Séroprévalence de l'hépatite A des enfants hospitalisés en service de pédiatrie générale de 2005 à 2007 selon leurs origines familiales et leurs voyages (propositions concernant la vaccination contre l'hépatite A en médecine générale)

Rappels : L hépatite A aiguë est connue pour être une maladie bénigne voire asymptomatique. Cependant 25% des hépatites aiguës graves de l enfant sont dues au virus de l hépatite A (VHA). Il s agit pourtant d une maladie évitable par des vaccins efficaces et donnant une immunité durable. L origine géographique des parents, s il s agit d un pays endémique pour l hépatite A, n est une indication à la vaccination de l enfant en France que depuis avril 2009. Nous nous sommes intéressés dans cette étude au lien qui pourrait exister entre l origine des parents, les antécédents de voyages de l enfant en pays endémique pour le VHA, et la séroprévalence contre le VHA. Méthodes : Dans cette étude rétrospective, nous avons mesuré la séroprévalence d une population d enfants hospitalisés dans un service parisien entre 2005 et 2007 inclus, non vaccinés contre le VHA, selon l origine (endémique ou non) de leurs parents, et leurs éventuels antécédents de voyage. Résultats : La séroprévalence globale était de 8.27% (n=266). Les enfants ayant déjà voyagé en pays endémique avaient une séroprévalence de 28.8 %. La séroprévalence de ceux qui n ont pas voyagé, quelle que soit l origine de leurs parents était de 2.4 %. 93 % des enfants voyageurs sont issus de parents nés en pays endémique. Parmi les enfants non voyageurs : l origine des parents n influe pas dans cette étude sur la séroprévalence contre le VHA. Dans cette étude, tous les enfants séropositifs contre le VHA non vaccinés ont au moins un de leur parents né en pays endémique. Conclusion : Il est primordial de vacciner tous les enfants de plus de 1 an, issus de parents nés en pays endémique, avant même tout projet de voyage.PARIS6-Bibl. St Antoine CHU (751122104) / SudocSudocFranceF

Rotating Hinge Knee Arthroplasty for Revision Prosthetic-Knee Infection: Good Functional Outcomes but a Crucial Need for Superinfection Prevention

Introduction: Management of chronic infection following total knee arthroplasty (TKA) is challenging. Rotating hinged prostheses are often required in this setting due to severe bone loss, ligamentous insufficiency, or a combination of the two. The nature of the mechanical and septic complications occurring in this setting has not been well-described. The aim of this study was to evaluate patient outcomes using a hinge knee prosthesis for prosthetic knee infections and to investigate risk factors for implant removal. Methods: This was a retrospective cohort study that included all patients treated in our tertiary level referral center between January 2009 and December 2016 for prosthetic knee infection with a hinge knee prosthesis. Only patients with a minimum 2-year of follow-up were included. Functional evaluation was performed using international knee society (IKS) "Knee" and "Function" scores. Survival analysis comparing implant removal risks for mechanical and septic causes was performed using Cox univariate analysis and Kaplan-Meier curves. Risk factors for implant removal and septic failure were assessed. Results: Forty-six knees were eligible for inclusion. The majority of patients had satisfactory functional outcomes as determined by mean IKS scores (mean knee score: 70.53, mean function score: 46.53 points, and mean knee flexion: 88.75°). The 2-year implant survival rate was 89% but dropped to 65% at 7 years follow-up. The risk of failure (i.e., implant removal) was higher for septic etiology compared to mechanical causes. Patients with American society of anesthesiologists (ASA) score>1, immunosuppression, or with peripheral arterial diseases had a higher risk for septic failure. Patients with acute infection according to the Tsukayamaclassification had a higher risk of failure. Of the 46 patients included, 19 (41.3%) had atleast one infectious event on the surgical knee and most of these were superinfections (14/19) with new pathogens isolated. Among pathogens responsible for superinfections (i) cefazolin and gentamicin were both active in six of the cases but failed to prevent the superinfection; (ii) cefazolin and/or gentamicin were not active in eight patients, leading to alternative systemic and/or local antimicrobial prophylaxis consideration. Conclusions: Patients with chronic total knee arthroplasty (TKA) infection, requiring revision using rotating hinge implant, had good functional outcomes but experienced a high rate of septic failure, mostly due to bacterial superinfection. These patients may need optimal antimicrobial systemic prophylaxis and innovative approaches to reduce the rate of superinfection

Long length SPNDs and Distributed Optical Fiber Sensors for Severe Accident remote monitoring & their contribution to Nuclear Safety in the post-Fukushima context

International audienceThe Fukushima-Daiichi nuclear accident of March 2011, and the subsequent loss of internal power supplies after the NPP (Nuclear Power Plant) water flooding caused by the tsunami, leaving the operator TEPCO with almost no information from the reactor pits, demonstrates that safety must always prevail.Accordingly, the French public authorities initiated the RSNR research program, to stimulate and fund new R&D projects to improve the safety of nuclear reactors in service and those of future NPPs.The DISCOMS project (Distributed Sensing for Corium Monitoring and Safety) aimed at developing and testing innovative and passive sensors dedicated to Nuclear Safety, namely an instrumented pole equipped with long length SPNDs (Self-Powered Neutron Detectors)-Thermocouple poles, and Distributed Optical Fiber Sensors, to be installed ex-core in both the reactor pit and concrete floor. The sensors, remotely operated from a safe place, will not only provide additional information during the Severe Accident, but also in post-accidental situation, even in case of loss of all power supplies.The modelling of a 60 year normal operation followed by a Severe Accident for two generations of reactors (Gen II, Gen III) permitted to demonstrate that ex-core long length SPNDs can identify different scenarios: reactor shut down, Normal Operation, Severe Accident without corium relocation, and Severe Accident with corium pouring on the concrete floor.Long length SPNDs were designed and manufactured, along with their electronics, to measure low currents ranging from 1 pA to 100 nA collected under radiations, and qualified in a research reactor with fluxes compliant with modelled scenarios.Optical Fibers Sensor cables are devoted to monitor the Molten Core - Concrete Interaction (MCCI): temperature and strain profiles can be provided in the concrete depth by embedded cables, as a result of using the Raman DTS, Brillouin and Rayleigh OFDR reflectometry techniques, based on the analysis of the backscattered light in single-mode optical fibers, for distributed measurements potentially up to 1000°C with Brillouin instrumentations. Additionally, such sensor cables can be used as fuses with telecom or photon counting OTDRs to detect corium vicinity.Sensor cables and radiation resistant optical fibers have been selected and tested to comply with the radiation conditions in the reactor pits as depicted by the modelling.A final MCCI experiment with prototypical corium, performed at the VULCANO CEA facility, involving also two instrumented SPNDs-Thermocouple poles, has demonstrated the ability of both kinds of sensors and corresponding instrumentations to deliver useful information about the corium status and its progression through the concrete

Long length SPNDs and Distributed Optical Fiber Sensors for Severe Accident remote monitoring & their contribution to Nuclear Safety in the post-Fukushima context

International audienceThe Fukushima-Daiichi nuclear accident of March 2011, and the subsequent loss of internal power supplies after the NPP (Nuclear Power Plant) water flooding caused by the tsunami, leaving the operator TEPCO with almost no information from the reactor pits, demonstrates that safety must always prevail.Accordingly, the French public authorities initiated the RSNR research program, to stimulate and fund new R&D projects to improve the safety of nuclear reactors in service and those of future NPPs.The DISCOMS project (Distributed Sensing for Corium Monitoring and Safety) aimed at developing and testing innovative and passive sensors dedicated to Nuclear Safety, namely an instrumented pole equipped with long length SPNDs (Self-Powered Neutron Detectors)-Thermocouple poles, and Distributed Optical Fiber Sensors, to be installed ex-core in both the reactor pit and concrete floor. The sensors, remotely operated from a safe place, will not only provide additional information during the Severe Accident, but also in post-accidental situation, even in case of loss of all power supplies.The modelling of a 60 year normal operation followed by a Severe Accident for two generations of reactors (Gen II, Gen III) permitted to demonstrate that ex-core long length SPNDs can identify different scenarios: reactor shut down, Normal Operation, Severe Accident without corium relocation, and Severe Accident with corium pouring on the concrete floor.Long length SPNDs were designed and manufactured, along with their electronics, to measure low currents ranging from 1 pA to 100 nA collected under radiations, and qualified in a research reactor with fluxes compliant with modelled scenarios.Optical Fibers Sensor cables are devoted to monitor the Molten Core - Concrete Interaction (MCCI): temperature and strain profiles can be provided in the concrete depth by embedded cables, as a result of using the Raman DTS, Brillouin and Rayleigh OFDR reflectometry techniques, based on the analysis of the backscattered light in single-mode optical fibers, for distributed measurements potentially up to 1000°C with Brillouin instrumentations. Additionally, such sensor cables can be used as fuses with telecom or photon counting OTDRs to detect corium vicinity.Sensor cables and radiation resistant optical fibers have been selected and tested to comply with the radiation conditions in the reactor pits as depicted by the modelling.A final MCCI experiment with prototypical corium, performed at the VULCANO CEA facility, involving also two instrumented SPNDs-Thermocouple poles, has demonstrated the ability of both kinds of sensors and corresponding instrumentations to deliver useful information about the corium status and its progression through the concrete

Long length SPNDs and Distributed Optical Fiber Sensors for Severe Accident remote monitoring and their contribution to Nuclear Safety in the post-Fukushima context

International audienceThe Fukushima-Daiichi nuclear accident of March 2011, and the subsequent loss of internal power supplies after the NPP (Nuclear Power Plant) water flooding caused by the tsunami, leaving the operator TEPCO with almost no information from the reactor pits, demonstrates that safety must always prevail. Accordingly, the French public authorities initiated the RSNR research program, to stimulate and fund new R&D projects to improve the safety of nuclear reactors in service and those of future NPPs. The DISCOMS project (Distributed Sensing for Corium Monitoring and Safety) aimed at developing and testing innovative and passive sensors dedicated to Nuclear Safety, namely an instrumented pole equipped with long length SPNDs (Self-Powered Neutron Detectors)-Thermocouple poles, and Distributed Optical Fiber Sensors, to be installed ex-core in both the reactor pit and concrete floor. The sensors, remotely operated from a safe place, will not only provide additional information during the Severe Accident, but also in post-accidental situation, even in case of loss of all power supplies.The modelling of a 60 year normal operation followed by a Severe Accident for two generations of reactors (Gen II, Gen III) permitted to demonstrate that ex-core long length SPNDs can identify differentscenarios: reactor shut down, Normal Operation, Severe Accident without corium relocation, and Severe Accident with corium pouring on the concrete floor. Long length SPNDs were designed and manufactured, along with their electronics, to measure low currents ranging from 1 pA to 100 nA collected under radiations, and qualified in a research reactor with fluxes compliant with modelled scenarios. Optical Fibers Sensor cables are devoted to monitor the Molten Core – Concrete Interaction (MCCI): temperature and strain profiles can be provided in the concrete depth by embedded cables, as a result ofusing the Raman DTS, Brillouin and Rayleigh OFDR reflectometry techniques, based on the analysis of the backscattered light in single-mode optical fibers, for distributed measurements potentially up to1000°C with Brillouin instrumentations. Additionally, such sensor cables can be used as fuses with telecom or photon counting OTDRs to detect corium vicinity.Sensor cables and radiation resistant optical fibers have been selected and tested to comply with the radiation conditions in the reactor pits as depicted by the modelling.A final MCCI experiment with prototypical corium, performed at the VULCANO CEA facility, involving also two instrumented SPNDs-Thermocouple poles, has demonstrated the ability of both kinds of sensors and corresponding instrumentations to deliver useful information about the corium status and its progression through the concrete

Long length SPNDs and Distributed Optical Fiber Sensors for Severe Accident remote monitoring and their contribution to Nuclear Safety in the post-Fukushima context

International audienceThe Fukushima-Daiichi nuclear accident of March 2011, and the subsequent loss of internal power supplies after the NPP (Nuclear Power Plant) water flooding caused by the tsunami, leaving the operator TEPCO with almost no information from the reactor pits, demonstrates that safety must always prevail. Accordingly, the French public authorities initiated the RSNR research program, to stimulate and fund new R&D projects to improve the safety of nuclear reactors in service and those of future NPPs. The DISCOMS project (Distributed Sensing for Corium Monitoring and Safety) aimed at developing and testing innovative and passive sensors dedicated to Nuclear Safety, namely an instrumented pole equipped with long length SPNDs (Self-Powered Neutron Detectors)-Thermocouple poles, and Distributed Optical Fiber Sensors, to be installed ex-core in both the reactor pit and concrete floor. The sensors, remotely operated from a safe place, will not only provide additional information during the Severe Accident, but also in post-accidental situation, even in case of loss of all power supplies.The modelling of a 60 year normal operation followed by a Severe Accident for two generations of reactors (Gen II, Gen III) permitted to demonstrate that ex-core long length SPNDs can identify differentscenarios: reactor shut down, Normal Operation, Severe Accident without corium relocation, and Severe Accident with corium pouring on the concrete floor. Long length SPNDs were designed and manufactured, along with their electronics, to measure low currents ranging from 1 pA to 100 nA collected under radiations, and qualified in a research reactor with fluxes compliant with modelled scenarios. Optical Fibers Sensor cables are devoted to monitor the Molten Core – Concrete Interaction (MCCI): temperature and strain profiles can be provided in the concrete depth by embedded cables, as a result ofusing the Raman DTS, Brillouin and Rayleigh OFDR reflectometry techniques, based on the analysis of the backscattered light in single-mode optical fibers, for distributed measurements potentially up to1000°C with Brillouin instrumentations. Additionally, such sensor cables can be used as fuses with telecom or photon counting OTDRs to detect corium vicinity.Sensor cables and radiation resistant optical fibers have been selected and tested to comply with the radiation conditions in the reactor pits as depicted by the modelling.A final MCCI experiment with prototypical corium, performed at the VULCANO CEA facility, involving also two instrumented SPNDs-Thermocouple poles, has demonstrated the ability of both kinds of sensors and corresponding instrumentations to deliver useful information about the corium status and its progression through the concrete

Long length SPNDs and Distributed Optical Fiber Sensors for Severe Accident remote monitoring & their contribution to Nuclear Safety in the post-Fukushima context

International audienceThe Fukushima-Daiichi nuclear accident of March 2011, and the subsequent loss of internal power supplies after the NPP (Nuclear Power Plant) water flooding caused by the tsunami, leaving the operator TEPCO with almost no information from the reactor pits, demonstrates that safety must always prevail.Accordingly, the French public authorities initiated the RSNR research program, to stimulate and fund new R&D projects to improve the safety of nuclear reactors in service and those of future NPPs.The DISCOMS project (Distributed Sensing for Corium Monitoring and Safety) aimed at developing and testing innovative and passive sensors dedicated to Nuclear Safety, namely an instrumented pole equipped with long length SPNDs (Self-Powered Neutron Detectors)-Thermocouple poles, and Distributed Optical Fiber Sensors, to be installed ex-core in both the reactor pit and concrete floor. The sensors, remotely operated from a safe place, will not only provide additional information during the Severe Accident, but also in post-accidental situation, even in case of loss of all power supplies.The modelling of a 60 year normal operation followed by a Severe Accident for two generations of reactors (Gen II, Gen III) permitted to demonstrate that ex-core long length SPNDs can identify different scenarios: reactor shut down, Normal Operation, Severe Accident without corium relocation, and Severe Accident with corium pouring on the concrete floor.Long length SPNDs were designed and manufactured, along with their electronics, to measure low currents ranging from 1 pA to 100 nA collected under radiations, and qualified in a research reactor with fluxes compliant with modelled scenarios.Optical Fibers Sensor cables are devoted to monitor the Molten Core - Concrete Interaction (MCCI): temperature and strain profiles can be provided in the concrete depth by embedded cables, as a result of using the Raman DTS, Brillouin and Rayleigh OFDR reflectometry techniques, based on the analysis of the backscattered light in single-mode optical fibers, for distributed measurements potentially up to 1000°C with Brillouin instrumentations. Additionally, such sensor cables can be used as fuses with telecom or photon counting OTDRs to detect corium vicinity.Sensor cables and radiation resistant optical fibers have been selected and tested to comply with the radiation conditions in the reactor pits as depicted by the modelling.A final MCCI experiment with prototypical corium, performed at the VULCANO CEA facility, involving also two instrumented SPNDs-Thermocouple poles, has demonstrated the ability of both kinds of sensors and corresponding instrumentations to deliver useful information about the corium status and its progression through the concrete

Reprise de l'audition de M. Carrier devant la Convention qui remplit les fonctions de jury d'accusation, lors de la séance du 3 frimaire an III (23 novembre 1794)

Le Cointre Laurent, Coren-Fustier Simon-Joseph, Tallien Jean-Lambert, Dubois de Crancé Edmond Louis, Menuau Henri, Cambon Pierre-Joseph, Bô Jean-Baptiste, Legendre (de Paris) Louis, Bourdon (de l'Oise) François-Louis, Treilhard Jean-Baptiste, Bourbotte Pierre, Carrier Jean-Baptiste. Reprise de l'audition de M. Carrier devant la Convention qui remplit les fonctions de jury d'accusation, lors de la séance du 3 frimaire an III (23 novembre 1794). In: Archives Parlementaires de 1787 à 1860 - Première série (1787-1799) Tome CII - Du 1er au 12 frimaire An III (21 novembre au 2 décembre 1794) Paris : CNRS éditions, 2012. pp. 84-93