Les enfants de moins de 15 ans amenés par les pompiers aux urgences pédiatriques d'un CHR (épidémiologie, justification de l'usage du transport urgent et du plateau technique, projet de remédiation aux mésusages constatés)

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

Delayed hemolytic transfusion reaction in children with sickle cell disease

International audienceBackground Transfusion is a cornerstone of the management of sickle cell disease but carries a high risk of hemolytic transfusion reaction, probably because of differences in erythrocyte antigens between blood donors of European descent and patients of African descent. Patients may experience hemolytic transfusion reactions that are delayed by from a few days to two weeks and manifest as acute hemolysis (hemoglobinuria, jaundice, and pallor), symptoms suggesting severe vaso-occlusive crisis (pain, fever, and acute chest syndrome), and profound anemia, often with reticulocytopenia. This case-series study aims to describe the main characteristics of this syndrome, to discuss its pathophysiology, and to propose a management strategy. DESIGN AND METHODS: We identified 8 pediatric cases of delayed hemolytic transfusion reactions between 2006 and 2009 in the database of the Necker Hospital, France. All patients had received cross-matched red cell units compatible in the ABO, RH, and KEL systems. We reviewed the medical charts in the computerized blood transfusion databases. All patients were admitted to the intensive care unit. We progressively adopted the following strategy: intravenous immunoglobulins, and darbopoietin alpha when the reticulocyte count was below 150×10(9)/L, without further blood transfusion during the acute episode unless absolutely necessary. RESULTS: The median time between the transfusion and the diagnosis of delayed hemolytic transfusion reaction was six days. All patients had severe bone pain; all but one had a high-grade fever. Five patients had hemoglobin levels less than than 4g/dL and 3 had reticulocytopenia. In 5 patients, no new antibody was found; one patient had weakly reactive antibodies. Only 2 patients had new allo-antibodies possibly responsible for the delayed hemolytic reaction. Conclusions The initial symptoms of delayed hemolytic transfusion reaction were complex and mimicked other complications of sickle cell disease. In most of our cases, no new antibody was identified, which underlines the complexity of the pathophysiology of this syndrome

Artistas latino-americanos na Paris modernista: a difícil consagração

Este artigo busca problematizar as possibilidades de reconhecimento obtidas por artistas latino-americanos na Paris modernista. A partir das teorias sobre consagração artística, analisa-se principalmente o processo de musealização das obras de artistas latino-americanos que passaram a compor os acervos públicos franceses entre a década de 1910 e a fundação do Musée National d’Art Moderne, em 1947. A pesquisa realizada nos Archives Nationales permitiu identificar quantos e quais, dentre os mais de trezentos artistas latino-americanos atuantes em Paris, foram escolhidos para comporem tais coleções. Como se verá, foram realmente poucos aqueles que conseguiram ter suas obras inseridas numa coleção pública francesa, e mesmo assim, isso não garantiu visibilidade na época, como as flagrantes ausências no MNAM bem revelam.This article seeks to problematize the recognition possibilities of Latin American artists in modernist Paris. Based on theories of artistic consecration, this article analyzes the process of musealization of works by Latin American artists, who became part of French public collections between the 1910s and the founding of the Musée National d’Art Moderne in 1947. The research, carried out in the Archives Nationales, made it possible to identify how many and which, among the more than three hundred Latin American artists who developed their work in Paris, were chosen to become part of these collections. As we will see, only a minuscule few actually managed to have their works included in a French public collection. Even when they did, this was hardly a guarantee of visibility, as revealed by certain blatant absences in the MNAM collection

L’identification biométrique

Depuis quelques années, tant au niveau national que transnational, la biométrie s’impose comme une technologie privilégiée d’identification des personnes. En effet, elle fait l’objet d’un essor considérable dans la sphère domestique, dans les établissements scolaires, dans les entreprises, dans le champ de la sécurité, etc. Ce phénomène soulève une profusion de nouveaux enjeux. De quelle manière appréhender la biométrie au regard de l’histoire longue des procédures visant à déterminer et fixer la singularité de chacun ? Comment les dispositifs biométriques fonctionnent-ils ? Quelles populations prennent-ils prioritairement pour cible ? Comment la biométrie affecte-t-elle la notion d’identité individuelle et le statut conféré au corps humain ? Constitue-t-elle une menace pour la vie privée et les droits fondamentaux ? À quels enjeux économiques renvoie-t-elle ? Dans quelle mesure son utilisation transforme-t-elle les logiques à l’œuvre dans l’univers policier ? Pourquoi certains l’acceptent-ils sans rechigner tandis que d’autres s’y opposent avec virulence en pointant les graves dangers dont elle serait porteuse ? Ce sont quelques-unes des questions passionnantes auxquelles s’intéressent les nombreuses contributions ici rassemblées. Croisant les regards de chercheurs issus de pays et de disciplines différentes (histoire, droit, science poli­tique, anthropologie, philosophie, etc.) et ceux d’acteurs en prise directe avec certains aspects de la biométrie du fait des fonctions qu’ils exercent, cet ouvrage collectif s’impose comme incontournable pour tous ceux qui sont désireux de mieux comprendre la complexité d’un sujet au cœur de l’actualité n’ayant pourtant jusqu’alors été que très peu étudié

Varia

Tema ovog rada je ranokršćansko i ranosrednjovjekovno preslojavanje antičkih kultnih mjesta u Dalmaciji. Prvo poglavlje sadržava kratki pregled povijesnih i društvenih okolnosti koje su utjecale na promjene koje su se događale u tom razdoblju u Dalmaciji. Iduća dva poglavlja obrađuju potvrđene i nepotvrđene primjere preslojavanja. Kada su u pitanju potvrđeni primjeri vidljivo je da su često lokaliteti prošli optimalno preslojavanje. Uglavnom se gradi na ostatcima hramova ili se hramovi adaptiraju. Samo jedan od potvrđenih primjera je primjer nasilnog preslojavanja. Nepotvrđeni primjeri su podijeljeni na kultne prostore uz gradska vrata, svetišta u prirodi, nepotvrđene primjere preslojavanja poganskih hramova, ranokršćanske građevine na rimskim forumima te preobrazbe poganskih kućnih svetišta. Ti primjeri nisu potvrđeni, ali ih se ne može u potpunosti odbaciti kada se obrađuje tema ranokršćanskog preslojavanja antičkih kultnih mjesta. Kroz obradu potvrđenih i nepotvrđenih primjera zaključuje se da je kršćanstvo uklanjalo poganske elemente i preuzimalo poganske građevine i lokalitete, ali da mu razaranje nije bio glavni cilj preslojavanja.The theme of this paper is the early Christian and the early medieval layering of ancient cult sites in Dalmatia. The first chapter provides a brief overview of the historical and social circumstances that influenced the changes that took place during this period in Dalmatia. The next two chapters deal with confirmed and unconfirmed examples of layering. When it comes to confirmed examples, it is obvious that often the sites have undergone optimal changes. They are mostly built on the remains of temples or in other cases the temples have been adapted. Only one confirmed example is an example of a violent overlay. Unconfirmed examples are divided into cult spaces next to city gates, shrines in nature, unconfirmed examples of layering of pagan temples, early Christian structures on Forum Romanum, and conversion of pagan home shrines. These examples are unconfirmed, but they cannot be completely dismissed when addressing the theme of early Christian layering of ancient cult sites. Through the processing of confirmed and unconfirmed examples, it is concluded that Christianity was removing pagan elements and taking over pagan buildings and sites, but that destruction was not the main purpose of the layering