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

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)

Guidelines of the French Society of Otorhinolaryngology (SFORL). Second-line treatment of epistaxis in adults

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 second-line treatment of epistaxis in adults, after failure of anterior and/or anterior-posterior nasal packing.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:Arterial embolization should be performed by an experienced interventional neuroradiologist with adequate technical facilities, to reduce the risk of complications. Cerebral and supra-aortic vessel CT angiography should be performed in case of post-traumatic epistaxis with suspected internal carotid injury. In case of persistent bleeding despite endoscopic hemostasis of the sphenopalatine artery, anterior ethmoidal artery hemostasis should be performed via a medial canthal incision, with endoscopic assistance as needed. In case of persistent epistaxis despite the usual surgical and neuroradiological procedures, surgical exploration of the sinonasal cavities should be performed, with elective coagulation in case of bleeding from secondary branches, and/or ethmoidectomy in case of diffuse bleeding. A decision-tree was drawn up for the management of second-line treatment of epistaxis

Guidelines of the French Society of Otorhinolaryngology (SFORL) (short version). Specific treatment of epistaxis in Rendu-Osler-Weber disease

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) concerning specific treatment of epistaxis in Rendu-Osler-Weber disease.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:Rendu-Osler-Weber disease is diagnosed from the presence of at least three of Curaçao's four criteria. In acute epistaxis, bidigital compression is recommended. Embolization is reserved for resistant epistaxis. Non-resorbable nasal packing and cauterization are contraindicated. Patient education is essential. Telangiectasia of the nasal mucosa can be treated by various local means. In the event of insufficient control, systemic administration of tranexamic acid is recommended

Guidelines of the French Society of Otorhinolaryngology (SFORL). First-line treatment of epistaxis in adults

International audienceOBJECTIVES:The authors present the guidelines of the French Otorhinolaryngology-Head and Neck Surgery Society (SFORL) on first-line treatment of epistaxis in adults.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 guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence.RESULTS:In first-line, clearing out blood-clots and bidigital compression are recommended. In case of persistent bleeding, local anesthesia with a vasoconstrictor is essential before nasal diagnostic and therapeutic procedures. When the origin of bleeding is not anterior, nasal endoscopy is an essential procedure, identifying the bleeding site in most cases. In case of active bleeding, cauterization is recommended but is only feasible if the bleeding site is clearly visible. When the bleeding site is not identifiable or the first measures failed, anterior packing may be performed by a non-specialist physician. Epistaxis requires subsequent nasal endoscopy performed by an ENT specialist. Patients should be informed of the measures to be taken in case of epistaxis at home, and the risks associated with the various treatments

Characterization of the ciliary beating efficiency in primary diffuse chronic rhinosinusitis

International audienceCiliary dysfunction may result in chronic airway inflammation and infection causing injury and structural changes to the airway epithelium, leading to a variety of diseases, like bronchiectasis and primary diffuse chronic rhinosinusitis (CRS). Currently, ciliary beating analysis has mainly been studied through the measure of the ciliary beating frequency (CBF) by high-speed digital video microscopy (HSDV). However, a normal CBF has been described in different forms of primary and acquired ciliary dyskinesia