Les sculptures de la fouille du parking Jean-Jaurès à Nîmes

À l’occasion de la construction d’un nouveau parking à Nîmes, avenue Jean-Jaurès, des fouilles de l’INRAP sous la direction de Jean-Yves Breuil (automne 2006 – été 2007) ont révélé des éléments de sculpture qui viennent enrichir le corpus de Narbonnaise. Outre une série d’autels aniconiques et anépigraphes et un autel orné d’une triade divine, trois autres œuvres viennent s’ajouter aux découvertes déjà anciennes du quartier Jean-Jaurès. Un fragment, composé de la partie supérieure d’une tête, appartient à une représentation de jeune fille. Un fragment, constitué d’une jambe et de plis de tissu, pourrait être rattaché à une statue de Vénus. La statue la plus complète et la mieux documentée représente un Neptune, avec une base en proue de navire. L’intervention de Sandrine et Benoît Coignard et le recours à un scanner 3-D ont permis de révéler les traces de polychromie et de proposer une restitution qui permettra un remontage de la statue (en cours).On the occasion of the construction of a new parking lot in Nîmes, avenue Jean-Jaurès, excavations conducted by INRAP under the supervision of Jean-Yves Breuil (autumn, 2006 - summer, 2007) revealed elements of sculpture, which enrich the corpus of Narbonnaise. Besides a series of aniconic and anepigraphic altars and an altar decorated with a divine triad, three other works can be added to the former discoveries of the Jean-Jaurès district. A fragment consisting of the upper part of a head belongs to the representation of a young girl. A fragment consisting of a leg and folds of textile could be connected with a statue of Venus. The most complete and best-documented statue represents Neptune, with a base depicting a ship’s prow. The intervention of Sandrine and Benoît Coignard and the use of a 3D scanner revealed traces of polychromy and will allow a reconstruction of the statue

F.A.R.O.G. FORUM, Vol. 3 No. 7

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F.A.R.O.G. FORUM, Vol. 2 No. 4

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F.A.R.O.G. FORUM, Vol. 3 No. 5

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Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

La sculpture romaine en Occident

Cet ouvrage réunit les résultats de deux manifestations complémentaires  : d’une part, la table ronde intitulée «  Rendre à César  », organisée le mercredi 20 juin 2012, à Paris, au Musée du Louvre et, d’autre part, les «  Rencontres autour de la sculpture romaine conservée en France  » qui ont eu lieu du 18 au 20 octobre 2012 au Musée départemental Arles antique. La richesse des interventions lors de ces deux manifestations permet de restituer un ouvrage composé de trente-huit articles, répartis en trois parties et une conclusion. La première partie, en écho et en développement de la table ronde du Louvre, porte sur le portrait du «  César du Rhône  », aussi bien que sur «  Le portrait romain en Gaule  ». La deuxième partie publie cinq études autour des «  nouvelles techniques d’investigations scientifiques  » et présente l’analyse des matériaux des sculptures en pierre et en bronze, découvertes dans le Rhône à Arles, ainsi qu’une étude ethnoarchéologique sur les techniques de production du portrait. Enfin une troisième partie présente les «  découvertes récentes et les nouvelles recherches  », déclinées en seize études qui sont consacrées à des études de cas (Autun, Vaison-la-Romaine, Nîmes, Metz-Divodurum, Apt), ainsi qu’à des relectures novatrices de sculptures méconnues (Plouarzel, Langres, Avignonet-Lauragais, Vernègues, vallée de l’Ubaye, Besançon, Lyon). Robert Turcan signe la conclusion. Ainsi, «  La sculpture romaine en Occident. Nouveaux regards   » reflète la variété et l’intérêt des questionnements actuels dans ce domaine

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

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570