Functional outcomes in adult patients with herpes simplex encephalitis admitted to the ICU: a multicenter cohort study

PURPOSE: We aimed to study the association of body temperature and other admission factors with outcomes of herpes simplex encephalitis (HSE) adult patients requiring ICU admission. METHODS: We conducted a retrospective multicenter study on patients diagnosed with HSE in 47 ICUs in France, between 2007 and 2017. Fever was defined as a body temperature higher or equal to 38.3 °C. Multivariate logistic regression analysis was used to identify factors associated with poor outcome at 90 days, defined by a score of 3-6 (indicating moderate-to-severe disability or death) on the modified Rankin scale. RESULTS: Overall, 259 patients with a score on the Glasgow coma scale of 9 (6-12) and a body temperature of 38.7 (38.1-39.2) °C at admission were studied. At 90 days, 185 (71%) patients had a poor outcome, including 44 (17%) deaths. After adjusting for age, fever (OR = 2.21; 95% CI 1.18-4.16), mechanical ventilation (OR = 2.21; 95% CI 1.21-4.03), and MRI brain lesions > 3 lobes (OR = 3.04; 95% CI 1.35-6.81) were independently associated with poor outcome. By contrast, a direct ICU admission, as compared to initial admission to the hospital wards (i.e., indirect ICU admission), was protective (OR = 0.52; 95% CI 0.28-0.95). Sensitivity analyses performed after adjustment for functional status before admission and reason for ICU admission yielded similar results. CONCLUSIONS: In HSE adult patients requiring ICU admission, several admission factors are associated with an increased risk of poor functional outcome. The identification of potentially modifiable factors, namely, elevated admission body temperature and indirect ICU admission, provides an opportunity for testing further intervention strategies

نشأة وعمر الصخور الجرانيتية المتداخلة بجبل كوليت وسيجه جنوب الصحراء الشرقية بمصر

In the South Eastern Desert of Egypt tonalite. granodiorite and granite intruded intermediate to acidic metavolcanics and volcanogenic metasedimentary rocks of Precambrian age. The geological features of these granitic masses were investigated and a geological map (scale 1 : 40 000) was prepared. They have been classified into two groups: tonalite and granodiorite (syn to late-tectonic), and biotite and Muscovite granites (younger granitoids). The two groups appear to be genetically related on the basis of their major and trace element contents. The chemical compositions of these tonalitic to granitic rocks indicate that these granitic rocks belong to calc-alkaline series. The magma, during crystallisation, was under 3-4 kb pressure. Radiometric age determination indicates that they have a Pan-African age of 589 to 603 Ma. It is believed that these granitic intrusions have been intruded directly after the tectonic modification of an island arc.يقع جبل سيجه وجبل كوليت في جنوب الصحراء الشرقية بمصر، وهما يمثلان بكتل جرانيتية يتراوح تركيبها من صخور التوناليت إلى صخور الجرانيت متداخلة في صخور بركانية متوسطة وحمضية. تم رسم خريطة جيولوجية للمنطقة مقياس 40000:1 وقسمت هذه الصخور إلى مجموعتين الأولى صخور التوناليت والجرانوديوريت ، والثانية صخور الجرانيت الممثلة بالبيوتيت جرانيت والمسكوفيت جرانيت . وقد اتضح من الدراسة البتروجرافية والكيميائية وجود علاقة بين المجموعتين من حيث النشأة والتطور الصهيري وأنهم يتبعون مجموعة الصخور الكلس قلوية ، وتد تبلورت هذه الصخور تحت ضغط متوسط أثناء تكون أقواس الجزر . ومن تقدير عمر صخور المسكوفيت جرانيت بطريقة البوتاسيوم / أرجون ، اتضح أن عمرها يتراوح بين 589 و 602 مليون سنة