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Search Results: 1 - 10 of 4186 matches for " Christophe Adrie "
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Administration of hydrogen sulfide via extracorporeal membrane lung ventilation in sheep with partial cardiopulmonary bypass perfusion: a proof of concept study on metabolic and vasomotor effects
Matthias Derwall, Roland CE Francis, Kotaro Kida, Masahiko Bougaki, Ettore Crimi, Christophe Adrie, Warren M Zapol, Fumito Ichinose
Critical Care , 2011, DOI: 10.1186/cc10016
Abstract: A partial venoarterial cardiopulmonary bypass was established in anesthetized, ventilated (fraction of inspired oxygen = 0.5) sheep. The ECML was alternately ventilated with air or air containing 100, 200, or 300 ppm H2S for intervals of 1 hour. Metabolic rate was estimated on the basis of total CO2 production ( V ˙ CO 2 ) and O2 consumption ( V ˙ O 2 ). Continuous hemodynamic monitoring was performed via indwelling femoral and pulmonary artery catheters. V ˙ CO 2 , V ˙ O 2 , and cardiac output ranged within normal physiological limits when the ECML was ventilated with air and did not change after administration of up to 300 ppm H2S. Administration of 100, 200 and 300 ppm H2S increased pulmonary vascular resistance by 46, 52 and 141 dyn·s/cm5, respectively (all P ≤ 0.05 for air vs. 100, 200 and 300 ppm H2S, respectively), and mean pulmonary artery pressure by 4 mmHg (P ≤ 0.05), 3 mmHg (n.s.) and 11 mmHg (P ≤ 0.05), respectively, without changing pulmonary capillary wedge pressure or cardiac output. Exposure to 300 ppm H2S decreased systemic vascular resistance from 1,561 ± 553 to 870 ± 138 dyn·s/cm5 (P ≤ 0.05) and mean arterial pressure from 121 ± 15 mmHg to 66 ± 11 mmHg (P ≤ 0.05). In addition, exposure to 300 ppm H2S impaired arterial oxygenation (PaO2 114 ± 36 mmHg with air vs. 83 ± 23 mmHg with H2S; P ≤ 0.05).Administration of up to 300 ppm H2S via ventilation of an extracorporeal membrane lung does not reduce V ˙ CO 2 and V ˙ O 2 , but causes dose-dependent pulmonary vasoconstriction and systemic vasodilation. These results suggest that administration of high concentrations of H2S in venoarterial cardiopulmonary bypass circulation does not reduce metabolism in anesthetized sheep but confers systemic and pulmonary vasomotor effects.Balancing cellular oxygen supply and demand is a key therapeutic approach to protecting organs such as the brain, kidneys and heart from ischemic injury. Permissive hypothermia and active
Cold Acid Postmortem Blood Most Probably Formed Pinkish-Red Heme-Madder Lake on Madder-Dyed Shroud of Turin  [PDF]
Adrie A. M. van der Hoeven
Open Journal of Applied Sciences (OJAppS) , 2015, DOI: 10.4236/ojapps.2015.511070
Abstract: The Turin Shroud was extensively scientifically investigated in 1978. In its pinkish red bloodstains, normal features of human blood were found, but also seemingly anomalous ones. In the present study, hitherto unnoticed details of the data are presented, Shroud data and more modern reference data are compared, and the results of a few experiments with linen, madder dye and blood are shown. It turns out that the Shroud’s ‘anomalous’ data are strong consistent evidence that its bloodstains contain acid heme-madder lake, of which the heme derived from cold acid postmortem blood and the madder had been applied to the Shroud at manufacture. It implies that the bloodstains were formed on the Shroud before the still not reproduced body-image was. Several other ‘red-color’ hypotheses for the Shroud’s bloodstains are discussed and dismissed.
DNAemia Detection by Multiplex PCR and Biomarkers for Infection in Systemic Inflammatory Response Syndrome Patients
Catherine Fitting, Marianna Parlato, Minou Adib-Conquy, Nathalie Memain, Fran?ois Philippart, Beno?t Misset, Mehran Monchi, Jean-Marc Cavaillon, Christophe Adrie
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0038916
Abstract: Fast and reliable assays to precisely define the nature of the infectious agents causing sepsis are eagerly anticipated. New molecular biology techniques are now available to define the presence of bacterial or fungal DNA within the bloodstream of sepsis patients. We have used a new technique (VYOO?) that allows the enrichment of microbial DNA before a multiplex polymerase chain reaction (PCR) for pathogen detection provided by SIRS-Lab (Jena, Germany). We analyzed 72 sepsis patients and 14 non-infectious systemic inflammatory response syndrome (SIRS) patients. Among the sepsis patients, 20 had a positive blood culture and 35 had a positive microbiology in other biological samples. Of these, 51.4% were positive using the VYOO? test. Among the sepsis patients with a negative microbiology and the non-infectious SIRS, 29.4% and 14.2% were positive with the VYOO? test, respectively. The concordance in bacterial identification between microbiology and the VYOO? test was 46.2%. This study demonstrates that these new technologies offer great hopes, but improvements are still needed.
Model for predicting short-term mortality of severe sepsis
Christophe Adrie, Adrien Francais, Antonio Alvarez-Gonzalez, Roman Mounier, Elie Azoulay, Jean-Ralph Zahar, Christophe Clec'h, Dany Goldgran-Toledano, Laure Hammer, Adrien Descorps-Declere, Samir Jamali, Jean-Francois Timsit, the Outcomerea Study Group
Critical Care , 2009, DOI: 10.1186/cc7881
Abstract: In this prospective multicentre observational study on a multicentre database (OUTCOMEREA) including data from 12 ICUs, 2268 patients with 2737 episodes of severe sepsis were randomly divided into a training cohort (n = 1458) and a validation cohort (n = 810). Up to four consecutive severe sepsis episodes per patient occurring within the first 28 ICU days were included. We developed a prognostic model for predicting death within 14 days after each episode, based on patient data available at sepsis onset.Independent predictors of death were logistic organ dysfunction (odds ratio (OR), 1.22 per point, P < 10-4), septic shock (OR, 1.40; P = 0.01), rank of severe sepsis episode (1 reference, 2: OR, 1.26; P = 0.10 ≥ 3: OR, 2.64; P < 10-3), multiple sources of infection (OR; 1.45, P = 0.03), simplified acute physiology score II (OR, 1.02 per point; P < 10-4), McCabe score ([greater than or equal to]2) (OR, 1.96; P < 10-4), and number of chronic co-morbidities (1: OR, 1.75; P < 10-3, ≥ 2: OR, 2.24, P < 10-3). Validity of the model was good in whole cohorts (AUC-ROC, 0.76; 95%CI, 0.74 to 0.79; and HL Chi-square: 15.3 (P = 0.06) for all episodes pooled).In ICU patients, a prognostic model based on a few easily obtained variables is effective in predicting death within 14 days after the first to fourth episode of severe sepsis complicating community-, hospital-, or ICU-acquired infection.Severe sepsis remains a leading cause of death in industrialised countries, and the number of deaths caused by sepsis is increasing despite improved survival rates [1,2]. Apart from measures directed to the infectious cause (antibiotics and surgery), the treatment remains chiefly supportive despite many randomised controlled trials [3,4]. Sepsis is a syndrome, not a disease; and many factors explain the variability of outcomes, such as differences in infection sites, causative pathogens, and time and location of infection onset (community, hospital or intensive care unit (ICU)) [1]. This hete
Outcome of ICU patients with Clostridium difficile infection
Jean-Ralph Zahar, Carole Schwebel, Christophe Adrie, Maité Garrouste-Orgeas, Adrien Fran?ais, Aurélien Vesin, Molière Nguile-Makao, Alexis Tabah, Kevin Laupland, Alban Le-Monnier, Jean-Fran?ois Timsit, the OUTCOMEREA study group
Critical Care , 2012, DOI: 10.1186/cc11852
Abstract: We compared patients with ICU-acquired CDI (watery or unformed stools occurring ≥ 72 hours after ICU admission with a stool sample positive for C. difficile toxin A or B) with two groups of controls hospitalized at the same time in the same unit. The first control group comprised patients with ICU-acquired diarrhea occurring ≥ 72 hours after ICU admission with a stool sample negative for C. difficile and for toxin A or B. The second group comprised patients without any diarrhea.Among 5,260 patients, 512 patients developed one episode of diarrhea. Among them, 69 (13.5%) had a CDI; 10 (14.5%) of them were community-acquired, contrasting with 12 (17.4%) that were hospital-acquired and 47 (68%) that were ICU-acquired. A pseudomembranous colitis was associated in 24/47 (51%) ICU patients. The median delay between diagnosis and metronidazole administration was one day (25th Quartile; 75th Quartile (0; 2) days). The case-fatality rate for patients with ICU-acquired CDI was 10/47 (21.5%), as compared to 112/443 (25.3%) for patients with negative tests. Neither the crude mortality (cause specific hazard ratio; CSHR = 0.70, 95% confidence interval; CI 0.36 to 1.35, P = 0.3) nor the adjusted mortality to confounding variables (CSHR = 0.81, 95% CI 0.4 to 1.64, P = 0.6) were significantly different between CDI patients and diarrheic patients without CDI. Compared to the general ICU population, neither the crude mortality (SHR = 0.64, 95% CI 0.34 to 1.21, P = 0.17), nor the mortality adjusted to confounding variables (CSHR = 0.71, 95% confidence interval (CI) 0.38 to 1.35, P = 0.3), were significantly different between the two groups. The estimated increase in the duration of stay due to CDI was 8.0 days ± 9.3 days, (P = 0.4) in comparison to the diarrheic population, and 6.3 days ± 4.3 (P = 0.14) in comparison to the general ICU population.If treated early, ICU-acquired CDI is not independently associated with an increased mortality and impacts marginally the ICU length of stay.
Impact of ureido/carboxypenicillin resistance on the prognosis of ventilator-associated pneumonia due to Pseudomonas aeruginosa
Catherine Kaminski, Jean-Fran?ois Timsit, Yohann Dubois, Jean-Ralph Zahar, Ma?té Garrouste-Orgeas, Aurélien Vesin, Elie Azoulay, Céline Feger, Anne-Sylvie Dumenil, Christophe Adrie, Yves Cohen, Bernard Allaouchiche, the OUTCOMEREA study group
Critical Care , 2011, DOI: 10.1186/cc10136
Abstract: A total of 223 episodes of PA-VAP recorded into the Outcomerea database were evaluated. Patients with ureido/carboxy-resistant P. aeruginosa (PRPA) were compared with those with ureido/carboxy-sensitive P. aeruginosa (PSPA) after matching on duration of ICU stay at VAP onset and adjustment for confounders.Factors associated with onset of PRPA-VAP were as follows: admission to the ICU with septic shock, broad-spectrum antimicrobials at admission, prior use of ureido/carboxypenicillin, and colonization with PRPA before infection. Adequate antimicrobial therapy was more often delayed in the PRPA group. The crude ICU mortality rate and the hospital mortality rate were not different between the PRPA and the PSPA groups. In multivariate analysis, after controlling for time in the ICU before VAP diagnosis, neither ICU death (odds ratio (OR) = 0.73; 95% confidence interval (CI): 0.32 to 1.69; P = 0.46) nor hospital death (OR = 0.87; 95% CI: 0.38 to 1.99; P = 0.74) were increased in the presence of PRPA infection. This result remained unchanged in the subgroup of 87 patients who received adequate antimicrobial treatment on the day of VAP diagnosis.After adjustment, and despite the more frequent delay in the initiation of an adequate antimicrobial therapy in these patients, resistance to ureido/carboxypenicillin was not associated with ICU or hospital death in patients with PA-VAP.Despite many improvements in the management of mechanically-ventilated patients, ventilator-associated pneumonia (VAP) remains the second leading cause of nosocomial infections in intensive care units (ICU). VAP has one of the highest mortality rates, ranking from 20 to 50% [1], and increases length of hospital stay, and hospital costs [2].Pseudomonas aeruginosa is a leading cause of nosocomial infections and one of the bacteria most frequently responsible for late-onset VAP. When VAP is documented by bronchoscopic techniques, P. aeruginosa is the most frequently isolated nosocomial bacteria, with m
Prognostic consequences of borderline dysnatremia: pay attention to minimal serum sodium change
Michael Darmon, Eric Diconne, Bertrand Souweine, Stéphane Ruckly, Christophe Adrie, Elie Azoulay, Christophe Clec'h, Ma?té Garrouste-Orgeas, Carole Schwebel, Dany Goldgran-Toledano, Hatem Khallel, Anne-Sylvie Dumenil, Samir Jamali, Christine Cheval, Bernard Allaouchiche, Fabrice Zeni, Jean-Fran?ois Timsit
Critical Care , 2013, DOI: 10.1186/cc11937
Abstract: Observational study on a prospective database fed by 13 intensive care units (ICUs). Unselected patients with ICU stay longer than 48 h were enrolled over a 14-year period were included in this study. Mild to severe hyponatremia were defined as serum sodium concentration < 135, < 130, and < 125 mmol/L respectively. Mild to severe hypernatremia were defined as serum sodium concentration > 145, > 150, and > 155 mmol/L respectively. Borderline hyponatremia and hypernatremia were defined as serum sodium concentration between 135 and 137 mmol/L or 143 and 145 respectively.A total of 11,125 patients were included in this study. Among these patients, 3,047 (27.4%) had mild to severe hyponatremia at ICU admission, 2,258 (20.3%) had borderline hyponatremia at ICU admission, 1,078 (9.7%) had borderline hypernatremia and 877 (7.9%) had mild to severe hypernatremia. After adjustment for confounder, both moderate and severe hyponatremia (subdistribution hazard ratio (sHR) 1.82, 95% CI 1.002 to 1.395 and 1.27, 95% CI 1.01 to 1.60 respectively) were associated with day-30 mortality. Similarly, mild, moderate and severe hypernatremia (sHR 1.34, 95% CI 1.14 to 1.57; 1.51, 95% CI 1.15 to 1.99; and 2.64, 95% CI 2.00 to 3.81 respectively) were independently associated with day-30 mortality.One-third of critically ill patients had a mild to moderate dysnatremia at ICU admission. Dysnatremia, including mild changes in serum sodium concentration, is an independent risk factor for hospital mortality and should not be neglected.Dysnatremia is a common finding at ICU admission [1-3]. Abnormal serum sodium concentrations are known to adversely affect physiologic function and an increasing body of evidence suggests that dysnatremia may be associated with adverse outcome [1-4]. Critically ill patients are particularly exposed to dysnatremia due to the nature of the disease leading to ICU admission and to lack of free access to water [2,4,5]. Up to one-third of critically ill patients have a dys
AN ANALYSIS OF BASE STATION LOCATION ACCURACY WITHIN MOBILE-CELLULAR NETWORKS
Liam Smit,Adrie Stander,Jacques Ophoff
International Journal of Cyber-Security and Digital Forensics , 2012,
Abstract: An important feature within a mobile-cellular net- work is that the location of a cellphone can be determined. As long as the cellphone is powered on, the location of the cellphone can always be traced to at least the cell from which it is receiving, or last received, signal from the cellular network. Such network-based methods of estimating the location of a cellphone is useful in cases where the cellphone user is unable or unwilling to reveal his or her location, and have practical value in digital forensic investigations. This study investigates the accuracy of using mobile-cellular network base station information for estimating the location of cellphones. Through quantitative analysis of mobile-cellular network base station data, large variations between the best and worst accuracy of recorded location information is exposed. Thus, depending on the requirements, base station locations may or may not be accurate enough for a particular application.
Reliability of diagnostic coding in intensive care patients
Beno?t Misset, Didier Nakache, Aurélien Vesin, Mickael Darmon, Ma?té Garrouste-Orgeas, Bruno Mourvillier, Christophe Adrie, Sébastian Pease, Marie-Aliette de Beauregard, Dany Goldgran-Toledano, Elisabeth Métais, Jean-Fran?ois Timsit, The Outcomerea Database Investigators
Critical Care , 2008, DOI: 10.1186/cc6969
Abstract: One hundred medical records selected randomly from 29,393 cases collected between 1998 and 2004 in the French multicenter Outcomerea ICU database were studied. Each record was sent to two senior physicians from independent ICUs who recoded the diagnoses using the International Statistical Classification of Diseases and Related Health Problems: Tenth Revision (ICD-10) after being trained according to guidelines developed by two French national intensive care medicine societies: the French Society of Intensive Care Medicine (SRLF) and the French Society of Anesthesiology and Intensive Care Medicine (SFAR). These codes were then compared with the original codes, which had been selected by the physician treating the patient. A specific comparison was done for the diagnoses of septicemia and shock (codes derived from A41 and R57, respectively).The ICU physicians coded an average of 4.6 ± 3.0 (range 1 to 32) diagnoses per patient, with little agreement between the three coders. The primary diagnosis was matched by both external coders in 34% (95% confidence interval (CI) 25% to 43%) of cases, by only one in 35% (95% CI 26% to 44%) of cases, and by neither in 31% (95% CI 22% to 40%) of cases. Only 18% (95% CI 16% to 20%) of all codes were selected by all three coders. Similar results were obtained for the diagnoses of septicemia and/or shock.In a multicenter database designed primarily for epidemiological and cohort studies in ICU patients, the coding of medical diagnoses varied between different observers. This could limit the interpretation and validity of research and epidemiological programs using diagnoses as inclusion criteria.Administrative coding of medical diagnoses has become mandatory in French hospitals in order to perform epidemiological studies and to calculate medical reimbursement costs. Most databases are used by hospital administrators, according to the local system for hospital funding, which is derived from the Diagnosis-Related Group (DRG) in the US [1
How to Value GDP-Linked Collar Bonds? An Introductory Perspective  [PDF]
Christophe Schinckus
Theoretical Economics Letters (TEL) , 2013, DOI: 10.4236/tel.2013.33024
Abstract:

This short paper proposed a pricing method for GDP-linked collar bonds based on the classical discounted pricing model and the assumption that the GDP can be described with a geometric Brownian motion. The estimation of parameters was not discussed because it is not central in our numerical exercise.

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