[Towards a pedagogical e-learning approach to improve preparation for medical school curriculum in Grenoble: results over the 10 last years].

Introduction: Before 2005, at Grenoble, the teaching of the first year of medicine satisfied neither the students, nor the teachers anxious to exempt a correctly targeted effective teaching.

Methods: By 2006, the Grenoble-native teaching method was reformed in-depth with the introduction of information and communication technology (ICT) in education. Each sequence was over 4 weeks connecting: self- learning using multi-media resources, questions submitted online, meetings with teaching staff for interactive question-answer sessions in the presence of the teacher,) tutorials animated by older students for Multiple Choice Question (MCQ) training in preparation for the exams.

When grandiosity and vulnerability collide: Implicit and explicit self-esteem in patients with narcissistic personality disorder.

Background And Objectives: Narcissistic personality disorder (NPD) is characterized by reports of grandiosity including exaggerated illusions of superiority and entitlement (DSM-IV-TR, APA, 2000). Based on clinical theories (e.g.

Impact of information leaflets on behavior of patients with gastroenteritis or tonsillitis: a cluster randomized trial in French primary care.

Objective: To assess the impact of four patient information leaflets on patients' behavior in primary care.

Design: Cluster randomized multicenter controlled trial between November 2009 and January 2011.

Participants: French adults and children consulting a participating primary care physician and diagnosed with gastroenteritis or tonsillitis.

Metallic nanowires can lead to wavelength-scale microlenses and microlens arrays.

We theoretically and experimentally demonstrate that the diffraction of microstructures based on silver nanowires leads to very efficient microfocusing effects. Pairs of parallel nanowires act as ultrasmall cylindrical microlenses with diffraction-limited resolution in the Fresnel region. This is a new diffraction scheme to make micron-sized optical lenses with higher transmittance than plasmonic microlens based on nano-aperture arrays.

Cardiovascular effects of particulate air pollution exposure: time course and underlying mechanisms.

Air pollution is now recognized as an important independent risk factor for cardiovascular morbidity and mortality and may be responsible for up to 3 million premature deaths each year worldwide. The mechanisms underlying the observed effects are poorly understood but are likely to be multifactorial. Here, we review the acute and chronic effects of air pollution exposure on the cardiovascular system and discuss how these effects may explain the observed increases in cardiovascular morbidity and mortality.

[Compression therapy and deep-vein thrombosis: a clinical practice survey].

Background: Compression therapy constitutes the cornerstone of prevention of post-thrombotic syndrome in patients with deep-vein thrombosis (DVT). However, no consensus has been reached regarding the optimal timing for initiation, duration, and strength of compression therapy.

Objective: To document prescribing practices of compression therapy in case of DVT by French Vascular Medicine physicians.

Cardiovascular mortality and C-reactive protein in elderly patients beginning dialysis: reverse epidemiology?

Background And Aims: Cardiovascular disease is a major cause of mortality in end-stage renal disease patients (ESRD). The rate of elderly and polypathologic patients in ESRD is increasing. Elevated levels of C-reactive protein (CRP) have been shown to be associated with increased mortality in ESRD patients.

Subthalamic stimulation in Parkinson's disease: restoring the balance of motivated behaviours.

Addictions to dopaminergic drugs or to pleasant behaviours are frequent and potentially devastating neuropsychiatric disorders observed in Parkinson's disease. They encompass impulse control disorders, punding and dopamine dysregulation syndrome. A relationship with dopaminergic treatment is strongly suggested.

Superficial vein thrombosis and recurrent venous thromboembolism: a pooled analysis of two observational studies.

Background: The management strategies for symptomatic isolated superficial vein thrombosis (SVT) (without concomitant deep vein thrombosis [DVT] or pulmonary embolism [PE]) have yet to achieve widespread consensus. Concerns have been raised regarding the usefulness of prescribing anticoagulant treatments to all patients with isolated SVT. Determining the isolated SVT subgroups who have the highest risks of venous thromboembolism (VTE) recurrence (composite of DVT, PE, and new SVT) may facilitate the identification of patients who are likely to benefit from anticoagulant treatment.

Emotions in sexual morality: testing the separate elicitors of anger and disgust.

Recent work suggests that negative moral judgements of sexual activities are informed by disgust and anger. A correlational study (N=62) and an experiment (N=176) examined the specific antecedents that elicit these distinct, though correlated, moral emotions. Participants in Study 1 rated their emotional reactions to, and judgements of, 10 sexual scenarios.

[Validation of a deep vein thrombosis prediction rule in primary care].

Objective: Suspected deep vein thrombosis (DVT) of lower limbs (LL) may require different tools to rule out or confirm the diagnosis. Clinical probability provides help to select useful tests, interpret their results, and decide to treat the patient meanwhile. Clinical prediction rules that risk stratify patients with suspected DVT can be established from inpatients, but no prediction rule not requiring laboratory tests has been established from primary care patients.

Antipsychotic drugs and risk of pulmonary embolism.

Background: Antipsychotic drugs (APs) expose users to several adverse effects. Some reports describe an increased risk of venous thromboembolism for particular drugs in this family.

Purpose: To examine the association between the risks of pulmonary embolism (PE) and AP use and assess any dose-effect relationships.

Diagnostic accuracy of ultrasonography in the acute assessment of common thoracic lesions after trauma.

Background: The accuracy of combined clinical examination (CE) and chest radiography (CXR) (CE + CXR) vs thoracic ultrasonography in the acute assessment of pneumothorax, hemothorax, and lung contusion in chest trauma patients is unknown.

Methods: We conducted a prospective, observational cohort study involving 119 adult patients admitted to the ED with thoracic trauma. Each patient, secured onto a vacuum mattress, underwent a subsequent thoracic CT scan after first receiving CE, CXR, and thoracic ultrasonography.

The comorbidity of psychotic symptoms and posttraumatic stress disorder: evidence for a specifier in DSM-5.

The comorbidity of posttraumatic stress disorder (PTSD) and psychotic symptoms is higher than what might be expected based on the prevalence of either disorder alone. Furthermore, the presence of psychotic symptoms is evident in PTSD patients who do not otherwise meet criteria for a psychotic spectrum disorder. The current paper discusses three existing hypotheses regarding the relation of PTSD and psychosis and presents a series of case studies that illustrates this phenomenon across a diverse group of patients and scenarios.

Corticosteroid after etomidate in critically ill patients: a randomized controlled trial.

Objective: To investigate the effects of moderate-dose hydrocortisone on hemodynamic status in critically ill patients throughout the period of etomidate-related adrenal insufficiency.

Design: : Randomized, controlled, double-blind trial (NCT00862381).

Setting: University hospital emergency department and three intensive care units.

Risk factors and early outcomes of patients with symptomatic distal vs. proximal deep-vein thrombosis.

Purpose Of Review: Isolated distal deep-vein thrombosis (iDDVT) is a distal deep-vein thrombosis (DVT) without proximal DVT or pulmonary embolism. Although its clinical significance is uncertain, its prevalence is increasing with the use of whole leg compression ultrasonography. Epidemiological data giving reported rates of venous thromboembolism (VTE) are scarce, and there is potential conflict regarding the need to treat with anticoagulant drugs.

Non-cardiac surgery in patients with coronary stents: the RECO study.

Context: Interruption or maintenance of oral antiplatelet therapy (OAT) during an invasive procedure may result in ischaemic and/or haemorrhagic complications. There is currently a lack of clear guidance regarding the issue of treatment interruption during surgical procedures.

Objective: To evaluate the rate of major adverse cardiac and cerebrovascular events (MACCEs) and major or minor bleeding complications and their associated independent correlates in coronary stented patients undergoing urgent or planned non-cardiac surgery.

Comparison of nine blood tests and transient elastography for liver fibrosis in chronic hepatitis C: the ANRS HCEP-23 study.

Background & Aims: Blood tests and transient elastography (Fibroscan™) have been developed as alternatives to liver biopsy. This ANRS HCEP-23 study compared the diagnostic accuracy of nine blood tests and transient elastography (Fibroscan™) to assess liver fibrosis, vs. liver biopsy, in untreated patients with chronic hepatitis C (CHC).

Community-acquired invasive aspergillosis and outdoor filamentous fungal spore load: a relationship?

The daily number of outdoor spores was counted and the cases of community-acquired invasive aspergillosis (IA) were observed over a period of 31 months. The outdoor fungal load preceding IA occurrences was significantly higher than that measured during IA-free periods, underlining the importance of preventive measures to protect high-risk patients, even at home.

[Severe trauma patients in a mountain area: an observational study].

Objectives: The main objective was to estimate the nature, severity and medical care of severe trauma injuries following mountain activities as compared to severe trauma following traffic accident in a mountain area.

Study Design: We conducted a prospective comparative monocentric observational study at a University Hospital located in the northern Alps area, using the First national study database (French intensive care recorded in severe trauma).

Patients And Methods: Three hundred and thirty-seven patients were included during a 2-year-period from January 2005 to December 2006.

Computerized physician order entry system combined with on-ward pharmacist: analysis of pharmacists' interventions.

Rationale, Aims And Objectives: To analyse pharmacists' interventions in a setting where a computerized physician order entry system (CPOE) is in use and a pharmacist works on the ward.

Method: A prospective cohort study was conducted in seven wards of a French teaching hospital using CPOE along with the presence of a full-time on-ward pharmacy resident. We documented the characteristics of pharmacists' interventions communicated to physicians during the medication order validation process whenever a drug-related problem was identified.

Physicians' perception of CPOE implementation.

Objective: To identify perceptions held by physicians of the benefits of computerized physician order entry (CPOE) and factors influencing its successful implementation in the context of the increased presence of a clinical pharmacist on ward.

Setting: A 2000-bed University Hospital.

Method: A cross-section opinion survey was conducted of all permanent physicians of the hospital to determine their perception on the benefits, or otherwise, of CPOE.

Transcranial Doppler to screen on admission patients with mild to moderate traumatic brain injury.

Background: Detecting patients at risk for secondary neurological deterioration (SND) after mild to moderate traumatic brain injury is challenging.

Objective: To assess the diagnostic accuracy of transcranial Doppler (TCD) on admission in screening these patients.

Methods: This prospective, observational cohort study enrolled 98 traumatic brain injury patients with an initial Glasgow Coma Scale score of 9 to 15 whose initial computed tomography (CT) scan showed either absent or mild lesions according to the Trauma Coma Data Bank (TCDB) classification, ie, TCDB I and TCDB II, respectively.

I feel like I know you: sharing negative attitudes of others promotes feelings of familiarity.

Holding similar negative-versus positive-attitudes toward a third party has been shown to predict increased closeness to a stranger. Here, the authors examined whether this effect is mediated by the heightened feelings of familiarity engendered by shared negative attitudes. In Study 1, participants who shared with a (bogus) stranger a negative attitude of a professor subsequently reported knowing more about the stranger than those who shared a positive attitude, but only when they did not feel strongly about the attitude.

Do patients still require admission to an intensive care unit after elective craniotomy for brain surgery?

Background: After elective craniotomy for brain surgery, patients are usually admitted to an intensive care unit (ICU). We sought to identify predictors of postoperative complications to define perioperative conditions that would safely allow ICU bypass.

Methods: This observational cohort study enrolled 358 patients admitted to neuro-ICU after elective intracranial procedures.