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1.
Sci Rep ; 12(1): 5928, 2022 Apr 08.
Article in English | MEDLINE | ID: mdl-35396372

ABSTRACT

A novel environmentally friendly recycling method is developed for large carbon-fibers reinforced-polymers composite panels whose efficiency is demonstrated through a proof-of-concept fabrication of a new composite part based on recycled fibers. The recycling process relies on formic acid as separation reagent at room temperature and atmospheric pressure with efficient recycling potential of the separating agent. Electron microscopy and thermal analysis indicate that the recycled fibers are covered by a thin layer of about 10wt.% of residual resin, alternating with few small particles, as compared to the smooth virgin fibers. The recycled composites show promising shear strength and compression after impact strength, with up to 93% retention of performance depending on the property as compared to the reference. The recycled carbon fibers can thus be reused for structural applications requiring moderate to high performances. The loss of properties is attributed to a lower adhesion between fresh epoxy resin and recycled carbon fibers due to the absence of sizing, partly compensated by a good interface between fresh and residual cured epoxy thanks to mechanical anchoring as well as chemical reactions. The room temperature and atmospheric pressure operating conditions combined to the recyclability of the forming acid contribute to the sustainability of the entire approach.

2.
Chemosphere ; 299: 134307, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35339522

ABSTRACT

For the performance assessment of radioactive waste disposal, it is critical to predict the mobility of radionuclides in the geological barrier that hosts it. A key challenge consists of assessing the transferability of current knowledge on the retention properties deduced from model systems to in natura situations. The case of the redox-sensitive element uranium in the Callovo-Oxfordian clay formation (COx) is presented herein. Extensive experimental work was carried out with respect to parameters affecting uranium speciation (pH, PCO2, [Ca] and redox potential) with illite, COx clay fraction and raw COx claystone. The "bottom-up" approach implemented, with illite and montmorillonite as reactive phases, quantitatively explains the adsorption results of U(VI) and U(IV) on COx. While retention is high for U(IV) (Rd∼104 L kg-1), it remains very low for U(VI) (Rd∼4 L kg-1) due to the formation of soluble ternary Ca(Mg)-U(VI)-carbonate complexes. The applicability of the sorption model was then assessed by comparing predictive analyses with data characterizing the behavior of naturally-occurring U (<3 mg kg-1). The COx clay phase is the largest reservoir of naturally-occurring U (∼65%) but only a small fraction appears to be adsorbed (∼1%). Under representative site conditions (especially with respect to reducing conditions), we have concluded that ternary U(VI) complexes control U speciation in solution while U(IV) surface species dominate U adsorption, with Rd values > 70 L kg-1.


Subject(s)
Uranium , Adsorption , Bentonite/chemistry , Carbonates , Clay , Uranium/analysis
3.
J Gynecol Obstet Hum Reprod ; 51(3): 102310, 2022 Mar.
Article in English | MEDLINE | ID: mdl-34998975

ABSTRACT

Femoral fracture is a rare but significant foetal injury, more frequent and likely to happen when the foetus is malpositioned or in a breech presentation. Cesarian section does not appear to be protective and all recent publications report cases occurring during cesarian section. We report a case that occurred in a vaginal delivery of a single footling breech presentation. This complication allows us to remind that femur fracture is a complication of breech delivery whatever the modality. The prognosis is good with early diagnosis.


Subject(s)
Breech Presentation , Femoral Fractures , Cesarean Section/adverse effects , Delivery, Obstetric/adverse effects , Female , Femoral Fractures/etiology , Femoral Fractures/surgery , Humans , Pregnancy
4.
Eur J Nucl Med Mol Imaging ; 48(3): 874-882, 2021 03.
Article in English | MEDLINE | ID: mdl-32820369

ABSTRACT

INTRODUCTION: This pilot study evaluated the imaging performance of pretargeted immunological positron emission tomography (immuno-PET) using an anti-carcinoembryonic antigen (CEA) recombinant bispecific monoclonal antibody (BsMAb), TF2 and the [68Ga]Ga-labelled HSG peptide, IMP288, in patients with metastatic colorectal carcinoma (CRC). PATIENTS AND METHODS: Patients requiring diagnostic workup of CRC metastases or in case of elevated CEA for surveillance were prospectively studied. They had to present with elevated CEA serum titre or positive CEA tumour staining by immunohistochemistry of a previous biopsy or surgical specimen. All patients underwent endoscopic ultrasound (EUS), chest-abdominal-pelvic computed tomography (CT), abdominal magnetic resonance imaging (MRI) and positron emission tomography using [18F]fluorodeoxyglucose (FDG-PET). For immuno-PET, patients received intravenously 120 nmol of TF2 followed 30 h later by 150 MBq of [68Ga]Ga-labelled IMP288, both I.V. The gold standard was histology and imaging after 6-month follow-up. RESULTS: Eleven patients were included. No adverse effects were reported after BsMAb and peptide injections. In a per-patient analysis, immuno-PET was positive in 9/11 patients. On a per-lesion analysis, 12 of 14 lesions were positive with immuno-PET. Median SUVmax, MTV and TLG were 7.65 [3.98-13.94, SD 3.37], 8.63 cm3 [1.98-46.64; SD 14.83] and 37.90 cm3 [8.07-127.5; SD 43.47] respectively for immuno-PET lesions. Based on a per-lesion analysis, the sensitivity, specificity, positive-predictive value and negative-predictive value were, respectively, 82%, 25%, 82% and 25% for the combination of EUS/CT/MRI; 76%, 67%, 87% and 33% for FDG-PET; and 88%, 100%, 100% and 67% for immuno-PET. Immuno-PET had an impact on management in 2 patients. CONCLUSION: This pilot study showed that pretargeted immuno-PET using anti-CEA/anti-IMP288 BsMAb and a [68Ga]Ga-labelled hapten was safe and feasible, with promising diagnostic performance. TRIAL REGISTRATION: ClinicalTrials.gov NCT02587247 Registered 27 October 2015.


Subject(s)
Colorectal Neoplasms , Gallium Radioisotopes , Antibodies, Monoclonal , Carcinoembryonic Antigen , Colorectal Neoplasms/diagnostic imaging , Fluorodeoxyglucose F18 , Heterocyclic Compounds, 1-Ring , Humans , Oligopeptides , Pilot Projects , Positron-Emission Tomography
5.
S Afr Med J ; 109(9): 673-678, 2019 Aug 28.
Article in English | MEDLINE | ID: mdl-31635593

ABSTRACT

BACKGROUND: Familial disease is implicated in 20 - 50% of cases of idiopathic dilated cardiomyopathy (IDCM) worldwide. The contribution of familial factors to IDCM in the Johannesburg area, South Africa, is unknown. OBJECTIVES: To describe the demographic details of patients with IDCM who presented at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), and to determine if there is evidence of familial disease through family history assessment and clinical screening of relatives. METHODS: This was a single-centre, cohort study performed at a quaternary care centre at CMJAH. Fifty unrelated probands diagnosed with IDCM and available first- and second-degree relatives were included in the study. A three-generation family pedigree was drawn up for all 50 probands. The pedigrees were analysed to identify the presence or absence of familial disease and categorised as positive, intermediate, negative or unreliable according to the family history obtained. From the 50 proband cases, there were 21 family members available for screening for features of IDCM. Eighty-two family members (55 first-degree and 27 second-degree relatives) were screened clinically. Screening included a personal history, full physical examination, electrocardiogram (ECG) and echocardiogram. RESULTS: The mean age at diagnosis of IDCM in the probands was 41.7 (standard deviation (SD) 12.4) years. The majority of probands were males (n=38; 76%). Of 50 pedigrees analysed, 14 (28%) were positive and likely to be indicative of familial dilated cardiomyopathy (DCM), and 9 (18%) patients were at intermediate risk of familial disease. Eighty-two asymptomatic family members were screened, with a median age of 33 (range 11 - 76) years. No asymptomatic family members were identified with features of DCM or presymptomatic DCM. Eleven of the 21 families screened had relatives with possible presymptomatic DCM identified by abnormalities on the echocardiogram in 3 families (14.3%) (4 individuals; all first-degree relatives of the index case) or identified on the basis of a conduction defect (an arrhythmia or first-/ second-/third-degree heart block) in 8 families (72.7%) (11 individuals; 9 first-degree and 2 second-degree relatives). CONCLUSIONS: Screening for IDCM should include a three-generation family history and clinical screening of all first-degree family members. As IDCM has an age-related penetrance, at-risk family members should receive follow-up for screening to assess symptoms and signs of IDCM. Genetic testing would potentially identify family members at high risk, who would benefit from screening; this might be a less expensive option.


Subject(s)
Cardiomyopathy, Dilated/epidemiology , Echocardiography , Family Health , Mass Screening/methods , Adolescent , Adult , Aged , Cardiomyopathy, Dilated/diagnosis , Child , Cohort Studies , Electrocardiography , Female , Genetic Testing/methods , Humans , Male , Middle Aged , South Africa/epidemiology , Young Adult
6.
S. Afr. med. j. (Online) ; 109(9): 673-678, 2019.
Article in English | AIM (Africa) | ID: biblio-1271248

ABSTRACT

Background. Familial disease is implicated in 20 - 50% of cases of idiopathic dilated cardiomyopathy (IDCM) worldwide. The contribution of familial factors to IDCM in the Johannesburg area, South Africa, is unknown.Objectives. To describe the demographic details of patients with IDCM who presented at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), and to determine if there is evidence of familial disease through family history assessment and clinical screening of relatives.Methods. This was a single-centre, cohort study performed at a quaternary care centre at CMJAH. Fifty unrelated probands diagnosed with IDCM and available first- and second-degree relatives were included in the study. A three-generation family pedigree was drawn up for all 50 probands. The pedigrees were analysed to identify the presence or absence of familial disease and categorised as positive, intermediate, negative or unreliable according to the family history obtained. From the 50 proband cases, there were 21 family members available for screening for features of IDCM. Eighty-two family members (55 first-degree and 27 second-degree relatives) were screened clinically. Screening included a personal history, full physical examination, electrocardiogram (ECG) and echocardiogram.Results. The mean age at diagnosis of IDCM in the probands was 41.7 (standard deviation (SD) 12.4) years. The majority of probands were males (n=38; 76%). Of 50 pedigrees analysed, 14 (28%) were positive and likely to be indicative of familial dilated cardiomyopathy (DCM), and 9 (18%) patients were at intermediate risk of familial disease. Eighty-two asymptomatic family members were screened, with a median age of 33 (range 11 - 76) years. No asymptomatic family members were identified with features of DCM or presymptomatic DCM. Eleven of the 21 families screened had relatives with possible presymptomatic DCM identified by abnormalities on the echocardiogram in 3 families (14.3%) (4 individuals; all first-degree relatives of the index case) or identified on the basis of a conduction defect (an arrhythmia or first-/ second-/third-degree heart block) in 8 families (72.7%) (11 individuals; 9 first-degree and 2 second-degree relatives).Conclusions. Screening for IDCM should include a three-generation family history and clinical screening of all first-degree family members. As IDCM has an age-related penetrance, at-risk family members should receive follow-up for screening to assess symptoms and signs of IDCM. Genetic testing would potentially identify family members at high risk, who would benefit from screening; this might be a less expensive option


Subject(s)
Cardiomyopathy, Dilated , Mass Screening
7.
Water Res ; 133: 47-59, 2018 04 15.
Article in English | MEDLINE | ID: mdl-29407714

ABSTRACT

Cold atmospheric plasmas are weakly ionized gases that can be generated in ambient air. They produce energetic species (e.g. electrons, metastables) as well as reactive oxygen species, reactive nitrogen species, UV radiations and local electric field. Their interaction with a liquid such as tap water can hence change its chemical composition. The resulting "plasma-activated liquid" can meet many applications, including medicine and agriculture. Consequently, a complete experimental set of analytical techniques dedicated to the characterization of long lifetime chemical species has been implemented to characterize tap water treated using cold atmospheric plasma process and intended to agronomy applications. For that purpose, colorimetry and acid titrations are performed, considering acid-base equilibria, pH and temperature variations induced during plasma activation. 16 species are quantified and monitored: hydroxide and hydronium ions, ammonia and ammonium ions, orthophosphates, carbonate ions, nitrite and nitrate ions and hydrogen peroxide. The related consumption/production mechanisms are discussed. In parallel, a chemical model of electrical conductivity based on Kohlrausch's law has been developed to simulate the electrical conductivity of the plasma-activated tap water (PATW). Comparing its predictions with experimental measurements leads to a narrow fitting, hence supporting the self-sufficiency of the experimental set, I.e. the fact that all long lifetime radicals of interest present in PATW are characterized. Finally, to evaluate the potential of cold atmospheric plasmas for agriculture applications, tap water has been daily plasma-treated to irrigate lentils seeds. Then, seedlings lengths have been measured and compared with untreated tap water, showing an increase as high as 34.0% and 128.4% after 3 days and 6 days of activation respectively. The interaction mechanisms between plasma and tap water are discussed as well as their positive synergy on agronomic results.


Subject(s)
Agricultural Irrigation , Plasma Gases , Water Purification , Ammonia/analysis , Ammonium Compounds/analysis , Carbonates/analysis , Colorimetry , Hydrogen Peroxide/analysis , Lens Plant/growth & development , Models, Chemical , Nitrates/analysis , Nitrites/analysis , Phosphates/analysis , Seeds/growth & development , Temperature , Water/analysis
8.
Anaesthesia ; 72(9): 1159, 2017 09.
Article in English | MEDLINE | ID: mdl-28804879
9.
J Acoust Soc Am ; 140(1): 641, 2016 07.
Article in English | MEDLINE | ID: mdl-27475186

ABSTRACT

Direct numerical simulations of the two-dimensional unsteady compressible Navier-Stokes equations are performed to study the acoustic field generated by an infrasonic source in a realistic atmosphere. Some of the main phenomena affecting the propagation of infrasonic waves at large distances from the source are investigated. The effects of thermal and wind-related refraction on the signals recorded at ground level are highlighted, with particular emphasis on the phase shift induced by the presence of caustics in the acoustic field. Nonlinear waveform steepening associated with harmonic generation, and period lengthening, both of which are typical of large source amplitudes, are illustrated, and the importance of thermoviscous absorption in the upper atmosphere is clearly demonstrated. The role of diffraction in the shadow zone, around caustics and at stratospheric altitudes is also pointed out. The Navier-Stokes equations are solved using high-order finite-differences and a Runge-Kutta time integration method both originally developed for aeroacoustic applications, along with an adaptive shock-capturing algorithm which allows high-intensity acoustic fields to be examined. An improvement to the shock detection procedure is also proposed in order to meet the specificities of nonlinear propagation at long range. The modeling as well as the numerical results are reported in detail and discussed.

10.
Arch Pediatr ; 23(6): 658-63, 2016 Jun.
Article in French | MEDLINE | ID: mdl-27133372

ABSTRACT

Inhaled corticosteroids are the cornerstone of asthma management. Inhaled corticosteroid regimens differ slightly in various international guidelines on asthma management but are based on the principles of continuous treatment and titration to the lowest effective dose. Several recent studies, nevertheless, appear to demonstrate the potential value of preemptive or "pro re nata" regimens in infants and children. These studies were included in GINA 2015 for children 5 years of age and younger in whom discontinuous treatment is proposed as a second-line option. Should we change our practices after a critical reading of these studies?


Subject(s)
Asthma/drug therapy , Glucocorticoids/therapeutic use , Nebulizers and Vaporizers , Administration, Inhalation , Child, Preschool , Dose-Response Relationship, Drug , Glucocorticoids/administration & dosage , Humans , Infant , Practice Guidelines as Topic
11.
Anat Histol Embryol ; 45(6): 450-456, 2016 Dec.
Article in English | MEDLINE | ID: mdl-26620874

ABSTRACT

Synovitis of the navicular bursa is common in performance horses. The objective of this study was to describe an ultrasound-guided technique to inject a distended navicular bursa and to evaluate its feasibility for use by a clinician not trained in the technique. Twenty distal limbs of horses of various breeds and sizes were used. To produce synovial distension, the navicular bursa of each limb was injected with contrast medium using a lateral approach and radiography was performed to confirm that the contrast medium was distending the bursa. The digit was positioned with the distal interphalangeal joint in hyperextension. A microconvex ultrasound probe was placed in the hollow of the pastern, palmar to the middle phalanx and the region was assessed in a transverse plane slightly oblique to the horizontal plane. The ultrasound probe was rotated to visualize both the lateral and medial recesses and to select which side was more distended to inject. A 21G 0.8 × 50 mm needle was inserted abaxially to the probe in the plane of the ultrasound beam into the proximal recess of this navicular bursa and a methylene blue solution was injected. Following injection, dissection was performed to assess whether the navicular bursa had been successfully injected. This ultrasound-guided technique was reliably performed with a success rate of 68%. The success of injection is influenced by hyperextension of the foot, quality of ultrasound images and degree of distension of the bursa.


Subject(s)
Bursa, Synovial/anatomy & histology , Hoof and Claw/anatomy & histology , Horses/anatomy & histology , Synovitis/diagnostic imaging , Synovitis/veterinary , Animals , Contrast Media , Forelimb/anatomy & histology , Hindlimb/anatomy & histology , Horse Diseases , Injections/methods , Tarsal Bones/anatomy & histology , Ultrasonography/veterinary
12.
Ann Bot ; 116(4): 669-78, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26346716

ABSTRACT

BACKGROUND AND AIMS: Loss of seed viability has been associated with deteriorative processes that are partly caused by oxidative damage. The breaking of dormancy, a seed trait that prevents germination in unfavourable seasons, has also been associated with oxidative processes. It is neither clear how much overlap exists between these mechanisms nor is the specific roles played by oxygen and reactive oxygen species. METHODS: Antioxidant profiles were studied in fresh (dormant) or after-ripened (non-dormant) sunflower (Helianthus annuus) embryos subjected to controlled deterioration at 40 °C and 75 % relative humidity under ambient (21 %) or high O2 (75 %). Changes in seed vigour and viability, dormancy, protein carbonylation and fatty acid composition were also studied. KEY RESULTS: After-ripening of embryonic axes was accompanied by a shift in the thiol-based cellular redox environment towards more oxidizing conditions. Controlled deterioration under high O2 led to a faster loss of seed dormancy and significant decreases in glutathione reductase and glutathione peroxidase activities, but viability was lost at the same rate as under ambient O2. Irrespective of O2 concentration, the overall thiol-based cellular redox state increased significantly over 21 d of controlled deterioration to strongly oxidizing conditions and then plateaued, while viability continued to decrease. Viability loss was accompanied by a rapid decrease in glucose-6-phosphate-dehydrogenase, which provides NADPH for reductive processes such as required by glutathione reductase. Protein carbonylation, a marker of protein oxidation, increased strongly in deteriorating seeds. The lipid-soluble tocochromanols, dominated by α-tocopherol, and fatty acid profiles remained stable. CONCLUSIONS: After-ripening, dormancy-breaking during ageing and viability loss appeared to be associated with oxidative changes of the cytosolic environment and proteins in the embryonic axis rather than the lipid environment. High O2 concentrations accelerated dormancy alleviation but, surprisingly, did not accelerate the rate of viability loss.


Subject(s)
Helianthus/growth & development , Oxygen/metabolism , Seeds/growth & development , Antioxidants/metabolism , Fatty Acids/metabolism , Glutathione/metabolism , Helianthus/metabolism , Oxidation-Reduction , Plant Dormancy , Protein Carbonylation , Seeds/metabolism , Vitamin E/metabolism
13.
Eur J Nucl Med Mol Imaging ; 42(12): 1784-93, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26194716

ABSTRACT

PURPOSE: To evaluate the therapeutic impact of (18)F-fluorocholine (FCH) PET/CT in biochemical recurrent prostate cancer (PC) and to investigate the value of quantitative FCH PET/CT parameters in predicting progression-free survival (PFS). METHODS: This retrospective study included 172 consecutive patients with PC who underwent FCH PET/CT for biochemical recurrence. Mean rising PSA was 10.7 ± 35.0 ng/ml. Patients with positive FCH PET were classified into three groups: those with uptake only in the prostatic bed, those with locoregional disease, and those with distant metastases. Referring physicians were asked to indicate the hypothetical therapeutic strategy with and without the FCH PET/CT results. Clinical variables and PET parameters including SUVmax, SUVpeak, SUVmean, total lesion choline kinase activity (TLCKA) and standardized added metabolic activity (SAM) were recorded and a multivariate analysis was performed to determine the factors independently predicting PFS. RESULTS: In 137 of the 172 patients, the FCH PET/CT scan was positive, and of these, 29.9 % (41/137) had prostatic recurrence, 42.3 % (58/137) had pelvic lymph node recurrence with or without prostatic recurrence, and 27.7 % (38/137) had distant metastases. The FCH PET/CT result led to a change in treatment plan in 43.6 % (75/172) of the 172 patients. Treatment was changed in 49.6 % (68/137) of those with a positive FCH PET/CT scan and in 20 % (7/35) of those with a negative FCH PET/CT scan. After a median follow-up of 29.3 months (95 % CI 18.9 - 45.9 months), according to multivariate analysis age <70 years, SAM ≥23 and SUVmean ≥3 were parameters independently predicting PFS. A nomogram constructed using the three parameters showed 49 months of PFS in patients with the best scores (0 or 1) and only 11 months in patients with a poor score (score 3). CONCLUSION: This study indicates that a positive FCH PET result in PC patients with biochemical recurrence predicts a shorter PFS and confirms the major impact of the FCH PET result on the management of biochemical recurrent PC.


Subject(s)
Choline/analogs & derivatives , Multimodal Imaging , Positron-Emission Tomography , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/metabolism , Tomography, X-Ray Computed , Aged , Aged, 80 and over , Disease-Free Survival , Follow-Up Studies , Humans , Male , Middle Aged , Prostatic Neoplasms/therapy , Recurrence , Retrospective Studies
14.
J Cyst Fibros ; 14(5): 615-20, 2015 Sep.
Article in English | MEDLINE | ID: mdl-25985911

ABSTRACT

BACKGROUNDS: Recent reports have pointed the low vaccine coverage in patients with chronic diseases. Data are lacking in patients with cystic fibrosis (CF). Gaining more information on coverage both for mandatory vaccines and those more specifically recommended would help to optimize care of these patients. METHODS: Data were extracted from the "MucoFlu" study, which was a prospective study performed in 2009 in the 5 cystic fibrosis centers of the Paris metropolitan area. Data on mandatory and recommended vaccines in CF were collected in the health booklet and compared to the coverage of the general population. RESULTS: A total of 134 CF children were included. Vaccination coverage for mandatory vaccines was insufficient (DTPCaHi, conjugate pneumococcal, BCG, MMR and hepatitis B) at 1year of age with no catching-up with age in contrast to the general population. Approximately 66% of the children had immunization for seasonal influenza and 91% for 2009 pandemic flu. Coverage for vaccines specifically recommended in CF was low for hepatitis A, non conjugate pneumococcal and varicella. CONCLUSION: This study shows a defect in vaccine coverage for both routine immunization and vaccines more specifically recommended in CF.


Subject(s)
Cystic Fibrosis/therapy , Vaccination/statistics & numerical data , Viral Vaccines/pharmacology , Virus Diseases/prevention & control , Adolescent , Child , Child, Preschool , Cystic Fibrosis/complications , Cystic Fibrosis/epidemiology , Female , France/epidemiology , Humans , Incidence , Infant , Male , Prospective Studies , Virus Diseases/complications , Virus Diseases/epidemiology
15.
Arch Pediatr ; 22(3): 247-54, 2015 Mar.
Article in French | MEDLINE | ID: mdl-25612876

ABSTRACT

INTRODUCTION: The number of emergency pediatric consultations continues to rise in France. The pediatric emergency department (PED) introduced relocated consultations (RlCs) for unwarranted visits to relieve the overload of emergency medical consultations. The objective of this study was to assess the advantages of implementing these RlCs. METHODS: A single-center prospective study was undertaken from 21st January to 18 March 2012, with RlCs opened on weekends from 1 to 8 pm in the PED of the Nice Lenval University Hospital Center. All children referred for medical reasons during this period were included. One out of two children labeled stage 5 were transferred to the RlCs. The data evaluated were waiting time, duration of the medical consultation, transit time, and patient and medical staff satisfaction. RESULTS: Eight hundred and seventy-five patients were included. All patients in stages 1-2, 3, 4, and 5, relocated or not, had a mean waiting time before the medical consultation lasting 39.1, 57.7, 54.8, 70.5, and 52.7 min, respectively. The mean duration of the medical consultation was longer for stages 1-2 (61.6 min). The total time spent in the PED did not differ between stage 5 patients who were not relocated (121.3 min) and stages 1-2 (118 min), but both were longer than stage 5 patients who were relocated (90.3 min). Patients and medical staff expressed overall satisfaction during this period. DISCUSSION: By relocating one out of two stage 5 children, waiting times and consultation times decreased for all patients consulting at the PED. These results confirm that implementing RlCs has improved working conditions and quality of patient management.


Subject(s)
Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/statistics & numerical data , Pediatrics , Workload , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Prospective Studies , Referral and Consultation/organization & administration , Time Factors
16.
Arch Pediatr ; 21(6): 654-62, 2014 Jun.
Article in French | MEDLINE | ID: mdl-24815598

ABSTRACT

These guidelines aim to standardize the care of infants diagnosed with a typical form of cystic fibrosis (CF) at neonatal screening. They have been implemented by the National Working Group for Neonatal Screening of the French Federation for CF and have been validated using the Delphi methodology by a large group of clinicians involved in the care of CF infants. These guidelines encompass management and organization of care at diagnosis and describe nutritional, digestive, and respiratory monitoring and treatment during the first 2 years of life.


Subject(s)
Cystic Fibrosis/therapy , Antibiotic Prophylaxis , Humans , Immunization Schedule , Infant , Infant Nutritional Physiological Phenomena , Nutritional Requirements , Respiratory Tract Infections/prevention & control , Vaccination
17.
Arch Pediatr ; 21(5): 461-8, 2014 May.
Article in French | MEDLINE | ID: mdl-24721414

ABSTRACT

CONTEXT AND AIM: Guidelines have been published regularly since 2010 by the ANSM (the Health Products Safety Agency) advising against antitussive drugs for infants because of their inefficacy and their side effects (convulsions, respiratory congestion). Antihistamines, mucolytics, and terpene-based suppositories have theoretically disappeared from infant pharmacopoeia. We assessed the degree of compliance with these guidelines on the part of health professionals. MATERIALS AND METHODS: From June 2012 to August 2012, 198 general practitioners and 44 pediatricians were assessed in the Alpes-Maritimes department of France by means of questionnaires. At the same time, an analysis of medical prescriptions was sought from the Regional Directorate of Medical Services (RDMS) of the PACA-Corse region Health Insurance. RESULTS: The rate of noncompliance with the contraindications was 14.9% (17.7% general practitioners and 2.3% pediatricians). The RDMS study showed a slight decrease in prescriptions for antitussives not recommended from 2011 to 2012: -21% for pediatricians, -15.5% for generalist physicians. CONCLUSION: Continued educational and informative campaigns are therefore needed to stop medical prescriptions of cough medicines for infants, which should also involve parents.


Subject(s)
Antitussive Agents , Cough/drug therapy , Guideline Adherence/statistics & numerical data , Antitussive Agents/adverse effects , Antitussive Agents/therapeutic use , Contraindications , Expectorants/adverse effects , Expectorants/therapeutic use , France , General Practice/statistics & numerical data , Health Surveys , Humans , Infant , Pediatrics/statistics & numerical data , Seizures/chemically induced , Suppositories , Terpenes/adverse effects , Terpenes/therapeutic use , Treatment Failure
18.
Arch Pediatr ; 21(5): 469-75, 2014 May.
Article in French | MEDLINE | ID: mdl-24726669

ABSTRACT

CONTEXT AND OBJECTIVE: Although commonplace and usually not serious, acute cough in the context of upper respiratory tract infection is a frequent reason for consultation and generates significant parental anxiety. Parents often request active drug intervention. Following the contraindications in infants of mucolytics, Hélicidine(®), antihistamines, and terpene-based suppositories, issued between 2010 and 2011 by the Agence nationale de sécurité du médicament et des produits de santé (ANSM), we wished to assess whether these contraindications were known by parents and applied in pharmacies. MATERIALS AND METHODS: An assessment of compliance with these contraindications was made by a double declarative prospective observational study in Nice, first with 29 pharmacists and pharmacy technicians (4-25 August 2012) and then with 289 parents of infants (December 2011 to April 2012). RESULTS: The rate of noncompliance with contraindications was 23.8 % for parents and 34.5 % of pharmacists and pharmacy technicians. Consumption of cough medicines was inversely correlated to the ability to perform a correct nasal wash (OR=2.3). Only 21 % of parents used nasal wash properly. Full-time work was a risk factor for noncompliance with contraindications (OR=1.91). CONCLUSION: ANSM contraindications still have a limited impact on pharmacists and families. Therefore, efforts must be pursued to stop delivering cough medicines for infants. The information and educational campaigns should also involve parents and help to improve nasal wash use.


Subject(s)
Antitussive Agents , Attitude of Health Personnel , Cough/drug therapy , Expectorants , Guideline Adherence , Health Literacy , Histamine Antagonists , Parents/education , Pharmacists , Terpenes , Tissue Extracts , Antitussive Agents/adverse effects , Antitussive Agents/therapeutic use , Contraindications , Expectorants/adverse effects , Expectorants/therapeutic use , France , Histamine Antagonists/adverse effects , Histamine Antagonists/therapeutic use , Humans , Infant , Nasal Lavage/psychology , Parents/psychology , Pharmacists/psychology , Prospective Studies , Suppositories , Terpenes/adverse effects , Terpenes/therapeutic use , Tissue Extracts/adverse effects , Tissue Extracts/therapeutic use
19.
J Acoust Soc Am ; 135(3): 1083-95, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24606252

ABSTRACT

The feasibility of using numerical simulation of fluid dynamics equations for the detailed description of long-range infrasound propagation in the atmosphere is investigated. The two dimensional (2D) Navier Stokes equations are solved via high fidelity spatial finite differences and Runge-Kutta time integration, coupled with a shock-capturing filter procedure allowing large amplitudes to be studied. The accuracy of acoustic prediction over long distances with this approach is first assessed in the linear regime thanks to two test cases featuring an acoustic source placed above a reflective ground in a homogeneous and weakly inhomogeneous medium, solved for a range of grid resolutions. An atmospheric model which can account for realistic features affecting acoustic propagation is then described. A 2D study of the effect of source amplitude on signals recorded at ground level at varying distances from the source is carried out. Modifications both in terms of waveforms and arrival times are described.


Subject(s)
Acoustics , Models, Theoretical , Sound , Algorithms , Computer Simulation , Feasibility Studies , Gravitation , Linear Models , Motion , Nonlinear Dynamics , Numerical Analysis, Computer-Assisted , Temperature , Time Factors
20.
Oral Oncol ; 50(2): 113-9, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24290982

ABSTRACT

BACKGROUND: Head and Neck Squamous Cell Carcinoma (HNSCC) is the sixth most common cancer worldwide. The treatment of advanced stages HNSCC is based on surgical treatment combined with radiotherapy and chemotherapy or concomitant chemo-radiotherapy. However, the 5-year survival remains poor for advanced stages HNSCC and the development of new targeted therapies is eagerly awaited. F14512 combines an epipodophyllotoxin core-targeting topoisomerase II with a spermine moiety introduced as a cell delivery vector. This spermine moiety facilitates selective uptake by tumor cells via the Polyamine Transport System (PTS) and reinforces topoisomerase II poisoning. Here we report the evaluation of F14512 toward HNSCC. MATERIALS AND METHODS: Four cell lines representative of head and neck cancer localizations were used: Fadu (pharynx), SQ20B (larynx), CAL33 and CAL27 (base of the tongue). PTS activity and specificity were evaluated by confocal microscopy and flow cytometry using the fluorescent probe F17073 which contains the same spermine moiety as F14512. Cytotoxicity, alone or in association with standard chemotherapeutic agents (cisplatin, 5FU), and radio-sensitizing effects were investigated using MTS and clonogenic assays, respectively. F14512 efficiency and PTS activity were also measured under hypoxic conditions (1% O2). RESULTS: In all 4 tested HNSCC lines, an active PTS was evidenced providing a specific and rapid transfer of spermine-coupled compounds into cell nuclei. Interestingly, F14512 presents a 1.6-11-fold higher cytotoxic effect than the reference compound etoposide (lacking the spermine chain). It appears also more cytotoxic than 5FU and cisplatin in all cell lines. Competition experiments with spermine confirmed the essential role of the PTS in the cell uptake and cytotoxicity of F14512. Hypoxia had almost no impact on the drug cytotoxicity. The combination of F14512 with cisplatin, but not 5FU, was found to be synergistic and, for the first time, we demonstrated the significant radio-sensitizing potential of F14512. CONCLUSION: The spermine moiety of F14512 confers a targeted effect and a much better efficacy than etoposide in HNSCC lines. The synergistic effect observed in association with cisplatin and radiotherapy augurs well for the potential development of F14512 in HNSCC.


Subject(s)
Carcinoma, Squamous Cell/metabolism , Laryngeal Neoplasms/metabolism , Pharyngeal Neoplasms/metabolism , Podophyllotoxin/analogs & derivatives , Tongue Neoplasms/metabolism , Antimetabolites, Antineoplastic/pharmacology , Antineoplastic Agents/pharmacology , Carcinoma, Squamous Cell/therapy , Cisplatin/pharmacology , Flow Cytometry , Fluorouracil/pharmacology , Humans , Laryngeal Neoplasms/therapy , Microscopy, Confocal , Pharyngeal Neoplasms/therapy , Podophyllotoxin/pharmacology , Tongue Neoplasms/therapy , Treatment Outcome
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