La refondation programmatique du SPD à l’aube des années 1990 : un « Bad Godesberg II » ?

En s’appuyant sur les débats idéologiques et les programmes du Parti social-démocrate allemand (SPD) de la seconde moitié des années 1980, cette contribution s’interroge sur la recréation d’un mythe fondateur et l’adéquation des idées social-démocrates avec leur époque. Elle porte un intérêt spécifique aux conditions de production d’écrits partisans, aux rapports de force nouveaux entre les acteurs et aux différentes temporalités qui présidèrent à l’entreprise de reconquête du pouvoir par le SPD, et à son échec, en 1990. Dans une perspective transnationale et comparative, elle intègre un questionnement succinct sur le Parti socialiste d’Autriche (SPÖ) puis Parti social-démocrate d’Autriche afin de mettre en perspective la transformation des social-démocraties germanophones à l’aube des années 1990.Looking at the ideological debates and platforms of the German Social Democratic Party (SPD) during the second half of the 1980s, this paper examines the reinvention of a foundational myth and how social democratic ideas were updated for changing times. This article will focus on the conditions under which partisan texts were produced, on the new balance of power between the various actors, and on the different temporalities that prevailed during the SPD’s attempt to regain power (leading to its political failure in 1990). From a transnational and comparative perspective, it includes a brief investigation of the Socialist Party of Austria (SPÖ) — then called the Social Democratic Party of Austria — in order to contextualize the transformation of German-speaking social democracies at the beginning of the 1990s

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

The Social Democratic Party of Germany and the social justice in the 80's. A Social Democratic identity to the test of the unification (1989-1990)

Cette thèse propose une analyse des notions de justice sociale et d'État-providence au prisme de la politique sociale du SPD dans les années 1980. À la fois parti d'opposition au Bundestag à Bonn et parti au pouvoir dans certains Länder en RFA, le SPD se trouvait dans une position ambiguë, propre au fédéralisme allemand. Afin de peser sur les réformes sociales initiées par le ministre du Travail Norbert Blüm (CDU) pour résoudre la crise de l'État-providence, les sociaux-démocrates adoptèrent une stratégie alternant opposition et coopération avec le gouvernement Kohl. Dans le même temps, ils engagèrent un travail de refondation programmatique en vue de reconquérir le pouvoir en 1990. Aux divisions générationnelles communément admises par la recherche se substitua une fracture entre une « aile sociale » adepte d'une politique traditionnelle et une « aile réformatrice » sensible aux valeurs post-matérialistes et « écosocialistes ». Du fait de son immédiateté, le processus d'unification de l'Allemagne (1989-1990) constitua un révélateur permettant de juger, à l'épreuve des faits, la validité des programmes et des discours sociaux-démocrates. Malgré les propositions concrètes de Rudolf Dreßler pour améliorer l'union sociale entre la RFA et la RDA, le SPD ne parvint ni à se faire entendre sur la question de l'unité allemande ni à imposer sa volonté de refonder l'État-providence. Les réserves d'Oskar Lafontaine sur l'emballement des coûts économiques et sociaux contribuèrent à entretenir la confusion concernant la position du SPD sur l'unité allemande.This doctoral thesis analyses the concepts of social justice and the welfare state in light of the social policies of the Social Democratic Party of Germany (SPD) in the 1980s. Both in the opposition in the Bundestag in Bonn and in office in some West German Länders, the SPD found itself in an ambiguous position, peculiar to German federalism. The Social Democrats took on a strategy based alternatively on opposition and cooperation with Helmut Kohl’s government, in order to influence the welfare reforms introduced by the Labour Minister Norbert Blüm (Christian Democratic Union, CDU). The SPD simultaneously started to overhaul its political platform with a view to taking back power in 1990. The generational conflicts, which have been widely established by researchers, gave way to a new divide between a “social wing” advocating a traditional policy and a “reforming wing” drawn towards post-materialist and “eco-socialist” values. By virtue of its immediacy, the German unification process (1989-1990) proved to be a litmus test, which allowed the efficiency of the SDP’s agenda and rhetoric to be evaluated. In spite of Rudolf Dreßler’s concrete propositions to improve the social union between East and West Germany, the SDP failed both to share its views on German unification and to impose its determination to overhaul the welfare state. Oskar Lafontaine’s reservations about the economic and social costs spiralling out of control contributed to a blurring of the lines on the SDP’s position on German unification.This doctoral thesis analyses the concepts of social justice and the welfare state in light of the social policies of the Social Democratic Party of Germany (SPD) in the 1980s. Both in the opposition in the Bundestag in Bonn and in office in some West German Länders, the SPD found itself in an ambiguous position, peculiar to German federalism. The Social Democrats took on a strategy based alternatively on opposition and cooperation with Helmut Kohl’s government, in order to influence the welfare reforms introduced by the Labour Minister Norbert Blüm (Christian Democratic Union, CDU). The SPD simultaneously started to overhaul its political platform with a view to taking back power in 1990. The generational conflicts, which have been widely established by researchers, gave way to a new divide between a “social wing” advocating a traditional policy and a “reforming wing” drawn towards post-materialist and “eco-socialist” values. By virtue of its immediacy, the German unification process (1989-1990) proved to be a litmus test, which allowed the efficiency of the SDP’s agenda and rhetoric to be evaluated. In spite of Rudolf Dreßler’s concrete propositions to improve the social union between East and West Germany, the SDP failed both to share its views on German unification and to impose its determination to overhaul the welfare state. Oskar Lafontaine’s reservations about the economic and social costs spiralling out of control contributed to a blurring of the lines on the SDP’s position on German unification

Patients with history of covid-19 had more side effects after the first dose of covid-19 vaccine

International audienceCOVID-19 vaccination seems to be the most pertinent pharmacologic public health measure to control the pandemic. Reactogenicity symptoms were frequent in vaccine recipients mostly mild to moderate and commonly reported after the second dose. However, there is a lack of data in patients with a previous diagnosis of Covid-19

Interest of Follow-Up Radiological Imaging in Patients with Pyogenic Vertebral Osteomyelitis

International audienceNo recommendations are established for monitoring pyogenic vertebral osteomyelitis (PVO). Thus, the realization of systematic follow-up radiological imaging is controversial. The objective of this study was to evaluate the interest in follow-up radiological imaging in patients with PVO. We conducted a retrospective cohort analysis of patients with PVO who had both baseline and follow-up radiological imaging. We classified the follow-up images into two groups, improvement/stability, and deterioration, compared with the baseline data. For each patient, we compared their radiological imaging follow-up to their clinical-biological condition assessed at the same time. Eighty-six patients were included. The mean age was 68 years (±13). A total of 99 radiological imaging examinations at diagnosis and at follow-up were analyzed, 69 Magnetic Resonance Imaging (MRI), and 30 Computerized Tomography (CT scans). The mean delay between the follow-up radiological imaging and clinical evaluation was 2.8 +/− 2.1 months. Of the 36 patients with clinical and biological recovery, 24 patients (67%) had improved radiological imaging and 12 patients (34%) had radiological worsening (new abscesses (n = 4), extension of soft tissue infiltration (n = 2) and/or epiduritis (n = 2) or appearance of new locations (n = 1)). Among the 50 patients considered as unhealed, on the contrary, radiological imaging showed an improvement in imaging in 39 patients (78%) and a worsening in 11 patients (22%). Our study showed that there was no correlation between the clinical condition of patients and their follow-up radiological imaging in the context of PVO

SARS‐CoV‐2 respiratory viral loads and association with clinical and biological features

International audienceTo determine the distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) respiratory viral loads (VL) during the acute phase of infection and their correlation with clinical presentation and inflammation-related biomarkers. Nasopharyngeal swabs from 453 adult SARS-CoV-2-infected patients from the Department of Infectious Diseases, Besançon, France, were collected at the time of admission or consultation for reverse transcriptase polymerase chain reaction (RT-PCR) analysis. Clinical information and concentrations of biological parameters (C-reactive protein [CRP], fibrinogen, lactate dehydrogenase [LDH], prealbumin) were noticed. Mean respiratory VL homogeneously decreased from 7.2 log10 copies/ml (95% confidence interval [CI]: 6.6-7.8) on the first day of symptoms until 4.6 log10 copies/ml (95% CI: 3.8-5.4) at day 10 (slope = -0.24; R2 = .95). VL were poorly correlated with COVID-19 symptoms and outcome, excepted for dyspnea and anosmia, which were significantly associated with lower VL (p < .05). CRP, fibrinogen, and LDH concentrations significantly increased over the first 10 days (median CRP concentrations from 36.8 mg/L at days 0-1 to 99.5 mg/L at days 8-10; p < .01), whereas prealbumin concentrations tended to decrease. Since SARS-CoV-2 respiratory VL regularly decrease in the acute phase of infection, determining the level of VL may help predicting the onset of virus shedding in a specific patient. However, the role of SARS-CoV-2 VL as a biomarker of severity is limited

Older adults with SARS‐CoV‐2 infection: Utility of the clinical frailty scale to predict mortality

International audienceThe objective of this study was to identify predictive factors of mortality in older adults with coronavirus disease 2019 (COVID-19), including the level of clinical frailty by using the clinical frailty scale (CFS). We analyzed medical records of all patients aged of 75 and older with a confirmed diagnosis of COVID-19 hospitalized in our Hospital between March 3 and April 25, 2020. Standardized variables were prospectively collected, and standardized care were provided to all patients. One hundred and eighty-six patients were included (mean 85.3 ± 5.78 year). The all cause 30-day mortality was 30% (56/186). At admission, dead patients were more dyspneic (57% vs. 38%, p = .014), had more often an oxygen saturation less than 94% (70% vs. 47%, p < .01) and had more often a heart rate faster than 90/min (70% vs. 42%, p < .001). Mortality increased in parallel with CFS score (p = .051) (20 deaths (36%) in 7-9 category). In multivariate analysis, CFS score (odds ratio [OR] = 1.49; confidence interval [CI] 95%, 1.01-2.19; p = .046), age (OR = 1.15; CI 95%, 1.01-1.31; p = .034), and dyspnea (OR = 5.37; CI 95%, 1.33-21.68; p = .018) were associated with all-cause 30-day mortality. It is necessary to integrate the assessment of frailty to determine care management plan of older patients with COVID-19, rather than the only restrictive criterion of age

Utility of CT scan in patients with initial negative PCR for SARS-CoV2: a report of three cases

International audiencePCR-based viral RNA to confirm the diagnosis of SARS-CoV-2 infection has a sensitivity of around 70%. We report three cases of patients with negative initial PCR and CT scan lesions that led us to suspect COVID-19, but which one(s) are really COVID-19

Efficacy and survival of biologic agents in psoriasis: a practical real-life 12-year experience in a French dermatology department

International audienceBackground: Drug survival in a real-life setting is critical to long-term use of biologics for psoriasis. Objective: We describe our 12-year experience with biologics in psoriasis patients. Patients and Methods: All patients treated with biologics including infliximab, adalimumab (ADA), etanercept (ETA), and ustekinumab (UST) for psoriasis vulgaris between January 2005 and December 2016 were retrospectively analyzed. Results: In total, 545 treatment series were administered to 269 patients, including 211 treatment series with ADA, 135 with ETA, 77 with infliximab, and 122 with UST. ADA and ETA were initiated most often as first-line therapy; 65.3% of treatment sequences were discontinued. UST had the highest drug survival. The major reason for treatment termination was a loss of efficacy (44.9%). Definitive discontinuation increased with the number of biologic therapy sequences. Limitations: Subjects were not randomized to the different treatments. Conclusions: In a long-term real-life setting, drug survival of UST is better than that of TNF-a inhibitors for both biologic-naive and biologic-experienced patients with psoriasis