Evaluation of procalcitonin and CRP as sepsis markers in 74 consecutive patients admitted with prolonged febrile neutropenia

International audienceFever is a major event in critically ill patients. Its causes are difficult to identify and among them, bacterial infections must be rapidly identified and treated before sepsis reach a life threatening stage. CRP is a very sensitive marker of inflammation of whatever causes including sepsis. This is particularly crucial in immunocompromised patients. On the other hand, PCT has been extensively shown to be strongly and rapidly produced in bacterial infections only. Furthermore, PCT decreases very soon after bacterial resolution, and is thus a very useful in monitoring adequacy and efficiency of antibiotics. The utility of this marker in sever sepsis is now widely admitted

Alzheimers Dement

Introduction: The free and cued selective reminding test is used to identify memory deficits in mild cognitive impairment and demented patients. It allows assessing three processes: encoding, storage, and recollection of verbal episodic memory. Methods: We investigated the neural correlates of these three memory processes in a large cohort study. The Memento cohort enrolled 2323 outpatients presenting either with subjective cognitive decline or mild cognitive impairment who underwent cognitive, structural MRI and, for a subset, fluorodeoxyglucose-positron emission tomography evaluations. Results: Encoding was associated with a network including parietal and temporal cortices; storage was mainly associated with entorhinal and parahippocampal regions, bilaterally; retrieval was associated with a widespread network encompassing frontal regions. Discussion: The neural correlates of episodic memory processes can be assessed in large and standardized cohorts of patients at risk for Alzheimer's disease. Their relation to pathophysiological markers of Alzheimer's disease remains to be studied

Mémento 2 : Résidences 1999-2000

This richly illustrated catalogue documents the work of 35 artists who took part in six residencies (including two events - La Cueillette and La Ruche) that took place in 1999 and 2000 at Centre Est-Nord-Est. The centre’s director, F. Michel, describes the nature and purpose of the residencies as well as that of the catalogue : to reflect each participant’s experience. Includes brief comments by the artist on their work and on their stay. Text in French and English. Biographical notes

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

The Multidimensional Nature of Research Ethics: Letters Issued by a French Research Ethics Committee Included Similar Proportions of Ethical and Scientific Queries

Debate is ongoing concerning the activities and functioning of Research Ethics Committees (REC), especially a possible science-or-ethics dichotomy in research ethics review. We retrospectively analyzed 145 letters issued by a French REC over 18 months. All queries were classified in three levels: qualification (definition of the problem), category (aggregation of broader topics) and finally fields (ethical, scientific, or administrative). Overall, 971 queries were identified, of which 407 (42%), 379 (39%), and 135 (14%) were deemed ethical, scientific, and administrative queries, respectively. The most frequent concern was about participants' information. The main influencing factor was the profession of the reporting readers-scientific queries were more frequently raised by a methodologist, whereas ethical queries were more frequently raised by an ethicist. These results indicate that research ethics review is a multidimensional task that should be considered a collaborative effort

Gestion des données géologiques en milieu urbain

National audienceLa banque de données BISMUTH (Banque d'Informations du Sous-sol en Milieu Urbain de Toulouse en géologie et Hydrogéologie) permet l'accès direct des services techniques de la ville de Toulouse aux informations géologiques et hydrogéologiques disponibles pour gérer l'impact des travaux aériens ou souterrains. Ce programme constitue une première étape pour une politique environnementale cohérente et durable en milieu urbai

Validation de l'impédancemétrie bi-fréquence lors de la sclérose latérale amyotrophique.

International audienc

Motherhood specificities with the Rorschach method: Results of a nonconsulting French population in the postnatal phase.

International audienceAbstract. Motherhood, listed by the World Health Organization as a period of fragility and vulnerability, involves significant changes at the individual, family and social level. Becoming a mother entails a number of risk factors to take into account. It is therefore necessary to carry out studies on general populations not suffering from psychopathological disorders to better understand these risk factors linked to motherhood. This study was carried out in France with a nonconsulting population in the postnatal phase ( N = 30) using the Rorschach test, as it presents numerous advantages to appreciate the psychic and corporeal transformations linked to birth. The quantitative results of the test were compared with recently updated norms ( De Tychey et al., 2012 ). Eight values of the psychogram remained normative (F%, F+%, W%, Dd%, M, C, H%, P) reflecting the characteristics of a general population; conversely, eight other values of the psychogram (R, D%, S%, A%, RC%, m, E, Anguish Index%) differed significantly from general population norms. These results increase knowledge to help appreciate the complexity of the psychic processes at work during the postnatal period, and to prevent psychopathological disorders. It is thus possible to distinguish these disorders from those that are transitory and classically linked to the upheaval caused by the onset of motherhood

Influence of short-chain fructo-oligosaccharides (sc-FOS) on absorption of Cu, Zn, and Se in healthy postmenopausal women

International audienceOBJECTIVE: This study was carried out to evaluate the effect of short-chain fructooligosaccharides (sc-FOS) on the absorption of Cu, Zn, and Se among postmenopausal women who are potential candidates to subclinical trace element deficiencies. DESIGN: A randomized double blind cross-over study. SETTING: This study was carried out at the Human Nutrition Research Center, Clermont-Ferrand, France. SUBJECTS: 11 postmenopausal women aged 53-70 y, not taking hormone replacement therapy were enrolled and completed the study. INTERVENTIONS: Diets with 10 g/day sc-FOS or placebo were given for 5 weeks each in random order followed by a wash-out period of at least 3 weeks. At the end of each period, stable isotopes (3.19 mg 67Zn as ZnCl2, 2.06 mg 65Cu as CuCl2 and 52.3 microg 74Se as sodium selenite) and radiopaque pellets (as fecal excretion index) were administered during lunch. Stools were collected for the next 5-7 days. Isotopes were determined by ICP-MS (Cu and Zn) or GC-MS (Se). RESULTS: Copper absorption was significantly enhanced (p = 0.042) by sc-FOS. No effect of sc-FOS was observed on Zn, and Se absorption. CONCLUSION: To our knowledge, this is the first study on the influence of sc-FOS on trace element metabolism. The observed increase in copper absorption may be of interest regarding daily copper requirements in menopausal women. However, the relevance of this observation remains to be established