Glutamine supplementation

Intravenous glutamine supplementation is standard care when parenteral nutrition is given for critical illness. There are data of a reduced mortality when glutamine supplementation is given. In addition, standard commercial products for parenteral nutrition do not contain any glutamine due to glutamine instability in aqueous solutions. For the majority of critical ill patients who are fed enterally, the available evidence is insufficient to recommend glutamine supplementation. Standard formulation of enteral nutrition contains some glutamine: 2-4 g/L. However, this dose is insufficient to normalize glutamine plasma concentration

Mental health among university students with eating disorders and irritable bowel syndrome in France

International audienceBACKGROUND:University students are subject to stress due to academic pressure, empowerment and transition from adolescence to adulthood. This young population may have a higher risk of functional disorders as eating disorders (ED) and irritable bowel syndrome (IBS). Our objective was to determine the prevalence of ED, IBS and both and the associated behaviours.METHODS:A cross sectional study was conducted in Rouen University (France). Participating students filled an anonymous self-questionnaire with items on socio-demographics, depression (Duke score), stress (Cohen score), emotional exhaustion (Maslach Inventory), insomnia (Insomnia Severity Index), cyberaddiction (Internet Addiction Test), ED (SCOFF-F test) and IBS (Rome III).RESULTS:This study included 731 students (male/female ratio=0.43). The prevalences of ED, IBS and co-existing ED-IBS were respectively 16.7%, 7.8% and 2.7%. ED and IBS were more common in female students. Depression, stress, emotional exhaustion, insomnia and cyberaddiction were significantly associated with ED and IBS or both. Students with ED had a higher risk of having IBS (Adjusted Odds Ratio (AOR)=2.42, 95% CI: 1.30-4.51), and conversely students with IBS had a higher risk of having ED (AOR=2.46, 95% CI: 1.32-4.55) and were more likely to be in the third year of academic study or above (AOR=2.95, 95% CI: 1.50-5.76).CONCLUSION:Students (female especially) suffer from ED and IBS, with a significant risk of co-existing ED-IBS. ED and IBS are related to multiple mental health symptoms, which could lead to negative academic consequences. Screening, using simple and quick tests as SCOFF questionnaire and ROME IV criteria (update of ROME III in 2016), is essential in this population of university students

La prise en compte des risques de fatigue dans les programmes de maintenance des tranches REP

Les zones présentant un risque de fatigue font l'objet d'une attention particulière en exploitation. On distingue trois cas principaux : 1- la fatigue mécanique oligo-cyclique : Essentiellement liée aux transitoires d'exploitation (les "situations") ; les zones ayant un facteur d'usage élevé (en fin d e vie) sont identifiées dans les DAC (Dossiers d'Analyse du Comportement) et suivies spécifiquement en service ; par la comptabilisation des situations, on s'assure par ailleurs que les zones ne sont pas sollicitées au delà des prévisions. 2- la fatigue vibratoire : Elle concerne en pratique des régimes vibratoires défavorables, le plus souvent difficiles à anticiper. Le retour d'expérience est mis à profit pour identifier les piquages de petit diamètre, dits "sensibles" (aux vibrations) et les parades sont variables (suppression du piquage, renforcement du piquage, diminution du balourd,...). Des contrôles très volumineux sont mis en oeuvre "aussi souvent que raisonnable", compte tenu des cinétiques parfois rapides des fissurations. 3- la fatigue thermique à grand nombre de cycles : Cette dégradation est difficile à anticiper et concerne certaines zones présentant des fluctuations thermiques plus ou moins rapides et importantes : barrières thermiques des Groupes Moto Pompes Primaires (900 MW), tuyauteries RIS et RRA . Les contrôles et les remises en en état, avec ou sans modification de conception/fabrication, sont longues, coûteuses et lourdes en dosimétrie (Cf. travaux sur les circuits RRA). Les zones présentant un risque de fatigue identifiées à la conception, lors d'essais de démarrage ou suite à un retour d'expérience en exploitation font l'objet d'actions correctives ou de maintenance préventive (contrôles périodiques dans l'attente de modifications s'attaquant aux causes profondes identifiées). A titre de précaution, un Programme d'Investigations Complémentaire (PIC) est mis en oeuvre à l'occasion des Visites Décennales n°2 des tranches REP 9 0 0 MW afin de conforter la pertinence des programmes de Base de Maintenance Préventive. Rappelons à cet égard que la décision de réaliser une expertise par ultrasons sur la zone de mélange du RRA d e TRICASTIN 1 (lors de sa VD2) a été prise avant que ne survienne l'incident de CIVAUX 2 sur la zone de mélange équivalente

Rotationplasty as a salvage of failed primary limb reconstruction: up to date review and case report

We report a case of a 15-year-old girl who is a known case for proximal focal femoral deficiency. She underwent several surgical lengthening procedures. Her course was complicated by femur nonunion, knee joint dislocation, stiff knee, and final lower limb discrepancy of over 15 cm. Rotationplasty was performed to salvage her previous surgical failures and restore her function. Surgery was uneventful and the patient was able to walk with the prosthesis in a few months after index surgery. Although the outcome of rotationplasty is visually unusual, for some children restored function and physical capabilities outweigh cosmetic concerns. The aim of the present study was to report a case of rotationplasty in salvaging a failed primary limb reconstruction in a patient with proximal femur focal deficiency