A 1-Year Prospective French Nationwide Study of Emergency Hospital Admissions in Children and Adults with Primary Immunodeficiency.

PURPOSE: Patients with primary immunodeficiency (PID) are at risk of serious complications. However, data on the incidence and causes of emergency hospital admissions are scarce. The primary objective of the present study was to describe emergency hospital admissions among patients with PID, with a view to identifying "at-risk" patient profiles. METHODS: We performed a prospective observational 12-month multicenter study in France via the CEREDIH network of regional PID reference centers from November 2010 to October 2011. All patients with PIDs requiring emergency hospital admission were included. RESULTS: A total of 200 admissions concerned 137 patients (73 adults and 64 children, 53% of whom had antibody deficiencies). Thirty admissions were reported for 16 hematopoietic stem cell transplantation recipients. When considering the 170 admissions of non-transplant patients, 149 (85%) were related to acute infections (respiratory tract infections and gastrointestinal tract infections in 72 (36%) and 34 (17%) of cases, respectively). Seventy-seven percent of the admissions occurred during winter or spring (December to May). The in-hospital mortality rate was 8.8% (12 patients); death was related to a severe infection in 11 cases (8%) and Epstein-Barr virus-induced lymphoma in 1 case. Patients with a central venous catheter (n = 19, 13.9%) were significantly more hospitalized for an infection (94.7%) than for a non-infectious reason (5.3%) (p = 0.04). CONCLUSION: Our data showed that the annual incidence of emergency hospital admission among patients with PID is 3.4%. The leading cause of emergency hospital admission was an acute infection, and having a central venous catheter was associated with a significantly greater risk of admission for an infectious episode

Modélisation systèmique et système agraire. Décision et organisation

National audienc

Modelisation systemique et systeme agraire. Decision et organisation

National audienc

Hydro-meteorological modelling of the Rhone basin: general presentation and objectives.

International audienceThe paper presents the French national effort undertaken these 5 last years in order to build a hydrological modelisation of the Rhone catchment, coupling the surface and the atmosphere at regional scale. The modelling strategy is based on the coupling of the operational surface model (the ISBA SVAT scheme), the snow model (CROCUS) of Meteo-France and the distributed hydrological model MODCOU developed at Centre d'Informatique G�ologique de l'Ecole Nationale Sup�rieure des Mines de Paris (CIG/ENSMP). As a first step, the coupled model (called in the following CIRSE) uses prescribed atmospheric forcing deduced from meteorological analysis. Several high resolution databases on a fourteen-year period have been constituted. The first part of the article presents the meteorological forcing database, the discharges database and the soil and vegetation maps. Then, the first results of CIRSE model and its validation on the riverflows are shown. As the coupled model was proved to be able to simulate present hydrology characteristics, it was finally used to conduct a preliminary climate change impact study. The impact of surface air temperature and precipitation variations on the hydrological cycle in a doubling CO2 scenario simulated by the Meteo-France climate General Circulation Model (GCM) are shown

Visible characteristics of living systems Esthetics and artificial life

SIGLEAvailable at INIST (FR), Document Supply Service, under shelf-number : DO 2246 / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc