En Côte d’Ivoire, les chaînes d’approvisionnement halieutiques jouent un rôle clé dans la sécurité alimentaire, mais la place du silure reste peu valorisée. Cet article analyse l’organisation et le fonctionnement de la chaîne d’approvisionnement du poisson‑chat en Côte d’Ivoire. L’étude mobilise une approche mixte combinant enquêtes quantitatives et investigations qualitatives menées entre janvier et avril 2025 auprès des principaux acteurs de la filière. Les résultats révèlent une architecture fragmentée caractérisée par une production aquacole locale marginale et non dédiée, des captures continentales invisibles dans les statistiques, et une dépendance aux importations de siluriformes. La filière est dominée par des relations informelles, sans contractualisation ni coordination verticale, et le silure demeure un produit secondaire pénalisé par des tabous alimentaires persistant. Le fumage apparaît toutefois comme un levier central de valorisation économique et d’acceptabilité sociale. L’étude plaide pour une gouvernance intégrée de la filière, articulant production, marchés et dimensions socioculturelles
BACKGROUND:Studies on surveillance of Intraductal Papillary Mucinous Neoplasms (IPMNs) are mainly retrospective with inherited bias. AIM:To identify factors associated with the development of relevant changes in low risk IPMN under surveillance. METHODS:This study analysed IPMN patients enrolled between 2015-2017 in the prospective observational multicentric registry PANcreatic CYsts (PANCY), focusing on brunch duct (BD). Extension of surveillance until December 31st, 2021 was proposed to the recruited patients. Relevant changes were defined as: worrisome features/high risk stigmata/pancreatic cancer, pancreatectomy, death due to IPMN/pancreatic cancer. RESULTS:At diagnosis, from 647 IPMNs, 547 (60%) were BD, 87 (9%) mixed type, and 13 (1%) main duct. 57 (8.8%) underwent immediate surgery and 590 (91.2%) active surveillance. Of them 34 (5.7%) underwent surgery with 2/3 malignancy. Malignancy rates for BD- and mixed-IPMNs under surveillance were 2.7% and 12.5%. Smoking (OR 2.2) and cyst size >15 mm at diagnosis (OR 7.1) were independent risk factors for relevant changes at multivariate analysis. The combination of cyst size ≤15 mm & age >65 was a protective factor at univariate analysis (OR 0.1), mainly in no smokers (OR 0.2, p < 0.01). CONCLUSIONS:BD-IPMN progression risk is low for lesions <15 mm in non-smokers, >65 years patients. Surgery and follow-up criteria are still imperfect, leading to inappropriate utilization of resources.
Background:Diabetic foot ulcers (DFUs) are associated with substantial clinical and economic burden and impaired health-related quality of life (HRQoL). Although wound healing remains a core endpoint, recent consensus work identifies HRQoL as an essential outcome in DFU studies. This study describes wound healing, patient-reported outcomes, function, and safety in adults with DFU treated with silicone superabsorbent polymer (SAP) dressings. Methods:This exploratory prospective, multicenter, nonrandomized cohort study reports the DFU subgroup from a broader single-arm investigation conducted at eight specialist centers in Poland. Adults with superficial, noninfected DFUs received silicone SAP dressings for up to 6 weeks with standard offloading. Prespecified patient-reported outcome measures were the Patient Benefit Index for wounds (PBI-W) and the Wound Quality of Life questionnaire (Wound-QoL-17). Additional endpoints included wound area reduction (centralized digital planimetry), complete epithelialization, accelerometry-based activity, offloading adherence, and safety. Results:Twenty-eight participants were included (75.0% male; mean age, 63.4 years), with a median wound duration of 166 days. By the final visit, 21 (77.8%) achieved at least 20% wound area reduction before cleansing/debridement and 24 (85.7%) after cleansing/debridement; 6 (22.2%) achieved complete epithelialization. Mean global Wound-QoL improved from 2.4 ± 0.6 to 1.5 ± 1.0 (mean change, -1.0 ± 0.8; P < 0.001), with greatest improvements in psyche and everyday-life domains. Mean PBI-W increased from 2.44 ± 0.94 to 2.94 ± 0.87 (mean change, 0.45 ± 1.10; P = 0.043). Activity intensity remained stable, offloading adherence exceeded 95%, and no device-related adverse events were reported. Conclusion:In this prospective DFU cohort, use of silicone SAP dressings within a structured care setting was associated with improvements in wound area reduction and wound-related quality of life over 6 weeks. These results highlight the feasibility of integrating patient-reported outcomes in DFU studies and provide a clinically relevant platform for future comparative and health-economic evaluations.
