[Outbreak of influenza A(H1N1)/2009: description of cases and crisis management in a ICU in Reunion Island]. / Épidémie de grippe A(H1N1/)2009 : description des cas et expérience de gestion de crise dans un service de réanimation réunionnais.

OBJECTIVES: to describe the characteristics, treatment and outcome of critically ill patients with influenza A(H1N1) infection at St Pierre Hospital in Reunion Island during the 2009 outbreak, as well as the measures of care reorganization implemented to face them. PATIENTS AND METHODS: prospective observational study of probable and confirmed cases of influenza A (H1N1)/2009 infection concerning hospitalized patients in a polyvalent intensive care unit (ICU). RESULTS: thirteen patients have been included between August and September 2009. Three (23 %) didn't have any medical history. The median age was 42 [22-69]. Eleven have required pulmonary ventilation for 10.3 days (± 8). Three (23 %) have developed an ARDS. Three patients (23 %) died. To cope with the influx of cases and considering our situation of geographic isolation, it has been needed to totally rework the organization of care: set-up of a specific welcoming channel, division into sectors of the department, opening of additional beds, new on-duty assignment, inter and intra hospital cooperation. CONCLUSION: reunion Island has been an experimental lab of crisis management during the H1N1/2009 epidemic, several months ahead of the mother country. To anticipate the reorganization of care in intensive care units during an outbreak period, particularly in small units or units isolated like ours, looks to us a must so to quietly face a sharp influx of patients.

Investigation of cochlear mechanisms using combined acoustical and electrical stimulations.

Electrically-evoked VIIIth nerve CAP responses evoked by electrical stimulation and derived by masking with sounds are recorded in the guinea pig, using different masking paradigms (pure tones and high-pass filtered white noise). CAP frequency threshold curves correlate with threshold curves determined by other means, in normal as well as in pathological guinea pigs. Amplitudes of the responses as a function of pure tones frequency and intensity are also measured. Such measurements provide an estimate of the number of fibers activated by the pure tones. These responses can be further analysed using masking with high-pass filtered white noise.

First results of chronic electrical stimulation with a round-window electrode in totally deaf patients.

A few patients who had become totally deaf in adulthood were chronically implanted with an electrode on the round window. Elicitable auditory sensations were limited but proved beneficial enough for a small portable stimulator to be suggested for everyday use. Over a period of several months subjects were monitored several times for a few days at the laboratory and trained to make better use of their prosthesis. Such a device appears safe and patients have become attached to its use. One subject suffering from tinnitus was also given another stimulator delivering positive direct current which suppresses the tinnitus.