[Amatoxin-containing mushroom poisoning: An update]. / Syndrome phalloïdien : mise au point.

Amatoxin-containing mushroom poisoning occurs after consumption of certain mushroom species, of the genera Amanita, Lepiota and Galerina. Amanita phalloides is the most implicated species, responsible for over more than 90% of mushroom-related deaths. The α-amanitin is responsible for most of the observed effects. Symptoms are characterized by severe delayed gastrointestinal disorders (more than six hours after ingestion). The liver being the main target organ, outcome is marked by an often severe hepatitis which can evolve towards terminal liver failure, justifying orthotopic liver transplantation. Acute renal failure is common. Diagnosis of amatoxin-containing mushroom poisoning is based primarily on clinical data; it can be biologically confirmed using detection of amatoxins, especially from urine samples. In the absence of an antidote, early hospital management is essential. It is based on supportive care (early compensation of hydroelectrolytic losses), gastrointestinal digestive decontamination, elimination enhancement, amatoxin uptake inhibitors and antioxidant therapy. Combined therapy associating silibinin and N-acetylcysteine is recommended. Prognosis of this severe poisoning has greatly benefited from improved resuscitation techniques. Mortality is currently less than 10%. In the event of a suspected or confirmed case, referral to a Poison Control Center is warranted in order to establish the diagnosis and guide the medical management of patients in an early and appropriate way.

Determination of Glyphosate and AMPA in Blood Can Predict the Severity of Acute Glyphosate Herbicide Poisoning.

OBJECTIVE: To evaluate a potential association between blood and urine concentration of glyphosate and its metabolite, aminomethylphosphonic acid (AMPA), with severity of acute glyphosate (herbicide) poisoning. METHODS: In our retrospective study of acute glyphosate poisoning, we examined records from the French National Database of Poisonings, dated between January 1, 2004, and December 31, 2016. We compared the severity of poisoning among case individuals using the Fisher exact test and Wilcoxon test. Also, we calculated ROC curves to determine the cutoff for blood and urine concentration. RESULTS: A total of 17 plasma glyphosate, 11 urine glyphosate, 13 plasma AMPA, and 10 urine AMPA specimens were included in our study, with collection dates ranging from January 1, 2004, through December 31, 2016. CONCLUSION: The optimal cutoff we discovered for blood concentration of AMPA was 0.88 mg/L; for glyphosate, it was 600 mg/L. The cutoff plasma concentration of AMPA has never been described in the literature, to our knowledge.

2,2'-Dipyridylamines: more than just sister members of the bipyridine family. Applications and achievements in homogeneous catalysis and photoluminescent materials.

2,2'-Dipyridylamines (dpa) and related compounds belong to the family of polydentate nitrogen ligands. More than a century has passed since their first report but new complexes and applications have been emerging in recent years owing to the versatility of dpa-based architectures. This review aims to present and highlight the main achievements attained with dpa-containing metal complexes in the domains of homogeneous catalysis and luminescent materials.

Effects of rotation on temperature fluctuations in turbulent thermal convection on a hemisphere.

Rotation is present in many physical and geophysical systems and its role in determining flow properties and modifying turbulent fluctuations is of crucial importance. Here we focus on the role of rotation on temperature fluctuations in turbulent thermal convection. The system used consists of a rotating half soap bubble heated from below. This system has features, curvature and a quasi two dimensional character, which are reminiscent of atmospheric and planetary systems. Our experiments and numerical simulations show that rotation changes the nature of turbulent fluctuations and a new scaling regime is obtained for the temperature field. This change in the scaling behavior of temperature fluctuations, due to rotation, is put forth by studying the so called second moment of temperature differences across different scales. For high enough rotation rates, these temperature differences display a transition from Bolgiano Obukhov scaling to a new scaling regime. This scaling is at odds with expectations from theory, numerics, and experiments in three dimensions, suggesting that the effects of rotation on turbulent flows depend strongly on geometry and spatial dimension.

Ruthenium(II) and iridium(III) complexes featuring NHC-sulfonate chelate.

Three new complexes bearing a chelating (κ(2)C,O) NHC-SO3 ligand have been prepared. An original method for the synthesis of the imidazolium-sulfonate NHC precursor is described. The 5-membered ruthena- and irida-cycle containing complexes were fully characterized and evaluated in a series of catalytic transformations involving hydrogen auto-transfer processes.

Shiitake dermatitis recorded by French Poison Control Centers - new case series with clinical observations.

CONTEXT: Shiitake (Lentinula edodes) is an edible mushroom which was initially grown in Japan and China and is now sold on the European market. Flagellate erythema may arise following shiitake consumption and was first described in Japan in 1974. OBJECTIVE: This paper reports a French shiitake dermatitis case series. METHODS: The findings of retrospective study of shiitake dermatitis cases, reported to French Poison Control Centres (PCC) from January 2000 to December 2013, are reported. RESULTS: Among 32 exposed patients, 15 presented flagellate urticarial lesions after raw shiitake consumption. The first case of this series was reported in 2006 and the last nine cases were reported as of 2012. After shared meals, no symptoms were reported among guests, who preferred cooked shiitake to the raw mushroom. In this series, rashes appeared 12 h to 5 days (median: 24 h) after raw shiitake ingestion. Linear and itchy urticarial lesions formed on the trunk, arms, and legs within a few hours and persisted for 3-21 days. In four cases, rash and pruritus were either triggered or worsened by sun exposure. Eleven patients received corticosteroids, antihistamines, or both. All patients completely recovered. CONCLUSION: Due to the rapidly increasing consumption of exotic food in Western countries, it is no surprise that cases of shiitake dermatitis are now appearing in Europe. The mechanism of shiitake dermatitis is thought to be toxic and due to lentinan, a polysaccharide component of the mushroom. There is no specific validated treatment for shiitake dermatitis. Health professionals and the general population should be aware of both the risk associated with raw shiitake consumption and of the good prognosis of this very spectacular and uncomfortable toxic dermatitis.

Intensity of vortices: from soap bubbles to hurricanes.

By using a half soap bubble heated from below, we obtain large isolated single vortices whose properties as well as their intensity are measured under different conditions. By studying the effects of rotation of the bubble on the vortex properties, we found that rotation favors vortices near the pole. Rotation also inhibits long life time vortices. The velocity and vorticity profiles of the vortices obtained are well described by a Gaussian vortex. Besides, the intensity of these vortices can be followed over long time spans revealing periods of intensification accompanied by trochoidal motion of the vortex center, features which are reminiscent of the behavior of tropical cyclones. An analysis of this intensification period suggests a simple relation valid for both the vortices observed here and for tropical cyclones.

Non-linear oscillatory rheological properties of a generic continuum foam model: comparison with experiments and shear-banding predictions.

The occurrence of shear bands in a complex fluid is generally understood as resulting from a structural evolution of the material under shear, which leads (from a theoretical perspective) to a non-monotonic stationary flow curve related to the coexistence of different states of the material under shear. In this paper we present a scenario for shear-banding in a particular class of complex fluids, namely foams and concentrated emulsions, which differs from other scenarios in two important ways. First, the appearance of shear bands is shown to be possible both without any intrinsic physical evolution of the material (e.g. via a parameter coupled to the flow such as concentration or entanglements) and without any finite critical shear rate below which the flow does not remain stationary and homogeneous. Secondly, the appearance of shear bands depends on the initial conditions, i.e. the preparation of the material. In other words, it is history dependent. This behaviour relies on the tensorial character of the underlying model (2D or 3D) and is triggered by an initially inhomogeneous strain distribution in the material. The shear rate displays a discontinuity at the band boundary whose amplitude is history dependent and thus depends on the sample preparation.

[Perception of health care quality by patients with chronic conditions]. / Perception de la qualité des soins reçus par les personnes atteintes de maladie chronique.

BACKGROUND: Patient opinion is becoming ever more important when considering healthcare quality and the reforms required to improve healthcare quality. The main aim of this study was to explore factors determining perceived healthcare quality among patients with chronic diseases. METHODS: Data are drawn from the survey carried out in 2008 by the Commonwealth Fund, in partnership with the French Superior Health Authority (Haute Autorité de santé). The prospective telephone survey targeted adults in eight countries who had serious health problems (chronic or severe disease, declared poor state of health, hospital admission or major surgery). Of the 1202 French respondents, 851 had at least one diagnosed chronic disease. A multinomial logistic model was used to identify the relationship between perceived healthcare quality and patients' recent experience with the healthcare system. RESULTS: People with chronic disease in general perceived that healthcare quality was excellent (45%) or good (44%). Only 11% of respondents judged it to be average or poor. There was a hint of "could do better", for example when considering podology and ophthalmology follow-up in diabetes or the management of multiple medications. The explanatory model revealed a positive correlation between excellent perceived healthcare quality and a strong doctor-patient relationship, taking into account both the length of this relationship and the ability of the doctor to involve the patient at all stages of decision-making concerning therapeutic management. There was no major link between the perceived quality of care and objective care quality, the quality of procedures, the cost of care to the patient or how frequently patients access the healthcare system. CONCLUSION: The quality of the relationship between the patient and his/her doctor is a determining factor in the patient's judgement of the quality of healthcare he/she receives.

Volume and diagnosis: an approach to cross-border care in eight European countries.

OBJECTIVES: Mobility of patients is a pertinent issue on the European Union's agenda. This study aimed to estimate the volume and main diagnoses of cross-border care in eight European countries, in order to provide policy makers with background information about the nature of patient mobility in Europe. METHODS: This article reports the combined findings from three independent studies that compiled self-reported information on admissions data and main diagnoses from more than 200 hospitals in eight European countries. RESULTS: The average volume of cross-border patients accounted for less than 1% of total admissions in the hospitals studied here. Diseases of the circulatory system (mainly acute myocardial infarction) and fractures were the most common reasons for hospitalisation of European patients abroad. Deliveries and other diagnoses related to pregnancy, pneumonia, appendicitis and other diseases of the digestive system, aftercare procedures, and disorders of the eye and adnexa were also common diagnoses for this population. CONCLUSIONS: Hospitals should reinforce their efforts to adapt the care provided to the needs of foreign patients in treatment areas that cover the most frequent pathologies identified in this population.

An elasto-visco-plastic model for immortal foams or emulsions.

A variety of complex fluids consists in soft, round objects (foams, emulsions, assemblies of copolymer micelles or of multilamellar vesicles--also known as onions). Their dense packing induces a slight deviation from their preferred circular or spherical shape. As a frustrated assembly of interacting bodies, such a material evolves from one conformation to another through a succession of discrete, topological events driven by finite external forces. As a result, the material exhibits a finite yield threshold. The individual objects usually evolve spontaneously (colloidal diffusion, object coalescence, molecular diffusion), and the material properties under low or vanishing stress may alter with time, a phenomenon known as aging. We neglect such effects to address the simpler behaviour of (uncommon) immortal fluids: we construct a minimal, fully tensorial, rheological model, equivalent to the (scalar) Bingham model. Importantly, the model consistently describes the ability of such soft materials to deform substantially in the elastic regime (be it compressible or not) before they undergo (incompressible) plastic creep--or viscous flow under even higher stresses.

Evaluación de los Componentes del Somatotipo e Índice de Masa Corporal en Escolares del Sector Precordillerano de la IX Región, Chile / Evaluation of the Somatotipe Components and Body Mass Index in Scholarships of Foothills at the IX Región, Chile

La obesidad en el mundo se ha convertido en un problema de salud pública, no escapando a esta situación los adolescentes de Chile. Los estudios de la composición corporal, estado nutricional e índice de masa corporal (IMC) son los parámetros recomendados por la OMS, para determinar el estado nutricional. Realizamos este estudio para conocer la realidad del sector cordillerano de la Novena Región de Chile. Evaluamos 662 adolescentes, 358 hombres (54,1%) y 304 mujeres (45,9%), entre 11 y 15 años de edad, alumnos de colegios urbanos municipalizados del sector Precordillerano de la Novena Región Chile. Para obtener el somatotipo utilizamos el método antropométrico de Heath & Carter, efectuándose la clasificación del IMC de acuerdo a las normas de la OMS. Los hombres, eran más mesomórficos que las mujeres, siendo esta diferencia estadísticamente significativa. Los componentes endomórfico y ectomórfico no presentaron diferencias estadísticamente significativas de acuerdo al sexo. El 50,8% de los hombres y el 34,1% de las mujeres presentaban un IMC normal. Observamos un predominio del componente mesoendomórfico. Los individuos presentaron obesidad en el 2,7% y sobrepeso en el 10,7% de los casos. Estos resultados revelan una prevalencia de obesidad baja si son comparados con otros estudios efectuados en Chile, siendo posiblemente la alta ruralidad, la pobreza, la alimentación y los diferentes estilos de vida los que han influido en estos resultados.

World obesity has become a public health problem, Chilean adolescents do not escape this situation. Studies on body composition, nutritional state, and body mass index (BMI), are parameters recommended by the WHO for determining human beings' nutritional state. This study has been carried out to know the real of situation of adolescents living in the foothills of the Andes, in the IX Región in Chile. Six hundreds and sixty two subjects were evaluated, 358 men (54,1%) and 304 women (45,9%), between 11 and 15 years old, all students at urban municipal public schools, in the foothills of the Andes, in the IX Region of the Chilean Araucanía. In order to obtain the somatotype the anthropometric Health & Carter method was used, classifying BMI according to the WHO norms. The sample was mesoendomorphofic and indicated that the females were more endomorphic that males, being this difference statistically significant. The endomorphic and ectomorphic components presented no statically significant differences according to sex. The MBI showed values of 47% higher than the norm in males and of 33% over the norm in females. The sample presented a predominance of the mesomorphic component. The obesity rate was 2,7% and overweight was 10,7%. These results showed low prevalence of obesity contrasted with the national rate, the reasons could be rurality, poverty, food, and different life style in relation to city life.

Experiments and direct numerical simulations of two-dimensional turbulence.

Experiments and direct numerical simulations reveal the coexistence of two cascades in two-dimensional grid turbulence. Several features of this flow such as the energy density and the scalar spectra are found to be consistent with well known theoretical predictions. The energy transfer function displays the expected up-scale energy transfers. The vorticity correlation function is logarithmic and thus consistent with recently proposed models.

A new dicoumarinyl ether and two rare furocoumarins from Ruta montana.

A new dicoumarinyl ether, rutamontine and two rare furocoumarins, heraclenol and isopimpinellin, were isolated from Ruta montana. The structure of rutamontine as 6-hydroxy-7-methoxy-3,7'-dicoumarinylether was determined by spectroscopic methods.

Multivariate analysis of determinants of bacterial contamination of whole-blood donations.

BACKGROUND AND OBJECTIVES: Introduction of bacteria into blood components at the collection stage seems to be a frequent occurrence. We therefore assessed determinants of bacterial contamination of whole-blood donations to gain insight into contamination mechanisms and direct prevention. MATERIALS AND METHODS: A cross-sectional study was carried out on donors accepted for whole-blood donation in four French blood banks. Each blood bank used its own two-stage procedure for phlebotomy site preparation. Contamination was identified by culturing two 15-ml samples (collected aseptically at the outset of donation) in a BacT/Alert 240 system. Determinants were assessed by logistic regression analysis. RESULTS: Bacterial contamination, mainly by skin flora, occurred in 76 (2.2%) out of 3385 donations. Significant determinants were as follows: the blood bank (odds ratio [OR] range = 3.0-5.6, P < 0.001); lack of repetition of scrub (OR = 2.7, P = 0.032); and donor age > 35 years (OR = 1.8, P = 0.036). CONCLUSION: Systematic scrub repetition should be implemented to reduce bacterial contamination by skin flora at the collection stage. Further research is required to clarify the role of different antiseptic agents and of donor age.

[Frequency of childhood injuries: first results of the Boulogne-Billancourt registry]. / Analyse des accidents de l'enfant: premiers résultats de l'Observatoire de Boulogne-Billancourt.

BACKGROUND: Boulogne-Billancourt database is in France the only permanent and specific childhood injury surveillance system. Integrated in an safe community program designed by the World Health Organization (WHO), the aims of a local database are to provide precise information intended to implement prevention actions. METHOD: All children less than sixteen years old living in Boulogne-Billancourt, victims of injuries occurring in that town, and requiring hospital care, are targeted. RESULTS: Two thousand five hundred and eighty accidents have been computed between 1(st) January 1998 and 31 December 1999, i.e. an average annual incidence of 79.7/1000 children. As in other similar databases, domestic accidents are prevalent in the average (40%), even though after five years old school injuries become the most frequent ones (36%). Falls are the main mechanism involved in injury at any age (44 to 54%). Distribution of other mechanisms varies with respect to age: foreign body prevalence is maximum between one and four (2.5%), struck-collisions (38%) between ten and fifteen years old. A significant increase of falls involving roller-skates or skateboards has been observed between 1998 and 1999 (3.8% versus 1.1%, p<0.001). Predominanting injury causes are contusions (38%), mainly head trauma (10%), open wounds (16%), fractures (10%), and sprains (6%). Two hundred and twenty four injuried children have been admitted in 1998, 205 in 1999, i.e. respectively 13.8/1000 and 12.7/1000 children dwelling in Boulogne. Overall recurrence rate is 32%, reaching 47% after eleven years old. A significant relationship has been observed between injury recurrence and problems related to education (odds ratio: 2.95; 95% CI: 1.75-5.00), atypical parenting situation (odds ratio: 1.70; 95% CI: 1.20-2.30), and family discord (odds ratio: 1.62; 95% CI: 1.05-2.50). Household accidents are the most avoidable ones in parents'opinion. This is not the case for road-traffic accidents, given evidence of the lack of means of protection observed in bicycle injuries. CONCLUSION: In spite of methodological issues such as control of exhaustivity of data, or difficulties to maintain a long-term surveillance sytem, this project worth carrying on with regard to provided information and usefulness for prevention. Other similar community experiences should be implemented with the aim of setting up a national-wide surveillance system, based on an homogenous data collection.

Efficacy of a new collection procedure for preventing bacterial contamination of whole-blood donations.

BACKGROUND: Transfusion-related bacterial contamination is a serious problem. The introduction of bacteria into donations at the collection stage seems frequent, despite well-conducted phlebotomy site preparation. Additional preventive measures are required. STUDY DESIGN AND METHODS: The aim of this study was to assess the potential efficacy of excluding the first 15 mL of blood to reduce the bacterial contamination of donations. A special device allowed the aseptic collection of two samples at the beginning of donation: S1 (first 15 mL) and S2 (next 15 mL). Bacteriologic cultures of S1 and S2 were performed by using an automated system. The procedure's efficacy was measured by the proportion of positive donations in S1 that were then negative in S2. RESULTS: S1 and/or S2 were positive in 76 (2.2%) of 3385 donations. In about three-fourths of the culture-positive donations, contamination was detected in the first 15-mL sample only. Gram-positive cocci accounted for 81 percent of species, gram-positive bacilli for 14 percent, and gram-negative bacilli for 5 percent. The new procedure would have prevented the introduction of bacteria in 55 donations, reducing to 0.6 percent the risk of contamination from the first 15 mL collected. CONCLUSION: Although the final effect on blood component bacterial contamination rates cannot be derived from the study, excluding the first 15 mL of blood may reduce the rate of bacterial contamination in donations.

Cationic ruthenium allenylidene complexes as catalysts for ring closing olefin metathesis

A series of well accessible cationic ruthenium allenylidene complexes of the general type [(eta6-arene)(R3P)RuCl(=C=CR'2)]+ X- is described which constitute a new class of pre-catalysts for ring closing olefin metathesis reactions (RCM) and provide an unprecedented example for the involvement of metal allenylidenes in catalysis. They effect the cyclization of various functionalized dienes and enynes with good to excellent yields and show a great tolerance towards an array of functional groups. Systematic variations of their basic structural motif have provided insights into the essential parameters responsible for catalytic activity which can be enhanced further by addition of Lewis or Bronsted acids, by irradiation with UV light, or by the adequate choice of the "non-coordinating" counterion X-. The latter turned out to play a particularly important role in determining the rate and selectivity of the reaction. A similarly pronounced influence is exerted by remote substituents on the allenylidene residue which indicates that this ligand (or a ligand derived thereof) may remain attached to the metal throughout the catalytic process. X-ray crystal structures of the catalytically active allenylidene complexes 3b.PF6 and 15.OTf as well as of the chelate complex 10 required for the preparation of the latter catalyst are reported.