Context. Rare types of variable stars may provide unique insight into short-lived stages of stellar evolution. The systematic monitoring of millions of stars and advanced light curve analysis ...techniques of microlensing surveys make them ideal for discovering such rare variable stars. One example is the R Coronae Borealis (RCB) stars, a rare type of evolved carbon-rich supergiant. Aims. We have conducted a systematic search of the EROS-2 database for the Galactic catalogue Bulge and spiral arms to find Galactic RCB stars. Methods. The light curves of ~100 million stars, monitored for 6.7 years (from July 1996 to February 2003), have been analysed to search for the main signature of RCB stars, large and rapid drops in luminosity. Follow-up spectroscopy has been used to confirm the photometric candidates. Results. We have discovered 14 new RCB stars, all in the direction of the Galactic Bulge, bringing the total number of confirmed Galactic RCB stars to about 51. Conclusions. After reddening correction, the colours and absolute magnitudes of at least 9 of the stars are similar to those of Magellanic RCB stars. This suggests that these stars are in fact located in the Galactic Bulge, making them the first RCB stars discovered in the Bulge. The localisation of the 5 remaining RCBs is more uncertain: 4 are either located behind the Bulge at an estimated maximum distance of 14 kpc or have an unusual thick circumstellar shell; the other is a DY Per RCB which may be located in the Bulge, even if it is fainter than the known Magellanic DY Per. From the small scale height found using the 9 new Bulge RCBs, $61<h^{\rm RCB}_{\rm Bulge}<246$ pc (95% C.L.), we conclude that the RCB stars follow a disk-like distribution inside the Bulge.
To identify most significant and therapeutically relevant prognostic factors in adults with localized primary synovial sarcomas (SS) and to confirm the usefulness of the French Federation of Cancer ...Centers (FNCLCC) grading system, the prognostic impact of which has been already proven in soft tissue sarcomas.
Data on 128 patients with nonmetastatic SS collected from a cooperative database by the FNCLCC Sarcoma Group between 1980 and 1994 were studied retrospectively. Immunohistochemistry was performed at diagnosis in 77 cases (61%). The tumors were classified as biphasic (n = 45), monophasic fibrous (n = 72), and poorly differentiated (n = 10) subtypes. Histologic grade was determined according to the FNCLCC method, and vascular invasion was assessed in every case.
The 5-year disease-specific survival (DSS) rate for this series of patients with localized SS was 62.9% (+/- 9.6% SD) with a median follow-up time of 37 months (range, 8 to 141 months). In multivariate analysis, the adverse risk factors associated with decreased DSS were International Union Against Cancer/American Joint Committee on Cancer stage III/IVA disease, male sex, and truncal tumor locations. For metastasis-free survival (MFS), disease stage III/IVA, tumor necrosis, and monophasic subtypes were the major factors associated with a less favorable prognosis. Separately, when not using disease stage, tumor necrosis, and mitotic activity, histologic grade became the most significant prognostic factor for both DSS and MFS. In addition, larger tumors and older patients become associated with a significantly worse prognosis. Independent adverse risk factors for local recurrence-free survival included histologic grade 3 and truncal tumor location.
These data confirm that not all SS present the same severe outcome. High-risk patients identified on the basis of these parameters may qualify for an aggressive treatment approach.
L’atropine peut être responsable, d’effets secondaires liés au mécanisme pharmacologique de la molécule et plus rarement de réactions allergiques. Nous rapportons une réaction systémique ...anaphylactique peropératoire à l’atropine ; réactions peu décrites dans la littérature.
Nous décrivons une anaphylaxie peropératoire, survenue au moment de la décurarisation (antagonisation par néostigmine et atropine).
Il s’agit d’une patiente de 41 ans opérée en 2022 d’une appendicite ; l’induction et la chirurgie se sont déroulées sans complication. Le patient a néanmoins présenté immédiatement après l’injection de néostigmine et d’atropine (soit 60 minutes après l’induction), une éruption cutanée thoracique et une bradycardie, puis une asystolie, ayant nécessité un massage cardiaque externe, un traitement par adrénaline, 2 chocs électriques externe et de l’amiodarone. Les dosages de tryptase effectués sont compatibles avec une dégranulation mastocytaire.
Un bilan allergologie a été réalisé trois mois après la réaction selon les recommandations du GERAP : tests cutanés à la néostigmine négatifs en IDR au 1/10e. Prick-test négatif à l’atropine et IDR positive à la dilution de 0,025mg/mL 1. Un test d’activation des basophiles a été réalisé 2 : négatif.
Le patient a présenté une anaphylaxie de grade IV à l’atropine avec des tests cutanés positifs. L’anaphylaxie à l’atropine est peu décrite. Les cas rapportés dans la littérature rapportent également des IDR positives, à la concentration de 0,1mg/mL, considérée non irritante. Il faut savoir évoquer le diagnostic en cas de choc en fin d’intervention, chez un patient que l’on décurarise. Le glycopyrrolate est évoqué comme alternative à l’atropine sous réserve de tests cutanés négatifs 2.
Le midazolam (MDZ) est un hypnotique sédatif très utilisé en anesthésie habituellement bien toléré.
Nous rapportons le cas d’une anaphylaxie au MDZ avec réaction croisée au diazépam (DZP).
Une femme ...de 50 ans, aux antécédents d’éruption après pénicilline est endormie en 2019 pour une cure de hernie discale. Trente minutes après l’induction (midazolam, kétamine, dexaméthasone, propofol, atracurium, sufentanyl, sevorane, vancomycine, paracétamol, profenid, nefopam, naropeine) surviennent une hypotension, tachycardie, urticaire et œdème facial avec modification de la tryptase (16,3 puis 4,3μg/L) résolutif après antihistaminiques.
Le bilan allergologique était négatif pour les molécules injectées mais avec un érythème pour le MDZ.
Le contrôle des tests retrouve une IDR MDZ positive à 0,5mg/mL. Les Ige spécifiques sont négatifs pour les curares et le latex.
En juin 2022 la patiente présente gêne respiratoire et vomissements intenses juste après l’injection de diazépam, morphine nefopam pour une sciatique. L’ensemble des molécules a ensuite été réintroduite ou administrée en particulier le nefopam la morphine et les curares lors d’une nouvelle chirurgie.
Notre patiente présente une allergie IgE dépendante au MDZ, avec réaction évocatrice d’anaphylaxie au DZP.
Quelques cas d’anaphylaxie sont décrits avec le MDZ, mais peu avec des tests cutanés positifs. Habituellement rapide après l’injection, la réaction peut être de survenue plus lente comme pour notre patiente, un délai de 2 heures a même été décrit. Les allergies croisées aux BZD sont rares lors des hypersensibilités retardées ou immédiates, alors que notre patiente a eu une réaction au DZP, une allergie croisée remidazolam–MDZ est décrite.
Il est licite de chercher une allergie au MDZ même si la réaction n’est pas immédiate après l’injection, avec recherche d’allergie croisée, certains auteurs contre indiquant toutes les BZD en cas de réaction grave.
Aims. The EROS-2 project has been designed to search for microlensing events towards any dense stellar field. The densest parts of the Galactic spiral arms have been monitored to maximize the ...microlensing signal expected from the stars of the Galactic disk and bulge. Methods. 12.9 million stars have been monitored during 7 seasons towards 4 directions in the Galactic plane, away from the Galactic center. Results. A total of 27 microlensing event candidates have been found. Estimates of the optical depths from the 22 best events are provided. A first order interpretation shows that simple Galactic models with a standard disk and an elongated bulge are in agreement with our observations. We find that the average microlensing optical depth towards the complete EROS-cataloged stars of the spiral arms is $\bar{\tau}$ = 0.51±.13$\times$10-6, a number that is stable when the selection criteria are moderately varied. As the EROS catalog is almost complete up to IC = 18.5, the optical depth estimated for the sub-sample of bright target stars with $I_C < 18.5$ ($\bar{\tau}$ = 0.39±.11$\times$10-6) is easier to interpret. Conclusions. The set of microlensing events that we have observed is consistent with a simple Galactic model. A more precise interpretation would require either a better knowledge of the distance distribution of the target stars, or a simulation based on a Galactic model. For this purpose, we define and discuss the concept of optical depth for a given catalog or for a limiting magnitude.
A 20
wt% Co/SiO
2 catalyst grafted on a stainless steel substrate was used for Fischer–Tropsch synthesis (FTS) in a micro-chamber reactor. The fabrication of the catalyst was a complex process ...involving several steps. The first one, the pre-treatment of the AISI316L substrate through a plasma assisted chemical vapour deposition process (PACVD), allowed the formation of a silicon based polymer. This thin polymeric film was thermally degraded into a silicon oxide bonding layer. The coating of this bonding layer with sol–gel precursor of the Co/SiO
2 catalysts was done with a spray coating process. The sequential combination of these steps led to a multilayered catalyst with a complex morphology.
This material demonstrated high activity under FTS reaction. Activity and selectivity were higher under micro-chamber conditions than in a classical fixed-bed catalytic test. This was attributed to the increase of mass and heat transfers within the micro-device. Moreover distribution of metallic masses within the catalyst showed significant evolutions post FTS, including steel compound migrations and possible cobalt segregation.
A sequential process including a catalyst spray-drying step for grafting a 20
wt% Co/SiO
2 catalyst on a stainless steel substrate is proposed. The obtained materials had a multilayered internal structure and a complex porous morphology.
Tested under low pressure Fischer–Tropsch synthesis conditions in a micro-chamber reactor they showed high activity and selectivity. After 720
h under reaction, cobalt segregation and contamination by steel compounds were detected.
The sequential combination of these steps led to a multilayered catalyst with a complex morphology.
▪
Aims.We present a new EROS-2 measurement of the microlensing optical depth toward the Galactic Bulge. Methods.Light curves of $5.6\times 10^{6}$ clump-giant stars distributed over $66\,\rm deg^2$ of ...the Bulge were monitored during seven Bulge seasons. 120 events were found with apparent amplifications greater than 1.6 and Einstein radius crossing times in the range $5\,{\rm d}<t_{\rm E}<400\,{\rm d}$. This is the largest existing sample of clump-giant events and the first to include northern Galactic fields. Results.In the Galactic latitude range $1.4\degr<|b|<7.0\degr$, we find $\tau/10^{-6}=(1.62\,\pm 0.23)\exp\,-a(|b|-3 \,{\rm deg})$ with $a=(0.43\,\pm0.16)~\rm deg^{-1}$. These results are in good agreement with our previous measurement, with recent measurements of the MACHO and OGLE-II groups, and with predictions of Bulge models.
Worldwide, chronic obstructive pulmonary disease (COPD) remains largely underdiagnosed.
To assess whether the use of Global Initiative for Chronic Obstructive Lung Disease (GOLD) questions and COPD ...coordination, either alone or combined, would detect new COPD cases in primary care.
GPs in Brittany, France, systematically enrolled patients aged 40-80 years over a 4-month period in this French multicentre cluster randomised controlled study.
GPs were randomly allocated to one of four groups: control (standard of care), GOLD questions (adapted from symptoms and risk factors identified by GOLD), COPD coordination, and GOLD questions with COPD coordination. New cases of COPD were those confirmed by spirometry: post-bronchodilator forced expiratory volume in 1 second over forced vital capacity of <0.7.
In total, 11 430 consultations were conducted by 47 GPs, who enrolled 3162 patients who did not have prior diagnosed asthma or COPD. Among these, 802 (25%) were enrolled in the control, 820 (26%) in the GOLD questions, 802 (25%) in the COPD coordination, and 738 (23%) in the GOLD questions with COPD coordination groups. In the control group, COPD was not evoked, and no spirometry was prescribed. All new cases of COPD diagnosed (
= 24, 0.8%) were in the intervention groups, representing 6.8% of patients who performed spirometry. Statistically significantly more new cases of COPD were detected with COPD coordination (
= 0.01).
Interventions that can be easily implemented, such as the GOLD questions and COPD coordination, can identify new cases of COPD. Studies are needed to identify the most appropriate case-finding strategies for GPs to detect COPD in primary care for each country.
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