El valor estratégico de la comunicación institucional en la Incubadora de Empresas UNC

La Incubadora de Empresas UNC, inaugurada en septiembre del 2012, forma parte del Parque Científico Tecnológico de la Universidad Nacional de Córdoba, que depende de la Secretaría de Ciencia y Tecnología y la Subsecretaría de Innovación, Transferencia y Vinculación Tecnológica. Esta institución se encuentra inserta en el seno de la ciudad universitaria más importante del interior del país, y en uno de los ecosistemas emprendedores más dinámicos. La creación del Parque Científico Tecnológico constituye una decisión estratégica por parte de la UNC en la búsqueda de mecanismos para fortalecer las relaciones y vínculos del sector científico tecnológico con el sector productivo. Los objetivos generales que se plantearon para la Incubadora de Empresas de la UNC son los siguientes: 1) promover el desarrollo de empresas de base tecnológica a partir del conocimiento generado en la Universidad; y 2) convertirse en institución referente en la región en materia de emprendedorismo, innovación y tecnología. Desde el punto de vista de la comunicación institucional, estos objetivos implicaban varios desafíos: la promoción del desarrollo de empresas tecnológicas requerían estrategias que apuntara a los docentes-investigadores y egresados recientes de la Universidad, un público que no estaba habituado al discurso empresarial. En cuanto al segundo, requería “competir” con varias instituciones que vienen desarrollando actividades de promoción del emprendedorismo desde hace varios años. Ante este escenario, la comunicación corporativa de la Incubadora se llenó de desafíos: ¿Cómo lograr un mensaje efectivo en una institución que contiene públicos tan diversos como docentes-investigadores, estudiantes avanzados, el sector emprendedor y el productivo?, ¿cómo instalar comunicacionalmente a la Incubadora de Empresas UNC, en una ciudad en la que existían cuatro incubadoras previamente? El diseño de estrategias de comunicación, por lo tanto, debía contemplar las lógicas de funcionamiento de grupos muy diferentes, que provienen tanto del sector académico y ámbito gubernamental, como del sector privado, sin excluir a ninguno de ellos en el mensaje. La Oficina de Comunicaciones junto con el Equipo de Gestión decidió encarar un diagnóstico institucional, previo al diseño de estrategias. Por su parte la Prosecretaría de Comunicación de la UNC acompañó todo el proceso a través de la definición de algunos lineamientos institucionales, fundamentales para dar coherencia a la imagen institucional

Role of gut microbiota and bacterial translocation in acute intestinal injury and mortality in patients admitted in ICU for septic shock

IntroductionSepsis is a life-threatening organ dysfunction with high mortality rate. The gut origin hypothesis of multiple organ dysfunction syndrome relates to loss of gut barrier function and the ensuing bacterial translocation. The aim of this study was to describe the evolution of gut microbiota in a cohort of septic shock patients over seven days and the potential link between gut microbiota and bacterial translocation.MethodsSixty consecutive adult patients hospitalized for septic shock in intensive care units (ICU) were prospectively enrolled. Non-inclusion criteria included patients with recent or scheduled digestive surgery, having taken laxatives, pre- or probiotic in the previous seven days, a progressive digestive neoplasia, digestive lymphoma, chronic inflammatory bowel disease, moribund patient, and pregnant and lactating patients. The primary objective was to evaluate the evolution of bacterial diversity and richness of gut microbiota during seven days in septic shock. Epidemiological, clinical and biological data were gathered over seven days. Gut microbiota was analyzed through a metagenomic approach. 100 healthy controls were selected among healthy blood donors for reference basal 16S rDNA values.ResultsSignificantly lower bacterial diversity and richness was observed in gut microbiota of patients at Day 7 compared with Day 0 (p<0.01). SOFA score at Day 0, Acute Gastrointestinal Injury (AGI) local grade, septic shock origin and bacterial translocation had an impact on alpha diversity. A large increase in Enterococcus genus was observed at Day 7 with a decrease in Enterobacterales, Clostridiales, Bifidobacterium and other butyrate-producing bacteria.DiscussionThis study shows the importance of bacterial translocation during AGI in septic shock patients. This bacterial translocation decreases during hospitalization in ICUs in parallel to the decrease of microbiota diversity. This work highlights the role of gut microbiota and bacterial translocation during septic shock

Les candidémies chez les patients non neutropéniques de réanimation (existe-t'-il des différences entre les patients médicaux et chirurgicaux?)

MONTPELLIER-BU Médecine UPM (341722108) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Nutrition Rehabilitation in the Intensive Care Unit

The maintenance of homeostasis after severe injury requires the restoration of the physiological regulation of food intake. A wide array of functional alterations can hinder the intake of adequate amounts of nutrients to support the recovery from critical illness. These alterations encompass changes in the preprandial phase, reflected by a loss of appetite; changes in the prandial phase, yielding swallowing disorders; and changes in the postprandial phase, including impairments of gastric emptying, gut motility, and satiety. This tutorial aims to review these often overlooked features and to suggest recommendations for the nutrition rehabilitation of the critically ill.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Exercise and Nutrition Strategies to Counteract Sarcopenic Obesity

Exercise and Nutrition Strategies to Counteract Sarcopenic Obesit

Monocyte human leukocyte antigen-DR but not β-d-glucan may help early diagnosing invasive Candida infection in critically ill patients

International audienceBackground Precision medicine risk stratification is desperately needed to both avoid systemic antifungals treatment delay and over prescription in the critically ill with risk factors. The aim of the present study was to explore the combination of host immunoparalysis biomarker (monocyte human leukocyte antigen-DR expression (mHLA-DR)) and Candida sp wall biomarker β- d -glucan in risk stratifying patients for secondary invasive Candida infection (IC). Methods Prospective observational study. Two intensive care units (ICU). All consecutive non-immunocompromised septic shock patients. Serial blood samples ( n = 286) were collected at day 0, 2 and 7 and mHLA-DR and β- d -glucan were then retrospectively assayed after discharge. Secondary invasive Candida sp infection occurrence was then followed at clinicians’ discretion. Results Fifty patients were included, 42 (84%) had a Candida score equal or greater than 3 and 10 patients developed a secondary invasive Candida sp infection. ICU admission mHLA-DR expression and β- d -glucan (BDG) failed to predict secondary invasive Candida sp infection. Time-dependent cause-specific hazard ratio of IC was 6.56 [1.24–34.61] for mHLA-DR  350 pg/mL. Predictive negative value of mHLA-DR > 5000 Ab/c and BDG > 350 pg/mL combination at day 7 was 81% [95% CI 70–92]. Conclusions This study suggests that mHLA-DR may help predicting IC in high-risk patients with septic shock. The added value of BDG and other fungal tests should be regarded according to the host immune function markers

Combination of Monocyte Human Leukocyte Antigen-DR and β-d-Glucan for the Early Diagnosis of Invasive Candida Infection in Critically Ill Patients: A Proof of Concept Study

Background : Precision medicine risk stratification is desperately needed to both avoid systemic antifungals treatment delay and over prescription in the critically ill with risk factors. The aim of the present study was to explore the combination of host immunoparalysis biomarker (monocyte human leukocyte antigen-DR expression (mHLA-DR)) and Candida sp wall biomarker β-d-glucan in risk stratifying patients for secondary invasive Candida infection (ICI). Methods : Prospective observational study. Two intensive care units (ICU). All consecutive non-immunocompromised septic shock patients. Serial blood samples (n=286) were collected at day 0, 2 and 7 and mHLA-DR and β-d-glucan were assayed. Secondary invasive Candida sp infection occurrence were then followed. Results : Fifty patients were included, 42 (84%) had a Candida score equal or greater than 3 and 10 patients developed a secondary invasive Candida sp infection. ICU admission mHLA-DR expression and β-d-glucan (BDG) failed to predict secondary invasive Candida sp infection. Time-dependent cause-specific hazard ratio of ICI was 6.56[1.24-34.61] for mHLA-DR 350pg/mL. Predictive negative value of mHLA-DR > 5000 Ab/c and BDG > 350 pg/mL combination at day 7 was 81% [95%CI 70-92]. Conclusion : This proof of concept study suggests that mHLA-DR predicts ICI in high risk patients with septic shock. The added value of BDG and other fungal tests should be regarded according to the host immune function markers. Trial registration: ClinicalTrials.gov identifier: NCT03136081 Take home message : Combination of monocytic HLA-DR expression and beta-D-glucan in patients hospitalized for septic shock failed to predict invasive candida infection but could be useful to rule out infection

Association between early nutrition support and 28-day mortality in critically ill patients: the FRANS prospective nutrition cohort study

International audienceAbstract Background Current guidelines suggest the introduction of early nutrition support within the first 48 h of admission to the intensive care unit (ICU) for patients who cannot eat. In that context, we aimed to describe nutrition practices in the ICU and study the association between the introduction of early nutrition support ( 3 days were consecutively included and followed for 10 days. Their mortality was assessed at D28. We investigated the association between early nutrition (< 48 h) and mortality at D28 using univariate and multivariate propensity-score-weighted logistic regression analyses. Results During the study period, 1206 patients were included. Early nutrition support was administered to 718 patients (59.5%), with 504 patients receiving enteral nutrition and 214 parenteral nutrition. Early nutrition was more frequently prescribed in the presence of multiple organ failure and less frequently in overweight and obese patients. Early nutrition was significantly associated with D28 mortality in the univariate analysis (crude odds ratio (OR) 1.69, 95% confidence interval (CI) 1.23–2.34) and propensity-weighted multivariate analysis (adjusted OR (aOR) 1.05, 95% CI 1.00–1.10). In subgroup analyses, this association was stronger in patients ≤ 65 years and with SOFA scores ≤ 8. Compared with no early nutrition, a significant association was found of D28 mortality with early enteral (aOR 1.06, 95% CI 1.01–1.11) but not early parenteral nutrition (aOR 1.04, 95% CI 0.98–1.11). Conclusions In this prospective cohort study, early nutrition support in the ICU was significantly associated with increased mortality at D28, particularly in younger patients with less severe disease. Compared to no early nutrition, only early enteral nutrition appeared to be associated with increased mortality. Such findings are in contrast with current guidelines on the provision of early nutrition support in the ICU and may challenge our current practices, particularly concerning patients at low nutrition risk. Trial registration ClinicalTrials.gov Identifier: NCT02599948. Retrospectively registered on November 5th 2015