Un hameau du Ve s. av. J.‑C. en Minervois : la Condamine (Villeneuve-Minervois, Aude)

Fouillé en 2008 dans le cadre d’une opération archéologique préventive sur la commune de Villeneuve-Minervois par Oxford Archéologie Méditerranée, le site de la Condamine correspond à un établissement rural dont l’occupation est centrée sur le Ve s. av. J.‑C. Les éléments architecturaux témoignent de la présence de constructions à ossatures de bois. Un examen de la répartition et de l’agencement des négatifs de poteaux permet de restituer la trame d’un hameau s’organisant autour d’un noyau principal réunissant des habitations, au nord et au sud desquelles se développent des petites constructions, correspondant pour certaines peut-être à des greniers. Deux séquences constructives se sont succédées. L’une d’elle concerne un vaste édifice bi-absidial, l’autre des bâtiments à plan quadrangulaire. D’autres structures liées au fonctionnement de l’occupation ont été mises au jour, notamment un foyer en fosse, un four et une carrière d’extraction d’argile.Excavated in 2008 thanks to a preventive archaeological operation in the municipality of Villeneuve-Minervois by Oxford Archéologie Méditerrannée, this site of La Condamine consists in a rural settlement occupied around the 5th century BC. The architectural elements testify of a presence of woodframe constructions. Analysing the distribution and the layout of the poles’ negatives allows to restore the frame of a hamlet. It is organised around a core of residential units with small constructions in their North and South. Some of the latter may correspond to granaries. Two periods of building have followed one another : one relative to a vast bi-apsidal edifice, the other to quadrangular buildings. Other structures linked to the functioning of the settlement have been uncovered, in particular a fireplace situated in a pit, an oven and a clay quarry

Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre, open-label, randomised, phase 3 trial

Background: Respiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity. Methods: PRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of pneumonia, endotracheal re-intubation, or death within 30 days after randomisation, assessed in the intention-to-treat population. Safety was assessed in all patients who received CPAP. The trial is registered with the ISRCTN registry, ISRCTN56012545. Findings: Between Feb 8, 2016, and Nov 11, 2019, 4806 patients were randomly assigned (2405 to the CPAP group and 2401 to the usual care group), of whom 4793 were included in the primary analysis (2396 in the CPAP group and 2397 in the usual care group). 195 (8\ub71%) of 2396 patients in the CPAP group and 197 (8\ub72%) of 2397 patients in the usual care group met the composite primary outcome (adjusted odds ratio 1\ub701 [95% CI 0\ub781-1\ub724]; p=0\ub795). 200 (8\ub79%) of 2241 patients in the CPAP group had adverse events. The most common adverse events were claustrophobia (78 [3\ub75%] of 2241 patients), oronasal dryness (43 [1\ub79%]), excessive air leak (36 [1\ub76%]), vomiting (26 [1\ub72%]), and pain (24 [1\ub71%]). There were two serious adverse events: one patient had significant hearing loss and one patient had obstruction of their venous catheter caused by a CPAP hood, which resulted in transient haemodynamic instability. Interpretation: In this large clinical effectiveness trial, CPAP did not reduce the incidence of pneumonia, endotracheal re-intubation, or death after major abdominal surgery. Although CPAP has an important role in the treatment of respiratory failure after surgery, routine use of prophylactic post-operative CPAP is not recommended