The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a Multicenter, Multinational, 14-Day Inception Cohort Study

PURPOSE: In this prospective, multicenter, 14-day inception cohort study, we investigated the epidemiology, patterns of infections, and outcome in patients admitted to the intensive care unit (ICU) as a result of severe acute respiratory infections (SARIs). METHODS: All patients admitted to one of 206 participating ICUs during two study weeks, one in November 2013 and the other in January 2014, were screened. SARI was defined as possible, probable, or microbiologically confirmed respiratory tract infection with recent onset dyspnea and/or fever. The primary outcome parameter was in-hospital mortality within 60 days of admission to the ICU. RESULTS: Among the 5550 patients admitted during the study periods, 663 (11.9 %) had SARI. On admission to the ICU, Gram-positive and Gram-negative bacteria were found in 29.6 and 26.2 % of SARI patients but rarely atypical bacteria (1.0 %); viruses were present in 7.7 % of patients. Organ failure occurred in 74.7 % of patients in the ICU, mostly respiratory (53.8 %), cardiovascular (44.5 %), and renal (44.6 %). ICU and in-hospital mortality rates in patients with SARI were 20.2 and 27.2 %, respectively. In multivariable analysis, older age, greater severity scores at ICU admission, and hematologic malignancy or liver disease were independently associated with an increased risk of in-hospital death, whereas influenza vaccination prior to ICU admission and adequate antibiotic administration on ICU admission were associated with a lower risk. CONCLUSIONS: Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients.

Mechanisms of inflammation in gout.

An acute attack of gout is a paradigm of acute sterile inflammation, as opposed to pyogenic inflammation. Recent studies suggest that the triggering of IL-1beta release from leucocytes lies at the heart of a cascade of processes that involves multiple cytokines and mediators. The NLRP3 inflammasome appears to have a specific role in this regard, but the biochemical events leading to its activation are still not well understood. We review the known mechanisms that underlie the inflammatory process triggered by urate crystals and suggest areas that require further research.

Wound infection after excision and primary midline closure for pilonidal disease: risk factor analysis to improve patient selection.

BACKGROUND: Excision and primary midline closure for pilonidal disease (PD) is a simple procedure; however, it is frequently complicated by infection and prolonged healing. The aim of this study was to analyze risk factors for surgical site infection (SSI) in this context. METHODS: All consecutive patients undergoing excision and primary closure for PD from January 2002 through October 2008 were retrospectively assessed. The end points were SSI, as defined by the Center for Disease Control, and time to healing. Univariable and multivariable risk factor analyses were performed. RESULTS: One hundred thirty-one patients were included [97 men (74%), median age = 24 (range 15-66) years]. SSI occurred in 41 (31%) patients. Median time to healing was 20 days (range 12-76) in patients without SSI and 62 days (range 20-176) in patients with SSI (P < 0.0001). In univariable and multivariable analyses, smoking [OR = 2.6 (95% CI 1.02, 6.8), P = 0.046] and lack of antibiotic prophylaxis [OR = 5.6 (95% CI 2.5, 14.3), P = 0.001] were significant predictors for SSI. Adjusted for SSI, age over 25 was a significant predictor of prolonged healing. CONCLUSION: This study suggests that the rate of SSI after excision and primary closure of PD is higher in smokers and could be reduced by antibiotic prophylaxis. SSI significantly prolongs healing time, particularly in patients over 25 years.

Effects of sodium arsenite on neurite outgrowth and glutamate AMPA receptor expression in mouse cortical neurons.

There has been broad concern that arsenic in the environment exerts neurotoxicity. To determine the mechanism by which arsenic disrupts neuronal development, primary cultured neurons obtained from the cerebral cortex of mouse embryos were exposed to sodium arsenite (NaAsO2) at concentrations between 0 and 2μM from days 2 to 4 in vitro and cell survival, neurite outgrowth and expression of glutamate AMPA receptor subunits were assessed at day 4 in vitro. Cell survival was significantly decreased by exposure to 2μM NaAsO2, whereas 0.5μM NaAsO2 increased cell survival instead. The assessment of neurite outgrowth showed that total neurite length was significantly suppressed by 1μM and 2μM NaAsO2, indicating that the lower concentration of NaAsO2 impairs neuritogenesis before inducing cell death. Immunoblot analysis of AMPA receptor subunit expression showed that the protein level of GluA1, a specific subunit of the AMPA receptor, was significantly decreased by 1μM and 2μM NaAsO2. When immunocytochemistry was used to confirm this effect by staining for GluA1 expression in neuropeptide Y neurons, most of which contain GluA1, GluA1 expression in neuropeptide Y neurons was found to be significantly suppressed by 1μM and 2μM NaAsO2 but to be increased at the concentration of 0.5μM. Finally, to determine whether neurons could be rescued from the NaAsO2-induced impairment of neuritogenesis by compensatory overexpression of GluA1, we used primary cultures of neurons transfected with a plasmid vector to overexpress either GluA1 or GluA2, and the results showed that GluA1/2 overexpression protected against the deleterious effects of NaAsO2 on neurite outgrowth. These results suggest that the NaAsO2 concentration inducing neurite suppression is lower than the concentration that induces cell death and is the same as the concentration that suppresses GluA1 expression. Consequently, the suppression of GluA1 expression by NaAsO2 seems at least partly responsible for neurite suppression induced by NaAsO2.

Prevalence of overweight and obesity among migrants in Switzerland: association with country of origin.

Migrants tend to present higher overweight and obesity levels, but whether this relationship applies to all nationalities has seldom been studied. The present study aimed to assess the prevalence of overweight and obesity according to nationality in adults. Cross-sectional population-based samples. Five-year nationwide interview surveys (Swiss Health Surveys - SHS) from 1992 to 2007 (n 63 766) and a local examination survey (CoLaus Study in Lausanne 2004-2006, n 6743). Participants were separated into Swiss, French, German, Italian, Portuguese, Spanish nationals, those from the former Republic of Yugoslavia and from other European and other countries. Compared with Swiss nationals, German and French nationals presented a lower prevalence of overweight and obesity, whereas nationals from Italy, Spain, Portugal and the former Republic of Yugoslavia presented higher levels. Adjusting the SHS data for age, gender, education, smoking, leisure-time physical activity and survey year, a lower risk for overweight and obesity was found for German (OR = 0·80, 95 % CI 0·70, 0·92) and French (OR = 0·74, 95 % CI 0·61, 0·89) nationals, whereas higher risks were found for participants from Italy (OR = 1·45, 95 % CI 1·33, 1·58), Spain (OR = 1·36, 95 % CI 1·15, 1·61), Portugal (OR = 1·25, 95 % CI 1·06, 1·47) and the former Republic of Yugoslavia (OR = 1·98, 95 % CI 1·69, 2·32). Similar findings were observed in the CoLaus Study for Italian (OR = 1·63, 95 % CI 1·29, 2·06), Spanish (OR = 1·54, 95 % CI 1·17, 2·04) and Portuguese (OR = 1·49, 95 % CI 1·16, 1·91) participants and for those from the former Republic of Yugoslavia (OR = 5·34, 95 % CI 3·00, 9·50). Overweight and obesity are unevenly distributed among migrants in Switzerland. Migrants from Southern Europe and from the former Republic of Yugoslavia present higher prevalence rates. This suggests that preventive messages should be tailored to these specific populations.

Comportamiento alimentario de los principales recursos pelágicos peruanos en verano y comienzos de otoño 1997

Se han analizado 626 contenidos estomacales de "anchoveta peruana" Engraulis ringes, 251 de "caballa" Scomber japonicus peruanus y 206 de "jurel" Trachurus picturatus murphyi, colectados entre lo 5°12 ' a 18°17 'S durante el verano de 1997. El alimento de la anchoveta estuvo compuesto por diatomeas, silicoflagelados, dinoflagelados, tintínidos, copépodos, entre los más importantes. La caballa y el jurel se alimentaron de crustáceos planctónicos destacando los eufáusidos; en la caballa, además e presentaron peces de las familias Engraulidae y Myctophidae. Usando el software MAXIMS se ha calculado la ración diaria de alimentación de la anchoveta en 0,4391 g.dia-1. Respecto a la caballa y al jurel se vienen realizando las primeras observaciones con este software, habiéndose determinado las raciones en 6,4452 g.dia-1 y 2,9129 g.dia-1, respectivamente. La similaridad alimentaria entre los mismos fue calculada utilizando el Índice de JACCARD que permitió observar diferencias sólo en la utilización del ítem anchoveta siendo la caballa la única que la consumió. En líneas generales la composición alimentaria observada corresponde a patrones e años normales.

L'Écho de Paris

1884/10/03 (Numéro 206).

Dialogus creaturarum, moralisatus, jucundus, fabulis plenus

[Dialogus creaturarum (latin). 1480]

Vetus Testamentum, pars.

Ce volume a été relié avec le BnF, Ms., Latin 104 pour former une bible complète, mais il semble que ces deux manuscrits ont été réalisés séparément, à une date et par un atelier différent. F. B, plusieurs notes du XIIIe siècle de mains différentes : au centre du feuillet : "Anno MCIII (sic) setagesimo IIII fu la fami per tutto lu mundu, et vauze lu tumenu de lu granu tr. XII" ; "Pahnutius humilis servus vestre sanctitatis".Au bas du feuillet : "Pahnutius humilis servus vestre sanctitatis" ; "Religioso viro venerabili abbati Santi Stephani de Nemore, salutem in Domino" ; "apnutius". F. 1, titre du XIIIe siècle : "Incipit epistula sancti Jeronimi presbiteri ad Paulinum de studio Scripturarum." Le manuscrit contient : Genesis (4) ; Exodus (20v) ; Levit. (34) ; Numeri (44v) ; Deuteron. (59) ; Josue (73) ; Judices (81v) ; Ruth (90) ; Reg. I-IV (91) ; Isaias (136) ; Jeremias (152) ; Baruch (170v) ; Jeremiae Lament. et Oratio (173, 174v) ; Ezechiel (175) ; Daniel (191v) ; XII Proph. min. (199).Avec prologues et « capitula » (sauf aux f. 90, 136, 152, 175, 192 et 199) . Quelques leçons en marge. F. 1-3v: Frater Ambrosius tua mihi munuscula perferens destulit...-... scripti sunt libri in latinum eos transferre sermonem. Explicit prefatio.F. 3v, tablesF. 4-124. "In principio creavit Deus caelum et terram ...-... et percutiam terram anathemate. Explicit Malachias propheta.