Intérêt de l'éthylglucuronide comme marqueur d'abus d'alcool, aspects analytiques, diagnostiques et médico-légaux

RESUMEUne consommation excessive et chronique d'alcool est associée à une augmentation significative de la morbidité et de la mortalité. L'identification de marqueurs biologiques fiables, permettant de mettre en évidence une consommation excessive et chronique, présente donc un intérêt certain pour prévenir les conséquences néfastes de l'abus d'alcool. L'approche couramment employée consiste à mesurer les marqueurs biologiques indirects dans le sang, tels que les marqueurs hépatiques dont l'augmentation peut résulter d'une consommation chronique et excessive d'alcool. Cependant, leur valeur diagnostique est souvent limitée par leur manque de sensibilité et/ou de spécificité et leur combinaison est généralement recommandée pour améliorer le diagnostic. A ce jour, il n'existe pas de marqueur biologique permettant le diagnostic fiable d'une consommation chronique et excessive d'alcool.L'objectif principal de cette thèse était d'évaluer la pertinence de l'éthylglucuronide (EtG), un métabolite direct de l'éthanol présentant la particularité d'être incorporé dans les cheveux, comme marqueur d'une consommation chronique et excessive d'alcool. Dans un premier temps, une revue de la littérature a permis de dresser un état des lieux de l'usage de l'EtG et d'identifier les axes de réflexion. L'EtG s'est révélé être un marqueur efficace pour identifier une consommation chronique et excessive d'alcool. Cependant, l'absence de seuil de positivité fiable et une méconnaissance des facteurs influençant l'incorporation de l'EtG dans les cheveux ont été mises en évidence. Afin d'investiguer ces différents points, deux études ont été conduites : (1) une étude chez le rat pour tenter de comprendre les facteurs influençant l'incorporation de l'EtG dans les cheveux et étudier la relation entre la quantité d'alcool administrée et la concentration d'EtG mesurée dans les cheveux; et (2) une étude clinique afin de déterminer les performances diagnostiques de l'EtG comme marqueur d'une consommation excessive et chronique d'alcool. Une méthode analytique sensible et sélective par chromatographic gazeuse couplée à la spectrométrie de masse en tandem a été développée et appliquée à l'analyse de l'EtG dans les cheveux.Le sang semblait jouer un rôle majeur dans l'incorporation de l'EtG dans les poils. Son incorporation n'était pas influencée par la pigmentation. La concentration d'EtG mesurée dans les poils de rats reflétait la dose d'éthanol administrée. De plus, la mesure de l'EtG dans les cheveux humains a démontré de très bonnes performances diagnostiques pour détecter une consommation excessive et chronique d'alcool. Les performances diagnostiques de l'EtG surpassaient celles des marqueurs hépatiques usuels seuls ou combinés. L'EtG n'était pas influencé par l'âge, le sexe ou l'indice de masse corporelle. Un seuil de positivité de 25 pg/mg permettait de détecter les consommateurs à usage nocif avec une grande fiabilité. Un seuil de positivité de 9 pg/mg permettait de détecter les consommateurs à risque.SUMMARYChronic and excessive alcohol consumption is associated with a significant increase of morbidity and mortality. The identification of a reliable biomarker to detect chronic and excessive alcohol consumers would be valuable to prevent alcohol's harmful effects. The combined analysis of 2 or more hepatic biomarkers, which are known to be increased following sustained alcohol consumption, is usually applied to enhance the diagnostic performance in identifying chronic and excessive alcohol consumers. However, their diagnostic value is often limited by their lack of sensitivity and / or specificity and their combination is generally recommended to improve diagnosis. To date, there are no reliable biomarkers available for diagnosing chronic and excessive alcohol consumption.The main objective of this research was to evaluate the relevance of EtG, a direct alcohol metabolite, as a biomarker of chronic and excessive alcohol consumption, thanks to its characteristic to incorporate into hair. First, a review of literature on the use of EtG was carried out. EtG demonstrated strong potential in detecting chronic and excessive alcohol consumption. However, the lack of reliable cutoff and the unawareness of factors that affect the EtG incorporation into hair were stressed. To investigate these points, two studies have been conducted: (1) a nonclinical study in rats to determine the factors affecting the incorporation of EtG into hair as well as to investigate the relationship between the amount of alcohol administered and the EtG concentration measured in hair; and (2) a clinical study to determine the diagnostic performance of EtG as a biomarker for the identification of chronic and excessive alcohol consumers. A sensitive and specific Gas Chromatography-Mass Spectrometry coupled to tandem Mass Spectrometry method has been developed and applied to hair EtG analysis.Bloodstream seemed to play a major role in the EtG incorporation into hair. EtG incorporation into rat hair was not affected by hair pigmentation. EtG concentration in rat hair appeared to reflect the EtG concentration in blood. Besides, EtG demonstrated strong diagnostic performance in detecting both heavy alcohol consumption and at-risk alcohol consumption, and clearly outperformed diagnostic performance of hepatic biomarkers. In contrast with hepatic biomarkers, EtG was not associated with age, gender or body mass index. A reliable cutoff value of 25 pg/mg allowed to detect heavy drinkers; a reliable cutoff value of 9 pg/mg allowed to detect at-risk drinkers.

L'évangile de Jean et son lecteur

(Résumé de l'ouvrage) La Bible est un texte à lire. Mais qu'est-ce que lire, et comment lire ? Depuis une trentaine d'années, à l'initiative de biblistes tels que Jean Delorme à qui ce livre rend hommage, sont apparues des méthodes de lecture issues de la linguistique : on parle maintenant d'analyse structurale, ou de lecture sémiotique.

Molecular biological approaches to the study of vectors in relation to malaria control

To a large extent, control of malaria vectors relies on the elimination of breeding sites and the application of chemical agents. There are increasing problems associated with the use of synthetic insecticides for vector control, including the evolution of resistance, the high cost of developing and registering new insecticides and an awareness of pollution from insecticide residues. These factors have stimulated interest in the application of molecular biology to the study of mosquito vectors of malaria; focussing primarily on two aspects. First, the improvement of existing control measures through the development of simplified DNA probe systems suitable for identification of vectors of malaria. The development of synthetic, non-radioactive DNA probes suitable for identification of species in the Anopheles gambiae complex is described with the aim of defining a simplified methodology wich is suitable for entomologist in the field. The second aspect to be considered is the development of completely novel strategies through the development of completely novel strategies through the genetic manipulation of insect vectors of malaria in order to alter their ability to transmit the disease. The major requirements for producing transgenic mosquitoes are outlined together with the progress wich has been made to date and discussed in relation to the prospects which this type of approach has for the future control of malaria.

Validation of the German version of the Career Adapt-Abilities Scale and its relation to orientations to happiness and work stress

Career adapt-ability has recently gained momentum as a psychosocial construct that not only has much to offer the field of career development, but also contributes to positive coping, adjustment and self-regulation through the four dimensions of concern, control, curiosity and confidence. The positive psychology movement, with concepts such as the orientations to happiness, explores the factors that contribute to human flourishing and optimum functioning. This research has two main contributions; 1) to validate a German version of the Career Adapt-Abilities Scale (CAAS), and 2) to extend the contribution of adapt-abilities to the field of work stress and explore its mediating capacity in the relation between orientations to happiness and work stress. We used a representative sample of the German-speaking Swiss working population including 1204 participants (49.8% women), aged between 26 and 56 (Mage = 42.04). Results indicated that the German version of the CAAS is valid, with overall high levels of model fit suggesting that the conceptual structure of career adapt-ability replicates well in this cultural context. Adapt-abilities showed a negative relationship to work stress, and a positive one with orientations to happiness. The engagement and pleasure scales of orientations to happiness also correlated negatively with work stress. Moreover, career adapt-ability mediates the relationship between orientations to happiness and work stress. In depth analysis of the mediating effect revealed that control is the only significant mediator. Thus control may be acting as a mechanism through which individuals attain their desired life at work subsequently contributing to reduced stress levels.

L'expérience de la poésie. A propos de l'utopie de la littérature chez Adorno

Par utopie de la littérature, j'entends le geste d'élection de la littérature comme réponse aux aspirations philosophiques laissées en souffrance par la philosophie elle-même. Ce geste caractérise le rapport de la pensée adornienne aux textes littéraires. Pour Adorno en effet, la littérature apparaît comme le paradigme d'une relation pacifiée du sujet avec son autre, le non-identique, et cela au travers d'un usage du langage dans lequel la maîtrise subjective se trouve suspendue. L'article se propose d'aborder plus particulièrement le rapport d'Adorno à la poésie par la lecture de deux textes des Noten zur Literatur, consacrés à Hölderlin et à Eichendorff. On verra se dessiner comme l'enjeu central de la poésie la transformation du langage « en seconde nature », tandis que la relation aux oeuvres littéraires se laissera penser en terme d'expérience (Erfahrung).

La relation ambiguë des protestantismes à la sociologie

(Résumé de l'ouvrage) What are the relations between sociology and the different religions - Christianity with its various branches, Judaism, Islam, Oriental religions, sects and New Religious Movements ? That is the question which this work, - conceived on the occasion of the XXVth Conference of the International Society for the Sociology of Religion/Société Internationale de Sociologie des Religions (SISR) - wishes to clarify. The book retraces the varied and troubled history of these relations and also reveals how in opening up its research to other religions besides the Christan, sociology is forced to redefine the very object of its field of study. What is the religious? This question, which until recently was considered impertinent, informs this book throughout. If confronts the necessity of rethinking theories and methodological appoaches which, constructed in the context of 19th and early 20th century Western Europe, prove to be rather inadequate for encompassing contemporary religious phenomena and religious manifestations in other contexts. To these new theoretical and methodological demands is added, for the sociologist, a deontological imperative, which takes on all the more importance today as the religious provokes passionate social debate.

RecA-mediated annealing of single-stranded DNA and its relation to the mechanism of homologous recombination.

We demonstrate that RecA protein can mediate annealing of complementary DNA strands in vitro by at least two different mechanisms. The first annealing mechanism predominates under conditions where RecA protein causes coaggregation of single-stranded DNA (ssDNA) molecules and where RecA-free ssDNA stretches are present on both reaction partners. Under these conditions annealing can take place between locally concentrated protein-free complementary sequences. Other DNA aggregating agents like histone H1 or ethanol stimulate annealing by the same mechanism. The second mechanism of RecA-mediated annealing of complementary DNA strands is best manifested when preformed saturated RecA-ssDNA complexes interact with protein-free ssDNA. In this case, annealing can occur between the ssDNA strand resident in the complex and the ssDNA strand that interacts with the preformed RecA-ssDNA complex. Here, the action of RecA protein reflects its specific recombination promoting mechanism. This mechanism enables DNA molecules resident in the presynaptic RecA-DNA complexes to be exposed for hydrogen bond formation with DNA molecules contacting the presynaptic RecA-DNA filament.

Prenatal manifestation and management of a mother and child affected by spondyloperipheral dysplasia with a C-propeptide mutation in COL2A1: case report.

It is not unusual for patients with "rare" conditions, such as skeletal dysplasias, to remain undiagnosed until adulthood. In such cases, a pregnancy may unexpectedly reveal hidden problems and special needs. A 28 year old primigravida was referred to us at 17 weeks for counselling with an undiagnosed skeletal dysplasia with specific skeletal anomalies suggesting the collagen 2 disorder, spondyloperipheral dysplasia (SPD; MIM 156550).She was counselled about the probability of dominant inheritance and was offered a prenatal diagnosis by sonography. US examination at 17, 18 and 20 weeks revealed fetal macrocephaly, a narrow thorax, and shortening and bowing of long bones. The parents elected to continue the pregnancy. At birth the baby showed severe respiratory distress for four weeks which then resolved. Mutation analysis of both mother and child revealed a hitherto undescribed heterozygous nonsense mutation in the C-propeptide coding region of COL2A1 confirming the diagnosis of SPD while reinforcing the genotype-phenotype correlations between C-propeptide COL2A1 mutations and the SPD-Torrance spectrum. This case demonstrates the importance of a correct diagnosis even in adulthood, enabling individuals affected by rare conditions to be made aware about recurrence and pregnancy-associated risks, and potential complications in the newborn.

La psychothérapie comme traité de navigation. Débat entre François Roustang et Nicolas Duruz

Entretien conduit par Bernard Garnger avec François Roustang et Nicolas Duruz, deux auteurs qui ont beaucoup écrit sur la psychothérapie et son évolution.