Acide tranexamique intra articulaire sans drainage après prothèse totale du genou - Etude prospective, continue, contrôlée de 107 patients

92ème réunion annuelle de la SOFCOT, PARIS, FRANCE, 06-/11/2017 - 09/11/2017L'acide tranexamique diminue le saignement dans la prothèse totale du genou. La procédure d'administration varie et son retentissement fonctionnel est une notion peu évaluée. L'objectif de notre travail est de vérifier qu'une injection intra-articulaire d'Exacyl sans évacuation ni drainage est efficace sur le saignement et garantit un résultat fonctionnel satisfaisant en termes de douleurs et de mobilité, en l'absence de majoration des complications

Unravelling the genetic relations between the Grenada Basin, the Aves Ridge, and the Lesser Antilles: a structural and stratigraphic analysis

International audienceLocated in the southeastern Caribbean, the Grenada Basin is bounded to the east by the modern Lesser Antillesisland arc, to the west by the Aves Ridge, commonly interpreted as a Cretaceous-Paleocene extinct volcanic arc,and to the south by the transpressive plate boundary with South America. The Grenada Basin has long beenregarded as a classical back-arc basin until recent studies suggest alternative models, such as forearc openingor Wernicke-type simple shear. The genetic relations between the Grenada Basin and its adjacent arcs remaintherefore controversial. Our analysis of seismic reflection and refraction data acquired during the GARANTIcruise (May-June 2017 onboard R/V L’Atalante) sheds light on basement nature and topography, depositionalhistory and deformation of the sedimentary infill, including vertical motions, of the Lesser Antilles back-arc area.Correlations with well logs located on the northern Venezuelan shelf, DSDP sites on the Aves Ridge, and IODPsites off the west coast of Martinique Island, also provide chronostratigraphic constraints.Seismic lines across the Grenada Basin reveal a significant asymmetry: the basement deepens from 5 to 10km southeastwards while flat-lying sediment units thicken from 2 to 7 km. A 6.5 to 7 km thick oceanic crustunderlies the southeastern half of the basin over a width of about 80 km. The Grenada Basin comprises threemajor depositional sequences defined by unconformities and/or changes in the seismic facies, from bottom to top:- Sequence 1: undifferentiated Eocene sediments represented by strong reflectors that drape the acoustic basement,as well as syntectonic deposits.- Sequence 2: Oligocene to Middle Miocene distal turbidites, probably originating from the Orinoco River thatflowed from the south into the Grenada Basin at that time. Sequence 2 lies unconformably over Sequence 1.- Sequence 3: Late Miocene to Recent arc-derived turbidites and pelagic sedimentation, with little detri-tal input from South America, due to the emplacement of the eastward drainage of the Orinoco River southof the northern Venezuelan coastal range during Middle Miocene. Sequence 3 lies unconformably over Sequence 2.Since the oldest syntectonic sediments date from the Eocene, the last tectonic event that shaped the present-daybasement topography dates back from the Eocene. Given the horizontality of Sequences 2 and 3 within the basinand along the Aves Ridge, no differential vertical motions occurred between the Grenada Basin and the AvesRidge since then. This raises questions about the subsidence mechanisms that led to the current depth of theoceanic crust in the southeastern Grenada Basin. By contrast, reflectors in Sequences 2 and 3 are bent upwardsalong the Lesser Antilles slope, reflecting the uplift of the Neogene Lesser Antilles arc. These observations will beintegrated in a future model for the evolution of the Lesser Antilles back-arc area, as part of the ANR GAARAntiproject

LES PLUS BEAUX TEXTES DE LOURDES

Comprend : REVUE MARIE / Paul CLAUDEL ; Jean MARCHAT - REVUE MARIE / Joseph FOLLIET ; Julien BERTHEAU - VoYAGE A LOURDES / Alexix CARREL ; Julien BERTHEAU - LES FOULES DE LOURDES / K. HUYSMANS ; Jean MARCHAT - LES MARGES DE LA PRIERE / Daniel ROPS ; Maurice ESCANDE - LES GEORGIQUES CHRETIENNES / Francis JAMMES ; Jean MARCHAT - LOURDES, VILLESAINTE / Louis MERCIER ; Maurice ESCANDE - BERNADETTE / Marcelle AUCLAIR ; Françoise ROSAY - ALLOCUTION A RADIO VATICAN DU 23 FEVRIER 1957 / Son Exc. Mgr THEAS - EXTRAIT DE L'ENCYCLIQUE DU 2 JUILLET 1957 / S.S. le Pape PIE XII ; Maurice ESCANDEBnF-Partenariats, Collection sonore - BelieveContient une table des matière

Population pharmacokinetics of daptomycin in patients with bone and joint infection: minimal effect of rifampicin co-administration and confirmation of a sex difference

International audienceBackground Daptomycin is increasingly used in the treatment of bone and joint infection (BJI), but its pharmacokinetics (PK) and dosage requirements have not been thoroughly investigated in this indication. Daptomycin may be co-administered with rifampicin, which raises questions about a potential drug interaction. Objectives To investigate the population PK and dosage requirements of daptomycin in patients with BJI, and examine the influence of rifampicin co-administration. Methods A population approach was used to analyse PK data from patients who received daptomycin in our regional reference for BJI. We examined the influence of available covariates, including rifampicin co-administration on daptomycin PK. Simulations performed with the final model investigated the influence of dosages and covariates on PTA for both efficacy and safety. Results A total of 1303 daptomycin concentrations from 183 patients were analysed. A two-compartment model best described the data. Significant intra-individual variability was observed. Daptomycin clearance was influenced by renal function and sex, with females having a 26% lower typical clearance than males. Central volume of distribution (V1) was influenced by body weight, age, sex and rifampicin co-administration. Typical V1 was 11% lower in patients who were co-administered rifampicin. In PK/PD simulations, sex influenced the probability of AUC24/MIC target attainment, while rifampicin had a marginal effect. Conclusions A daptomycin dosage of 8 mg/kg/24 h in women and 10 mg/kg/24 h in men should optimize efficacy but may lead to excessive trough concentrations in many patients, especially in women. Therapeutic drug monitoring appears necessary for precision dosing of daptomycin