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Objective: the aim of this work was to develop a screening intervention targeting residents of Parisian immigrant hostels, and then to assess the results using a descriptive and quantitative study. Methods: the intervention was performed twice in two immigrant hostels located in the 13thdistrict of Paris between December 2015 and July 2016. The following tests were performed on each willing participant: rapid diagnostic tests for HIV and Hepatitis C and B, capillary glycemia and blood pressure measurement. Furthermore we have identified people over 50 requiring ascreening test for colorectal cancer. The results were announced by a doctor. In case of positive result the resident was adressed to a relevant local primary care structure and called back four weeks after. Results: 184 people have been tested (among them 28% didn’t have any social security). The screening results were : 14% of BHV+, 0 CHV+, 0 HIV+, 14% of hyperglycemia, 21% of high blood pressure. 84% of people over 50 had never done a colorectal cancer screening test. Moreover, 40% of the residents reported suffering from dental issues. We have been able to follow 74% of the oriented residents after four weeks. Among them, 62% had attended a medical consultation. Conclusion: apart from HIV and CHV, our screening rate was systematically higher than the rate found in the French population. This work is part of a new medical approach called “community oriented primary care” which focuses on groups excluded from the common health care system. It consisted in considering their needs, modifying the health care facilities in order to meet those needs and assess the impact of such an intervention.; Objectif : le but de notre travail était de concevoir un parcours de dépistage s’adressant aux résidents des foyers de travailleurs migrants puis d’en évaluer les résultats par une étude quantitative descriptive. Matériel et Méthode : deux foyers parisiens du 13ème arrondissement ont chacun bénéficié de deux interventions de dépistage entre décembre 2015 et juillet 2016. Il a été réalisé pour chaque résident des tests rapides VIH, VHB et VHC, une mesure de la glycémie capillaire et de la pression artérielle. De plus nous avons identifié les personnes de plus de 50 ans relevant du dépistage du cancer colorectal. Les résultats ont été annoncés par un médecin et les cas positifs ont été adressés aux structures de droit commun du quartier avant d’être recontactés au bout de quatre semaines. Résultat : 184 personnes ont été dépistées (28% d’entre elles n’avaient aucune couverture sociale). Le dépistage a révélé : 14% de VHB+, 0 VHC+, 0 VIH+, 14% d'hyperglycémies, 21% d'HTA. 84% des 50 personnes de plus de 50 ans n’avaient jamais réalisé le test de dépistage du CCR. D’autre part, 40% des résidents rapportaient un problème bucco-dentaire. 74% des résidents orientés ont pu être recontactés après quatre semaines. Parmi eux 62% avaient effectivement consulté. Conclusion : hors VIH et VHC, le taux de dépistage par pathologie était systématiquement supérieur à celui retrouvé dans la population française. Ce travail s'inscrit dans une démarche de "community oriented primary care" consistant à repérer à l’échelle locale les groupes exclus du système de santé usuel, à examiner leurs besoins, modifier l’offre de soins pour y répondre et évaluer l’impact des actions menées.

IF 4.258; International audience; Diabetes is characterized by increased lipogenesis as well as increased endoplasmic reticulum (ER) stress and inflammation. The nuclear hormone receptor liver X receptor (LXR) is induced by insulin and is a key regulator of lipid metabolism. It promotes lipogenesis and cholesterol efflux, but suppresses endoplasmic reticulum stress and inflammation. The goal of these studies was to dissect the effects of insulin on LXR action. We used antisense oligonucleotides to knock down Lxr alpha in mice with hepatocytespecific deletion of the insulin receptor and their controls. We found, surprisingly, that knock-out of the insulin receptor and knockdown of Lxr alpha produced equivalent, non-additive effects on the lipogenic genes. Thus, insulin was unable to induce the lipogenic genes in the absence of Lxr alpha, and LXR alpha was unable to induce the lipogenic genes in the absence of insulin. However, insulin was not required for LXR alpha to modulate the phospholipid profile, or to suppress genes in the ER stress or inflammation pathways. These data show that insulin is required specifically for the lipogenic effects of LXR alpha and that manipulation of the insulin signaling pathway could dissociate the beneficial effects of LXR on cholesterol efflux, inflammation, and ER stress from the negative effects on lipogenesis.