Devenir à long terme des patients intubés pour état de mal asthmatique [Late outcome after life-threatening asthma]

Pour connaître le devenir à long terme des patients intubés pour état de mal asthmatique, nous avons recontacté en 1990 les 34 patients qui avaient présenté, entre 1978 et 1988, quarante épisodes de détresse respiratoire aiguë. Deux patients sont vivants mais ont été perdus de vue, 3 sont morts dont un seul d'état de mal asthmatique 6 mois après l'épisode initial. Des 29 patients restants (7 hommes et 22 femmes, âge moyen de 48,5 ans) représentant un suivi moyen de 9,6 ans, quinze n'ont jamais été réhospitalisés; des 14 autres, seuls 5 ont requis une intubation et une ventilation mécanique lors d'un épiode ultérieur. La majorité des hospitalisations ultérieures (81%) sont survenues dans les 6 ans suivant l'épiode initial

Roman amphora trade across the Straits of Gibraltar: An ancient 'anti-economic practice'?

Summary. Olive oil and fish products from the south of Hispania and North Africa played an important role in the Roman economy. The authors call attention to the asymmetrical distribution of archaeological data available on this subject, in particular the location of amphora kilns, and try to give an explanation, based on the evolution of European archaeology in the twentieth century.

Naevus du repli semi-lunaire de la conjonctive de découverte tardive [Conjunctival semi-lunar fold nevus of presumed late onset].

Conjunctival nevi are lesions observed commonly occasionnally and can be found later in a life. Such a lesion was observed on the conjunctival semilunar fold in a 76-year-old female patient. It was oval in shape, pigmented, and was mainly visible when the affected eye was in abduction. As no accurate anterior clinical history was available, surgical resection was performed. Hitopathological study disclosed a subepithelial nevus, which was completely resected. Regular follow-up was recommended, as is usual after surgical resection of a conjunctival pigmented tumor.

Roman d'apprentissage et liberté romanesque

RésuméA l'image de son personnage, qui se déplace en subissant toutes sortes d'expériences lui permettant de « grandir », le roman d'apprentissage traverse les siècles et les cultures en Occident, mais trouve aussi un écho tout à fait particulier parmi de nombreux romans d'Afrique noire francophone. Ce genre littéraire se découvre tant parmi les productions de l'époque coloniale que parmi les plus contemporaines et peut être envisagé en tant que métaphore d'une autonomie langagière et littéraire progressivement acquise, tout en gardant à l'esprit que les catégories génériques occidentales n'ont pas à être dupliquées telles quelles sur les productions fictionnelles africaines. L'hypothèse de travail associe les dimensions diachronique et synchronique pour observer un croisement de pratiques formelles et génériques dans les textes de fiction romanesque d'Afrique subsaharienne. Elle utilise dans ce cadre les romans Karim d'Ousmane Socé (1935) et Une Vie de boy de Ferdinand Oyono (1956).AbstractLike their protagonists, who undergo a journey and in the process come of age, coming-on-age novels have abounded and evolved throughout the centuries in the West - but they are also present in sub-Saharian African literature. The coming-of-age genre was popular during colonial times and is even more so today. Where African Francophone literature is concerned, we can take this type of novel as a metaphor for its gradually acquired linguistic and literary autonomy, keeping in mind that Western genres and patterns cannot be applied willy-nilly to this new generation of African litterateurs. Taking into account both historical and territorial aspects, we will examine African Francophone literature, stylistically and thematically, in its approch to gender. To do so, we will analyse Ousmane Socé's Karim (1935) and Ferdinand Oyono's Une vie de boy (A boy servant's life, 1956).

Late Triassic phaeodarian Radiolaria from the Northern Chichibu Belt, Shikoku, Japan

A new genus (Triassiphaeodina gen. nov.) and two new species (Medusetta japonica sp. nov. and Triassiphaeodina niyodoensis sp. nov.) of Late Triassic (Rhaetian) phaeodarian Radiolaria are described from a phosphatic nodule found in melange rocks of the Northern Chichibu Belt, Shikoku, Japan. The Rhaetian age of the nodule and of the phaeodarian new taxa is based on co-occurring Polycystina Radiolaria, including Bipedis acrostylus Bragin, Livarella densiporata Kozur and Mostler, Fontinella primitiva Carter, and Ferresium sp. A of Carter (1993). This finding shows that phaeodarian Radiolaria were already represented in Late Triassic oceans, with morphologies similar to those known in the Late Cretaceous and Cenozoic, from which they have previously been reported. The new taxa described herein represent the oldest known phaeodarian fossils.

Treatment of genital mycoplasma in colonized pregnant women in late pregnancy is associated with a lower rate of premature labour and neonatal complications.

Mycoplasma hominis and Ureaplasma spp. may colonize the human genital tract and have been associated with adverse pregnancy outcomes such as preterm labour and preterm premature rupture of membranes. However, as these bacteria can reside in the normal vaginal flora, there are controversies regarding their true role during pregnancy and so the need to treat these organisms. We therefore conducted a retrospective analysis to evaluate the treatment of genital mycoplasma in 5377 pregnant patients showing symptoms of potential obstetric complications at 25-37 weeks of gestation. Women presenting with symptoms were routinely screened by culture for the presence of these bacteria and treated with clindamycin when positive. Compared with uninfected untreated patients, women treated for genital mycoplasma demonstrated lower rates of premature labour. Indeed preterm birth rates were, respectively, 40.9% and 37.7% in women colonized with Ureaplasma spp. and M. hominis, compared with 44.1% in uncolonized women (Ureaplasma spp., p 0.024; M. hominis, p 0.001). Moreover, a reduction of neonatal complications rates was observed, with 10.9% of newborns developing respiratory diseases in case of Ureaplasma spp. colonization and 5.9% in the presence of M. hominis, compared with 12.8% in the absence of those bacteria (Ureaplasma spp., p 0.050; M. hominis, p <0.001). Microbiological screening of Ureaplasma spp. and/or M. hominis and pre-emptive antibiotic therapy of symptomatic pregnant women in late pregnancy might represent a beneficial strategy to reduce premature labour and neonatal complications.

Strategies for preventing late-onset cytomegalovirus disease in organ transplant recipients.

Objective: The incidence of late-onset cytomegalovirus disease (i.e. disease appearing after discontinuation of antiviral prophylaxis) in solid-organ transplant recipients remains excessively high. This review will focus on describing the several strategies that could potentially reduce the incidence of late-onset cytomegalovirus disease. Methods: We reviewed the literature and presented our own clinical experience in the field. Results: The incidence of late-onset cytomegalovirus disease in recent trials can be as high as 36% in high-risk patients (donor positive/recipient negative for cytomegalovirus). The extension of antiviral prophylaxis to six months has recently proven in a prospective randomized controlled trial to be effective for reducing late-onset cytomegalovirus disease. The monitoring of cytomegalovirus viral load by PCR after the discontinuation of prophylaxis seems to be of moderate usefulness in low/intermediate-risk patients. The use of low-dose valganciclovir could reduce drug toxicity and costs while maintaining similar efficacy, but further studies are needed. A potentially interesting approach to predict the individual risk for development of cytomegalovirus disease appears to be the assessment of specific cell-mediated immune response. If cell-mediated immunity assays become widely available in transplant centers in the future, these assays may possibly be used to tailor the cytomegalovirus preventive strategy on an individual basis. Finally, recent prospective trials have evaluated novel cytomegalovirus vaccines that merit further evaluation in the transplant setting, although currently there is no cytomegalovirus vaccine that has been approved for routine clinical use. Conclusions: Several studies have recently evaluated novel strategies to reduce the incidence of late-onset cytomegalovirus disease. It is therefore expected that this improvement in preventive strategies will allow to further reduce the negative effects of cytomegalovirus disease after transplantation.