Publications by authors named "Philippon A"
Article Synopsis
- The study investigates the effect of early antibiotic administration on 28-day in-hospital mortality in patients with suspected sepsis in the emergency department.
- Among 872 participants, those who received antibiotics within an hour had a significantly lower mortality rate (9.6%) compared to those who received them later (14.7%).
- Delays in antibiotic treatment were linked to increased mortality risk, with an adjusted odds ratio of 2.00 for those who received antibiotics after one hour and a 1.06 increase in risk for each additional hour of delay.
Background: The value of simulation in emergency medicine is indisputable because it allows training and acquisition of many technical and non-technical skills (TS and NTS). In France, there are no curriculum regarding the use of simulation as a teaching tool during emergency medicine residency. The aim of this study was to design the content of a national simulation-based curriculum for emergency medicine residency programs.
View Article and Find Full Text PDFObjective: To study the prevalence of alcohol use among French adolescents over time and factors associated with heavy episodic drinking (HED) among drinkers.
Method: Our analysis relies on six waves of a standardized cross, sectional survey conducted in mainland France between 2005 and 2022. The overall sample size comprises 179905 adolescents aged 17 (90166 males and 89739 females).
Background: The assessment of technical and nontechnical skills in emergency medicine requires reliable and usable tools. Three Acute Care Assessment Tools (ACATs) have been developed to assess medical learners in their management of cardiac arrest (ACAT-CA), coma (ACAT-coma) and acute respiratory failure (ACAT-ARF).
Objective: This study aims to analyze the reliability and usability of the three ACATs when used for in situ (bedside) simulation.
Article Synopsis
- The study aimed to evaluate how well the Pulmonary Embolism Rule-out Criteria (PERC) and the age-modified PERC-35 tool perform in emergency departments for patients aged 35 and younger suspected of having a pulmonary embolism (PE).
- Data from 1,235 patients indicated that while both PERC and PERC-35 could rule out PE in nearly half the cases, there were still a few missed diagnoses.
- Results showed that both tools had similar safety and efficacy, but the research couldn't definitively confirm their reliability due to large confidence intervals.
Background: Healthcare curricula need summative assessments relevant to and representative of clinical situations to best select and train learners. Simulation provides multiple benefits with a growing literature base proving its utility for training in a formative context. Advancing to the next step, "the use of simulation for summative assessment" requires rigorous and evidence-based development because any summative assessment is high stakes for participants, trainers, and programs.
View Article and Find Full Text PDFPurpose: Task interruptions (TI) are frequent disturbances for emergency professionals performing advanced life support (ALS). The aim of our study was to evaluate a specific training intervention with TI on the quality of simulated ALS.
Methods: During this multi centered randomized controlled trial, each team included one resident, one nurse and one emergency physician.
Class C β-lactamases or cephalosporinases can be classified into two functional groups (1, 1e) with considerable molecular variability (≤20% sequence identity). These enzymes are mostly encoded by chromosomal and inducible genes and are widespread among bacteria, including Proteobacteria in particular. Molecular identification is based principally on three catalytic motifs (SXSK, YXN, KTG), but more than 70 conserved amino-acid residues (≥90%) have been identified, many close to these catalytic motifs.
View Article and Find Full Text PDFArticle Synopsis
- The Sim'Cup, a simulation-based challenge, adapted from in-person to virtual format due to the COVID-19 pandemic, involved participants piloting avatars in high-fidelity simulations while safely at home.
- Twenty-seven participants took part in two e-Sim'Cup events, where they experienced real-time scenarios, provided instructions through smartphones, and engaged in debriefings to enhance learning.
- Feedback from participants indicated a high level of satisfaction and perceived improvement in communication and clinical skills despite some technical challenges, with a combined Educational Practices Questionnaire score reflecting effective educational practices.
Article Synopsis
- The study aimed to validate the safety of a combined diagnostic strategy for ruling out pulmonary embolism (PE) that incorporates the YEARS rule and age-adjusted D-dimer thresholds in emergency departments across France and Spain.
- It involved a total of 1414 patients who were either at low risk for PE or had an intermediate risk, examining the outcomes of using different intervention strategies regarding chest imaging and D-dimer levels.
- The results showed that the intervention group had a very low rate of venous thromboembolism at 3 months (0.15%), suggesting that this combined strategy is a safe alternative for excluding PE without unnecessary imaging.
Objectives: It is critical to assess competency of medical students and residents in emergency medicine (EM) during undergraduate and graduate medical education. However, very few valid tools exist to assess both technical and nontechnical skills in the specific context of EM. Three Acute Care Assessment Tools (ACAT 1, 2, and 3) have been previously developed for three acute care conditions: cardiac arrest (1), coma (2), and acute respiratory failure (3).
View Article and Find Full Text PDFBackground: Although simulation-based assessment (SBA) is being implemented in numerous medical education systems, it is still rarely used for undergraduate medical students in France. Objective structured clinical examinations (OSCEs) will be integrated into the national medical curriculum in 2021. In 2016 and 2017, we created a mannequin SBA to validate medical students' technical and psychometric skills during their emergency medicine and paediatric placements.
View Article and Find Full Text PDFArticle Synopsis
- WGS-based antimicrobial susceptibility testing (AST) can be as effective as traditional phenotypic methods, but its use is limited by the need for specialized bioinformatics skills.
- New tools like ResFinder and PointFinder have been improved to make them user-friendly for those with limited bioinformatics knowledge.
- Validation studies showed that ResFinder 4.0 achieved a high concordance rate (≥95%) in predicting antimicrobial resistance in various bacterial species, demonstrating its reliability for public health applications.
Introduction: In the work-up strategy for pulmonary embolism (PE) in the ED, the recently introduced YEARS rule allows the raising of the D-dimer threshold to 1000 ng/ml in patients with no signs of deep venous thrombosis and no hemoptysis and in whom PE is not the most likely diagnosis. However, this decision rule has never been prospectively compared to the usual strategy. Furthermore, it is unclear if the YEARS rule can be used on top of the Pulmonary Embolism Rule-out Criteria (PERC).
View Article and Find Full Text PDFBackground: This paper studies the evolution of transitions from first cigarette use to daily use by socioeconomic status (SES) among French adolescents over the course of 17 years, in a context of decreasing prevalence of tobacco use.
Methods: A total of 182 266 adolescents participated in the nationally representative ESCAPAD survey at nine different time points between 2000 and 2017. Discrete time-event analysis was used to model the transition to daily cigarette use as a function of SES, gender, age at onset and the use of other psychoactive substances.
Article Synopsis
- A multicenter study in France aimed to determine the prevalence of pulmonary embolism in patients presenting to the emergency department with syncope but without chest pain or difficulty breathing.
- Among 411 patients analyzed, only 9 confirmed cases of pulmonary embolism were found, resulting in a prevalence of 2.2% overall.
- The study indicates that while this prevalence isn't low enough to dismiss the need for thorough evaluation in these patients, the results have limitations due to the wide confidence interval.
Structure-based classification of class A beta-lactamases, an update.
Curr Res Transl Med
November 2019
Beta-lactamase (EC 3.5.2.
View Article and Find Full Text PDFUnlabelled: The peak expiratory flow rate (PEFR) is the gold standard for monitoring asthmatic patients. However, its measurement requires understanding and active participation. End tidal carbon dioxide (EtCO2) may be considered an accurate surrogate for PaCO2, a severity marker in acute asthma.
View Article and Find Full Text PDFArticle Synopsis
- - The study evaluated the effectiveness of combining the PERC and YEARS rules for diagnosing pulmonary embolism (PE) in emergency department patients with low clinical probability of PE.
- - Researchers analyzed 1,951 patients, finding that the combination strategy had a low failure rate for correctly diagnosing PE, with only 11 missed cases and a 0.83% failure rate at three months follow-up.
- - By using the combined PERC-YEARS strategy, the study suggested that nearly half of the patients could have avoided a costly CT pulmonary angiogram, indicating a potentially more efficient approach to ruling out PE.