La collection du site de La Tène (Suisse) conservée au musée d'Archéologie nationale de Saint-Germain-en-Laye: Un ensemble d'armement, d'outillage et de parure celtiques aux origines de l'archéologie gauloise

<a l'hiver 1857, Hans Kopp, un "pêcheur d'antiquités lacustres", revient avec une pêche miraculeuse. Sur le fond du lac de Neuchâtel, près de la rive aux environs du village de Marin (Suisse), il a récolté un ensemble d'armes et d'outils en fer extraordinairement bien conservés. Ces objets atypiques sont-ils les premiers témoins de l'époque celtique contemporaine de la civilisation gauloise ? C'est le début d'une aventure scientifique qui conduira bientôt à faire du site de La Tène la référence mondiale pour l'identification de la période du Second âge du Fer européen. Tous les grands musées cherchent alors à obtenir des collections de ce gisement désormais célèbre. Fondé par l'empereur Napoléon III, le Musée des Antiquités nationales de Saint-Germain-en-Laye acquiert plusieurs séries d'objets auprès des découvreurs scientifiques du site, que sont le colonel Friedrich Schwab et le naturaliste Edouard Desor.Lancée en 2007, la série La Tène : un site, un mythe a pour but la publication des collections qui sont actuellement dispersées dans une trentaine d'institutions en Europe et dans le monde. Le volume consacré à la collection du musée de Saint-Germain-en-Laye a fait appel aux meilleurs spécialistes de l'archéologie et des collections du site de la Tène, comme à ceux qui travaillent sur l'histoire de l'archéologie et des musées. La constitution de cette collection de référence française éclaire en effet la démarche des chercheurs des débuts de l'archéologie celtique, comme elle révèle l'état des connaissances et les débats qui ont marqué la reconnaissance de cette phase majeure de la Protohistoire européenne qu'est l'époque de La Tène

Intraoperative transfusion practices in Europe

© 2016 The Author. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.Background: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. Methods: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. Results: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl-1 and increased to 9.8 (1.8) g dl-1 after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). Conclusions: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl-1), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold

Intraoperative transfusion practices and perioperative outcome in the European elderly: A secondary analysis of the observational ETPOS study

The demographic development suggests a dramatic growth in the number of elderly patients undergoing surgery in Europe. Most red blood cell transfusions (RBCT) are administered to older people, but little is known about perioperative transfusion practices in this population. In this secondary analysis of the prospective observational multicentre European Transfusion Practice and Outcome Study (ETPOS), we specifically evaluated intraoperative transfusion practices and the related outcomes of 3149 patients aged 65 years and older. Enrolled patients underwent elective surgery in 123 European hospitals, received at least one RBCT intraoperatively and were followed up for 30 days maximum. The mean haemoglobin value at the beginning of surgery was 108 (21) g/l, 84 (15) g/l before transfusion and 101 (16) g/l at the end of surgery. A median of 2 [1–2] units of RBCT were administered. Mostly, more than one transfusion trigger was present, with physiological triggers being preeminent. We revealed a descriptive association between each intraoperatively administered RBCT and mortality and discharge respectively, within the first 10 postoperative days but not thereafter. In our unadjusted model the hazard ratio (HR) for mortality was 1.11 (95% CI: 1.08–1.15) and the HR for discharge was 0.78 (95% CI: 0.74–0.83). After adjustment for several variables, such as age, preoperative haemoglobin and blood loss, the HR for mortality was 1.10 (95% CI: 1.05–1.15) and HR for discharge was 0.82 (95% CI: 0.78–0.87). Preoperative anaemia in European elderly surgical patients is undertreated. Various triggers seem to support the decision for RBCT. A closer monitoring of elderly patients receiving intraoperative RBCT for the first 10 postoperative days might be justifiable. Further research on the causal relationship between RBCT and outcomes and on optimal transfusion strategies in the elderly population is warranted. A thorough analysis of different time periods within the first 30 postoperative days is recommended