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Severe asthma exacerbation:Changes in patient characteristics,management,and outcomes from 1997 to 2016 in 40 ICUs in the greater Paris area

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Journal of Intensive Medicine 2024年第2期4卷 209-215页

作者： Romy Younan jean Loup Augy Bertrand Hermann Bertrand Guidet Philippe Aegerter Emmanuel Guerot Ana Novara Caroline Hauw-Berlemont Amer Hamdan Clotilde Bailleul Francesca Santi jean-Luc Diehl Nicolas Peron Nadia Aissaoui Intensive Care Unit AP-HPGeorges Pompidou European HospitalUniversitéde ParisParisFrance Intensive Care Unit AP-HPSaint Antoine HospitalUniversités de SorbonneUniversitéPierre et Marie CurieParisFrance INSERM U1136 ParisFrance Versailles Saint-Quentin-en-Yvelines University INSERM U1018Groupe Interrégional de Recherche Clinique et d'InnovationÎle-de-FranceFrance Respiratory Medicine Department AP-HPGeorges Pompidou European HospitalUniversitéde ParisParisFrance Innovative Therapies in Hemostasis INSERM UMR-S1140Universitéde ParisParisFrance Intensive Care Unit and Biosurgical Research Lab(Carpentier Foundation) AP-HPGeorges Pompidou European HospitalParisFrance Paris-Cardiovascular-Research-Center INSERM U970ParisFrance

Background Despite advances in asthma treatments,severe asthma exacerbation(SAE)remains a life-threatening condition in adults,and there is a lack of data derived from adult patients admitted to intensive care units(ICUs)for *** current study investigated changes in adult patient characteristics,management,and outcomes of SAE over a 20-year period in 40 ICUs in the greater Paris *** In this retrospective observational study,admissions to 40 ICUs in the greater Paris area for SAE from January 1,1997,to December 31,2016 were *** primary outcome was the proportion of ICU admissions for SAE during 5-year *** outcomes were ICU and hospital mortality,and the use of mechanical ventilation and *** analysis was performed to assess factors associated with ICU *** A total of 7049 admissions for SAE were *** each 5-year period,the proportion decreased over time,with SAE accounting for 2.84%of total ICU admissions(n=2841)between 1997 and 2001,1.76%(n=1717)between 2002 and 2006,1.05%(n=965)between 2007 and 2011,and 1.05%(n=1526)between 2012 and *** median age was 46 years(interquartile range[IQR]:32–59 years),55.41%were female,the median Simplified Acute Physiology Score II was 20(IQR:13–28),and 19.76%had mechanical *** use of mechanical ventilation remained infrequent throughout the 20-year period,whereas the use of catecholamine *** and hospital mortality rates *** associated with ICU mortality were renal replacement therapy,catecholamine,cardiac arrest,pneumothorax,acute respiratory distress syndrome,sepsis,and invasive mechanical ventilation(IMV).Non-survivors were older,had more severe symptoms,and were more likely to have received *** ICU admission for SAE remains uncommon,and the proportion of cases decreased over *** a slight increase in symptom severity during a 20-year period,ICU and hospital mortality *** requirin

关键词： Epidemiology Intensive care unit Mechanical ventilation Severe asthma exacerbation

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Comparative Analysis of Meteorological Drought Indices in Quantifying and Characterizing Drought Events Over Burundi

Comparative Analysis of Meteorological Drought Indices in Qu...

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作者： jean marie NDAYIRAGIJE 扬州大学

学位级别：硕士

1.绪论气候变化对与天气有关的自然灾害的发生产生越来越大的影响。本世纪极端天气比以往任何时候都多。气候变化,除了使人口脆弱性和暴露度迅速增加外,还增加了与极端天气相关灾害的风险,包括洪水、干旱、热浪和风暴。此外,自然灾害仍... 详细信息

1.绪论气候变化对与天气有关的自然灾害的发生产生越来越大的影响。本世纪极端天气比以往任何时候都多。气候变化,除了使人口脆弱性和暴露度迅速增加外,还增加了与极端天气相关灾害的风险,包括洪水、干旱、热浪和风暴。此外,自然灾害仍然是政策制定者和管理者的当务之急,尤其是在高风险地区。当这些极端灾难发生的强度高或持续时间长时,可能会对生命安全和社会经济活动造成破坏。在气候变化的情况下,天气变化对水资源的利用和管理产生了巨大影响。世界上有很多人正在遭受水资源短缺危机,或者因为降雨量超过正常平均水平而产生洪涝灾害。干旱是一种自然灾害,由于其对自然环境、生态、水文,特别是农业的有害影响,严重影响人类的生存和经济财产安全。在布隆迪北部,干旱是一种持续时间长且反复发生的自然灾害。尽管该地区容易发生干旱,而且经常遭受干旱,但依然缺乏对该地区旱事件的系统调查与研究。为了量化和表征干旱事件,本研究使用了两个干旱指数,即标准化降水蒸发蒸腾指数(SPEI)和标准化降水指数(SPI),在2个月、6个月和24个月的时间尺度上进行分析。由于布隆迪的大多数种植植物分别需要2至6个月才能完全生长成熟并收获,因此为了与农业生产相对应,采用了以上时间尺度。根据计算的SPEI和SPI值,利用Mann-Kendall(MK)检验和Sen的斜率估计器来分析干旱趋势。本文比较了这两个干旱指数,并定量地阐明SPEI和SPI之间的差异。调查结果显示,1993-2000年和2002-2009年期间,不同类型的干旱威胁着布隆迪北部。这两个指数都表明,2005年、2006年和2007年是极端干旱的年份。SPEI指数检测到的干旱事件分为中度和重度两类,其特征是持续时间长、规模大。相比之下,SPI检测到的干旱事件被归类为“极度干旱”类别,其特征是持续时间有限,烈度较低,但强度较高。这项研究强调,SPEI在量化和表征干旱方面与SPI不同,并建议在评估干旱时同时使用SPEI和SPI。这项研究的结果将有助于布隆迪各地的干旱预防和缓解,特别是有助于农业生产。此外,强烈建议采取积极的缓解干旱的措施、缓解气候变化和完善水资源管理政策,以减少干旱风险及其对人口和自然环境的影响。1.1研究背景干旱事件是发生在全球各地的自然灾害,但其频率、持续时间、严重程度和强度等特征因地形和地理条件而异,因地区和国家而异。根据干旱的严重程度和持续时间,干旱可能对人类和环境产生危险和深远的影响,特别是影响社会、经济和生态系统。气候变化和天气多变等自然现象是造成干旱的主要原因。此外,采矿和砍伐森林等人类活动会加剧干旱的频率和严重程度。干旱事件比较难定义,因为它取决于地区和气候条件、水资源的需求和学科观点的差异。尽管干旱以多种方式影响自然环境和人类生命和财富,但干旱的概念本身是不确定的。直到今天,还没有普遍的干旱定义,但科学家和研究人员就干旱的非常普遍和广为人知的定义达成了一致。一般而言,干旱始于特定地区长时间的降水不足,导致某些农牧业活动、学校和医院等人群或环境部门缺水(***/whatis/***)。另一方面,政府间气候变化专门委员会(Intergovernmental Panel on Climate Change,IPCC)将干旱定义为异常干燥的天气,持续时间长到足以导致严重的水文失衡并导致河流、池塘和湖泊等水体枯竭,世界气象组织(WMO)将干旱定义为持续和长期的降水短缺。1.2研究目的与意义论文的研究目的包括:1.定义不同类型的干旱、其原因和影响;2.干旱事件的量化、表征和分析;3.干旱指数SPEI和SPI的比较分析;4.说明气象干旱指数在干旱监测中的有效性;5.为研究区提出可能的减轻干旱影响的缓解措施。这项研究旨在量化、识别和描述布隆迪的干旱事件。该研究将使人们更好地了解干旱的发生、风险和影响。此外,这项研究的成果将使决策者、规划者和水资源管理者能够在抗旱准备和实施抗旱措施方面做出更多选择。另外,目前很少有关于布隆迪干旱事件的研究。它将作为进一步研究的参考,并提供政策制定和决策制定所需的理论支持,以改善水资源管理和环境保护,特别是减轻干旱。1.3研究内容与技术路线技术路线见图1.1。研究主要包括以下内容:(1)气象数据采集:八个气象站月降水量、最高、最低气温;(2)采用两项气象干旱指数;(3)使用R中的SPEI包生成SPEI和SPI值;(4)干旱量化、干旱事件识别与表征。#12图1-1技术路线图2.研究区域与方法2.1研究区简介布隆迪是一个内陆国家,北部与卢旺达接壤,南部和东部与坦桑尼亚接壤,西部与刚果民主共和国接壤。由于位于赤道带,该国属热带气候。布隆迪的地形以五个不同的微气候区为特征:以洼地和平原为特征的北部和东部,米尔瓦的悬崖,在西部,刚果-尼罗河洋脊将布隆迪的水

关键词：干旱特征 SPEI和SPI指数干旱发生率气候变化 Mann-Kendall检验布隆迪

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Anatomical and electrophysiological plasticity of locomotor networks following spinal transection in the salamander

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Neuroscience Bulletin 2013年第4期29卷 467-476页

作者： jean-marie Cabelguen Stéphanie Chevallier Ianina Amontieva-Potapova Céline Philippe Neurocentre Magendie INSERM U 862 - Bordeaux University

Recovery of locomotor behavior following spinal cord injury can occur spontaneously in some vertebrates, such as fish, urodele amphibians, and certain reptiles. This review provides an overview of the current status of our knowledge on the anatomical and electrophysiological changes occurring within the spinal cord that lead to, or are associated with the [e-expression of locomotion in spinally-transected salamanders. A better understanding of these processes will help to devise strategies for restoring locomotor function in mammals, including humans.

关键词： salamander spinal cord locomotor recovery regeneration

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Reciprocal interactions between gut microbiota and autophagy

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World Journal of Gastroenterology 2021年第48期27卷 8283-8301页

作者： Pierre Lapaquette jean-Baptiste Bizeau Niyazi Acar marie-Agnès Bringer UMR PAM A 02.102 University Bourgogne Franche-ComtéAgrosup DijonDijon 21000France Eye and Nutrition Research Group Centre des Sciences du Goût et de l'AlimentationAgroSup DijonCNRSINRAEUniversitéBourgogne Franche-ComtéDijon 21000France

A symbiotic relationship has set up between the gut microbiota and its host in the course of evolution,forming an interkingdom *** gut offers a favorable ecological niche for microbial communities,with the whole body and external factors(e.g.,diet or medications)contributing to modulating this ***,the gut microbiota is important for maintaining health by acting not only on the gut mucosa but also on other ***,failure in one or another of these two partners can lead to the breakdown in their symbiotic equilibrium and contribute to disease onset and/or *** microbial and host processes are devoted to facing up the stress that could alter the symbiosis,ensuring the resilience of the *** these processes,autophagy is a host catabolic process integrating a wide range of stress in order to maintain cell survival and *** cytoprotective mechanism,which is ubiquitous and operates at basal level in all tissues,can be rapidly down-or upregulated at the transcriptional,post-transcriptional,or post-translational levels,to respond to various stress *** of its sensitivity to all,metabolic-,immune-,and microbial-derived stimuli,autophagy is at the crossroad of the dialogue between changes occurring in the gut microbiota and the host *** this review,we first delineate the modulation of host autophagy by the gut microbiota locally in the gut and in peripheral ***,we describe the autophagy-related mechanisms affecting the gut *** conclude this review with the current challenges and an outlook toward the future interventions aiming at modulating host autophagy by targeting the gut microbiota.

关键词： Gut microbiota Autophagy Probiotic Brain Liver Muscle

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The potential value of intravascular ultrasound imaging in diagnosis of aortic intramural hematoma

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Journal of Geriatric Cardiology 2011年第4期8卷 224-229页

作者： Wei Hu Francois Schiele Nicolas Meneveau marie-France Seronde Pierre Legalery jean-Francois Bonneville Sidney Chocron jean-Pierre Bassand Department of Cardiology Min Hang District Central HospitalShanghai 201100China Department of Cardiology University Hospital Jean MinjozBesançon 25000France Department of Radiology University Hospital Jean MinjozBesançon 25000France Department of Cardiac Surgery University Hospital Jean MinjozBesançon 25000France

Objective To evaluate the potential value of intravascular ultrasound(IVUS)imaging in the diagnosis of aortic intramural hematoma(AIH).Methods From September 2002 to May 2005,a consecutive series of 15 patients with suspected aortic dissection(AD)underwent both IVUS imaging and spiral computed tomography(CT).Six patients diagnosed as acute type B AIH by CT or IVUS composed the present study *** The study group consisted of five males and one female with mean age of 66 years *** of them had chest or back *** one patient,CT omitted a localized AIH and an associated penetrating atherosclerotic ulcer(PAU),which were detected by *** another patient,CT mistaken a partly thrombosed false lumen as an AIH,whereas IVUS detected a subtle intimal tear and slow moving blood in the false *** the four rest patients,both CT and IVUS made the diagnosis of AIH,however,IVUS detected three PAUs in three of them,only one of them was also detected by CT,and two of them escaped initial CT and were confirmed by follow up CT or magnetic resonance *** IVUS imaging is a safe examination and has high accuracy in the diagnosis of AIH,particularly for diagnosing localized AIH,distinguishing AIH with thrombosed classic AD and detecting accompanied small PAUs.

关键词： intravascular ultrasound diagnosis aortic intramural hematom

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Modification of the adsorption and catalytic properties of micro-and mesoporous materials by reactions with organometallic complexes

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Science China Chemistry 2010年第9期53卷 1862-1869页

作者： LEFEBVRE Frédéric PUTAJ Piotr BASSET jean-marie Université de Lyon ICL C2P2 UMR 5265(CNRS-CPE-Université Lyon 1) LCOMS-CPE Lyon

This review describes the work of two laboratories in the field of the modification of micro-and mesoporous molecular sieves through reactions with organometallic *** modification of zeolites can occur inside the pore channels or on the external surface,depending on the size of the organometallic *** the modification occurs on the external surface,it results in a decrease of the pore entrance,which will lead in turn to a modification of the sorption properties of the zeolite,by decreasing the rate of the adsorption(mainly by a kinetic control).Such a material can be also used in catalysis,because the external acid sites,which are responsible for side-reactions,have been removed upon *** small organometallic complexes are used,they can fill the channels and cages of the zeolite and react with internal hydroxyl *** to the high acidity of zeolites,the reaction occurs very easily(for example at-100℃ on faujasite),in contrast to what is observed on the external surface,therefore leading to high metal *** that case,the modification of the sorption properties will be mainly related to a thermodynamic *** resulting materials can be useful in catalysis,by combining the activity of the organometallic complex and properties(for example shape-selectivity) of the *** of mesoporous molecular sieves occurs always in the pores and results in altering of the sorption properties of the solid,by changing the interaction type between the sorbent and the *** example the sorption isotherm of alkanes is changed from type II to type III according to the IUPAC nomenclature.

关键词： zeolites transition metals organometallic compounds adsorption properties

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Use of a new retrograde filling material(Biodentine) for endodontic surgery: two case reports

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International Journal of Oral Science 2014年第4期6卷 250-253页

作者： Grégory Caron jean Azérad marie-Odile Faure Pierre Machtou Yves Boucher Private practice Dental School Paris Diderot University Dental Service Pitié Salpêtrière Hospital Septodont Saint-Maur-des-Fosses

Mineral trioxide aggregate（MTA） is considered at the present time as the gold standard for root-end filling in endodontic ***, this biocompatible material presents several drawbacks such as a long setting time and handling difficulties. The aim of this article is to present a new commercialized calcium silicate-based material named Biodentine with physical improved properties compared to MTA in a clinical application. Two endodontic microsurgeries were performed by using specific armamentarium（microsurgical instrumentation, ultrasonic tips） under high-power magnification with an operatory microscope. Biodentine was used as a root-end filling in order to seal the root canal system. The two cases were considered completely healed at 1 year and were followed for one more year. The 2-year follow-up consolidated the previous observation with absence of clinical symptoms and radiographic evidence of regeneration of the periapical tissues.

关键词： Biodentin endodontics healing periapical surgery retrograde filling

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Cadaveric liver transplantation for non-acetaminophen fulminant hepatic failure:A 20-year experience

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World Journal of Gastroenterology 2007年第9期13卷 1427-1430页

作者： Olivier Detry Arnaud De Roover Carla Coimbra jean Delwaide marie-France Hans marie Hélène Delbouille Joseé Monard jean Joris Pierre Damas Jacques Belache Michel Meurisse Pierre Honoré Department of Liver Surgery and Transplantation University of Liège CHU Sart Tilman B35Liège B4000 Belgium Department of Hepato- gastroenterology University of Liège CHU Sart Tilman B35 Liège B4000 Belgium Department of Anaesthesia and Intensive Care University of Liège CHU Sart Tilman B35Liège B4000Belgium

AIM: To investigate the long-term results of liver transplantation (LT) for non-acetaminophen fulminant hepatic failure (FHF). METHODS: Over a 20-year period, 29 FHF patients underwent cadaveric whole LT. Most frequent causes of FHF were hepatitis B virus and drug-related (not acetaminophen) liver failure. All surviving patients were regularly controlled at the out-patient clinic and none was lost to follow-up. Mean follow-up was 101 mo. RESULTS: One month, one-, five- and ten-year patient survival was 79%, 72%, 68% and 68%, respectively. One month, one-, five- and ten-year graft survival was 69%, 65%, 51% and 38%, respectively. Six patients needed early (< 2 mo) retransplantation, four for primary non-function, one for early acute refractory rejection because of ABO blood group incompatibility, and one for a malignant tumor found in the donor. Two patients with hepatitis B FHF developed cerebral lesions peri-transplantion: One developed irreversible and extensive brain damage leading to death, and one suffered from deep deficits leading to continuous medical care in a specialized institution. CONCLUSION: Long-term outcome of patients transplanted for non-acetaminophen FHF may be excellent. As the quality of life of these patients is also particularly good, LT for FHF is clearly justified, despite lower graft survival compared with LT for other liver diseases.

关键词： Liver transplantation Liver failure Surgery Hepatitis B Liver support

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Actigraphy: A new diagnostic tool for hepatic encephaiopathy

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World Journal of Gastroenterology 2006年第14期12卷 2243-2244页

作者： Isabelle Hourmand-Ollivier marie-Astrid Piquet jean Pierre Toudic Pierre Denise Thng Dao Department of Nutrition and Hepatogastroenterology CHU Cte de Nacre-14033 cedex Caen France Physiology Laboratory CHU Cte de Nacre-14033 cedex Caen France

AIM： To assess the actigraphy, an ambulatory and continuous monitoring of wrist motor activity fitted to study sleep/wake patterns in hepatic encephalopathy （HE）. METHODS： Twenty-five cirrhotic patients （17 M, 8 F, mean age 56± 11 years, 24/25 alcoholic, Child-Pugh A, B, C： 2, 6, 17） were included. The patients were classified into 3 groups： stage 0 group （n = 12）, stage 1-2 group （n = 6）, and stage 3-4 group （n = 7） of encephalopathy. Over three consecutive days, patients had clinical evaluation 3 times a day with psychometric test, venous ammoniemia, flash visually evoked potentials （VEP）, electroencephalogram and continuous actigraphic monitoring for 3 d, providing 5 parameters： mesor, amplitude, acrophase, mean duration of activity （MDAI） and inactivity （MDII） intervals. RESULTS： Serum ammonia and VEP did not differ among the 3 groups. Electroencephalography mean dominant frequency （MDF） correlated significantly with clinical stages of HE （r=0.65, P=0.003）. The best correlation with HE stage was provided by actigraphy especially with MDAI （r= 0.7, P〈10^-4） and mesor （r= 0.65, P〈 10^-4）. MDAI correlated significantly with MDF （r= 0.62, 0.004） and was significantly shorter in case of HE compared to patients without HE （stage 0： 5.33± 1.6 min; stage 1-2：3.28±1.4 min; stage 3-4：2.52±1.1 min; P〈0.05）. Using a threshold of MDAI of less than 4.9 min, sensitivity, specificity, positive predictive value, negative predictive value for HE diagnosis were 85%, 67%, 73% and 80%, respectively. CONCLUSION： Actigraphy may be an objective method to identify HE, especially for early HE detection. Motor activity at the wrist correlates well with clinical stages of HE. MDAI and mesor are the most relevant parameters.

关键词： Hepatic encephalopathy Cirrhosis Actigraphy

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Gender influence on defecographic abnormalities in patients with posterior pelvic floor disorders

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World Journal of Gastroenterology 2010年第4期16卷 462-466页

作者： Céline Savoye-Collet Guillaume Savoye Edith Koning Anne-marie Leroi jean-Nicolas Dacher Radiology Department QUANT-IF LITIS EA 4108Rouen University Hospital Charles Nicolle1 rue de GermontF76031 RouenFrance Gastroenterology Department ADEN EA 4311Rouen University Hospital Charles Nicolle1 rue de GermontF-76031 RouenFrance Physiology Department ADEN EA 4311Rouen University Hospital Charles Nicolle1 rue de GermontF-76031 RouenFrance

AIM:To compare defecographic abnormalities in symptomatic men and women and to analyze differences between men and age-and symptom-matched ***:Sixty-six men(mean age:55.4 years,range:20-81 years) who complained of constipation and/or fecal incontinence and/or pelvic pain underwent defecography after intake of a barium *** were analyzed for the diagnosis of rectocele,enterocele,intussusception and perineal *** were compared with age-and symptom-matched women(n = 198) who underwent defecography during the same ***:Normal defecography was observed in 22.7% of men vs 5.5% of women(P < 0.001).Defecography in men compared with women showed 4.5%vs 44.4%(P < 0.001) rectocele,and 10.6% vs 29.8%(P < 0.001) enterocele,*** difference was observed for the diagnosis of intussusception(57.6% vs 44.9%).Perineal descent at rest was more frequent in women(P < 0.005).CONCLUSION:For the same complaint,diagnosis of defecographic abnormalities was different in men than in women:rectocele,enterocele and perineal descent at rest were observed less frequently in men than in women.

关键词： Fecal incontinence Defecography Rectocele Hernia Pelvic floor Constipation

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