Few studies have focused on food allergies in the elderly, even though it may persist or appear de novo. We reviewed data for all cases of food-induced anaphylaxis in people age ≥ 60 reported to the French "Allergy Vigilance Network" (RAV) between 2002 and 2021. RAV collates data reported by French-speaking allergists regarding cases of anaphylaxis graded II to IV according to the Ring and Messmer classification. In total, 191 cases were reported, with an even sex distribution and mean age was 67.4 years (range 60 to 93). The most frequent allergens were mammalian meat and offal (31 cases, 16.2%), often associated with IgE to α-Gal. Legumes were reported in 26 cases (13.6%), fruits and vegetables in 25 cases (13.1%), shellfish 25 cases (13.1%), nuts 20 cases (10.5%), cereals 18 cases (9.4%), seeds 10 cases (5.2%), fish 8 cases (4.2%) and anisakis 8 cases (4.2%). Severity was grade II in 86 cases (45%), grade III in 98 cases (52%) and grade IV in 6 cases (3%) with one death. Most episodes occurred at home or in a restaurant and in most cases adrenaline was not used to treat the acute episode. Potentially relevant cofactors such as beta-blocker, alcohol or non-steroidal anti-inflammatory drug intake were present in 61% of cases. Chronic cardiomyopathy, present in 11.5% of the population, was associated with greater, grade III or IV reaction severity (OR 3.4; 1.24-10.95). Anaphylaxis in the elderly has different causes to younger people and requires detailed diagnostic testing and individualized care plans.

Le recours à l'hormonothérapie, ou suppression androgénique (SA), a augmenté au cours du temps dans le traitement du cancer de la prostate (CaP). La SA s'accompagne de modifications dont certaines seraient responsables d'une augmentation du risque cardio-vasculaire (CV). Le but de cette étude était d'évaluer la prévalence des risques cardiovasculaires et la qualité de vie des patients après l'initiation de dégarélix, antagoniste de la GnRH chez des patients atteints d'un CaP hormono-dépendant avancé. L'étude observationnelle DUO, PASS, pharmaco-épidémiologique, longitudinale, multicentrique a été proposée pour recruter une cohorte prospective, afin de décrire la prévalence des comorbidités cardiovasculaires en vie réelle chez des patients atteints d'un CaP, durant les six premiers mois d'un traitement par dégarélix. L'étude a été conduite en France de juin 2017 à Mars 2019 dans 46 centres d'urologie. La prévalence des risques ostéoporotiques, métaboliques, dépressifs, sexuels et gériatriques a aussi été évaluée grâce aux outils et questionnaires recommandés par le comité de cancérologie de l'AFU. La qualité de vie a été mesurée grâce au questionnaire EQ-5D. L'évolution de la pathologie (taux de PSA) et la tolérance du traitement ont également été rapportés. Au total 124 patients, ayant d'un CaP hormono-dépendant avancé (dont 26,6 % à un stade métastatique), et bénéficiant d'une première prescription de dégarélix ont été inclus consécutivement et évalués à l'inclusion (J0) et à 6±1 mois (M6). A J0, 57,7 % des patients avaient une comorbidité CV. Les patients avaient également des comorbidités métaboliques dans 60,6 %, une altération de la trame osseuse dans 34 %, des troubles sexuels dans 58 %, et des troubles de l'humeur dans 36 % ; 45,6 % des patients âgés ≥70 ans avaient un score ONCO-G8 ≤ 14. A M6, la proportion de patients avec comorbidités CV est restée stable (56,7 %). Les taux des altérations métaboliques, sexuelles, ou liées à un état dépressif sont aussi restés stables. De même, la qualité de vie est restée stable entre J0 et M6 (scores: 0,765 et 0,813 respectivement). Parallèlement, le taux médian du PSA a diminué de - 98.4 % par rapport à J0 (p<0,001). 42 évènements indésirables (EI) ont été rapportés chez 22 patients: 4,4% (5 patients) ont eu un EI relié à dégarélix. Les résultats de l'étude DUO ne montrent pas d'augmentation significative des comorbidités cardio-vasculaires pendant les 6 premiers mois de traitement. L'antagoniste de la GnRH était bien toléré chez les patients pour lesquels il avait été prescrit sans retentissement majeur sur la qualité de vie. Les recommandations du CCAFU étaient suivies par la majorité des confrères. L'évaluation des différentes comorbidités à l'initiation et au cours du traitement par suppression androgénique reste primordiale pour une prise en charge transversale et optimale des patients. Les auteurs n'ont pas précisé leurs éventuels liens d'intérêts.

62 Background: The use of androgen deprivation therapy (ADT), has increased over time in the treatment of prostate cancer (PCa). ATD is accompanied by side effects, some of which may increase the cardiovascular (CV) risk. The aim of this study was to evaluate the prevalence of cardiovascular risks and quality of life at the initiation of degarelix, a GnRH antagonist, and 6 months later, in patients with advanced hormone-sensitive PCa. Methods: The DUO study is a PASS, pharmaco-epidemiologic, longitudinal, multicenter observational study. It prospectively enrolled PCa patients during the first 6 months of treatment with degarelix. cohort to describe the prevalence of real-life cardiovascular co-morbidities in. The study was carried out in 46 French urology centers. At D0 and M6, the prevalence of CV, osteoporotic, metabolic, mood disorder, geriatric and sexual morbidity and risk factors were recorded using validated tools and questionnaires. EQ-5D questionnaire measured quality of life. The evolution of the disease (PSA levels) and the tolerance of the treatments were also reported. Results: A total of 124 patients with advanced hormone-dependent PCa (of whom 26.6% were metastatic) were included. At D0 57.7% of patients had a CV morbidity and CV risk factors. Metabolic co-morbidities were also present in 60.6% of patients, osteoporotic risk factors in 34%, sexual disorders in 58%, and mood disorders in 36%. ONCO-G8 score ≤ 14 was observed in 45.6% of patients aged ≥ 70 years. The percentage of patients with CV co-morbidities remained stable (56.7%). The rates of osteoporotic, metabolic, sexual, and mood-related morbidity and risk factors also remained unaltered. Likewise, quality of life remained stable between D0 and M6 (Scores: 0.765 and 0.813 respectively). At the same time, the median PSA rate decreased by -98.4% from D0 (p &lt; 0.001). 42 adverse events (AEs) were reported in 22 patients: degarelix-related AEs were reported in 4.4% of patients. Conclusions: The results of the DUO study showed high prevalence of CV co-morbidity and risk factors in patients with advanced PCa. It also showed no significant increase in CV co-morbidities and risk-factors during the first 6 months of treatment with degarelix as it was observed for osteoporotic, metabolic, sexual, and mood-related disorders. The GnRH antagonist was well tolerated without major impact on quality of life. Assessment of multiple co-morbidities at the initiation and during ADT is mandatory for the optimal management of patients.

Background: Accuracy of continuous subcutaneous insulin infusion (CSII) is essential for glycaemic control. Our study presents results of accuracy assessment of three off-the-shelves CSII under fluctuating temperature at 0,5UI/h. Methods: CSII systems accuracy was assessed by a double measurement approach utilizing a direct mass flow meter and a time-stamped micro-gravimetric test bench combined with a Kalman mathematical filter. CSII was placed inside a chamber of fluctuating temperature: 8h-tests were composed of successions of 1h at 32°C, 1h at 5°C, and compared to 8-hour tests at a 22°C fixed temperature. Accuracy was evaluated using mean of dose error. Mean absolute relative dispersion (MARD) of error was also computed for 15min time-windows. Stroke regularity was assessed in terms of frequency and volume. Tests were conducted both with insulin and medical water. Results: Delivery errors follow temperature profile. MARD of error is significantly higher with fluctuating temperature (85.2%, 44.4%, 20.4% according to each of the 3 CSII pump models) vs. fixed temperature (13.3%, 9.5%, 12.7%). No difference was observed between insulin and medical water. Stroke volume is affected by temperature changes rather than stroke frequency. Conclusion: Temperature and its fluctuations may affect the accuracy and amounts of insulin delivered by CSII. The clinical impact of the difference in insulin intake requires clinical investigations. Disclosure S. Girardot: Employee; Self; Air Liquide. Employee; Spouse/Partner; Air Liquide. P. Jacquemier: Employee; Self; Air Liquide. F. Mousin: Employee; Self; Air Liquide. C. Rendekeu: Employee; Self; Air Liquide. S. Hardy: None. J. Riveline: None.

Understanding how small molecules cross cell membranes is crucial to pharmaceutics. Several methods have been developed to evaluate such a process, but they need improvement since many false-positive candidates are often selected. Robust tools enabling rapid and reproducible screening can increase confidence on hits, and artificial membranes based on droplet interface bilayers (DIBs) offer this possibility. DIBs consist in the adhesion of two phospholipid-covered water-in-oil droplets which reproduce a bilayer. By having donor and acceptor droplets, the permeability of an analyte can be studied. However, the relevance of this system relies on the comprehension of how well the physical chemistry of the produced bilayer recapitulates the behavior of cell membranes. This information is missing, and we address it here. Taking small fluorophores as model analytes, we studied their permeation through DIBs made of a wide range of phospholipids. We found that both the phospholipid acyl chain and polar head affect permeability. Overall, these parameters impact the phospholipid shape and thereupon the membrane lateral pressure, which is a major factor modulating with permeability in our system. These results depend on the nature of the chosen oil. We thereupon identified relevant physical chemistry conditions that best mimic the compactness and subsequent permeability of biological membranes.

Aim of the studyOur goal was to evaluate the impact of progression type (prostate-specific antigen [PSA] only, radiological or clinical) at initiation of first-, second- and third life-extending therapy (LET) on treatment outcomes in metastatic castration-resistant prostate cancer (mCRPC) patients, by performing a post-hoc analysis using data from the CATS international registry. MethodsThe 669 consecutive mCRPC patients of the CATS registry were classified according to their type of progression at initiation of each LET: PSA only (PSA-p), radiological (±PSA) (Radio-p); or clinical (±PSA, ±radiological) progression (Clin-p). Overall survival (OS), the primary endpoint, was calculated from initiation of the first-, second- and third-LET to death for each sequence. ResultsMedian OS was shorter in the Clin-p group compared with the PSA-p group (14-month difference in first line; around 7-month difference in second- and third line). Shorter progression-free survival (PFS) was also observed in Clin-p patients, whatever the treatment is. Clinical progression seemed to be associated with a shorter duration of therapy with androgen receptor-targeted therapy (ART) compared with taxanes. ConclusionsClinical progression at initiation of a LET is associated with poor outcomes including shorter PFS and OS as well as clinical and biological features of aggressive disease. Stratifying patients in clinical trials according to disease progression type may prevent selection bias and data heterogeneity. In daily practice, first signs of clinical progression may prompt physicians to consider starting a new LET, independently of PSA levels.

Introduction: Insulin pump is nowadays one of the trendiest treatment for type 1 diabetes and is about to become one artificial pancreas (AP) major component. Insulin pump accuracy and performances are essentials and have not been so much studied so far, especially for smallest basal rate used for pediatric treatment and gold-standard assessment method also appears limited. Method: A leading edge assessment method based on a double measurement - direct mass flow meter and a time-stamped micro-gravimetric bench test - combined with a Kalman bayesian-based mathematical filter has been elaborated here and is proven to measure insulin pump delivering accuracy at the lowest limit of flow rate with a much better accuracy compared with previous methods. Its advantages and performances are illustrated while assessing the delivery precision of an already-marketed insulin pump at several flow rate. Mean absolute relative dispersion (MARD) is used to indicate overall errors for each 15-minutes error dose of a 8-hours experiments. Results: The new proposed methodology offers a double reading - volume and flow rate - within a much more timewise precise measurement (0.03Hz to 10Hz): direct instantaneous basal rate is displayed for the first time. Measurement accuracy is also considerably improved: pediatric basal rate is read with a 1.2%error instead of 15.3% error before. Accuracy is shown to be different regarding the flowrate value:Pump#1(2UI/h): MARD = 12.7%, Pump#1(0.5UI/h): MARD = 20.4%Pump#1(0.1UI/h): MARD = 65.7% Conclusion: This innovative method to assess insulin pump administration highlights an imprecision of insulin delivery, especially for lowest basal rate as used in pediatric. Error identification might increase clinical impact and feed AP control algorithm while anticipating delivering errors. Disclosure S. Girardot: Employee; Self; Air Liquide. F. Mousin: Employee; Self; Air Liquide. S. Hardy: Employee; Self; Air Liquide. J. Riveline: Board Member; Self; Abbott, Lilly Diabetes, Novo Nordisk Inc. Consultant; Self; Novo Nordisk Inc. Research Support; Self; Air Liquide, Amgen Inc. Speaker's Bureau; Self; Abbott, Lilly Diabetes, Sanofi.

Ontology alignment plays a key role in achieving interoperability on the semantic Web. Inspired by the success of word embedding techniques in several NLP tasks, we propose a new ontology alignment approach based on the combination of word embedding and the radius measure. We tested our system on the OAEI (http://oaei.ontologymatching.org/) conference track and then applied it to aligning ontologies in a real-world case study. The experimental results show that using word embedding and the radius measure make it possible to determine, with good accuracy, not only equivalence relations, but also hierarchical relations between concepts.