Manioc : Portail | resultats 21 - 40 pour la recherche: Clermont, Raymond

Systemic antifungal therapy for proven or suspected invasive candidiasis: the AmarCAND 2 study
Auteur(s) : Leroy, Olivier Bailly, Sébastien Gangneux, Jean-Pierre Mira, Jean-Paul Devos, Patrick Dupont, Hervé Montravers, Philippe Perrigault, Pierre-François
Auteurs secondaires : Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823) ; Université Joseph Fourier - Grenoble 1 (UJF) - CHU Grenoble - EFS - Institut National de la Santé et de la Recherche Médicale (INSERM) Institut de recherche, santé, environnement et travail [Rennes] (Irset) ; Université d'Angers (UA) - Université des Antilles et de la Guyane (UAG) - Université de Rennes 1 (UR1) - École des Hautes Études en Santé Publique [EHESP] (EHESP) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) Service de Parasitologie-Mycologie [Rennes] ; Université de Rennes 1 (UR1) - Hôpital Pontchaillou - CHU Pontchaillou [Rennes] Institut Cochin (UM3 (UMR 8104 / U1016)) ; Université Paris Descartes - Paris 5 (UPD5) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Centre National de la Recherche Scientifique (CNRS) Service de Réanimation polyvalente ; Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Cochin [AP-HP] - Université Paris Descartes - Paris 5 (UPD5) Département de biostatistiques ; Université de Lille, Droit et Santé CHU Amiens-Picardie Service d'anesthésie - réanimation chirurgicale ; Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Bichat - Claude Bernard [Paris] - Université Paris Diderot - Paris 7 (UPD7)

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BACKGROUND: In the context of recent guidelines on invasive candidiasis (IC), how French intensive care units (ICUs) are managing IC? METHODS: This is a prospective observational multicenter cohort study. During 1 year (2012-2013), 87 French ICUs enrolled consecutive patients with suspected or proven IC (SIC or PIC) and receiving systemic antifungal therapy (SAT). Data were collected up to 28 days after inclusion. RESULTS: We studied 835 patients, 291 with PIC and 544 with SIC. At SAT initiation, patients with SIC were significantly more severe (SAPS II 50.1 ± 18.7 vs. 46.2 ± 18.0). Severe sepsis or septic shock prompted to initiate empiric SAT in 70 % of SIC. Within 4 days in median, the initial SAT was modified in 49 % of patients with PIC vs. 33 % patients with SIC. Modifications were most often motivated by mycological results, and de-escalation was the most frequent change. Regarding compliance to IC management guidelines, echinocandin was used for 182 (62.5 %) patients with PIC, and 287 (52.7 %) of those with SIC; central venous catheter was removed in 87 (54.3 %) of patients with candidaemia, and 43 of the remaining patients received echinocandin; and de-escalation was undertaken after 5 days of SAT in 142 patients, after 10 days in 13 patients. As 20.6 % of SIC were secondarily documented, 403/835 (48 %) patients had finally a proven IC. Candida albicans was the main pathogen (65.3 %), then Candida glabrata (15.9 %). The 28-day mortality rates were 40.0 % in candidaemia, 25.4 % in cIAI, and 26.7 % in deep-seated candidiasis. In the overall population of patients with proven IC, four independent prognostic factors were identified: immunosuppression (Odds Ratio (OR) = 1.977: 1.03-3.794 95 % confidence interval (CI), p = 0.04), age (OR = 1.035; 1.017-1.053 95 % CI; p extless 0.001), SAPS extgreater46 on ICU admission (OR = 2.894; 1.81-4.626 95 % CI; p extless 0.001), and surgery just before or during ICU stay (OR = 0.473; 0.29-0.77 95 % CI; p extless 0.001). CONCLUSION: When SAT is initiated in French ICUs, the IC is ultimately proven for 48 % of patients. Empiric SAT is initiated in severely ill ICU patients. The initial SAT is often adapted, with de-escalation to fluconazole when possible. Mortality rate remains high
ISSN: 2110-5820

hal-01259216
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01259216
DOI : 10.1186/s13613-015-0103-7
PUBMED : 26743881

| Plus

Histoire de la Martinique depuis la colonisation jusqu'en 1815. Tome 1
Auteur(s) : Daney de Marcillac, Sidney (1810-1893)
Auteurs secondaires : Mauduison (18..-18.. )
Année de publication :

| Plus

France pittoresque ou Description pittoresque, topographique et statistique des départements et colonies de la France : offrant en résumé, pour chaque département et colonie, l'histoire, les antiquités, la topographie, la météorologie, l'histoire naturelle, la division politique et administrative, la description générale et pittoresque du pays, la description particulière des villes, les bourgs, les communes et châteaux, celles des moeurs, coutumes et costumes, etc. ; avec des notes sur les langues, idiomes, et patois, sur l'instruction publique et la bibliographie locale, sur les hommes célèbres, etc. ; et des renseignements statistiques sur la population, l'industrie, le commerce, l'agriculture, la richesse territoriale, les impôts, etc., etc. ; accompagnée de la statistique générale de la France sous le rapport politique, militaire, judiciaire, financier, moral, médical, agricole, industriel et commercial. T. 3.
Auteur(s) : Hugo, Abel (1798-1855)
Année de publication :

| Plus

Le globe-trotter chez M. David Levat
Année de publication :

| Plus

Histoire générale des Antilles Tome premier de la première série
Auteur(s) : Dessalles, Adrien (1809-1870)
Année de publication :

| Plus

La France équinoxiale. [Tome second], Voyage à travers les Guyanes et l'Amazonie
Auteur(s) : Coudreau, Henri Anatole (1859-1899)
Année de publication :

| Plus

Guidelines for the use and interpretation of assays for monitoring autophagy.
Auteur(s) : Klionsky, Daniel J Abdalla, Fabio C Abeliovich, Hagai Abraham, Robert T Acevedo-Arozena, Abraham Adeli, Khosrow Agholme, Lotta Agnello, Maria
Auteurs secondaires : Molecular and Cellular Biology ; University of Leuven Laboratoire d'Epigénétique et Cancer ; CNRS - Université Paris-Sud - Paris 11 (UP11) Department of Pharmacology ; Department of Pharmacology Immunobiologie des Cellules Dendritiques ; INSERM - Institut Pasteur de Paris Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (FEMTO-ST) ; CNRS - Université de Franche-Comté - Université de Technologie de Belfort-Montbeliard - Ecole Nationale Supérieure de Mécanique et des Microtechniques Telethon Institute for Genetics and Medicine ; Telethon Institute Medical Genetics ; Federico II University Department of Molecular and Human Genetics ; Baylor College of Medicine

Éditeur(s) : HAL CCSD Landes Bioscience
Résumé : International audience
In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field.
Autophagy

hal-00735751
https://hal.archives-ouvertes.fr/hal-00735751
PUBMED : 22966490

| Plus