Étude descriptive sur la prise en charge des pyélonéphrites aigües de l enfant au CHU de Grenoble durant l année 2011 (évaluation des pratiques professionnelles confrontées aux recommandations)

La pyélonéphrite aigue est une infection bactérienne fréquente en pédiatrie. Sa prise en charge n est pas consensuelle. Il s agit d une étude observationnelle, sur 342 enfants hospitalisés pour PNA durant 2011 au CHU de Grenoble, afin d évaluer nos pratiques. Le recueil urinaire est réalisé sur poche, mais avec un taux inacceptable de faux positifs. La ponction sus-pubienne et le sondage sont à privilégier malgré les difficultés de réalisation. Les hémocultures sont à réaliser plus systématiquement pour adapter la durée de l antibiothérapie parentérale. L échographie rénovésicale doit être réalisée dans de brefs délais pour infirmer des diagnostiques, détecter les formes sévères et les anomalies urologiques. Il faut respecter les critères diagnostiques, 7,3% des patients ne présentant pas d infection urinaire auraient dû voir leur diagnostic infirmé. Les hospitalisations dépassent les recommandations. Les hospitalisations de courte durée et le traitement IV ambulatoire sont à réaliser plus souvent. La prescription d aminosides dépasse les indications. Des précautions sont à prendre sur la lecture de la créatinine à comparer aux valeurs normales en fonction de l âge ou calculer le DFG pour adapter les doses d aminosides. La durée du traitement doit être respectée, plus de 50% des traitements sont supérieurs à 14 jours. Le traitement est parentéral puis relais per os, en guettant l antibiogramme afin d adapter l antibiotique, au vu des résistances et de l émergence de BLSE. Les indications d antibioprophylaxie et cystographie sont à discuter au cas par cas. Suite à cette étude, un nouveau protocole est proposé, afin de respecter au mieux les données de la littérature.Acute pyelonephritis is a frequent bacterial paediatric infection. The management is not consensual. We carried out an observational study focused on 342 hospitalised children for acute pyelonephritis during 2011 at the Grenoble hospital center, in order to evaluate our management. Urinary collection is performed on bag, but with an unacceptable rate of false positives. Priority should be given to suprapubic puncture and urinary catheterization, despite any difficulties of realisation. Blood culture ought to be performed more systematically, for an adaptation of the duration of parenteral antibiotherapy. Renal echography should be performed within short time in order to invalidate certain diagnosis, detect any severe forms and urological problems. We have to respect diagnostic criteria, for the 7.3% patients who do not show urinary tract infection the diagnosis should have been invalidated. Hospitalisations exceed recommendations. Short duration hospitalisation and ambulatory intravenous treatment should be performed more frequently. Prescription of aminoglycosides exceeds indications. It seems precautions must be taken when reading the creatinine values, to be compared with the regular values depending on age or the GFR calculation, to adapt aminoglycosides dose. Treatment duration should be respected. More than 50% treatment durations are higher than 14 days. The treatment begins with parenteral treatment then oral relay, taking into account the resistances and ESBL emergence. Prophylactic antibiotic and cystography indications should be discussed case by case. Following this study, a new protocol will be proposed, in order to respect at best the data of the literature.GRENOBLE1-BU Médecine pharm. (385162101) / SudocSudocFranceF

Odin observations of H2O in the Galactic Centre

The Odin satellite has been used to detect emission and absorption in the 557-GHz H2O line in the Galactic Centre towards the Sgr A* Circumnuclear Disk (CND), and the Sgr A +20 km/s and +50 km/s molecular clouds. Strong broad H2O emission lines have been detected in all three objects. Narrow H2O absorption lines are present at all three positions and originate along the lines of sight in the 3-kpc Spiral Arm, the -30 km/s Spiral Arm and the Local Sgr Spiral Arm. Broad H2O absorption lines near -130 km/s are also observed, originating in the Expanding Molecular Ring. A new molecular feature (the ``High Positive Velocity Gas'' - HPVG) has been identified in the positive velocity range of ~ +120 to +220 km/s, seen definitely in absorption against the stronger dust continuum emission from the +20 km/s and +50 km/s clouds and possibly in emission towards the position of Sgr A* CND. The 548-GHz H2_18O isotope line towards the CND is not detected at the 0.02 K (rms) level.Comment: 5 pages, 3 figures, accepted by A&A, special Odin Letters issu

IARC Monographs: 40 Years of Evaluating Carcinogenic Hazards to Humans

Background: Recently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans. Objectives: The authors of this Commentary are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We examined criticisms of the IARC classification process to determine the validity of these concerns. Here, we present the results of that examination, review the history of IARC evaluations, and describe how the IARC evaluations are performed. Discussion: We concluded that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various disciplines and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed. Conclusions: The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public’s health

The population of barred galaxies in the local universe I. Detection and characterisation of bars

(Abridge) Bars are very common in the centre of the disc galaxies, and they drive the evolution of their structure. A volume-limited sample of 2106 disc galaxies extracted from the Sloan Digital Sky Survey Data Release 5 was studied to derive the bar fraction, length, and strength as a function of the morphology, size, local galaxy density, light concentration, and colour of the host galaxy. The bars were detected using the ellipse fitting method and Fourier analysis method. The ellipse fitting method was found to be more efficient in detecting bars in spiral galaxies. The fraction of barred galaxies turned out to be 45%. A bar was found in 29% of the lenticular galaxies, in 55% and 54% of the early- and late-type spirals, respectively. The bar length (normalised by the galaxy size) of late-type spirals is shorter than in early-type or lenticular ones. A correlation between the bar length and galaxy size was found with longer bars hosted by larger galaxies. The bars of the lenticular galaxies are weaker than those in spirals. Moreover, the unimodal distribution of the bar strength found for all the galaxy types argues against a quick transition between the barred and unbarred statues. There is no difference between the local galaxy density of barred and unbarred galaxies. Besides, neither the length nor strength of the bars are correlated with the local density of the galaxy neighbourhoods. In contrast, a statistical significant difference between the central light concentration and colour of barred and unbarred galaxies was found. Bars are mostly located in less concentrated and bluer galaxies. These results indicate that the properties of bars are strongly related to those of their host galaxies, but do not depend on the local environment.Comment: 15 pages, 13 figures. Accepted for publication in A&

Polysaccharides by XPS : analysis of maltodextrin

Maltodextrin was analyzed as a model compound representative of polysaccharides. A relatively smooth surface was obtained by pressing the maltodextrin powder in a small trough. The C 1s peak component was split into three components with the same FWHM. The main component was found at 286.3 eV and was attributed to carbon involved in the alcohol functions. The component found at 287.8 eV was attributed to carbon in the acetal function; the alcohol to acetal ratio ([C¯¯¯–OH]/[O–C¯¯¯–O]) was 0.21, i.e., close to the stoichiometric ratio 0.20. A component found at 284.8 eV indicated the presence of hydrocarbon-like surface contamination. The O 1s peak showed only one component at 532.7 eV; oxygen involved in hydroxyl could not be distinguished from oxygen involved in a acetal function. The surface analysis of model compounds was performed under conditions of practical significance for the analysis of microbial cells and of materialstreated by biological fluids. This approach allowed quantification of chemical functions of biosurfaces and modeling of the composition of the latter in terms of classes of biochemical compounds (polysaccharides, proteins,lipids, …

Drug-induced nephrolithiasis and crystalluria: The particular case of the sulfasalazine derivatives

peer reviewedIntroduction: Drug-induced calculi are rarely reported in literature but represent a seldom reported complication of long-term or high-dose prescription of certain medications. We review here some drugs involved in stone formation from first case reports of sulfonamides in the 1930s to protease inhibitors and sulfadiazine with more recent emergence of HIV and opportunistic infections. Finally, we will study in particular sulfasalazine and mesalazine, two different forms of a drug used for treatment of ulcerative colitis or Crohn's disease. Material and methods: Review of the literature and report of a series of ten new cases of mesalazine-induced nephrolithiasis. Results and discussion: Ten patients (eight women and two men) produced stones spontaneously passed (n = 9) or surgically removed (n = 1). Patients received mesalazine either for ulcerative colitis (n = 6) or Crohn's disease (n = 4). The daily oral dose was 4 g/d in nine patients and only 2 g/d in one subject. The duration of medication before stone episode ranged from one month up to 15 years with an average of four years. Stone analysis found pure mesalazine in all stones analyzed (n = 9). Rod-shaped crystals found in urine of one patient (stone unavailable) were identified as mesalazine by Fourier transform infrared spectroscopy. Conclusion: We report the largest case-series of mesalazine nephrolithiasis, and the first case of mesalazine crystalluria to date. Nonmetabolized mesalazine composition of concretions suggests peculiar drug absorption and/or metabolism in these patients. Of note, women seem to be more affected by this side effect

Hemodynamic and thermal aspects of prolonged intermittent exercise

9 young normal subjects were studied during two types of prolonged intermittent exercise requiring periods of heavy work (12 min at 80% {Mathematical expression} max.) alternating with intervening rest periods (for 18 min) in first type and light work (18 min about 40% {Mathematical expression} max.) in second type. In a third experiment, heavy exercise was repeated after 1 hr of rest and followed by light exercise. Hemodynamic variables and body temperature (oesophageal) were measured sequentially. Prolonged intermittent work was characterized by progressive increase in heart rate, fall in stroke volume and mean brachial pressure while cardiac output remained constant. These variations occurred more rapidly when rest periods were replaced by light work. They were attended by a progressive rise in body temperature. Heart rate closely correlated with oesophageal temperature during prolonged intermittent exercise (r from 0.90 to 0.96). When resting period was extended to 1 hr, subsequent heavy exercise initiates the same hemodynamic and temperature responses. After heavy exercise, light exercise was performed with higher heart rate and oesophageal temperature and lower stroke volume. Drift in body temperature with prolonged intermittent exercise could be partly responsible for hemodynamic changes by means of redistribution of blood volume and flow to the skin. Relationship between exercise body temperature and percentage of {Mathematical expression} max. is modified by repeating exercise after a short recovery period. © 1972 Springer-Verlag.SCOPUS: ar.jinfo:eu-repo/semantics/publishe