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Search Results: 1 - 10 of 1575 matches for " Benoit Misset "
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Ten-year decrease of acquired methicillin-resistant Staphylococcus aureus (MRSA) bacteremia at a single institution: the result of a multifaceted program combining cross-transmission prevention and antimicrobial stewardship
Annie Chalfine, Marie Dominique Kitzis, Yvonnick Bezie, Adel Benali, Laurence Perniceni, Jean Claude NGuyen, Marie Francoise Dumay, Jacqueline Gonot, Gilles Rejasse, Fred Goldstein, Jean Carlet, Benoit Misset
Antimicrobial Resistance and Infection Control , 2012, DOI: 10.1186/2047-2994-1-18
Abstract: We implemented a multifaceted hospital-wide prevention program and measured the effects on HA-MRSA colonization and bacteremia rates between 2000 and 2009. From 2000 to 2003, active screening and decontamination of ICU patients, hospital wide alcohol based hand rubs (ABHR) use, control of specific classes of antibiotics, compliance audits, and feed-backs to the care providers were successively implemented. The efficacy of the program was assessed by HA-MRSA colonized and bacteremic patient rates per 1000 patient-days in patients hospitalized for more than twenty-four hours.Compliance with the isolation practices increased between 2000 and 2009. Consumption of ABHR increased from 6.8?L to 27.5?L per 1000 patient-days. The use of antibiotic Defined Daily Doses (DDD) per 1000 patient-days decreased by 31%. HA-MRSA colonization decreased by 84% from 1.09 to 0.17 per 1000 patient-days and HA-MRSA bacteremia by 93%, from 0.15 to 0.01 per 1000 patient-days (p?<?10?7 for each rate).In an area highly endemic for MRSA, a multifaceted prevention program allows for sustainable reduction in HA-MRSA bacteremia rates.
Quality of life in patients aged 80 or over after ICU discharge
Alexis Tabah, Francois Philippart, Jean Timsit, Vincent Willems, Adrien Fran?ais, Alain Leplège, Jean Carlet, Cédric Bruel, Benoit Misset, Maité Garrouste-Orgeas
Critical Care , 2010, DOI: 10.1186/cc8231
Abstract: We performed a prospective observational study in a medical-surgical ICU in a tertiary non-university hospital. We included patients aged 80 or over at ICU admission in 2005 or 2006 and we recorded age, admission diagnosis, intensity of care, and severity of acute and chronic illnesses, as well as ICU, hospital, and one-year mortality rates. Self-sufficiency (Katz Index of Activities of Daily Living) was assessed at ICU admission and one year after ICU discharge. Quality of life (WHO-QOL OLD and WHO-QOL BREF) was assessed one year after ICU discharge.Of the 115 consecutive patients aged 80 or over (18.2% of admitted patients), 106 were included. Mean age was 84 ± 3 years (range, 80 to 92). Mortality was 40/106 (37%) at ICU discharge, 48/106 (45.2%) at hospital discharge, and 73/106 (68.9%) one year after ICU discharge. In the 23 patients evaluated after one year, self-sufficiency was unchanged compared to the pre-admission status. Quality of life evaluations after one year showed that physical health, sensory abilities, self-sufficiency, and social participation had slightly worse ratings than the other domains, whereas social relationships, environment, and fear of death and dying had the best ratings. Compared to an age- and sex-matched sample of the general population, our cohort had better ratings for psychological health, social relationships, and environment, less fear of death and dying, better expectations about past, present, and future activities and better intimacy (friendship and love).Among patients aged 80 or over who were selected at ICU admission, 80% were self-sufficient for activities of daily living one year after ICU discharge, 31% were alive, with no change in self-sufficiency and with similar quality of life to that of the general population matched on age and sex. However, these results must be interpreted cautiously due to the small sample of survivors.The human lifespan is increasing across the world as a result of economic progress, technol
M.C. Pitassi, Entre croire et savoir. Le problème de la méthode critique chez Jean Le Clerc
C.J. Misset
BMGN : Low Countries Historical Review , 1989,
C.S. Maffioli, L.C. Palm, Italian scientists in the Low Countries in the XVIIth and XVIIIth centuries
C.J. Misset
BMGN : Low Countries Historical Review , 1992,
J. Almagor, Pierre des Maizeaux (1673-1745), journalist and English correspondent for Franco-Dutch periodicals, 1700-1720
C.J. Misset
BMGN : Low Countries Historical Review , 1991,
Phenomenologic analysis of healthcare worker perceptions of intensive care unit diaries
Antoine Perier, Anne Revah-Levy, Cédric Bruel, Nathalie Cousin, Stéphanie Angeli, Sandie Brochon, Fran?ois Philippart, Adeline Max, Charles Gregoire, Benoit Misset, Maité Garrouste-Orgeas
Critical Care , 2013, DOI: 10.1186/cc11938
Abstract: We used a phenomenologic approach to conduct a qualitative study of 36 semistructured interviews in a medical-surgical ICU in a 460-bed tertiary hospital.Two domains of perception were assessed: reading and writing in the diaries. These two domains led to four main themes in the ICU workers' perceptions: suffering of the families; using the diary as a source of information for families but also as generating difficulties in writing bad news; determining the optimal interpersonal distance with the patient and relatives; and using the diary as a tool for constructing a narrative of the patient's ICU stay.The ICU workers thought that the diary was beneficial in communicating the suffering of families while providing comfort and helping to build the patient's ICU narrative. They reported strong emotions related to the diaries and a perception of intruding into the patients' and families' privacy when reading the diaries. Fear of strong emotional investment may adversely affect the ability of ICU workers to perform their duties optimally. ICU workers are in favor of ICU diaries, but activation by the diaries of emotions among younger ICU workers may require specific support.Patient diaries were first used in Denmark, Sweden, and Norway, and then introduced several decades later in other European countries, such as the UK, Switzerland, and, finally, France [1]. Diary entries were found to fall into four main categories: sharing the story, sharing the presence, sharing feelings, and sharing through support [2]. The multiple roles of diaries kept for ICU patients include reconstruction of the illness narrative [3], communication of caring intent [4], debriefing to deal with posttraumatic stress syndrome (PTSD) [5], and the promotion of family healing [3]. ICU diaries have been reported to help in the transition of patients from critical illness to normalcy [2,5-8].We previously evaluated the effect of an ICU diary on the well-being of patients and families and found that th
Mortality associated with timing of admission to and discharge from ICU: a retrospective cohort study
Kevin B Laupland, Benoit Misset, Bertrand Souweine, Alexis Tabah, Elie Azoulay, Dany Goldgran-Toledano, Anne-Sylvie Dumenil, Aurélien Vésin, Samir Jamali, Hatem Kallel, Christophe Clec'h, Michael Darmon, Carole Schwebel, Jean-Francois Timsit
BMC Health Services Research , 2011, DOI: 10.1186/1472-6963-11-321
Abstract: Adults (≥18 years) admitted to French ICUs participating in Outcomerea between January 2006 and November 2010 were included.Among the 7,380 patients included, 61% (4,481) were male, the median age was 62 (IQR, 49-75) years, and the median SAPS II score was 40 (IQR, 28-56). Admissions to ICU occurred during weekends (Saturday and Sunday) in 1,708 (23%) cases, during the night (18:00-07:59) in 3,855 (52%), and on nights and/or weekends in 4,659 (63%) cases. Among 5,992 survivors to ICU discharge, 903 (15%) were discharged on weekends, 659 (11%) at night, and 1,434 (24%) on nights and/or weekends. After controlling for a number of co-variates using logistic regression analysis, admission during the after hours was not associated with an increased risk for death. However, patients discharged from ICU on nights were at higher adjusted risk (odds ratio, 1.54; 95% confidence interval, 1.12-2.11) for death.In this study, ICU discharge at night but not admission was associated with a significant increased risk for death. Further studies are needed to examine whether minimizing night time discharges from ICU may improve outcome.Patients who suffer acute illness and are admitted during the "after hours" (weekends or nights) may be at higher risk for adverse outcome as compared to patients admitted during weekdays [1]. Cavallazzi et al recently conducted a meta-analysis of ten studies conducted in adult ICUs and found that while night time admission was not associated with an increased risk, a small but significant increased risk for death was associated with weekend admission [2]. Since, Kuijsten et al reported a relative risk for death associated with admission in the afterhours of 1.059 (95% confidence interval 1.031-1.088) among 149,894 admissions to Dutch ICUs [3]. More recently Kevat et al reported on 245,057 admissions to Australian ICUs and found an increased risk for hospital mortality associated with admission during evenings/nights (17% vs. 14%; p < 0.001) and during
Comment enquêter sur une émeute ?
Vincenzo Cicchelli,Olivier Galland,Séverine Misset
SociologieS , 2007,
Abstract: En novembre 2005, la France a été touchée par une vague de violences urbaines inédites. Issu d’une enquête monographique menée dans la ville d’Aulnay-sous-Bois (au nord de Paris), cet article souhaite revenir sur le terrain, en mettant en lumière d’une part ses aspérités, en prenant d’autre part très au sérieux la parole des jeunes impliqués, directement ou pas, dans ces évènements. Considérant les interviewés comme capables de dire leur expérience (en leur donnant un sens), nous avons fait état de la pluralité des versions que les jeunes ont donné de ces évènements, en formalisant leurs tentatives au travers de trois grandes figures explicatives (l’émeute déviante, l’émeute protestataire et l’émeute ludique). France was affected by an unseen wave of riots in November 2005. This paper comes from a monographic survey made in Aulnay-sous-Bois (a town in the north of Paris). This paper aims to focus on some significant difficulties during the fieldwork. We also attempt to take seriously the discourse of the young interviewees (those actively involved as well as those not actively involved in these events). We have considered our interviewees as “able” to tell their experiences and to give them a meaning. Thanks to this attitude, this survey found out that young people gave several versions of the riots summarised in three great explanations: for them these riots were the result of deviance, protest or a game. En Noviembre de 2005 Francia fue afectada por una oleada de violencia urbana inédita hasta entonces. Fruto de una investigación monográfica realizada en la ciudad de Aulnay-sous-Bois (al norte de París), este artículo desea volver a estos hechos, por un lado para poner de relieve la dificultad de la investigación, y por otro, para dar voz a los jóvenes implicados, directamente o no, en estos acontecimientos. Considerando a los protagonistas sociales “capaces” de contar su experiencia, describimos la pluralidad de versiones que los jóvenes dieron de estos sucesos, creando para ello tres grandes modelos explicativos (la revuelta como desviación, la revuelta como protesta y la revuelta como diversión).
Homeostatic pulmonary microenvironment is responsible for alveolar macrophages resistance to endotoxin tolerance
F Philippart, C Fitting, B Misset, J Cavaillon
Critical Care , 2012, DOI: 10.1186/cc10613
Abstract: We used different wild-type mice strains (BALB/c, C57BL/6,129SV), and KO mice lacking different leukocytes subset rag2-/-, rag2gc-/-, cd3e-/-, μ-/-, il-15-/- and Ja18-/-. We used an ex vivo model consisting of intravenous injection of LPS 20 hours prior to an in vitro stimulation of AM, peritoneal macrophages and monocytes with LPS. We pretreated the wild-type mice with anti-cytokines antibodies, and KO mice with B cells and NK cells adoptive transfer.We confirmed the absence of AM tolerance to endotoxin in all the strain of wild-type mice. Inhibiting either GM-CSF or INFγ in vivo at homeostasis led to a decrease in TNF production by AM during the in vitro stimulation by LPS, suggesting the involvement of these cytokines in the prevention of tolerance within the lungs. The fact that AM from rag2-/-, rag2gc-/-, μ-/- could be tolerated, the fact that adoptive transfer of B lymphocytes in these deficient mice restores the wild-type response, and the presence of INFγ mRNA in the lungs at homeostasis in wild-type mice and before and after adoptive B-lymphocyte transfer in KO mice demonstrated the involvement of these cells in the wild-type phenotype.We confirm the resistance of AM to endotoxin tolerance. Both GM-CSF and INFγ within the lung microenvironment at homeostasis are involved in this phenomenon. B lymphocytes play a key role in the local expression of INFγ.
Recent Advances in Neural Recording Microsystems
Benoit Gosselin
Sensors , 2011, DOI: 10.3390/s110504572
Abstract: The accelerating pace of research in neuroscience has created a considerable demand for neural interfacing microsystems capable of monitoring the activity of large groups of neurons. These emerging tools have revealed a tremendous potential for the advancement of knowledge in brain research and for the development of useful clinical applications. They can extract the relevant control signals directly from the brain enabling individuals with severe disabilities to communicate their intentions to other devices, like computers or various prostheses. Such microsystems are self-contained devices composed of a neural probe attached with an integrated circuit for extracting neural signals from multiple channels, and transferring the data outside the body. The greatest challenge facing development of such emerging devices into viable clinical systems involves addressing their small form factor and low-power consumption constraints, while providing superior resolution. In this paper, we survey the recent progress in the design and the implementation of multi-channel neural recording Microsystems, with particular emphasis on the design of recording and telemetry electronics. An overview of the numerous neural signal modalities is given and the existing microsystem topologies are covered. We present energy-efficient sensory circuits to retrieve weak signals from neural probes and we compare them. We cover data management and smart power scheduling approaches, and we review advances in low-power telemetry. Finally, we conclude by summarizing the remaining challenges and by highlighting the emerging trends in the field.
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