Les multiples facettes du système d'informations spatialisées du département de l'Hérault

Le système d’informations spatialisées du Conseil Général de l’Hérault répond à deux objectifs: serveur pour les collectivités et partenaires pour les deux bases de référence, fédérateur de cette information au sein des services. Enrichi par les informations de ceux-ci et ouvert sur l’extérieur, il est susceptible de valorisation en vue d’une aide à la décision, notamment pour l’analyse du territoire

Retrospective French nationwide survey of childhood aggressive vascular anomalies of bone, 1988-2009

<p>Abstract</p> <p>Objective</p> <p>To document the epidemiological, clinical, histological and radiological characteristics of aggressive vascular abnormalities of bone in children.</p> <p>Study design</p> <p>Correspondents of the French Society of Childhood Malignancies were asked to notify all cases of aggressive vascular abnormalities of bone diagnosed between January 1988 and September 2009.</p> <p>Results</p> <p>21 cases were identified; 62% of the patients were boys. No familial cases were observed, and the disease appeared to be sporadic. Mean age at diagnosis was 8.0 years [0.8-16.9 years]. Median follow-up was 3 years [0.3-17 years]. The main presenting signs were bone fracture (n = 4) and respiratory distress (n = 7), but more indolent onset was observed in 8 cases. Lung involvement, with lymphangiectasies and pleural effusion, was the most frequent form of extraosseous involvement (10/21). Bisphosphonates, alpha interferon and radiotherapy were used as potentially curative treatments. High-dose radiotherapy appeared to be effective on pleural effusion but caused major late sequelae, whereas antiangiogenic drugs like alpha interferon and zoledrenate have had a limited impact on the course of pulmonary complications. The impact of bisphosphonates and alpha interferon on bone lesions was also difficult to assess, owing to insufficient follow-up in most cases, but it was occasionally positive. Six deaths were observed and the overall 10-year mortality rate was about 30%. The prognosis depended mainly on pulmonary and spinal complications.</p> <p>Conclusion</p> <p>Aggressive vascular abnormalities of bone are extremely rare in childhood but are lifethreatening. The impact of anti-angiogenic drugs on pulmonary complications seems to be limited, but they may improve bone lesions.</p

Prescription de clichés d'abdomen sans préparation aux urgences pédiatriques (un exemple de mise en oeuvre des recommandations et évaluation des pratiques au CHU de Limoges)

LIMOGES-BU Médecine pharmacie (870852108) / SudocSudocFranceF

Les multiples facettes du système d’informations spatialisées du département de l’Hérault

The Conseil Général de l’Hérault’s spatially referenced information system meets two objectives in that it provides two databases for local government and other institutions, and acts as a centre of information for the Conseil’s various departments. Continually fed by information from those departments as well as outside sources, it can be developed as aid to decision-making, particularly in the field of regional development.Le système d’informations spatialisées du Conseil Général de l’Hérault répond à deux objectifs : serveur pour les collectivités et partenaires pour les deux bases de référence, fédérateur de cette information au sein des services. Enrichi par les informations de ceux-ci et ouvert sur l’extérieur, il est susceptible de valorisation en vue d’une aide à la décision, notamment pour l’analyse du territoire.Bonnefont Elisabeth, Languepin Marie, Petit-Hugon Philippe. Les multiples facettes du système d’informations spatialisées du département de l’Hérault. In: Mappemonde, 1993/4. Facettes de SIG. pp. 32-33

Évaluation des paysages de l'Hérault: une approche méthodologique et une application SIG adaptée

L’élaboration d’un outil d’évaluation des paysages a été rendue possible grâce à un partenariat entre l’INRA, la DIREN et l’Observatoire du Territoire, avec le souci commun d’intégrer la réflexion sur les paysages dans les problématiques de gestion de l’espace. Les modules d’analyse élaborés à partir des fonctionnalités des Systèmes d’Information Géographique produisent des résultats très prometteurs en vue de la sensibilisation au paysage des partenaires et acteurs et laissent entrevoir d’intéressantes perspectives de valorisation

Évaluation des paysages de l’Hérault: une approche méthodologique et une application SIG adaptée

A partnership between INRA, DIREN and the Observatoire du Territoire has enabled the implementation of a landscape-evaluation tool, based on a mutual preoccupation to combine reflection on the landscape with space management issues. Starting from the analysis modules realised using GIS functions, very promising results have been obtained which may help to attract the attention of decision-makers to landscape-related issues and offer interesting opportunities for validation.L’élaboration d’un outil d’évaluation des paysages a été rendue possible grâce à un partenariat entre l’INRA, la DIREN et l’Observatoire du Territoire, avec le souci commun d’intégrer la réflexion sur les paysages dans les problématiques de gestion de l’espace. Les modules d’analyse élaborés à partir des fonctionnalités des Systèmes d’Information Géographique produisent des résultats très prometteurs en vue de la sensibilisation au paysage des partenaires et acteurs et laissent entrevoir d’intéressantes perspectives de valorisation.La elaboración de un instrumento de evaluación de los paisajes fue posibilitada por una colaboración entre el INRA, la DIREN y el Observatorio del Territorio con la preocupación común de integrar la reflexión sobre los paisajes en la problemática de gestión del espacio. Los módulos de análisis elaborados a partir de las funcionalidades de los Systemas de Información Geográfica arrojan resultados muy prometedores con objeto de la sensibilización al paisaje de los agentes y actores sociales y permiten conjeturar perspectivas interesantes de valorización.Falque Marie-Cécile, Bonnefont Elisabeth, Languepin Marie, Butel Jacques, Esteben Marc. Évaluation des paysages de l’Hérault: une approche méthodologique et une application SIG adaptée. In: Mappemonde, 1995/2. pp. 14-17

Interest of postmortem-collected specimens in the diagnosis of fulminant meningococcal sepsis.

International audienceWe reported the case of a child who died of purpura fulminans. The diagnosis of Neisseria meningitidis serogroup C could be assessed using postmortem specimens collected up to 10 h after death. We were able to identify the bacteria by culture and/or PCR on samples without having autopsy performed. Soluble antigens were also detected in serum

Management of Central Venous Catheters in Children and Adults on Home Parenteral Nutrition: A French Survey of Current Practice

Although central venous catheter (CVC)-related thrombosis (CRT) is a severe complication of home parenteral nutrition (HPN), the amount and quality of data in the diagnosis and management of CRT remain low. We aimed to describe current practices regarding CVC management in French adult and pediatric HPN centers, with a focus on CVC obstruction and CRT. Current practices regarding CVC management in patients on HPN were collected by an online-based cross-sectional survey sent to expert physicians of French HPN centers. We compared these practices to published guidelines and searched for differences between pediatric and adult HPN centers' practices. Finally, we examined the heterogeneity of practices in both pediatric and adult HPN centers. The survey was completed by 34 centers, including 21 pediatric and 13 adult centers. We found a considerable heterogeneity, especially in the responses of pediatric centers. On some points, the centers' responses differed from the current guidelines. We also found significant differences between practices in adult and pediatric centers. We conclude that the management of CVC and CRT in patients on HPN is a serious and complex situation for which there is significant heterogeneity between HPN centers. These findings highlight the need for more well-designed clinical trials in this field

Results from the French National Esophageal Atresia register: one-year outcome

International audienceBACKGROUND: The aim of the present national prospective population-based study was to assess the early morbidity of esophageal atresia (EA).METHODS: All 38 multidisciplinary French centers that care for patients with EA returned a specific questionnaire about the 1-year outcome for each patient. This information was centralized, checked, and entered into a database.RESULTS: From the total population of 307 EA patients born in 2008 and 2009, data about the 1-year outcome were obtained from 301 (98%) patients, of whom 4% were lost to follow-up and 5% died. Medical complications occurred in 34% of the patients: anastomotic leaks (8%), recurrent tracheoesophageal fistula (4%), and anastomotic stenosis (22%); all of the latter group needed dilation (median, 2 dilations/patient). A new hospitalization was required for 59% of patients (2.5 hospitalizations/patient) for digestive (52%) or respiratory (48%) reasons. Twelve percent of patients required antireflux surgery at a median age of 164 days (range, 33-398 days), and 1% underwent an aortopexy for severe tracheomalacia. The weight/age Z-score was -0.8 (range, -5.5 to 3.7 months) at 12 months. Fifteen percent of patients were undernourished at 12 months of age, whereas 37% presented with respiratory symptoms and 15% had dysphagia at the last follow-up. Significant independent factors associated with medical complications were anastomotic esophageal tension (p = .0009) and presence of a gastrostomy (p = .0002); exclusive oral feeding at discharge was associated with a decreased risk of complications (p = .007).CONCLUSIONS: Digestive and respiratory morbidities remain frequent during the first year of life and are associated with difficult anastomosis and lack of full oral feeding.</p

Rapid Improvement after Starting Elexacaftor–Tezacaftor–Ivacaftor in Patients with Cystic Fibrosis and Advanced Pulmonary Disease

International audienceRationale: Elexacaftor-tezacaftor-ivacaftor is a CFTR (cystic fibrosis [CF] transmembrane conductance regulator) modulator combination, developed for patients with CF with at least one Phe508del mutation. Objectives: To evaluate the effects of elexacaftor-tezacaftor- ivacaftor in patients with CF and advanced respiratory disease. Methods: A prospective observational study, including all patients aged ⩾12 years and with a percent-predicted FEV1 (ppFEV1) <40 who initiated elexacaftor-tezacaftor-ivacaftor from December 2019 to August 2020 in France was conducted. Clinical characteristics were collected at initiation and at 1 and 3 months. Safety and effectiveness were evaluated by September 2020. National-level transplantation and mortality figures for 2020 were obtained from the French CF and transplant centers and registries. Measurements and Main Results: Elexacaftor-tezacaftor- ivacaftor was initiated in 245 patients with a median (interquartile range) ppFEV1 = 29 (24-34). The mean (95% confidence interval) absolute increase in the ppFEV1 was +15.1 (+13.8 to +16.4; P < 0.0001), and the mean (95% confidence interval) in weight was +4.2 kg (+3.9 to +4.6; P < 0.0001). The number of patients requiring long-term oxygen, noninvasive ventilation, and/or enteral tube feeding decreased by 50%, 30%, and 50%, respectively (P < 0.01). Although 16 patients were on the transplant waiting list and 37 were undergoing transplantation evaluation at treatment initiation, only 2 received a transplant, and 1 died. By September 2020, only five patients were still on the transplantation path. Compared with the previous 2 years, a twofold decrease in the number of lung transplantations in patients with CF was observed in 2020, whereas the number of deaths without transplantation remained stable. Conclusions: In patients with advanced disease, elexacaftor-tezacaftor-ivacaftor is associated with rapid clinical improvement, often leading to the indication for lung transplantation being suspended