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Factors associated with decreased compliance after on-site extracorporeal membrane oxygenation cannulation for acute respiratory distress syndrome:A retrospective,observational cohort study

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Journal of Intensive Medicine 2024年第2期4卷 194-201页

作者： Sylvain Le Pape Florent Joly François Arrivé Jean-Pierre Frat Maeva Rodriguez Maïa Joos Laura Marchasson Mathilde Wairy Arnaud WThille Rémi Coudroy Centre Hospitalier Universitaire de Poitiers Service de Médecine Intensive RéanimationPoitiersFrance INSERM Centre d'Investigation clinique 1402 IS-ALIVE Research GroupUniversitéde PoitiersPoitiersFrance

Background Extracorporeal membrane oxygenation(ECMO)for acute respiratory distress syndrome(ARDS)is systematically associated with decreased respiratory system compliance(CRS).It remains unclear whether transportation to the referral ECMO center,changes in ventilatory mode or settings to achieve ultra-protective ventilation,or the natural evolution of ARDS drives this change in respiratory ***,we assessed the precise moment when CRS decreases after ECMO cannulation and identified factors associated with decreased *** To rule out the effect of transportation and the different modes of ventilation on CRS,we conducted a retrospective,single-center,observational cohort study from January 2013 to May 2020,on 22 patients with severe ARDS requiring on-site ECMO and ventilated in pressure-controlled mode to achieve ultra-protective *** was assessed at different time points ranging from 12 h before ECMO cannulation to 72 h after ECMO *** primary outcome was the relative change in CRS between 3 h before and 3 h after ECMO *** secondary outcomes included variables associated with the relative changes in CRS within the first 3 h after ECMO cannulation and the relative changes in CRS at each time *** CRS decreased within the first 3 h after ECMO cannulation(−28.3%,95%confidence interval[CI]:−38.8 to−17.9,Pdecrease was mild before and after these first 3 h after ECMO *** achieve ultra-protective ventilation,respiratory rate decreased in the mean by–13 breaths/min(95%CI:−15 to−11)and driving pressure by−8.3 cmH2O(95%CI:−11.2 to−5.3),resulting in decreased tidal volume by−3.3 mL/kg of predicted body weight(95%CI:−3.9 to−2.6)as compared to before ECMO cannulation(Pg pressure reduction,and tidal volume reduction were significantly associated with decreased CRS after ECMO cannulation,whereas neither respiratory rate,positive end-expiratory pr

关键词： Acute respiratory distress syndrome Extracorporeal membrane oxygenation Driving pressure Respiratory compliance

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Advancing immunosuppression in liver transplantation: A narrative review

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 441-448页

作者： Samuele Iesari Francesca Laura Nava Ilaria Elena Zais Laurent Coubeau Mariano Ferraresso Evaldo Favi Jan Lerut general Surgery and Kidney Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico15 Via della Commenda20122 MilanItaly Institut de Recherche Expérimentale et clinique Universitécatholique de Louvain10 Avenue Hippocrate1200 BrusselsBelgium Service de Chirurgie et Transplantation Abdominale Cliniques Universitaires Saint-Luc55 Avenue Hippocrate1200 BrusselsBelgium department of Clinical Sciences and Community Health Universitàdegli Studi di Milano19 Via della Commenda20122 MilanItaly

Immunosuppression is essential to ensure recipient and graft survivals after liver transplantation(LT). However, our understanding and management of the immune system remain suboptimal. Current immunosuppressive therapy cannot selectively inhibit the graft-specific immune response and entails a significant risk of serious side effects, i.e., among others, de novo cancers, infections, cardiovascular events, renal failure, metabolic syndrome, and late graft fibrosis, with progressive loss of graft function. Pharmacological research, aimed to develop alternative immunosuppressive agents in LT, is behind other solidorgan transplantation subspecialties, and, therefore, the development of new compounds and strategies should get priority in LT. The research trajectories cover mechanisms to induce T-cell exhaustion, to inhibit co-stimulation, to mitigate non-antigen-specific inflammatory response, and, lastly, to minimize the development and action of donor-specific antibodies. Moreover, while cellular modulation techniques are complex, active research is underway to foster the action of T-regulatory cells, to induce tolerogenic dendritic cells, and to promote the function of B-regulatory cells. We herein discuss current lines of research in clinical immunosuppression, particularly focusing on possible applications in the LT setting.

关键词： Liver transplantation Immunosuppression Drug development Long-term results Clinical operational tolerance

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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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Protein-S-100-beta is increased in patients with decompensated cirrhosis admitted to ICU

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Journal of Intensive Medicine 2024年第2期4卷 222-230页

作者： Nicolas Weiss Simona Tripon Maxime Mallet Françoise Imbert-Bismut Mehdi Sakka Dominique Bonnefont-Rousselot Philippe Sultanik Sarah Mouri Marika Rudler Dominique Thabut Sorbonne Université AP-HP.Sorbonne UniversitéHôpital de la Pitié-SalpêtrièreDépartement de NeurologieUnitéde Médecine Intensive RéanimationàOrientation NeurologiqueParisFrance Brain Liver Pitié-Salpêtrière(BLIPS)Study group INSERM UMR_S 938Centre de recherche Saint-AntoineMaladies métaboliquesBiliaires et Fibro-Inflammatoire du FoieInstitute of Cardiometabolism and Nutrition(ICAN)ParisFrance groupe de Recherche clinique en REanimation et Soins intensifs du Patient en Insuffisance Respiratoire aiguE(gRC-RESPIRE)Sorbonne Université ParisFrance Assistance Publique-Hôpitaux de Paris AP-HP.Sorbonne UniversitéHôpital de la Pitié-SalpêtrièreService d'hépato-GastroentérologieUnitéde Soins Intensifs d'HépatologieParisFrance Assistance Publique-Hôpitaux de Paris AP-HP.Sorbonne UniversitéService de Biochimie MétaboliqueHôpitaux Universitaires Pitié-Salpêtrière-Charles FoixDMU BioGeMParis F-75013France UniversitéParis Cité UFR de PharmacieCNRSInsermUTCBSParisFrance

Background Hepatic encephalopathy(HE)is highly prevalent in patients with liver *** pathophysiology of HE is centered on the synergic role of hyperammonemia and systemic ***,some data suggest altered functioning of the blood–brain barrier(BBB).Assessing BBB function is challenging in clinical practice and at the ***-S-100 Beta(PS100-Beta)could be a useful peripheral marker of BBB permeability in *** study aimed to assess plasmatic PS100-Beta levels in a prospective cohort of patients admitted to the intensive care unit(ICU)with decompensated cirrhosis with and without overt *** We retrospectively evaluated a prospective cohort of cirrhotic patients admitted to the ICU from October 2013 to September 2015 that had an available plasmatic PS100-Beta *** with previous neurological impairment or limitation of intensive or resuscitative measures were *** HE was defined as West-Haven grades 2 to *** patients were compared to a control cohort of outpatient clinic cirrhotic and non-cirrhotic patients explored for isolated elevation of liver *** ICU discharge,the patients were followed for at least 3 months for the occurrence of overt *** outcomes(liver transplantation or death)were *** ability of PS100-Beta–in combination with other factors–to predict overt HE was evaluated in a multivariate analysis using logistic *** ratios were used to determine the effects and calculate odds ratios(OR).Survival analysis was performed by using the Kaplan–Meier method and survival between groups was compared using a Log-rank *** A total of 194 ICU patients and 207 outpatients were included in the *** levels of plasmatic PS100-Beta were detected in the ICU decompensated cirrhotic patients compared with the outpatients([0.15±0.01]mg/L vs.[0.08±0]mg/L,Pgher levels of PS100-Beta([0.19±0.03]mg/L)compared with the

关键词： Cirrhosis Hepatic encephalopathy Blood-brain barrier PS100-Beta Liver disease

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Phytochemical Analysis and Antimicrobial Activity of Lawsonia inermis Leaf Extracts from Burkina Faso

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American Journal of Plant Sciences 2024年第7期15卷 552-576页

作者： Ollo Youl Soumaïla Konaté Ernest N. Sombié Rainatou Boly Boukaré Kaboré Moumouni Koala Arouna Zoungrana Saybou Savadogo Christian Marc Tahita Innocent Valea Halidou Tinto Adama Hilou Maminata Traoré-Coulibaly Laboratoire de Biochimie et de Chimie Applique (LABIOCA) Universit de Ouagadougou Ouagadougou Burkina Faso Agence Nationale Pour la Scurit Sanitaire de lEnvironnement de lAlimentation du Travail et des Produits de Sant (ANSSEAT) Ouagadougou Burkina Faso Laboratoire de Recherche-Dveloppement de Phytomdicaments et Mdicaments (L-RD/PM) Institut de Recherche en Sciences de la Sant (IRSS-CNRST) Ouagadougou Burkina Faso Laboratoire de Chimie Organique et de Physique Applique (LCOPA) cole Doctorale Sciences et Technologie Universit Joseph KI-ZERBO Ouagadougou Burkina Faso Laboratoire Sciences de la Vie et de la Terre (LASVT) cole Doctorale Sciences et Technologie Universit Norbert ZONGO Koudougou Burkina Faso Unit de Recherche clinique de Nanoro Institut de Recherche en Sciences de la Sant (IRSS-CNRST) Nanoro Burkina Faso

Lawsonia inermis is a hairless plant growing in various regions of North Africa, the Indian subcontinent, and the Middle East. It possesses many medicinal attributes, including curative properties against infectious dermatoses. This study was carried out to evaluate the phytochemical profile of the crude ethanolic extract of the plant leaves and its fractions as well as their antimicrobial activities. The phytochemical profile was performed using high-performance thin-layer chromatography (HPTLC), gas chromatography-mass spectrometry (gC-MS), and high-performance liquid chromatography (HPLC). Additionally, the phenolic and flavonoid contents were determined using the Folin-Ciocalteu spectrophotometric and the aluminum trichloride methods. Antimicrobial activity was tested using disc diffusion and microdilution methods. The presence of flavonoids, tannins, sterols, and triterpenes was revealed. gC-MS detected twelve compounds main compounds consisting of saturated and unsaturated fatty acids and phenolic and terpenoid compounds among twenty-seven components. HPLC also detected high contents of phenolic acids and flavonoids. The most abundant triterpene and sterols were ursolic acid (around 43.14 g/100g DW, 13.9 g/100g dry weight (DW), and 0.68 g/100g DW) in the crude ethanolic extract of leaves (FeLi), hexane fraction (FHLi) and dichloromethane fraction (FDLi), respectively and, β-sitosterol in FeLi (56.7 mg/100g DW), FHLi (10.55 g/100g DW), FDLi (106.1 mg/100g DW) and butanol fraction (FBLi) (357.4 mg/100g DW). Among the flavonoids, rutin = 3.24 g/100g and quercetin = 0.63 g/100g in the ethanolic extract, rutin = 15.73 g/100g in the dichloromethane fraction, and rutin = 0.23 g/100g) in the aqueous fraction;and among phenolic compounds, caffeic acid (37.65 g/100g DW) and vanillic acid (22.70 g/100g DW) were the most important in the ethyl acetate fraction (FAeLi). All organic fractions exhibited interesting antibacterial and antifungal activities against the tested s

关键词： Lawsonia inermis Phytochemical Profile HPLC gC-MS Analysis Antimicrobial Activity

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Profile of Extra-Pulmonary Tuberculosis in Internal Medicine

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Open Journal of Internal Medicine 2024年第1期14卷 64-73页

作者： Mouhamed Dieng Djiby Sow demba Diédhiou Michel Assane Ndour Boundia Djiba Mouhamed Almahy Niang Matar Ndiaye Oumar Boun Khattab Diouf Fatou Kiné gadji Anna Sar Maïmouna Ndour Mbaye clinique Médicale II H&ocircpital Aristide Abass Ndao Université Cheikh Anta Diop Dakar Sénégal

Introduction: Tuberculosis is an infectious disease that mainly affects the lung. Extrapulmonary localizations are a reason for hospitalization in our health facilities. The objective of this study was to describe the epidemiological, clinical, paraclinical and evolutionary aspects of extra pulmonary tuberculosis (EPT) at the Abass Ndao Hospital Center. Patients and Methods: This was a descriptive cross-sectional study conducted over a period of 11 years (January 1, 2010 to december 30, 2021). All patients with extrapulmonary tuberculosis hospitalized in the department of internal medicine during the recruitment period were included. Results: Fifty-two (52) patients were collected. The year 2019 recorded the most cases 23.08% (n = 20). The mean age of the patients was 40.56 ± 18.24 years. The age group 20 - 34 years 42.31% (n = 22) was the most represented. Females were in the majority 61.54% (n = 32) with a sex ratio (M/F) was 0.63. Housewives were in the majority 40.38% (n = 21). 60.87% of the cases (n = 14) came from a health facility. 38.46% of the cases had been infected. 21.74% (n = 9) were smokers. The reasons for consultation were dominated by fever (67.44%), AEg (62.79%) and cough (41.86%). Eighteen patients (40.91%) had fever. The mean time to consultation was 77.37 ± 90.3 days with extremes of 3 and 365 days. The median was 45 days. More than half of the patients 61.90% (n = 26) had anemia. Positive retroviral serology was noted in 21.43% of cases. All patients had a CRP greater than 6. More than half of the patients 51.92% (n = 27) had multifocal tuberculosis. The peritoneum 44.23% (n = 23) was the main organ affected. The average hospital stay was 9.8 ± 4.9 days with extremes of 1 and 19 days. All patients had received the protocol in force at the national level. death was noted in 4 patients (9.52%). Conclusion: EPT is characterized in our context by a notorious diagnostic difficulty due to the multiplicity of clinical presentations, the complexity of

关键词： Extrapulmonary Tuberculosis Epidemiology Diagnosis Senegal

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Epidemiological Aspects of Obesity, Overweight and Cardiovascular Risk Factors at Associes in Semi-Urban Areas (Case of Sébikotane)

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Food and Nutrition Sciences 2024年第5期15卷 390-400页

作者： Djiby Sow Nafy Ndiaye Mouhamed Yakham Leye Maty Diagne Camara Michel Assane Ndour Mouhamed Dieng Houleye Saou Ndiouga Fall Boundia Djiba demba Diédhiou Im Diallo Anna Sarr Mbaye Maimouna Ndour Abdoulaye Leye clinique Mé dicale II Centre Hospitalier Abass Ndao Universit&#233 Cheikh Anta Diop de Dakar Dakar Senegal Pikine department of Internal Medicine and Endocrinology Cheikh Anta Diop University Dakar Senegal department of Public Health Cheikh Anta Diop University Dakar Senegal

Introduction: Obesity and overweight are a public health problem. The general objective was to determine the epidemiological aspects of obesity, overweight and associated risk factors in a semi-urban environment. Patients and Methods: This was a cross-sectional, descriptive study conducted on November 28 and 29, 2023 in Sébikotane. It focused on volunteers for screening for chronic non-communicable diseases. Epidemiological and clinical data were evaluated. Results: One hundred and twenty-nine cases of obesity were recorded (28%). Two hundred and eighty-two cases were overweight or obese (61.3%). The mean age was 49.55 years, with a standard deviation of 12.41 years. The age group [40 - 49 years] was the most representative, with 85 cases (30.1%), and the majority were female, with 264 cases (93.6%). Primary education was the most common, with 75 cases (46.3%). grade 1 obesity concerned ninety-seven cases (75.2%), and diabetes was present in thirty cases (23%). Hypertension was present in ninety-five cases (33.7%). Obesity was more marked in the age group [40 - 49 years] with 45 cases (36%). Conclusion: Obesity and overweight are a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.

关键词： Obesity Overweight Risk Factors Sébikotane Senegal

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Survey on Knowledge of Cardiovascular Disease Risk Factors in the Dakar Region

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Journal of Diabetes Mellitus 2024年第2期14卷 122-132页

作者： Djiby Sow Nafy Ndiaye Mouhamed Yakham Leye Fulgence A. Faye Michel Assane Ndour Marie Joseph gomis Fall Ndiouga Mouhamed Dieng Boundia Djiba Houleye Saou Ibrahima M. Diallo demba Diédhiou Anna Sarr Mbaye Maimouna Ndour Abdoulaye Leye clinique Mé dicale II Centre Hospitalier Abass Ndao UCAD Dakar Senegal department of Internal Medicine and Endocrinology Centre Hospitalier Pikine Dakar Senegal department of Medicine Faculty of Health and Sustainable Development Alioune Diop University of Bambey Bambey Senegal

Introduction: Non-communicable diseases constitute a major public health problem, due to their morbi-mortality. The aim was to study knowledge of cardiovascular risk factors among residents of Dakar. Patients and Methods: This was a descriptive cross-sectional study. Our investigations were recruited over a six-month period (October 17, 2021 to March 21, 2022). Results: Two hundred and twenty-six (226) patients were enrolled. The mean age was 45.9 years. The under-40 age group was the most represented with 37.2%. There were 129 men (57.1%), giving a male/female sex ratio of 1.33. The highest level was represented by 159 people (70.4%). Those who responded (heart disease) were in the majority (38.1%). Hypertension was the most common CVD for 101 people (44.7%). One hundred and ninety (190) people (84%) knew the risk factors for CVD. good knowledge of risk factors concerned 103 people (54.2%). Obesity was the best-known risk factor in 156 cases (69%). The media was the most important source of information for 121 people (53.5%). Hypertensives were the most represented with 8.4%. One hundred and thirty (130) people (57.5%) had previously paid attention to these FDRCVs. Awareness campaigns were the most effective means of communication for 170 cases (75.2%). Sixteen (16) people (35.6%) were taking antihypertensive medication. Walking was the most popular physical activity for 102 people (45%). People with a balanced diet were in the majority, with 174 respondents (77.0%). Conclusion: NCDs are a major cause of morbidity and mortality. It is essential to develop and implement a prevention and management program.

关键词： Hypertension Diabetes Risk Factors Senegal

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Modern technology,liver surgery and transplantation

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Hepatobiliary & Pancreatic Diseases International 2022年第4期21卷 307-309页

作者： Jan Lerut Institut de Recherche Expérimentale et clinique Universitécatholique de LouvainAvenue Hippocrate 551200BrusselsBelgium

Since the first right hepatectomy performed by Jean-Louis Lortat-Jacob on October 16,1951 and the first liver transplantation by Thomas Earl Starzl on March 1,1963,hepatobiliary surgery and liver transplantation had a spectacular development[1,2].After the hesitating beginning in the 1950’s and 1960’s,their evolution really took off in the 1980’,reaching high-speed velocity in the 21st century.

关键词： surgery liver really

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Immunovirological Profile of HIV1 Infection in Children and Adolescents Followed at the Bangui Pediatric University Hospital

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Open Journal of Pediatrics 2024年第3期14卷 585-597页

作者： Simplice Cyriaque Kango Synthia Ningatoloum Nazita Marie Colette Nganda-Bangue Michaël Dan-Houron Alexandre Manirakiza Jean Chrysostome gody department of The clinique Mé dicale Infantile Raymond Max Siopathis University Children&#8217s Hospital Bangui CAR Faculty of Health Sciences (FACSS) Bangui CAR National Laboratory of Clinical Biology and Public Health Bangui CAR Pasteur Institute Bangui CAR

History: Pediatric management of HIV infection in children in the Central African Republic began in 2004 with the use of fractionated adult antiretrovirals and Cotrimoxazole. It has evolved over the years with the use of pediatric forms, oral suspensions and dispersible tablets. The transition to Dolutegravir took place in 2020. The active file of our patients will grow from 78 to over 1900 today. Follow-up examinations are carried out to assess adherence to treatment. Objective: To determine the immunovirological profile and factors associated with treatment failure during follow-up of children on ART at the Bangui pediatric university hospital. Patients and Method: This was a cross-sectional, analytical study from May 30 to december 02, 2022. The study sample was drawn from a cohort of HIV-1-infected children followed up at the Bangui pediatric university hospital and on ART for three semesters who met the selection criteria. Results: The prevalence of treatment failure varied from one semester to the next. Thus, the prevalence of therapeutic failure was 20% in the first semester, 10% in the second semester and 7% in the third semester. The prevalence of virological failure was 10.28% in the first half of the year, 6.91% in the second half and 4.98% in the third. Secondly, immunological failure was 0.48% in the first half of the year, 0.32% in the second 0.64% in the third half. Finally, clinical failure was 8.82% in the first half, 4.82% in the second half, 1.92% in the third half. Socio-demographic and clinical factors associated with treatment failure were male gender (p 1000 copies/ml (p Conclusion: The occurrence of treatment failures in children is a major problem, especially in our resource-limited countries, given the challenges facing antiretroviral therapy. It is therefore necessary to carry out a study on resistance genotyping in order to propose correct management protocols, as the future of treatment programs depends on it.

关键词： Profile Immunovirological HIV/AIDS Children Bangui

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