Réservoir extra-digestif d’entérobactéries productrices de bêtalactamase à spectre élargi chez des patients non infectés: étude à partir d’une recherche systématique dans les urines et d’autres prélèvements à visée diagnostique

Notre objectif était d’étudier le réservoir extra-digestif d’entérobactéries productrices de β-lactamases à spectre élargi (EBLSE) en les recherchant dans des prélèvements à visée diagnostique (PVD) pour lesquels les colonies bactériennes isolées sur les milieux de cultures utilisés ne sont pas obligatoirement analysées (identification bactérienne et antibiogramme) en routine. Pendant une période de 5 semaines, des identifications et des antibiogrammes ont été réalisés de manière systématique pour les colonies correspondant à des entérobactéries isolées dans certains PVD comme les urines, les prélèvements respiratoires, et un groupe de prélèvements appelé “divers”. Les prélèvements pour lesquels un antibiogramme a été réalisé conformément à la pratique de routine du laboratoire ont été considérés comme infectés. Les prélèvements pour lesquels les entérobactéries ont été recherchées et étudiées suivant le protocole de l’étude ont été considérés comme colonisés. Au cours de l’étude, 2 312 urines, 327 prélèvements respiratoires et 1 887 prélèvements divers ont été envoyés au laboratoire. Parmi les 114 urines colonisées par au moins une entérobactérie, 13 (11,4 %) comportaient une EBLSE, alors que cette proportion était de 5,1 % (35/682) dans les urines infectées (p < 0,01). Parmi les prélèvements respiratoires et divers, 3 EBLSE ont été isolées dans 55 prélèvements colonisés par au moins une entérobactérie. Au total, la recherche systématique d’EBLSE dans les PVD a permis une augmentation de 27,7 % du nombre de patients identifiés comme porteurs de ces bactéries. D’autres études pourraient être utiles pour évaluer l’intérêt de mettre en place une telle stratégie comme alternative au dépistage rectal habituellement pratiqué

New neutron detector based on Micromegas technology for ADS projects

A new neutron detector based on Micromegas technology has been developed for the measurement of the simulated neutron spectrum in the ADS project. After the presentation of simulated neutron spectra obtained in the interaction of 140 MeV protons with the spallation target inside the TRIGA core, a full description of the new detector configuration is given. The advantage of this detector compared to conventional neutron flux detectors and the results obtained with the first prototype at the CELINA 14 MeV neutron source facility at CEA-Cadarache are presented. The future developments of operational Piccolo-Micromegas for fast neutron reactors are also described

Measurement of the 14^{14}N(n,p)14^{14}C cross section at the CERN n_TOF facility from sub-thermal energy to 800 keV

Background: The $^{14}$N(n,p)$^{14}$C reaction is of interest in neutron capture therapy, where nitrogen-related dose is the main component due to low-energy neutrons, and in astrophysics, where 14N acts as a neutron poison in the s-process. Several discrepancies remain between the existing data obtained in partial energy ranges: thermal energy, keV region and resonance region. Purpose: Measuring the 14N(n,p)14C cross section from thermal to the resonance region in a single measurement for the first time, including characterization of the first resonances, and providing calculations of Maxwellian averaged cross sections (MACS). Method: Time-of-flight technique. Experimental Area 2 (EAR-2) of the neutron time-of-flight (n_TOF) facility at CERN. $^{10}$B(n,${\alpha}$)$^7$Li and $^{235}$U(n,f) reactions as references. Two detection systems running simultaneously, one on-beam and another off-beam. Description of the resonances with the R-matrix code sammy. Results: The cross section has been measured from sub-thermal energy to 800 keV resolving the two first resonances (at 492.7 and 644 keV). A thermal cross-section (1.809$\pm$0.045 b) lower than the two most recent measurements by slightly more than one standard deviation, but in line with the ENDF/B-VIII.0 and JEFF-3.3 evaluations has been obtained. A 1/v energy dependence of the cross section has been confirmed up to tens of keV neutron energy. The low energy tail of the first resonance at 492.7 keV is lower than suggested by evaluated values, while the overall resonance strength agrees with evaluations. Conclusions: Our measurement has allowed to determine the $^{14}$N(n,p) cross-section over a wide energy range for the first time. We have obtained cross-sections with high accuracy (2.5 %) from sub-thermal energy to 800 keV and used these data to calculate the MACS for kT = 5 to kT = 100 keV.Comment: 18 pages, 15 figures, 4 table

Neutron capture cross section measurements of Am-241 at the n_TOF facility

Neutron capture on Am-241 plays an important role in the nuclear energy production and also provides valuable information for the improvement of nuclear models and the statistical interpretation of the nuclear properties. A new experiment to measure the Am-241(n,gamma) cross section in the thermal region and the first few resonances below 10 eV has been carried out at EAR2 of the n_TOF facility at CERN. Three neutron-insensitive C6D6 detectors have been used to measure the neutron-capture gamma cascade as a function of the neutron time of flight, and then deduce the neutron capture yield. Preliminary results will be presented and compared with previously obtained results at the same facility in EAR1. In EAR1 the gamma-ray background at thermal energies was about 90% of the signal while in EAR2 is up to a 25 factor much more favorable signal to noise ratio. We also extended the low energy limit down to subthermal energies. This measurement will allow a comparison with neutron capture measurements conducted at reactors and using a different experimental technique

Measurements of the capture cross sections of natural silver in the resonance range with the time of flight technique

Neutron capture cross section measurements have been performed at the time-of-flight facility GELINA of the EC-JRC-Geel. Prompt gamma rays, originating from a natural silver sample, were detected by a pair of C6D6 liquid scintillation detectors. The total energy detection principle in combination with the pulse height weighting technique has been used. In this contribution the experimental details together with the data reduction process are described. In addition, first results of calculations with REFIT are presented to verify the quality of recommended cross section data in the resolved resonance region

Thermal neutron activation experiments on Ag, In, Cs, Eu, V, Mo, Zn, Sn and Zr in the MINERVE facility

International audienceThe MAESTRO experimental program has been designed to improve nuclear data uncertainty on a large range of materials used for detection, absorption, moderation and structures in LWRs. It consists of pile-oscillation and neutron activation experiments, carried out in the MINERVE low power facility. For this program, the core configuration has been designed to be representative of HZP (Hot Zero Power) conditions of a typical PWR. Samples of high purity elements have been manufactured with severe technological constraints to reach a target accuracy of $\pm$2% (1$\sigma$) on the measurement. This paper presents a preliminary analysis of activation experiments, based on TRIPOLI4 Monte-Carlo calculations and various nuclear data libraries

New therapies for patients with multiple endocrine neoplasia type 1

In 1953, for the first time, Paul Wermer described a family presenting endocrine gland neoplasms over several generations. The transmission was autosomal dominant and the penetrance was high. Forty years later in 1997, the multiple endocrine neoplasia type 1 (MEN1) gene was sequenced, thus enabling diagnosis and early optimal treatment. Patients carrying the MEN1 gene present endocrine but also non-endocrine tumors. Parathyroid, pancreatic and pituitary impairment are the three main types of endocrine involvement. The present article details therapeutic management of hyperparathyroidism, neuroendocrine pancreatic tumors and pituitary adenomas in patients carrying the MEN1 gene. Significant therapeutic progress has in fact been made in the last few years. As concerns the parathyroid glands, screening of family members and regular monitoring of affected subjects now raise the question of early management of parathyroid lesions and optimal timing of parathyroid surgery. As concerns the duodenum-pancreas, proton-pump inhibitors are able to control gastrin-secreting syndrome, reducing mortality in MEN1 patients. Mortality in MEN1 patients is no longer mainly secondary to uncontrolled hormonal secretion but to metastatic (mainly pancreatic) disease progression. Tumor risk requires regular monitoring of morphological assessment, leading to iterative pancreatic surgery in a large number of patients. Finally, pituitary adenomas in MEN1 patients are traditionally described as aggressive, invasive and resistant to medical treatment. However, regular pituitary screening showed them to be in fact infra-centimetric and non-secreting in the majority of patients. Consequently, it is necessary to regularly monitor MEN1 patients, with regular clinical, biological and morphological work-up. Several studies showed that this regular monitoring impairs quality of life. Building a relationship of trust between patients and care provider is therefore essential. It enables the patient to be referred for psychological or psychiatric care in difficult times, providing long-term support and preventing any breakdown in continuity of care. (C) 2021 Elsevier Masson SAS. All rights reserved.Paroxysmal Cerebral Disorder