Low GWP Refrigerant and Partial Miscible Lubricant

Lubricant selection is based on several lubricant properties to satisfied compressor and system reliability, longevity and energy efficiency performances. The use of non-miscible or low soluble lubricant can bring some technical advantage for the compressor and the system. This paper presents investigations results on low GWP refrigerant alternatives for light commercial and commercial applications. The work also targets the reduction refrigerant charge associated with the compressor characteristics

Longitudinal change in professional divers’ lung function: literature review

Background: The aim of this study was to assess changes in lung function of professional divers. Materials and Methods: This is a review of the literature. Only studies about professional divers were included. All published studies between 01.01.1984 and 07.01.2014 were systematically searched. The search was performed in Medline and Embase databases and in the “Medicina Maritima” journal. The results of pulmonary function tests were extracted from each study. Results: Fifteen articles were found. Four studies showed a significant decrease in forced vital capacity (FVC). Five studies demonstrated a significant decrease in forced expiratory flows (FEF) at 75% and 50% of FVC expired (FEF75% and FEF50%) after 3 years of diving. Seven studies demonstrated a significant decrease in forced expiratory volume in 1 second (FEV1) after 3 years of diving. But only 2 studies did an age-standardisation so that only 1 study demonstrated a significant decrease in FEV1 after age-standardisation. Three articles showed a decrease in transfer factor for carbon monoxide (TLCO) after 5 years. Dives parameters (like depth, number by year) were not always related to variations on the different lung variables. Conclusions: This literature review showed a decrease in TLCO, FEF75% and FEF25–75%. One wonders whether these variations are due to the age or to diving. The results of such a long-term study would be interesting and might help to guide fundamental research

Predicted nine-year risk of diabetes among professional divers: a prospective study

Background: The purpose of this study was to assess diabetes predictive score for professional divers followed-up in one medical centre in France. Materials and Methods: This prospective study, performed during 2013, included professional divers who were followed in a French maritime medicine centre. Data about their professional history of diving and dive profiles were collected. The clinical and biological data collected included: age, waist circumference, biometrics, body mass index, smoking status, blood pressure, practicing sports, glycaemia, triglyceridaemia, total cholesterolaemia, HDL and LDL cholesterolaemia. The predicted 9-year risk of diabetes was calculated according to the DESIRE score. Data were analysed using Epidata® software, by Pearson c2 test or by Fisher’s exact test, by analysis of variance or Kruskal-Wallis test, and by Spearman correlation coefficient. Results: Out of the 64 deep-sea divers taking part in the study, diabetes risk was estimated for 60 divers. The predictive 9-year risk of diabetes was higher than 10% for 31.7% of the divers and higher than 30% for 6.7% of the divers. Conclusions: In France, people with diabetes have been declared definitely medically unfit to dive. The interest to assess the prevalence of risk factors and the predictive risk of diabetes arises from the need for prevention

Skin infection by Staphylococcus aureus in a fisherman: difficulty in continuing work on board

Background and aim: The aim of this study was to understand why an infectious skin disease due to colonisation by Staphylococcus aureus methi-S led to disembarkation of a fisherman for treatment and follow-up.Materials and methods: While discussing this case we have analysed different reasons why the studied fisherman could not be successfully treated on board.Results: A 42-year-old fisherman was first presented with skin lesions while fishing for hake. When the fisherman had developed a fever and exfoliative skin lesions on both hands, the ship’s captain called the radio-medical centre for the maritime consultation in Toulouse and for the advice on treatment. After 3 days on penicillin, the fever decreased, but the dermatitis became incapacitating. On his return to shore, the fisherman was hospitalised. Bacteriological swabs of the skin lesion showed colonisation with Staphylococcus aureus methi-S with presence of Panton Valentine leukocidin. Seven-day treatment witha follow-up of antibioticotherapy was necessary to resolve the skin eruption and obtain definitive apyrexia. Treatment ashore was advised because of difficulty in continuing manual work on board whilst suffering from significant skin lesions and also due to fear of contagion.Conclusions: Skin infection with Staphylococcus aureus methi-S with presence of Panton Valentine leukocidinis difficult to treat on board because of difficulty in carrying out manual work when hands are affected, and also due to slow improvement of dermatitis even when appropriate treatment is undergone. The maritime environment is also a risk factor for skin abrasion, which can lead to secondary colonisation of pathogenic bacteria

Characterization of acute kidney injury in critically ill patients with severe coronavirus disease 2019

Abstract Background Coronavirus disease 2019 (COVID-19)-associated acute kidney injury (AKI) frequency, severity and characterization in critically ill patients has not been reported. Methods Single-centre cohort performed from 3 March 2020 to 14 April 2020 in four intensive care units in Bordeaux University Hospital, France. All patients with COVID-19 and pulmonary severity criteria were included. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. A systematic urinary analysis was performed. The incidence, severity, clinical presentation, biological characterization (transient versus persistent AKI; proteinuria, haematuria and glycosuria) and short-term outcomes were evaluated. Results Seventy-one patients were included, with basal serum creatinine (SCr) of 69 ± 21 µmol/L. At admission, AKI was present in 8/71 (11%) patients. Median [interquartile range (IQR)] follow-up was 17 (12–23) days. AKI developed in a total of 57/71 (80%) patients, with 35% Stage 1, 35% Stage 2 and 30% Stage 3 AKI; 10/57 (18%) required renal replacement therapy (RRT). Transient AKI was present in only 4/55 (7%) patients and persistent AKI was observed in 51/55 (93%). Patients with persistent AKI developed a median (IQR) urine protein/creatinine of 82 (54–140) (mg/mmol) with an albuminuria/proteinuria ratio of 0.23 ± 20, indicating predominant tubulointerstitial injury. Only two (4%) patients had glycosuria. At Day 7 after onset of AKI, six (11%) patients remained dependent on RRT, nine (16%) had SCr >200 µmol/L and four (7%) had died. Day 7 and Day 14 renal recovery occurred in 28% and 52%, respectively. Conclusion Severe COVID-19-associated AKI is frequent, persistent, severe and characterized by an almost exclusive tubulointerstitial injury without glycosuria

Analyse des facteurs cliniques, histologiques et moléculaires impliqués dans la récidive des cancers colorectaux de stade II

Introduction : L'évaluation des facteurs de risque de rcécidive chez des patients suivis pour un cancer colorectal de stade II (CCR) est capitale pour identifier les patients qui pourraient être traités par chimiothérapie adjuvante. Bien que certains de ces facteurs soient bien identifiés (perforation, stade T, nombre de ganglions analysés, faible degré de différenciation), de nombreuses études s'intéressent à trouver d'autres facteurs prédictifs, encore plus fiables. But : Etudier des facteurs de récidive cliniques, histologiques et moléculaires dans une série de patients pris en charge pour un CCR de stade II. Matériel et Méthodes : Nous avons recueilli rétrospectivement les données cliniques, histologiques de 100 patients pris en charge dans deux centres d'oncologie digestive à Nantes (CHU de Nantes et Institut de Cancérologie de l'Ouest, René Gauducheau) entre le 1er août 2001 et le 21 décembre 2009 (suivi minimal de 3 ans). Les blocs tumoraux ont été désarchivés afin d'analyser, prospectivement le statut des microsatellites et la mutation du gène BRAF. Résultats : Parmi les 100 patients étudiés (âge médian 70,5 ans {23-96} dont 61 hommes), 18 (18%) ont récidivé pendant la période de suivie. Aucun facteur prédictif histologique ou moléculaire de récidive n'a été identifié, mais la localisation tumorale droite était associée avec une diminution significative de la SSR à 3 ans (p=0,048). De plus, la présence d'une anémie ou d'un syndrome rectal révélateur était associée avec une tendance à l'amélioration de la SSR à 3 ans (p= 0,061 et p= 0,052 respectivement). Il n'a pas été identifié d'association entre risque de récidive et l'âge, le sexe, la présence d'une perforation ou occlusion révélatrice, du degré de différenciation, de la présence de VELIPI. Conclusion : Les patients pris en charge pour un CCR de stade II ont une meilleure SSR à 3 ans lorsque la localisation tumorale est colique droite.NANTES-BU Médecine pharmacie (441092101) / SudocSudocFranceF