Intercalation of Poly(bis-(methoxyethoxyethoxy)phosphazene) into Lithium Hectorite

Poly(bis-(methoxyethoxyethoxy)phosphazene) (MEEP) intercalated into lithium hectorite was investigated for its potential application as a solid polymer electrolyte in lithium-ion polymer batteries. Varying amounts of MEEP were intercalated into lithium hectorite, and the physical properties of the nanocomposites were monitored using powder X-ray diffraction, thermogravimetric analysis, differential scanning calorimetry, and attenuated total reflectance spectroscopy. Alternating current (AC) impedance spectroscopy was used to determine the ionic conductivity of the nanocomposites when complexed with lithium triflate salt

Infections Ostéo-articulaires et Réunion de Concertation Pluridisciplinaire (Exemple dans les Pyrénées Orientales)

Contexte: Les Réunions de Concertation Pluridisciplinaire (RCP) doivent permettre d'améliorer la prise en charge des infections ostéo-articulaires (IOA). A notre connaissance, il existe peu de données sur la nature des cas qui y sont discutés et aucun article sur l'observance des propositions qui y sont faites. Objectifs: Décrire les caractéristi.q ues des patients dont le dossier est discuté en RCP ostéo- \ articulaire et analyser l'observance des propositions qui y sont faites. Méthodes: Nous avons analysé rétrospectivement les patients dont le dossier a été discuté en RCP ostéo-articulaire entre Mai 2011 et Mai 2012 au CH de Perpignan. Les données cliniques, biologiques et microbiologiques étaient recueillies de façon standardisée. L'observance des propositions issues des RCP a été contrôlée sur dossIer et le cas échéant par contact avec les patients ou médecins/chirurgiens référents. Résultats: Cent trente-trois patients, âgés de 5 à 96 ans ont été présentés en RCP ostéo-articulaire. Les IOA sur matériel concernaient 74 patients (59%). L'étiologie était staphylococcique dans 52% des cas, poly-microbienne pour 29% des patients. La RCP proposait une démarche diagnostique (12 patients, 9%) un traitement antibiotique (1:8 patients, 73 %) une intervention chirurgicale (41 patients, 30%). Les propositions médicales étaient en adéquation avec les référentiels dans 94% des cas. Elles n'étaient pas suivies, en totalité ou en partie, pour l'antibiothérapie chez 30% des patients et pour la chirurgie chez 7% des patients. Les facteurs de non observance des propositions médicales étaient principalement les effets indésirables cliniques (65%) et biologiques (13%) liés aux antibiotiques, un refus du patient (13 %), un choix divergent du médecin référent (20%) ou une voie d'administration inadaptée (13%). Conclusions: Les dossiers des cas discutés en RCP ostéo-articlliaires sont variables et complexes. Les propositions médicales qui y sont réalisées sont conformes aux référentiels en vigueur mais se heurtent à une inobservance liée dans la plupart des cas à une intolérance aux antibiotiques. La com unication des propositions et l'organisation du suivi pourraient être un axe d'él:mélioration de la prise en charge des IOA.MONTPELLIER-BU Médecine UPM (341722108) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Time interval between infective endocarditis first symptoms and diagnosis: relationship to infective endocarditis characteristics, microorganisms and prognosis.

International audienceOBJECTIVE: To analyze the characteristics and outcome of infective endocarditis (IE) according to the time interval between IE first symptoms and diagnosis.METHODS: Among the IE cases of a French population-based epidemiological survey, patients having early-diagnosed IE (diagnosis of IE within 1 month of first symptoms) were compared with those having late-diagnosed IE (diagnosis of IE more than 1 month after first symptoms).RESULTS: Among the 486 definite-IE, 124 (25%) had late-diagnosed IE whereas others had early-diagnosed IE. Early-diagnosed IE were independently associated with female gender (OR = 1.8; 95% CI [1.0-3.0]), prosthetic valve (OR= 2.6; 95% CI [1.4-5.0]) and staphylococci as causative pathogen (OR = 3.7; 95% CI [2.2-6.2]). Cardiac surgery theoretical indication rates were not different between early and late-diagnosed IE (56.3% vs 58.9%), whereas valve surgery performance was lower in early-diagnosed IE (41% vs 53%; p = .03). In-hospital mortality rates were higher in early-diagnosed IE than in late-diagnosed IE (25.1% vs 16.1%; p < .001).CONCLUSIONS: The time interval between IE first symptoms and diagnosis is closely related to the IE clinical presentation, patient characteristics and causative microorganism. Better prognosis reported in late-diagnosed IE may be related to a higher rate of valvular surgery. KEY MESSAGES Infective endocarditis, which time interval between first symptoms and diagnosis was less than one month, were mainly due to Staphylococcus aureus in France. Staphylococcus aureus infective endocarditis were associated with septic shock, transient ischemic attack or stroke and higher mortality rates than infective endocarditis due to other bacteria or infective endocarditis, which time interval between first symptoms and diagnosis was more than one month. Infective endocarditis, which time interval between first symptoms and diagnosis was more than one month, were accounting for one quarter of all infective endocarditis in our study and were associated with vertebral osteomyelitis and a higher rate of cardiac surgery performed for hemodynamic indication than other infective endocarditis

Molecular Landscape of Therapy-related Myeloid Neoplasms in Patients Previously Treated for Gynecologic and Breast Cancers

International audienceDefinition of therapy-related myeloid neoplasms (TRMN) is only based on clinical history of exposure to leukemogenic therapy. No specific molecular classification combining therapy-related acute myeloid leukemia and therapy-related myelodysplastic syndromes has been proposed. We aimed to describe the molecular landscape of TRMN at diagnosis, among 77 patients with previous gynecologic and breast cancer with a dedicated next-generation sequencing panel covering 74 genes. We investigated the impact of clonal hematopoiesis of indeterminate potential-associated mutations (CHIP-AMs defined as presence at TRMN stage of mutations described in CHIP with a frequency >1%) on overall survival (OS) and the clinical relevance of a modified genetic ontogeny-based classifier that categorized patients in 3 subgroups. The most frequently mutated genes were TP53 (31%), DNMT3A (19%), IDH1/2 (13%), NRAS (13%), TET2 (12%), NPM1 (10%), PPM1D (9%), and PTPN11 (9%). CHIP-AMs were detected in 66% of TRMN patients, with no impact on OS. Yet, patients with CHIP-AM were older and had a longer time interval between solid tumor diagnosis and TRMN. According to our modified ontogeny-based classifier, we observed that the patients with TP53 or PPM1D mutations had more treatment lines and complex karyotypes, the "MDS-like" patients were older with more gene mutations, while patients with "De novo/pan-AML" mutations were younger with more balanced chromosomal translocations. Median OS within each subgroup was 7.5, 14.5, and 25.2 months, respectively, with statistically significant difference in multivariate analysis. These results support the integration of cytogenetic and molecular markers into the future TRMN classification to reflect the biological diversity of TRMN and its impact on outcomes

L’université et la ville

La place accordée à la ville dans l’histoire des universités est généralement limitée. Pourtant, l’université est depuis sa naissance, au xiie siècle, une institution exclusivement urbaine et contribue à la fabrique de la ville en suscitant des espaces spécifiques. Saisir la nature spatiale et sociale de ces interactions sur la longue durée, du xiiie au xxie siècle et à l’échelle de l’Europe, est l’objectif de cet ouvrage. Au-delà des périodisations classiques, les dix-sept études réunies ici mobilisent trois grilles de lecture : la première interroge le lien entre ville et université lors des périodes de fondation et de refondation ; la seconde analyse les rapports entre le corps universitaire et les sociétés urbaines ; la dernière s’intéresse à la dissémination de l’université dans la ville, bien antérieure à son développement dans les banlieues des grandes villes européennes à la fin du xxe siècle. Les deux figures du quartier et du campus ne résistent guère à l’analyse historique qui décrit la perméabilité des espaces et la difficulté à séparer les mondes de la ville et de l’université

Travel Med Infect Dis

BACKGROUND: Literature on health events in HIV-infected travellers is scarce, particularly in sub-Saharan African (SSA) migrants. METHODS: We investigated health events in HIV-infected SSA migrants living in France during and after travel to their native country. All had a pre-travel plasma viral load (pVL) below 200 copies/mL and were on stable combined antiretroviral therapy (cART). Logistic regression models were used to assess the risk factors for at least one adverse health event or febrile event. RESULTS: Among 264 HIV migrants, pre-travel median CD4 count was 439/mm3 and 27 migrants (6%) experienced a low-level viremia between 50 and 200 copies/mL. One hundred (38%) experienced at least one event (13 experienced two events). The most common events were gastrointestinal, including diarrhoea (n=29, 26%), respiratory events (n=20, 18%), and malaria (n=17, 15%; 1 death). In multivariable analysis, a pre-travel low-level viremia and a lack of pre-travel medical advice significantly increased the risk for any event (OR 4.31, 95% CI, 1.41-13.1; and OR 3.62, 95% CI, 1.38-9.47; respectively). A lack of pre-travel advice significantly increased the risk for febrile event. CONCLUSIONS: Early and tailored counselling on pre-travel medical advice regarding diarrhoea and vector-borne diseases prophylactic measures in HIV-infected SSA migrants should be emphasised before travel to Africa

Persistent headaches one year after bacterial meningitis: prevalence, determinants and impact on quality of life

International audienceBackground: Little is known on headaches long-term persistence after bacterial meningitis and on their impact on patients' quality of life.Methods: In an ancillary study of the French national prospective cohort of community-acquired bacterial meningitis in adults (COMBAT) conducted between February 2013 and July 2015, we collected self-reported headaches before, at onset, and 12 months (M12) after meningitis. Determinants of persistent headache (PH) at M12, their association with M12 quality of life (SF 12), depression (Center for Epidemiologic Studies Depression Scale) and neuro-functional disability were analysed.Results: Among the 277 alive patients at M12 87/274 (31.8%), 213/271 (78.6%) and 86/277 (31.0%) reported headaches before, at the onset, and at M12, respectively. In multivariate analysis, female sex (OR: 2.75 [1.54-4.90]; p < 0.001), pre-existing headaches before meningitis (OR: 2.38 [1.32-4.30]; p < 0.01), higher neutrophilic polynuclei percentage in the CSF of the initial lumbar puncture (OR: 1.02 [1.00-1.04]; p < 0.05), and brain abscess during the initial hospitalisation (OR: 8.32 [1.97-35.16]; p < 0.01) were associated with M12 persistent headaches. Neither the responsible microorganism, nor the corticoids use were associated with M12 persistent headaches. M12 neuro-functional disability (altered Glasgow Outcome Scale; p < 0.01), M12 physical handicap (altered modified Rankin score; p < 0.001), M12 depressive symptoms (p < 0.0001), and M12 altered physical (p < 0.05) and mental (p < 0.0001) qualities of life were associated with M12 headaches.Conclusion: Persistent headaches are frequent one year after meningitis and are associated with quality of life alteration

One-Year Sequelae and Quality of Life in Adults with Meningococcal Meningitis: Lessons from the COMBAT Multicentre Prospective Study

Trial registration: ClinicalTrial.Gov identification number NCT01730690.International audienceIntroduction: COMBAT is a prospective, multicentre cohort study that enrolled consecutive adults with community-acquired bacterial meningitis (CABM) in 69 participating centres in France between February 2013 and July 2015 and followed them for 1 year.Methods: Patients aged at least 18 years old, hospitalised with CABM were followed during their hospitalisation and then contacted by phone 12 months after enrolment. Here we present the prevalence of sequelae at 12 months in a subgroup of patients with meningococcal meningitis.Results: Five of the 111 patients with meningococcal meningitis died during initial hospitalisation and two died between discharge and 12 months, leaving 104 patients alive 1 year after enrolment, 71 of whom provided 12-month follow-up data. The median age was 30.0 years and 54.1% of the patients had no identified risk factor for meningitis. More than 30% reported persistent headache, more than 40% were not satisfied with their sleep and 10% had concentration difficulties. Hearing loss was present in about 15% of the patients and more than 30% had depressive symptoms. About 13% of the patients with a previous professional activity had not resumed work. On the SF-12 Health Survey, almost 50% and 30% had physical component or mental component scores lower than the 25th percentile of the score distribution in the French general population. There was a non-significant improvement in the patients' disability scores from hospital discharge to 12 months (p = 0.16), but about 10% of the patients had residual disability.Conclusions: Although most patients in our cohort survive meningococcal meningitis, the long-term burden is substantial and therefore it is important to ensure a prolonged follow-up of survivors and to promote preventive strategies, including vaccination

Relationship between serotypes, disease characteristics and 30-day mortality in adults with invasive pneumococcal disease

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Erratum to 'Predominance of healthcare-associated cases among episodes of community-onset bacteraemia due to extended-spectrum β-lactamase-producing Enterobacteriaceae' [International Journal of Antimicrobial Agents 49/1 67-73]

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