170 results match your criteria: "Centre Hospitalier Général Robert Ballanger[Affiliation]"

[From the religion of work to the madness].

Vertex

April 2024

Médico psiquiatra, Département de psychiatrie, Groupement Hospitalier de Territoire Grand Paris Nord-Est, Centre Hospitalier Intercommunal « Robert Ballanger », Aulnay Sous-Bois, Francia.

Starting from an apocryphal quote by Sigmund Freud about work and mental health, we carry out a historical investigation that leads from the creation of the first convents in the 4th century AD, to the works of the German psychiatrist Hubertus Tellenbach. Curiously, following this common thread, we find the notion of form-of-life that the Italian philosopher Giorgio Agamben exploits in his work on monasticism, and above all, and in an unexpected way, the central work of the German sociologist Max Weber The Protestant ethic and the spirit of capitalism that brings together religion and economic success at a high subjective cost. Focused in this way, they raise a figure of great frequency in the most contemporary clinic: the melancholic type of Tellenbach as one of the faces of the spirit of our time.

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Background: Paediatric sepsis is the leading cause of death in children under 5 years. No studies have evaluated the application of the Surviving Sepsis Campaign 2020 (SSC-2020) guidelines in paediatric emergency departments (PEDs).

Objective: To assess physician adherence to the SSC-2020 fluid resuscitation guidelines in children with suspected septic shock in PEDs.

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Article Synopsis
  • Recreational use of nitrous oxide (NO) has led to a rise in severe neurological disorders, particularly affecting young adults in economically disadvantaged areas.
  • The study analyzed 181 patients, noting a significant incidence increase in 2020-2021, especially in those aged 20-25.
  • Compared to other inflammatory neurological disorders, NI-NDs were found to be two to three times more common in these vulnerable populations.
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Introduction: New tools have been developed to distinguish the COVID-19 diagnosis from other viral infections presenting similar symptomatology and mitigate the lack of sensitivity of molecular testing. We previously identified a specific "sandglass" aspect on the white blood cells (WBC) scattergram of COVID-19 patients, as a highly reliable COVID-19 screening test (sensitivity: 85.9%, specificity: 83.

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Introduction: Obtaining vascular access is crucial in critically ill patients. The EZ-IO® device is easy to use and has a high insertion success rate. Therefore, the use of intraosseous vascular access (IOVA) has gradually increased.

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Article Synopsis
  • Ventilator associated pneumonia (VAP) caused by wild-type AmpC-producing Enterobacterales is common in ICU patients, and the study explores the effectiveness of different antimicrobial therapies (AMT), specifically piperacillin ± tazobactam (PTZ) and third-generation cephalosporins (3GCs).
  • In a study involving 274 ICU patients, no significant differences in treatment success at day 7 were found between the groups receiving PTZ, 3GCs, or other control treatments, with all groups showing success rates around 68-74%.
  • However, patients treated with 3GCs had a higher likelihood of pneumonia recurrence by day 28 compared to those on PTZ
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Association of severe postpartum hemorrhage and development of psychological disorders: Results from the prospective and multicentre HELP MOM study.

Anaesth Crit Care Pain Med

April 2024

Département d'Anesthésie-Réanimation et Centre de Traitement des Brûlés, Hôpitaux Universitaires Saint-Louis - Lariboisière, AP-HP, Paris, France; UMR-S 942, INSERM, MASCOT, Paris University, Paris, France; Université de Paris Cité, Paris, France; FHU PROMICE, France. Electronic address:

Objective: Post-partum hemorrhage (PPH) is the leading preventable cause of worldwide maternal morbidity and mortality. Risk factors for psychological disorders following PPH are currently unknown. HELP-MOM study aimed to determine the incidence and identify risk factors for psychological disorders following PPH.

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Article Synopsis
  • The study examines the long-term effectiveness of immune checkpoint inhibitor (ICI) rechallenge in patients with advanced melanoma who previously responded to ICI treatment.
  • A total of 85 patients participated, with a notable 54% showing a positive response to the rechallenge, including 35% achieving a complete response.
  • However, safety concerns emerged, as 27% experienced adverse events, and those who underwent other treatments between ICI courses had lower response rates and shorter progression-free survival.
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Updated mortality and causes of death in 2020-2021 in people with HIV: a multicenter study in France.

AIDS

November 2023

Département des Maladies Infectieuses et Tropicales, GH Saint-Louis/Lariboisière-Fernand Widal, Université de Paris Cité, INSERM U 944.

Objective: The aim of this study was to assess updated mortality and causes of death in people with HIV (PWH) in France.

Design And Methods: We analyzed all deaths in PWH followed up between January 1, 2020, and December 31, 2021, in 11 hospitals in the Paris region. We described the characteristics and causes of death among deceased PWH, and evaluated the incidence of mortality and associated risk factors using a multivariate logistic regression.

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Introduction: New beta-lactams, associated or not with beta-lactamase inhibitors (NBs/BIs), can respond to the spread of carbapenemase-producing enterobacteriales and nonfermenting carbapenem-resistant bacteria. The risk of emergence of resistance to these NBs/BIs makes guidelines necessary. The SRLF organized a consensus conference in December 2022.

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Article Synopsis
  • Imported malaria is becoming a significant health issue in non-endemic countries, particularly due to increased global travel, prompting a study to explore cytokine profiles in affected individuals in France.
  • The research involved 278 adults with Plasmodium falciparum malaria, classifying them into uncomplicated (UM) and severe malaria (SM), with findings showing a notable association between high IL-10 levels and both disease severity and higher parasitemia.
  • The study revealed that many patients had undetectable cytokine levels at admission, indicating that routine cytokine testing may not be useful, but high IL-10 concentrations could be important for monitoring severe cases and potential infections.
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Quantifying physician's bias to terminate resuscitation. The TERMINATOR study.

Resuscitation

July 2023

SAMU 93, UF Recherche-Enseignement-Qualité, Université Paris 13, Sorbonne Paris Cité, Inserm U942. Hôpital Avicenne, APHP, 125, rue de Stalingrad, 93009 Bobigny, France. Electronic address:

Context: Deciding on "termination of resuscitation" (TOR) is a dilemma for any physician facing cardiac arrest. Due to the lack of evidence-based criteria and scarcity of the existing guidelines, crucial arbitration to interrupt resuscitation remains at the practitioner's discretion.

Aim: Evaluate with a quantitative method the existence of a physician internal bias to terminate resuscitation.

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Digit preference and biased conclusions in cardiac arrest studies.

Am J Emerg Med

July 2023

SAMU 93, UF Recherche-Enseignement-Qualité, Université Paris 13, Sorbonne Paris Cité, Inserm U942, Hôpital Avicenne, APHP, 125, rue de Stalingrad, 93009 Bobigny, France. Electronic address:

Background: In cardiac arrest (CA), time is directly predictive of patients' prognosis. The increase in mortality resulting from delayed cardiopulmonary resuscitation has been quantified minute by minute. Times reported in CA management studies could reflect a timestamping bias referred to as "digit preference".

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Hydrocortisone in Severe Community-Acquired Pneumonia.

N Engl J Med

May 2023

From Université de Tours, INSERM, Center for the Study of Respiratory Diseases Unité 1100, Médecine Intensive-Réanimation and INSERM Centre d'Investigation Clinique 1415, Centre Hospitalier Universitaire (CHU) (P.-F.D.), Délégation à la Recherche Clinique et à l'Innovation, CHU (M.L., C.C.), Pharmacie à Usage Interne, CHU (H.B.), Centre Régional de Pharmacovigilance et d'Information sur le Médicament, Service de Pharmacosurveillance, CHU (C.L.), Université de Tours, Université de Nantes, INSERM SPHERE Unité 1246 (B.G.), and INSERM Centre d'Investigation Clinique 1415, CHU (B.G., A.L.G.), Tours, INSERM, Unité Mixte de Recherche 1260, Regenerative Nanomedicine, Université de Strasbourg, Faculté de Médecine, and Médecine Intensive-Réanimation Nouvel Hôpital Civil (F.M.), Médecine Intensive Réanimation, Hôpital de Hautepierre (J.-E.H.), Hôpitaux Universitaires de Strasbourg, Strasbourg, the Lipness Team, INSERM Lipids, Nutrition, Cancer-Unité Mixte de Recherche 1231 and LabEx LipSTIC, INSERM Centre d'Investigation Clinique 1432, Clinical Epidemiology, Université de Bourgogne, and Médecine Intensive Réanimation, CHU (J.-P.Q.), Dijon, Médecine Intensive Réanimation, Hôpital de la Source, Orléans (T.K.), INSERM Infection, Antimicrobials, Modeling, and Evolution (IAME) Unité 1137, Université Paris Cité (J.-D.R.), Sorbonne Université, Centre de Recherche Saint-Antoine Unité Mixte de Recherche 938 INSERM, Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Tenon (G.V.), and Université Paris Cité, Paris, Médecine Intensive Réanimation, AP-HP, Hôpital Cochin (J.-P.M.), Médecine Intensive Réanimation, DMU ESPRIT, Colombes (J.-D.R.), Réanimation Polyvalente, Hôpital Nord Franche-Comté, Trévenans (J.B.), Université de Nantes et Médecine Intensive-Réanimation, Hôtel-Dieu, Nantes (J.R.), Fédération Hospitalo Universitaire (FHU) SEPSIS, INSERM Unité 1173, Faculté de Médecine Simone Veil, Université Versailles Saint Quentin, Université de Paris Saclay, and Médecine Intensive-Réanimation, AP-HP, Hôpital Raymond Poincaré (N.H.), Garches, Réanimation Polyvalente, CH Victor Dupouy, Argenteuil (G.P.), Université Clermont Auvergne Unité Mixte de Recherche, French National Center for Scientific Research (CNRS) 6023, Laboratoire Microorganismes: Génome Environnement and Médecine Intensive Réanimation, CHU Clermont-Ferrand, Clermont-Ferrand (B.S.), Médecine Intensive Réanimation, Centre Hospitalier Départemental de Vendée, La Roche-Sur-Yon (G.C.), INSERM Centre d'Investigation Clinique 1402, Investigations of Sleep, Acute Lung Injury, and Ventilation, Université de Poitiers, Faculté de Médecine et de Pharmacie de Poitiers, and Médecine Intensive Réanimation, CHU (J.-P.F.), Poitiers, Réanimation, Centre Hospitalier, Saint Brieuc (N.B.), Unité Mixte de Recherche 1092, Université, Limoges, and INSERM Centre d'Investigation Clinique 1435 and Réanimation Polyvalente, CHU (B.F.), Limoges, Réanimation Polyvalente, Hôpital de Mercy, Centre Hospitalier Régional (CHR) Metz-Thionville, Metz (G.L.), Université de Lorraine, and Médecine Intensive Réanimation, Hôpital Central, CHU, Nancy (S.G.), Réanimation Médico-Chirurgicale, Hôpital, Le Mans (C. Guitton), Réanimation Polyvalente, Hôpital d'Instruction des Armées Clermont Tonnerre (C. Giacardi), Laboratoire de Traitement de l'Information Médicale INSERM Mixte de Recherche Unité 1101, Université de Bretagne Occidentale (E.L.), and Médecine Intensive Réanimation, CHU de la Cavale Blanche (E.L.), Brest, Aix-Marseille Université, Health Service Research and Quality of Life Center, the Department of Medical Information, Assistance Publique-Hopitaux de Marseille (AP-HM), Marseille, and Médecine Intensive-Réanimation, AP-HM, Hôpital Nord, Marseille (S.H.), Réanimation, Centre Hospitalier, Montauban (S.V.), Médecine Intensive Réanimation, Centre Hospitalier Intercommunal Robert Ballanger, Aulnay-Sous-Bois (H.F.), Réanimation, Centre Hospitalier, Bourg-en-Bresse (C.B.), Médecine Intensive Réanimation, CHU, Caen (A.J.), INSERM Unité 1042, HP-2, Université Grenoble-Alpes, and Médecine Intensive Réanimation, CHU Grenoble Alpes, Grenoble (N.T.), Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Rennes (A.G.), Réanimation, Centre Hospitalier, Saint-Malo (C.Q.), INSERM Unité 1190, Université de Lille, and the Département de Réanimation, Hôpital Roger Salengro, CHU, Lille (M.J.), and INSERM Centre d'Investigation Clinique 1435, CHU, Limoges (C.C.-F.) - all in France.

Article Synopsis
  • A phase 3 clinical trial investigated if intravenous hydrocortisone could reduce mortality in patients with severe community-acquired pneumonia compared to a placebo.
  • The study involved 800 patients, and results showed that those receiving hydrocortisone had a significantly lower death rate (6.2%) at 28 days versus 11.9% in the placebo group.
  • Additionally, patients on hydrocortisone required less mechanical ventilation and vasopressors compared to those on placebo, with similar rates of hospital-acquired infections and bleeding risks.
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Background: Generalised convulsive status epilepticus (GCSE) is a medical emergency. Guidelines recommend a stepwise strategy of benzodiazepines followed by a second-line anti-seizure medicine (ASM). However, GCSE is uncontrolled in 20-40% patients and is associated with protracted hospitalisation, disability, and mortality.

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Article Synopsis
  • The study evaluated the effectiveness of switching HIV patients on stable antiretroviral therapy to a co-formulated drug called E/C/F/TDF, measuring success by the number of patients maintaining low viral loads at 48 weeks.
  • A total of 382 patients were analyzed, showing that 82% maintained viral loads below 50 copies/mL, while only 3.5% experienced virological failure, primarily linked to past treatment issues.
  • Resistance to integrase inhibitors was noted in those who failed treatment, though overall, the switch to E/C/F/TDF was well tolerated with minimal adverse effects reported.
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Syncope after a long-haul flight revealing multiple embolic events: the management strategy dilemma.

J Travel Med

June 2023

SAMU 93 - UF Recherche-Enseignement-Qualité, Université Paris 13, Sorbonne Paris Cité, Inserm U942, Hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny, France.

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Idiopathic multicentric Castleman disease (iMCD) is a lymphoproliferative disease of unknown etiology. Deciphering mechanisms involved in CD pathogenesis may help improving patients' care. Six cases of stereotyped sub-diaphragmatic iMCD affecting lower limb-draining areas and associated with severe and often ulcerative lower extremity chronic dermatological condition were identified in our cohort.

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Background: The COVID-19 pandemic has raised questions regarding the management of chronic skin diseases, especially in patients on systemic treatments. Data concerning the use of biologics in adults with psoriasis are reassuring, but data specific to children are missing. Moreover, COVID-19 could impact the course of psoriasis in children.

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Article Synopsis
  • - The study investigates the diagnosis and treatment outcomes of multidrug-resistant osteoarticular tuberculosis (MDR-OATB) in France, based on a review of 23 cases from 2007 to 2018.
  • - Most affected patients were young males, with the spine being the most common site of infection; a significant portion had prior tuberculosis treatments.
  • - Despite a high treatment success rate (91%) achieved with a mean regimen of four drugs over approximately 20 months, the ideal treatment protocol for MDR-OATB, including drug combinations and surgical options, is still not established.
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The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies.

Proc Natl Acad Sci U S A

May 2022

Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, 75015 Paris, France.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection fatality rate (IFR) doubles with every 5 y of age from childhood onward. Circulating autoantibodies neutralizing IFN-α, IFN-ω, and/or IFN-β are found in ∼20% of deceased patients across age groups, and in ∼1% of individuals aged <70 y and in >4% of those >70 y old in the general population. With a sample of 1,261 unvaccinated deceased patients and 34,159 individuals of the general population sampled before the pandemic, we estimated both IFR and relative risk of death (RRD) across age groups for individuals carrying autoantibodies neutralizing type I IFNs, relative to noncarriers.

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