Triple therapy is independently associated with a higher survival rate among patients with CAPS.

L’entretien constitue l’outil de collecte de données le plus utilisé dans le cadre des travaux de recherche menés en sciences de la santé, en sciences humaines et en sciences sociales. Après avoir distingué les différents types d’entretien, l’attention est portée sur l’entretien semi-directif, lors de ses différentes étapes de réalisation, en incluant le traitement et l’analyse des données, ceci à partir de la restitution d’une expérience de recherche vécue lors de travaux situés à la frontière du champ de la santé publique et de l’anthropologie. Si cette approche ainsi contextualisée de l’entretien semi-directif pourra apparaître, a priori , singulière, le lecteur intéressé par le développement de travaux de recherche qualitative dans une perspective humaniste et par la mise en place de stratégies multidisciplinaires constatera son caractère universel.

BackgroundMedical progress and the lifestyle modification have prolonged life expectancy, despite the development of chronic diseases. Support and care for older subjects are often provided by a network of informal caregivers composed of family, friends and neighbors, who are essential in helping older persons to continue living at home. It has been shown that the extent and diversity of informal tasks may jeopardize the physical, mental and social wellbeing of caregivers.Methods/designThe aim of the Informal Carers of Elderly cohort is to define, through a longitudinal study, profiles of caregivers of older patients with a diagnosis of one of the following diseases: cancer (breast, prostate, colorectal), neurodegenerative diseases (Parkinson’s disease, Alzheimer’s disease and similar diseases), neurovascular diseases (stroke), sensory diseases (age-related macular degeneration (AMD)) and heart disease (heart failure). Patients must be at least 60 years old and living in the region of Burgundy-Franche-Comte (France). By following the different phases of the caregiving relationship from the announcement of the diagnosis, it will be possible to assess the quality of life of caregivers, coping strategies, levels of anxiety and depression, social support and the extent of their burden. We will also evaluate the efficacy and efficiency of the implementation of a pragmatic intervention by a social worker to help informal caregivers, through a randomized interventional trial nested in the cohort. Qualitative approaches aimed at studying the caregiver/patient relationship, and situations leading to breakdown of the caregiver relationship will be also undertaken.DiscussionThrough an analytical and longitudinal definition of profiles of informal caregivers, this study will gather detailed information on their life courses and their health trajectory by identifying consequences associated with the concept of their role as carers. In addition, the randomized interventional trial will explore the relevance of the implementation of a supportive intervention by a social worker to help caregivers. These data will help to identify strategies that could be used to improve the existing sources of aid and to propose new approaches to help caregivers. This study will provide the opportunity to identify the most relevant means of support adapted to caregivers, and provide an impulse for new health care policies.Trial registrationClinicalTrials.gov Identifier: NCT02626377. Retrospectively registered on 9 December 2015. Protocol date/version: 23 October 2014/version 2.

Bacteria of the genus Achromobacter are environmental germs, with an unknown reservoir. It can become opportunistic pathogens in immunocompromised patients, causing bacteremia, meningitis, pneumonia, or peritonitis. In recent years, Achromobacter xylosoxidans has emerged with increasing incidence in patients with cystic fibrosis (CF). Recent studies showed that A. xylosoxidans is involved in the degradation of the respiratory function of patients with CF. The respiratory ecosystem of patients with CF is colonized by bacterial species that constantly fight for space and access to nutrients. The type VI secretion system (T6SS) empowers this constant bacterial antagonism, and it is used as a virulence factor in several pathogenic bacteria. This study aimed to investigate the prevalence of the T6SS genes in A. xylosoxidans isolated in patients with CF. We also evaluated clinical and molecular characteristics of T6SS-positive A. xylosoxidans strains. We showed that A. xylosoxidans possesses a T6SS gene cluster and that some environmental and clinical isolates assemble a functional T6SS nanomachine. A. xylosoxidans T6SS is used to target competing bacteria, including other CF-specific pathogens. Finally, we demonstrated the importance of the T6SS in the internalization of A. xylosoxidans in lung epithelial cells and that the T6SS protein Hcp is detected in the sputum of patients with CF. Altogether, these results suggest for the first time a role of T6SS in CF-lung colonization by A. xylosoxidans and opens promising perspective to target this virulence determinant as innovative theranostic options for CF management.

The troubling evolution of Type 2 Diabetes into epidemic proportions bearing dramatic consequences has generated significant interest leading to a strong research focus and therefore the subject of several studies in recent years. This article examines Type 2 Diabetes Mellitus and its complications on the basis of a literature review addressing their epidemiological situation on an international scale--including indigenous peoples--and their socio-cultural determinants. This study reveals important ethnic disparities in terms of mortality and morbidity, as well as the multi-factored origin of this metabolic disorder, most notably among indigenous populations. Above and beyond the limits of prevention programmes, this literature review addresses the importance of reinforcing ethnoepidemiological studies among vulnerable peoples in order to improve our understanding of the emergence and development of this particularly complex pathological phenomenon