F-02: Antibiothérapies anti-SARM dans le traitement probabiliste des bactériémies à Staphylococcus aureus au CHU d'Angers

Introduction – objectifs La résistance à la méticilline du Staphylococcus aureus (SA) ne cesse de diminuer en France. Nous avons évalué la prescription des antibiothérapies probabilistes dans les bactériémies à SA et leur impact clinique. Matériels et méthodes Il s’agit d’une étude rétrospective incluant les bactériémies à Staphylococcus aureus sur le CHU d’Angers entre novembre 2012 et septembre 2013 avec recueil de l’antibiothérapie prescrite au rendu « cocci gram (CG)+ », à J5, hospitalisation depuis plus de 5 jours ou dans les six derniers mois, signes de gravité clinique, mortalité à J5. Résultats Nous avons inclus 146 épisodes de bactériémies. A l’annonce de CG+, 10 patients étaient décédés, 38,2 % ont reçu un anti-SARM (n = 52), 54,4 % un anti-SASM (n = 74), 7,4 % aucun antibiotique (n = 10). Parmi les bactériémies à SARM (n = 23), 60,9 % (n = 14) ont reçu une antibiothérapie initiale à visée SARM contre 36,3 % (n = 41) pour les bactériémies à SASM (n = 113) (OR = 2,71, p = 0,03). Cette adaptation semble influencée par une hospitalisation récente (OR = 1,82 ; p = 0,33) et la présence de signes de gravité (OR = 1,87, p = 0,23). Dans 21,4 % (n = 6) des bactériémies à SASM, l’antibiothérapie anti-SARM n’a pas été désecaladée. La mortalité à J5 est 13 %. L’absence d’antibiothérapie dans les 24 premières heures (OR = 2,97 ; p = 0,046) et une prescription de C3G (OR = 5,2, p = 0,05) en monothérapie augmentent le risque de décès à J5. Conclusion L’antibiothérapie initale semble adaptée à l’histoire et la présentation des patients. L’initiation sans délai, la visée staphylococcique et la désescalade sont les éléments importants du traitement

Scaling fields in the two-dimensional abelian sandpile model

We consider the isotropic two-dimensional abelian sandpile model from a perspective based on two-dimensional (conformal) field theory. We compute lattice correlation functions for various cluster variables (at and off criticality), from which we infer the field-theoretic description in the scaling limit. We find a perfect agreement with the predictions of a c=-2 conformal field theory and its massive perturbation, thereby providing direct evidence for conformal invariance and more generally for a description in terms of a local field theory. The question of the height 2 variable is also addressed, with however no definite conclusion yet.Comment: 22 pages, 1 figure (eps), uses revte

Measurements of hydrogen cyanide (HCN) and acetylene (C2H2) from the Infrared Atmospheric Sounding Interferometer (IASI)

Hydrogen cyanide (HCN) and acetylene (C2H2) are ubiquitous atmospheric trace gases with medium lifetime, which are frequently used as indicators of combustion sources and as tracers for atmospheric transport and chemistry. Because of their weak infrared absorption, overlapped by the CO2 Q branch near 720 cm−1, nadir sounders have up to now failed to measure these gases routinely. Taking into account CO2 line mixing, we provide for the first time extensive measurements of HCN and C2H2 total columns at Reunion Island (21° S, 55° E) and Jungfraujoch (46° N, 8° E) in 2009–2010 using observations from the Infrared Atmospheric Sounding Interferometer (IASI). A first order comparison with local ground-based Fourier transform InfraRed (FTIR) measurements has been carried out allowing tests of seasonal consistency which is reasonably captured, except for HCN at Jungfraujoch. The IASI data shows a greater tendency to high C2H2 values. We also examine a nonspecific biomass burning plume over austral Africa and show that the emission ratios with respect to CO agree with previously reported values

Validation and data characteristics of methane and nitrous oxide profiles observed by MIPAS and processed with Version 4.61 algorithm

The ENVISAT validation programme for the atmospheric instruments MIPAS, SCIAMACHY and GOMOS is based on a number of balloon-borne, aircraft, satellite and ground-based correlative measurements. In particular the activities of validation scientists were coordinated by ESA within the ENVISAT Stratospheric Aircraft and Balloon Campaign or ESABC. As part of a series of similar papers on other species [this issue] and in parallel to the contribution of the individual validation teams, the present paper provides a synthesis of comparisons performed between MIPAS CH4 and N2O profiles produced by the current ESA operational software (Instrument Processing Facility version 4.61 or IPF v4.61, full resolution MIPAS data covering the period 9 July 2002 to 26 March 2004) and correlative measurements obtained from balloon and aircraft experiments as well as from satellite sensors or from ground-based instruments. In the middle stratosphere, no significant bias is observed between MIPAS and correlative measurements, and MIPAS is providing a very consistent and global picture of the distribution of CH4 and N2O in this region. In average, the MIPAS CH4 values show a small positive bias in the lower stratosphere of about 5%. A similar situation is observed for N2O with a positive bias of 4%. In the lower stratosphere/upper troposphere (UT/LS) the individual used MIPAS data version 4.61 still exhibits some unphysical oscillations in individual CH4 and N2O profiles caused by the processing algorithm (with almost no regularization). Taking these problems into account, the MIPAS CH4 and N2O profiles are behaving as expected from the internal error estimation of IPF v4.61 and the estimated errors of the correlative measurements

Extended multiplet structure in Logarithmic Conformal Field Theories

We use the process of quantum hamiltonian reduction of SU(2)_k, at rational level k, to study explicitly the correlators of the h_{1,s} fields in the c_{p,q} models. We find from direct calculation of the correlators that we have the possibility of extra, chiral and non-chiral, multiplet structure in the h_{1,s} operators beyond the `minimal' sector. At the level of the vacuum null vector h_{1,2p-1}=(p-1)(q-1) we find that there can be two extra non-chiral fermionic fields. The extra indicial structure present here permeates throughout the entire theory. In particular we find we have a chiral triplet of fields at h_{1,4p-1}=(2p-1)(2q-1). We conjecture that this triplet algebra may produce a rational extended c_{p,q} model. We also find a doublet of fields at h_{1,3p-1}=(\f{3p}{2}-1)(\f{3q}{2}-1). These are chiral fermionic operators if p and q are not both odd and otherwise parafermionic.Comment: 24 pages LATEX. Minor corrections and extra reference

Experimental study of accelerating field distribution optimization in the H-structure with comb holders

We have suggested to perform the tuning the structure accelerating field distribution at the wave similar to H, by changing the inductivity of the holder of a single drift tube. Changing the angle of bend of the adjacent drift tube holders along different sides relatively to the comb holder plane allows one to increase and decrease the field amplitude in the gap between them. The value Rch ≈90 MОhm/m has been obtained for the structure under consideration that is higher than that obtained by known methods of tuning.Пропонується проводити настройку розподілу прискорюючого поля структури на хвилі, аналогічній Н, зміною індуктивності утримувача одиночної трубки дрейфу. Зміна кута повороту утримувачів сусідніх трубок дрейфу в різні боки щодо площини гребінчастого утримувача дає можливість як збільшувати, так і зменшувати амплітуду поля в зазорі між ними. Для структур, що розглядаються, отримано значення Rш ≈ 90 МОм⋅м⁻¹, що більш, ніж при відомих методах настройки.Предлагается проводить настройку распределения ускоряющего поля структуры на волне, аналогичной Н, изменением индуктивности держателя одиночной трубки дрейфа. Изменение угла поворота держателей соседних трубок дрейфа в разные стороны относительно плоскости гребенчатого держателя дает возможность как увеличивать, так и уменьшать амплитуду поля в зазоре между ними. Для рассматриваемых структур получено значение Rш ≈90 МОм⋅м⁻¹, что больше, чем при известных методах настройки

The prognosis of streptococcal prosthetic bone and joint infections depends on surgical management-A multicenter retrospective study

BACKGROUND: The optimal treatment of streptococcal prosthetic joint infections (PJIs) is unclear. METHODS: A cohort of streptococcal PJIs was reviewed retrospectively in seven reference centers for the management of complex bone and joint infections, covering the period January 1, 2010 to December 31, 2012. RESULTS: Seventy patients with monomicrobial infections were included: 47 had infections of total hip arthroplasty and 23 had infections of total knee arthroplasty. The median age was 77 years (interquartile range (IQR) 69-83 years), the median Charlson comorbidity score was 4 (IQR 3-6), and 15.6% (n=11) had diabetes. The most commonly identified streptococcal species were Streptococcus agalactiae and Streptococcus dysgalactiae (38.6% (n=27) and 17.1% (n=12), respectively). Debridement, antibiotics and implant retention (DAIR) was performed after a median time of 7 days (IQR 3-8 days), with polyethylene exchange (PE) in 21% of cases. After a minimum follow-up of 2 years, 27% of patients had relapsed, corresponding to 51.4% of DAIR treatment cases and 0% of one-stage (n=15) or two-stage (n=17) exchange strategy cases. Rifampicin or levofloxacin in combination therapy was not associated with a better outcome (adjusted p= 0.99). S. agalactiae species and DAIR treatment were associated with a higher risk of failure. On multivariate analysis, only DAIR treatment and S. agalactiae were independent factors of relapse. Compared to DAIR without PE, DAIR with PE was only associated with a trend towards a benefit (odds ratio 0.33, 95% confidence interval 0.06-1.96; adjusted p= 0.44). CONCLUSIONS: Streptococcal PJIs managed with DAIR have a poor prognosis and S. agalactiae seems to be an independent factor of treatment failure

Acetylene (C2H2) and hydrogen cyanide (HCN) from IASI satellite observations: Global distributions, validation, and comparison with model

We present global distributions of C$_{2}$H$_{2}$ and hydrogen cyanide (HCN) total columns derived from the Infrared Atmospheric Sounding Interferometer (IASI) for the years 2008–2010. These distributions are obtained with a fast method allowing to retrieve C$_{2}$H$_{2}$ abundance globally with a 5% precision and HCN abundance in the tropical (subtropical) belt with a 10% (25 %) precision. IASI data are compared for validation purposes with ground-based Fourier transform infrared (FTIR) spectrometer measurements at four selected stations.We show that there is an overall agreement between the ground-based and space measurements with correlation coefficients for daily mean measurements ranging from 0.28 to 0.81, depending on the site. Global C$_{2}$H$_{2}$ and subtropical HCN abundances retrieved from IASI spectra show the expected seasonality linked to variations in the anthropogenic emissions and seasonal biomass burning activity, as well as exceptional events, and are in good agreement with previous spaceborne studies. Total columns simulated by the Model for Ozone and Related Chemical Tracers, version 4 (MOZART-4) are compared to the ground-based FTIR measurements at the four selected stations. The model is able to capture the seasonality in the two species in most of the cases, with correlation coefficients for daily mean measurements ranging from 0.50 to 0.86, depending on the site. IASI measurements are also compared to the distributions from MOZART-4. Seasonal cycles observed from satellite data are reasonably well reproduced by the model with correlation coefficients ranging from -0.31 to 0.93 for C$_{2}$H$_{2}$ daily means, and from 0.09 to 0.86 for HCN daily means, depending on the considered region. However, the anthropogenic (biomass burning) emissions used in the model seem to be overestimated (underestimated), and a negative global mean bias of 1% (16 %) of the model relative to the satellite observations was found for C$_{2}$H$_{2}$ (HCN)

Spatial Asymmetric Two dimensional Continuous Abelian Sandpile Model

We insert some asymmetries in the continuous Abelian sandpile models, such as directedness and ellipticity. We analyze probability distribution of different heights and also find the field theory corresponding to the models. Also we find the fields associated with some height variables.Comment: 14 Pages, 11 Figure