Optical spectroscopy for real-time neuronavigation during deep brain stimulation surgeries

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A historical overview of the classification, evolution, and dispersion of Leishmania parasites and sandflies

Background The aim of this study is to describe the major evolutionary historical events among Leishmania, sandflies, and the associated animal reservoirs in detail, in accordance with the geographical evolution of the Earth, which has not been previously discussed on a large scale. Methodology and Principal Findings Leishmania and sandfly classification has always been a controversial matter, and the increasing number of species currently described further complicates this issue. Despite several hypotheses on the origin, evolution, and distribution of Leishmania and sandflies in the Old and New World, no consistent agreement exists regarding dissemination of the actors that play roles in leishmaniasis. For this purpose, we present here three centuries of research on sandflies and Leishmania descriptions, as well as a complete description of Leishmania and sandfly fossils and the emergence date of each Leishmania and sandfly group during different geographical periods, from 550 million years ago until now. We discuss critically the different approaches that were used for Leishmana and sandfly classification and their synonymies, proposing an updated classification for each species of Leishmania and sandfly. We update information on the current distribution and dispersion of different species of Leishmania (53), sandflies (more than 800 at genus or subgenus level), and animal reservoirs in each of the following geographical ecozones: Palearctic, Nearctic, Neotropic, Afrotropical, Oriental, Malagasy, and Australian. We propose an updated list of the potential and proven sandfly vectors for each Leishmania species in the Old and New World. Finally, we address a classical question about digenetic Leishmania evolution: which was the first host, a vertebrate or an invertebrate? Conclusions and Significance We propose an updated view of events that have played important roles in the geographical dispersion of sandflies, in relation to both the Leishmania species they transmit and the animal reservoirs of the parasites

Pneumopathies communautaires à Staphylococcus aureus secréteur de leucocidine de Panton-Valentine (à propos de 4 cas cliniques)

PARIS6-Bibl.Pitié-Salpêtrie (751132101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Analyse descriptive et facteurs prédictifs de mortalité des hémoptysies admises en réanimation entre 1995 et 2006

Les données de la littérature concernant les hémoptysies admises en réanimation sont rares. L objectif de cette étude est de préciser les facteurs prédictifs de mortalité hospitalière de cette pathologie, à partir des données disponibles à l admission en réanimation. Nous avons recrutés 712 patients dont 70% d hommes et 66% de tabagiques, actifs ou sevrés, admis en réanimation dans un hôpital universitaire pour hémoptysie de 1995 à 2006. L age moyen est de 53 ans (+-17). Le volume de l hémoptysie à l admission a une moyenne de 219mL (+-196) et une médiane de 150mL. Les étiologies sont : la dilatation des bronches (36%), le cancer (15%), la tuberculose active (12%) et les aspergillomes (6%). 15% des hémoptysies sont cryptogéniques. La mortalité hospitalière globale est de 7,2%. L analyse analyse multivariée permet de dégager les facteurs prédictifs de mortalité hospitalière suivants : le Performance Status supérieur ou égal à 1, la consommation de plus du 50 grammes d alcool par jour, un traitement anticoagulant, la nécessité d une ventilation mécanique ou d amines vaso-actives, d un traitement par glypressine systémique. Le volume de l hémoptysie ne ressort pas comme facteur prédictif de mortalité. Ceci peut être expliqué par l utilisation de cette donnée dans l algorithme décisionnel de prise en charge des hémoptysies et par l association entre le volume et l indication de la glypressine. Ces données doivent maintenant être confirmées par une étude prospective.PARIS6-Bibl.Pitié-Salpêtrie (751132101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Facteurs prédictifs de mortalité à court terme chez les patients atteints de cancer bronchique admis en réanimation

Centre Technique Livre Ens. Sup. (774682301) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Pronostic des hémorragies intra-alvéolaires de l adulte immunocompétent

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Hémorragies intra-alvéolaires de l'immunocompétent (diagnostic précoce des formes immunes, facteurs pronostiques)

PARIS6-Bibl.Pitié-Salpêtrie (751132101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Hémoptysie sur cancer pulmonaire dans une unité de soins intensifs

Dans l hémoptysie grave secondaire au cancer pulmonaire, les données sur la prise en charge, l efficacité des traitements notamment l artériographie bronchique avec embolisation et l évolution sont rares. Nous avons conduit une étude rétrospective sur 102 patients admis pour une hémoptysie grave secondaire à un cancer pulmonaire hospitalisés entre mai 1995 et février 2008, dans une unité de soins intensifs. Ces patients, avec un âge médian de 63 ans (+-19) et un PS= 2, le caractère étendu du cancer (stade IIIB, IV ou cancer à petites cellules disséminées) et le recours à la ventilation mécanique. Les facteurs pronostics de mortalité à un an, sont l usage abusif d alcool, le performans status >= 2, un volume émis à l admission >= 300ml et un cancer en progression. Les patients, présentant une hémoptysie secondaire à un cancer pulmonaire dont l état général est satisfaisant, ont un pronostic justifiant une prise en charge multidisciplinaire en unité de soins intensifs compte tenu de l efficacité des thérapeutiques proposées et de la survie à un an. L artério-embolisation peut être proposé comme traitement de première intention.In patients admitted to the intensive care unit (ICU) for severe haemoptysis related with lung cancer, there are limited data on management, effectiveness of arterial embolization and patients'outcome. We conducted a retrospective study of 102 cases of severe haemoptysis due to bronchial carcinoma (non-small cell lung cancer 92%) admitted to he ICU between may 1995 and february 2008. Median age was 63 (53-71) years, performance status (PS) was 2, mechanical ventilation, and an extensive disease (stage IIIB, IV or extensive small cell cancer) .Also, alcohol abuseand a cumulated volume of haemoptysis at admission were associated with one year mortality in the multivariate model. In conclusion, our results suggests that a multidisciplinary approach should be adopted for the management of patients with hemoptysis as a complication of their lung cancer and arterial embolization should be proposed as first line therapy in such patients.ST QUENTIN EN YVELINES-BU (782972101) / SudocSudocFranceF

Transformation and Evaluation of the MIMIC Database in the OMOP Common Data Model: Development and Usability Study

BackgroundIn the era of big data, the intensive care unit (ICU) is likely to benefit from real-time computer analysis and modeling based on close patient monitoring and electronic health record data. The Medical Information Mart for Intensive Care (MIMIC) is the first open access database in the ICU domain. Many studies have shown that common data models (CDMs) improve database searching by allowing code, tools, and experience to be shared. The Observational Medical Outcomes Partnership (OMOP) CDM is spreading all over the world. ObjectiveThe objective was to transform MIMIC into an OMOP database and to evaluate the benefits of this transformation for analysts. MethodsWe transformed MIMIC (version 1.4.21) into OMOP format (version 5.3.3.1) through semantic and structural mapping. The structural mapping aimed at moving the MIMIC data into the right place in OMOP, with some data transformations. The mapping was divided into 3 phases: conception, implementation, and evaluation. The conceptual mapping aimed at aligning the MIMIC local terminologies to OMOP's standard ones. It consisted of 3 phases: integration, alignment, and evaluation. A documented, tested, versioned, exemplified, and open repository was set up to support the transformation and improvement of the MIMIC community's source code. The resulting data set was evaluated over a 48-hour datathon. ResultsWith an investment of 2 people for 500 hours, 64% of the data items of the 26 MIMIC tables were standardized into the OMOP CDM and 78% of the source concepts mapped to reference terminologies. The model proved its ability to support community contributions and was well received during the datathon, with 160 participants and 15,000 requests executed with a maximum duration of 1 minute. ConclusionsThe resulting MIMIC-OMOP data set is the first MIMIC-OMOP data set available free of charge with real disidentified data ready for replicable intensive care research. This approach can be generalized to any medical field