Functional Decline in COVID-19 Older Survivors Compared to Other Pneumonia Patients, a Case Control Study.

OBJECTIVES: Among patients over 75 years, little is known about functional decline due to COVID-19. The aim of this study was to explore this functional decline, compare to other infectious pneumonia. DESIGN AND SETTING: This case-control study included all COVID-19 patients hospitalized from March to December 2020 in Acute Geriatric Ward in Nantes University Hospital matched 1/1 with patients with pneumonia hospitalized in geriatric department between March 2017 and March 2019 (controls) on sex, age. Functional decline was assessed at 3 month follow up as it is routinely done after hospitalization in geriatric ward. We performed multivariable analyses to compare clinical outcomes between patients with COVID-19 vs controls. RESULTS: 132 pairs were matched on age (mean: 87 y-o), and sex (61% of women). In multivariable logistic regression analysis, there were no statistical significant association between COVID-19 infection and functional decline (OR=0.89 p=0.72). A statistical significant association was found between functional decline and Charlson comorbidity index (OR=1.17, p=0.039); prior fall (OR=2.08, p=0.012); malnutrition (OR=1.97, p=0.018); length of hospital stay (OR=1.05, p=0.002) and preadmission ADL(OR=1.25, p=0.049). CONCLUSION: COVID-19 does not seem to be responsible for a more frequent or severe functional decline than other infectious pneumonia in older and comorbid population after 3 month follow up. In this population, pneumonia is associated with functional decline in almost 1 in 2 cases. The individual preadmission frailty seems to be a more important predictor of functional decline, encouraging multidimensional care management for this population.

Development and validation of the Standard method EN ISO 19020 - microbiology of the food chain - Horizontal method for the immunoenzymatic detection of staphylococcal enterotoxins in foodstuffs.

In the frame of the CEN Mandate M/381 from the European Commission to CEN (European Committee for Standardization), a method for the detection of staphylococcal enterotoxins in foodstuffs has been developed, validated and standardized. An extraction procedure based on dialysis concentration followed by an immuno-enzymatic detection has been defined. In addition, performance criteria (minimum values of sensitivity, specificity and level of detection) to be achieved by the commercially available immuno-enzymatic kits that could be used to detect staphylococcal enterotoxins in food matrices, were developed. A 2-stage validation study was conducted: The first stage aimed at selecting the commercial kits to be included in the second stage, which consisted in an interlaboratory study, using eight matrices covering five food categories (ready-to-eat food, meat products, milk products, dessert and fish). Results showed that two detection kits included in the study met the pre-defined performance criteria. The implementation of dialysis concentration step increased significantly the sensitivity of the method. The method developed allowed to achieve the Benchmark Dose lower limit (BMD10) estimated at 6.1 ng. In 2019, finally, the European Commission recognized this standard as the European Union reference method for the detection of staphylococcal enterotoxins in food.

Estimulador elétrico de alta potência para experimentos fisiológicos / High-powered electrical stimulator for physiological experiments

The present high-power electrical stimulator can generate monopolar or bipolar pulses for stimulation of excitable tissues and cells in physiological experiments...

Parotidectomy: a plastic approach.

Three disadvantages are frequent after parotidectomy: a scar affecting the neck, a deep hollow between the sternocleidomastoid muscle and the mandible (the larger the resection is, the deeper is the hollow), and a sweat secretion. These disadvantages can be prevented or reduced by using four simple procedures: (1) using a facelift incision; (2) using a very simple and original "trick," by displacing outward the posterior belly of the digastric muscle; (3) using a flap with an upper pedicle taken from the sternocleidomastoid muscle; and (4) using a double free graft, taken from the superficial and deep temporal fascias. These two grafts lay down on the net constituted by the preceding flaps. They line the skin, thus blocking the wrong innervation.

[Familial Budd Chiari syndrome and glomerular involvement]. / Syndrome de Budd Chiari familial et atteinte glomérulaire.

We report a case of a child with familial Budd-Chiari syndrome and proteinuria. Renal biopsy disclosed predominant arteriolo-capillary endothelial and mesangial lesions suggesting a microangiopathy. This may be due to hypoxemic damage with polycythemia and high venous pressure resulting from precapillary pulmonary arteriovenous shunts.