition.

Etude du Pañcakrama: introduction et traduction annotée = Etude du Pancakrama: introduction et traduction annotée

RÉSUMÉ Traditionnellement attribué à Nāgārjuna, le Pañcakrama («Procédé de la méditation en cinq étapes») est l'un des ouvrages les plus influents du bouddhisme tantrique indo-tibétain. Bien que ce texte ait été accessible au monde indianiste européen dès le milieu du XIXe siècle, seules quelques portions en ont été traduites à ce jour dans une langue occidentale. La présente thèse a pour but premier d'offrir une traduction française annotée du Pañcakrama dans son intégralité. Elle comporte deux parties principales : 1) l'introduction au texte et 2) la traduction annotée. Une édition critique de la version tibétaine du Caryāmelāpakapradïpa est incluse à titre d'annexe (3). (1) L'introduction comporte trois chapitres. Le chapitre 1, intitulé «Le corpus textuel de l'École Ārya», présente d'abord un aperçu des ouvrages de l'école exégétique (appelée l'«École Ārya» < tib. ̒phags lugs) du Guhyasamājatantra à laquelle appartient le Pañcakrama. Cet aperçu est suivi d'une présentation détaillée des informations bibliographiques et philologiques relatives au Pañcakrama et à ses commentaires indiens. Sont également décrits deux autres textes d'une importance particulière pour la compréhension du Pañcakrama, à savoir le Caryāmelāpakapradïpa et le Pradïpoddyotana. Deux textes mineurs apparentés au Pañcakrama, le Karmāntavibhāga et le Svādhisthānaprabheda, sont aussi présentés brièvement. Le chapitre 2 de l'introduction, « La formation textuelle du Pañcakrama», discute quelques problèmes relatifs à la structure textuelle du Pañcakrama et à sa position historique au sein du corpus de l'École Ārya. Nous y examinons d'abord différentes positions à l'égard des cinq (pañca) unités textuelles qui constituent l'ensemble appelé «Pañcakrama». La chronologie relative traditionnellement acceptée pour les trois textes principaux de l'École Ārya, le Pañcakrama, le Caryāmelāpakapradïpa et le Pradïpoddyotana, est ensuite réexaminée. Nous proposons, en conclusion de ce chapitre, la première moitié du IXe siècle comme date de composition du Pañcakrama. Le chapitre 3, «Une analyse synoptique du Pañcakrama», est une présentation du système yogique que décrivent le Pañcakrama et les ouvrages apparentés. Nous y organisons les sujets en cinq groupes : i) les trois discernements (viveka); ii) la théorie des prakrti et āloka; iii) les deux verités; iv) la notion du yuganaddha; v) les trois sortes de caryā. Cette analyse thématique du contenu du Pañcakrama se propose non seulement de présenter le système yogique de l'École Ārya, mais aussi d'éclaircir l'arrière-plan historique de la formation de cette école exégétique. (2) Notre traduction française du Pañcakrama est basée sur le texte sanscrit que nous avons édité en 1994 en collaboration avec le professeur K. Mimaki (Université de Kyoto). En interprétant le texte, nous avons essayé de distinguer deux sortes de données philologiques supplémentaires, à savoir, d'une part, les données tirée des sources qui précèdent chronologiquement le Pañcakrama et, d'autre part, celles offertes par des ouvrages tardifs tels que les commentaires. Une telle distinction est importante du point de vue méthodologique : afin de mieux comprendre le texte dans le contexte historique de sa composition, nous devons nous garder d'adopter sans discrimination les interprétations des commentateurs qui, éloignés dans le temps, sont parfois influencés par des développements tardifs et par des systèmes philosophico-religieux étrangers au texte de base. (3) Dans l'appendice, nous présentons une édition critique du texte tibétain du Caryāmelāpakapradïpa. Cette édition est basée sur quatre éditions xylographiques (Cone, Derge, Narthang et Pékin) ainsi qu'un manuscrit paracanonique qui transmet une version révisée par 'Gos Khug pa 1Has btsas (première moitié du XIe siècle).

Wechsel von einem mechanischen Mikrokeratom auf einen Femtosekunden-Laser zur Korrektur von Astigmatismus mittels LASIK: klinische Ergebnisse einer retrospektiven, konsekutiven Vergleichsstudie Moving from a Mechanical Microkeratome to a Femtosecond Laser for LASIK to Correct Astigmatic Patients: Clinical Outcomes of a Retrospective, Consecutive, Comparative Study.

Background: To evaluate outcomes after optimized laser in situ keratomileusis (LASIK) for astigmatism correction with flap created by a mechanical microkeratome or a femtosecond laser. Patients and Methods: In this retrospective study, a total of 102 eyes of 71 consecutive patients were enrolled undergoing optimized LASIK treatments using the Allegretto laser system (WaveLight Laser Technologie AG, Erlangen, Germany). A mechanical microkeratome for flap creation was used (One Use, Moria®) in 46 eyes (31 patients, spherical equivalent [SE] -4.44 D ± 2.4) and a femtosecond laser was used (LDV, Ziemer®) in 56 eyes (40 patients, spherical equivalent [SE] -3.07 D ± 3.3). The two groups were matched for inclusion criteria and were operated under similar conditions by the same surgeon. Results: Overall, the preoperative spherical equivalent was -9.5 diopters (D) to +3.37 D; the preoperative manifest astigmatism was between -1.5 D and -3.5 D. At 6 months postoperatively, the mean postoperative uncorrected distance visual acuity (UDVA) was 0.93 ± 0.17 (range 0.4 to 1.2) in the Moria group and 1.0 ± 0.21 (range 0.6 to 1.6) in the Femto group, which was statistically significant (p = 0.003). Comparing the cylinder power there was a statistical difference between the two groups (p = 0.0015). Conclusions: This study shows that the method of flap creation has a significant impact on postoperative astigmatism with a significantly better postoperative UDVA in the Femto group. These findings suggest that the femtosecond laser provides a better platform for LASIK treatment of astigmatism than the commonly used microkeratome.

« Creations du Colleige des Notaires et Secrétaires du Roy et Maison de France, privilleiges, dons et octroys faictz par les roys de France à icelluy Colleige ».

Exemplaire enluminé aux armes : d'azur, à 3 éléphants d'argent, au chef cousu de gueules, avec les devises : Mortalis non est sors mea et Hic et ubique.

Activation of a HIF1alpha-PPARgamma axis underlies the integration of glycolytic and lipid anabolic pathways in pathologic cardiac hypertrophy.

Development of cardiac hypertrophy and progression to heart failure entails profound changes in myocardial metabolism, characterized by a switch from fatty acid utilization to glycolysis and lipid accumulation. We report that hypoxia-inducible factor (HIF)1alpha and PPARgamma, key mediators of glycolysis and lipid anabolism, respectively, are jointly upregulated in hypertrophic cardiomyopathy and cooperate to mediate key changes in cardiac metabolism. In response to pathologic stress, HIF1alpha activates glycolytic genes and PPARgamma, whose product, in turn, activates fatty acid uptake and glycerolipid biosynthesis genes. These changes result in increased glycolytic flux and glucose-to-lipid conversion via the glycerol-3-phosphate pathway, apoptosis, and contractile dysfunction. Ventricular deletion of Hif1alpha in mice prevents hypertrophy-induced PPARgamma activation, the consequent metabolic reprogramming, and contractile dysfunction. We propose a model in which activation of the HIF1alpha-PPARgamma axis by pathologic stress underlies key changes in cell metabolism that are characteristic of and contribute to common forms of heart disease.

Radar analysis of the life cycle of mesoscale convective systems during the 10 June 2000 event

The 10 June 2000 event was the largest flash flood event that occurred in the Northeast of Spain in the late 20th century, both as regards its meteorological features and its considerable social impact. This paper focuses on analysis of the structures that produced the heavy rainfalls, especially from the point of view of meteorological radar. Due to the fact that this case is a good example of a Mediterranean flash flood event, a final objective of this paper is to undertake a description of the evolution of the rainfall structure that would be sufficiently clear to be understood at an interdisciplinary forum. Then, it could be useful not only to improve conceptual meteorological models, but also for application in downscaling models. The main precipitation structure was a Mesoscale Convective System (MCS) that crossed the region and that developed as a consequence of the merging of two previous squall lines. The paper analyses the main meteorological features that led to the development and triggering of the heavy rainfalls, with special emphasis on the features of this MCS, its life cycle and its dynamic features. To this end, 2-D and 3-D algorithms were applied to the imagery recorded over the complete life cycle of the structures, which lasted approximately 18 h. Mesoscale and synoptic information were also considered. Results show that it was an NS-MCS, quasi-stationary during its stage of maturity as a consequence of the formation of a convective train, the different displacement directions of the 2-D structures and the 3-D structures, including the propagation of new cells, and the slow movement of the convergence line associated with the Mediterranean mesoscale low.

Heel and toe clearance estimation for gait analysis using wireless inertial sensors.

Tripping is considered a major cause of fall in older people. Therefore, foot clearance (i.e., height of the foot above ground during swing phase) could be a key factor to better understand the complex relationship between gait and falls. This paper presents a new method to estimate clearance using a foot-worn and wireless inertial sensor system. The method relies on the computation of foot orientation and trajectory from sensors signal data fusion, combined with the temporal detection of toe-off and heel-strike events. Based on a kinematic model that automatically estimates sensor position relative to the foot, heel and toe trajectories are estimated. 2-D and 3-D models are presented with different solving approaches, and validated against an optical motion capture system on 12 healthy adults performing short walking trials at self-selected, slow, and fast speed. Parameters corresponding to local minimum and maximum of heel and toe clearance were extracted and showed accuracy ± precision of 4.1 ± 2.3 cm for maximal heel clearance and 1.3 ± 0.9 cm for minimal toe clearance compared to the reference. The system is lightweight, wireless, easy to wear and to use, and provide a new and useful tool for routine clinical assessment of gait outside a dedicated laboratory.

Distribuição do amônio, nitrato, potássio e fósforo em colunas de latossolos fertirrigadas

Na fertirrigação, é conveniente aplicar os nutrientes de forma a conseguir sua localização na profundidade mais adequada para absorção por parte das culturas: em maior profundidadepara a cultura perene e, mais superficialmente, nas culturas de ciclo curto. Com os objetivos de estabelecer em que fração da lâmina de irrigação devem ser aplicada as doses de N (NH4+ e NO3-); K+ e H2PO4-, de investigar qual o melhor fracionamento de suas doses, de modo a localizá-los na profundidade adequada, e de determinar a distribuição na coluna de NH4+, NO3-, K+ e H2PO4- aplicados por fertirrigação, foi realizado um experimento em laboratório, utilizando colunas de percolação. Os tratamentos corresponderam a um fatorial 4 (1 + 7), sendo quatro Latossolos de Minas Gerais [dois Latossolos Vermelho-Amarelos distróficos (LVAd1 e LVAd2), um Latossolo Vermelho distroférrico (LVdf) e um Latossolo Vermelho distrófico (LVd)], uma testemunha (aplicação de água deionizada) e sete formas de aplicação de 1 mmol dm-3 de NH4+, 1 mmol dm-3 de NO3-, 2 mmol dm-3 de K+ e 0,667 mmol dm-3 de H2PO4-. A lâmina de água foi dividida em cinco frações iguais (F1 a F5) e a dose dos nutrientes aplicada integralmente (D), ou fracionada em duas (D1/2) ou em três vezes (D1/3). Assim, a aplicação dos nutrientes foi feita segundo o esquema: F2D, F3D, F4D, F2D1/2F3D1/2 , F3D1/2F4D 1/2, F2D1/2F4D1/2 ou F2D1/3F3D1/3 F4D1/3. Subamostras foram utilizadas na análise de NH4+; NO3-; K+ e H2PO4-, determinando-se a distribuição desses nutrientes na coluna de solo. A mobilidade apresentou a seguinte ordem nos solos LVAd1, LVAd2 e LVd: NO3- > NH4+ > K+ > H2PO4-. Já para o solo LVdf, a ordem foi NH4+ > NO3- > K+ > H2PO4-. A ordem de risco de contaminação de águas subterrâneas por NO3- foi a seguinte: LVAd1 > LVAd2 > LVdf > LVd. A quantidade de água acrescentada a cada coluna, inferior a meio volume de poros, não foi suficiente para deslocar o H2PO4- além do primeiro anel. Para os outros íons em estudo, a localização em maior profundidade, quando aplicados como pulso único, foi verificada com a maior concentração no pulso (D > D1/2 > D 1/3) e com a maior lâmina de água posterior à sua aplicação (F2D > F3D > F 4D e F2D1/2F3D1/2 > F3D1/2F4D1/2 ). Os resultados evidenciam que a mobilidade diferencial de N (NH4+ e NO3-) e K+ exigiria escolha cuidadosa das doses desses nutrientes na solução, a fim de evitar perdas de N (NH4+ e NO3-) por lixiviação, ou localização excessivamente superficial do K+. A baixa mobilidade do H2PO4- mostra que a fertirrigação não seria uma técnica apropriada para sua incorporação no perfil do solo, visando à fertilização das culturas.

La fortuna di Luciano nel Rinascimento : il volgarizzamento del manoscritto Vaticano Chigiano L.VI.215 : edizione critica dei volgarizzamenti delle "Storie vere"

Résumé II lavoro verte sui volgarizzamenti quattro-cinquecenteschi di Luciano di Samosata, importante capitolo nella fortuna dell'autore greco, che diede l'avvio a quel vasto fenomeno chiamato "lucianesimo", esteso in Europa fino al XIX sec. In particolare fornisco l'edizione critica e commentata delle Storie vere volgarizzate, contenute nella prima, assai ampia (41 opuscoli), e per molto tempo unica, silloge lucianea in volgare, che ho datato a poco prima del 1480. Essa ci è giunta tramite un unico manoscritto, il Vaticano Chigiano L.VI.215, confezionato a Ferrara per Ercole I d'Este, nonché in almeno otto edizioni veneziane apparse fra il 1525 e il 1551. La princeps, da cui dipendono in vario modo tutte le edizioni successive, è pubblicata da Niccolò Zoppino. I1 ms. e le prime due edizioni (1525; 1527 Bindoni e Pasini) tacciono il nome del traduttore, che compare solo nell'edizione del 1529 (Zoppino): Niccolò Leoniceno (1428-1524), medico umanista e valente grecista, attivo a Ferrara dal 1464 al 1524, studioso e traduttore di Ippocrate e Galeno, editore di Aristotele e volgarizzatore di storici per Ercole d'Este. L'edizione ha richiesto uno studio preliminare sulle numerose traduzioni in latino e in volgare di Luciano, per valutare meglio le modalità della sua fortuna umanistica. Confrontando ms. e stampe, per le Storie vere si hanno due volgarizzamenti totalmente diversi, fin dal titolo: La vera historia nel ms., Le vere narrazioni nelle cinquecentine. Ma per l'ultimo quarto di testo, ms. e stampe in sostanza coincidono. La collazione ha coinvolto anche il testo greco (con gli apparati delle edizioni critiche) e la versione latina dell'umanista umbro Lilio Tifernate (1417/18-1486) risalente al 1439-43 ca., intitolata De veris narrationibus, di cui si hanno almeno tre redazioni d'autore; una quarta è invece dovuta probabilmente a Benedetto Bordon, che la inserì nella sua silloge latina di Luciano del 1494. Ho cosa stabilito che il volgarizzamento del ms. Chigiano, La vera historia, è stato eseguito direttamente dal greco, fatto eccezionale nel panorama delle traduzioni umanistiche, mentre quello a stampa, Le vere narrazioni, deriva dalla redazione Bordon del De veris narrationibus. La diversità dei titoli dipende dalle varianti dei codici greci utilizzati dai traduttori: il Vat. gr. 1323, o una sua copia, è utilizzato sia dal volgarizzatore del Chigiano, sia da Bordon, indipendentemente l'uno dall'altro; il Marc. gr. 434, o una sua copia, dal Tifernate. Il titolo latino mantenuto da Bordon risale al Tifernate. Per quanto riguarda l'attribuzione dei due volgarizzamenti, come già per altri due testi della silloge da me studiati (Lucio 01 Asino e Timone), anche per La vera historia del Chigiano è accettabile il nome di Niccolò Leoniceno, poiché: 1) essa è tradotta direttamente dal greco, correttamente e con buona resa in volgare, 2) Paolo Giovio -che conobbe di persona il Leoniceno -, negli Elogia veris clarorum virorum imaginibus apposita ricorda che i volgarizzamenti di Luciano e di Dione eseguiti dal Leoniceno piacquero molto ad Ercole d'Este, 3) nessuno nella prima metà del sec. XVI rivendica, per sé o per un suo maestro, il volgarizzamento di Luciano. Le vere narrazioni a stampa, tradotte dal latino del Bordon, dopo il 1494 e prima del 1525, per la parte che diverge dalla Vera historia rimangono invece anonime. Dato che si tratta di due volgarizzamenti distinti, ho allestito l'edizione a fronte dei due testi fin dove essi divergono, seguendo per l'uno il ms., per l'altro la princeps; per la parte finale, in cui confluiscono, mi baso invece sul manoscritto e relego in apparato le varianti più vistose della princeps (non è emerso un chiaro rapporto di dipendenza fra i due testimoni). Oltre all'apparato critico con le lezioni rifiutate, fornisco un commento con la giustificazione delle scelte e il confronto con i corrispondenti passi greci e latini.

Moving from a Mechanical Microkeratome to a Femtosecond Laser for LASIK to Correct Astigmatic Patients: Clinical Outcomes of a Retrospective, Consecutive, Comparative Study.

Background: To evaluate outcomes after optimized laser in situ keratomileusis (LASIK) for astigmatism correction with flap created by a mechanical microkeratome or a femtosecond laser. Patients and Methods: In this retrospective study, a total of 102 eyes of 71 consecutive patients were enrolled undergoing optimized LASIK treatments using the Allegretto laser system (WaveLight Laser Technologie AG, Erlangen, Germany). A mechanical microkeratome for flap creation was used (One Use, Moria®) in 46 eyes (31 patients, spherical equivalent [SE] -4.44 D ± 2.4) and a femtosecond laser was used (LDV, Ziemer®) in 56 eyes (40 patients, spherical equivalent [SE] -3.07 D ± 3.3). The two groups were matched for inclusion criteria and were operated under similar conditions by the same surgeon. Results: Overall, the preoperative spherical equivalent was -9.5 diopters (D) to +3.37 D; the preoperative manifest astigmatism was between -1.5 D and -3.5 D. At 6 months postoperatively, the mean postoperative uncorrected distance visual acuity (UDVA) was 0.93 ± 0.17 (range 0.4 to 1.2) in the Moria group and 1.0 ± 0.21 (range 0.6 to 1.6) in the Femto group, which was statistically significant (p = 0.003). Comparing the cylinder power there was a statistical difference between the two groups (p = 0.0015). Conclusions: This study shows that the method of flap creation has a significant impact on postoperative astigmatism with a significantly better postoperative UDVA in the Femto group. These findings suggest that the femtosecond laser provides a better platform for LASIK treatment of astigmatism than the commonly used microkeratome.

Differences in glucose transporter gene expression between rat pancreatic alpha- and beta-cells are correlated to differences in glucose transport but not in glucose utilization.

Glucose exerts inverse effects upon the secretory function of islet alpha- and beta-cells, suppressing glucagon release and increasing insulin release. This diverse action may result from differences in glucose transport and metabolism between the two cell types. The present study compares glucose transport in rat alpha- and beta-cells. beta-Cells transcribed GLUT2 and, to a lesser extent, GLUT 1; alpha-cells contained GLUT1 but no GLUT2 mRNA. No other GLUT-like sequences were found among cDNAs from alpha- or beta-cells. Both cell types expressed 43-kDa GLUT1 protein which was enhanced by culture. The 62-kDa beta-cell GLUT2 protein was converted to a 58-kDa protein after trypsin treatment of the cells without detectable consequences upon glucose transport kinetics. In beta-cells, the rates of glucose transport were 10-fold higher than in alpha-cells. In both cell types, glucose uptake exceeded the rates of glucose utilization by a factor of 10 or more. Glycolytic flux, measured as D-[5(3)H]glucose utilization, was comparable in alpha- and beta-cells between 1 and 10 mmol/liter substrate. In conclusion, differences in glucose transporter gene expression between alpha- and beta-cells can be correlated with differences in glucose transport kinetics but not with different glucose utilization rates.

Development of an aggregation assay to screen FimH antagonists.

Alpha-D-mannopyranosides are potent FimH antagonists, which inhibit the adhesion of Escherichia coli to highly mannosylated uroplakin Ia on the urothelium and therefore offer an efficient therapeutic opportunity for the treatment and prevention of urinary tract infection. For the evaluation of the therapeutic potential of FimH antagonists, their effect on the disaggregation of E. coli from Candida albicans and guinea pig erythrocytes (GPE) was studied. The mannose-specific binding of E. coli to yeast cells and erythrocytes is mediated by type 1 pili and can be monitored by aggregometry. Maximal aggregation of C. albicans or GPE to E. coli is reached after 600 s. Then the FimH antagonist was added and disaggregation determined by light transmission over a period of 1400 s. A FimH-deleted mutant of E. coli, which does not induce any aggregation, was used in a control experiment. The activities of FimH antagonists are expressed as IC(50)s, the half maximal inhibitory concentration of the disaggregation potential. n-Heptyl alpha-D-mannopyranoside (1) was used as a reference compound and exhibits an IC(50) of 77.14 microM , whereas methyl alpha-D-mannopyranoside (2) does not lead to any disaggregation at concentrations up to 800 microM. o-Chloro-p-[N-(2-ethoxy-3,4-dioxocyclobut-1-enyl)amino]phenyl alpha-D-mannopyranoside (3) shows a 90-fold and 2-chloro-4-nitrophenyl alpha-D-mannopyranoside (4) a 6-fold increased affinity compared to 1. Finally, 4-nitrophenyl alpha-D-mannopyranoside (5) exhibits an activity similar to 1. As negative control, D-galactose (6) was used. The standardized aggregation assay generates concentration-dependent, reproducible data allowing the evaluation of FimH antagonists according to their potency to inhibit E. coli adherence and can therefore be employed to select candidates for experimental and clinical studies for treatment and prevention of urinary tract infections.

How High Dose(s) of Oral Vitamin D3 Can Correct Insufficiency in a Non Supplemented Rheumatologic Population ?

Introduction: 700 to 1000 UI Vitamin D/day prevent 20% of fall and fracture. Higher dosage could prevent other health problems, such as immune diseases. Adherence to oral daily vitamin D supplementation is low. There is no guideline on how to supplement patients with rheumatic diseases. We evaluated if 1-2 dose(s) of 300'000 UI oral vitamin D3 was enough to reach an optimal level of 25-OH vitamin D in late winter in patients with insufficiency. Methods: During November 2009 (M0) patients attending our Rheumatology Outpatient Clinic had a blood test to measure 25-OH vitamin D. Results were classified as: deficiency <10µg/l, insufficiency 10µg/l to 30µg/l and normal >30µg/l. Patients on daily oral vitamin D3 or who received a single high dose of vitamin D3 in the last 6 months and patients with deficiency or normal results were excluded. Patients included received a single dose of 300'000 IU of oral vitamin D3 and were asked to come back for a blood test for 25-OH vitamin D after 3 (M3) and 6 months (M6). If they were still insufficient at M3, they received a second high dose of 300'000 IU of oral vitamin D3. Results: 292 patients had their level of 25-OH vitamin D determined at M0. 141 patients (70% women) had vitamin D insufficiency (18.5µg/l (10.2-29.1)) and received a prescription for a single dose of 300'000 IU of oral vitamin D3. Men and women were not statistically different in term of age and 25-OH vitamin D level at M0. 124/141 (88%) patients had a blood test at M3. 2/124 (2%) had deficiency (8.1µg/l (7.5-8.7)), 50/124 (40%) normal results (36.7µg/l (30.5-56.5)). 58% (72/124) were insufficient (23.6µg/l (13.8-29.8)) and received a second prescription for 300'000 IU of oral vitamin D3. Of the 50/124 patients who had normal results at M3 and did not receive a second prescription, 36 (72%) had a test at M6. 47% (17/36) had normal results (34.8µg/l (30.3-42.8)), 53% (19/36) were insufficient (25.6µg/l (15.2-29.9)). Out of the 54/72 (75%) patients who received a second prescription, 28/54 (52%) had insufficiency (23.2µg/l (12.8-28.7)) and 26/54 (48%) had normal results (33.8µg/l (30.0-43.7)) at M 6. Discussion: This real life study has shown that one or two oral bolus of 300'000 IU of vitamin D3 in autumn and winter was not enough to completely correct hypovitaminosis D but was a good way of preventing a nadir of 25-OH vitamin D usually observed in spring in a Swiss rheumatologic population.