Le classement des écoles d'ingénieurs du point de vue multicritère.

International audienceLe journal l'Etudiant présente chaque année un classement des écoles d'ingénieurs, qui suscite de nombreuses réactions de la part des écoles, sachant qu'un large public s'appuie sur ce classement pour choisir son orientation. Une étape préliminaire d'analyse a porté sur les données partielles 2010, 2011 et 2012 mises à disposition par le journal et a permis de définir une méthode approchée (basée sur une combinaison linéaire des critères) de la méthode utilisée, afin de mieux en comprendre le mécanisme (certains critères ne sont pas numériques et ont pourtant un coefficient). En parallèle, une rétro-analyse du classement a été effectuée avec l'outil JMAF, afin de mieux évaluer les poids proposés. Notre analyse a également porté sur le format de présentation du résultat : un classement où des écoles ayant des notes globales très similaires se trouvent classées très loin l'une de l'autre ne parait pas le plus approprié. Un résultat sous formes de classes semble une solution beaucoup plus appropriée à ce genre de problématique. L'analyse critique a permis d'identifier parmi les méthodes d'aide multicritère à la décision la méthode ELECTRE TRI, qui produit des résultats très différents des classements publiés. Cela nous a conduits à dégager une réflexion critique sur les critères structurant le classement proposé par le journal et à mettre en avant que ce genre de classement ne reflète que partiellement la réalité.</p

Allergy to local anesthetics: Reality or myth?

International audienceThe incidence of allergic reactions to local anesthetics is low. Most cases involve a psychogenic reaction rather than an allergic reaction. Additives and preservatives added to local anesthetics may cause allergic reactions. Vascular resorption of epinephrine-containing local anesthetics may produce cardiovascular signs similar to an allergic reaction. Diagnosis of allergy to local anesthetics must be established by skin testing and provocative challenge

Response

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Anticoagulation in COVID-19: not strong for too long?

International audienceSeveral randomised controlled trials are currently underway to evaluate the value of increasing the dose of prophylactic anticoagulation in critically ill COVID-19 patients, either at an intermediate or therapeutic dose, in order to decrease thrombotic complications, organ failure and possibly reduce mortality in these patients

Impaired Myocardial Mitochondrial Function in an Experimental Model of Anaphylactic Shock

Anaphylactic shock (AS) is associated with a profound vasodilation and cardiac dysfunction. The cellular mechanisms underlying AS-related cardiac dysfunction are unknown. We hypothesized that myocardial mitochondrial dysfunction may be associated with AS cardiac dysfunction. In controls and sensitized Brown Norway rats, shock was induced by ovalbumin i.v bolus, and abdominal aortic blood flow (ABF), systemic mean arterial pressure (MAP), and lactatemia were measured for 15 min. Myocardial mitochondrial function was assessed with the evaluation of mitochondrial respiration, oxidative stress production by reactive oxygen species (ROS), reactive nitrogen species (RNS), and the measurement of superoxide dismutases (SODs) activity. Oxidative damage was assessed by lipid peroxidation. The mitochondrial ultrastructure was assessed using transmission electronic microscopy. AS was associated with a dramatic drop in ABF and MAP combined with a severe hyperlactatemia 15 min after shock induction. CI-linked substrate state (197 &plusmn; 21 vs. 144 &plusmn; 21 pmol/s/mg, p &lt; 0.05), OXPHOS activity by complexes I and II (411 &plusmn; 47 vs. 246 &plusmn; 33 pmol/s/mg, p &lt; 0.05), and OXPHOS activity through complex II (316 &plusmn; 40 vs. 203 &plusmn; 28 pmol/s/mg, p &lt; 0.05) were significantly impaired. ROS and RNS production was not significantly increased, but SODs activity was significantly higher in the AS group (11.15 &plusmn; 1.02 vs. 15.50 &plusmn; 1.40 U/mL/mg protein, p = 0.02). Finally, cardiac lipid peroxidation was significantly increased in the AS group (8.50 &plusmn; 0.67 vs. 12.17 &plusmn; 1.44 &micro;M/mg protein, p &lt; 0.05). No obvious changes were observed in the mitochondrial ultrastructure between CON and AS groups. Our experimental model of AS results in rapid and deleterious hemodynamic effects and was associated with a myocardial mitochondrial dysfunction with oxidative damage and without mitochondrial ultrastructural injury

Reply to the authors of “Age-adjusted D-dimer cut-off levels to exclude venous thromboembolism in COVID-19 patients”

International audienceWe thank the authors for taking interest in the 2021 updated GIHP/GFHT proposals on thromboprophylaxis for COVID-19 patients. The authors proposed to consider an ageadjusted D-dimer cutoff to exclude venous thromboembolism (VTE) in COVID-19 patients. We would like to clarify this misunderstanding regarding D-dimers during COVID-19. I

The e-OCEA project: towards an Internet decision system for scheduling problems

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Use and Interpretation of Acute and Baseline Tryptase in Perioperative Hypersensitivity and Anaphylaxis

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Diagnostic performance of serial serum total tryptase measurement to differentiate positive from negative allergy testing among patients with suspected perioperative hypersensitivity

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