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1.
Environ Monit Assess ; 196(8): 687, 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38958826

RESUMO

Fluvial sediment analysis and water quality assessment are useful to identify anthropic and natural sources of pollution in rivers. Currently, there is a lack of information about water quality in the Pixquiac basin (Veracruz state, Mexico), and this scarcity of data prevents authorities to take adequate measures to protect water resources. The basin is a crucial territory for Xalapa, the capital city of Veracruz state, as it gets 39% of its drinkable water from it. This research analyzed 10 physicochemical parameters and 12 metal concentrations in various rivers and sources during two seasons. Dissolved metals presented average concentrations (µg/L): Al (456.25) > Fe (199.4) > Mn (16.86) > Ba (13.8) > Zn (7.6) > Cu (1.03) > Pb (0.27) > As (0.12) > Ni (0.118) (Cd, Cr and Hg undetectable). Metals in sediment recorded average concentrations (ppm): Fe (38575) > Al (38425) > Mn (460) > Ba (206.2) > Zn (65.1) > Cr (29.8) > Ni (20.9) > Cu (16.4) > Pb (4.8) > As (2.1) (Cd and Hg undetectable). During the rainy season, Water Quality Index (WAWQI) classified stations P17 and P18's water as "unsuitable for drinking" with values of 110.4 and 117.6. Enrichment factor (EF) recorded a "moderate enrichment" of Pb in sediment in P24. Pollution was mainly explained by wastewater discharges in rivers but also because of erosion and rainfall events. Statistical analysis presented strong relationships between trace and major metals which could explain a common natural origin for metals in water and sediment: rock lixiviation.


Assuntos
Água Potável , Monitoramento Ambiental , Sedimentos Geológicos , Poluentes Químicos da Água , Qualidade da Água , Abastecimento de Água , México , Poluentes Químicos da Água/análise , Monitoramento Ambiental/métodos , Sedimentos Geológicos/química , Água Potável/química , Rios/química , Metais Pesados/análise , Metais/análise
2.
Pancreatology ; 23(4): 403-410, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37037682

RESUMO

BACKGROUND: Palliative care (PC) is integrated into standard oncology care. However, its clinical impact at the end of life remains unclear in pancreatic adenocarcinoma (PA). We aimed to describe the end-of-life care pathway and to assess whether PC referral influences survival after chemotherapy discontinuation (CD) among advanced PA patients. METHODS: This retrospective single-centre observational study was conducted among deceased patients with advanced PA who had received chemotherapy between January 1, 2016, and December 31, 2021. Baseline characteristics, the timing of PC referral and events after CD were collected. The primary outcome was time from CD to death. RESULTS: Among the 148 included patients, 53.4% (n = 79) received PC, mostly late after the CD (n = 133, 89.9%), 16.9% (n = 25) received chemotherapy in the last 14 days of life and 75.6% died at the hospital. None received PC in the 8 weeks following the diagnosis. PC referral significantly increased PC department admissions (p < 0.001) and decreased medical unit admissions (p < 0.001). The median survival after the CD was 35 days (IQR: 19-64.5). PC referral was associated with increased survival after CD (HR: 0.65 [0.47-0.90], p = 0.010, Cox) and after adjusting (HR: 0.65 [0.42-0.99], p = 0.045, Cox). CONCLUSION: The study suggests that PC may be associated with longer survival after CD in advanced PA patients. However, PC is underused, and patients are referred late in their care pathway.


Assuntos
Adenocarcinoma , Neoplasias , Neoplasias Pancreáticas , Humanos , Cuidados Paliativos , Neoplasias Pancreáticas/tratamento farmacológico , Estudos Retrospectivos , Adenocarcinoma/tratamento farmacológico , Neoplasias Pancreáticas
3.
J Ultrasound Med ; 42(11): 2567-2582, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37490582

RESUMO

OBJECTIVES: Here we report on the intra- and inter-operator variability of the backscatter coefficient (BSC) estimated with a new low-variance quantitative ultrasound (QUS) approach applied to breast lesions in vivo. METHODS: Radiofrequency (RF) echo signals were acquired from 29 BIRADS 4 and 5 breast lesions in 2 sequential cohorts following 2 imaging protocols: cohort 1) radial and antiradial views, and cohort 2) short- and long-axis views. Protocol 2 was implemented after retraining and discussion on how to improve reproducibility. Each patient was scanned by at least 2 of 3 radiologists; each performed 3 acquisitions with transducer and patient repositioning in between acquisitions. BSC was estimated using a low-variance QUS approach based on regularization. Intra- and inter-operator variability of the intra-lesion median BSC was evaluated with a multifactorial ANOVA test (P-values) and the intraclass correlation coefficient (ICC). RESULTS: Inter-operator variability was only significant in the first protocol (P < .007); ICCinter = .77 (95% CI .71-.82), indicating good inter-operator agreement. In the second protocol, the inter-operator variability was not significant (P > .05) and agreement was excellent (ICCinter = .92 [.89-.94]). In both protocols, the intra-operator variability was not significant. CONCLUSIONS: Our findings demonstrate the need for standardizing image acquisition protocols for backscatter-based QUS to reduce inter-operator variability and ensure its successful translation to the characterization of suspicious breast masses.

4.
BMC Cancer ; 22(1): 1219, 2022 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-36434607

RESUMO

BACKGROUND: Previous studies have observed an increased incidence of Cetuximab-induced hypersensitivity infusion reactions (CI-IRs) in the southeastern states of the USA. Tick's bites were suspected of generating cross-reactions between cetuximab and alpha-gal. This study aims was to describe the incidence and associated risk factors of CI-IRs, in the French areas chosen according to their Lyme disease incidence. PATIENTS AND METHODS: A retrospective chart review was conducted on patients that received cetuximab infusion from January 2010 to June 2019 in 4 French areas with different Lyme disease incidence rates. RESULTS: Of 1392 patients, 117 (8.4%) experienced a CI-IR, including 68 severe (grade 3 or 4) reactions (4.9%). This CI-IR incidence was significantly higher in the Lyme disease high-risk area than in the other areas (13.2% versus 7.1%, 8.1% and 6.4%; P = 0.016). Sex (P = 0.53), premedication (P = 0.91), primary cancer location (P = 0.46) and chemotherapy regimen type (P = 0.78) had no impact on CI-IR incidence in the overall population. In the head and neck squamous cell carcinoma (HNSCC) patient subgroup, CI-IRs were significantly more frequent in the high-risk area (16.4% versus 6.7%, 7.1% and 7.0%; P = 0.0015). CONCLUSION: This study suggests that patients treated in the French area with the highest incidence of Lyme disease are at a higher risk of CI-IRs.


Assuntos
Hipersensibilidade a Drogas , Neoplasias de Cabeça e Pescoço , Doença de Lyme , Humanos , Cetuximab/efeitos adversos , Incidência , Estudos Retrospectivos , Hipersensibilidade a Drogas/epidemiologia , Hipersensibilidade a Drogas/etiologia , Infusões Intravenosas , Neoplasias de Cabeça e Pescoço/complicações , Doença de Lyme/tratamento farmacológico , Doença de Lyme/epidemiologia , Doença de Lyme/complicações
5.
Phys Rev Lett ; 127(3): 037204, 2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34328783

RESUMO

The monolayer halides CrX_{3} (X=Cl, Br, I) attract significant attention for realizing 2D magnets with genuine long-range order (LRO), challenging the Mermin-Wagner theorem. Here, we show that monolayer CrCl_{3} has the unique benefit of exhibiting tunable magnetic anisotropy upon applying a compressive strain. This opens the possibility to use CrCl_{3} for producing and studying both ferromagnetic and antiferromagnetic 2D Ising-type LRO as well as the Berezinskii-Kosterlitz-Thouless (BKT) regime of 2D magnetism with quasi-LRO. Using state-of-the-art density functional theory, we explain how realistic compressive strain could be used to tune the monolayer's magnetic properties so that it could exhibit any of these phases. Building on large-scale quantum Monte Carlo simulations, we compute the phase diagram of strained CrCl_{3}, as well as the magnon spectrum with spin-wave theory. Our results highlight the eminent suitability of monolayer CrCl_{3} to achieve very high BKT transition temperatures, around 50 K, due to their singular dependence on the weak easy-plane anisotropy of the material.

6.
Reproduction ; 158(1): 71-83, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31013477

RESUMO

Beneficial effects of n-3 polyunsaturated fatty acid (PUFA) supplementation on dairy cow reproduction have been previously reported. The objectives of the present study were to assess whether n-3 PUFA supplementation would affect in vitro embryo production (IVP) after ovarian stimulation. Holstein cows received a diet with 1% dry matter supplementation of either n-3 PUFA (n = 18, microencapsulated fish oil) or a control, n-6 PUFA (n = 19, microencapsulated soy oil). Both plasma and follicular fluid FA composition showed integration of total PUFA through the diet. All cows underwent an IVP protocol consisting of ovarian stimulation, ultrasound-guided transvaginal oocyte retrieval (ovum pick-up, OPU, five per cow) followed by in vitro maturation, fertilisation and 7 days of embryo development. A tendency toward an increase in the blastocyst rate (diet effect, P = 0.0865) was observed in n-3 cows, with 49.6 ± 5.5% vs 42.3 ± 5.5% in control n-6 cows. A significant increase (diet effect, P = 0.0217) in the good-quality blastocyst rate (freezable blastocysts) was reported in n-3 cows (42.2 ± 7.7%) compared to control n-6 cows (32.7 ± 7.7%). A significant difference in lipid composition was shown in the oocytes recovered by OPU from n-3 and n-6 treated cows, by intact single-oocyte MALDI-TOF mass spectrometry. The 42 differentially abundant identified lipids were mainly involved in cell membrane structure. In conclusion, n-3 PUFA supplementation enhanced oocyte quality and modified their lipid composition. Further studies are necessary to investigate the potential link of these lipid modifications with enhanced oocyte quality.


Assuntos
Dieta/veterinária , Suplementos Nutricionais , Embrião de Mamíferos/citologia , Desenvolvimento Embrionário/efeitos dos fármacos , Ácidos Graxos Ômega-3/administração & dosagem , Oócitos/citologia , Indução da Ovulação/veterinária , Animais , Bovinos , Embrião de Mamíferos/efeitos dos fármacos , Feminino , Fertilização in vitro/veterinária , Oócitos/efeitos dos fármacos
7.
Phys Rev Lett ; 121(17): 177202, 2018 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-30411922

RESUMO

The coupled spin-1 chains material NiCl_{2}-4SC(NH_{2})_{2} (DTN) doped with Br impurities is expected to be a perfect candidate for observing many-body localization at high magnetic field: the so-called "Bose glass," a zero-temperature bosonic fluid, compressible, gapless, incoherent, and short-range correlated. Using nuclear magnetic resonance, we critically address the stability of the Bose glass in doped DTN, and find that it hosts a novel disorder-induced ordered state of matter, where many-body physics leads to an unexpected resurgence of quantum coherence emerging from localized impurity states. An experimental phase diagram of this new "order-from-disorder" phase, established from nuclear magnetic resonance T_{1}^{-1} relaxation rate data in the 13±1% Br-doped DTN, is found to be in excellent agreement with the theoretical prediction from large-scale quantum Monte Carlo simulations.

8.
Encephale ; 40(2): 180-7, 2014 Apr.
Artigo em Francês | MEDLINE | ID: mdl-24630532

RESUMO

INTRODUCTION: Awareness disorders in Alzheimer's disease still remains unclear despite much research regarding this phenomenon. Papers report various and contrasted results with varying frequency from one study to another. Hence, the interest in awareness in Alzheimer's disease remains limited. Nevertheless, this symptom is closely associated with caregivers' burden and increases the patient's dependency, since the patient is unable to avoid dangers, requiring some care services or institutionalization The purpose of this current review is to recall the main neuro-anatomical and theoretical basis of awareness disorders, and to highlight the recent findings in Alzheimer's disease and in its pre-clinical stages. METHOD: With this in mind, we have conducted a non-exhaustive search using the pubmed online database to collect the most important reviews and the most recent findings regarding awareness disorders in Mild Cognitive Impairment (MCI) and/or in Alzheimer's disease. LITERATURE FINDINGS: In Alzheimer's disease, the links between awareness disorders and other variables, such as severity of dementia or depression, change from one study to the other and do not permit one to understand whether unawareness is an intrinsic or extrinsic reaction to the pathological process itself. Recent results suggest executive, cognitive and behavioral correlates more than psychopathological correlates, although the latter cannot be excluded. In Mild Cognitive Impairment, studies show varied results. Some studies report that patients suffering from Mild Cognitive Impairment can be compared to healthy control subjects and both groups have better awareness than patients with Alzheimer's disease. However, other studies show contrary results and awareness disorders might be a predictor of conversion from Mild Cognitive Impairment to dementia, as with apathy, in which the ability to cope with difficulties represents one of the main features. DISCUSSION: These controversial results are due to the heterogeneity of Alzheimer patients and in particular of MCI patients, but also to various conceptions of awareness disorders in Alzheimer's disease; none of them, however, taking into account all its diversity and complexity. Thus, neurological approaches underline neuropsychological dysfunctions linked to right frontal and/or hemispheric damage but are based on brain injury or strokes, which are events that differ greatly from a neurodegenerative disease involving progressive cognitive, emotional and social disturbances. Psychiatric approaches have taken into account the various aspects of insight, which before were often forbidden and reduced to a categorical point of view, and so could contribute to a better understanding of awareness disorders in Alzheimer's disease. However, these aspects have been conceptualized for psychiatric patients, suffering from positive symptoms, where compliance in treatment is the central key. Insight in neurological diseases is more focused on negative symptoms and generally concerns a basic perception of impairments in mainly cognitive domains. Moreover, modeling has often opposed neurological and psychological mechanisms, so awareness disorders are out of scope of a primary and secondary symptomatology. Although some authors have proposed to take into account these two mechanisms (unawareness and denial), clinical practice has shown that it was impossible to distinguish them both. Finally, some social cognitive approaches are able to demonstrate that there is no correlation between severity of dementia and awareness disorders. Nevertheless, the Self-concept, underlying this point of view, does not permit distinguishing neuropsychological from psycho-social factors. Moreover, only one evaluation tool based on Self-modeling in Alzheimer's disease exists, and to conceptualize Self in a specific pathology does not permit the comparison of this pathology to others or to healthy control subjects. So, the authors present the multidimensional model proposed by Clare et al., and some perspectives to stimulate future research, and perform potential meta-analyses.


Assuntos
Agnosia/psicologia , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Conscientização , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Idoso , Agnosia/diagnóstico , Diagnóstico Diferencial , Humanos , Modelos Psicológicos , Testes Neuropsicológicos , Pesquisa
9.
Acta Chir Belg ; 113(2): 112-22, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23741930

RESUMO

OBJECTIVE: The purpose of this study was to evaluate prospectively Magnetic Resonance Imaging (MRI) for the preoperative localization of hyperfunctioning parathyroid glands. DESIGN: Prospective study of 58 consecutive patients with biochemically confirmed primary hyperparathyroidism who underwent preoperative MRI. SETTING: The setting is a referral centre. PATIENTS: Fifty-six of the 58 consecutive patients (41 women, 17 men) were studied by both preoperative MRI and 99mTC MIBI scintigraphy, and two by MRI alone. The same surgeon, using the information from both MRI and 99mTC MIBI, performed surgery in 58 patients, including 19 with a history of neck surgery. Initial interpretation of each MR study was done independently by one radiologist and the surgeon and then results were compared. At surgery, the operative duration, the precise anatomical location, weight, and dimensions as well as complete histopathological evaluations of all excised glands were recorded. MAIN OUTCOME MEASURE: In addition to the prospective assessment of MRI, this study compared performance of MRI with double-phase 99mTC MIBI scintigraphy for preoperative localization of hyperfunctioning parathyroid glands. RESULTS: All patients became normocalcaemic after surgery. MRI and 99mTC MIBI imaging revealed 53 of 58 (91%) and 47 of 56 (84%) of abnormal glands, respectively. Sensitivities of MRI and 99mTC MIBI were respectively 94.3 and 88.0. Positive predictive values were 96.15 and 93.60. When MRI and 99mTC MIBI were interpreted together, the sensitivity and positive predictive values both raised to 98.10. Median operative duration was 30 minutes (ranges 20-300 minutes, mean 65). CONCLUSION: MRI has better sensitivity and positive predictive value than 99mTC MIBI scintigraphy for the detection of hyperfunctioning parathyroid glands. The combination of the two studies provides an additional increase in sensitivity and positive predictive value leading to a more precise anatomical localization of the abnormal parathyroid glands reducing both the extent of the surgical dissection and the operative duration.


Assuntos
Hiperparatireoidismo Primário/patologia , Hiperparatireoidismo Primário/cirurgia , Imageamento por Ressonância Magnética , Glândulas Paratireoides/patologia , Paratireoidectomia , Cirurgia Assistida por Computador , Adulto , Idoso , Idoso de 80 Anos ou mais , Competência Clínica , Estudos de Viabilidade , Feminino , Humanos , Hiperparatireoidismo Primário/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Glândulas Paratireoides/diagnóstico por imagem , Glândulas Paratireoides/cirurgia , Valor Preditivo dos Testes , Estudos Prospectivos , Cintilografia , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes , Tecnécio Tc 99m Sestamibi
10.
Eur Respir J ; 39(3): 582-8, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22088971

RESUMO

Type 7 phosphodiesterases (PDE7) are responsible for the decrease of intracellular cyclic AMP (cAMP) in many cells involved in allergic asthma by suppressing their potential to respond to many activating stimuli. The elevation of intracellular cAMP has been associated with immunosuppressive and anti-inflammatory activities and represents a potential treatment of asthma. Our aim was to evaluate the impact of the deletion of the murine phosphodiesterase (PDE)7B gene and then to evaluate the efficacy of a newly described selective PDE7A and -B inhibitor on an ovalbumin (OVA)-induced airway inflammation and airway hyperreactivity (AHR) model in mice. Inflammation was determined 72 h after single OVA challenge or 24 h after multiple challenges by the relative cell influx and cytokine content in bronchoalveolar lavage fluid. AHR and immunoglobulin E levels in serum were determined after multiple challenges. For the first time, we have demonstrated that the deletion of the PDE7B gene or the pharmacological inhibition of PDE7A and -B had no effect on all the parameters looked at in this model. These results highlight the absence of any implication of the PDE7 enzyme in our model.


Assuntos
Asma/genética , Nucleotídeo Cíclico Fosfodiesterase do Tipo 7/genética , Aminopiridinas/uso terapêutico , Animais , Asma/tratamento farmacológico , Asma/enzimologia , Asma/imunologia , Benzamidas/uso terapêutico , Líquido da Lavagem Broncoalveolar/química , Líquido da Lavagem Broncoalveolar/imunologia , Nucleotídeo Cíclico Fosfodiesterase do Tipo 7/antagonistas & inibidores , Ciclopropanos/uso terapêutico , Citocinas/análise , Citocinas/imunologia , Modelos Animais de Doenças , Feminino , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Camundongos Knockout
12.
Resuscitation ; 168: 1-5, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34506875

RESUMO

PURPOSE: Fluid boluses (FB) are often used in post-cardiac arrest (CA) patients with haemodynamic instability. Although FB may improve cardiac output (CO) and mean arterial pressure (MAP), FB may also increase central venous pressure (CVP), reduce arterial PaO2, dilute haemoglobin and cause interstitial oedema. The aim of the present study was to investigate the net effect of FB administration on cerebral tissue oxygenation saturation (SctO2) in post-CA patients. METHODS: Pre-planned sub-study of the Neuroprotect post-CA trial (NCT02541591). Patients with anticipated fluid responsiveness based on stroke volume variation (SVV) or passive leg raising test were administered a FB of 500 ml plasma-lyte A (Baxter Healthcare) and underwent pre- and post-FB assessments of stroke volume, CO, MAP, CVP, haemoglobin, PaO2 and SctO2. RESULTS: 52 patients (mean age 64 ±â€¯12 years, 75% male) received a total of 115 FB. Although administration of a FB resulted in a significant increase of stroke volume (63 ±â€¯22 vs 67 ±â€¯23 mL, p = 0.001), CO (4,2 ±â€¯1,6 vs 4,4 ±â€¯1,7 L/min, p = 0.001) and MAP (74,8 ±â€¯13,2 vs 79,2 ±â€¯12,9 mmHg, p = 0.004), it did not improve SctO2 (68.54 ±â€¯6.99 vs 68.70 ±â€¯6.80%, p = 0.49). Fluid bolus administration also resulted in a significant increase of CVP (10,0 ±â€¯4,5 vs 10,7 ±â€¯4,9 mmHg, p = 0.02), but did not affect PaO2 (99 ±â€¯31 vs 94 ±â€¯31 mmHg, p = 0.15) or haemoglobin concentrations (12,9 ±â€¯2,1 vs 12,8 ±â€¯2,2 g/dL, p = 0.10). In a multivariate model, FB-induced changes in CO (beta 0,77; p = 0.004) and in CVP (beta -0,23; p = 0.02) but not in MAP (beta 0,02; p = 0.18) predicted post-FB ΔSctO2. CONCLUSIONS: Despite improvements in CO and MAP, FB administration did not improve SctO2 in post-cardiac arrest patients.


Assuntos
Hidratação , Parada Cardíaca , Idoso , Pressão Arterial , Débito Cardíaco , Pressão Venosa Central , Feminino , Parada Cardíaca/terapia , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade
13.
Cancer Radiother ; 23(8): 926-929, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31611052

RESUMO

Stereotactic body radiation therapy is still controversial for inoperable patients with central lung lesion. We report the case of a 59-year-old woman with previous history of head and neck squamous cell carcinoma who was treated by lung stereotactic body irradiation for an inoperable lymph node in station 10R. One year after, a fibroscopy showed a necrosis of the right main bronchus mucosae and the CT showed a radio-induced aneurysm protruding into the right inferior lobular bronchus. The patient eventually died a few hours later with a massive haemoptysis. This case highlights the potential toxicity of central lung stereotactic body radiation therapy and raises the question of its legitimacy.


Assuntos
Aneurisma/etiologia , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Neoplasias Pulmonares/radioterapia , Irradiação Linfática/efeitos adversos , Artéria Pulmonar/efeitos da radiação , Radiocirurgia/efeitos adversos , Aneurisma/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/terapia , Fracionamento da Dose de Radiação , Feminino , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Neoplasias Pulmonares/patologia , Irradiação Linfática/métodos , Pessoa de Meia-Idade , Neoplasias Primárias Desconhecidas/terapia , Artéria Pulmonar/diagnóstico por imagem , Radiocirurgia/métodos
14.
Med Mal Infect ; 49(7): 540-544, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31277834

RESUMO

OBJECTIVE: We aimed to describe the effectiveness and safety of the moxifloxacin-rifampicin combination in non-staphylococcal Gram-positive orthopedic implant-related infections. METHODS: Patients treated with the moxifloxacin-rifampicin combination for an implant-related infection from November 2014 to November 2016 were retrospectively identified from the database of the referral centers for bone and joint infections in Western France. RESULTS: Twenty-three cases of infection due to Streptococcus spp. (n=12), Cutibacteriumacnes (n=6), and Enterococcus faecalis (n=5) were included. Ten patients with hip prosthesis were included. Infection was polymicrobial in 11 cases. According to the MIC, moxifloxacin was 1.5 to 11.7 times as active as levofloxacin against non-staphylococcal Gram-positive bacteria. We reported an 81.8% success rate, and no severe adverse effect. CONCLUSION: The moxifloxacin-rifampicin combination is a valuable alternative for the treatment of non-staphylococcal Gram-positive implant-related infections because of the good activity of moxifloxacin against these bacteria and the potential activity on the biofilm.


Assuntos
Antibacterianos/administração & dosagem , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/etiologia , Prótese de Quadril/efeitos adversos , Moxifloxacina/administração & dosagem , Infecções Relacionadas à Prótese/tratamento farmacológico , Rifampina/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/efeitos adversos , Combinação de Medicamentos , Enterococcus faecalis , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Moxifloxacina/efeitos adversos , Propionibacteriaceae , Estudos Retrospectivos , Rifampina/efeitos adversos , Infecções Estreptocócicas , Resultado do Tratamento
15.
PLoS One ; 14(10): e0223857, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31652280

RESUMO

OBJECTIVES: We assessed the determinants of mortality in infective endocarditis (IE), using the national hospital discharge databases (HDD) in 2011. METHODS: IE stays were extracted from the national HDD, with a definition based on IE-related diagnosis codes. This definition has been assessed according to Duke criteria by checking a sample of medical charts of IE giving a predictive positive value of 86.1% (95% confidence interval (CI): 82.7% - 89.5%). The impact of heart valve surgery on survival has been studied if performed during the initial stay, and over the year of follow-up. Risk factors of in-hospital mortality were identified using logistic regression model for the initial stay and Cox Time-dependent model for the 1-year mortality. RESULTS: The analysis included 6,235 patients. The annual incidence of definite IEs was 63 cases/million residents. Staphylococci and Streptococci were the most common bacteria (44% and 45%, respectively). A valvular surgery was performed in 20% of cases, but substantial variations existed between hospitals. The in-hospital mortality was 21% (ranging 12% to 27% according to the region of patients), associated with age>70, chronic liver disease, renal failure, S. aureus, P. aeruginosa or candida infection and strokes whereas valvular surgery, a native valve IE or intraveinous drug use (right heart IE) were significantly protective for an initial death. The same factors were associated with the one-year mortality, except for valvular surgery which was associated with a 1.4-fold higher risk of death during the year post IE. CONCLUSION: We reported a high IE incidence rate. Valvular surgery was considerably less frequent in this study than in the previous published data (near 50%) whereas mortality was similar. Surgery was associated with higher survival if undergone within the initial stay. There were significant regional differences in frequency of surgery but it did not impact mortality.


Assuntos
Endocardite/microbiologia , Valvas Cardíacas/cirurgia , Alta do Paciente/estatística & dados numéricos , Infecções Estafilocócicas/mortalidade , Infecções Estreptocócicas/mortalidade , Idoso , Idoso de 80 Anos ou mais , Endocardite/mortalidade , Feminino , França/epidemiologia , Valvas Cardíacas/microbiologia , Mortalidade Hospitalar , Humanos , Incidência , Estimativa de Kaplan-Meier , Tempo de Internação , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Mortalidade , Estudos Retrospectivos , Infecções Estafilocócicas/epidemiologia , Infecções Estreptocócicas/epidemiologia
16.
Resuscitation ; 123: 92-97, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29122649

RESUMO

AIM: To study the association between global hemodynamics, blood gases, epileptiform EEG activity and survival after out-of-hospital CA (0HCA). METHODS: We retrospectively analyzed 195 comatose post-CA patients. At least one EEG recording per patient was evaluated to diagnose epileptiform EEG activity. Refractory epileptiform EEG activity was defined as persisting epileptic activity on EEG despite the use of 2 or more anti-epileptics. The time weighted average mean arterial pressure 48h (TWA-MAP48), the percentage of time with a MAP below 65 and above 85mmHg and the percentage of time with normoxia, hypoxia (<70mmHg), hyperoxia (>150mmHg), normocapnia, hypocapnia (<35mmHg) and hypercapnia (>45mmHg) were calculated. RESULTS: We observed epileptiform EEG activity in 57 patients (29%). A shockable rhythm was associated with a decreased likelihood of epileptic activity on the EEG (OR: 0.41, 95%CI 0.22-0.79). We did not identify an association between the TWA-MAP48, the percentage of time with MAP below 65mmHg or above 85mmHg, blood gas variables and the risk of post-CA epileptiform EEG activity. The presence of epileptiform activity decreased the likelihood of survival independently (OR: 0.10, 95% CI: 0.04-0.24). Interestingly, survival rates of patients in whom the epileptiform EEG resolved (n=20), were similar compared to patients without epileptiform activity on EEG (60% vs 67%,p=0.617). Other independent predictors of survival were presence of basic life support (BLS) (OR:5.08, 95% CI 1.98-13.98), presence of a shockable rhythm (OR: 7.03, 95% CI: 3.18-16.55), average PaO2 (OR=0.93, CI 95% 0.90-0.96) and% time MAP<65mmHg (OR: 0.96, CI 95% 0.94-0.98). CONCLUSION: Epileptiform EEG activity in post-CA patients is independently and inversely associated with survival and this effect is mainly driven by patients in whom this pattern is refractory over time despite treatment with anti-epileptic drugs. We did not identify an association between hemodynamic factors, blood gas variables and epileptiform EEG activity after CA, although both hypotension, hypoxia and epileptic EEG activity were predictors of survival.


Assuntos
Anticonvulsivantes/uso terapêutico , Gasometria , Dióxido de Carbono/sangue , Parada Cardíaca Extra-Hospitalar/mortalidade , Oxigênio/sangue , Convulsões/tratamento farmacológico , Idoso , Reanimação Cardiopulmonar/estatística & dados numéricos , Estudos de Casos e Controles , Coma/etiologia , Eletroencefalografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Parada Cardíaca Extra-Hospitalar/complicações , Estudos Retrospectivos , Convulsões/etiologia , Análise de Sobrevida
17.
J Clin Invest ; 91(4): 1490-8, 1993 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-7682573

RESUMO

Recently we demonstrated that the nonadherent (to plastic) fraction of human PBMC could be activated by IL-2 to inhibit Cryptococcus neoformans growth. Here we characterize the antifungal effector cells. Depletion by panning of natural killer (NK) (CD16+, CD56+) cells from nylon wool-treated, IL-2-activated PBMC markedly decreased lytic activity against a tumor cell target (K562) but did not affect antifungal activity. Panning out T (CD3+, CD5+) cells enhanced activity against tumor cells but partially abrogated activity against C. neoformans. IL-2-activated T cells of 95% purity, obtained by panning out NK cells from PBMC forming rosettes with sheep erythrocytes, had excellent antifungal activity but suboptimal antitumor activity. The nonrosetted cells (which were virtually free of T cells and enriched for NK cells) had both antitumor and antifungal activity, even if cultured without IL-2. CD4+, CD8+, and CD56+ cells, purified by positive selection by panning, directly inhibited cryptococcal growth. Conjugate formation between fungi and both CD56+ and CD5+ effector cells was demonstrated by videomicroscopy and immunoperoxidase staining. Thus, IL-2-activated T cells and NK cells form conjugates with and directly inhibit the growth of C. neoformans. To our knowledge, these data are the first demonstration of human T cells directly inhibiting growth of a microbial target.


Assuntos
Cryptococcus neoformans/crescimento & desenvolvimento , Interleucina-2/farmacologia , Células Matadoras Naturais/imunologia , Ativação Linfocitária/efeitos dos fármacos , Linfócitos T/imunologia , Animais , Antígenos CD/análise , Antígenos de Diferenciação de Linfócitos T/análise , Antígeno CD56 , Antígenos CD8/análise , Adesão Celular , Separação Celular/métodos , Cryptococcus neoformans/efeitos dos fármacos , Eritrócitos/imunologia , Humanos , Técnicas Imunoenzimáticas , Leucócitos Mononucleares/citologia , Microscopia/métodos , Monócitos/citologia , Formação de Roseta , Ovinos/sangue , Gravação em Vídeo
18.
Transfus Clin Biol ; 14(4): 381-5, 2007 Oct.
Artigo em Francês | MEDLINE | ID: mdl-18037318

RESUMO

UNLABELLED: The proposal for a 300 microg anti-RH1 injection at 28 GW by RH:-1 pregnant women complicates the interpretation of the screening for alloantibodies during pregnancy; to distinguish an alloantibody from a passive one is nevertheless important for the care of the patients. Testing a technique allowing this distinction seems thus necessary. MATERIAL AND METHODS: The technique of microtitration of anti- RH1 antibodies is an indirect antiglobulin test. Two hundred specimens were tested in comparison with a standard prepared from a national anti- RH1 standard. If the anti- RH1 concentration measured is lower or equal to the expected concentration, there is a passive antibody. If the concentration is largely higher, we can suspect an allo-immunization. RESULTS: With this technique, 38 alloanti- RH1 and 112 passive anti- RH1 antibodies were confirmed. Twenty-five diagnosis were modified: seven alloanti- RH1 initially labeled passive and 18 passive anti- RH1 previously considered as alloantibodies. 15 cases can not be concluded, because the blood sample was taking away too early after the injection, and 10 cases are on standby, waiting for a control. DISCUSSION: The microtitration is an important exam in the follow-up of the RH:-1 pregnant women when an anti-RH1 antibody is found. This exam should be offered each time we have no information about the anti-D injection, or when an incoherent reaction compared to the presumed date of injection is observed.


Assuntos
Isoanticorpos/sangue , Gravidez/sangue , Sistema do Grupo Sanguíneo Rh-Hr/imunologia , Feminino , Humanos , Imunoglobulina G/imunologia , Gravidez/imunologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
19.
Arch Pediatr ; 14(7): 887-9, 2007 Jul.
Artigo em Francês | MEDLINE | ID: mdl-17442552

RESUMO

Acute leukemia is uncommon in neonates and has a much poorer prognosis than in older children. We report on a case of acute lymphoblastic leukemia observed in a neonate who had bleeding and hepatosplenomegaly at birth, which justified intensive care during the first postnatal week. Despite early appropriate treatment, the patient died at 7 months of age. We present here physical and laboratory findings, which indicate a grim prognosis. These criteria should be considered carefully in order to ensure a realistic information for the parents and appropriate decisions.


Assuntos
Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Salas de Parto , Evolução Fatal , Humanos , Recém-Nascido , Masculino
20.
Chem Commun (Camb) ; 53(47): 6288-6302, 2017 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-28534592

RESUMO

Thermo-electrochemical cells (also called thermocells) are promising devices for harvesting waste heat for the sustainable production of energy. Research into thermocells has increased significantly in recent years, driven by advantages such as their ability to continuously convert heat into electrical energy without producing emissions or consuming materials. Until relatively recently, the commercial viability of thermocells was limited by their low power output and conversion efficiency. However, there have lately been significant advances in thermocell performance as a result of improvements to the electrode materials, electrolyte and redox chemistry and various features of the cell design. This article overviews these recent developments in thermocell research, including the development of new redox couples, the optimisation of electrolytes for improved power output and high-temperature operation, the design of high surface area electrodes for increased current density and device flexibility, and the optimisation of cell design to further enhance performance.

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