Oxidative degradation of polylactide (PLA) and its effects on physical and mechanical properties

The thermo-oxidative degradation of polylactide (PLA) films was studied between 70 and 150 C. It was shown that the oxidative degradation of PLA leads to a random chain cission responsible for a reduction of the molar mass. These molar mass changes affect Tg and the degree of crystallinity, and it was found that Tg decreases according to the Fox–Flory theory whereas the degree of crystallinity increases due to a chemicrystallization process. A correlation between molar mass and strain at break during oxidation has been established: PLA displays a brittle behavior when Mn falls below 40 kg mol 1 in agreement with relationships linking the critical value for embrittlement with the molar mass between entanglements

DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39–3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18–0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Neuropathie diabétique : mise au point

La neuropathie diabétique est une entité hétérogène regroupant des atteintes multiples, dont la forme la plus classique est la polyneuropathie distale symétrique (PNDS). Son diagnostic repose dans la majorité des cas sur une anamnèse et un examen clinique compatibles. Le dépistage de la PNDS, pour permettre la mise en place de mesures préventives de ses complications, reste la pierre angulaire de la prise en charge en l’absence de traitement spécifique. Nous proposons dans cet article une revue des différentes formes de neuropathie diabétique et de leur prise en charge.Diabetic neuropathy is a heterogeneous entity, grouping multiple disorders, of which the most classic form is distal symmetric polyneuropathy (DSPN). Its diagnosis is based in most cases on a compatible history and clinical examination. Screening for DSPN, to allow the implementation of preventive measures against its complications, remains the cornerstone of management, in the absence of specific treatment. In this article, we propose a review of the different forms of diabetic neuropathy and their management

Orbital myositis induced by alendronate: A case report

Background and purpose: Bisphosphonates are widely used, notably for osteoporosis treatment. Their common side effects are well known. However, they can trigger less common effects such as orbital inflammation. Here, the case is reported of an orbital myositis triggered by alendronate. Methods: This is a case report at an academic medical center. An orbital magnetic resonance imaging scan, a thoraco-abdominal computed tomography scan and blood sample analyses were performed. Results: A 66-year-old woman treated by alendronate for her osteoporosis was investigated. She developed an orbital myositis after the first intake. Neurological examination revealed a painful diplopia with decreased downward and adduction movements of the right eye and edema of the upper eyelid. Orbital magnetic resonance imaging showed an orbital myositis of the right eye. No other cause of orbital myositis was found than the alendronate intake. After alendronate arrest and a short course of prednisone, the symptoms resolved. Conclusion: This case highlights that alendronate can cause an orbital myositis whose early diagnosis is of major importance because it is a treatable side effect.</p

Cardiac arrest during deep brain stimulation: A case report

Key Clinical Message We present the case of a 54‐year‐old male with severe Parkinson's disease and chronic, non‐reversible pulmonary artery hypertension who had seizures and a cardiorespiratory arrest during surgery for deep brain stimulation, a minimally invasive procedure usually associated with a low risk of complications. This case illustrates how perioperative changes in antiparkinsonian therapy in patient with multiple comorbidities may significantly affect the risk profile

A double linear driving force approximation for non-isothermal mass transfer modeling through bi-disperse adsorbents

International audienceThe aim of this paper is to derive a double LDF non-isothermal model to describe mass transfer through a fixed bed of bi-disperse adsorbent pellets. Firstly, we perform an analysis concerning the different way the composition within the pellets can be described and the consequence on the model structure and compactness. Secondly, we present a bed model including a simplified intra-particle model that is based on a double LDF approximation. This bi-disperse pellet model reduces the number of variables and parameters that are needed. This simplified model is used to simulate breakthroughs of a methane/carbon dioxide mixture over a 5 A zeolite and of a 2,2-dimethylbutane/2-methylpentane mixture over a silicalite molecular sieve. It is also compared with a more detailed model based on Stefan–Maxwell theory that we have previously developed

Neuropathie des petites fibres dans les maladies autoimmunes systémiques

La neuropathie des petites fibres (NPF) implique une atteinte des fibres nerveuses de petit calibre : les fibres C non myélinisées et les fibres A-delta myélinisées. Elle se manifeste principalement par des troubles sensitifs : paresthésies, dysesthésies ou douleurs neuropathiques (brûlures) et déficits protopathiques, associés à des symptômes dysautonomiques. Les étiologies possibles des NPF sont variées : idiopathiques, toxiques, métaboliques, immunologiques, infectieuses et héréditaires. Nous présentons dans cet article la démarche diagnostique des NPF, les étiologies autoimmunes les plus fréquemment associées aux NPF, ainsi que des éléments de prise en charge thérapeutique