Elevation of cardiac troponin I during non-exertional heat-related illnesses in the context of a heatwave

International audienc

Variability of Intensive Care Admission Decisions for the Very Elderly

Although increasing numbers of very elderly patients are requiring intensive care, few large sample studies have investigated ICU admission of very elderly patients. Data on pre triage by physicians from other specialities is limited. This observational cohort study aims at examining inter-hospital variability of ICU admission rates and its association with patients' outcomes. All patients over 80 years possibly qualifying for ICU admission who presented to the emergency departments (ED) of 15 hospitals in the Paris (France) area during a one-year period were prospectively included in the study. Main outcome measures were ICU eligibility, as assessed by the ED and ICU physicians; in-hospital mortality; and vital and functional status 6 months after the ED visit. 2646 patients (median age 86; interquartile range 83–91) were included in the study. 94% of participants completed follow-up (n = 2495). 12.4% (n = 329) of participants were deemed eligible for ICU admission by ED physicians and intensivists. The overall in-hospital and 6-month mortality rates were respectively 27.2% (n = 717) and 50.7% (n = 1264). At six months, 57.5% (n = 1433) of patients had died or had a functional deterioration. Rates of patients deemed eligible for ICU admission ranged from 5.6% to 38.8% across the participating centers, and this variability persisted after adjustment for patients' characteristics. Despite this variability, we found no association between level of ICU eligibility and either in-hospital death or six-month death or functional deterioration. In France, the likelihood that a very elderly person will be admitted to an ICU varies widely from one hospital to another. Influence of intensive care admission on patients' outcome remains unclear

Mise en place d'une stratégie qualité pour la prise en charge des migraines dans un service d'urgences de Paris

LE KREMLIN-B.- PARIS 11-BU Méd (940432101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Instabilités induites par évaporation : modèle solutal

National audienc

Instabilités induites par évaporation : modèle solutal

National audienc

Instabilités induites par évaporation : modèle solutal

National audienc

Transient Rayleigh-Bénard-Marangoni solutal convection

Solutal driven flow is studied for a binary solution submitted to solvent evaporation at the upper free surface. Evaporation induces an increase in the solute concentration close to the free surface and solutal gradients may induce a convective flow driven by buoyancy and/or surface tension. This problem is studied numerically, using several assumptions deduced from previous experiments on polymer solutions. The stability of the system is investigated as a function of the solutal Rayleigh and Marangoni numbers, the evaporative flux and the Schmidt number. The sensitivity of the thresholds to initial perturbations is analyzed. The effect of viscosity variation during drying is also investigated. At last numerical simulations are presented to study the competition between buoyancy and Marangoni effects in the nonlinear regime

Sensitivity of diffusive-convective transition to the initial conditions in a transient Bénard-Marangoni problem

International audienc