Background Whether genetic background and/or dietary behaviors influence weight gain in middle-aged subjects is debated. Objective To assess whether genetic background and/or dietary behaviors are associated with changes in obesity markers (BMI, weight, and waist and hip circumferences) in a Swiss population-based cohort. Methods Cross-sectional and prospective (follow-up of 5.3 y) study. Two obesity genetic risk scores (GRS) based on 31 or 68 single nucleotide polymorphisms were used. Dietary intake was assessed using a semiquantitative FFQ. Three dietary patterns “Meat & fries” (unhealthy), “Fruits & vegetables” (healthy), and “Fatty & sugary” (unhealthy), and 3 dietary scores (2 Mediterranean and the Alternative Healthy Eating Index [AHEI]) were computed. Results On cross-sectional analysis (N = 3033, 53.2% females, 58.4 ± 10.6 y), obesity markers were positively associated with unhealthy dietary patterns and GRS, and negatively associated with healthy dietary scores and patterns. On prospective analysis (N = 2542, 54.7% females, age at baseline 58.0 ± 10.4 y), the AHEI and the “Fruits & vegetables” pattern were negatively associated with waist circumference gain: multivariate-adjusted average ± SE 0.96 ± 0.25 compared with 0.11 ± 0.26 cm (P for trend 0.044), and 1.14 ± 0.26 compared with –0.05 ± 0.26 cm (P for trend 0.042) for the first and fourth quartiles of the AHEI and the “Fruits & vegetables” pattern, respectively. Similar inverse associations were obtained for changes in waist >5 cm: multivariate-adjusted OR (95% CI): 0.65 (0.50, 0.85) and 0.67 (0.51, 0.89) for the fourth versus the first quartile of the AHEI and the “Fruits & vegetables” dietary pattern, respectively. No associations were found between GRS and changes in obesity markers, and no significant gene-diet interactions were found. Conclusion Dietary intake, not GRS, are associated with waist circumference in middle-aged subjects living in Lausanne, Switzerland.

Troubles neurocognitifs chez les personnes âgées avec maladie oncologiqueLes chimiothérapies peuvent induire une dysfonction cognitive transitoire ou permanente, pouvant aller d'une plainte cognitive subjective à une atteinte réelle de la mémoire de travail, de l'attention ou du langage. L'interaction entre l'atteinte cognitive attribuée à ces thérapies et celle liée à l'âge est une question grandissante compte tenu du vieillissement de la population. Elle justifie une attention particulière à la détection précoce de troubles cognitifs afin d'en réduire l'impact négatif sur la qualité de vie et optimiser la prise en charge médicale. Dans cet article, nous abordons le concept de « chemobrain », et en revoyons les connaissances actuelles de physiopathologie, de neuro-imagerie ainsi que les phénotypes neuropsychologiques, afin de proposer quelques outils de détection et de prise en charge au cabinet. Cancer-related cognitive impairment in older adultsChemotherapy is associated with transient or permanent cognitive dysfunction ranging from subjective complaints to measurable deficits in working memory, attention and language. Given that old age may be related to cognitive decline, the interaction between chemotherapy-induced cognitive impairment and the effects of age is of growing concern in view of our aging population. Chemotherapy-associated cognitive dysfunction may have an additive impact on pre-existing age-related cognitive performance decline, which calls for awareness in its detection, to reduce impact on quality of life and improve management of older patients. We discuss here the « chemobrain », concept, review the existing evidence about pathophysiology, neuroimaging and cognitive phenotype and propose practical tools for routine detection in the outpatient setting.Vu l'hétérogénéité des études sur lesquelles les connaissances actuelles se basent, l'importance des facteurs confondants Dre LAÏLA BARATALI a,b , Dr KRISTOF MAJOR a,b , Dr OLIVIER ROUAUD b et Pr BOGDAN DRAGANSKI b,c,d

La psychothérapie diminue les rechutes de dépression lors de la réduction ou de l'arrêt des antidépresseurs. En cas d'infection respiratoire communautaire, l'antibiothérapie retardée est efficace et sûre. La réadaptation physique après une décompensation cardiaque aiguë est utile chez les patients fragiles. Un sommeil de 6 heures semble être associé à un risque plus élevé de démence chez les personnes de 50 à 70 ans. Les patients modifient le recours aux soins de santé après la cessation d'activité de leur médecin référent. La recherche de fibrillation auriculaire chez les patients de 65 ans ou plus en bonne santé n'est pas bénéfique. Les compétences médicales de lecture d'ECG diminuent en l'absence de formation régulière. Les patients hospitalisés pour un Covid-19 sont souvent impactés aux niveaux clinique, psychologique et économique. scientific breakthroughs in ambulatory general internal medicinePsychotherapy diminishes depression relapses when antidepressants are reduced or stopped. Delayed antibiotic therapy is effective and safe while treating community-acquired respiratory infection. Physical rehabilitation after hospitalization due to acute cardiac decompensation is useful in frail patients. Six hours of sleep appears to be associated with a higher risk of dementia in people aged 50-70 years. Patients modify healthcare use after losing their referring physician. Screening for atrial fibrillation in healthy patients aged 65 or older is not beneficial. Physicians' ECG reading skills decrease in the absence of regular training. Patients hospitalized with COVID-19 are often clinically, psychologically, and economically impacted.

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