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Search Results: 1 - 10 of 13176 matches for " Eric Meaudre "
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B-type natriuretic peptide release and left ventricular filling pressure assessed by echocardiographic study after subarachnoid hemorrhage: a prospective study in non-cardiac patients
Eric Meaudre, Christophe Jego, Nadia Kenane, Ambroise Montcriol, Henry Boret, Philippe Goutorbe, Gilbert Habib, Bruno Palmier
Critical Care , 2009, DOI: 10.1186/cc7891
Abstract: All adult patients with SAH admitted to our intensive care unit were eligible. Patients were excluded for the following reasons: admission >48 hours after aneurysm rupture, pre-existing hypertension, or cardiac disease. Levels of BNP and cardiac troponin Ic were measured daily for 7 days. Echocardiography was performed by a blinded cardiologist on days 1, 2, and 7. Doppler signals from the mitral inflow, tissue Doppler, and the color M-mode–derived flow propagation velocity (FPV) were obtained to assess echo-estimated LVFP.During a 3-year period, sixty-six consecutive patients with SAH were admitted. Thirty one patients were studied. The BNP level was >100 ng/L in 25 patients (80%) during the first 3 days, with a peak on day 2 (median, 126 ng/L) followed by a gradual decrease (median variation days 1 to 7, 70%). All patients had an ejection fraction >50%. Early transmitral velocity/tissue Doppler mitral annular early diastolic velocity was low: 5.4 (± 1.5) on day 1, 5.8 (± 1.2) on day 2, and 5.1 (± 0.9) on day 7. Early transmitral velocity/FPV was also low: 1.27 (± 0.4), 1.25 (± 0.3), and 1.1 (± 0.2) on days 1, 2, and 7, respectively. Cardiac troponin Ic levels ranged from 0 to 3.67 μg/L and were correlated with BNP (r = 0.63, P < 0.01).BNP rises gradually over two days and return to normal within a week after SAH. Its release is associated with myocardial necrosis, but is unrelated to elevated LVFP assessed by echocardiography.Serum plasma B-type natriuretic peptide (BNP) is a global indicator of left cardiac dysfunction. Recent reports have shown the contribution of left ventricular (LV) diastolic function to plasma BNP levels and the usefulness of BNP in the diagnosis of diastolic dysfunction [1]. Stretch of cardiomyocytes due to elevated filling pressures is reported to be the most important stimulus of BNP regulation [2]. Doppler echocardiography, color flow imaging, and myocardial tissue imaging can assess intrinsic diastolic function and estimate left ventric
Cardiac arrest following a glucose 30% bolus: what happened?
Philippe Goutorbe, Nadia Kenane, Julien Bordes, Christophe Jego, Ambroise Montcriol, Eric Meaudre
Critical Care , 2008, DOI: 10.1186/cc6216
Abstract: One hour later hypoglycemia was detected, and 20 ml of 30% glucose was given intravenously. At the end of the injection, ventricular fibrillation developed. Cardiopulmonary resuscitation successfully restored adequate circulation within 12 minutes. Blood analysis performed using an ABL 700 (Radiometer, Copenhagen, Denmark) 1 minute after beginning cardiac resuscitation showed serum potassium of 5.1 mmol/l, ionised calcium of 1.1 mmol/l, and serum sodium of 140 mmol/l. The empty ampoule was checked, and had contained the correct solution. The cardiac rhythm had been normal before the glucose bolus was given, but sinus arrest with junctional or idioventricular escape rhythm developed at the end of bolus administration, immediately followed by ventricular fibrillation (Figure 1). The patient was discharged 2 weeks later without any sequelae.Electrocardiographic changes are not usually seen until serum potassium exceeds 6.0–6.5 mmol/l. Disappearance of the P wave is usually seen when serum potassium exceeds 8 mmol/l [1]. We were surprised, however, to find changes in the absence of any increase in serum potassium. There was neither hyponatremia nor hypocalcemia, both of which increase sensitivity to hyperkalemia [2,3]. Even if serum potassium was normal, we think it possible there could have been local hyperkalemia, which led to sinus arrest and then to ventricular fibrillation. The mechanism of this hyperkalemia, we postulate, is that the high potassium concentration (1,074 mmol/l) in the deadspace of the tubing was flushed by the glucose, corresponding to a 11 mEq intravenous bolus of K+.The present case highlights a dangerous aspect of using concentrated solutions for K+ therapy. Although an infusion rate of 17 mEq/hour is usually considered safe, in the particular situation here, with a central venous catheter in an intrathoracic position, flushing the catheter created a bolus injection. Theoretically, such a poorly mixed bolus can cause dangerous concentrations in
Evaluation of early mini-bronchoalveolar lavage in the diagnosis of health care-associated pneumonia: a prospective study
Guillaume Lacroix, Bertrand Prunet, Julien Bordes, Nathalie Cabon-Asencio, Yves Asencio, Tiphaine Gaillard, Sandrine Pons, Erwan D'aranda, Delphine Kerebel, Eric Meaudre, Philippe Goutorbe
Critical Care , 2013, DOI: 10.1186/cc12501
Abstract: We prospectively included all patients presenting with HCAP in the emergency department. Blood cultures and fiberoptic bronchoscope-guided distal protected small volume bronchoalveolar lavage (FODP mini-BAL) were performed in each patient. Empiric antibiotic therapy was adapted microbiological findings were available. The primary objective was to assess that FODP mini-BAL is more efficient than blood cultures to identify pathogens with the ratio of identification between both techniques as principal criteria.We included 54 patients with HCAP. Pathogens were identified in 46.3% of cases using mini-BAL, and in 11.1% of cases using blood cultures (p < 0.01). When patient did not receive antibiotic therapy before the procedure, pathogens were identified in 72.6% of cases using mini-BAL, and in 9.5% of cases using blood cultures (p<0.01). We noted multidrug-resistant pathogens in 16% of cases. All bronchoscopic procedures could be performed in patients without complications.FODP mini-BAL was more efficient than blood cultures for identifying pathogens in patients presenting with HCAP. When bacteriological identification was obtained, antibiotic therapy was adapted in 100% of cases.
A Tale of Two Motives: Endogenous Time Preference, Cash-in-Advance Constraints and Monetary Policy  [PDF]
Eric Kam
Modern Economy (ME) , 2013, DOI: 10.4236/me.2013.46045

This paper demonstrates the effects of modeling an endogenous rate of time preference and two cash-in-advance constraints. If the constraint is levied on consumption and capital goods, time preference effects are neutral and cash-in-advance constraint effects invert the Tobin Effect. If the constraint applies solely to consumption goods, opposing motives are offsetting and monetary policy is super neutral.

Targeting Phosphodiesterase 4 to Block the Link between Acute Exacerbation of Chronic Obstructive Pulmonary Disease and the Metabolic Complications  [PDF]
Eric Cho
Journal of Biosciences and Medicines (JBM) , 2015, DOI: 10.4236/jbm.2015.311007
Abstract: The metabolic disorders such as obesity and diabetes are found to be more frequent in chronic obstructive pulmonary disease (COPD). The chronic systemic inflammation orchestrated by macrophages constitutes one critical pathophysiological process underlying both acute exacerbation of COPD (AECOPD) and its metabolic complications such as obesity and diabetes. The cyclic adenosine monophosphate (cAMP) signaling controlled by phosphodiesterase (PDE) 4 is a pivotal intracellular modulator for macrophages functions in immune inflammatory response underlying AECOPD as well as obesity and diabetes. Targeting PDE4/cAMP signaling has been suggested to be effective in treating AECOPD or the metabolic disorders of obesity and diabetes. It is therefore reasonable to hypothesize that the chronic systemic inflammation can be a critical link between AECOPD and the metabolic disorders and targeting the PDE4/cAMP signaling can be effective to block this link between AECOPD and the associated metabolic complications.
Community Knowledge and Perceptions about Buruli Ulcers in Obom Sub-District of the Ga South Municipality in the Greater Accra Region of Ghana  [PDF]
Eric Koka
Advances in Applied Sociology (AASoci) , 2018, DOI: 10.4236/aasoci.2018.89037
Abstract: Community knowledge and perceptions of the cause and consequently the appropriate measure to remedy an ailment determine whom people turn to for advice, help, information and treatment when bogged down with a disease. The role that community plays in the etiology, explanation, prognosis and treatment seeking behaviour cannot be underscored, because it provides indepth information on the burden of the disease, the local understanding of the causes of the disease and therefore its management. The purpose of the study was to describe community knowledge and perceptions about Buruli ulcer (BU) and how to prevent Buruli ulcer in the Obom sub-district of Ghana. Survey questionnaire was used as an instrument for data collection to solicit information on community knowledge and perceptions of Buruli ulcer in the communities. In selecting respondents for the community survey, systematic sampling was used to select 300 respondents for the study. The study revealed a high level of knowledge about Buruli ulcer in the selected endemic communities. However, Buruli ulcer patients were perceived as people who have been bewitched (36.7%). Others (21%) blamed them as people who did not take good care of themselves while another 11.1% saw Buruli ulcer infected people as having normal wounds. Findings therefore show that although there was a high knowledge of signs and symptoms of Buruli ulcer among community members in the Obom sub-district, their understandings and interpretations of its causative factors varied from those of the biomedical understandings. Based on the results of the study, it is recommended that community outreach and education on the treatment and management of Buruli ulcer should be continued on a sustainable basis in the endemic communities.
Child Migration and Dropping Out of Basic School in Ghana: The Case of Children in a Fishing Community  [PDF]
Eric Daniel Ananga
Creative Education (CE) , 2013, DOI: 10.4236/ce.2013.46057

The government of Ghana’s effort on increasing access to basic education led to removal of school fees, introduction of capitation grants, school feeding and free school uniforms. While such moves have been applauded leading to improved access, child migration remains a barrier to educational access for children living in fishing communities in Ghana. This paper presents the experiences of schoolchildren who drop out of school as a result of child labour and seasonal migration. The central questions of the study are how and why migration acts as a barrier to education of children who had initial access. The paper presents in-depth analysis of qualitative data. The findings presented in the paper demonstrate that children enroll and attend school until they begin to migrate during mid-school sessions resulting in their exclusion from basic school. The paper concludes by highlighting some policy implications of children’s seasonal migration during school sessions and access to basic school in Ghana.

Extremes of Severe Storm Environments under a Changing Climate  [PDF]
Elizabeth Mannshardt, Eric Gilleland
American Journal of Climate Change (AJCC) , 2013, DOI: 10.4236/ajcc.2013.23A005

One of the more critical issues in a changing climate is the behavior of extreme weather events, such as severe tornadic storms as seen recently in Moore and El Reno, Oklahoma. It is generally thought that such events would increase under a changing climate. How to evaluate this extreme behavior is a topic currently under much debate and investigation. One approach is to look at the behavior of large scale indicators of severe weather. The use of the generalized extreme value distribution for annual maxima is explored for a combination product of convective available potential energy and wind shear. Results from this initial study show successful modeling and high quantile prediction using extreme value methods. Predicted large scale values are consistent across different extreme value modeling frameworks, and a general increase over time in predicted values is indicated. A case study utilizing this methodology considers the large scale atmospheric indicators for the region of Moore, Oklahoma for Class EF5 tornadoes on May 3, 1999 and more recently on May 20, 2013, and for the class EF5 storm in El Reno, Oklahoma on May 31, 2013.

Look Ma, We’re Still Theorizing: The Continued Search for Theoretical Integration  [PDF]
Kathleen Waggoner, Eric Roark
Sociology Mind (SM) , 2014, DOI: 10.4236/sm.2014.41009

In this paper, we explore the often-fractured attempt at theoretical integration within contemporary sociological thought. Theoretical integration was a goal of the early pioneers of sociology but has since been discounted by many as unattainable idealistic vision. We challenge this virtually universal assessment. The belief that theoretical integration is beyond grasp has been owed to a number of debates within contemporary sociological thought, including but not limited to, those surrounding human nature and rationality. We conclude our paper with a proposal for a new direction forward and a hopeful starting place for a promising integrated sociological perspective.

Practical Applications of Cosmology to Human Society  [PDF]
Eric J. Chaisson
Natural Science (NS) , 2014, DOI: 10.4236/ns.2014.610077
Abstract: Complex systems throughout Nature display structures and functions that are built and maintained, at least in part, by optimal energies flowing through them—not specific, ideal values, rather ranges in energy rate density below which systems are starved and above which systems are destroyed. Cosmic evolution, as a physical cosmology that notably includes life, is rich in empirical findings about many varied systems that can potentially help assess global problems facing us here on Earth. Despite its grand and ambitious objective to unify theoretical understanding of all known complex systems from big bang to humankind, cosmic evolution does have useful, practical applications from which humanity could benefit. Cosmic evolution’s emphasis on quantitative data analyses might well inform our attitudes toward several serious issues now challenging 21st-century society, including global warming, smart machines, world economics, and cancer research. This paper comprises one physicist’s conjectures about each of these applied topics, suggesting how energy-flow modeling can guide our search for viable solutions to real-world predicaments confronting civilization today.

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