Prevention of gastrointestinal (GI) lesions and hemorrhage in patients receiving antithrombotics relies on gastroprotection with proton pump inhibitors (PPIs) in high-risk individuals. During the recent European Days of the French Society of Cardiology 2025 held in Paris from the Intercommunal Hospital Group Le Raincy Montfermeil reviewed updated strategies for prescribing PPIs While 50%-80% of PPI prescriptions are unjustified particularly for unnecessary nonsteroidal anti-inflammatory drug (NSAID)-related ulcer prophylaxis PPIs remain underprescribed for patients at risk for bleeding on antithrombotics particularly direct oral anticoagulants (DOACs) A Danish study based on a national health data register found that only 40% of the patients treated with dual antiplatelet therapy of GI bleeding did not receive PPIs PPIs have been demonstrated to be effective in this regard. A meta-analysis showed that PPIs used as gastroprotective treatments are associated with an 80% reduction in the risk for bleeding “It is now well established that there is a benefit of PPIs in the prophylaxis of digestive lesions and bleeding in these at-risk patients,” Macaigne said No specific recommendations are available for the prevention of bleeding in patients receiving antithrombotic drugs. However, the European guidelines for chronic coronary syndrome recommend PPIs (Class I Level A) for high-risk patients receiving aspirin To gain a clearer picture of risk factors in patients receiving antithrombotics to prevent cardiovascular risk, Macaigne proposed an algorithm based on the European consensus In patients receiving antiplatelet drugs such as aspirin PPI treatment is recommended in the following cases: PPIs are also recommended in the presence of at least two of the following risk factors: Age ≥ 65 years but “age becomes a major risk factor,” justifying PPI prophylaxis “Patients over 65 years of age on DOACs must receive prophylactic PPI treatment,” as do patients treated with a combination of antithrombotics rivaroxaban is associated with the highest risk for GI bleeding with a fivefold increased risk in placebo-controlled studies while apixaban has a lower risk than other DOACs (threefold increased risk) Half-dose PPIs (except omeprazole) should be administered 30 minutes before breakfast for optimal acid suppression “A single dose of PPI allows a reduction in gastric acidity of approximately 60% for almost 24 hours,” Macaigne noted omeprazole) may reduce the efficacy of clopidogrel Since clopidogrel requires CYP450 metabolism to release its active metabolite Macaigne recommended maintaining a 12-hour gap between clopidogrel (evening dose) and PPIs (morning dose) or switching to rabeprazole rabeprazole is preferred in case of treatment with clopidogrel the risk for interaction being lower with this drug clopidogrel can also be substituted by prasugrel Although H pylori infection does not increase the risk for digestive bleeding with anticoagulant therapy, eradication improves chronic gastritis and reduces the risk for gastric cancer in patients on PPIs. The 2022 Maastricht VI/Florence Consensus Report recommends screening for H pylori infection in these patients diagnosis is based on endoscopy and biopsy whereas asymptomatic patients require a breath test “The PPI must then be stopped 2 weeks before the test to increase its sensitivity and not take antibiotics during the previous 4 weeks,” Macaigne advised Tapering PPIs gradually helps avoid symptom flareups “A sudden interruption of PPIs is accompanied by acid secretion at a rate higher than before the start of treatment,” which induces digestive symptoms Another side effect of PPIs is hypomagnesemia especially in patients aged more than 65 years A serum magnesium test should be performed in these patients and supplementation should be prescribed if necessary PPIs may also promote digestive infections by acid-sensitive bacteria and bacterial proliferation in the upper part of the digestive tract Microscopic colitis-related secretory diarrhea may also occur “It usually occurs in patients who have started PPI treatment for about 4 months.” Lansoprazole should be considered a potential trigger if secretory diarrhea appears after this treatment period This story was translated from Medscape’s French edition using several editorial tools Human editors reviewed this content before publication Send comments and news tips to news@medscape.net Since last April, the picorette has been based on avenue de la Résistance in Le Raincy after many years in a first location in the town mother of three daughters and solar entrepreneur who wanted to create a new place to live in the town where she lives I saw that there was nothing for children," says the former nurse who left the hospital to set up her own toy store "like the ones she knew in Paris and Montreuil" all products are also available for purchase on the boutique's online site The big plus of this huge toy store is certainly thechildren's play area: in the center of the store it's a cocoon where you can play with tea sets or put your baby down on the play mat for a gentle family moment Or you can put your baby down on the play mat for a gentle family moment la picorette also offers workshops for children: sophrology creative workshops and other initations await the little ones every Wednesday Older children also have the right to their own workshops parents' café and creative aperitif sessions the café Beber - located within the boutique with its saffron-yellow tiled floor and blue-painted columns - allows those who wish to warm up over a hot drink (with vegetable or cow's milk) or a cold one bread with a chocolate bar and other delicacies straight from the bakery next door the café has quickly become a meeting place for families and local residents alike "a place where grannies rub shoulders with newborn babies La Picorette is open every day of the week If you're looking for a must-visit address in Raincy This test was conducted as part of a professional invitation Refer your establishment, click herePromote your event, click here Coral Springs, Fla. – The 2015 All-American Scholars have been announced by the Women's Golf Coaches Association (WGCA) and Georgia State's Solene Le Coz has earned that recognition To become a WGCA All-American Scholar a student-athlete golfer must have a cumulative GPA of 3.5 or higher produced a 4.06 spring GPA to earn President's List status at GSU as she lifted her cumulative GPA to 3.71 France (in metro Paris) is majoring in accounting managerial sciences and had made the Dean's List during the fall semester Le Coz had three top 25 finishes during her sophomore season including at the Sun Belt Conference championship Thanks for visiting ! The use of software that blocks ads hinders our ability to serve you the content you came here to enjoy. We ask that you consider turning off your ad blocker so we can deliver you the best experience possible while you are here. The scene in the Paris docklands last month could have been anywhere across the Torah world In the massive former industrial space regenerated to serve the entertainment industry singers rehearsed and microphones were adjusted for roshei yeshivah Underway were the last preparations for the signature blend of Torah inspiration and musical extravaganza with which Dirshu marks events like the global siyum of the three-year Mishnah Berurah cycle Accents apart — and a certain resonance that comes from being only miles from where Baalei HaTosafos such as Rabbeinu Yechiel of Paris lived — the identikit venue could have been anywhere from South Africa to New Jersey as Mir Rosh Yeshivah Rav Yitzchak Ezrachi finished his keynote address with a signature roar of “Only Torah!” and a cross section of Paris Jews erupted in singing That’s because a French revolution is underway A city whose Torah glory was long in the past and had become a mussar byword for decadence Exhibit A in that metamorphosis is Dirshu itself Like ubiquitous consumer brands that signal a country’s socio-economic status the presence of hundreds of shiurim from the ground-breaking Torah organization is a sure sign that today’s French Jewish community is changing rapidly The traditional Jews and fine Parisian living of yesteryear are still there but these have been joined by multiple yeshivos and kollelim As the community moves east and west from the inner-city neighborhoods to the suburbs a parallel process of spiritual upgrade is taking place as well the almost half-million-strong community lives in fear as the specter of terror attacks sends masses stampeding for the exit the country’s Jewish community is evolving to cope with the security realities and a quiet Torah revolution is well underway a main avenue in Paris’s heavily Jewish 19th arrondissement the first thing that strikes you is a question the 300,000 Jews in this city don’t live in a ghetto they’re spread out thinly across large areas with other populations That means that as late afternoon gives way to dusk a visitor starts to look nervously over his shoulder The idea that you can’t walk around the streets of Paris without a baseball cap is also wrong yarmulkes are readily visible in this part of the city I find an older-looking man with a kippah obviously bent on the same mission “Are you not worried to walk around without a cap?” I ask as we walk “I am a bit nervous,” he admits in a mixture of French and Ivrit His destination — a large Moroccan shul — is typical of the French Jewish experience and guard booth speak of the security that is normal in a community that has suffered recent terror attacks But inside there are other telling signs of the specific circumstances that had molded today’s French Jewry Ditto for the collection of Yalkut Yosef from Rav Ovadiah reverential plaque for Rav Gershon Liebman “Reb Gershon” survived both Soviet and Nazi forced labor went on to found yeshivos in Germany and eventually France where he set up a vast network of Torah institutions the current French Torah boom is a child of the fearless Novardoker pioneer and others like him About 15 kilometers east of the 19th — or half an hour in Paris traffic terms — is a window into the ground zero of the latest stage in the country’s Jewish growth the suburb of Le Raincy is an island of upmarket suburbia in a wider sea of socioeconomic deprivation It’s also the home to a unique set of Torah institutions His Merkaz HaTorah campus is an entire ecosystem catering from nursery age to high school and yeshivah What stands out is the parallel existence of two different educational approaches: In one building is a yeshivah high school of a type familiar from London or New York Inside a building that flies the French and European Union flags are 200 students whose day is divided between Gemara and secular studies is an institution more familiar from Bnei Brak Chazon Nachum is a high-level Torah-only yeshivah ketanah Rav Toledano explains the origins of the twin approach and was sent by his father to learn first in Schneider’s Yeshiva in London “In the ’70s and ’80s,” says Rav Yehudah Toledano “French Jewish life was what was called ‘Consistoire Judaism,’ after the establishment Jewish organization dating from Napoleon’s time It was a Judaism of synagogues — mostly Ashkenazic — with some shiurim added.” The waves of North African Jews from traditional backgrounds who arrived from the 1960s onward didn’t feel at home in these shuls and were anyway preoccupied with establishing themselves in the new land of economic promise It was in that unpromising soil that a handful of pioneers such as Rav Yitzchak Chaikin of Aix-les-Bains (a talmid of the Chofetz Chaim) Rav Mordechai Rottenberg (known as the “Rouv”) of Paris “When my father arrived in France in 1967,” explains Rav Yehudah Toledano “he saw that there was no chance of getting local Jews to send their children to a yeshivah but if there were high-level secular studies these traditional Jews would send their children.” Rav Yaakov was able to found a classic yeshivah we are able to offer different options,” says his son Rav Yehudah Toledano who took over the institutions when his father passed away in 1996 Today’s French Torah world is built on the first fruits of that struggle decades ago a great kiruv boom took place under leaders such as former chief rabbi Yosef Sitruk whose Monday evening lectures could draw 1,000 people,” says Rav Toledano “Movements like Arachim were successful and introduced Jews to real Gemara learning and there was an explosion of kosher stores as well as the number of mikvaos.” As is evident from the gigantic campus of the Chabad elementary school in the 19th district — which educates close to 2,000 children — Lubavitch played a key part in the country’s spiritual progress There are multiple yeshivos and kollelim in Paris As a leading figure in France’s Dirshu movement Rav Toledano points to what the organization’s success means in the context of the community’s evolution “Dirshu founder Rav Dovid Hofstedter sees France as unique in that Dirshu has facilitated a sense of community to allow the different Orthodox communities to feel a sense of belonging to the wider Torah world.” Somewhere around the 19th’s main thoroughfare one that sends a chill through the bones because of the association with the deadly attack in 2015 — although it’s only a branch of a Paris-wide chain and Jews are less safe than across the channel in London where a large French expat population lives The slightly threatening feeling of districts like the 19th have persuaded many Jews to up sticks and head to suburbs like Le Raincy But Rav Toledano explains that educational opportunities are as much a factor as hatred “The movements to the west of Paris and the Île-de-France in the city’s east are a reaction to anti-Semitism but also in good part because the baalei teshuvah mentioned above are financially well-off and have gone to live in the more affluent districts of western Paris “They also want to get closer to Orthodox Jewish schools That’s why the community around Merkaz HaTorah with nearly 1,000 students has grown in 30 years from about 20 families to nearly 500 families.” The trend of couples going to learn in Israel and then remaining there acts as a brain drain But it’s specifically those who move to Israel to flee bigotry in their native country that concern Rav Toledano “The panic to leave after the terror attacks has finished,” he says “especially as it’s now clear that moving to Israel can often be disastrous for children they’re not forced to choose between secular and yeshivah education he was pessimistic about the future of French Jewry But now it’s clear that the Orthodox Jewish community is on a growth trajectory “We’re going to see a growth of Torah learning in Jewish schools and kollelim with the tradition and warmth that is uniquely French.” Yisrael YoskowitzNo Regrets  “Anti-Semitism hasn’t disappeared Today it hides under the guise of ‘criticism of Israel,’ but it’s the same old poison” Yitzchok LandaLimited LiabilityShe can’t undo the insurance mess but Shuli Berger makes sure the system works for you Tzivia MethStill in the Story   Rabbi Marcus Lehmann's pen instilled Jewish confidence in his generation and beyond  Mishpacha StaffHalf the Battle For Rav Meir Mazuz every struggle was about the sanctity of the Jewish nation Binyamin RoseReady, Willing, and Able   Israel's US ambassador Yechiel Leiter relives his knock on history's door  Yaacov LipszycDevils’ AdvocatesA guide to the web of evil that spirited away Nazis to sanctuary in South America Depending on where you’re spending Sukkot finding a kosher restaurant with a Sukkah can be difficult We’ve been collecting restaurant names from around the world that will have a Sukkah accessible to diners during Chol Hamoed for the chag This list is still being updated with locations around the world. Please notify us at info [at] YeahThatsKosher.com or via DM on Instagram what we missed and we will add it Thanks.Note: it is safe to assume that kosher restaurants in Israel that choose to stay open on chol hamoed will likely have a Sukkah We use ads & sponsored posts to support the creation of new content © YeahThatsKosher 2024 – Reproduction without explicit permission is strictly prohibited. | Privacy PolicyDownload our kosher restaurant directory app Please enable JS and disable any ad blocker The Paris suburb of Noisy-le-Grand is known for its architecturally unique environment, most notably home to the Espaces d'Abraxas Similar in concept but much different in style the Arènes de Picasso or "Picasso's Arenas" is a massive housing complex consisting of 540 residences designed by Spanish architect Manuel Núñez Yanowsky The complex is locally nicknamed "camemberts" after its iconic round façades a pair of circles facing one another across a promenaded square this post-modernist colossus is supposed to be an abstract representation of an overturned cart A cluster of cylindrical apartment buildings nod to the city’s vegital past The unique design of these skyscrapers in a Paris suburb led to them being nicknamed "cloud towers." an example of Art Deco Streamline Moderne style was designed to embody the curves of a great ship architectural experiment designed to increase a resident's longevity After local authorities changed the design the building is the best example of Spanish organicist architecture in Madrid This spaceship-like structure was once a popular roadside restaurant A medieval shrine set into a towering canyon wall visit former industrial plants steeped in many years of history - in short cultural sites and other nuggets that make up France's rich heritage le programme est mis à jour en fonction des annonces officielles Heritage Days 2024 at the Château d'Eau de La Courneuve Heritage Days 2024 at the Diplomatic Archives in La Courneuve Long live JEP in the 93 The Grand Paris Metropolis is characterised by an enormous demand for social housing linked to its economic attractiveness and high rents in the private housing sector Out of the 680,000 applications made for social housing recorded at the end of  2016 in Île-de-France 491,000 targeted a Métropole du Grand Paris municipality as first choice that is 72% of demands in Île-de-France while the social housing stock within MGP makes up only 67% of its social housing stock The pressure of demand in the Metropolis amounts to an average of 10 applications made for 1 housing unit allocated Paris undergoes even more pressure with 16 applications for one allocated housing unit Other municipalities are also under pressure like Neuilly-sur-Seine This severe pressure reflects a great demand but equally a low rate of allocated social housing The pressure weighing upon the social housing stock in the Metropolis is also caused by a low rate of rotation among occupants and a high demand to move to another housing unit: 28% of applicants wish to change their social housing Apur processes your data to manage sending out the newsletter. For more information on the management of your personal data and to exercise your rights, please click here Photographer Thibaud Poirier has been making his way across Europe to capture the incredible interiors of churches and temples. In a continuation of his series Sacred Spaces Poirier explores 15 more modernist places of worship through photographs he carefully preserves the same composition—a perfectly centered image with the focal point at the front of the pulpit Thanks to the symmetry of this careful approach to documentation scrolling through the series allows viewers to make quick comparisons of the aesthetics of each structure The height of vaults and length of corridors may change but other qualities tend to remain the same such as the long rows of pews and the imagery at the pulpit The series also acts as a celebration of light and structure The holy atmosphere of these spaces can begin to be understood as the result of a perfectly placed skylight or an impressive arch While the architectural gestures obviously play a role Poirier is more poetic when describing the shared qualities of these interiors “Despite their great stylistic differences,” he explains “the glue between these churches remains invisible to the human eye yet vibrates within each of us: the emotional state created whilst one is present The conviction of something larger than us all.” The series has adapted to the travel restrictions caused by the COVID-19 pandemic Sacred Spaces II mostly includes photographs from churches in France built mostly between the 20th and 21st centuries Poirier will soon add more to the series as restrictions lift United States Air Force Academy Cadet Chapel Cathédrale de la Résurrection France (Corinne Callies et Jean-Marie Duthilleul Celebrating creativity and promoting a positive culture by spotlighting the best sides of humanity—from the lighthearted and fun to the thought-provoking and enlightening On August 20, 2018, Dr Basma M’Barek assumed her new role as Head of Oncology at FV Hospital Dr Basma is highly experienced in radiotherapy immunotherapy and palliative care and ensures patients benefit from pain relief throughout treatment to recover quickly Dr Basma is a member of the European Society of Therapeutic Radiation and Oncology (ESTRO) Dr Basma M’Barek graduated from the University of Tunis El Manar in 2002 and University of Paris VI in France in 2003 She also graduated with a Master in Human Genetics from the University of Medicine and Pharmacy in Tunis before completing advanced training courses in radiotherapy and oncology head and neck cancer and new technologies in radiotherapy Dr Basma has worked in many French hospitals University Hospital Saint Louis and Le Raincy-Montfermeil Hospital As a member of FV family, Dr Basma will work with her colleagues to implement the latest advanced treatments to establish FVH’s Oncology Department as the leading oncology centre in Vietnam providing hope for even more cancer patients Making an appointment on FV website is for scheduling only any doctors/physician with whom an appointment has been made by use of this website has not agreed to provide the undersigned with any medical advice diagnostic or 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Secrets of decades-long Golden Owl treasure hunt to be revealed Lifestyle Inside Chanel's French leather workshops Culture Subscribers only The marvelous bronzes of Angkor on display at the Musée Guimet in Paris The risks of staff shortages and working conditions in maternity wards require urgent measures from the authorities say a group of perinatal care professionals working in the Ile-de-France region Published on June 3, 2022, at 7:17 am (Paris), updated on June 3, 2022, at 7:17 am 3 min read Lire en français At the maternity ward of the Diaconesses hospital MARTIN BUREAU / AFP Perinatal health care professionals (midwives childcare assistants and pediatricians) are extremely worried about the risk that staff shortages pose to pregnant women and after having alerted our supervisors on many occasions over the last few years as heads of department and members of the management of the maternity units of Ile-de-France university and non-university maternity units in the public service wish to raise the alarm on the extremely worrying situation perinatal care has suffered due to the organization and working conditions imposed by regulating bodies who do not necessarily work in the field are not recognized as such and the staff must fill the gaps under the watchful eye of authorities who are aware of the problem but fail to propose any significant measure the boat is sinking and there are still no concrete plans on the table in an attempt to avoid the shipwreck The situation is only getting worse and nursing staff are fleeing the poor working conditions Those who choose to stay see their working conditions change for the worse Despite our regular alerts to the regional health agency of Ile-de-France and the ministry they do not seem to truly understand the gravity of the situation and the urgency You have 75.27% of this article left to read Lecture du Monde en cours sur un autre appareil Vous pouvez lire Le Monde sur un seul appareil à la fois Ce message s’affichera sur l’autre appareil Parce qu’une autre personne (ou vous) est en train de lire Le Monde avec ce compte sur un autre appareil Vous ne pouvez lire Le Monde que sur un seul appareil à la fois (ordinateur En cliquant sur « Continuer à lire ici » et en vous assurant que vous êtes la seule personne à consulter Le Monde avec ce compte Que se passera-t-il si vous continuez à lire ici Ce dernier restera connecté avec ce compte Vous pouvez vous connecter avec votre compte sur autant d’appareils que vous le souhaitez mais en les utilisant à des moments différents Nous vous conseillons de modifier votre mot de passe Votre abonnement n’autorise pas la lecture de cet article merci de contacter notre service commercial L'Avant-Poste defines itself as a committed Located in a postal building that has been vacant since 2014 in Raincy, L'Avant Poste 's mission is to improve the quality of urban life in the 93 département by offering coworking spaces (with 50 workstations available and 3 meeting rooms) non-alcoholic drinks à la carte) and snack bar (charcuterie fresh vegetables...) not forgetting a series of cultural events (conferences A 350 m² garden can also be discovered on site In all, 944 m² of the former postal building have been renovated to create L'Avant Poste To create an environment conducive to work but also "to anchor entrepreneurship in the region Signing up enhances your TCE experience with the ability to save items to your personal reading list Our team will be reviewing your submission and get back to you with any further questions Thanks for contributing to The Canadian Encyclopedia View upcoming auction estimates and receive personalized email alerts for the artists you follow The opening of TEFAF 2025 confirmed that the art market is still doing well despite the ongoing global geopolitical challenges Looking back at the early decades of modernism we may sense something inevitable about the ascent of Picasso and Matisse honoring Parisian art dealer Berthe Weill (1865–1951) constitutes its subject through far-reaching networks of aesthetic trajectories mirroring her vision for vanguard experimentation and enterprise Burger King patties and Taco Bell ground meat eating horse is not unheard of in much of Europe Trendy Parisian restaurants have had it on their menus for years while about 500 French horse butchers serve it up as a tastier and healthier alternative to beef the operator of one such boucherie chevaline in the Paris suburb of Le Raincy says a loyal clientele has gladly gobbled up his once-galloping prime cuts since his family opened the shop 32 years ago Do you only sell horse at this butcher shop We own the boucherie chevaline and keep it separate from the traditional butcher shop we also own just a few hundred metres away on a different street The French industry body for horse butchers has said that there has been a 15 per cent rise in sales of horse meat since the scandal broke I have heard all of the news about horse meat being used as a substitute for beef There is a lot of sentimentality about horses It has always been popular here; I have not noticed much of a change I think people who grow up eating horse meat carry on eating it all their lives I eat it and I have raised my children on it We source our horse meat from two countries: Canada and Belgium and we have around 300 customers who regularly buy our horse products The horses themselves are usually about four or five years old Do you buy the whole animal directly from the farms but by far the most popular is steak hachée (minced meat) We sell lots of products from horse meat: sausages A horse steak right now is about €22 [Dh105] for a kilogram People say it is a lot like beef but it is not business@thenational.ae This website is using a security service to protect itself from online attacks The action you just performed triggered the security solution There are several actions that could trigger this block including submitting a certain word or phrase You can email the site owner to let them know you were blocked Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page ‘Robin Hood’ the ever popular hero of the poor originated in English folklore and later featured in literature and still later in cinema has returned with the latest depiction directed by Otto Bathurst the film depicts how Robin of Loxley [...] the film depicts how Robin of Loxley (Taron Egerton) a war-hardened Crusader and his Moorish commander (Jamie Foxx) mount an audacious revolt against the corrupt English crown in a thrilling action-adventure packed with gritty battlefield exploits with Egerton signing on as the lead role that September the shooting was done from February to may 2017 at different locations in Dubrovnik The film is now being released at Liberty by Scope Cinemas Liberty Lite in Colombo and other cinemas around the country The Sunday Times Sri Lanka