Registre national de l’atrésie de l’œsophage : résultats 2008 Sfeir, R.; Michaud, L.; Bonnard, A. ...
Archives de pédiatrie : organe officiel de la Société française de pédiatrie,
December 2011, 2011-12-00, Letnik:
18, Številka:
12
Journal Article
The aim ot tnis study was to assess the results of interventional strategy in patients over 75 years of age admitted to hospital with acute coronary syndromes (ACS) without persistent ST elevation. ...Over three months, patients over the age of 75 undergoing coronary angiography for ACS were included in a multicentre register and followed up for 6 months. A total of 126 patients with an average age of 79 were included: 70% had at least one poor prognostic factor. The treatment on admission included: Aspirin (84%), Clopidogrel (60%), anti GpIIb-IIIa (12%) and Heparin (81%, of which 3/4 of cases were low molecular weight heparins). Coronary angiography (average delay 80 hours) showed single, double and triple vessel disease in 21, 29 and 35% of cases respectively. Coronary angioplasty was proposed in 83 patients and carried out in 82. Eleven patients underwent coronary artery bypass grafting and 31 were treated medically. During the hospital phase, there were 3 major cardiovascular complications: 1 death during coronary angiography, 1 intra-stent thrombosis and 1 death in the group undergoing bypass grafting, with no major bleeding complications. At 6 months, there were 8 (6.5%) major cardiovascular adverse events with 6 in the "angioplasty" group; 5 deaths (3 cardiac deaths), 3 myocardial infarcts. Two thirds of patients were asymptomatic. The authors conclude that interventional strategy in ACS of elderly patients is associated with a low rate of major adverse events. The benefits of this strategy should be confirmed by randomised trial.
A preliminary genealogical investigation of all the known ancestors from the year 1608 of 4 apparently unrelated French Canadian kindreds with Friedreich's ataxia reveals that the original ataxia ...gene in the province of Quebec was present within a core of no more than 10 families living in Quebec City in the mid-1600's.
Proceder a un análisis descriptivo de los pacientes a quienes se les realizaron embolizaciones de colaterales por vía percutánea.
Se revisaron las historias clínicas de 27 pacientes entre febrero de ...2004 y marzo de 2012. Se hace una descripción de las variables analizadas.
En el período descrito se efectuó la embolización percutánea de 33 colaterales en 27 pacientes. La edad promedio al momento del procedimiento fue de 53 meses (1-143 meses). Al 68% se les había realizado previamente cirugía de Glenn o de Fontan, al 8% fístula Blalock-Taussig y al 24% otros procedimientos quirúrgicos. En el 76% de los casos el vaso embolizado fue una colateral venovenosa, y en el 24% restante, una colateral aortopulmonar. Los dispositivos mecánicos fueron los más utilizados (coils y plug vascular). El Amplatzer Vascular Plug se usó para embolizar colaterales de mayor tamaño. Se obtuvo la oclusión inmediata en el 92% de los casos. No hubo mortalidad asociada con los procedimientos.
La embolización de colaterales por vía percutánea es un procedimiento seguro y con alta tasa de eficacia. Los dispositivos utilizados mostraron ser igualmente efectivos.
To perform a descriptive analysis of patients who underwent percutaneous embolization of collateral vessels.
We reviewed the medical records of 27 patients between February 2004 and March 2012, and made a description of the variables analyzed.
In the period described, percutaneous embolization of 33 collateral vessels was performed in 27 patients. The mean age at the time of the procedure was 53 months (1-143 months). 68% had previously undergone Glenn or Fontan surgery, 8% Blalock-Taussig shunt and 24% other surgical procedures. In 76% of cases the vessel embolized was a venovenous collateral and in the remaining 24% an aortopulmonary collateral. Mechanical devices were most commonly used (coils and vascular plug). The Amplatzer Vascular Plug was used to embolize larger collateral vessels. Immediate occlusion was obtained in 92% of cases. There was no mortality associated with the procedures.
Percutaneous embolization is a safe procedure with high success rate. The devices used were shown to be equally effective.
Cet article analyse les conséquences socio-économiques des politiques de ralentissement dynamique, mises en place en France dans le cadre des PAPI, programmes d'action pour la prévention des ...inondations. Ces politiques visent à réduire le risque à l'échelle du bassin, par exemple en transférant les inondations des zones très vulnérables vers des zones moins vulnérables, la plupart du temps de zones urbaines vers des zones rurales. Légalement, les gestionnaires de bassin sont tenus de prendre en compte les sur-dommages occasionnés. Comme les systèmes d'indemnisation nationaux ne fonctionnent pas dans ce contexte, la création de fonds de compensation locaux est exigée par la profession agricole. Cet article analyse la mise en place des mécanismes de compensation et leur acceptation locale, à travers une enquête auprès des quarante-huit PAPI existants au moment de l'étude. Il montre pourquoi les politiques mises en place risquent de ne pas être pérennes et propose des solutions alternatives, qui s'appuient sur une coopération entre gestionnaires de bassin, compagnies d'assurances et autorités publiques.
Suite à un cas certain de légionellose nosocomiale, le centre hospitalier Sud-Francilien (CHSF) a engagé une démarche visant à diminuer le risque d’acquisition de
Legionella pneumophila dans ses ...différents sites. Un groupe de travail multidisciplinaire a été constitué et a élaboré un plan d’action conduit à travers les concentrations de légionelles dans le réseau d’eau chaude sanitaire (ECS). De 2003 au premier semestre de l’année 2009, le pourcentage de points positifs en légionelles dans le réseau d’ECS des quatre principaux sites de l’hôpital est passé de 85,71 à 28,00 %, correspondant à une diminution significative de 67,33 %. Des résultats similaires ont été obtenus pour trois des quatre sites alors que pour le dernier, aucune réduction prononcée de ces concentrations n’était observée et des souches de sérogroupe 1 étaient isolées de façon persistante. Durant cette période, les investigations menées à l’occasion de cas suspects de légionellose ont démontré une acquisition nosocomiale pour l’un des cas sur ce dernier site. Au terme de ce travail, le risque lié aux légionelles a été diminué sur trois des quatre principaux sites de notre établissement, en grande partie grâce à la mobilisation multidisciplinaire.
To reduce the
Legionella-link risk in the several sites of Sud-Francilien Hospital, following a hospital-acquired legionellosis case, a multidisciplinary working group performed an action plan monitored through
Legionella pneumophila counts in hot water supply. From 2003 to the first half year 2009, positive points for
Legionella pneumophila on the main sites of the hospital decreased from 85.71 to 28.00%, representing a significant reduction of 67.33%. Similar results were observed for three of the four establishments, whereas the last did not describe a pronounced reduction of
Legionella pneumophila counts and showed constantly serogroup 1 strains. During this period, investigations of additional cases of legionellosis demonstrated a nosocomial transmission in one case in this last site. Multidisciplinary mobilization in management of
Legionella-link risk contributed to these results.
Female brown trout were sacrificed every month or twice a month during the reproductive season. Plasma gonadotropin (GtH) and estradiol-17 beta (E2-17 beta) were measured using radioimmunological ...techniques, in relation with the state of gametogenesis. From ovulation to July egg's diameters remained less than 1 mm, and ovogenesis was characterized from the histological appearance of three types of vitellus: glycoproteique (type I), lipidique (type II), lipidoprotéique (type III), and the immunological plasma detection of the vitellogenin. During this period GtH levels remained lower than 1 ng/ml except in March, when they increased around 5 ng/ml, both with pituitary GtH and plasma E2 17 beta. This rise occurred just before the appearance of the type III vitellus within the oocyte, and might correspond to a critical phase of the reproductive cycle during which vitellogenin could not be detected in 70% of the animals. During rapid growth of the oocyte from 1 to 5 mm, mean GtH levels increased from 0.75 to 2.5 ng/ml when those of the E2-17 beta increased more rapidly but began to drop before the end of vitellogenesis. Maturation and ovulation were accompanied by a rise of the GtH level, in correlation with the lower levels of E2-17 beta measured during the cycle, GtH remained high even after ovulation, and more in fish which had kept their eggs within the body cavity. Correlation among GtH, E2-17 beta, and the diameters of eggs had been calculated. There was a positive correlation among GtH, E2-17 beta levels, and the diameters of eggs during exogenous vitellogenesis, and a negative between GtH and E2-17 beta at the end of the reproductive cycle. These results were discussed, in relation to the existence of a pulsatile mode of GtH secretion.
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