Le syndrome de Stewart-Treves est une maladie rare définie par la survenue d’un angiosarcome sur un lymphœdème, surtout secondaire après traitement de cancer. Le délai de survenue est retardé de plusieurs années par rapport à l’apparition du lymphœdème. Son origine reste incertaine ; la principale hypothèse est celle d’une immunodépression locale induite par le lymphœdème. La présentation clinique est trompeuse, initialement à type de macule violacée pseudo-ecchymotique. L’évolution est rapide sous forme d’une extension locale d’aspect nodulaire et d’une dissémination métastatique. Le diagnostic est histologique et doit être réalisé le plus précocement possible au stade de maladie localisée pour permettre un traitement optimal. Malgré les traitements, le pronostic reste mauvais.Stewart-Treves syndrome (STS) is a rare disease defined by the onset of an angiosarcoma, especially on secondary lymphedema after cancer treatment. The time to onset is delayed by several years from the start of lymphedema. Its cause remains uncertain and the main hypothesis is based on local immunosuppression induced by the lymphedema. The clinical presentation is misleading, initially comprising a type of pseudo-ecchymotic purplish macule. STS progresses rapidly, with local nodular extension and metastatic dissemination. Diagnosis is histological and should be made as early as possible at the stage of localized disease to allow optimal treatment. Despite the existing treatments, the prognosis remains poor.

In obesity, oxidative stress is responsible for the aberrant production of adipokines such as adiponectin, plasminogen activator inhibitor (PAI)-1 and interleukin-6 (IL-6), which is causally associated with obesity-related inflammation, insulin resistance and cardiovascular disease. However, the signaling transduction pathways participating in adipokine dysregulation induced by oxidative stress are largely unknown. Thus, the aim of the present study was to identify possible involved signaling pathways.3T3-L1 cells were differentiated into adipocytes and underwent oxidative stress by exposure to extraneous H2O2. Quantitative PCR and immunoassays were performed to determine mRNA and protein levels of adipokines (adiponectin, PAI-1 and IL-6), respectively. Possible signaling pathways involved were high-throughout identified by Bioplex phosphoprotein assays and subsequently confirmed by inhibition of the targeted protein kinases such as Akt, ERK1/2, JAK/STAT, JNK, and p70 S6 K, respectively.H2O2 markedly suppressed adiponectin mRNA expression as well as protein secretion; however, it enhanced PAI-1 and IL-6 production in mature adipocytes. Akt,JAK/STAT and ERK1/2 participated in the H2O2-induced increase of PAI-1 and IL-6 expression, whereas adiponectin expression was reduced by H2O2 via Akt and JAK/STAT.Akt and JAK/STAT are congenerous pathways through which oxidative stress downregulates adiponectin and upregulates PAI-1 and IL-6 expression. ERK1/2 participates not in H2O2-induced decrease of adiponectin expression, but in the increase of PAI-1 and IL-6.

Resilience and vulnerability in the supply chain are two concepts that fall within the area of risk management. These two concepts are the factors ensuring the performance and sustainability of the supply chain. The main aim of this paper is to synthesis and review the state of the art of research on vulnerability management and resilience in this context. Through structured review of the literature, this study provides an overview of the conceptual and methodological research in this field, not as a collection of independent items, but as a whole, in an integrated manner. We provide the consideration of a review of relevant literature methods and approaches developed to understand the various issues raised in the domain of vulnerability and resilience in the supply chain. Our intention is to cover the full spectrum of these problems and to provide potential challenges, along with conclusions and recommendations for novice and researchers by positioning most promising paths of future research. Particular attention was paid to researches that focus on performance measurement.

Des troubles cognitifs légers apparaissent au cours du vieillissement normal. Ils atteignent la mémoire, les fonctions exécutives et les capacités attentionnelles sans retentir sur les activités de la vie quotidienne. Ils sont en rapport avec les facteurs de risque vasculaire présents à l’âge adulte. Néanmoins, l’incidence des démences augmente fortement après 65 ans. Avec l’augmentation continue de l’espérance de vie, la prévalence des sujets déments augmentera de 75 % en 2030. La prise en charge des patients âgés atteints de cancer doit tenir compte de l’éventualité de troubles cognitifs qui retentiraient sur la compréhension du diagnostic et du traitement et la gestion des prises médicamenteuses ou des rendez-vous médicaux. L’évaluation gériatrique permet de diagnostiquer ces troubles cognitifs et d’apprécier leur retentissement sur les activités instrumentales (instrumental activities of daily living [IADL]) et les activités élémentaires (activities of daily living [ADL]) de la vie quotidienne. Un certain nombre d’interventions doivent être mises en place avec la famille. Les prescriptions médicales concernent les soins infirmiers, la kinésithérapie et l’orthophonie. Les aides à domicile relèvent du champ social et une partie de leur coût peut être prise en charge par les mutuelles ou par l’allocation personnalisée autonomie (APA). Les cas complexes sont pris en charge à domicile par les maisons pour l’autonomie et l’intégration des malades d’Alzheimer (MAIA) dont les gestionnaires de cas assurent un suivi personnalisé et une coordination des soins et des services autour de la personne cognitivement atteinte. Enfin, les mesures de protection juridique sont à envisager lorsque la personne n’a aucune aide familiale et que sa perte d’autonomie psychique est importante.Mild cognitive impairment occurs frequently with ageing, concerning memory complaint, attention and executive dysfunction without any consequence on the activities of daily living. They are strongly linked to the presence of vascular risk factors in adulthood. Nevertheless with the continuous progression of life expectancy, the incidence of dementia drastically increases after sixty-five years of age and the number of old people with dementia is expected to increase by 75% in 2030 in France. Caring for elderly patients with cancer needs to face the possibility of cognitive impairment and its consequences on a good comprehension of diagnosis and treatment and ability to properly take medication. Comprehensive geriatric assessment can help to diagnose cognitive impairment and evaluate the consequences on instrumental activities of daily living (IADL) and activities of daily living (ADL). Home care may be organised with the help of the family or social workers. Physiotherapy and speech rehabilitation are often useful. Assistance for housekeeping, shopping and cooking may be financed by social organisations such as APA in France. Complex cases must be referred to case managers in homes for patients suffering for Alzheimer's disease (MAIA) who liaise between doctors and home carers with good results.

Vitamin C (Vit C) is a potent antioxidant with several applications in the cosmetic and pharmaceutical fields. However, the biggest challenge in the utilization of Vit C is to maintain its stability and improve its delivery to the active site. Several strategies have been developed such as: controlling the oxygen levels during formulation and storage, low pH, reduction of water content in the formulation and the addition of preservative agents. Additionally, the utilization of derivatives of Vit C and the development of micro and nanoencapsulated delivery systems have been highlighted. In this article, the multiple applications and mechanisms of action of vitamin C will be reviewed and discussed, as well as the new possibilities of delivery and improvement of stability.

Polyaromatic hydrocarbons (PAHs) and polychlorobiphenyls (PCBs), were investigated in urban effluents to wastewater treatment plants in the Paris area (France), under different meteorological conditions. The Achères plant was considered with special attention because of its particular features. Wastewater PAH concentration level was 6 fold higher than that of PCBs. In March, PCB concentrations did not vary whatever the meteorological conditions whereas, for PAHs, they were markedly higher during rainy episodes. In September, concentrations of both pollutants increased due to rainy weather. The rise was 30 fold stronger for PAHs. Daily fluxes displayed the same trends. This suggests that the contribution of atmospheric wet deposition to wastewater contamination prevails for PCBs. In contrast, PAHs appeared to originate mainly from urban runoff processes.

Les sociétés d’exercice libéral constituées pour l’exploitation d’une pharmacie d’officine doivent être inscrites au tableau de l’ordre tout comme leurs associés. En cas de non-respect des principes déontologiques, les chambres de discipline des différents conseils de l’ordre des pharmaciens pourront prononcer une peine d’interdiction d’exercice tant à l’égard des personnes physiques que des personnes morales. Si les modalités de remplacement des praticiens condamnés sont explicitées par le Code de la santé publique, aucun texte n’organise pour l’heure le remplacement des personnes morales. Aussi, le conseil national de l’ordre des pharmaciens a pu estimer que la condamnation d’une société à une peine d’interdiction d’exercice impliquait nécessairement la fermeture de l’officine. Néanmoins, sur le fondement de la rupture d’égalité entre les praticiens selon leur mode d’exercice, le conseil d’État souligne, d’une part, que la sanction ordinale n’entraîne pas nécessairement la cessation d’activité et, d’autre part, qu’aucune disposition n’interdit qu’un pharmacien habilité à exercer la profession puisse exploiter l’officine pendant la durée de la peine. Les modalités du remplacement d’une personne morale restent, toutefois, à déterminer.The societies of liberal exercise constituted for the exploitation of a pharmacy must be registered on the professional board as their partners. In case of disregard of the ethical principles, the disciplinary chambers of different councils could pronounce a professional interdiction against both the physical persons and the society. Whereas the modalities of replacement of the condemned practitioners are clarified by the Public health code, no text organizes at present the replacement of the society. The national council of the pharmacists was able to consider that the condemnation of a society to a punishment of ban on exercise involved inevitably the closure of the pharmacy. Nevertheless, on the foundation of the break of equality between the practitioners according to their mode of exercise, the administrative Supreme Court considers, on one hand, that the ordinal penalty does not impose the discontinuance of business and on the other hand, that no measure forbids that a pharmacist authorized to exercise the profession can exploit the pharmacy during the punishment period. The modalities of the replacement of a legal entity remain however to determine.

A rehydration randomized trial was performed to compare the respective advantages of the subcutaneous and intravenous routes in 30 elderly subjects. For an equal effectiveness, the subcutaneous route was found to be superior as regards practicality, acceptability and comfort; it deserves to be developed in geriatrics.

A rehydration randomized trial was performed to compare the respective advantages of the subcutaneous and intravenous routes in 30 elderly subjects. For an equal effectiveness, the subcutaneous route was found to be superior as regards practicality, acceptability and comfort ; it deserves to be developed in geriatrics.