American consensus recommendations for gastric scintigraphy: curve fitting with only a few points remains an easy and accurate method to obtain reliable and reproducible gastric emptying estimates.

International audienceBACKGROUND: In 2008, American consensus recommendations for performing gastric emptying (GE) scintigraphy were published. It was recommended that data are acquired only at 0, 1, 2, and 4 h and that the results are expressed as percentages of meal retention. Until now, it was established that the GE time-activity curves should have many points (every 10, 15, or 20 min) to reflect the GE process accurately and to be optimally adjusted by a mathematical model. In this study, we have evaluated the curve fitting using only a few points as proposed by the consensus protocol. MATERIALS AND METHODS: GE scintigraphy tests of 224 patients were retrospectively analyzed. Two curve fittings were done for each patient, either using data acquired every 20 min or using data acquired every hour. A comparison of these two methods was made based on the values of the computed GE parameters. RESULTS: We observed strong correlations between the two methods (r=0.81-0.99, P<0.05). Using the Bland-Altman analysis, more than 95% of the differences were included in the mean difference 95% confidence interval. The mean differences were weak with a relatively small SD and Cohen's k coefficients ranging from 0.84 to 0.93, indicating an excellent agreement between the two methods. CONCLUSION: Our results showed the feasibility and accuracy of curve fitting using only a few points. The curve fitting is easy to perform and allows the computation of reliable and reproducible parameters that reflect the whole GE process

Computed tomography pulmonary angiography versus ventilation-perfusion lung scanning for diagnosing pulmonary embolism during pregnancy: a systematic review and meta-analysis

Differences between computed tomography pulmonary angiography and ventilation-perfusion lung scanning in pregnant patients with suspected acute pulmonary embolism are not well-known, leading to ongoing debate on which test to choose. We searched in PubMed, EMBASE, Web of Science and the Cochrane Library databases and identified all relevant articles and abstracts published up to October 1, 2017. We assessed diagnostic efficiency, frequency of non-diagnostic results and maternal and fetal exposure to radiation exposure. We included 13 studies for the diagnostic efficiency analysis, 30 for the analysis of non-diagnostic results and 22 for the radiation exposure analysis. The pooled rate of false negative test results was 0% for both imaging strategies with overlapping confidence intervals. The pooled rates of non-diagnostic results with computed tomography pulmonary angiography and ventilation-perfusion lung scans were 12% (95% confidence interval: 817) and 14% (95% confidence interval: 10-18), respectively. Reported maternal and fetal radiation exposure doses were well below the safety threshold, but could not be compared between the two diagnostic methods given the lack of high quality data. Both imaging tests seem equally safe to rule out pulmonary embolism in pregnancy. We found no significant differences in efficiency and radiation exposures between computed tomography pulmonary angiography and ventilation-perfusion lung scanning although direct comparisons were not possible.Thrombosis and Hemostasi

Projet ANR EVALUFQ-VOL : Persistance des enterobacteriacae resistantes aux fluoroquinolones dans le sol après épandage de fumier de volailles

National audienceDeux fumiers frais, l'un issu de poulets de chair conventionnels non traités et l'autre de poulets traités à l'enrofloxacine (BaytrilND) pendant cinq jours à la dose thérapeutique, ont été épandus sur céréales à raison de 8 T /ha. Une quantification des entérobactéries et des résidus d'antibiotique a été réalisée sur les fumiers à la sortie du bâtiment d'élevage et dans le sol pendant 2 mois après épandage. La proportion de bactéries résistantes à 32 mg/L de ciprofloxacine (métabolite de l'enrofloxacine) dans les fumiers en sortie du bâtiment était inférieure à 0,003% pour les animaux non traités et d'environ 2% pour les animaux traités. Les concentrations en enrofloxacine et ciprofloxacine correspondantes étaient de 11 et 1 mg/kg pour les fumiers d'animaux traités respectivement, et inférieures à la limite de quantification pour les fumiers d'animaux non traités. L'apport de fumier a augmenté d'un facteur 10 les teneurs en entérobactéries présentes dans le sol et a conduit à des concentrations en enrofloxacine voisines de 20 μg/kg et en limite de quantification pour la ciprofloxacine. Ces teneurs en antibiotiques ont peu évolué au cours des deux mois suivant l'épandage. Aucune entérobactérie résistante à la ciprofloxacine n'a été observée dans le sol épandu avec du fumier d'animaux non traités. En revanche, les bactéries résistantes à 1 mg /L de ciprofloxacine représentaient environ 60% des entérobactéries totales 7 jours après l'épandage du fumier d'animaux traités. Cette proportion a diminué au cours du temps et aucune résistance n'a été observée un mois après l'épandage. Des Escherichia coli (bactérie fécale) ont cependant été détectés deux mois après l'épandage. 114 colonies recueillies tout au long de l'expérience ont été analysées par typage moléculaire (PCR ERIC). L'analyse des profils distingue 51 souches représentées par une à 19 colonies. Elle démontre la persistance d'une souche depuis le fumier traité jusqu'au sol 7 jours après l'épandage et la persistance d'une autre souche d'E. coli sur le sol pendant au moins 41 jours. / Two fresh manure, one from broiler conventional untreated and the other from chickens treated with enrofloxacin (BaytrilND) for five days at the therapeutic dose, have been applied to cereals at 8 T / ha. Quantification of enterobacteria and antibiotic residues was conducted on manure leaving the barn and land for 2 months after application. The proportion of bacteria resistant to 32 mg / L of ciprofloxacin (metabolite of enrofloxacin) in manure at the output of the building was less than 0.003% for untreated animals and about 2% for treated animals. The concentrations of enrofloxacin and ciprofloxacin were respectively 11 and 1 mg / kg for animals treated manure, and below the limit of quantification (LOQ) for the manure of untreated animals. The manure application increased by 10-fold the level of enterobacteria in soil and led to concentrations of enrofloxacin close to 20 μg / kg and LOQ for ciprofloxacin. These levels of antibiotics did not really change over two months after application. No enterobacteria resistant to ciprofloxacin was observed in soil receiving manure from untreated animals. However, bacteria resistant to more than 1 mg / L of ciprofloxacin accounted for about 60% of total enterobacteria 7 days after application of manure from treated animals. This proportion decreased over time and no resistance was observed one month after application. Escherichia coli (faecal bacteria) were detected two months after application. 114 colonies collected throughout the experiment were analyzed by a molecular typing method (ERIC PCR). The analysis of the profiles distinguished 51 strains represented by one to 19 colonies. It demonstrated the persistence of a strain from the treated manure up to soil until 7 days after application and the persistence of another strain of E. coli on soil for at least 41 days