Éditeur(s) : HAL CCSD Nature Publishing Group
Résumé : International audience
Collisional mountain belts grow as a consequence of continental plate convergence and eventuallydisappear under the combined effects of gravitational collapse and erosion. Using a decade ofGPS data, we show that the western Alps are currently characterized by zero horizontal velocityboundary conditions, offering the opportunity to investigate orogen evolution at the time ofcessation of plate convergence. We find no significant horizontal motion within the belt, but GPS andlevelling measurements independently show a regional pattern of uplift reaching ~2.5 mm/yr in thenorthwestern Alps. Unless a low viscosity crustal root under the northwestern Alps locally enhancesthe vertical response to surface unloading, the summed effects of isostatic responses to erosion andglaciation explain at most 60% of the observed uplift rates. Rock-uplift rates corrected from transientglacial isostatic adjustment contributions likely exceed erosion rates in the northwestern Alps. In theabsence of active convergence, the observed surface uplift must result from deep-seated processes.
ISSN: 2045-2322

hal-01357450
https://hal.archives-ouvertes.fr/hal-01357450
https://hal.archives-ouvertes.fr/hal-01357450/document
https://hal.archives-ouvertes.fr/hal-01357450/file/noquet2016.pdf
DOI : 10.1038/srep28404

Éditeur(s) : Cayenne : Imprimerie du gouvernement
Résumé : Année 1834
Siècle(s) traité(s) : 19
Droits : Domaine public
Provenance : Collectivité territoriale de Guyane. Bibliothèque Alexandre-Franconie
Permalien : http://www.manioc.org/patrimon/FRA11262-1
FRA11262-1

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : Contaminant migration in aquifers is one of the most debated issues in hydrogeology, as most experimental results display large deviations from the standard (asymptotic) Fickian dispersion theories. Multi-scale investigation and high-resolution sensors are required to determine the origin of non-asymptotic dispersion and validate models. For this, a set of multi-scale Single-Well Injection-Withdrawal (SWIW) tracer tests using a new dual-packer probe CoFIS, including a high resolution optical sensor TELog, are presented. When compared to standard techniques such as salinity measurements, it is shown that high-resolution optical measurements allow an improved characterization of the long-lasting non-asymptotic dispersion mechanisms.
ISSN: 1631-0713

hal-00445250
https://hal.archives-ouvertes.fr/hal-00445250
DOI : 10.1016/j.crte.2009.07.012

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : In French Guiana, the population growth will result in an increase in demand for agricultural products and thus, will lead to an increase in the amount of tropical forests converted into cropland or pasture. Impacts of different agricultural systems on greenhouse gas (GHG) fluxes have not been studied in French Guiana. In this context, the fire-free chop-and-mulch method was used to convert a tropical forest site to agriculture. This study focused on soil nitrous oxide (N2O) emissions and we compared four land uses: (1) the undisturbed tropical forest, (2) recently converted grassland and recently converted croplands (fertilized soybean/maize rotation) with either (3) disk tillage or (4) no tillage.N2O measurements were obtained through the chamber technique and conducted over a 1-year period (measurements began 19 months after the forest was cleared). N2O fluxes were related to soil parameters measured at each sampling date: nitrate and ammonium contents, gravimetric water content (GWC) and temperature.Through the entire period, the mean (±standard error) and median N2O fluxes were 3.8 ± 0.5 and 2.7 g N ha−1 day−1, respectively for undisturbed tropical forest and 2.4 ± 0.9 and 0.8 g N ha−1 day−1, respectively for grassland (mowed Brachiaria ruziziensis). For croplands, no significant difference was found for N2O emissions between both agricultural practices. The mean (±standard error) and median N2O fluxes were 8.5 ± 1.2 and 4.0 g N ha−1 day−1, respectively for disk tillage plots and 8.5 ± 1.3 and 3.6 g N ha−1 day−1, respectively for no tillage plots. Nitrogen inputs (due to the application of fertilizer or due to the mineralization of crop residues) led to higher N2O fluxes, resulting in significantly higher mean N2O emissions from croplands compared to the forest, when only considering land use effect on N2O fluxes in a statistical model. The soil nitrate content, GWC and temperature had a significant positive effect on N2O fluxes. Taking into account these soil parameters in another statistical model, N2O emissions from croplands were not higher than the natural N2O emissions from tropical forest soils. Our results suggest that, if more forest will have to be converted in the course of the expected population growth in French Guiana, it could have low impact on the soil N2O fluxes (similar to natural fluxes from forest) with the improving of farming techniques (for example modification of the splitting of N-fertilizer) in the cropping plots.
ISSN: 0167-8809

hal-01204228
https://hal.archives-ouvertes.fr/hal-01204228
DOI : 10.1016/j.agee.2015.04.004
PRODINRA : 307607

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
Alveolar proteinosis (AP) is a rare disease characterized by alveolar accumulation of surfactant components, which impairs gas exchange. AP is classified into three groups: auto-immune AP defined by the presence of plasma autoantibodies anti-GM-CSF, the most frequent form (90 % of all AP); secondary AP, mainly occurring as a consequence of haematological diseases, or following on from toxic inhalation or infections, and genetic AP, which affects almost exclusively children. AP diagnosis is suspected where chest CT-scan demonstrates interstitial lung disease with a crazy paving aspect; and confirmed by bronchoalveolar lavage, which has a milky appearance and contains periodic acid Schiff positive proteinaceous alveolar deposits. The use of surgical lung biopsy to confirm AP is less frequent nowadays. In this context, positive antibodies against GM-CSF indicates an auto-immune etiology of the AP. Concerning management, whole lung lavage is the gold standard therapy. In refractory AP, new treatments are available such as subcutaneous or inhaled GM-CSF supplementation, or rituximab infusions. The clinical course is unpredictable. Spontaneous improvement or even cure can occur, and the 5-year actuarial survival is 95 %. The most frequent complications are infectious etiology.
La protéinose alvéolaire pulmonaire (PAP) est une maladie rare caractérisée par l’accumulation alvéolaire de composants du surfactant qui gêne les échanges gazeux. Les PAP sont séparées en trois groupes : les PAP auto-immunes caractérisées par la présence d’anticorps sériques anti-GM-CSF qui sont les plus fréquentes ; les PAP secondaires à une maladie sous-jacente, le plus souvent hématologique, mais aussi à l’inhalation de toxiques et à des infections ; enfin, les PAP d’origine génétique. Le diagnostic de PAP est évoqué sur le scanner thoracique avec une pneumopathie infiltrante diffuse ayant un aspect classique de crazy paving, puis confirmé par l’aspect laiteux du lavage bronchoalvéolaire, et la présence de matériel lipoprotéinacé PAS positif. La confirmation du diagnostic de PAP par biopsie pulmonaire chirurgicale est désormais rarement nécessaire. La positivité des anticorps sériques anti-GM-CSF signe le caractère auto-immun de la maladie. Le traitement de référence des PAP auto-immunes est le « grand lavage pulmonaire thérapeutique ». En cas de maladie réfractaire, d’autres traitements sont disponibles, tels que le GM-CSF en injection sous-cutanée ou en aérosol et le rituximab. L’évolution de la maladie est imprévisible. Une évolution spontanément favorable ou même une guérison spontanée peuvent survenir et la survie actuarielle à 5 ans est de 95 %. Les principales complications sont infectieuses.
ISSN: 0761-8425

hal-01085907
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01085907
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01085907/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01085907/file/Prot%C3%A9inose%20alv%C3%A9olaire%20pulmonaire_accepted.pdf
DOI : 10.1016/j.rmr.2014.08.009

Éditeur(s) : Us Government Printing Office
Initial Reports Of The Deep Sea Drilling Project (Us Government Printing Office), 1985 , Vol. 80 , N. Part VIII , P. 1153-1165

Droits : info:eu-repo/semantics/openAccess
http://archimer.ifremer.fr/doc/00184/29494/27815.pdf
DOI:10.2973/dsdp.proc.80.156.1985
http://archimer.ifremer.fr/doc/00184/29494/

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
PURPOSE: Two hundred and fifty-three patients were included in a study on the etiology of encephalitis, carried out in France in 2007. Tuberculosis was the second most frequently identified cause, after HSV and with the same number of cases as VZV. The authors report the specific features of patients presenting with tuberculosis encephalitis (TE). METHODS: TE patients were defined as patients presenting with encephalitis, with positive culture or PCR for Mycobacterium tuberculosis, or the association of clinical, biological, imaging, and epidemiological evidence (possible cases). Clinical, microbiological, and brain imaging data was analyzed and compared to that of other included patients. RESULTS: Twenty cases of TE were identified. The M/F sex-ratio was 1.5, the mean age 53 years. Four (20%) patients had a history of tuberculosis before the encephalitis. The median delay between the onset of general and neurological symptoms was significantly longer for tuberculosis cases than for others (10 days vs. 2; P<10(-10)). The median CSF protein level was significantly higher for tuberculosis cases (2.1 g/L vs. 0.8 g/L, P=0.002). CT scan and MRI were normal on admission for eight patients out of 17. Fourteen isolated strains of M. tuberculosis were susceptible to first-line anti-tuberculosis drugs and one was rifampicin-resistant. Six (33%) patients died during hospitalization and two were lost to follow-up. Ten out of 12 (78.6%) had persisting neurological symptoms on discharge. DISCUSSION: Despite non-multiresistant MT strains, the case fatality rate among TE patients was high in our series. Early brain imaging is poor contributive for the diagnosis of TE.
ISSN: 0399-077X

hal-00874835
https://hal.archives-ouvertes.fr/hal-00874835
DOI : 10.1016/j.medmal.2013.05.003
PUBMED : 23816146

Éditeur(s) : Paris : Berger-Levrault
Description : La vie quotidienne des martiniquais au travers de leurs us et coutumes.

Droits : Domaine public
Provenance : Ville de Pointe-à-Pitre. Réseau des bibliothèques
Permalien : http://www.manioc.org/patrimon/PAP11065
PAP11065

Éditeur(s) : Paris : Payot
Siècle(s) traité(s) : 18
Droits : Domaine public
Provenance : Ville de Pointe-à-Pitre. Réseau des bibliothèques
Permalien : http://www.manioc.org/patrimon/PAP11110
PAP11110

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
ISSN: 1631-0691

hal-01109741
https://hal-agroparistech.archives-ouvertes.fr/hal-01109741
DOI : 10.1016/j.crvi.2011.04.002

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
The maintenance in the long run of a positive carbon balance under very low irradiance is a prerequisite for survival of tree seedlings below the canopy or in small gaps in a tropical rainforest. To provide a quantitative basis for this assumption, experiments were carried out to determine whether construction cost (CC) and payback time for leaves and support structures, as well as leaf life span (i) differ among species and (ii) display an irradiance-elicited plasticity. Experiments were also conducted to determine whether leaf life span correlates to CC and payback time and is close to the optimal longevity derived from an optimization model. Saplings from 13 tropical tree species were grown under three levels of irradiance. Specific-CC was computed, as well as CC scaled to leaf area at the metamer level. Photosynthesis was recorded over the leaf life span. Payback time was derived from CC and a simple photosynthesis model. Specific-CC displayed only little interspecific variability and irradiance-elicited plasticity, in contrast to CC scaled to leaf area. Leaf life span ranged from 4 months to >26 months among species, and was longest in seedlings grown under lowest irradiance. It was always much longer than payback time, even under the lowest irradiance. Leaves were shed when their photosynthesis had reached very low values, in contrast to what was predicted by an optimality model. The species ranking for the different traits was stable across irradiance treatments. The two pioneer species always displayed the smallest CC, leaf life span, and payback time. All species displayed a similar large irradiance-elicited plasticity.
ISSN: 1631-0691

hal-01095975
https://hal-agroparistech.archives-ouvertes.fr/hal-01095975
DOI : 10.1016/j.crvi.2011.01.007

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
ISSN: 1156-5233

hal-01659742
https://hal.archives-ouvertes.fr/hal-01659742
DOI : 10.1016/j.mycmed.2017.10.004

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : no abstract
ISSN: 0033-2984

hal-01360231
https://hal.archives-ouvertes.fr/hal-01360231

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : While oceanic circulation in the Gulf of Lion (GoL) has often been studied in calm weather or with northerly winds (Tramontane or Mistral) through observations and numerical circulation models, few studies have focused on southeasterly storm events. Yet, correct representation of the circulation during storms is crucial if the suspension of sediments is to be correctly modelled throughout the Gulf. The purpose of this paper is to describe the hydrodynamics in the Gulf of Aigues-Mortes (NW of the GoL) during the storm of 18 February 2007 by using a set of data from an ADCP station placed at a depth of 65 m on the sea bed off the coast at Sète, supplemented by the ocean circulation model SYMPHONIE. This storm was characterized by a moderate south-easterly wind (15 m . s−1) and waves of up to 5 m of significant height at its apex. At the ADCP, strong currents of up to 0.8 m . s−1 near the surface and 0.5 m . s−1 near the bottom were recorded, parallel to the coast, flowing towards the south-west. The simulated currents were widely underestimated, even taking the effect of waves into account in the model. It was suspected that the representation of the wind in the atmospheric model was an underestimation. A new simulation was therefore run with an arbitrarily chosen stronger wind and its results were in much better agreement with the measurements. A simplified theoretical analysis successfully isolated the wind-induced processes, responsible for the strong currents measured during the apex and the strong vertical shear that occurred at the beginning of the storm. These processes were: 1/ the barotropic geostrophic current induced by a wind parallel to the coast and 2/ the Ekman spiral. The duration of the storm (about 36 h at the apex) explains the continuous increase of the current as predicted by the theory. The frictionally induced Ekman transport explains the current shear in the surface layer in the rising stage of the storm, and the addition of high waves and strong wind at the apex is more in favour of strong vertical mixing in the surface layer.
ISSN: 1631-0713

hal-00908200
https://hal.archives-ouvertes.fr/hal-00908200
DOI : 10.1016/j.crte.2013.07.001

Éditeur(s) : HAL CCSD American Meteorological Society
Résumé : Global positioning system (GPS) data from a dense network have been used for the analysis of the diurnal cycle of water vapor over Marseille, France, during the second intensive observation period (IOP2; 21–26 June 2001) of the Expérience sur Sites pour Contraindre les Modèles de Pollution Atmosphérique et de Transport d'Emission (ESCOMPTE) field experiment. Both tomographic analyses and integrated water vapor (IWV) contents from GPS have been used, in addition to wind profiler data and surface observations. Tomographic analysis of data from the dense GPS network and radiosondes provided the continuous temporal evolution of the vertical distribution of water vapor over the city of Marseille. The city is located on the shore of the Mediterranean Sea in southeastern France and is often under the influence of sea-breeze effects. Two different layers of breeze circulation are identified: a shallow sea breeze, blowing perpendicular to the local coastline, and a deep sea breeze, induced by the regional temperature gradient between sea and land. The origin of water vapor is shown to be mainly due to the advection of marine moist air by these sea-breeze circulations. However, the diurnal cycle of water vapor over Marseille is strongly influenced by the synoptic situation, which changes during the IOP2 (between a northerly mistral in the early stage of the IOP and an easterly wind at the end). It is shown that vertical profiles from tomographic analyses (combined with wind profiler data) allow for a proper interpretation of the diurnal cycle observed in IWV. Two-dimensional maps of IWV are also shown to complement the description of the horizontal advection of moisture by the different circulation regimes.
ISSN: 1558-8424

hal-00273624
https://hal.archives-ouvertes.fr/hal-00273624
https://hal.archives-ouvertes.fr/hal-00273624/document
https://hal.archives-ouvertes.fr/hal-00273624/file/drJAM_cycle_diurne_GPS_rev1.pdf
DOI : 10.1175/JAM2450.1

Résumé : This study contributes to inventory programme on emerging pollutants in French waters and to the general reflection which will enable to update the list of relevant substnaces to be included in the new monitoring programmes to come. This work concerns the coastal part of the inventory programme on marine waters and sediments of France and five overseas french departments (OFD). In this goal, passive sampling techniques and direct extraction techniques have been tested through the implementation of in situ systems integrators POCIS (Polar Organic Chemical Integrative Sampler) and the extraction by SBSE bars (Stir bar sorptive extraction) directly in the waters sampled. Finally, analyzes of sediment completed the acquisition of data. Arount 40 stations were sampled for shore waters and sediments were collected from 7 stations in France and 5 stations in the OFD (one station/OFD). In analytical terms, 1054 analyzes were carried out on POCIS membranes and only 64 data exceeded the limit of detection (LD), 12726 analyzes came from SBSE extractions and 304 were above the LD and 1536 analyzes in sediment showed that 237 data were above the limit of quantification (LQ). Finally, 169 different substances were investigated and 68 of them were detected at least once in water or sediment. The lack of replicates for POCIS analyzes and those in the sediment limited the statistical treatment of data. The results were used to determine the level of contamination, the detection frequency (FD), the distribution of substances between France and OFD, the comparison with environmental thresholds (the PNEC) and the origin/use of the substances. In littoral waters, 32 substances were identified and 19 were quantified. In the sediment, 47 substances were quantified. Nine substances were detected in both water and sediment. In France, the 15 substances that were quantified at higher frequencies (> 50 %, one out of 2 sites) were quantified in sediments. These are the congeners of PAHs (11 substances), organic forms of tin (2 substances), diethyl lead and 209 PBDE congener. In the OFD, the 22 substances that were quantified at higher frequencies (> 50 %, one out of 2 sites) were measured in sediments. These are congeners of PAHs (13 substances) , alkylphenols ( 3 molecules: the mono and diethoxyate nonylphenol and the 4-ter butylphenol ), the organic forms of tin (2 substances), products of metabolism insecticide DDT ( 2 products), diethyl lead and the 209 PBDE congener. The study of the highest concentrations distribution of substances between France and OFD shows that the 5 (among 19 molecules) highest concentrations in water and the 6 (among 47 molecules) highest concentrations in sediments are found in OFD. Reference to PNEC indicates that four pesticides in water and 11 different substances in sediments exceed the environmental thresholds. Substances with highest detection frequency are found in the sediment. The distribution of data by use or nature of the substance shows that plasticizers and pesticides predominate in raw water, both in France and overseas departments while PAHs in sediments dominate in France and in OFD.
Cette étude contribue au programme d’inventaire des substances chimiques émergentes dans les eaux françaises et à la réflexion qui doit permettre d’actualiser la liste des substances pertinentes à surveiller de manière régulière dans le cadre des nouveaux programmes de surveillance. Ce travail concerne la partie littorale de l’inventaire, sur les eaux brutes et les sédiments de la métropole et des 5 DOM. Dans ce cadre, des techniques d’échantillonnage passif (EP) et d’extraction directe ont été testées grâce à la mise en place in situ de systèmes intégrateurs POCIS (Polar Organic Chemical Integrative Sampler) et à l’extraction par des barres SBSE (Stir Bar Sorptive Extraction) directement dans les eaux échantillonnées. Enfin des analyses de sédiments ont complété l’acquisition des données. L’eau d’une quarantaine de stations a été échantillonnée et des sédiments ont été prélevés sur 7 stations en métropole et dans 5 stations dans les DOM (une station par DOM). En termes analytiques, 1054 analyses ont été réalisées sur les membranes POCIS et 64 dépassaient la limite de détection (LD), 12726 analyses ont concerné les extractions par SBSE pour 304 résultats situés au dessus de la LD et 1536 analyses effectuées dans le sédiment ont donné 237 valeurs supérieures à la limite de quantification (LQ). Au bilan 169 substances différentes ont été recherchées et 68 d’entre elles ont été détectées au moins une fois dans l’eau brute ou le sédiment. L’absence de réplicats pour les analyses POCIS et celles dans le sédiment a limité le traitement statistique des données. Les résultats ont permis de déterminer le niveau de contamination, la fréquence de détection (FD), la distribution métropole/DOM des substances, la comparaison avec les seuils environnementaux (PNEC) et l’origine des substances. Dans l’eau 32 substances ont été identifiées et 19 ont été quantifiées. Dans le sédiment 47 substances sont quantifiées .Neuf substances sont détectées à la fois dans l’eau et le sédiment. En métropole, les 15 substances quantifiées aux plus hautes fréquences (> 50%, soit un site sur 2) sont quantifiées dans les sédiments. Ce sont les congénères de la famille des HAP (11 substances), des formes organiques de l’étain (2 substances), le plomb diéthyle et le congénère 209 des PBDE. Dans les DOM, les 22 substances quantifiées aux plus hautes fréquences (> 50%, soit un site sur 2) sont mesurées dans les sédiments. Ce sont des congénères de la famille des HAP dans (13 substances), des alkylphénols (3 substances : nonylphénols mono et diéthoxylés et 4-ter butylphénol), des formes organiques de l’étain (2 substances), des produits de métabolisation de l’insecticide DDT (2 produits), du plomb diéthyle et du congénère 209 des PBDE. L’étude de la répartition des plus fortes concentrations entre la métropole et les DOM montre que les 5 (sur 19) concentrations les plus élevées mesurées dans l’eau et les 6 (sur 47) plus fortes concentrations mesurées dans les sédiments sont trouvées dans les DOM. Les substances mesurées aux fortes fréquences sont observées dans le sédiment. La référence à la PNEC indique le dépassement de la norme pour 4 pesticides dans l’eau brute et 11 substances diverses dans les sédiments. L’exploitation des données par usage ou nature des substances montre que les plastifiants et les pesticides sont majoritaires dans les eaux brutes, à la fois en métropole et dans les DOM alors que ce sont les HAP qui dominent dans les sédiments, en métropole et dans les DOM.

Droits : 2014 ONEMA, Ifremer
http://archimer.ifremer.fr/doc/00259/36994/35483.pdf
http://archimer.ifremer.fr/doc/00259/36994/

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
Nous avons comparé les concentrations sanguines de lactate chez huit triathètes au cours d'un test triangulaire, avant et après (22,4 ± 2,6 heures) un triathlon classique. Les résultats montrent des concentrations sanguines de lactate significativement plus basses après le triathlon, malgré une puissance maximale (Pmax) et une consommation maximale d'oxygène (VO2max) comparables lors des deux tests triangulaires. Cette baisse des concentrations de lactate sanguin observée après le triathlon est interprétée comme étant le résultat d'une diminution des réserves de glycogène musculaire, d'une réutilisation plus grande du lactate produit, d'un recours plus important aux substrats lipidiques, ainsi que d'une diminution des catécholamines circulantes lors du test réalisé après le triathlon.
ISSN: 0765-1597

hal-00720458
https://hal.univ-antilles.fr/hal-00720458
DOI : 10.1016/S0765-1597(99)80005-7

Éditeur(s) : HAL CCSD Elsevier Elsevier Masson
Résumé : New field and micropalaeontological investigations have been conducted in four of the Pliocene rias of the internal zone of the Rif in Morocco, on the southern margin of the Alboran Sea. We found that marine sediments outcropping in these rias were deposited mainly during the Early Zanclean, between 5.04 and 3.8 Ma. After a transgressive episode that led to the deposition of terrestrial to marine conglomerates, dark clays deposited first at shallow palaeo-depths and then at bathyal palaeo-depths. The rias were then infilled with a shallowing upward succession comprising marine clays and sandstone and, locally, terrestrial sediments that indicate their final emersion. No Gilbert-deltas were observed in these rias. The presence of transgressive deposits at the bottom of the rias, also identified in other basins of the external zone of the Rif, and the absence of Gilbert deltas question a catastrophic reflooding after the Messinian Salinity Crisis in this area.
ISSN: 1631-0713

hal-01115243
https://hal.archives-ouvertes.fr/hal-01115243
DOI : 10.1016/j.crte.2014.03.002

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
The Société de pneumologie de langue française defines acute exacerbation of chronic obstructive pulmonary disease (AE COPD) as an increase in daily respiratory symptoms, basically duration ≥ 48h or need for treatment adjustment. Etiology of EA COPD are mainly infectious, viral (rhinovirus, influenzae or parainfluenzae virus, coronavirus, adenovirus and respiratory syncytial virus) or bacterial (Haemophilus influenzae, Streptococcus pneumoniae, or Moraxella catarrhalis). Pollutant exposure can also lead to AE COPD, such as NO2, SO2, ozone or particulates (PM10 and PM2.5). In 30% the etiology remains unknown. Differential diagnoses of AE COPD include infectious pneumonia, pneumothorax, acute heart failure and pulmonary embolism. Presences of signs of severity impose hospitalization: signs of respiratory distress, shock, acute confusion but also fragile patients, insufficient home support or absence of response to initial treatment. AE COPD treatments consist on increase in bronchodilators, chest physiotherapy, and antibiotics if sputum is frankly purulent. Systemic corticosteroids should not be systematic.Recommended dose is 0.5 mg/kg on short course (7 days). During hospitalization, oxygen supplementation and thromboprophylaxis could be prescribed. The main interest in noninvasive ventilation is persistent hypercapnia despite optimal medical management. During ambulatory management or hospitalization, clinical assessment at 48-72h is mandatory. L’exacerbation aiguë de bronchopneumopathie chronique obstructive (EA BPCO) représente un événement important dans l’histoire naturelle de la BPCO, notamment en cas d’hospitalisation. Les EA BPCO interviennent dans la gravité et l’évolution de la BPCO ; et leur prévention est un des objectifs principal des traitements de fond.
La Société de pneumologie de langue française définie l’exacerbation aiguë de bronchopneumopathie chronique obstructive (EA BPCO) comme une majoration des symptômes respiratoires au-delà des variations quotidiennes, en pratique, d’une durée ≥ 48h ou justifiant une modification thérapeutique. L’étiologie de ces EA BPCO est principalement infectieuse, virale (rhinovirus, virus influenzae et parainfluenzae, coronavirus, adénovirus et virus respiratoire syncytial) ou bactérienne (principalement Haemophilus influenzae, Streptococcus pneumoniae et Moraxella catarrhalis). Elles peuvent également résulter de l’exposition à certains polluants comme le NO2, le SO2, l’ozone et la pollution particulaire (PM10 et PM2,5). L’étiologie reste indéterminée dans près de 30 % des cas. Les diagnostics différentiels des EA BPCO incluent les pneumopathies infectieuses, les pneumothorax, les poussées d’insuffisance cardiaque et les embolies pulmonaires. La présence de signes de gravité conditionnent l’hospitalisation : signes d’insuffisance respiratoire aiguë, de choc ou de défaillance neurologique, mais aussi en cas de patient fragile, d’absence de soutien familial à domicile ou d’absence de réponse au traitement initial. Le traitement d’une EA BPCO consiste en une majoration des bronchodilatateurs, une kinésithérapie respiratoire, une antibiothérapie en cas d’expectoration franchement purulente.La prescription de corticoïdes systémiques ne doit pas être systématique. La dose recommandée est de 0,5 mg/kg sur une courte période (7 jours). Lors d’une hospitalisation, une oxygénothérapie et une thromboprophylaxie peuvent être prescrite. La ventilation noninvasiveest principalement indiquée en cas de persistance d’une hypercapnie malgré un traitement médical optimal. Que le patient soit pris en charge en ambulatoire ou en hospitalisation, une réévaluation clinique à 48-72h est indispensable.
ISSN: 0755-4982

hal-01117949
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01117949
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01117949/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01117949/file/Prise%20en%20charge%20des%20exacerbations_accepted.pdf
DOI : 10.1016/j.jeurea.2015.02.002

Éditeur(s) : [S.l.] : [s.n.]
Extrait de : L'illustration - Journal universel
Résumé : N°3358 du journal hebdomadaire L'illustration, pp. 6 et 7 concernant l'or en Guyane française
Siècle(s) traité(s) : 20
Droits : Domaine public
Provenance : ORkidé|Association Le Planeur Bleu (Cacao), Collection Philippe Soler
Permalien : http://www.manioc.org/patrimon/ORK13059
ORK13059