Clinical features of H1N1 2009 infection in critically ill immunocompromised patients

Seasonal influenza virus has been described as an emerging and severe pathogen in immunocompromised hosts. Since the beginning of the 2009 influenza A novel H1N1 pandemic, several series have described the clinical course of the disease in various populations. We report the clinical course of H1N1 2009 infection in 10 immunocompromised patients. Half of the patients received long-term steroid therapy. Disease was characterized by a clinical picture similar to that of non-immunocompromised patients but with prolonged course and higher mortality

Suivi des patients implantés par un défibrillateur automatique implantable (facteurs pronostiques d'utilisation de l'appareil)

NICE-BU Médecine Odontologie (060882102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Very late intubation in COVID-19 patients : a forgotten prognosis factor ?

International audienceDescription of all consecutive critically ill COVID 19 patients hospitalized in ICU in University Hospital of Guadeloupe and outcome according to delay between steroid therapy initiation and mechanical ventilation onset. Very late mechanical ventilation defined as intubation after day 7 of dexamethasone therapy was associated with grim prognosis and a high mortality rate of 87%

Epidemiology, risk factors and prognosis of ventilator-associated pneumonia during severe COVID-19: Multicenter observational study across 149 European Intensive Care Units

International audienceBackground: COVID-19 patients requiring mechanical ventilation are particularly at risk of developing ventilator-associated pneumonia (VAP). Risk factors and the prognostic impact of developing VAP during critical COVID-19 have not been fully documented.Methods: Patients invasively ventilated for at least 48 h from the prospective multicentre COVID-ICU database were included in the analyses. Cause-specific Cox regression models were used to determine factors associated with the occurrence of VAP. Cox-regression multivariable models were used to determine VAP prognosis. Risk factors and the prognostic impact of early vs. late VAP, and Pseudomonas-related vs. non-Pseudomonas-related VAP were also determined.Main findings: 3388 patients were analysed (63 [55-70] years, 75.8% males). VAP occurred in 1523/3388 (45.5%) patients after 7 [5-9] days of ventilation. Identified bacteria were mainly Enterobacteriaceae followed by Staphylococcus aureus and Pseudomonas aeruginosa. VAP risk factors were male gender (Hazard Ratio (HR) 1.26, 95% Confidence Interval [1.09-1.46]), concomitant bacterial pneumonia at ICU admission (HR 1.36 [1.10-1.67]), PaO2/FiO2 ratio at intubation (HR 0.99 [0.98-0.99] per 10 mmHg increase), neuromuscular-blocking agents (HR 0.89 [0.76-0.998]), and corticosteroids (HR 1.27 [1.09-1.47]). VAP was associated with 90-mortality (HR 1.34 [1.16-1.55]), predominantly due to late VAP (HR 1.51 [1.26-1.81]). The impact of Pseudomonas-related and non-Pseudomonas-related VAP on mortality was similar.Conclusion: VAP affected almost half of mechanically ventilated COVID-19 patients. Several risk factors have been identified, among which modifiable risk factors deserve further investigation. VAP had a specific negative impact on 90-day mortality, particularly when it occurred between the end of the first week and the third week of ventilation

A Tale of a Two Waves Epidemic: Characteristics and Mortality Risk Factors for COVID-19 ICU Patients in the French West Indies

International audienceIntroduction: Guadeloupe, a French West Indies island, has been fiercely affected by two large waves of COVID.Therapeutic approach was different between the two waves in the intensive care unit (ICU). We aimed to compare the two different periods in terms of characteristics and outcomes and to evaluate risk factors associated with 60-day mortality in our overall cohort. Methods: All consecutive patients with laboratory confirmed COVID-19 pneumonia and requiring oxygen support admitted in our ICU unit of University Hospital of Guadeloupe were prospectively included. Patients were treated during the first wave with a combination of Hydroxychloroquine and Azithromycin and during the second wave with dexamethasone and reinforced anticoagulation. Results: In our cohort, 187 patients were included, 31 during the first one and 156 during the second. Patients were mostly male (69%) with a median age of 64years old. Patients tend to be younger during the second wave and body mass index was higher (respectively 31 vs 27kg/m2, p=0.01). Overall mortality at Day 60 was high (45%) and not different between the two waves. Among patients under mechanical ventilation risk factors associated with death in a multivariate analysis were a high number of comorbidities, a high level of SOFA score and the delay of invasive mechanical ventilation (IMV) onset after admission in ICU (OR=1.6 (95% CI 1.2 – 2.4). Conclusion: Although therapeutics approach evolve, COVID-19 severe pneumonia is still associated with a high mortality rate in ICU

MOESM1 of The passive leg raising test to guide fluid removal in critically ill patients

Additional file 1:  Tables SDC1, SDC2 and SDC3

Âges et générations : la communication revisite ses publics

L’objectif de ce numéro est d’ouvrir un champ de réflexion et d’analyse communicationnelle sur la question des publics de la communication, en mettant en lumière les représentations, discours et pratiques autour des nouvelles et anciennes générations, des jeunesses et vieillesses. Ce numéro propose donc un ensemble de recherches en Sciences de l’information et de la communication qui investit les problématiques de l’âge, des cycles de vie et des générations. L’intérêt d’une approche générationnelle est qu’elle permet de saisir les tendances culturelles des différents groupes sociaux constituant la société, d’en comprendre les évolutions (les passages entre hier, aujourd’hui et demain) et de (ré)interroger les cohabitations entre les générations dans les différentes sphères publiques ou privées, familiales ou organisationnelles. En parallèle des segmentations communicationnelles par âges et cycles de vie, le marketing se fait transgénérationnel, certains médias se veulent intergénérationnels, l’entreprise se concentre plus sur la gestion des âges de la vie qu’à la politique d’un âge, les collectivités se polarisent sur les solidarités et cohésions sociales. La communication, quel que soit son champ d’application, s’interroge sur la segmentation ou non de ses publics, sur les représentations des âges et cycles de vie, sur les profils des générations en vie, autant d’éléments qui impactent sur ses stratégies et qui sont, dans ce numéro, questionnés

Additional file 1 of One-year survival of aneurysmal subarachnoid hemorrhage after airplane transatlantic transfer – a monocenter retrospective study

Supplementary Material

Additional file 1 of Ventilator-associated pneumonia related to extended-spectrum beta-lactamase producing Enterobacterales during severe acute respiratory syndrome coronavirus 2 infection: risk factors and prognosis

Additional file 1. Table E1. Centers informations; Table E2. Multivariable analysis of risk factors of ESBL-E related VAP after exclusion of the 8 patients with CRE related VAP; Table E3. Antibiotics administered in the 24 hours following VAP according to ESBL-E; Table E4. Outcome according to the occurrence of ESBL-E VAP; Table E5. Risk factors for death in patients with VAP related to enterobacterales according to species