The Role of Adjunctive Therapies in Septic Shock by Gram Negative MDR/XDR Infections

Patients with septic shock by multidrug resistant microorganisms (MDR) are a specific sepsis population with a high mortality risk. The exposure to an initial inappropriate empiric antibiotic therapy has been considered responsible for the increased mortality, although other factors such as immune-paralysis seem to play a pivotal role. Therefore, beyond conventional early antibiotic therapy and fluid resuscitation, this population may benefit from the use of alternative strategies aimed at supporting the immune system. In this review we present an overview of the relationship between MDR infections and immune response and focus on the rationale and the clinical data available on the possible adjunctive immunotherapies, including blood purification techniques and different pharmacological approaches

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Combination of low doses of Enzastaurin and Lenalidomide has synergistic activity in B-non-Hodgkin lymphoma cell lines

Less toxic and more active treatments are needed for indolent lymphomas as there is no curative treatment, and patients eventually die due to complications related to their disease. The purpose of the present study was to assess the antitumour activity of the combination of low doses of Enzastaurin and Lenalidomide (Revlimid) on B-lymphoma cell lines. The combination of Enzastaurin and Lenalidomide, at doses as low as 1 μM, showed strong synergism against indolent lymphomas by reducing cell growth, producing an increase in G0-G1 phase followed by significant decrease in S phase, increasing apoptosis, and inhibiting PI3K/AKT, PKC and MAPK/ERK pathways. These preclinical findings, together with promising results obtained with Lenalidomide for the treatment of non-Hodgkin lymphoma, suggest that further evaluation of the combination of Enzastaurin and Lenalidomide for the treatment of indolent lymphomas is warranted. These compounds, with a favourable toxicity profile, are not classic chemotherapeutic agents, causing severe side effects, and could be considered an example of a new innovative attempt of an anti-cancer 'soft treatment'

Les métaux précieux en Méditerranée médiévale

Cet ouvrage rassemble les actes d’un colloque international tenu à la Maison Méditerranéenne des Sciences de l’Homme d’Aix-en-Provence les 6, 7 et 8 octobre 2016. Organisée par le Laboratoire d’Archéologie Médiévale et Moderne en Méditerranée (CNRS, Aix-Marseille Université) et par le Dipartimento di Scienze Storiche e dei Beni Culturali de l’Université de Sienne, cette rencontre a réuni près de cinquante spécialistes du Moyen Âge – archéologues, historiens, géochimistes – autour des métaux précieux en Méditerranée. Ce livre entend examiner un long processus qui s’étend de l’extraction des minerais jusqu’à la diffusion des métaux, en articulant les techniques aux sociétés et aux pouvoirs. Le panorama des principaux lieux de la production, ici présenté sous forme de synthèses régionales, côtoie des études qui suivent les différentes phases de ce processus, de façon à confronter les sources, les approches et à faciliter les comparaisons. L’enquête se focalise enfin sur les circulations des métaux, en mettant en évidence les problèmes de sources et de méthodes que cela induit, tout en proposant des relectures historiographiques fondées sur les résultats de travaux récents. Pour la première fois, la Méditerranée médiévale fournit le cadre géographique d’une réflexion collective consacrée aux productions et circulations des métaux précieux. Au-delà du simple bilan de connaissances, ce livre entend finalement proposer quelques jalons pour une histoire comparée et connectée : l’approfondissement, puis la confrontation d’enquêtes monographiques et régionales offrent dans cette optique de fécondes perspectives pour les années à venir