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Search Results: 1 - 10 of 2854 matches for " Julien Bordes "
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Persistent left vena cava incidentally recognized during subclavian vein catheterization
Julien Bordes, Yves Asencio, Erwan d'Arranda, Philippe Goutorbe
Critical Care , 2010, DOI: 10.1186/cc8840
Abstract: Persistent LSVC occurs in 0.5% of the population and 5% to 10% of patients with congenital heart diseases. It usually drains into the right atrium through the coronary sinus, and it is associated with an absent right superior vena cava in 20% of cases [1]. The diagnosis can be made by bedside transthoracic or transesophageal echocardiography [2,3]. Computed tomography can also be useful [4]. Persistent LSVC is not a contraindication to subclavian vein catheterization but can make difficult the attempt to place a central venous line, pulmonary artery catheter, or pacemaker. Some authors described the uneventful use of a catheter placed in the LSVC for several days, after checking that the catheter tip was not in the coronary sinus [3]. The use of a pulmonary artery catheter has also been reported [1]. But manipulation of a catheter through the coronary sinus may result in hypotension, angina, or cardiac rhythm trouble.LSVC: left superior vena cava.The authors declare that they have no competing interests.Written consent for publication was obtained from the patient's relative.
A Rare Cause of Heart Failure Treated by Heart Transplantation: Noncompaction of the Ventricular Myocardium
Julien Bordes,Bertrand Jop,Sandrine Imbert,Sami Hraiech,Frédéric Collard,Fran ois Kerbaul
Case Reports in Medicine , 2009, DOI: 10.1155/2009/725879
Abstract: Noncompaction of the ventricular myocardium is a rare cardiomyopathy due to an arrest of myocardial morphogenesis. The characteristic echocardiographic findings are prominent myocardial trabeculations and deep intertrabecular spaces communicating with the left ventricular cavity. The clinical manifestations include heart failure (HF) signs, ventricular arrhythmias, and cardioembolic events. We describe an illustrative case of noncompaction of the ventricular myocardium associated with bicuspid aortic valve, a 42-year-old male presenting a refractory acute heart failure successfully treated by emergency heart transplantation.
Ischemic Stroke of the Artery of Percheron with Normal Initial MRI: A Case Report
Guillaume Cassourret,Bertrand Prunet,Fabrice Sbardella,Julien Bordes,Olga Maurin,Henry Boret
Case Reports in Medicine , 2010, DOI: 10.1155/2010/425734
Abstract: The artery of Percheron is a solitary trunk representing an uncommon anatomic variant that provides bilateral arterial supply to the paramedian thalami and the rostral midbrain. Occlusion of this artery results in bilateral thalamic and mesencephalic infarctions. The clinical diagnosis is difficult because the complex anatomy causes large clinical variability. We report a case of a comatose patient with normal early head-computed tomography and magnetic resonance imaging. A bilateral paramedian thalamic infarct due to an occlusion of the artery of Percheron was revealed two days later by a new head computed tomography. To our knowledge, this is the first report in the literature of a symptomatic patient presenting an acute Percheron stroke with normal early brain magnetic resonance imaging. Our case indicates that a normal initial magnetic resonance imaging cannot formally eliminate the diagnosis of acute stroke of the artery of Percheron. We discuss the causes of noncontributive brain magnetic resonance imaging at the onset of this acute Percheron stroke and the alternative diagnosis and therapy methods.
Cytomegalovirus infection monitored by quantitative real-time PCR in critically ill patients
Julien Bordes, Tiphaine Gaillard, Jér?me Maslin, Pierre Esnault, Philippe Goutorbe, Patrick Brisou
Critical Care , 2011, DOI: 10.1186/cc10066
Abstract: All the patients were CMV IgG seropositive on admission. They were monitored for CMV reactivation once to twice a week. Detection of CMV DNA in blood samples was performed by quantitative RT-PCR on whole blood. The patients' characteristics are described in Table 1. Patient 2 presented a CMV-associated hemophagocytic syndrome and was treated by ganciclovir for a duration of 21 days. DNAemia became undetectable in patients 3 and 4 spontaneously. These examples demonstrate that critically ill patients may experience several episodes of CMV reactivation during their ICU stay, and that CMV viral load can be very changeable. Furthermore, CMV viremia may be highly variable over a short period.In our opinion, CMV reactivation in critically ill patients should be monitored with quantitative methods of detection, such as RT-PCR. Indeed, we hypothesize that the potential role of CMV on patient outcome is mostly due to the intensity of CMV reactivation rather than the CMV reactivation per se. That is why we suggest that studies aimed at determining the role of CMV reactivation as a contributor to outcome in critically ill patients should use quantitative methods of detection. Consequently, a CMV viremia threshold could be determined to guide preemptive therapy in these patients.Written consent for publication was obtained from the patients or patients' relatives.CMV: cytomegalovirus; PCR: polymerase chain reaction; RT-PCR: real-time PCR.The authors declare that they have no competing interests.
The complications of percutaneous endoscopic gastrostomy
Julien Bordes, Emmanuel Hornez, Nadia Kenane, Christophe Carrere, Yves Asencio, Philippe Goutorbe
Critical Care , 2008, DOI: 10.1186/cc6962
Abstract: A 59-year-old man was admitted to our hospital with intracerebral hemorrhage. On day 40, a PEG was performed in the intensive care unit using the 'pull' technique as previously described [5]. The needle puncture of the stomach was accomplished only on the second attempt, although the rest of the procedure was completed uneventfully. The material used was the Bard?Fastrac? Pull PEG Kit (Bard Access Systems, Salt Lake City, USA). One hour after the end of the procedure, the patient presented a tachycardia (120 beats per minute), with cardiovascular collapse (arterial pressure 70/50 mmHg). Physical examination revealed a distended abdomen. The hemoglobin concentration was 5.5 g/dL. Abdominal echography showed the presence of intraperitonal liquid. An emergency laparotomy was performed, revealing a massive hemoperitoneum due to active bleeding from a small vessel of the minor curvature. X-sutures were applied and the bleeding stopped. A gastrostomy was recreated at the end of surgery.The massive hemoperitoneum we described is a rare complication in relation to its rapidity and its severity. We think that the initial, unsuccessful passage of the needle could have caused the gastric artery branch laceration. Indeed, such a mechanism of injuries has already been suggested as an explanation for a fatal retroperitoneum due to breaches in the splenic and superior mesenteric veins [4]. In the patient we described, prompt recognition could minimize morbidity.Although generally considered safe, PEG can be associated with life-threatening bleeding, especially when multiple needle punctures have been made. It presents with unexplained postprocedure hypotension. Intensivists who are used to performing PEG should be aware of this complication because early recognition and treatment are essential.PEG = percutaneous endoscopic gastrostomy.The authors declare that they have no competing interests.Written consent for publication was obtained from the patient's relatives.
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
De la sociedad a la postsociedad. Una aproximación a las transformaciones del campo de la salud desde la teoría sociológica contemporánea
Mariana Bordes
Espacio Abierto , 2011,
Abstract: Uno de los desafíos de la teoría sociológica contemporánea consiste en redefinir su bagaje conceptual, en un contexto histórico en el que las instituciones de la sociedad salarial -de aspiración inclusiva y universalista- sufren un retroceso como organizadoras de las relaciones sociales. El artículo intenta dar cuenta de las repercusiones que este desafío genera en una serie de trabajos contemporáneos que abordan una temática en particular: la de la salud, la enfermedad y la atención, pero no desde el área subdisciplinar, sino desde el campo de la teoría social general. Con un objetivo comparativo, la primera parte del trabajo se centra en la obra de Talcott Parsons, uno de los autores de teoría sociológica que contribuye a configurar una mirada sobre la realidad médica de las sociedades de la primera modernidad. En la segunda parte, nos centramos en analizar dos enfoques contemporáneos que, desde el campo de la teoría social, se interesan por las problemáticas vinculadas a la salud: las teorías de la gubernamentalidad -cuyos autores son comúnmente denominados anglofoucaultianos -, y las teorías de la reflexividad. En términos generales, se llega a la conclusión de que los autores actuales analizados sitúan el foco de interés hacia la gestión (individual y/o colectiva) del riesgo, así como la configuración de una ética para el cuidado de sí, que se distancia de la centralidad que reviste la noción de rol social -y sus supuestos teóricos fundamentales, como el de integración socio-cultural- en el modelo explicativo parsoniano
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.
Frequency-Dependent Streaming Potentials: A Review
L. Jouniaux,C. Bordes
International Journal of Geophysics , 2012, DOI: 10.1155/2012/648781
Abstract: The interpretation of seismoelectric observations involves the dynamic electrokinetic coupling, which is related to the streaming potential coefficient. We describe the different models of the frequency-dependent streaming potential, mainly Packard's and Pride's model. We compare the transition frequency separating low-frequency viscous flow and high-frequency inertial flow, for dynamic permeability and dynamic streaming potential. We show that the transition frequency, on a various collection of samples forwhich both formation factor and permeability are measured, is predicted to depend on the permeability as inversely proportional to the permeability. We review the experimental setups built to be able to perform dynamic measurements. And we present some measurements and calculations of the dynamic streaming potential.
Strong and weak convergence of nonparametric estimat
L Bordes, KE Gneyou
Afrika Statistika , 2011,
Abstract: In this paper we consider a competing risks model including covariates in which the observations are subject to random right censoring. Without any assumption of independence of the competing risks, and based on a nonparametric kernel-type estimator of the incident regression function, an estimator of the conditional regression function is proposed. We show that at a given covariate value and under suitable conditions the nonparametric estimator of the regression function is asymptotically normal. A simulation study is provided showing that our estimators have good behaviour for moderate sample sizes. Nous consid′erons dans ce papier un mod`ele de risques comp′etitifs dans lequel les observations sont soumises `a une censure al′eatoire `a droite en pr′esence de covariables. Sans aucune hypoth`ese d’ind′ependance sur les risques comp′etitifs, un estimateur non param′etrique de la fonction de r′epartition conditionnelle incidente est propos′e. Cet estimateur est obtenu via celui d’un estimateur non param′etrique de type noyau de la fonction de r′egression incidente. Nous d′emontrons que pour une valeure fix′ee de la covariable, et sous certaines conditions, l’estimateur non param′etrique de la fonction de r′egression incidente est asymptotiquement normal. Des simulations illustrent le bon comportement de nos estimateurs pour des tailles mod′er′ees d’′echantillons.
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