Thibaut Markarian

Background: Emotional eating is considered as a mediator between depression and obesity. Combining mindfulness and sport activities can improve obesity-related psychological disorders but inconsistencies in effect and duration have been reported. We aimed to evaluate the effects of a combined mindfulness-diving Bathysmed® program on emotional eating scores in participants with obesity. Methods: This unblinded randomized controlled trial was performed in the community setting, Montpellier, France. Adults with a BMI > 30 kg/m2 were randomly assigned (1:1) to a Bathysmed® 2-month program (intervention group) therapeutic scuba-diving protocol with mindfulness exercises plus standard care, or stand-alone standard care including dietary and psychological support (control group). The primary outcome was the mean change in the emotional eating subscale of the Dutch Eating Behaviour Questionnaire (DEBQ-EE) at 2-months as intention to treat. Findings: Between July-August 2022, 63 participants were randomised, with 31 in the intervention group. One participant from each group were excluded. Fifty-five (87·3%) were female, median age 46 [35.5;54] and BMI 35.46 [33.45;39.48]. There was a statistically significant reduction of DEBQ-EE at 2 months in the intervention group (−0·82 (SD 0·81)) versus control group (−0·27 (SD 0·61) p = 0·004). This effect was maintained at 5 and 8-month follow up. There was a significant reduction in weight self-stigma, stress, and quality of life change scores in the intervention group. Interpretation: This combined diving and mindfulness program effectively reduces emotional eating, self-stigma and quality of life scores in participants with obesity, with sustained benefits. Health policies should integrate physical activity and psychological therapies for obesity management. Trial registration: Clinicaltrials NCT06882200 .

Introduction: Right diaphragmatic excursion is a reliable and reproducible technique used in intensive care to assess diaphragmatic function. The aim of this study was to investigate the relationship between the appearance of diaphragmatic motion and the etiological diagnosis of patients admitted to the emergency department with acute respiratory failure (ARF).Materials: A prospective, observational, and multicenter pilot study was conducted. All adult patients admitted in the emergency department with ARF were included. The different visual patterns of diaphragmatic motion were analyzed according to the three main etiologies of ARF encountered in emergency departments.Results: A total of 39 adult patients were included. We observed a different visual pattern in patients with pneumonia. A sum of plateau times of less than 0.2 s predicted that the main diagnosis was pneumonia, with sensitivity = 89% 95%CI [52%; 100%], specificity = 87% 95%CI [69%; 96%].Conclusion: Our study seems to show that the shape of diaphragmatic motion in patients with ARF secondary to pneumonia is different from that in patients with exacerbation of chronic obstructive pulmonary disease or acute heart failure. Trial Registration: ClinicalTrials.gov: NCT04591509

Introduction: Assessment of left ventricular ejection fraction (LVEF) is one of the primary objectives of echocardiography. The gold standard assessment technique in emergency medicine is eyeballing. A new tool is now available on pocket ultrasound devices (PUD): automatic LVEF. The primary aim of this study was to evaluate the concordance between LVEF values estimated by automatic LVEF with PUD and by cardiac magnetic resonance imaging (MRI). Materials: This was a prospective, monocentric, and observational study. All adult patients with an indication for cardiac MRI underwent a point-of-care ultrasound. Blinded to the MRI results, the emergency physician assessed LVEF using the automatic PUD tool and by visual evaluation. Results: Sixty patients were included and analyzed. Visual estimation of LVEF was feasible for all patients and automatic evaluation for 52 (87%) patients. Lin’s concordance correlation coefficient between automatic ejection fraction with PUD and by cardiac MRI was 0.23 (95% CI, 0.03–0.40). Conclusion: Concordance between LVEF estimated by the automatic ejection fraction with PUD and LVEF estimated by MRI was non-existent.

Les Annales françaises de médecine d’urgence, organe officiel de la Société française de médecine d’urgence, s’adressent à tous les professionnels de l’urgence

Background: Cardiac output (CO) monitoring is recommended in patients with shock. The search for a reliable, rapid, and noninvasive tool is necessary for clinical practice. A new echocardiographic CO flow index (COF) is the automatic calculation of the sub-aortic VTI multiplied by the automatic calculation of the heart rate (HR). The primary objective of this study was to show the correlation between COF and CO measured by thermodilution (COth) in a controlled hemorrhagic shock model in anesthetized piglets. Secondary objectives were to show the correlation between COth and CO calculated from left outflow tract (LVOT) measurement and manual VTI (COman), and CO measured by LVOT measurement and VTIauto (COauto). Methods: Prospective interventional experimental study. In seventeen ventilated and anesthetized piglets, a state of hemorrhagic shock was induced, maintained, then resuscitated and stabilized. The gold standard for CO and stroke volume measurement was thermodilution (COth). Results: 191 measurements were performed. The correlation coefficients (r) between COth and COF, COman, and COauto were 0.73 [0.62; 0.81], 0.66 [0.56; 0.74], and 0.73 [0.63; 0.81], respectively. Conclusions: In this study, the COF appears to have a strong correlation to the COth. This automatic index, which takes into account the HR and does not require the measurement of LVOT, could be a rapidly obtained index in clinical practice.

Blood cell analysis is a major pillar of biomedical research and healthcare. These analyses are performed in central laboratories. Rapid shipment from collection site to the central laboratories is currently needed because cells and biomarkers degrade rapidly. The dried blood spot from a fingerstick allows the preservation of cellular molecules for months but entire cells are never recovered. Here leucocyte elution is optimized from dried blood spots. Flow cytometry and mRNA expression profiling are used to analyze the recovered cells. 50–70% of the leucocytes that are dried on a polyester solid support via elution after shaking the support with buffer are recovered. While red blood cells lyse upon drying, it is found that the majority of leucocytes are preserved. Leucocytes have an altered structure that is improved by adding fixative in the elution buffer. Leucocytes are permeabilized, allowing an easy staining of all cellular compartments. Common immunophenotyping and mRNAs are preserved. The ability of a new biomarker (CD169) to discriminate between patients with and without Severe Acute Respiratory Syndrome induced by Coronavirus 2 (SARS‐CoV‐2) infections is also preserved. Leucocytes from blood can be dried, shipped, and/or stored for at least 1 month, then recovered for a wide variety of analyses, potentially facilitating biomedical applications worldwide.