Sand, salt, and models : The legacy of Bruno Vendeville

Acknowledgements We are grateful for the support of numerous colleagues who contributed, either materially or simply with encouragement, to putting together this memorial to our friend Bruno. The important task of reviewing and editing manuscripts was carried out by the co-editors along with Jürgen Adam, Ian Davison, Tim Dooley, Carl Fiduk, Pablo Granado, Geoffroy Mohn, Webster Mohriak, Van Mount, Josep Anton Muñoz, Thierry Nalpas, Fabrizio Storti, Gabor Tari, Lei Wu, and 16 reviewers who chose to remain anonymous. And of course, this volume would not have happened without the hard work and persistence of the many authors and coauthors who contributed their manuscripts. We also thank Lorna Stewart and other staff at the Journal of Structural Geology for their help and guidance, as well as Tim Dooley for supplying original versions of the figures used here.Peer reviewe

Pulmonary Barotrauma Including Huge Pulmonary Interstitial Emphysema in an Adult with Status Asthmaticus: Diagnostic and Therapeutic Challenges

Introduction: Pulmonary interstitial emphysema is a rare finding defined as abnormal air collection inside the lung interstitial tissues. Described more frequently in ventilated new-borns, pulmonary interstitial emphysema is an uncommon barotrauma-related complication in adults. Management and clinical sequelae are poorly described. Patient: We describe the case of a 64-year-old man who presented with huge pulmonary interstitial emphysema together with simultaneous pulmonary barotrauma in status asthmaticus requiring invasive ventilation. Discussion: There are no guidelines for the management of such complications and their possible sequelae but conservative treatment seems to be effective. The treatment of our patient is described

Cerebral Vasculitis Complicating Pneumococcal Meningitis

Introduction: Cerebral vasculitis is an uncommon life-threatening complication of community-acquired bacterial meningitis. Patient and methods: We report the case of a 64-year-old woman with pneumococcal meningitis who developed parainfectious vasculitis causing ischaemic brain damage. Cerebral magnetic resonance imaging (MRI) confirmed the diagnosis. Clinical and radiological recovery after delayed addition of corticosteroid was achieved. Discussion: This report shows that the onset of neurological deficits following pneumococcal meningitis can be caused by cerebral vasculitis. Underdosing with antibiotics and delayed adjunctive dexamethasone seem to favour this complication. There are no guidelines for treatment but high doses of steroids led to resolution in this case

Pandemic Influenza and Hospital Resources

Even during the peak of a pandemic, all patients requiring intensive care can be served

Transferring patients home to die : what is the potential population in UK critical care units?

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/OBJECTIVES: Most people when asked, express a preference to die at home, but little is known about whether this is an option for critically ill patients. A retrospective cohort study was undertaken to describe the size and characteristics of the critical care population who could potentially be transferred home to die if they expressed such a wish. METHODS: Medical notes of all patients who died in, or within 5 days of discharge from seven critical care units across two hospital sites over a 12-month period were reviewed. Inclusion/exclusion criteria were developed and applied to identify the number of patients who had potential to be transferred home to die and demographic and clinical data (eg, conscious state, respiratory and cardiac support therapies) collected. RESULTS: 7844 patients were admitted over a 12-month period. 422 (5.4%) patients died. Using the criteria developed 100 (23.7%) patients could have potentially been transferred home to die. Of these 41 (41%) patients were diagnosed with respiratory disease. 53 (53%) patients were conscious, 47 (47%) patients were self-ventilating breathing room air/oxygen via a mask. 20 (20%) patients were ventilated via an endotracheal tube. 76 (76%) patients were not requiring inotropes/vasopressors. Mean time between discussion about treatment withdrawal and time of death was 36.4 h (SD=46.48). No patients in this cohort were transferred home. CONCLUSIONS: A little over 20% of patients dying in critical care demonstrate potential to be transferred home to die. Staff should actively consider the practice of transferring home as an option for care at end of life for these patients.Final Published versio

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Application de traitements thermique et enzymatique de solubilisation et saccharification de la fraction hémicellulosique en vue de la valorisation de la bagasse de canne à sucre

Diplôme : Dr. d'UniversitéSugarcane bagasse is one of the co-products of agro-industries the most widely present on earth. Because of its composition and its availability as a renewable resource, bagasse constitutes a good candidate for valorization in view of the production of added value molecules. A reasonable approach of bagasse valorization should be integrated to the principal activity using sugarcane, namely, sugar factory with application of the concept of biorefinery. Such an approach would consist in installing a workshop of extraction of xylose which will be fed with bagasse coming out of the crushers or diffusion of sugarcane and will give it back to the factory for traditional use in vapor and electricity generators after dewatering in presses. A small workshop can be installed for enzyme production in a solid fermentor using bagasse as a carbon source for the chosen fungi. The sample of bagasse used in this work was supplied by CERF, a center of research on sugar cane at La Réunion. The high content of xylan (26%) particularly rich in xylose (92%) of the experimented bagasse makes it a good source of extraction of this pentose. Moreover, we have shown the validity of bagasse as a carbon source for induction of different enzyme activities by different microorganisms among which xylanase and ß-glucosidase are the most important. To extract xylose, an optimized hydro-thermal treatment (170°C – 2h) was applied. It allowed solubilization of the hemicellulotic fraction of bagasse. This step was followed by an enzymatic treatment. Two enzymes were used to catalyse hydrolysis of xylans in the soluble fraction. These enzymes were a purified endo-xylanase from Thermobacillus xylanilyticus and a supernatant from Humicola insolens fungal broth rich in endo-xylanase. Comparison between the 2 enzymes incited us to use the non purified supernatant. Another supernatant of Trichoderma Reesei was used because it was rich in β-xylosidase. It allowed hydrolyzing the oligo-xylan fractions liberated by the endo-xylanase into xylose. Optimization of enzyme concentrations was achieved. Conditions for obtaining a yield of about 60% of xylose were defined.La bagasse de canne à sucre est l’un des co-produits d’industries agricoles les plus générés de la planète. Elle constitue, du fait de sa composition, une source renouvelable de matière lignocellulosique pouvant être d’un grand intérêt pour la production de molécules à haute valeur ajoutée. Une démarche valorisation de la bagasse qui ne lui ferait pas perdre sa valeur énergétique et s’intégrerait parfaitement à l’activité principale – la sucrerie – consisterait à se baser sur le concept de la bioraffinerie. On installerait alors un atelier de fabrication de xylose qui recevrait la bagasse à la sortie des moulins ou des diffusions de canne à sucre et la restituerait après passage dans des presses à la sucrerie. Un petit atelier de fermentation fongique sur milieu solide constitué de bagasse permettrait de préparer les enzymes nécessaires au traitement. La bagasse ayant servi à ce travail provient de l’Ile de la Réunion. Elle a été fournie par le CERF (Centre d’Etude, Recherche et Formation sur la canne à sucre). Sa teneur élevée (26%) en xylane pratiquement pur (92% xylose) en fait une bonne source d’extraction de ce pentose. De plus, la bagasse de canne à sucre semble être intéressante pour une utilisation comme source de carbone pour l’induction de production d’activités enzymatiques par des microorganismes. Pour extraire le xylose, un traitement hydrothermique optimisé (170°C – 2h) a été appliqué. Cela a permis la solubilisation de la fraction hemicellulosique de la bagasse qui a par la suite été soumise à l’hydrolyse enzymatique.Deux enzymes ont été utilisées pour catalyser le fractionnement des hémicelluloses de la bagasse : une enzyme purifiée de Thermobacillus xylanilyticus et un surnageant de culture d’Humicola insolens à activité xylanolytique prédominante. Une comparaison entre ces deux enzymes a été réalisée et a montré l’intérêt d’utiliser le surnageant de culture plutôt qu’une enzyme purifiée. Un surnageant de culture de Trichoderma Reesei riche en β-xylosidase a été utilisé pour poursuivre la saccharification jusqu’à obtenir du xylose. Les concentrations optimales d’enzymes et de substrat ont été déterminées. Les conditions d’obtention d’un bon rendement, de l’ordre de 60% de xylose en présence d’un taux réduit d’impuretés sont définies