21 research outputs found
Leptotrichia endocarditis: report of two cases from the International Collaboration on Endocarditis (ICE) database and review of previous cases.
Leptotrichia species typically colonize the oral cavity and genitourinary tract. We report the first two cases of endocarditis secondary to L. goodfellowii sp. nov. Both cases were identified using 16S rRNA gene sequencing. Review of the English literature revealed only two other cases of Leptotrichia sp. endocarditi
Leptotrichia endocarditis: report of two cases from the International Collaboration on Endocarditis (ICE) database and review of previous cases.
Leptotrichia species typically colonize the oral cavity and genitourinary tract. We report the first two cases of endocarditis secondary to L. goodfellowii sp. nov. Both cases were identified using 16S rRNA gene sequencing. Review of the English literature revealed only two other cases of Leptotrichia sp. endocarditis
Health care-associated native valve endocarditis: importance of non-nosocomial acquisition.
BACKGROUND: The clinical profile and outcome of nosocomial and non-nosocomial
health care-associated native valve endocarditis are not well defined.
OBJECTIVE: To compare the characteristics and outcomes of community-associated
and nosocomial and non-nosocomial health care-associated native valve
endocarditis.
DESIGN: Prospective cohort study.
SETTING: 61 hospitals in 28 countries.
PATIENTS: Patients with definite native valve endocarditis and no history of
injection drug use who were enrolled in the ICE-PCS (International Collaboration
on Endocarditis Prospective Cohort Study) from June 2000 to August 2005.
MEASUREMENTS: Clinical and echocardiographic findings, microbiology,
complications, and mortality.
RESULTS: Health care-associated native valve endocarditis was present in 557
(34%) of 1622 patients (303 with nosocomial infection [54%] and 254 with
non-nosocomial infection [46%]). Staphylococcus aureus was the most common cause
of health care-associated infection (nosocomial, 47%; non-nosocomial, 42%; P =
0.30); a high proportion of patients had methicillin-resistant S. aureus
(nosocomial, 57%; non-nosocomial, 41%; P = 0.014). Fewer patients with health
care-associated native valve endocarditis had cardiac surgery (41% vs. 51% of
community-associated cases; P < 0.001), but more of the former patients died (25%
vs. 13%; P < 0.001). Multivariable analysis confirmed greater mortality
associated with health care-associated native valve endocarditis (incidence risk
ratio, 1.28 [95% CI, 1.02 to 1.59]).
LIMITATIONS: Patients were treated at hospitals with cardiac surgery programs.
The results may not be generalizable to patients receiving care in other types of
facilities or to those with prosthetic valves or past injection drug use.
CONCLUSION: More than one third of cases of native valve endocarditis in
non-injection drug users involve contact with health care, and non-nosocomial
infection is common, especially in the United States. Clinicians should recognize
that outpatients with extensive out-of-hospital health care contacts who develop
endocarditis have clinical characteristics and outcomes similar to those of
patients with nosocomial infection.
PRIMARY FUNDING SOURCE: None
Conception d'un moniteur faisceau basé sur l'utilisation de détecteurs diamants pour le contrÎle en ligne de faisceaux pulsés
National audienc
Développement de moniteurs faisceaux en technologie diamant pour le monitorage de radiothérapies innovantes : hadronthérapie et thérapies "flash"
National audienceAu cours dâune sĂ©ance dâirradiation en hadronthĂ©rapie, une partie des ions incidents va subir des rĂ©actions de fragmentations nuclĂ©aires qui ont pour effet de dĂ©localiser le dĂ©pĂŽt de dose dans le patient. Câest donc une source dâincertitude qui peut nuire Ă une dĂ©livrance optimale des traitements.La collaboration Clarys (IP2I CPPM LPSC CREATIS) met au point un systĂšme de contrĂŽle en ligne basĂ© sur la dĂ©tection de gamma prompts Ă©mis le long du parcours des ions. Afin de rĂ©aliser une mesure de temps de vol absolue (ion + gamma prompt), ClaRys inclut dans son projet le dĂ©veloppement dâun hodoscope de marquage de faisceau installĂ© en amont du patient. Il est destinĂ© Ă fournir une information temporelle et spatiale des ions entrants. Ces informations peuvent ĂȘtre utilisĂ©es pour le processus de reconstruction d'image et dans la rĂ©duction des bruits de fond.Un premier hodoscope basĂ© sur un maillage de fibres scintillantes lues par des photo-multiplicateurs (PM) a Ă©tĂ© dĂ©veloppĂ©. En raison des limitations du taux de comptage des PM, l'efficacitĂ© de dĂ©tection de l'hodoscope Ă fibres diminue pour les courants de faisceau Ă©levĂ©s. Ces limitations ont conduit au dĂ©veloppement d'un hodoscope Ă base de diamant synthĂ©tiques (croissance par dĂ©pĂŽt chimique en phase vapeur ou CVD).Les qualitĂ©s intrinsĂšques du diamant (rapiditĂ©, faible courant de fuite, excellent rapport signal sur bruit, rĂ©sistance aux radiations, Ă©quivalence tissu humain) font de ce semi-conducteur un parfait candidat pour rĂ©pondre aux exigences de monitorage. L'hodoscope diamant devrait permettre d'atteindre des rĂ©solutions temporelles de 100 ps qui vont au-delĂ des performances de lâhodoscope Ă fibres et permettrait de faire de lâUltra Fast Timing cela constitue le projet ClaRys-UFT.Par ailleurs, la radiothĂ©rapie innovante «flash» qui permet de dĂ©livrer des faisceaux pendant un temps ultracourt (quelques milliĂšmes de secondes au lieu de plusieurs minutes pour la radiothĂ©rapie conventionnelle) requiert un monitorage spĂ©cifique de faisceaux en mode pulsĂ©. La rapiditĂ© des dĂ©tecteurs diamants constitue lĂ un atout essentiel pour un tel dĂ©veloppement avec une capacitĂ© de marquage en temps « dĂ©but » et « fin » des paquets des trains dâimpulsions ainsi que de comptage des particules dans le train Ă haute intensitĂ© faisceau. Cela a conduit au dĂ©veloppement du moniteur faisceau diamant DIAMMONI dans le cadre du projet R&T IN2P3 DIAMTECH (collaboration LPSC SUBATECH ARRONAX)