992 resultados para Paris (France) -- District de la Cité


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La Cité de Dieu a été rédigée dans une perspective polémique vis-à-vis les païens. La prise de Rome, en 410, a entraîné en Afrique du Nord la venue d’une élite cultivée, revivaliste et admirative du vieux polythéisme. Contre cette mouvance nostalgique, tributaire des anciens majoritairement sur le plan intellectuel et livresque, Augustin s’en prend à la bibliothèque des nouveaux arrivants. La Cité de Dieu peut, le cas échéant, être lue par la négative, c’est-à-dire par le biais de la critique qu’élabore Augustin de trois auteurs choisis, Varron, Cicéron et Salluste, qui résument et représentent conjointement l’essence de la culture classique. Tant chez les païens que chez l’évêque d’Hippone – leur détracteur –, Varron incarne la fine pointe de la théologie romano-hellénistique, Salluste est celui qui a mené à sa perfection la discipline de l’histoire, Cicéron a écrit le parachèvement des oeuvres sur la République, et chacun préconise sa structure idéologique propre, les trois domaines formant pourtant un ensemble systémique. Tout en louant ses illustres prédécesseurs, Augustin leur porte une critique générale et c’est à cette critique que seront consacrées nos analyses.

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Background: In acute lung injury positive end-expiratory pressure (PEEP) and recruitment maneuver are proposed to optimize arterial oxygenation. The aim of the study was to evaluate the impact of such a strategy on lung histological inflammation and hyperinflation in pigs with acid aspiration-induced lung injury. Methods: Forty-seven pigs were randomly allocated in seven groups: (1) controls spontaneously breathing; (2) without lung injury, PEEP 5 cm H2O; (3) without lung injury, PEEP titration; (4) without lung injury, PEEP titration + recruitment maneuver; (5) with lung injury, PEEP 5 cm H2O; (6) with lung injury, PEEP titration; and (7) with lung injury, PEEP titration + recruitment maneuver. Acute lung injury was induced by intratracheal instillation of hydrochloric acid. PEEP titration was performed by incremental and decremental PEEP from 5 to 20 cm H2O for optimizing arterial oxygenation. Three recruitment maneuvers (pressure of 40 cm H2O maintained for 20 s) were applied to the assigned groups at each PEEP level. Proportion of lung inflammation, hemorrhage, edema, and alveolar wall disruption were recorded on each histological field. Mean alveolar area was measured in the aerated lung regions. Results: Acid aspiration increased mean alveolar area and produced alveolar wall disruption, lung edema, alveolar hemorrhage, and lung inflammation. PEEP titration significantly improved arterial oxygenation but simultaneously increased lung inflammation in juxta-diaphragmatic lung regions. Recruitment maneuver during PEEP titration did not induce additional increase in lung inflammation and alveolar hyperinflation. Conclusion: In a porcine model of acid aspiration-induced lung injury, PEEP titration aimed at optimizing arterial oxygenation, substantially increased lung inflammation. Recruitment maneuvers further improved arterial oxygenation without additional effects on inflammation and hyperinflation.