Clinical outcomes and characteristics of critically ill patients with influenza- and COVID-19-induced ARDS: A retrospective, matched cohort study

IntroductionSeasonal epidemic influenza and SARS-CoV-2 are the most frequent viruses causing acute respiratory distress syndrome (ARDS). To what extent these two etiologies differ in ICU patients remains uncertain. We, therefore, aimed at comparing the severity and outcomes of influenza and SARS-CoV-2-induced ARDS in mechanically ventilated patients.MethodsThis retrospective, analytic, single-center study was conducted in the medical ICU of Nancy University Hospital in France. Adult patients hospitalized with confirmed influenza (from 2009 to 2019) or SARS-CoV-2-induced ARDS (between March 2020 and May 2021) and those under mechanical ventilation were included. Each patient with influenza was matched with two patients with COVID-19, with the same severity of ARDS. The primary endpoint was death in ICU on day 28. The secondary endpoints were the duration of vasopressors, the use of renal replacement therapy, the duration of mechanical ventilation, and the ICU length of stay.ResultsA total of 42 patients with influenza were matched with 84 patients with COVID-19. They had similar sex distribution, age, Charlson comorbidity index, and ARDS severity. On day 28, 11 (26.2%) patients in the influenza group and nine (10.7%) patients in the COVID-19 group had died (p = 0.0084, HR = 3.31, CI 95% [1.36–8.06]). In the univariate Cox model, being infected with SARS-CoV-2, SOFA and SAPS II scores, initial arterial pH, PaCO2, PaO2/FiO2, serum lactate level, platelet count, and use of renal replacement therapy were significantly associated with mortality. In the multivariate Cox model, the SOFA score at admission (p < 0.01, HR = 1.284, CI 95% [1.081; 1.525]) and the initial pH (p < 0.01, HR = 0.618, CI 95% [0.461; 0.828]) were the only predictors of mortality. The type of virus had no influence on mortality, though patients with COVID-19 underwent longer mechanical ventilation and received more neuromuscular blockers and prone positioning.ConclusionIn mechanically ventilated patients with ARDS, 28-day mortality was higher among patients with influenza as compared to patients with COVID-19 because of a higher initial extra-pulmonary severity. However, the type of virus was not, by itself, correlated with mortality

Impact of the COVID-19 pandemic on work capacities of researchers: An overlooked problem

Background: The new coronavirus pandemic has substantially changed research and teaching activities. The aim of our survey was to investigate the impact of the current health emergency on teaching and research activities, focusing on the perspectives of research unit members.Methods: This was an anonymous web-survey conducted between April 29 and May 6, 2020. All members of the center of Biology, Medicine, and Health sciences (BMS) of the Lorraine University were invited to participate in this survey through collective e-mails.Results: Eighty-three subjects participated in our survey. Research activities were totally (86.8%) or partially (75.9%) stopped in most centers and most of respondents were working from home occasionally (15.7%) or every day (78.3%). The main activity during lockdown was writing original articles from already collected data (39.8%). More than a third of the respondents (39.7%) reported remarkable reduction in their work. Similarly, most of conferences (82%) and internships (73.3%) were canceled and graduation of students were postponed in 58.8% of cases.&nbsp;Conclusions: Work from home was a valid alternative to workplace activities during the pandemic. Further studies are needed to evaluate the long-term effects of this new approach on quality of research and teaching.</p

Analysis of lesion development during acute inflammation and remission in a rat model of experimental autoimmune encephalomyelitis by visualization of macrophage infiltration, demyelination and blood-brain barrier damage.

In vivo tracking of macrophage migration is feasible by labeling cells with ultra-small particles of iron oxide (USPIO). It is demonstrated that it is possible to monitor distinct patterns of macrophage migration during the early states of inflammation in a rodent model of chronic relapsing experimental autoimmune encephalomyelitis (EAE). As previous MRI studies showed that EAE inflammation processes are clearly linked to macrophage infiltration in the brain, a longitudinal protocol for macrophage visualization was designed, where USPIOs were injected repeatedly during the acute phase of the disease, the remitting phase and the first relapse. In addition to USPIO-enhanced MRI, blood-brain barrier (BBB) damage, magnetization transfer ratios (MTRs) and neurological impairment were assessed as classical markers for central nervous system (CNS) inflammation and tissue damage. During the acute phase, animals showed severe paralysis of the hind paws, intense accumulation of macrophages in brain tissue and some diffuse patterns of BBB disruption. While USPIO-accumulation completely disappeared after the acute phase, residual damage of the BBB remained detectable in some lesions during the remitting phase. During the first relapse, the accumulation of USPIO-loaded cells was less pronounced but still detectable. The time course of MTR, which is used as a marker for myelin loss, was linked to the infiltration of macrophages during the acute phase

Differential item functioning (DIF) of SF-12 and Q-LES-Q-SF items among french substance users

International audienceBackgroundDifferential Item Functioning (DIF) is investigated to ensure that each item displays a consistent pattern of responses irrespective of the characteristics of the respondents. Assessing DIF helps to understand the nature of instruments, to assess the quality of a measure and to interpret results. This study aimed to examine whether the items of the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) and Short-Form 12 (SF-12) exhibit DIF.MethodA total of 124 outpatients diagnosed with substance dependence participated in a cross-sectional, multicenter study. In addition to the Q-LES-Q-SF and SF-12 results, demographic data such as age, sex, type of substance dependence and education level were collected. Rasch analysis was conducted (using RUMM2020 software) to assess DIF of the Q-LES-Q-SF and SF-12 items.ResultsFor SF-12, significant age-related uniform DIF was found in two of the 12 items, and sex-related DIF was found in one of the 12 items. All of the observed DIF effects in SF-12 were found among the mental health items. Three items showed DIF on the Q-LES-Q-SF; however, the impact of DIF item on the delta score calculation for the comparisons of self-reported health status between the groups was minimal in the SF-12 and small in the Q-LES-Q-SF.ConclusionThese results indicated that no major measurement bias affects the validity of the self-reported health status assessed using the Q-LES-Q-SF or SF-12. Thus, these questionnaires are largely robust measures of self-reported health status among substance users

Can Paper Replace Laser Film to Communicate the Results of Wrist Radiographs in Trauma Cases? A Reproducibility Study of the Reading of Wrist Trauma Case Radiographs on a PACS Workstation, Laser Film, and Paper

International audienceThe main goal of this study was to determine the reproducibility of the reading of wrist trauma case radiographs using three different media: laser film, a picture archiving and communication systems (PACS) workstation, and paper with an optimized layout. The study was conducted retrospectively in 200 consecutive patients consulting at the emergency department for wrist trauma and who underwent wrist X-ray investigation using a computed radiography system. There were 82 men and 118 women. The mean age was 48.3 years (16–95 years). Our institutional review board does not require patient approval or informed consent for retrospective review of case records. The readings were made by two independent readers who analyzed the 200 patient radiographs consecutively in one session for each type of media: paper, laser film, and on a PACS dual-screen workstation. The inter-reader agreements were substantial or almost perfect, with kappa values of 0.83 (0.76–0.90) for the PACS, 0.83 (0.76–0.90) for film, and 0.80 (0.72–0.87) for paper. The inter-technique agreement was almost perfect in all cases. There is a high interobserver agreement between PACS, laser film, and paper readings for wrist trauma cases. With a layout of one radiograph on each sheet, paper could replace laser films to communicate the results of wrist radiographs in trauma cases for outpatients

Clinical Medicine Setting up a Virtual Calprotectin Clinic in Inflammatory Bowel Diseases: Literature Review and Nancy Experience

International audienceTechnological progress, including virtual clinics, web or smartphone-based applications, and assessment of fecal calprotectin (FC) at home has favored the implementation of treat to target strategies for patients with inflammatory bowel diseases (IBD). Although these innovations are promising and have been associated with a significant reduction in health costs, their application in clinical practice is limited. Here, we summarize the most recent literature on virtual clinics and available FC home tests. In addition, we report the experience of IBD patients monitored through the IBDoc ® test at the Nancy University Hospital, focusing on usability testing and patient's satisfaction. This pilot experience shows that a virtual calprotectin clinic doubles adherence rate to FC in IBD patients. This finding is especially clinically relevant in the post-coronavirus disease 2019 (COVID-19) pandemic era, with an increasing use of e-health

From perception to recognition memory: time course and lateralization of neural substrates of word and abstract picture processing

International audienceThrough study of clinical cases with brain lesions as well as neuroimaging studies of cognitive processing of words and pictures, it has been established that material-specific hemispheric specialization exists. It remains however unclear whether such specialization holds true for all processes involved in complex tasks, such as recognition memory. To investigate neural signatures of transition from perception to recognition, according to type of material (words or abstract pictures), high-resolution scalp ERPs were recorded in adult humans engaged either in categorization or in memory recognition tasks within the same experimental setup. Several steps in the process from perception to recognition were identified. Source localization showed that the early stage of perception processing (N170) takes place in the fusiform gyrus and is lateralized according to the nature of stimuli (left side for words and right side for pictures). Late stages of processing (N400/P600) corresponding to recognition are material independent and involve anterior medial-temporal and ventral prefrontal structures bilaterally. A crucial transitional process between perception (N170) and recognition (N400/P600) is reflected by the N270, an often overlooked component, which occurs in anterior rhinal cortices and shows material-specific hemispheric lateralization