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International audience; Cognitive abilities were studied in rainbow trout, the first continental fish production in Europe. Increasing public concern for the welfare of farmed-fish species highlighted the need for better knowledge of the cognitive status of fish. We trained and tested 15 rainbow trout with an operant conditioning device composed of self-feeders positioned in front of visual stimuli displayed on a screen. The device was coupled with a two-alternative forced-choice (2-AFC) paradigm to test whether rainbow trout can discriminate 2-D photographs of conspecifics (S+) from different visual stimuli (S-). The S- were applied in four stages, the last three stages representing increasing discrimination difficulty: (1) blue shapes; (2) black shape (star); (3) photograph of an object (among a pool of 60); (4) photograph of another fish species (among a pool of 60). Nine fish (out of 15) correctly managed to activate the conditioning device after 30–150 trials. The rainbow trout were able to discriminate images of conspecifics from an abstract shape (five individuals out of five) or objects (four out of five) but not from other fish species. Their ability to learn the category "fish shape" rather than distinguishing between conspecifics and heterospecifics is discussed. The successful visual discrimination task using this complex operant conditioning device is particularly remarkable and novel for this farmed-fish species, and could be exploited to develop cognitive enrichments in future farming systems. This device can also be added to the existing repertoire of testing devices suitable for investigating cognitive abilities in fish.

International audience; For many fish species, environmental colour may act either as a source of stress or as a stress-buffer, alleviating behavioural and physiological responses after a stressful situation. While much is known on the effects of environmental colour on fish stress parameters, knowledge on the effects of stress on fish colour preferences is still lacking. In order to test the effects of stress on colour preference in fish, in this work, we exposed rainbow trout embryos (Oncorhynchus mykiss) to stressful conditions (air exposure, pheromone alarm cue or control, with minimal stress) from 19 to 44 days post fertilization (dpf). They were then raised up to 56 dpf in bright, dark, green or blue environments. After that, fry were individually tested for colour preference in a three-chambered arena where they could choose between green and blue areas. The time spent in the blue and in the green chamber was compared between experimental groups. Rainbow trout fry exposed to minimal stress (control) or to biotic stress (pheromone alarm) showed increased time in the blue environment, with little effect of ambient colour where they were raised. However, fish that experienced air exposure stress showed a lack of colour preference irrespective of the colour they were raised in afterwards. These results imply that early life stress affects colour preference in rainbow trout, suggesting that abiotic stressors, such as air exposure, may affect colour perception or behavioural plasticity in young fish. If the results presented herein are corroborated by future studies in fish at different life stages, beyond the embryonic phase, colour preference tests may be used as an additional and potential welfare indicator to estimate, in a retrospective manner, which stressors were faced by the individuals during early stages. By knowing whether or not their fish were exposed to certain stressful conditions may allow farmers to better adapt fish rearing conditions and to implement strategies that alleviate any long-term impacts that may exist, and, therefore, improve fish welfare.

Background Voice disorders are frequent after thyroidectomy. We report the long-term voice quality outcomes after thyroidectomy using the voice handicap index self-questionnaire. Methods Eight hundred patients who underwent total thyroidectomy between 2014 and 2017 in 7 French hospitals were prospectively included. All patients filled in voice handicap index questionnaires, preoperatively and 2 and 6 months after surgery. Results Median (range) voice handicap index scores were significantly increased at month 2 (4 [0; 108]) compared to preoperative values (2 [0; 76]) and were unchanged at month 6 (2 [2; 92]). Clinically significant voice impairment (voice handicap index score difference ≥18 points) was reported in 19.7% at month 2 and 13% at month 6. Thirty-seven (4.6%) had postoperative vocal cord palsy. In patients with vocal cord palsy compared to those without, median voice handicap index scores were increased at month 2 (14 [0; 107] vs 4 [0; 108]; P = .0039), but not at month 6 (5 [0; 92] vs 2 [0; 87]; P = .0702). Clinically significant impairment was reported in 38% vs 19% at month 2 (P = .010), and in 19% vs 13% at month 6 (P = .310). Thyroid weight, postoperative hypocalcemia, vocal cord palsy, and absence of intraoperative neuromonitoring utilization were associated with an increased risk of clinically significant self-perceived voice impairment at month 2. Conclusion Thyroidectomy impairs patients’ voice quality perception in patients with and without vocal cord palsy.

Postthyroidectomy voice disorders can occur without any recurrent laryngeal nerve injury, and probably are the most frequent complication after thyroidectomy. We report the long-term voice quality outcomes after total thyroidectomy without vocal cord palsy using a simple self-assessment tool: the voice handicap index self-questionnaire.This observational prospective multicenter study included 203 patients from the "ThyrQoL" study (ClinicalTrial NCT02167529), who underwent total thyroidectomy between October 2014 and August 2015 in 3 French Hospitals (Nantes, La Roche-sur-Yon, and Limoges). Exclusion criteria included confirmed malignant disease, age18 years, and preoperative voice troubles with confirmed vocal cord palsy. Direct flexible laryngoscopy was performed after surgery. Nineteen patients with a postoperative vocal cord palsy were excluded from analysis.One hundred and seventy-six patients with no vocal cord palsy were analyzed. Voice handicap index scores were significantly altered on postoperative month 2 compared with preoperative values (7.02 ± 11.56 vs 14.41 ± 19.44; P.0001). Voice handicap index scores were not significantly different on postoperative month 6 compared with preoperative values (7.02 ± 11.56 vs 7.61 ± 14.02; P=.381). Thirty-six patients (20.5%) described significant voice impairment 2 months after total thyroidectomy. Nine patients (5.7%) still experienced significant discomfort at 6 months.Twenty percent of patients had initial voice impairment at 2 months postthyroidectomy, with a progressive recovery to preoperative levels at 6 months with6% with persistent voice complaints.

International audience; In fish, the presence of predator cues in the parental or juvenile environment engenders plasticity in the expression of fear-related behaviours. Whether these cues may engender developmental plasticity when they are present in the environment of embryos remains unexplored. Here, we tested in rainbow trout, Oncorhynchus mykiss: (1) whether exposure to alarm cues during embryonic stages engendered developmental plasticity; and (2) whether an abiotic stressor could also orient the behavioural development of fry. We divided fertilized eggs into three groups: a control nonstressed group (Control), a group of embryos exposed to a conspecific alarm pheromone (e.g. predator-related cue stressor, PS), and a group of embryos that were chronically air exposed for 1 min (e.g. abiotic stressor, AS). Stressors were applied once a day, 3 times per week from 19 days postfertilization (dpf) until 52 dpf. Between 57 and 143 dpf, and for each individual, we assessed the propensity to express fear responses in different contexts and learning performances. When exposed to a novel environment or a novel object, PS fish showed significantly less fear-related behaviour, less freezing and higher activity levels than Control fish. PS fish also showed slower acquisition of a learning task than controls. AS fish did not differ from controls in any test situation. Our results show that in ovo exposure to a natural but not an abiotic signal is a prominent inducer of rainbow trout behavioural plasticity across a number of contexts. Our study provides evidence that the expression of neophobia by fish fry may be modulated by the level of risk perceived by embryos in the environment.

Backgrounds Central pancreatectomy (CP) is an alternative to pancreaticoduodenectomy and distal pancreatectomy in benign tumours of pancreatic isthmus management. It is known for a high post-operative pancreatic fistula (POPF) rate. The purpose of this study was to compare POPF incidence between pancreatico-jejunostomy (PJ) and pancreatico-gastrostomy (PG). Methods Fifty-eight patients (mean age 53.9 ± 1.9 years) who underwent a CP in four French University Hospitals from 1988 to 2011 were analysed. The distal pancreatic remnant was either anastomosed to the stomach (44.8%, n = 25) or to a Roux-en-Y jejunal loop (55.2%, n = 35) with routine external drainage allowing a systematic search for POPF. POPF severity was classified according to the International Study Group on Pancreatic Fistula (ISGPF) and Clavien-Dindo classifications. Results The groups were similar on sex ratio, mean age, ASA score, pancreas texture, operative time and operative blood loss. Mean follow-up was 36.2 ± 3.9 months. POPF were significantly more frequent after PG (76.9 versus 37.5%, P = 0.003). PG was associated with significantly higher grade of POPF both when graded with ISGPF classification (P = 0.012) and Clavien-Dindo classification (P = 0.044). There was no significant difference in post-operative bleeding (0.918) and delayed gastric emptying (0.877) between the two groups. Hospital length of stay was increased after PG (23.6 ± 3.5 days versus 16.5 ± 1.9 days, P = 0.071). There was no significant difference in incidence of long-term exocrine (3.8 versus 19.2%, P = 0.134) and endocrine (7.7 versus 9.4%, P = 0.575) pancreatic insufficiencies. Conclusion PG was associated with a significantly higher POPF incidence and severity in CP. We recommend performing PJ especially in older patients to improve CP outcomes.

The incidence of biliary lithiasis is increased after bariatric surgery due to rapid weight loss [1]. Trans-oral endoscopic management in cases of common bile duct gallstone complication is not possible in patients with Roux-en-Y gastric bypass (RYGB) due to the modified anatomy. Access to the biliary tree after RYGB with a classical direct surgical approach of common bile duct and choledocoscopy can be used, but may be complicated in situations of acute cholangitis because of the fragility of common duct, or in cases of previous cholecystectomy. Multiple alternatives have been described, such as percutaneous transhepatic cholangiography or laparoscopic transgastric endoscopic retrograde cholangiopancreatography (LTG-ERCP) [2, 3]. The aim of this video was to present the management of common bile duct gallstone complication after RYGB and the technical features of LTG-ERCP [4]. We present the case of a 79-year-old woman (98 kg, BMI 40.2 kg/m2) with a 24-month history of RYGB, who presented with gallstone cholangitis and septic shock. Imaging revealed a 16-mm dilatation of the common bile duct upstream of a biliary gallstone. A previous history of laparotic cholecystectomy leads us to favor LTG-ERCP. We present the step-by-step LTG-ERCP technique. The laparoscopic procedure started with an excluded stomach dissection and gastrostomy on the great curvature at 10 cm from the pylorus with a 15-mm extra-long port. The placement of the gastrotomy should be carefully chosen with respect to the antrum, in order to provide straightforward access to the pylorus. The transgastric endoscopic procedure should include sphincterotomy (if not formerly performed) and gallstone removal. The patient experienced no specific complication of LTG-ERCP. Control of sepsis was favorable with adapted antibiotic treatment. Hepatic cytolysis and cholestasis normalized within postoperative day 3. Postoperative imaging showed a reduction of the common bile duct diameter to 12 mm. The patient required hemodialysis because of acute kidney injury. She finally left the hospital on postoperative day 16. LTG-ERCP is a safe and feasible alternative for gallstone cholangitis management in patients with RYGB. This procedure should be recommended for cases of cholangitis rather than laparoscopic choledocoscopy or a percutaneous transhepatic approach, especially in cases of prior cholecystectomy, or in patients where the BMI remains high. LTG-ERCP should be performed in a referral center by a skilled endoscopist and surgeon following a standardized technique.

International audience; OBJECTIVE: Bariatric surgery appears as the most efficient therapeutic alternative in morbidly obese patients. In addition to its efficiency to decrease body weight, it also improves metabolic complications associated to morbid obesity, including dyslipidemia. Although the cholesterol-lowering effect varies with the bariatric procedures, the underlying molecular mechanisms remain poorly defined. This study aims to assess the consequence of both restrictive (sleeve gastrectomy; SG) and malabsorptive (Roux-en-Y gastric bypass; RYGB) procedures on cholesterol metabolism in mice. SUBJECTS: Ten-week-old C57BL6/J males were fed with a high-fat diet for 8-14 weeks before sleeve or RYGB surgery. RESULTS: SG has a modest and transient effect on plasma cholesterol levels, linked to a reduction in food intake. In contrast, modified RYGB led to a sustained ≈35% reduction in plasma cholesterol concentrations with a drastic increase in fecal cholesterol output. Mechanistically, RYGB exerts a synergystic effect on cholesterol metabolism by inducing the trans-intestinal cholesterol efflux and reducing the intestinal cholesterol absorption. CONCLUSIONS: In mice, RYGB, but not sleeve, strongly favors plasma cholesterol elimination by concomitantly increasing trans-intestinal cholesterol excretion and by decreasing intestinal cholesterol absorption. Our models open new perspective for deciphering the hypocholesterolemic effects of bariatric procedures.

Central pancreatectomy (CP) is an alternative to pancreaticoduodenectomy and distal pancreatectomy in benign tumours of pancreatic isthmus management. It is known for a high post-operative pancreatic fistula (POPF) rate. The purpose of this study was to compare POPF incidence between pancreatico-jejunostomy (PJ) and pancreatico-gastrostomy (PG).Fifty-eight patients (mean age 53.9 ± 1.9 years) who underwent a CP in four French University Hospitals from 1988 to 2011 were analysed. The distal pancreatic remnant was either anastomosed to the stomach (44.8%, n = 25) or to a Roux-en-Y jejunal loop (55.2%, n = 35) with routine external drainage allowing a systematic search for POPF. POPF severity was classified according to the International Study Group on Pancreatic Fistula (ISGPF) and Clavien-Dindo classifications.The groups were similar on sex ratio, mean age, ASA score, pancreas texture, operative time and operative blood loss. Mean follow-up was 36.2 ± 3.9 months. POPF were significantly more frequent after PG (76.9 versus 37.5%, P = 0.003). PG was associated with significantly higher grade of POPF both when graded with ISGPF classification (P = 0.012) and Clavien-Dindo classification (P = 0.044). There was no significant difference in post-operative bleeding (0.918) and delayed gastric emptying (0.877) between the two groups. Hospital length of stay was increased after PG (23.6 ± 3.5 days versus 16.5 ± 1.9 days, P = 0.071). There was no significant difference in incidence of long-term exocrine (3.8 versus 19.2%, P = 0.134) and endocrine (7.7 versus 9.4%, P = 0.575) pancreatic insufficiencies.PG was associated with a significantly higher POPF incidence and severity in CP. We recommend performing PJ especially in older patients to improve CP outcomes.

International audience; Obesity is a major public health issue, with a prevalence of 4 to 28% for men and 6.2 to 36.5% for women in Europe (from 2003 to 2008). Morbid obesity is frequently associated with metabolic complications, such as type 2 diabetes, hypertension, and dyslipidemia, reducing life expectancy and quality. In the absence of any effective noninvasive treatments, bariatric surgery is a valuable therapeutic option for patients with morbid obesity (body mass index (BMI) \textgreater40 kg/m(2)), leading to long-term, sustained weight loss and improvements in metabolic complications. However, the underlying cellular and molecular mechanisms sustaining the beneficial effects of bariatric surgery are not yet fully understood. Due to the numerous genetically-modified strains available, the mouse model is the most convenient animal model to explore the molecular mechanisms behind the pleiotropic beneficial effects of bariatric surgeries. Here, we detailed the optimized healthcare methods and surgical protocols in mice for the two most widely-used bariatric surgeries: the sleeve gastrectomy and the modified Roux-en-Y gastric bypass. Deciphering the molecular mechanisms underlying the therapeutic effects of bariatric surgeries offers the promise of identifying new therapeutics targets.

Introduction Les troubles de la voix post-thyroidectomie sont une complication frequente. Nous rapportons l’evolution a long terme de la qualite de la voix apres thyroidectomie totale grâce a l’utilisation du Voice Handicap Index (VHI). Methode Huit-cent patients operes d’une thyroidectomie totale entre octobre 2014 et decembre 2017 dans sept centres experts ont ete inclus prospectivement. L’autoevaluation de la voix utilisait l’auto-questionnaire VHI, en pre- et postoperatoire a 2 et 6 mois (M2, M6). Resultats Trente-sept patients (4,5 %) presentaient une paralysie d’une corde vocale (PCV) postoperatoire ; leur score VHI etait significativement altere a M2 (24,8 ± 29,2 versus 13,3 ± 19,4 ; p = 0,0013) et M6 (13,5 ± 22,6 versus 8,4 ± 13,9 ; p = 0,0453). Parmi les patients sans PCV, 18,8 % et 8,5 % decrivaient une alteration significative de la voix a respectivement 2 et 6 mois. Le poids de la thyroide (p = 0,047), l’hypocalcemie postoperatoire (p = 0,031), la PCV (p = 0,046), et l’absence d’utilisation du neuromonitoring peroperatoire du nerf recurrent (p = 0,031) etaient des facteurs de risque d’alteration de la qualite de la voix a M2. Conclusion La PCV postoperatoire n’est pas le seul facteur d’alteration de la voix. Meme en l’absence de PCV, pres d’un patient sur 5 presente initialement des troubles de la voix.

This study evaluated the efficiency of transcutaneous laryngeal ultrasonography (TLUS) as an alternative to direct flexible laryngoscopy (DFL) in the early postoperative screening of vocal cord palsy (VCP) after total thyroidectomy, performed for benign and non-extensive malignant disease. A prospective study was performed on patients who underwent total thyroidectomy between October 2013 and January 2015 at the Nantes University Hospital (France). Patients underwent DFL on postoperative day 1 performed by an otolaryngologist, followed by TLUS performed by a radiologist on postoperative day 1 or 2. One hundred and three (103) patients were included in this study, 17.5 % were male and 82.5 % were female, with a mean age of 51 ± 12 years. Nine patients (9.5 %) were diagnosed with postoperative VCP using DFL of these cases 2 were not completely resolved at 3 months postoperatively. Three cases of VCP (33 %) were diagnosed using TLUS. TLUS had a sensitivity of 33 % and a negative predictive value (NPV) of 95 % for the diagnosis of postoperative VCP. Vocal cords (VC) were unassessable in 27.2 % of patients. Unassessable VC were significantly associated with male gender (p = 0.0001), age (p = 0.0001), weight (p = 0.002), operating time (p = 0.032), postoperative drainage (p = 0.001), and thyroid weight (p = 0.001). Independent risk factors in the multivariate analysis were male gender (p = 0.0001) and age (p = 0.0001). In the group of women under 50-year old, TLUS had a sensitivity of 50 % and a NPV of 97.4 %. TLUS sensitivity is insufficient in early postoperative screening of VCP after thyroid surgery. Ultrasonographic VCP diagnosis should be confirmed with DFL.

Objectif Les troubles de la voix apres thyroidectomie peuvent survenir meme sans lesion du nerf larynge recurrent. Il s’agit probablement de la complication la plus frequente apres thyroidectomie. L’objectif de cette etude etait d’etudier l’evolution de qualite de la voix apres thyroidectomie totale en l’absence d’une paralysie des cordes vocales (PCV), en utilisant l’auto-questionnaire Voice Handicap Index (VHI). Methode Deux-cent-trois patients operes d’une thyroidectomie totale entre octobre 2014 et aout 2015 dans trois centres experts (CHU de Nantes, CHD Vendee, CHU de Limoges) ont ete inclus a partir de l’etude ThyrQoL (ClinicalTrial NCT02167529 ). Une nasofibroscopie systematique etait realisee en post-operatoire precoce. Dix-neuf patients avec une PCV post-operatoire ont ete exclus de l’analyse. Resultats Cent-soixante-six patients sans PCV postoperatoire ont ete analyses. Les scores VHI etaient significativement alteres deux mois apres la chirurgie par rapport aux scores preoperatoire (7,02 ± 11,56 vs. 14,41 ± 19,44 ; p Conclusion Il existe une alteration initiale de la qualite de la voix apres thyroidectomie totale. On observe une recuperation de la fonction vocale anterieure avec moins de 6 % de patients decrivant une alteration significative de la qualite de leur voix six mois apres la chirurgie.

Introduction L’objectif de cette etude etait d’evaluer les performances de l’echographie des cordes vocales (ECV) comme alternative a la laryngoscopie directe (LD) pour le diagnostic des paralysies des cordes vocales (PCV) en postoperatoire de thyroidectomie totale (TT). Methode Les patients operes d’une TT entre octobre 2013 et janvier 2015 au CHU de Nantes ont ete inclus prospectivement. Ils beneficiaient d’une LD realisee par un ORL suivie d’une ECV realisee par un radiologue dans les 2 premiers jours postoperatoires. Resultats Cent trois patients ont ete inclus, dont 17,5 % d’hommes et 82,5 % de femmes, avec un âge moyen de 51 ± 12 ans. Neufs patients (9,5 %) ont presente une PCV diagnostiquee a la LD, dont 2 non completement regressives a 3 mois. L’ECV avait une sensibilite de 33 % et une valeur predictive negative (VPN) de 89 % pour le diagnostic de PCV. Les cordes vocales etaient mal visualisees dans 27,2 % des cas. Les facteurs de risques de mauvaise visualisation etaient le sexe masculin ( p = 0,0001), l’âge ( p = 0,0001), la duree operatoire ( p = 0,032), le drainage ( p = 0,001) et le poids de la thyroide ( p = 0,001). En analyse multivariee, les facteurs de risque etaient le sexe masculin ( p = 0,0001) et l’âge ( p = 0,0001). Les performances de l’ECV etaient superieures chez les femmes de moins de 50 ans, avec une sensibilite de 50 % et une VPN de 97,4 %. Conclusion L’ECV peut etre proposee en alternative a la LD chez les femmes de moins de 50 ans pour le diagnostic de PCV en postoperatoire de TT.