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Plassard, Frédéric, Lise Aurière, François-Xavier Chauvière, Carole Fritz, and Morgane Dachary. "New discoveries of portable art in the Magdalenian of Bourrouilla Cave (Arancou, Pyrénées-Atlantiques, France)." Paléo, no. 26 (December 1, 2015): 215–24. http://dx.doi.org/10.4000/paleo.3037.
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Aurière, Lise, François-Xavier Chauvière, Frédéric Plassard, Carole Fritz, and Morgane Dachary. "Unpublished portable art from Bourrouilla cave in Arancou (Pyrénées-Atlantiques, France): techno-stylistic and chrono-cultural data." Paléo, no. 24 (December 15, 2013): 192–217. http://dx.doi.org/10.4000/paleo.2863.
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Lepetit, Bernard. "Sur les dénivellations de l'espace économique en France, dans les années 1830." Annales. Histoire, Sciences Sociales 41, no. 6 (December 1986): 1243–72. http://dx.doi.org/10.3406/ahess.1986.283347.
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Au départ, l'art du puzzle semble un art bref,un art mince, tout entier contenu dans un maigreenseignement de la Gestalt-théorie. L'objet visén'est pas une somme d'éléments qu'il faudraitd'abord isoler et analyser, mais un ensemble, c'està-dire une forme, une structure : la connaissancedu tout et de ses lois, de l'ensemble et de sa structurene saurait être déduite de la connaissanceséparée des parties qui la composent : cela veutdire qu ‘on peut regarder une pièce d'un puzzle pendanttrois jours et croire tout savoir de sa configurationet de sa couleur sans avoir le moins dumonde avancé.G. Perec, La vie mode d'emploi.On connaît le destin historiographique de la ligne Saint-Malo/Genève. L'invention de la frontière et sa première représentation cartographique datent de 1826. Dans une conférence prononcée au Conservatoire des Arts et Métiers, Charles Dupin appelle l'attention de son auditoire sur « une ligne tranchée et noirâtre qui sépare le Nord et le Midi de la France » depuis Genève jusqu'à Saint-Malo. De part et d'autre, des taux de scolarisation très dissemblables opposent la « France éclairée » et la « France obscure ». Oubliée après 1850, la ligne de démarcation est exhumée un siècle plus tard, sur le même terrain de la géographie culturelle. En suivant, d'après Maggiolo, les « progrès de l'instruction élémentaire de Louis XIV à Napoléon III », on retrouve, validée dans le long terme, l'opposition caractéristique du temps des monarchies parlementaires, et l'existence d'une « ligne charnière » menant de la baie du Mont Saint- Michel au lac de Genève.
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Aurière, Lise, François-Xavier Chauvière, Frédéric Plassard, Carole Fritz, and Morgane Dachary. "Art mobilier inédit du gisement de Bourrouilla à Arancou (Pyrénées-Atlantiques, France) : données techno-stylistiques et chrono-culturelles." Paléo, no. 24 (December 15, 2013): 192–217. http://dx.doi.org/10.4000/paleo.2624.
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Rivero, Olivia, and Diego Garate. "Gravettian portable art on lithic support from Isturitz cave (Saint-Martin-d’Arberoue, Pyrénées-Atlantiques, France) : a rediscovered collection." Paléo, no. 25 (December 28, 2014): 247–76. http://dx.doi.org/10.4000/paleo.3016.
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Dachary, Morgane, François-Xavier Chauvière, and Frédéric Plassard. "The Middle/Upper Magdalenian transition at Bourrouilla cave in Arancou (Pyrénées-Atlantiques, France): Portable art and context-induced considerations." Journal of Archaeological Science: Reports 28 (December 2019): 102019. http://dx.doi.org/10.1016/j.jasrep.2019.102019.
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HAINES, JOHN. "Living troubadours and other recent uses for medieval music." Popular Music 23, no. 2 (May 2004): 133–53. http://dx.doi.org/10.1017/s0261143004000133.
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This essay aims to expand on existing narratives of medieval music performance by exploring recent interpretations of the troubadours. Recent advances in the field of ethnomusicology, popular music and medieval music reception suggest the need to view medieval music performance in ways other than the conventional narrative of early music performance. This article focuses on the troubadours, originally song-makers in the late medieval Midi, or South of France. Based on my interviews with recent ‘living troubadours’ in the United States and France, I present evidence for multifarious musical interpretations of the art de trobar, or medieval troubadour art. Living troubadours under consideration here include Eco-Troubadour Stan Slaughter from Missouri and Occitan rap group Massilia Sound System from Marseille. The latter claim a special distinction as living descendants of the original troubadours; the former views himself as more remotely related to medieval music. And while all the different musicians considered here offer widely contrasting interpretations of the medieval art de trobar, they do have in common certain recent musical influences, along with a view of folk music as an open-ended, and musically flexible category. All of these artists are also united in their belief that the essence of folk song is an urgent message which, though it may range from recycling to anti-centralist politics, consistently controls the musical medium. What the groups considered here have in common with traditional early music groups is their creative use of contemporary influences to evoke for their audience the Middle Ages.
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Garate, Diego, Olivia Rivero, Raphaëlle Bourrillon, and Jean-Marc Pétillon. "The rock art of Tastet Cave (Sainte-Colome, Pyrénées-Atlantiques, France): at the crossroads of the Late Glacial artistic traditions." Paléo, no. 24 (December 15, 2013): 103–20. http://dx.doi.org/10.4000/paleo.2858.
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Silvester, James, O. Kochukhov, G. A. Wade, N. Piskunov, J. D. Landstreet, and S. Bagnulo. "Cartography of the magnetic fields and chemical spots of Ap stars." Proceedings of the International Astronomical Union 4, S259 (November 2008): 403–4. http://dx.doi.org/10.1017/s1743921309030877.
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AbstractWe will introduce a project using Magnetic Doppler Imaging (MDI) to create assumption-free vector magnetic field maps and chemical surface structure maps of chemically peculiar A and B type (or Ap) stars. We are exploiting the latest generation of spectropolarimeters (NARVAL at the Pic du Midi observatory, and ESPaDOnS at the Canada-France-Hawaii telescope), to obtain high-resolution time series of Stokes IQUV spectra of a selection of Ap stars. The spectra have superior signal-to-noise ratio, resolution and wavelength coverage to those used previously. This combined with the ground-breaking inversion techniques introduced by Kochukhov et al. (2002) results in maps which represent the state-of-the-art in the field of stellar cartography. These maps will allow us to better understand the links between the magnetic field and the physical processes leading to the formation of chemical structures in the photosphere and allow us to address questions surrounding the detailed magnetic field geometry of Ap stars.
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Daran, Jean-Claude, Lionel Mourey, Anne-Magali Seydoux, and Nicolas Ratel-Ramond. "IYCr2014 in the « Midi-Pyrénées » Region, France." Acta Crystallographica Section A Foundations and Advances 70, a1 (August 5, 2014): C1297. http://dx.doi.org/10.1107/s2053273314087026.
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To promote crystallography through the "Midi-Pyrénées" Region, our association, « Les Cristallographes en Midi-Pyrénées » has scheduled different events from October 2013 until the end of 2014. These events will cover scientific demonstrations and/or lectures open to the general public. 1) Events - The Novela (7-12 October 2013), organized by the Toulouse-Metropole, is an event whose major goal is to share knowledge, in all its diversity, in a festive and popular spirit. It aimed at pupils and students as well as the general public. This will be performed once again in October 2014. - The "Kiosque-Actu" at the Toulouse Museum provides an opportunity to inquire and to exchange with researchers on a scientific topical subject. On the 2nd of February 2014, researchers coming from several laboratories in Toulouse (CEMES, CIRIMAT, GET, IPBS, and LCC; from the CNRS and the Paul Sabatier University) and involved in all domains of X-ray diffraction (Biology, Mineralogy, Chemistry, Materials, etc.) came to meet the general public and to demonstrate the importance of crystallography. Exhibition "Voyage dans le cristal / Journey within a crystal" at (i) the Philadelphe Thomas Museum in Gaillac (14 February-4 May 2014) and (ii) at the library of the Paul Sabatier University (from the 1st of September until the end of the year). Panels from this exhibition have been/will be also displayed during all events mentioned above. 2) Conferences - Maryvonne Hervieu (ENSICAEN, Caen, France), 17 February 2014, "Des cristaux et des hommes / Of crystals and men". - Jean-Claude Daran (LCC, Toulouse, France), 20 February 2014, "Les cristaux de Louis Pasteur / Louis Pasteur's crystals". - Lionel Mourey (IPBS, Toulouse, France), 27 February 2014, "Des cristaux au secours de la médecine / Crystals to help medicine". - Anne-Magali Seydoux (GET, Toulouse, France), 10 April 2014, "Effets de la radioactivité sur les structures des minéraux / Effects of radioactivity on the structure of minerals".
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Ambrose, Kirk. "A Visual Pun at Vézelay: Gesture and Meaning on a Capital Representing the Fall of Man." Traditio 55 (2000): 105–23. http://dx.doi.org/10.1017/s0362152900000040.
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In a description of a trip through the Midi of France in 1835, Prosper Merimée devotes a lengthy paragraph to the analysis of the Christ in Vézelay's Pentecost tympanum (fig. 1). He marvels at the carving of the figure's feet and “blessing” hands, as well as the placement of the thighs in relation to the torso. Later in his treatment of the abbey church and its sculpture, the author notes that figures on the nave capitals convey a “savage zeal” (zèle farouche) by means of posture and facial expressions. Gestures, in the widely construed, medieval sense of the word, clearly struck the celebrated French author as a salient feature of Vézelay's sculpture. Merimée sympathized with Romantic visions of the Middle Ages as a period less tainted by the stifling effects of civilization, and perhaps his fascination with the dramatic body movement carved throughout the abbey church reflects the belief that these were unfettered by the artistic or social constraints of the early nineteenth century. Yet throughout his description of Vézelay's sculpture, he never attempts to explore the meanings that the carved body might have held for a medieval audience; their meaning is not considered to be historical, but rather to be self-evident. The operative assumption that gestures in medieval art are transparent in meaning anticipates much subsequent scholarship.
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Gomez de Soto, José, Pierre-Yves Milcent, Jean-Philippe Baigl, Alexis Gorgues, Pierre Moret, Olivier Nillesse, and Christophe Sireix. "La France du Centre aux Pyrénées (Aquitaine, Centre, Limousin, Midi-Pyrénées, Poitou-Charentes)." Gallia 60, no. 1 (2003): 107–38. http://dx.doi.org/10.3406/galia.2003.3145.
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Hemery, C., and S. Haeghebaert. "New outbreak of trichinellosis in the Midi-Pyrénées region of France, September-October 1998." Eurosurveillance 4, no. 1 (January 1, 1999): 13–14. http://dx.doi.org/10.2807/esm.04.01.00082-en.
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Le 6 octobre 1998 onze cas de trichinellose survenus, en France, dans les départements de la Haute Garonne et du Tarn ont été déclarés aux autorités sanitaires de la région Midi-Pyrénées. Les toutes premières informations fournies par les médecins suggéra
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Laborie, Jean-Paul, G. Stecktman-Labry, and P. Jové. "L'urbanisation des bourgs ruraux en France : des exemples en Midi-Pyrénées." Revue géographique des Pyrénées et du Sud-Ouest 58, no. 4 (1987): 357–70. http://dx.doi.org/10.3406/rgpso.1987.3094.
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Audiot, Annick, and J. C. Flamant. "LES RACES ANIMALES ANCIENNES: UN ATOUT ECONOMIQUE POUR LE SUD-OUEST DE LA FRANCE." Animal Genetic Resources Information 10 (April 1992): 27–33. http://dx.doi.org/10.1017/s1014233900003266.
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RESUMECette note décrit l'action entreprise dans le Sud-Ouest de la France par la Région Midi-Pyrénées pour la conservation des races d'animaux domestiques en voie d'extinction. Leur association avec leur terroir d'origine et des systèmes d' élevage non intensifiés pour aboutir à des produits typés de qualité, identifiables par les consommateurs, constitue aujourd'hui un nouvel atout économique dans le cadre d'une politique de diversification des débouchés de l'agriculture.
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Arcelin, Patrice, Philippe Gruat, Philippe Boissinot, Jean Chausserie-Laprée, Bernard Dedet, Philippe Ferrando, Éric Gailledrat, et al. "La France du Sud-Est (Languedoc-Roussillon, Midi-Pyrénées, Provence-Alpes-Côte d'Azur)." Gallia 60, no. 1 (2003): 169–241. http://dx.doi.org/10.3406/galia.2003.3147.
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Haeghebaert, S., M. Servat, C. Duchen, J. C. Minet, A. EAgrech, I. Thièse, C. Leclerc, et al. "Outbreak of trichinellosis in the Midi-Pyrénées region of France January - March 1998." Eurosurveillance 3, no. 8 (August 1, 1998): 83–5. http://dx.doi.org/10.2807/esm.03.08.00118-en.
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Two outbreaks of trichinellosis in the Tarn et Garonne, département, France were reported by the departmental health autorities on 2 March 1998, to the Réseau National de Santé Publique (RNSP). An epidemiological investigation began on 3 March in order to
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Basson, Jean-Charles, Nadine Haschar-Noé, and Ivan Theis. "Territorial Translation of the National Health and Nutrition Program in Midi-Pyrénées, France." Healthcare Policy | Politiques de Santé 9, SP (October 30, 2013): 26–37. http://dx.doi.org/10.12927/hcpol.2013.23588.
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De-León Almaraz, Sofía, Catherine Azzaro-Pantel, Ludovic Montastruc, and Serge Domenech. "Hydrogen supply chain optimization for deployment scenarios in the Midi-Pyrénées region, France." International Journal of Hydrogen Energy 39, no. 23 (August 2014): 11831–45. http://dx.doi.org/10.1016/j.ijhydene.2014.05.165.
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Prosperi, P., J. M. Terres, S. Doublet, and P. Pointereau. "Conservation agriculture effects and policy support to mitigate soil degradation in Midi-Pyrénées (France)." Land Degradation & Development 22, no. 1 (January 2011): 70–83. http://dx.doi.org/10.1002/ldr.1021.
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Pasquier, Christophe, Mathieu Fehlmann, Charlotte Bresson, Sylvain Fremaux, Alain Jean, and Jean-Philippe Thelliez. "Monitoring of Peregrine Falcons in the Ariège Pyrenees and Toulouse, Midi-Pyrénées region, France." Ornis Hungarica 26, no. 2 (December 1, 2018): 143–58. http://dx.doi.org/10.1515/orhu-2018-0023.
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Abstract Since the 1980s, the volunteers of the ornithological group of the Nature Midi-Pyrénées association have been monitoring the Peregrine Falcon (Falco peregrinus) population in the Ariège Pyrenees and in the Toulouse agglomeration. The data collected over the last 30 years show stability of the Ariège population: little variation has been observed in brood size, occupation rate of the sites or reproductive success. Only the increasing number of known nesting sites is significant, due to better knowledge of the territory by observers over time. In 2017, the breeding population was estimated to be 24 pairs. Urban monitoring proved the presence of individuals in passage, wintering or resident in Toulouse. Since 2002, downtown Toulouse has been visited by several individuals of both sexes and interactions between males and females have been observed since 2005. Despite the multiplicity of possible eyries or nesting sites in Toulouse, and the massive presence of Peregrine Falcons and dedicated bird watchers, no case of breeding has been reported. In addition to monitoring, measures to protect and support the presence of the species have been put in place. In the Pyrenees, in the light of the growth of human activities near nesting sites, some sites are now subject to official protective measures, coupled with constant vigilance and awareness. In Toulouse, to encourage the breeding of the individuals present, two nesting boxes were installed in 2016, on two buildings frequented by a female and a male. In 2017, a first attempt to reproduce in one of these installations confirmed the value of such developments in urban areas.
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Le Moal, Joëlle, Matthieu Rolland, Sarah Goria, Vérène Wagner, Perrine De Crouy-Chanel, Annabel Rigou, Jacques De Mouzon, and Dominique Royère. "Semen quality trends in French regions are consistent with a global change in environmental exposure." REPRODUCTION 147, no. 4 (April 2014): 567–74. http://dx.doi.org/10.1530/rep-13-0499.
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A retrospective study carried out recently in a large sample of men, close to the general population, has reported a significant and strong decline in sperm concentration and morphology in the whole of France between 1989 and 2005. We studied these trends within each region of France. Data were obtained from the Fivnat database. The study sample comprised male partners of sterile women in whom both tubes were absent or blocked. They were located at the assisted reproductive technology center. A Bayesian spatio-temporal model with parametric time trends, adjusted for age, was used to model overall time trends for each region. The results show that sperm concentration decreased in almost all regions of France. Among them, Aquitaine showed the highest decrease and Midi-Pyrénées had the lowest average for the whole period. Regarding total motility, most regions showed a slight increase while Bourgogne showed a steep and significant decrease. While considering sperm morphology, there was a decrease in most of the regions. The decrease in Aquitaine and Midi-Pyrénées was stronger when compared with the overall trend. In conclusion, a decrease in sperm concentration and morphology, already shown at the French metropolitan territory level, was observed in most regions of France. This is consistent with a global change in environmental exposure, according to the endocrine disruptor hypothesis especially. Indeed, ubiquitary exposure to chemicals has been growing in the general population of France since the 1950s, and the results do not appear to support the lifestyle hypothesis. The highest decreases and lowest values are consistently observed in two proximate regions that are both highly agricultural and densely populated.
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Azam, Martine. "Le credo identitaire comme ressource pour l’art ?" Sociologie et sociétés 34, no. 2 (April 29, 2004): 185–205. http://dx.doi.org/10.7202/008138ar.
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Résumé À travers un siècle de relations entre art et territoire en région Midi-Pyrénées, l’article s’intéresse à la façon dont les acteurs, collectifs et individuels, ont érigé en ressources les notions de territoire et d’identité. Abordée de façon chronologique, la première partie de l’article retrace les périodes au cours desquelles le mouvement régionaliste et les milieux artistiques se sont retrouvés pour porter la revendication d’une identité spécifique. La seconde partie cherche à dépasser les circonstances propres à chacun des moments de l’histoire régionale et dégage les composantes humaines et discursives — les acteurs, le discours identitaire, le « retard » — et les variantes qu’elles enregistrent.
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Rieu, Anne-Marie. "Itinéraires socio-professionnels et rapports de sexe en agriculture." Articles 2, no. 2 (April 12, 2005): 79–99. http://dx.doi.org/10.7202/057560ar.
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Plusieurs recherches sur le terrain, dans la région Midi-Pyrénées en France, alliant des méthodes d'enquête complémentaires (questionnaires, entretiens biographiques) m'ont permis de saisir le fonctionnement des rapports sociaux de sexe dans la constitution des itinéraires professionnels des agricultrices. À l'œuvre dans l'ensemble des instances socialisatrices (famille, école), ces rapports sociaux de sexe impriment une professionnalité différente pour les hommes et pour les femmes. Cependant, malgré les obstacles juridiques qui pénalisent les femmes dans l'accès au métier, il reste au quotidien un espace de possibles que certaines agricultrices vont utiliser pour développer des stratégies d'autonomie. Elles deviennent ainsi les actrices de leur propre destin.
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Jackson, Ian, and Augustin Pyramus de Candolle. "Voyage de Tarbes 1807: Première grande traversée des Pyrénées: Un voyage dans le midi de la France." Taxon 49, no. 1 (February 2000): 136. http://dx.doi.org/10.2307/1223947.
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Marchand, M. "La place des médicaments biologiques similaires des érythropoïétines sur le marché en France et en Midi-Pyrénées." Revue d'Épidémiologie et de Santé Publique 63, no. 2 (April 2015): 145–46. http://dx.doi.org/10.1016/j.respe.2015.02.014.
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Diaz, Hugo, Haleh Bagheri, Aurore Palmaro, Vanessa Rousseau, Robert Bourrel, Jean-Louis Montastruc, and Jordan Birebent. "Patterns of direct oral anticoagulant drug prescription in France in 2010–2013: a study in the Midi-Pyrénées area." European Journal of Clinical Pharmacology 74, no. 7 (March 27, 2018): 945–51. http://dx.doi.org/10.1007/s00228-018-2449-x.
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Pouey, J., L. Grout, V. Schwoebel, C. Raffy, and B. Magnier. "Représentation cartographique des bassins de recrutement des services d’urgence : un plus pour la surveillance sanitaire non spécifique en Midi-Pyrénées, France, 2008." Revue d'Épidémiologie et de Santé Publique 58 (April 2010): S35. http://dx.doi.org/10.1016/j.respe.2010.02.095.
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Hermida, Lucía, José Luis Sánchez, Laura López, Claude Berthet, Jean Dessens, Eduardo García-Ortega, and Andrés Merino. "Climatic Trends in Hail Precipitation in France: Spatial, Altitudinal, and Temporal Variability." Scientific World Journal 2013 (2013): 1–10. http://dx.doi.org/10.1155/2013/494971.
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Hail precipitation is characterized by enhanced spatial and temporal variability. Association Nationale d’Etude et de Lutte contre les Fléaux Atmosphériques (ANELFA) installed hailpad networks in the Atlantic and Midi-Pyrénées regions of France. Historical data of hail variables from 1990 to 2010 were used to characterize variability. A total of 443 stations with continuous records were chosen to obtain a first approximation of areas most affected by hail. The Cressman method was selected for this purpose. It was possible to find relationships between spatial distributions of the variables, which are supported by obtained Pearson correlations. Monthly and annual trends were examined using the Mann-Kendall test for each of the total affected hailpads. There were 154 pads with a positive trend; most were located between Tarbes and Saint-Gaudens. We found 177 pads with a negative trend, which were largely south of a pine forest in Landes. The remainder of the study area showed an elevated spatial variability with no pattern, even between relatively close hailpads. A similar pattern was found in Lérida (Spain) and Southeast France. In the entire area, monthly trends were predominantly negative in June, July, and August, whereas May had a positive trend; again, however, there was no spatial pattern. There was a high concentration of hailpads with positive trend near the Pyrenees, probably owing to orographic effects, and if we apply cluster analysis with the Mann-Kendall values, the spatial variability is accentuated for stations at higher altitude.
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Llasat, M. C., M. Llasat-Botija, O. Petrucci, A. A. Pasqua, J. Rosselló, F. Vinet, and L. Boissier. "Towards a database on societal impact of Mediterranean floods within the framework of the HYMEX project." Natural Hazards and Earth System Sciences 13, no. 5 (May 24, 2013): 1337–50. http://dx.doi.org/10.5194/nhess-13-1337-2013.
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Abstract. The NW Mediterranean region experiences every year heavy rainfall and flash floods that occasionally produce catastrophic damages. Less frequent are floods that affect large regions. Although a large number of databases devoted exclusively to floods or considering all kind of natural hazards do exist, usually they only record catastrophic flood events. This paper deals with the new flood database that is being developed within the framework of HYMEX project. Results are focused on four regions representative of the NW sector of Mediterranean Europe: Catalonia, Spain; the Balearic Islands, Spain; Calabria, Italy; and Languedoc-Roussillon, Midi-Pyrénées and PACA, France. The common available 30-yr period starts in 1981 and ends in 2010. The paper shows the database structure and criteria, the comparison with other flood databases, some statistics on spatial and temporal distribution, and an identification of the most important events. The paper also provides a table that includes the date and affected region of all the catastrophic events identified in the regions of study, in order to make this information available for all audiences.
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Claire Taylor. "Hérésie et inquisition dans le midi de la France (review)." Catholic Historical Review 96, no. 3 (2010): 519–21. http://dx.doi.org/10.1353/cat.0.0866.
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Heller, Sarah-Grace. "Mocking Medieval French Fashion." French Historical Studies 43, no. 2 (April 1, 2020): 145–66. http://dx.doi.org/10.1215/00161071-8018441.
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Abstract A debate poem (partimen PC 16,17) from the early thirteenth century richly demonstrates attitudes toward medieval French fashion, debating who was better, the “French” of France and England for their sumptuous apparel and generous feasts or the “Catalan” Occitan speakers for whom acquisition meant jovial pillage. Fashion appears as a preoccupation of the north, in contrast with southern poverty. Examined in context with political sirventes poems celebrating plunder, the Chanson de la croisade albigeoise (ca. 1210–12), which expresses pathos through clothing tropes, and the hyperbolic fair in Flamenca (ca. 1223), this study places these representations in the context of the military culture of Languedoc and Provence and its developing markets. This troubadour mockery of pretentious French display also expresses implicit envy and criticizes the damage the pillage ideal imposed on the fashion economy of the Midi. Un partimen (PC 16,17) du début du treizième siècle présente un aperçu très riche des attitudes à l'égard de la mode française médiévale, en mettant en débat la question suivante: qui étaient les meilleurs, les « Français » de France et d'Angleterre avec leurs somptueux habits et leurs fêtes généreuses, ou bien les « Catalans » (à savoir les Occitans situés de chaque côté des Pyrénées), qui acquéraient des objets en pillant plutôt qu'en les achetant ? A cette époque, la mode apparaît davantage comme une préoccupation en région septentrionale qu'en région méridionale, plus pauvre. En comparant des sirventes politiques célébrant le pillage et le pathos vestimentaire dans la Chanson de la croisade albigeoise (c. 1210–12) et la foire hyperbolique dans Flamenca (c. 1223), cette étude situe ces représentations dans le contexte des guerres et des industries textiles naissantes en Languedoc et en Provence. Le rire troubadour vis-à-vis de l'ostentation française trahit la convoitise des Occitans à l'égard des Français tout en critiquant aussi les dommages occasionnés par l'idéal de pillage sur l'économie de la mode dans le Midi.
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Berger, E., C. Delpierre, F. Despas, E. Bérard, P. Bories, A. Sarry, C. Recher, and S. Lamy. "La position sociale influence-t-elle le choix du traitement dans la leucémie aiguë myéloïde du sujet âgé ? Une étude longitudinale en Midi-Pyrénées (France)." Revue d'Épidémiologie et de Santé Publique 67 (February 2019): S55—S56. http://dx.doi.org/10.1016/j.respe.2018.12.036.
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Berger, E., C. Delpierre, F. Despas, E. Berard, P. Bories, A. Sarry, C. Recher, and S. Lamy. "La position sociale influence-t-elle le choix du traitement dans la leucémie aiguë myéloïde du sujet âgé ? Une étude longitudinale en Midi-Pyrénées (France)." Revue d'Épidémiologie et de Santé Publique 66 (May 2018): S188. http://dx.doi.org/10.1016/j.respe.2018.03.321.
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CLEMENT, F., and E. BASSECOULARD. "La recherche équine en France et dans le monde au travers d’une analyse bibliométrique." INRAE Productions Animales 17, no. 1 (March 20, 2004): 69–76. http://dx.doi.org/10.20870/productions-animales.2004.17.1.3554.
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Pour obtenir un panorama actuel de la recherche équine en France et dans le monde, une étude bibliométrique a été réalisée à partir des publications scientifiques concernant le cheval et recensées dans les bases CAB abstracts de CAB International et Current Contents de l’Institute for Scientific Information au cours des années 1998-2000. Après une structuration thématique combinant méthodes bibliométriques et avis d’experts, ces articles ont été ventilés en fonction des thématiques étudiées, des localisations des équipes signataires et du support de communication. Le fichier final comporte 6775 publications, pour deux tiers issues de journaux scientifiques, 31 % provenant de journaux de transfert et 6 % de comptes rendus de congrès.
Plus de la moitié des contributions traitent de pathologie. Viennent ensuite la locomotion et médecine sportive (17 %), la reproduction (11 %). La nutrition et la génétique se partagent 9 % des contributions. Les autres thématiques définies en sciences du vivant sont le comportement et bien-être, les espèces asines et les équidés sauvages, le dopage. Environ 4 % des notices relèvent des sciences humaines et sociales.
L’Amérique du Nord et l’Union Européenne constituent les deux principaux pôles de recherche mondiaux avec 40 et 36 % des articles chacun. La France occupe la 7ème place (3,4 % des articles scientifiques) derrière les USA, le Royaume-Uni (12,5 %), l’Allemagne (6,3 %), le Japon (4,3 %), le Canada (3,8 %) et l’Australie (3,8 %). La France remonte à la 4ème place si l’on si l’on considère l’ensemble des articles. Ceci illustre l’importance de la littérature de transfert ou de comptes rendus de colloques.
La France apparaît relativement spécialisée sur la reproduction, le dopage et les sciences humaines et sociales, avec en revanche un investissement relatif moindre sur le comportement et la pathologie. La région Ile de France est la première région française en matière de recherche équine, avec 37,5 % des articles. Les autres régions importantes sont les régions Centre, Rhône-Alpes, Pays de la Loire, Midi-Pyrénées et Basse-Normandie. Cette atomisation géographique des équipes explique qu’aucune ville française ne figure parmi les 25 villes leaders.
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Lamy, S., D. Ducros, C. Dimeglio, R. Fantin, E. Berger, P. Grosclaude, C. Delpierre, and B. Bouhanick. "Comprendre l’accès aux soins et à la prévention chez les patients diabétiques : une étude observationnelle des inégalités socio-spatiales en population sur l’ex-région Midi-Pyrénées, France." Revue d'Épidémiologie et de Santé Publique 65 (May 2017): S81—S82. http://dx.doi.org/10.1016/j.respe.2017.03.073.
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Dejoux, Jean-François, Gérard Dedieu, Olivier Hagolle, Danièle Ducrot, Jean-Claude Menaut, Eric Ceschia, Frédéric Baup, et al. "Kalideos OSR MiPy : un observatoire pour la recherche et la démonstration des applications de la télédétection à la gestion des territoires." Revue Française de Photogrammétrie et de Télédétection, no. 197 (April 22, 2014): 17–30. http://dx.doi.org/10.52638/rfpt.2012.79.
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Ces dernières années, le CESBIO a mis en place un Observatoire Spatial Régional (OSR), dispositif d'observation couplant mesures de terrain et télédétection dans le sud-ouest de la France. L'OSR se base sur des acquisitions mensuelles de données satellitaires à résolution décamétrique depuis 2002 et sur des sites expérimentaux lourdement instrumentés (mesures en continu de flux d'eau et de carbone) à partir de 2004. Ce dispositif a été reconnu service d'observation par l'INSU/CNRS en 2007 et site Kalideos par le CNES fin 2009 sous le nom de « OSR MiPy ». Le site atelier correspond à l'emprise d'une image Spot, soit environ 50 x 50 km, et couvre une grande diversité de milieux (pédologie, topographie), d'occupation et d'utilisation des sols, de pratiques et de modalités de gestion (agricole, forestière…) et de conditions climatiques (fort gradient de déficits hydriques estivaux).Pour la télédétection, ce site a servi la préparation de SMOS et soutient maintenant en priorité la préparation des missions VENµS et Sentinel-2. Les aspects radar, imagerie thermique et les approches multi-capteurs se développent depuis peu. Le traitement du signal, la physique de la mesure et l'amélioration de la qualité des données constituent le premier axe de recherche. Au niveau thématique, le CESBIO a pour priorité le suivi et la modélisation des agrosystèmes de grandes cultures. L'implication récente d'autres partenaires scientifiques ou de gestionnaires a permis d'initier des travaux sur d'autres aspects, comme la biodiversité, l'aménagement du territoire, le suivi de l'extension urbaine, les risques environnementaux, la santé des forêts, l'enfrichement, la diversité et la productivité des prairies. La valorisation des 10 années d'archives 2002-2011 débute et semble très pertinente pour la caractérisation en haute et en basse résolution des conséquences d'années climatiques atypiques (2003, 2011) sur les éco-agro-systèmes. L'extrapolationdes résultats obtenus sur ce site atelier à toute la région Midi-Pyrénées ou à la chaine des Pyrénées est aussi initiée.
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McClelland, John. "Montaigne and the Sports of Italy." Renaissance and Reformation 39, no. 2 (January 1, 2003): 41–51. http://dx.doi.org/10.33137/rr.v39i2.8867.
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De son propre aveu (Essais II, 17) Montaigne n’était pas très sportif. Pourtant, dès la première édition des Essais il y inséra de nombreuses allusions aux sports et de fréquentes métaphores tirées de pratiques athlétiques.De même, pendant son voyage en Allemagne, Suisse et Italie il assista — à une exception près — à toutes les manifestations sportives qui se présentèrent, préférant toutefois celles qui impliquaient la noblesse ou qui lui rappelaient la Rome ancienne. En France à l’époque il y avait très peu de possibilités de regarder des concours athlétiques, et encore moins de parler sport avec des gens de sa classe sociale et intellectuelle. En Italie, il a pu faire les deux, et se réjouissait d’être invité parmi des nobles florentins à discourir un après-midi sur l’escrime.
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Colineaux, Helene, Fanny Pelissier, Laure Pourcel, Thierry Lang, Michelle Kelly-Irving, Olivier Azema, Sandrine Charpentier, and Sebastien Lamy. "Why are people increasingly attending the emergency department? A study of the French healthcare system." Emergency Medicine Journal 36, no. 9 (July 16, 2019): 548–53. http://dx.doi.org/10.1136/emermed-2018-208333.
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ObjectiveIt is often asserted that the crowding phenomenon in emergency departments (ED) can be explained by an increase in visits considered as non-urgent. The aim of our study was to quantify the increase in ED visit rates and to determine whether this increase was explained by non-severe visit types.MethodsThis observational study covers all ED visits between 2002 and 2015 by adult inhabitants of the Midi-Pyrénées region in France. Their characteristics were collected from the emergency visit summaries. We modelled the visit rates per year using linear regression models, and an increase was considered significant when the 95% CIs did not include zero. The severity of the patients’ condition during ED visit was determined through the ‘Clinical Classification of Emergency’ score. Non-severe visits were those where the patient was stable, and the physician deemed no intervention necessary. Intermediate-severity visits concerned patients who were stable but requiring diagnostic or therapeutic procedures.ResultsThe 37 studied EDs managed >7 million visits between 2002 and 2015. There was an average increase of +4.83 (95% CI 4.33 to 5.32) visits per 1000 inhabitants each year. The increase in non-severe visit types was +0.88 (95% CI 0.42 to 1.34) per 1000 inhabitants, while the increase in intermediate-severity visit types was +3.26 (95% CI 2.62 to 3.91) per 1000 inhabitants. This increase affected all age groups and all sexes.DiscussionIt appears that the increase in ED use is not based on an increase in non-severe visit types, with a greater impact of intermediate-severity visit types requiring diagnostic or therapeutic procedures in ED.
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Higounenc, Catherine, and Jean-Marc Soulat. "Faire face à la pénurie de médecins du travail dans la fonction publique hospitalière : une initiative de l’Agence régionale de santé et de la Fédération hospitalière de France en région Languedoc-Roussillon–Midi-Pyrénées." Archives des Maladies Professionnelles et de l'Environnement 77, no. 3 (June 2016): 457. http://dx.doi.org/10.1016/j.admp.2016.03.232.
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Moulis, Guillaume, Manuela Rueter, Margaux Lafaurie, and Maryse Lapeyre-Mestre. "Eltrombopag for Immune Thrombocytopenia in Adult Patients in the Real-World in France. Final Results of the Elextra Study." Blood 136, Supplement 1 (November 5, 2020): 11–12. http://dx.doi.org/10.1182/blood-2020-139967.
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Introduction:Eltrombopag has been available in Europe for the treatment of chronic primary immune thrombocytopenia (ITP) since 2010. Since 2019, it has been indicated in patients with primary ITP, lasting 6 months or longer from diagnosis and who are refractory to other treatments, aged 1 year and above. However, data are lacking regarding the use, the efficacy and the safety of eltrombopag in clinical practice in Europe. The ELEXTRA study aimed to assess these questions in France. The intermediate results were presented at the 2019 ASH Annual Meeting. We present here the final results of the ELEXTRA study. Methods:Population source was the CARMEN-France registry. The CARMEN (Cytopénies Auto-immunes : Registre Midi-PyréneEN) registry is aimed at the prospective follow-up of all incident ITP adults in the French Midi-Pyrénées region (South-West of France, 3 million inhabitants) since June 2013. Each investigator follows all adult patients (aged ≥18 years) newly diagnosed with ITP in routine visits or hospital stays, and detailed information on patients' characteristics and management of ITP are prospectively recorded. This registry has been implemented in other French centers since 2016, taking the name of CARMEN-France. ITP was defined by platelet count <100 x 109/L and exclusion of other causes of thrombocytopenia. The study population consisted of all incident ITP adults included in the CARMEN-France registry from June 2013 to December 2019 who were exposed to eltrombopag during the disease course. We described the time from ITP diagnosis to first exposure to eltrombopag, and patients' characteristics. Efficacy was assessed in patients who had a platelet count <30 x 109/L at eltrombopag initiation. Overall response was defined by platelet count ≥30 x 109/L and complete response by platelet count ≥100 x 109/L. Adverse drug reactions (ADRs) that occurred during eltrombopag exposure were collected and assessed according to the World Health Organization causality assessment scale. All ADRs with causality score assessed at least as "possible"were described. Results:Out of 795 patients included in the registry, 156 (19.6%) had been exposed to eltrombopag for a median duration of 100 days (range: 1-1427). Mean age was 60.2 years (standard deviation: 20.9) and 79 (50.6%) were males; 60 (38.5%) had at least one comorbidity of the Charlson Comorbidity Index score; 89 (57.1%) had at least one cardiovascular risk factor (not including age and sex) and 9 (5.8%) a history of venous thrombosis. At ITP diagnosis, the median platelet count was 8 x 109/L (range: 1-88 x 109/L) and 118 (75.6%) patients had bleeding. Median time from ITP onset to first exposure to eltrombopag was 3.3 months (range: 0.1-82.2): 74 (47.4%) patients were exposed before 3 months of ITP duration, 21 (13.5%) between 3 and 6 months and 61 (39.1%) after 6 months. Exposures to ITP treatments before eltrombopag initiation were: corticosteroids in 150 (96.2%) patients, intravenous immunoglobulin (IVIg) in 106 (67.9%), dapsone in 28 (17.9%), rituximab in 26 (16.7%), romiplostim in 12 (7.7%), hydroxychloroquine in 14 (9.0%), danazol in 8 (5.1%), vinblastine in 5 (3.2%), azathioprine in 2 (1.3%), ciclosporin in 1 (0.6%) and splenectomy in none. Eltrombopag was used as second-line agent in 52 (33.3%) patients and third-line in 56 (35.9%). Among the 156 patients, 75 (48.1%) had a platelet count <30 x 109/L at eltrombopag initiation; among them, 65 (86.7%) achieved overall response and 53 (70.7%) complete response at any time during exposure to eltrombopag. Among the 65 patients who achieved overall response, 58 (89.2%) had a concomitant exposure to another ITP treatment at eltrombopag initiation (including steroids, n=42; IVIg during the past month, n=44; rituximab in the past 6 months, n=11). Overall, 47 ADRs were reported: the most frequent were: thrombocytosis (n=10), thrombosis (n=8: 6 pulmonary embolism, 1 deep and 1 superficial vein thrombosis), rash (n=4), hepatitis (n=3),and headache (n=3). Conclusion:In French real-world practice, eltrombopag is used early in the ITP course. Efficacy is similar to that observed in clinical trials. The safety profile identified in clinical trials is also confirmed. Disclosures Moulis: Grifols: Research Funding; Amgen: Other: meeting attendance grant; Novartis SAS: Membership on an entity's Board of Directors or advisory committees, Other: meeting attendance grant, Research Funding. OffLabel Disclosure: Real-World use of eltrombopag in immune thrombocytopenia
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Moulis, Guillaume, Manuela Rueter, Margaux Lafaurie, Maryse Lapeyre-Mestre, and Carmen investigators Group. "Eltrombopag for Immune Thrombocytopenia Adult Patients in the Real-Life Practice in France. Interim Results of the Elextra Study." Blood 134, Supplement_1 (November 13, 2019): 2372. http://dx.doi.org/10.1182/blood-2019-126000.
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Introduction: Eltrombopag has been marketed in Europe in 2010 for the treatment of chronic primary immune thrombocytopenia (ITP) lasting 12 months or longer from diagnosis, refractory to other treatments in splenectomized patients or patients who are contraindicated for splenectomy. Based on results of clinical trials, this marketing indication has been modified in 2019 for the treatment of patients aged 1 year and above with primary ITP lasting 6 months or longer from diagnosis and who are refractory to other treatments. However, data are lacking regarding the use, the efficacy and the safety of eltrombopag in the clinical practice in Europe. The ELEXTRA study was aimed at assessing these questions in France. Methods: Population source was the CARMEN-France registry. The CARMEN (Cytopénies Auto-immunes : Registre Midi-PyréneEN) registry is aimed at the prospective follow-up of all incident ITP adults in the French Midi-Pyrénées region (South-West of France, 3 million inhabitants) since June 2013. Each investigator follows all adult patients (aged ≥18 years) newly diagnosed for ITP in routine visit or hospital stay and detailed information on patients' characteristics and management of ITP are prospectively recorded. This registry has been implemented in other French centers since 2016, taking the name of CARMEN-France. ITP was defined by platelet count <100 x 109/L and exclusion of other causes of thrombocytopenia. Study population consisted in all incident ITP adults included in the CARMEN-France registry from June 2013 to December 2018 and exposed to eltrombopag during the disease course. We described the time of exposure to eltrombopag from ITP diagnosis and patients' characteristics. Efficacy was assessed in patients who had a platelet count <30 x 109/L at eltrombopag initiation. Overall response was defined by platelet count ≥30 x 109/L and complete response by platelet count ≥100 x 109/L. Adverse drug reactions (ADRs) that occurred during exposure to eltrombopag were collected and assessed using the World Health Organization causality assessment scale. All ADRs at least "possible" were described. Results: Out of 552 patients included in the registry, 81 (14.7%) had been exposed to eltrombopag for a median duration of 92 days (range: 1-1523). Mean age was 60.9 years (standard deviation: 20.9) and 45 (55.6%) were males; 36 (44.4%) had at least one comorbidity of the Charlson Comorbidity Index score; 45 (55.6%) had at least one cardiovascular risk factor (not including age and sex) and 4 (4.9%) a history of venous thrombosis. At ITP diagnosis, median platelet count was 7 x 109/L (range: 1-88 x 109/L) and 67 (82.7%) patients had bleeding. Median time from ITP onset to first exposure to eltrombopag was 2.7 months (range: 0.2-72.2): 43 (53.1%) patients were exposed before 3 months of ITP duration, 8 (9.9%) between 3 and 6 months, 18 (22.2%) between 6 and 12 months and 12 (14.8%) after 12 months. Exposures to ITP treatments before eltrombopag initiation were: corticosteroids in 75 (92.6%) patients, intravenous immunoglobulin (IVIg) in 61 (75.3%), dapsone in 15 (18.5%), rituximab in 14 (17.3%), romiplostim in 10 (12.3%), hydroxychloroquine in 9 (11.1%), danazol in 5 (6.2%), vinblastine in 3 (3.7%), azathioprine in 1 (1.2%), ciclosporin in 1 (1.2%) and splenectomy in none. Eltrombopag was used as second-line agent in 24 (28.6%) patients and third-line in 20 (24.7%). Among the 81 patients, 39 (48.1%) had a platelet count <30 x 109/L at eltrombopag initiation; 34 (87.2%) achieved overall response and 31 (79.5%) complete response. These response rates were stable across disease duration phases (<3 months, 3-6 months and >6 months), age groups (<60 vs. ≥60 years), Charlson Comorbidity Index score (0, 1-2 and ≥3). Among the 34 patients who achieved overall response, 29 (85.3%) had a concomitant exposure to ITP treatment at eltrombopag initiation (including steroids, n=12; IVIg during the past month, n=15; rituximab in the past 6 months, n=5). Overall, 17 ADRs were reported: the most frequent were: rash (n=3), thrombosis (n=3: 1 deep vein thrombosis, 1 pulmonary embolism and 1 ischemic stroke), thrombocytosis (n=2), hepatitis (n=2) and bronchitis (n=2). Conclusion: In the French real-life practice, eltrombopag is used early in ITP course. Efficacy is similar to efficacy in clinical trials, and is stable by subgroups of patients. The profile of ADRs identified in clinical trials is also confirmed. Introduction: Eltrombopag has been marketed in Europe in 2010 for the treatment of chronic primary immune thrombocytopenia (ITP) lasting 12 months or longer from diagnosis, refractory to other treatments in splenectomized patients or patients who are contraindicated for splenectomy. Based on results of clinical trials, this marketing indication has been modified in 2019 for the treatment of patients aged 1 year and above with primary ITP lasting 6 months or longer from diagnosis and who are refractory to other treatments. However, data are lacking regarding the use, the efficacy and the safety of eltrombopag in the clinical practice in Europe. The ELEXTRA study was aimed at assessing these questions in France. Methods: Population source was the CARMEN-France registry. The CARMEN (Cytopénies Auto-immunes : Registre Midi-PyréneEN) registry is aimed at the prospective follow-up of all incident ITP adults in the French Midi-Pyrénées region (South-West of France, 3 million inhabitants) since June 2013. Each investigator follows all adult patients (aged ≥18 years) newly diagnosed for ITP in routine visit or hospital stay and detailed information on patients' characteristics and management of ITP are prospectively recorded. This registry has been implemented in other French centers since 2016, taking the name of CARMEN-France. ITP was defined by platelet count <100 x 109/L and exclusion of other causes of thrombocytopenia. Study population consisted in all incident ITP adults included in the CARMEN-France registry from June 2013 to December 2018 and exposed to eltrombopag during the disease course. We described the time of exposure to eltrombopag from ITP diagnosis and patients' characteristics. Efficacy was assessed in patients who had a platelet count <30 x 109/L at eltrombopag initiation. Overall response was defined by platelet count ≥30 x 109/L and complete response by platelet count ≥100 x 109/L. Adverse drug reactions (ADRs) that occurred during exposure to eltrombopag were collected and assessed using the World Health Organization causality assessment scale. All ADRs at least "possible" were described. Results: Out of 552 patients included in the registry, 81 (14.7%) had been exposed to eltrombopag for a median duration of 92 days (range: 1-1523). Mean age was 60.9 years (standard deviation: 20.9) and 45 (55.6%) were males; 36 (44.4%) had at least one comorbidity of the Charlson Comorbidity Index score; 45 (55.6%) had at least one cardiovascular risk factor (not including age and sex) and 4 (4.9%) a history of venous thrombosis. At ITP diagnosis, median platelet count was 7 x 109/L (range: 1-88 x 109/L) and 67 (82.7%) patients had bleeding. Median time from ITP onset to first exposure to eltrombopag was 2.7 months (range: 0.2-72.2): 43 (53.1%) patients were exposed before 3 months of ITP duration, 8 (9.9%) between 3 and 6 months, 18 (22.2%) between 6 and 12 months and 12 (14.8%) after 12 months. Exposures to ITP treatments before eltrombopag initiation were: corticosteroids in 75 (92.6%) patients, intravenous immunoglobulin (IVIg) in 61 (75.3%), dapsone in 15 (18.5%), rituximab in 14 (17.3%), romiplostim in 10 (12.3%), hydroxychloroquine in 9 (11.1%), danazol in 5 (6.2%), vinblastine in 3 (3.7%), azathioprine in 1 (1.2%), ciclosporin in 1 (1.2%) and splenectomy in none. Eltrombopag was used as second-line agent in 24 (28.6%) patients and third-line in 20 (24.7%). Among the 81 patients, 39 (48.1%) had a platelet count <30 x 109/L at eltrombopag initiation; 34 (87.2%) achieved overall response and 31 (79.5%) complete response. These response rates were stable across disease duration phases (<3 months, 3-6 months and >6 months), age groups (<60 vs. ≥60 years), Charlson Comorbidity Index score (0, 1-2 and ≥3). Among the 34 patients who achieved overall response, 29 (85.3%) had a concomitant exposure to ITP treatment at eltrombopag initiation (including steroids, n=12; IVIg during the past month, n=15; rituximab in the past 6 months, n=5). Overall, 17 ADRs were reported: the most frequent were: rash (n=3), thrombosis (n=3: 1 deep vein thrombosis, 1 pulmonary embolism and 1 ischemic stroke), thrombocytosis (n=2), hepatitis (n=2) and bronchitis (n=2). Conclusion: In the French real-life practice, eltrombopag is used early in ITP course. Efficacy is similar to efficacy in clinical trials, and is stable by subgroups of patients. The profile of ADRs identified in clinical trials is also confirmed. Disclosures Moulis: Novartis pharma: Research Funding, Speakers Bureau; Amgen pharma: Research Funding, Speakers Bureau; CSL Behring: Research Funding. OffLabel Disclosure: Eltrombopag was used off-label in some patients in this real-life study
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Sokal, Aurélien, Thomas de Nadaï, Thibault Comont, Nicolas Limal, Marc Michel, Odile Beyne-Rauzy, Bertrand Godeau, et al. "Immune Thrombocytopenia in Very Elderly Patients: Particularities in Presentation and Management. Results from the Multicenter Prospective Carmen-France Registry." Blood 134, Supplement_1 (November 13, 2019): 1091. http://dx.doi.org/10.1182/blood-2019-126019.
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Introduction: The incidence of immune thrombocytopenia (ITP) is high in the elderly. Observational studies demonstrated that age above 65 years impacts ITP presentation and management. However, data are lacking in very elderly patients (VEP) with ITP. The aim of this study was to describe the presentation and the management of primary ITP that occurs in VEP (≥80 year-old) in comparison with elderly patients (EP; ≥65-79 year-old). Methods: Data source was the CARMEN-France registry. The CARMEN (Cytopénies Auto-immunes : Registre Midi-PyréneEN) registry is aimed at the prospective follow-up of all incident ITP adult patients in the French Midi-Pyrénées region (South-West of France, 3 million inhabitants) since June 2013. Each investigator follows all adult patients (aged ≥18 years) newly diagnosed for ITP in routine visit or hospital stay and detailed information on patients' characteristics and management of ITP are prospectively recorded. This registry has been implemented in the French referral center for ITP (Créteil) since October 2015, taking the name of CARMEN-France. Inclusion criteria in the present study were: inclusion in the CARMEN-France registry between June 2013 and December 2018; age ≥65 years at ITP onset; primary ITP defined by international criteria (platelets count <100 x 109/L and exclusion of other causes of thrombocytopenia) and with normal bone marrow examination. Patients were then categorized by age groups (VEP vs EP). We compared patients' characteristics, ITP presentation including bleeding by platelet counts, exposure to first and second-line treatments. We also assessed the factors associated to any and severe (hematuria, gastro-intestinal tract or intracranial) bleeding at ITP onset in the VEP group using logistic regression models. Results: Out of 541 patients included in the CARMEN-France registry, 184 fulfilled inclusion criteria: 87 in the VEP group and 97 in the EP group. Mean age was 85.7 years in the VEP group versus 71.8 in the EP group. Male:female sex-ratio was similar (63.2% vs. 60.8%). Patients in the VEP group had more frequently comorbidities of the Charlson's Index (67.4% versus 47.9%) and polypharmacy (≥4 drugs; 63.3% versus 45.4%); they were more frequently exposed to antiplatelet drugs (37.9% versus 23.7%) and to anticoagulant (18.4% versus 10.3%). Median platelet counts at ITP onset were similar (22.0 versus 18.0 x 109/L). The frequencies of any bleeding were similar (58.6% versus 54.6%) as well as mucosal bleeding (25.3% versus 26.8%), but severe bleeding was more frequent in the VEP group (10.3% versus 4.1%). The frequencies of any bleeding and mucosal bleeding were higher in case of platelet count <20 x 109/L in both groups. Severe bleeding occurred with platelet count <20 x 109/L in all EP cases (n=4) while they occurred at any platelet count in the VEP group. In the VEP group, 85.1% of the patients were treated for ITP, versus 80.4% in the EP group. Among treated patients, 36.5% in the VEP group had steroids alone and 60.3% steroids plus intravenous immunoglobulin (IVIg), in comparison with 50.0% and 48.7% in the EP group, respectively. Second-line treatment was prescribed in 39.1% of VEP versus 37.5% of EP: thrombopoietin receptor agonists (13.8% versus 13.4%), dapsone (8.1% versus 8.2%), rituximab (6.9% versus 6.2%), and danazol (6.9% versus 4.1%). In univariate analysis, the factors associated with any bleeding in the VEP group were: female sex (odds ratio - OR: 1.97; 95% confidence interval - CI: 0.79-4.93), polypharmacy (OR: 2.64; 95% CI: 1.08-6.48); infection within the six weeks before ITP onset (OR: 2.60; 95% CI: 0.66-10.4) and platelet count < 20 x 109/L (OR: 10.0; 95% CI: 3.49-28.63). In univariate analysis, the main factors associated with severe bleeding were exposure to anticoagulant (OR: 7.61; 95% CI: 1.77-32.83), polypharmacy (OR: 5.28; 95% CI: 0.63-44.30), a Charlson's Comorbidity Index score ≥1 (OR: 4.32; 95% CI: 0.51-36.38); the OR for a platelet count <20 x 109/L was 1.54 (95% CI: 0.38-6.16). Conclusion: VEP had more frequently severe bleeding at ITP onset. They were more frequently exposed to IVIg but did not require more frequently a second-line treatment. The pattern of second-line treatment was similar between VEP and EP. Platelet count <20 x 109/L was a major risk factor for any bleeding in VEP. In contrast, exposure to anticoagulant, and not platelet count <20 x 109/L, was highly associated with severe bleeding in VEP. Introduction: The incidence of immune thrombocytopenia (ITP) is high in the elderly. Observational studies demonstrated that age above 65 years impacts ITP presentation and management. However, data are lacking in very elderly patients (VEP) with ITP. The aim of this study was to describe the presentation and the management of primary ITP that occurs in VEP (≥80 year-old) in comparison with elderly patients (EP; ≥65-79 year-old). Methods: Data source was the CARMEN-France registry. The CARMEN (Cytopénies Auto-immunes : Registre Midi-PyréneEN) registry is aimed at the prospective follow-up of all incident ITP adult patients in the French Midi-Pyrénées region (South-West of France, 3 million inhabitants) since June 2013. Each investigator follows all adult patients (aged ³18 years) newly diagnosed for ITP in routine visit or hospital stay and detailed information on patients' characteristics and management of ITP are prospectively recorded. This registry has been implemented in the French referral center for ITP (Créteil) since October 2015, taking the name of CARMEN-France. Inclusion criteria in the present study were: inclusion in the CARMEN-France registry between June 2013 and December 2018; age ≥65 years at ITP onset; primary ITP defined by international criteria (platelets count <100 x 109/L and exclusion of other causes of thrombocytopenia) and with normal bone marrow examination. Patients were then categorized by age groups (VEP vs EP). We compared patients' characteristics, ITP presentation including bleeding by platelet counts, exposure to first and second-line treatments. We also assessed the factors associated to any and severe (hematuria, gastro-intestinal tract or intracranial) bleeding at ITP onset in the VEP group using logistic regression models. Results: Out of 541 patients included in the CARMEN-France registry, 184 fulfilled inclusion criteria: 87 in the VEP group and 97 in the EP group. Mean age was 85.7 years in the VEP group versus 71.8 in the EP group. Male:female sex-ratio was similar (63.2% vs. 60.8%). Patients in the VEP group had more frequently comorbidities of the Charlson's Index (67.4% versus 47.9%) and polypharmacy (³4 drugs; 63.3% versus 45.4%); they were more frequently exposed to antiplatelet drugs (37.9% versus 23.7%) and to anticoagulant (18.4% versus 10.3%). Median platelet counts at ITP onset were similar (22.0 versus 18.0 x 109/L). The frequencies of any bleeding were similar (58.6% versus 54.6%) as well as mucosal bleeding (25.3% versus 26.8%), but severe bleeding was more frequent in the VEP group (10.3% versus 4.1%). The frequencies of any bleeding and mucosal bleeding were higher in case of platelet count <20 x 109/L in both groups. Severe bleeding occurred with platelet count <20 x 109/L in all EP cases (n=4) while they occurred at any platelet count in the VEP group. In the VEP group, 85.1% of the patients were treated for ITP, versus 80.4% in the EP group. Among treated patients, 36.5% in the VEP group had steroids alone and 60.3% steroids plus intravenous immunoglobulin (IVIg), in comparison with 50.0% and 48.7% in the EP group, respectively. Second-line treatment was prescribed in 39.1% of VEP versus 37.5% of EP: thrombopoietin receptor agonists (13.8% versus 13.4%), dapsone (8.1% versus 8.2%), rituximab (6.9% versus 6.2%), and danazol (6.9% versus 4.1%). In univariate analysis, the factors associated with any bleeding in the VEP group were: female sex (odds ratio - OR: 1.97; 95% confidence interval - CI: 0.79-4.93), polypharmacy (OR: 2.64; 95% CI: 1.08-6.48); infection within the six weeks before ITP onset (OR: 2.60; 95% CI: 0.66-10.4) and platelet count < 20 x 109/L (OR: 10.0; 95% CI: 3.49-28.63). In univariate analysis, the main factors associated with severe bleeding were exposure to anticoagulant (OR: 7.61; 95% CI: 1.77-32.83), polypharmacy (OR: 5.28; 95% CI: 0.63-44.30), a Charlson's Comorbidity Index score ³1 (OR: 4.32; 95% CI: 0.51-36.38); the OR for a platelet count <20 x 109/L was 1.54 (95% CI: 0.38-6.16). Conclusion: VEP had more frequently severe bleeding at ITP onset. They were more frequently exposed to IVIg but did not require more frequently a second-line treatment. The pattern of second-line treatment was similar between VEP and EP. Platelet count <20 x 109/L was a major risk factor for any bleeding in VEP. In contrast, exposure to anticoagulant, and not platelet count <20 x 109/L, was highly associated with severe bleeding in VEP. Disclosures Comont: BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees. Michel:Rigel: Consultancy; Amgen: Consultancy; Novartis: Consultancy. Beyne-Rauzy:Cellgene: Research Funding; Novartis: Research Funding. Godeau:Amgen: Consultancy, Speakers Bureau; Novartis: Consultancy, Speakers Bureau. Moulis:Amgen pharma: Research Funding, Speakers Bureau; Novartis pharma: Research Funding, Speakers Bureau; CSL Behring: Research Funding.
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Moulis, Guillaume, Thibault Comont, Johanne Germain, Anaïs Essilini, Natacha Brun, Claire Dingremont, Brice Castel, et al. "Positivity Rates of Tests Used at Immune Thrombocytopenia Diagnosis to Detect Associated Diseases. a Prospective Multicenter Cohort Study of 218 Patients." Blood 128, no. 22 (December 2, 2016): 1367. http://dx.doi.org/10.1182/blood.v128.22.1367.1367.
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Abstract I ntroduction:The frequency ofimmune thrombocytopenia (ITP)-associated diseases detected at ITP onset is not well known. The positivity rates of tests performed at ITP onset in order to detect these diseases are discussed or unknown, leading to discrepancies among recommendations. The aim of this study was to compare the positivity rates of tests used at ITP diagnosis to detect ITP-associated diseases in the overall ITP population, in the presence of signs evocative of these diseases and in the absence of these signs. Methods:We studied all patients included between June 2013 and May 2016 in the CARMEN (CytopéniesAuto-immunes : Registre Midi-PyréneEN) registry. This multicenter registry is aimed at the prospective follow-up of all incident ITP adults in the French Midi-Pyrénées region (South of France, 3 million inhabitants). Each investigator prospectively follows every patient newly diagnosed for ITP in routine visit or hospital stay. ITP is defined in accordance with French guidelines: platelet count <150 x 109/L and exclusion of other causes of thrombocytopenia. Investigations performed at ITP diagnosis are recorded with their results. We assessed their positivity rates in the entire cohort and depending on the clinical and biological context. Patients with a cause of secondary ITP already known at ITP diagnosis were excluded for these calculations. Results:We included 218patients. Median age was 66 years (range: 18-96), 47.3% were female, 34 (15.8%) had a secondary ITP, 104 (48.2%) had bleeding signs, median platelet count was 18 x109/L (range: 1-135) and 144 (66.1%) were treated for ITP within the month following the diagnosis. Bone marrow examination was performed in 167patients. Fivemyelodysplastic syndromes (MDS) were found (3 refractory cytopenia with unilineage dysplasia and 2 with multilineage dysplasia). These 5 ITP patients had platelet count <15x 109/L and responded to corticosteroids. The positivity rate among patients with anemia or neutropenia was 6.6% (4/61 patients) and 0.9% in case of isolated thrombocytopenia (1/106). Among patients aged >60 years, these rates were 8.3% and 1.5%, respectively. Antinuclear antibodies (ANAs) were tested in 170 patients without known connective tissue disease and were positive (titer³1/160) in 73 (42.9%). The positivity rates were 40.0% incase of clinical signs of connective tissue disease and 41.8% otherwise. Antiphospholipid antibodies were positive in 7 patients (73 tested). The positivity rates were 11.1%in case of history of thrombosis or fetal loss and 9.4% in the absence of evocative context. The positivity rates ofdirectantiglobulintest (tested in 64 patients) were 30.4% in case of anemia or lowhaptoglobinlevel, and 7.3% otherwise. Serum protein electrophoresis was performed in 158 patients. None had a history of repeated or severe infections.Hypogammaglobulinemia(<5g/L) was detected in 1 patient over 76 with lymphopenia and in1 patient without lymphopenia. HCV, HBV and HIV were tested in respectively 143, 140 and 159 patients. No new infection was detected. Nine patients were tested for Helicobacter pylori infection and 3 were positive. One patient had symptoms evocative of gastritis and was positive for Helicobacter. Among the 7 patients without symptoms of gastritis, 2 were positive (28.6%). Thyroid stimulating hormone (TSH) was tested in 112 patients without history of thyroid dysfunction. The positivity rates were 50.0% in case of symptoms evocative of thyroid dysfunction and 7.3% otherwise. Conclusions: Except for ANAs (whose presence may lead to hydroxychloroquine prescription) andhypogammaglobulinemia, the positivity rates were at least three-fold higher in case of evocative context, discussing the systematic use of these tests. HIV, HCV and HBV infections revealed by ITP seem very rare in France. Disclosures Beyne-Rauzy: Celgene, Novartis: Honoraria.
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Mezaache, Salim, Hélène Derumeaux, Pierre Ferraro, Pascal Capdebon, Jean-Christophe Steinbach, Xavier Aballe, Deborah Palas, et al. "Validation of an Algorithm Identifying Incident Primary Immune Thrombocytopenia in the French National Health Insurance Database." Blood 128, no. 22 (December 2, 2016): 4764. http://dx.doi.org/10.1182/blood.v128.22.4764.4764.
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Abstract Introduction: Population-based studies using health insurance databases are very useful for epidemiological studies, notably for rare diseases such as immune thrombocytopenia (ITP). French health insurance databases, called SNIIRAM (Système d'Information Inter-Régimes de l'Assurance Maladie) cover the entire French population (66 million inhabitants).We developed an algorithm that identifies incident primary ITP cases in the SNIIRAM. The aim of this study was to evaluate the positive predictive value (PPV) of this algorithm. Methods: The SNIIRAM is an electronic database prospectively recording demographic, hospitalization, long term disabling disease (LTD) and out-hospital drugs dispensing as well as other healthcare data. The algorithm used to identify newly diagnosed primary ITP patients follows several steps: 1) extraction of patients with at least one ITP code (D69.3 code of the International Classification of Disease, version 10 -ICD-10) as primary diagnosis during a hospital stay or as LTD; 2) exclusion of patients with ambiguous or contradictory codes, i.e.other D69 ICD-10 codes as LTD or hospital diagnosis between 12 months before and 6 months after the first ITP code, except D69.6 (thrombocytopenia, unspecified) and D69.9 (hemorrhagic condition, unspecified); 3) refining of the presumed date of diagnosis searching ITP drug dispensing in the six-month period before the first ITP code. A six-month wash out period is used to define incident ITP; 4) lastly, secondary ITPs are defined by a LTD or a hospitalization with codes corresponding to hematological malignancies, chronic viral infections and connective tissue diseases between 12 months before and 6 months after the presumed date of diagnosis. For the present validation study, we applied this algorithm to regional SNIIRAM data of the Midi-Pyrénées region (South of France, 3 million inhabitants) to identify incident ITP patients between July 1, 2012 and June 30, 2014. Medical charts were independently reviewed by two investigators. We calculated the PPVs of: 1) the diagnosis of ITP; 2) the fact that ITP was incident or not (compared with the true date of diagnosis and the true date of first ITP symptoms); 3) the identification of secondary ITPs. Results: We identified 200 incident ITP patients in the Midi-Pyrénées regional SNIIRAM during the study period. We could assess by medical chart review 168 cases. At ITP diagnosis, 70.4% of the patients were adults (≥18 years). Median age was 2.8 years in children and 63.0 years in adults. The male:female sex-ratio was 0.83. Overall, 66.6% of the patients had bleeding symptoms. The median platelet count was 10 x 109/L. After medical chart review, 161 cases were true ITP yielding a PPV of 95.8% (95% confidence interval - 95% CI: 92.8-98.8). Among them, 128 were incident according to the date of symptom onset and 134 were incident according to the true diagnosis date yielding PPVs of 79.5% (95% CI: 73.2-85.7) and 83.2% (95% CI: 77.4-89.0), respectively. As expected, the PPV for newly diagnosed ITP was significantly lower in case of low platelet count as first symptom compared tobleeding revealing ITP (respectively, 65.4%, 95% CI: 52.5-78.3 and 92%, 95% CI 86.9-97.0, p=0.08). The median time from the date of first symptoms and the estimated date of ITP onset by the algorithm was 3 days (interquartile range - IQR: 0 to 20). The median time from the true date of diagnosis and the estimated date of ITP diagnosis by the algorithm was 0 days (IQR: 0 to 15). Ten patients were identified as having a secondary ITP using the algorithm: 4 lymphoid neoplasms (2 B-cell lymphoma, 1 Hodgkin lymphoma and 1 chronic lymphoid leukemia), 4 connective tissue diseases (sarcoidosis, rheumatoid arthritis, systemic sclerosis and Sjögren syndrome, 1 case each) and 2 chronic infections (HIV and HCV). There was no misclassification after medical chart review. On the contrary, 7 secondary ITPs identified by medical chart review were not detected by the algorithm: 3 CMV and 1 EBV infections, 1 Waldenström disease, 1 plasmocytoma and 1 myelodysplastic syndrome. Conclusions: This algorithm showed good PPV in identifying incident primary ITP patients and could be extended to other similar databases. The estimated date of ITP onset may be delayed in case of isolated chronic thrombocytopenia because platelet count results are not recorded in the database. The SNIIRAM is not a useful database to detect virus-associated secondary ITP. Disclosures No relevant conflicts of interest to declare.
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Hartmann-Virnich, Andreas. "Saint-Gilles-du-Gard (Gard). AEGIMAIOR. L’ancienne abbaye de Saint-Gilles-du-Gard. Archéologie et histoire monumentale d’un site monastique majeur du Midi de la France." Archéologie médiévale, no. 48 (December 20, 2018): 285–87. http://dx.doi.org/10.4000/archeomed.17282.
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Hartmann-Virnich, Andreas. "Saint-Gilles-du-Gard (Gard). AEGIMAIOR. L’ancienne abbaye de Saint-Gilles-du-Gard. Archéologie et histoire monumentale d’un site monastique majeur du Midi de la France." Archéologie médiévale, no. 47 (December 20, 2017): 220–22. http://dx.doi.org/10.4000/archeomed.7002.
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Lapeyre-Mestre, Maryse. "Long-term Consequences of Acute Pain for Patients under Methadone or Buprenorphine Maintenance Treatment." Pain Physician 6;16, no. 6;11 (November 14, 2013): E739—E747. http://dx.doi.org/10.36076/ppj.2013/16/e739.
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Background: Acute and chronic pains are reported to be highly prevalent in patients under opioid maintenance treatment (OMT). Lack of knowledge concerning the complex relationship between pain, opioid use, and their impact on OMT efficacy can account for the barriers encountered for pain management. Objectives: To assess the impact of acute pain exposure on long-term OMT retention in a cohort of patients under buprenorphine or methadone followed up during 12 months. Study Design: Prospective, multi-center observational cohort clinical study. Setting: Emergency departments, surgery departments, and specialized addiction care centers in an outpatient setting in south-western France (Midi-Pyrénées area), from April 2008 to January 2010. Methods: Patients aged 18 or more under OMT for at least 3 months, and followed up by a physician were recruited. Acute pain was assessed using the Visual Analog Scale (VAS) or the Verbal Rating Scale (VRS). Exposed patients were those with a pain score greater than 0 at the time of admission on any of the rating scales. The OMT rate after 12 months was compared among exposed and unexposed patients. OMT retention was also investigated after 3 and 6 months follow-up. Results: A total of 151 patients, 81 exposed and 70 unexposed, were recruited; among them, respectively, 26 (32%) and 34 (49%) completed 12-months follow-up. Acute pain exposure appeared to be significantly and negatively associated with retention in treatment (crude OR: 0.44; 95% CI [0.22 – 0.87]; adjusted OR: 0.46; 95% CI [0.23 – 0.93]). Compared to methadone users, patients under buprenorphine were less likely to have their OMT maintained after 12 months (OR 0.37; 95% CI [0.18 – 0.75]; adjusted OR 0.38; 95% CI [0.18 – 0.80]). Limitations: Follow-up rate was 40 % (60/151). Conclusion: This study demonstrates the strong negative impact of acute pain on OMT in a population mainly composed of patients under buprenorphine, as well as differential response depending on the OMT medication. The findings highlight the need to consider the characteristics of pain in the population under OMT and to develop evidence-based guidelines for pain management. Trial registration: The study was registered at www.clinical.trials.gov with the study identifier: NCT00738036. Ethics Committee approval was received on February 11, 2008. Participants’ written consent was not required. Key words: Analgesic drug, methadone, buprenorphine, opioid, opioid maintenance treatment, acute pain, long-term retention, pharmacodependence, pharmacoepidemiology
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Ponel, Philippe, G. Russell Coope, Valérie Andrieu-Ponel, and Maurice Reille. "Coleopteran evidence for a mosaic of environments at high altitude in the eastern Pyrénées, France, during the climatic transition between the Allerød and Younger Dryas." Journal of Quaternary Science 14, no. 2 (March 1999): 169–74. http://dx.doi.org/10.1002/(sici)1099-1417(199903)14:2<169::aid-jqs429>3.0.co;2-c.
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Hartmann-Virnich, Andreas. "Saint-Gilles-du-Gard (Gard). Projet collectif de recherche « AEGIMAIOR. L’ancienne abbaye de Saint-Gilles-du-Gard. Archéologie et histoire monumentale d’un site monastique majeur du Midi de la France »." Archéologie médiévale, no. 44 (December 1, 2014): 251. http://dx.doi.org/10.4000/archeomed.9266.
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