Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project

Purpose: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Climat et ville : interactions et enjeux en Provence-Alpes-Côte d'Azur

Pour approfondir les connaissances diffusées dans la publication générale du Groupe régional d'experts sur le climat en Provence-Alpes-Côte d'Azur (GREC-PACA), animé par A.I.R. Climat, et apporter des réponses spécifiques, le comité régional d'orientations (CRO) a constitué des groupes de travail thématiques (GTT). Ces derniers sont composés de chercheurs de toutes les disciplines et de spécialistes du climat qui contribuent à la rédaction de cahiers thématiques destinés aux décideurs et gestionnaires des territoires de la région PACA : élus, ingénieurs et techniciens des collectivités locales ou des espaces protégés ou encore des grands équipements, mais aussi responsables d'associations et d'entreprises. L'objectif est de décrypter les résultats scientifiques et les enjeux du changement climatique pour informer et sensibiliser le public visé à l'échelle régionale et locale. Par thème, une synthèse de travaux scientifiques est proposée afin d'aider les acteurs territoriaux à évaluer les impacts du changement climatique sur leur territoire et de découvrir des innovations. Les précédents cahiers thématiques portaient sur l'évolution du climat en PACA, les effets du changement climatique sur l'agriculture et la forêt, la mer et le littoral. De nouveaux cahiers (ressource en eau, montagne, santé…) sont en préparation. Cette publication aborde la relation entre le climat et la ville dans ses dimensions techniques, mais aussi dans son rapport aux émissions de gaz à effet de serre (GES). La complexité des interactions entre la ville et le climat est mise en évidence par les contributeurs. Les mécanismes, les enjeux spécifiquement urbains et les moyens de lutte dont nous disposons aujourd'hui sont ici abordés en soulignant l'importance des observations et de la recherche. L'espace urbain est l'un des principaux enjeux du changement climatique car il touche aujourd'hui la majorité de la population et les mécanismes d'interactions et d'adaptation1 sont peu connus. Comme dans les précédents cahiers, les chercheurs et experts exerçant leur métier en région PACA et dans les territoires limitrophes, apportent leurs connaissances afin de mieux cerner les problématiques en lien avec le changement climatique

Effects of anodal transcranial direct current stimulation combined with virtual reality for improving gait in children with spastic diparetic cerebral palsy: A pilot, randomized, controlled, double-blind, clinical trial.

To compare the effects of anodal vs. sham transcranial direct current stimulation combined with virtual reality training for improving gait in children with cerebral palsy.A pilot, randomized, controlled, double-blind, clinical trial.Rehabilitation clinics.A total of 20 children with diparesis owing to cerebral palsy.The experimental group received anodal stimulation and the control group received sham stimulation over the primary motor cortex during virtual reality training. All patients underwent the same training programme involving a virtual reality (10 sessions). Evaluations were performed before and after the intervention as well as at the one-month follow-up and involved gait analysis, the Gross Motor Function Measure, the Pediatric Evaluation Disability Inventory and the determination of motor evoked potentials.The experimental group had a better performance regarding gait velocity (experimental group: 0.63 ±0.17 to 0.85 ±0.11???m/s; control group: 0.73 ±0.15 to 0.61 ±0.15???m/s), cadence (experimental group: 97.4 ±14.1 to 116.8 ±8.7???steps/minute; control group: 92.6 ±10.4 to 99.7 ±9.7???steps/minute), gross motor function (dimension D experimental group: 59.7 ±12.8 to 74.9 ±13.8; control group: 58.9 ±10.4 to 69.4 ±9.3; dimension E experimental group: 59.0 ±10.9 to 79.1 ±8.5; control group: 60.3 ±10.1 to 67.4 ±11.4) and independent mobility (experimental group: 34.3 ±5.9 to 43.8 ±75.3; control group: 34.4 ±8.3 to 37.7 ±7.7). Moreover, transcranial direct current stimulation led to a significant increase in motor evoked potential (experimental group: 1.4 ±0.7 to 2.6 ±0.4; control group: 1.3 ±0.6 to 1.6 ±0.4).These preliminary findings support the hypothesis that anodal transcranial direct current stimulation combined with virtual reality training could be a useful tool for improving gait in children with cerebral palsy

Cercospora beticola toxins. Part VI : preliminary studies of protonation and complexation equilibria

International audienc

Hydrogen bonding and proton transfer involving the trihydride complexes Cp*M(dppe)H 3 (M = Mo, W) and fluorinated alcohols: the competitive role of the hydride ligands and metal

International audienceThe protonation of complexes Cp*M(dppe)H3 (dppe is ethylenebis(diphenylphosphine), M = Mo (1), W (2)) by a variety of fluorinated alcohols of different acid strength (FCH2CH2OH, CF3CH2OH, (CF3)2CHOH, and (CF3)3COH) was investigated experimentally by the variable temperature spectroscopic methods (IR, NMR) and stopped-flow technique (UV-Vis). The structures of the hydrogen-bonded and proton transfer products were studied by DFT calculations. In agreement with the calculation results, the IR data suggest that the initial hydrogen bond is established with a hydride site for complex 1 and with the metal site for complex 2. However, no intermediate dihydrogen complex found theoretically was detected experimentally on the way to the final classical tetrahydride product