South American perspective of the International Charter "Space and Major Disasters"

International audienceThe International Charter "Space and Major Disasters" is about joint operations and tasking of imaging satellites and other space resources of the member space agencies and operators in the delivery of information products to assist in responding to disasters of natural and technological causes. Authorized Users, who are the civil protection, emergency response or similar organizations of a state that is member of the Charter, can request the data and products. A specialist, called the Project Manager (PM), manages the overall data acquisition and delivery process. Regional initiatives, as for the Latin American countries, are under way to involve PMs from non-member states to have access to satellite data and apply these to disaster coverage in their respective regions. Volcanic eruptions are typical examples of disasters that affect the Latin American countries. A few Charter activations on this disaster type are described to highlight the information products provided under the Charter

Automating the measurement of physiological parameters: a case study in the image analysis of cilia motion

International audienceAs image processing and analysis techniques improve, an increasing number of procedures in bio-medical analyses can be automated. This brings many benefits, e.g improved speed and accuracy, leading to more reliable diagnoses and follow-up, ultimately improving patients outcome. Many automated procedures in bio-medical imaging are well established and typically consist of detecting and counting various types of cells (e.g. blood cells, abnormal cells in Pap smears, and so on). In this article we propose to automate a different and difficult set of measurements, which is conducted on the cilia of people suffering from a variety of respiratory tract diseases. Cilia are slender, microscopic, hair-like structures or organelles that extend from the surface of nearly all mammalian cells. Motile cilia, such as those found in the lungs and respiratory tract, present a periodic beating motion that keep the airways clear of mucus and dirt. In this paper, we propose a fully automated method that computes various measurements regarding the motion of cilia, taken with high-speed video-microscopy. The advantage of our approach is its capacity to automatically compute robust, adaptive and regionalized measurements, i.e. associated with different regions in the image. We validate the robustness of our approach, and illustrate its performance in comparison to the state-of-the-art

Supportive care in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis : an international, multidisciplinary Delphi-based consensus

Background Supportive care is the cornerstone of management of adult and paediatric Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, consensus on the modalities of supportive care is lacking. Objectives Our aim in this international multicentric Delphi exercise was to establish a multidisciplinary expert consensus to standardize recommendations regarding supportive care in the acute phase of SJS/TEN. Methods Participants were sent a survey via the online tool SurveyMonkey, consisting of 103 statements organized into 11 topics: multidisciplinary team composition, suspect drug management, infection prevention, fluid resuscitation and prevention of hypothermia, nutritional support, pain and psychological distress management, management of acute respiratory failure, local skincare, ophthalmological management, management of other mucosa, and additional measures. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). The results were analysed according to the RAND/UCLA Appropriateness Method. Results Forty-five participants from 13 countries (on three continents) participated. After the first round, a consensus was obtained for 82.5% of the 103 initially proposed statements. After the second round, a final consensus was obtained for 102 statements. Conclusions We have reached an international Delphi-based consensus on best supportive care practice for SJS/TEN. Our expert consensus should help guide physicians in treating patients with SJS/TEN and thereby improve short-term prognosis and the risk of sequelae.Peer reviewe

A new index for characterizing micro-bead motion in a flow induced by ciliary beating: Part I, experimental analysis.

Mucociliary clearance is one of the major lines of defense of the respiratory system. The mucus layer coating the pulmonary airways is moved along and out of the lung by the activity of motile cilia, thus expelling the particles trapped in it. Here we compare ex vivo measurements of a Newtonian flow induced by cilia beating (using micro-beads as tracers) and a mathematical model of this fluid flow, presented in greater detail in a second companion article. Samples of nasal epithelial cells placed in water are recorded by high-speed video-microscopy and ciliary beat pattern is inferred. Automatic tracking of micro-beads, used as markers of the flow generated by cilia motion, enables us also to assess the velocity profile as a function of the distance above the cilia. This profile is shown to be essentially parabolic. The obtained experimental data are used to feed a 2D mathematical and numerical model of the coupling between cilia, fluid, and micro-bead motion. From the model and the experimental measurements, the shear stress exerted by the cilia is deduced. Finally, this shear stress, which can easily be measured in the clinical setting, is proposed as a new index for characterizing the efficiency of ciliary beating

Calendrier pollinique et rhinite allergique a caen

No Abstract. Journal Tunisien d\'ORL et de chirurgie cervico-faciale Vol. 17 2006: pp. 19-2

« Paralysie récurrentielle unilatérale après thyroïdectomie : savoir rechercher un syndrome d’hyperventilation »

International audienceLa paralysie unilatérale du nerf récurrent peut être responsable d’une dysphonie et de troubles de la déglutition. La physiopathologie de l’apparition d’une dyspnée induite par une paralysie récurrentielle unilatérale n’est pas complètement élucidée. Notre hypothèse est que la fuite d’air au niveau glottique pourrait être responsable du développement d’un syndrome d’hyperventilation (SHV).ObjectifL’objectif de cette étude était de déterminer, chez les patients atteints de paralysie récurrentielle unilatérale, si la dyspnée pouvait être associée au SHV.Matériel et méthodesSur une période de 12 mois, tous les patients atteints de paralysie récurrentielle unilatérale permanente (> 6 mois) après thyroïdectomie se plaignant de l’apparition d’une dyspnée inexpliquée ont été explorés. Les tests suivants ont été réalisés : score de Nijmegen, test d’hyperventilation provoquée, gazométrie artérielle, épreuves fonctionnelles respiratoires et tests cardiaques. Le diagnostic de SHV a été posé si au moins deux critères étaient présents parmi les suivants : score de Nijmegen > 23 ; reproduction d’au moins 2 symptômes habituels lors du test d’hyperventilation ; pression télé-expiratoire en CO2 (PetCO2) < 30 mmHg ou < 90 % de la PetCO2 initiale après une période de récupération de 5 min à la suite d’une hyperventilation volontaire de 3 min.RésultatsDix patients sur 366 opérés d’une thyroïdectomie pour une maladie bénigne présentaient une paralysie récurrentielle unilatérale permanente et une dyspnée. Parmi les 10 patients inclus, chez 8 le diagnostic de SHV a été retenu lors du test d’hyperventilation provoquée sans dysfonctionnement cardiaque/pulmonaire.ConclusionEn résumé, cette étude est en faveur de l’implication du SHV dans la dyspnée associée à la paralysie récurrentielle unilatérale

Unilateral recurrent laryngeal nerve palsy post-thyroidectomy: Looking for hyperventilation syndrome

International audienceAims: Unilateral Recurrent Laryngeal Nerve (RLN) palsy is responsible for dysphonia and difficulties in swallowing. The role of unilateral RLN palsy on dyspnea is not fully elucidated. Our hypothesis is that air leak could be responsible for development of hyperventilation syndrome (HVS).Objective: The objective of this study was to determine in patients with unilateral RLN palsy if dyspnea could be associated with HVS.Material and methods: Over a 12-month period, all patients with permanent unilateral RLN palsy after thyroidectomy complaining from the onset of unexplained dyspnea were tested. Measurement of Nijmegen score, an hyperventilation test, an arterial blood gas, lung function and cardiac tests were performed. The diagnosis of HVS was defined if at least two criteria were present among: Nijmegen score>23; reproduction of at least 2 usual symptoms during hyperventilation test; an expirated pressure of CO2 (EpCO2)<30mmHg or<90% of the initial EpCO2 after a 5minutes recovery period following a 3minutes voluntary hyperventilation.Results: Ten out of 366 patients with thyroidectomy for benign disease had permanent unilateral RLN palsy and dyspnea. Among 10 patients included, 8 were diagnosed having HVS on the hyperventilation test without cardiac/lung dysfunction.Conclusion: In summary, this study is a proof of concept that HVS might be involved in dyspnea associated with unilateral RLN palsy

Guidelines of the French Society of Otorhinolaryngology (SFORL). Epistaxis and high blood pressure

International audienceOBJECTIVES:The authors present the guidelines of the French Oto-Rhino-Laryngology - Head and Neck Surgery Society (Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou: SFORL) on epistaxis in high blood pressure.METHODS:A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence.RESULTS:It is recommended to measure the blood pressure of patients in acute-phase epistaxis (Grade A); to control high blood pressure medically in the acute phase of bleeding, to reduce its duration; to monitor blood pressure at the waning of nosebleed; and to control high blood pressure medically in the waning phase to reduce the risk of recurrence. In case of persistent high blood pressure on waning of severe epistaxis, it is recommended to prescribe cardiovascular evaluation to screen for underlying hypertensive disease (Grade B)