7 research outputs found
La protection contre la foudre des établissements recevant du public : quel cadre juridique ?
Il nâexiste pas, dans la lĂ©gislation française, de normes obligatoires concernant le choix et les modes dâinstallation des paratonnerres sur les Ă©tablissements recevant du public. Cette lacune surprend quelque peu : les textes lĂ©gislatifs et, surtout, rĂ©glementaires traitant de la protection contre lâincendie sont, en effet, trĂšs dĂ©taillĂ©s, le titre II de la partie rĂ©glementaire du code de la construction et de lâurbanisme Ă©tant entiĂšrement consacrĂ© Ă ce problĂšme. On peut donc sâĂ©tonner de lâ..
La responsabilité dans le cimetiÚre
Ce texte prĂ©sente la situation du cimetiĂšre en droit français. Le cimetiĂšre est une dĂ©pendance du domaine communal affectĂ© au service public. Le maire y dispose du pouvoir de police et peut constater lâĂ©tat dâabandon dâune sĂ©pulture.This text sets out the situation of the cemetery in french law. The cemetery is an outbuilding of the council estate assigned to the public utilities. There, the mayor has the power to inforce law and order, and he can record the neglected State burials can be in
Les orages dans lâespace francilien
Les franciliens ne sont-ils pas encore quelque peu esclaves du « temps » mĂ©tĂ©orologique ? GĂ©ographes, juristes, historiens de l'art, archĂ©ologues, plasticiens ont confrontĂ© leurs regards sur les orages, le « temps » d'une journĂ©e. MĂ©tĂ©ore peu frĂ©quent en Ăle-de-France, l'orage est pourtant... ... dĂ©sordre et risques Les milieux urbains sont vulnĂ©rables aux effets de la foudre, du vent violent et des prĂ©cipitations de forte intensitĂ©. L'artificialisation des substrats accroĂźt le ruissellement des pluies. L'afflux brutal d'eau polluĂ©e met en pĂ©ril la qualitĂ© des sols cultivĂ©s et des stocks d'approvisionnement en eau, la circulation automobile sur la voirie inondĂ©e. ... drame et spectacle Une grande richesse d'images s'attache Ă la reprĂ©sentation des nuages menaçants, des Ă©clairs et des arcs-en-ciel dans la peinture, la poĂ©sie et la chanson populaire
La mort en Ăle-de-France
La mort est un sujet tabou dans notre sociĂ©tĂ©. Pourtant, câest Ă sa maniĂšre dâenvisager ou de reprĂ©senter la mort quâune sociĂ©tĂ© montre sa face cachĂ©e, ses angoisses profondes. Pour conjurer la crainte de ce franchissement, quoi de plus salutaire que dâĂ©crire un livre Ă son sujet et de croiser des regards diffĂ©rents sur un phĂ©nomĂšne souvent vĂ©cu de maniĂšre trĂšs, voire trop, personnelle. ...Les archĂ©ologues voient dans les sĂ©pultures et les nĂ©cropoles un tĂ©moignage prĂ©cieux des mentalitĂ©s du passĂ©. ...Les amĂ©nageurs ont Ă rĂ©soudre les problĂšmes posĂ©s par les cimetiĂšres dans les grandes mĂ©tropoles. ...Les juristes tentent de dĂ©finir les droits et obligations des vivants face Ă la mort des autres et aux procĂ©dures qui sâensuivent. ...Les artistes dĂ©sacralisent les reprĂ©sentations habituelles en « truquant » la mort quand le cadavre devient travesti.Du moment que quelqu'un est neÌ, a veÌcu, il en restera toujours quelque chose, meÌme si on ne peut dire quoi ; nous ne pouvons plus faire deÌsormais comme si ce quelqu'un eÌtait inexistant en geÌneÌral, ou n'avait jamais eÌteÌ. Jusqu'aux sieÌcles des sieÌcles, il faudra tenir compte de ce mysteÌrieux « avoir-eÌteÌ Â». Vladimir JankeÌleÌvitch, La mort, Flammarion, 1977 *** Quand on habite rue Belgrand ou rue des PyrĂ©nĂ©es, On ne peut Ă©viter dâapercevoir souvent Les deux Ă©normes cheminĂ©es DâoĂč chaque jour des corps sâĂ©chappent en fumĂ©es Que disperse le vent. Les Ăąmes ont sans doute pris de lâavance ; Ă©tonnĂ©es, Elles regardent fuir ce nuage mouvant : La chair qui durant tant dâannĂ©es Les tint dans sa chaleur dĂ©lectable enfermĂ©es. Jacques RĂDA, FumĂ©es, in La Course, Gallimard, 199
Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial
International audienc
Effect of Tocilizumab vs Usual Care in Adults Hospitalized With COVID-19 and Moderate or Severe Pneumonia
International audienceImportance Severe pneumonia with hyperinflammation and elevated interleukin-6 is a common presentation of coronavirus disease 2019 (COVID-19).Objective To determine whether tocilizumab (TCZ) improves outcomes of patients hospitalized with moderate-to-severe COVID-19 pneumonia.Design, Setting, and Particpants This cohort-embedded, investigator-initiated, multicenter, open-label, bayesian randomized clinical trial investigating patients with COVID-19 and moderate or severe pneumonia requiring at least 3 L/min of oxygen but without ventilation or admission to the intensive care unit was conducted between March 31, 2020, to April 18, 2020, with follow-up through 28 days. Patients were recruited from 9 university hospitals in France. Analyses were performed on an intention-to-treat basis with no correction for multiplicity for secondary outcomes.Interventions Patients were randomly assigned to receive TCZ, 8 mg/kg, intravenously plus usual care on day 1 and on day 3 if clinically indicated (TCZ group) or to receive usual care alone (UC group). Usual care included antibiotic agents, antiviral agents, corticosteroids, vasopressor support, and anticoagulants.Main Outcomes and Measures Primary outcomes were scores higher than 5 on the World Health Organization 10-point Clinical Progression Scale (WHO-CPS) on day 4 and survival without need of ventilation (including noninvasive ventilation) at day 14. Secondary outcomes were clinical status assessed with the WHO-CPS scores at day 7 and day 14, overall survival, time to discharge, time to oxygen supply independency, biological factors such as C-reactive protein level, and adverse events.Results Of 131 patients, 64 patients were randomly assigned to the TCZ group and 67 to UC group; 1 patient in the TCZ group withdrew consent and was not included in the analysis. Of the 130 patients, 42 were women (32%), and median (interquartile range) age was 64 (57.1-74.3) years. In the TCZ group, 12 patients had a WHO-CPS score greater than 5 at day 4 vs 19 in the UC group (median posterior absolute risk difference [ARD] â9.0%; 90% credible interval [CrI], â21.0 to 3.1), with a posterior probability of negative ARD of 89.0% not achieving the 95% predefined efficacy threshold. At day 14, 12% (95% CI â28% to 4%) fewer patients needed noninvasive ventilation (NIV) or mechanical ventilation (MV) or died in the TCZ group than in the UC group (24% vs 36%, median posterior hazard ratio [HR] 0.58; 90% CrI, 0.33-1.00), with a posterior probability of HR less than 1 of 95.0%, achieving the predefined efficacy threshold. The HR for MV or death was 0.58 (90% CrI, 0.30 to 1.09). At day 28, 7 patients had died in the TCZ group and 8 in the UC group (adjusted HR, 0.92; 95% CI 0.33-2.53). Serious adverse events occurred in 20 (32%) patients in the TCZ group and 29 (43%) in the UC group (Pâ=â.21).Conclusions and Relevance In this randomized clinical trial of patients with COVID-19 and pneumonia requiring oxygen support but not admitted to the intensive care unit, TCZ did not reduce WHO-CPS scores lower than 5 at day 4 but might have reduced the risk of NIV, MV, or death by day 14. No difference on day 28 mortality was found. Further studies are necessary for confirming these preliminary results.Trial Registration ClinicalTrials.gov Identifier: NCT0433180