Le Corpus de ce numéro de La Nouvelle Revue du Travail porte sur les relations professionnelles, approchées de plusieurs points de vue. Que ce soit en France, en Belgique, au Québec ou en Australie, ...les auteurs scrutent les profondes transformations des relations professionnelles depuis trois décennies. Au-delà de leurs évolutions, les articles du Corpus s’intéressent au contexte de ce qu’il faut bien nommer leur dérégulation généralisée. Laquelle résulte d’un faisceau de phénomènes tels que la globalisation de la production et des échanges, la financiarisation de l’économie, les innovations managériales du capitalisme de plateforme, l’éloignement des centres décisionnels par rapport aux lieux de travail, l’essoufflement des formes syndicales traditionnelles, les modifications du droit du travail par les États, etc. La Controverse prolonge les réflexions du Corpus : elle offre un riche débat sur l’état du champ des relations professionnelles en France. D’une part, celles-ci dépendent de décisions politiques qui les transforment en donnant par exemple plus de poids à la négociation d’entreprise, d’autre part, émergent lentement de nouvelles relations d’emploi qui, encore marginales numériquement, influencent le cœur des relations professionnelles. Par ailleurs, les sept spécialistes interrogent l’évolution des regards portés par les sciences sociales sur l’objet « relations professionnelles », sur sa construction et sur ses évolutions contemporaines. L’article en Varia traite de l’identité professionnelle des « musiciens ordinaires » en France, au Chili et en Suisse en examinant les différents contextes nationaux. Ainsi, « être musicien » ne recouvre pas les mêmes réalités dans les trois pays, notamment en fonction du degré de régulation de l’emploi dans le spectacle vivant par l’État et de la forme de cette régulation. Champs et contrechamps s’intéresse à Commune commune, film documentaire sorti en salle en 2022. Lequel traite de la démocratie participative mise en œuvre par la municipalité de Saillans (Drôme) de 2014 à 2020, en donnant la parole aux habitants et aux élus. Un sociologue et un politiste proposent une lecture personnelle du film à laquelle répondent les deux réalisatrices. Dans la rubrique Matériaux et Méthodes, l’entretien avec François Guérin fait revivre l’émergence de l’école francophone d’ergonomie autour d’Alain Wisner au CNAM. Puis il met en relief les interventions de l’Agence nationale pour l’amélioration des conditions de travail (ANACT), dont il a été le directeur-adjoint, dans la recherche des compromis pour réorganiser le quotidien des salarié.es. Ce témoignage d’un adepte de leur participation à l’organisation de leur devenir illustre les tensions entre des intérêts contradictoires ou des visions divergentes du rôle des sciences sociales. Une quinzaine de Recensions et de notes de lecture, très diversifiées, portent la critique sur des ouvrages récemment parus. Profitons de cette présentation du no 21 pour saluer la naissance d’une nouvelle revue francophone, Salariat, qui se situe dans un domaine proche de la NRT. Salariat est une revue de sciences sociales, fondée à l’initiative de l’Institut Européen du Salariat. Pluridisciplinaire, elle s’attache à l’étude du salariat entendu comme rapport social, mais aussi comme classe sociale et comme ensemble institutionnel. Elle publiera des travaux portant sur le travail, l’emploi, la protection sociale, le syndicalisme ou les groupes sociaux en lien avec la question salariale (http://www.revue-salariat.fr/). Bienvenue et plein succès à cette nouvelle revue, qui vient enrichir un espace scientifique très vivant.
MRI is the current way for the diagnosis of acute myocarditis, based on the Lake Louise criteria (presence of at least two of the three following criteria: myocardial edema, hyperaemia and/or a late ...Gadolinium enhancement). The first-pass perfusion sequence, used for detecting myocardial ischemia, may also be used to highlight a myocardial hyperemia in acute myocarditis.
The aim of our study was to assess subepicardial hyperemia, seen on the first pass perfusion sequence by MRI, as a new method for the diagnosis of acute myocarditis.
47 patients (mean age = 42.4±15,6 years; 35 men) with acute myocarditis were included and compared to 16 healthy controls (without heart disease). The first-pass perfusion was evaluated by two blinded observers and compared to myocardial late Gadolinium enhancement, considered the reference method for the diagnosis of acute myocarditis, using both a qualitative (visual analysis) and a semi-quantitative method (ratio of the signals: infarction hyperaemia / healthy myocardium).
24 (51.1%) patients with myocarditis exhibited detectable hyperemia. Qualitative analysis showed good inter-observer variability (kappa = 0.75). There was an increase of the signal intensity in the myocardium with hyperhemia as compared to the adjacent normal myocardium (myocarditis vs controls: 1.08±0.03 vs 0.95±0.05, p=0.03; myocarditis with hyperhemia vs myocarditis non hyperhemia: 1.22±0.04 vs 0.94 ±0.04, p<0.0001). The correlation between the first-pass perfusion and late Gadolinium enhancement was good (kappa = 0,70). Considering the late Gadolinium enhancement as gold standard, the calculated values of sensitivity and specificity were 85% and 94%, respectively.
Hyperhemia on the First-pass perfusion sequence, is a valuable and reproducible tool for the diagnosis of acute myocarditis.
The author hereby declares no conflict of interest
To assess the prognostic value of the clinically infarct-like pattern and cardiac magnetic resonance (CMR) parameters on long-term outcome after acute myocarditis.
Between 2006 and 2015, 112 ...consecutive patients with CMRbased diagnosis of acute myocarditis according to the Louise-Lake criteria were identified in our institution. Of them, 88 were available for clinical follow-up and represent our studied population. Patients were divided into Infarct-like, (n=48) (association of acute chest pain, raised Troponin and STElevation) and non-infarct-like, (n=40) with any other presentation. The composite primary endpoint of Major CardioVascular Events included: all-cause mortality, cardiac mortality, recurrence of myocarditis, heart failure or sustained ventricular tachycardia.
During follow-up, 21 patients (24%) experienced MACE and the infarct-like patients were significantly more at risk for MACE than group B patients (HR 2.4, 95% CI 1.01 – 5.80 p=0.04). Patients of the Group A exhibited in particular a higher risk of sustained ventricular tachycardia and recurrence of myocarditis as compared with group B patients (p=0.03). Infarct-like patients had lower CMR-derived left (p=0.03) and right (p=0.001) ventricular ejection fractions, and exhibited larger areas of late Gadolinium enhancement (LGE) (p=0.001) as compared with group B patients. In multivariate analysis, both initial NYHA functional class>II and LGE mass were independent predictors for long-term MACE occurrence after acute myocarditis (HR 5.8 and 1.07 per g respectively, p=0.007). Moreover, a threshold of LGE mass>17g provided a high discrimination for MACE occurrence (AUC of 0.81).
The infarct-like pattern of acute myocarditis is associated with MACE, especially sustained ventricular tachycardia and recurrence of myocarditis.
The author hereby declares no conflict of interest
The diagnosis of acute myocarditis is difficult because of the wide range of clinical symptoms. Noninvasive diagnosis relies on cardiac MRI, but its availability remains limited. CT spectral imaging ...has recently been proposed in this setting.
The aim of this study is to compare cardiac spectral CT scan to MRI for the diagnosis of myocarditis.
Between 2013 and 2015, 20 consecutive patients had an acute myocarditis according to cardiac MRI in our institution. All underwent a CT scan during the same time to compare with the MRI considered the gold standard. A coronary CT angiography was performed during the early enhancement and spectral analyses were performed 5 min after injection of iodine contrast agent, with late hyperenhancement defining inflammation. Using the 17 segments classification, we compared each myocardial segment using the 2 methods.
Mean age was 34±12 years with 90% of men. Symptoms were chest pain (100%) and palpitation (5%), and 75% of patients had a recent history of viral infection. Mean CRP was 64±65mg/l and troponin peak levels were 12±13ng/ml (normal <0.04). In Cardiac MRI, mean LVEF was 54±8%. The number of inflammatory myocardial segments was 3.1±3 in MRI and 3.6±2 in CT scan. When comparing each of the 17 segments using cardiac MRI or CT scan, no significant difference was found and the concordance Kappa coefficients was 0.83 p=0.001. The sensitivity in per patient and per segment analyses was respectively 100% and 81%. The effective dose to the patient during coroscanner and spectral scanner was respectively 4.6±1.8 and 1.2±0.2.
Spectral CT scan is valid compared to myocardial MRI for the diagnosis of acute myocarditis. Since CT scan is more easily available than MRI and can also rule out a coronary syndrome, it appears as an interesting option to diagnose myocarditis.
The author hereby declares no conflict of interest Display omitted
The logistic Euroscore (Euroscore I) has been shown to lack accuracy when applied to contemporary patients. The Euroscore II has therefore been recently proposed to improve the prediction of ...operative mortality, but external validations are scarce. We compared the predictive performances of the Euroscore I and II in our institution.
The Euroscore I and II were was computed in 5114 consecutive patients who underwent cardiac surgery over a 5-year period. Discrimination was assessed using the c-index and calibration by comparing predicted and observed mortality. Besides the overall population we also specifically studied elderly patients (age ≥80) and patients with a body mass index (BMI) <25.
Mean age was 63±14 years. Mean Euroscore I was 6.8±8.7%, mean Euroscore II 4.6±6.7% and 30-day mortality 4.8% (245 patients). Cindex and comparisons between predicted and observed mortality are detailed in Table 1 for the overall population and for subgroups according to age and BMI.
Euroscore II has indeed a better predictive performance than the Euroscore I. Its discrimination and calibration are however less satisfying in patients with BMI<25 or aged ≥80. BMI should thus be taken into account, and in the elderly, other variables such as frailty may help to estimate more accurately surgical risk.
La Sociologie du travail salarié proposée par Sylvie Monchatre, professeure à l’Institut d’études du travail de Lyon, s ’ouvre sur un paradoxe. Certes, le salariat s’est affirmé comme norme de ...travail ultra-dominante dans la société française contemporaine (et plusieurs autres sociétés équivalentes de ce point de vue), en dépit des supposées rigidités qu’on lui reproche. Pourtant, la sociologie du travail classique (celle de Georges Friedmann notamment), en se focalisant sur l’activité de tra...
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