Impact of frailty and older age on weaning from invasive ventilation: a secondary analysis of the WEAN SAFE study.

Objective: To understand the impact of both frailty and chronologic age on outcomes of weaning from invasive mechanical ventilation (MV).

Methods: The study population consisted of patients enrolled in the 'WorldwidE. AssessmeNt of Separation of pAtients From ventilatory assistancE (WEAN SAFE) study.

Early systemic insults following severe sepsis-associated encephalopathy of critically ill patients: association with mortality and awakening-an analysis of the OUTCOMEREA database.

Background: Sepsis-associated encephalopathy (SAE) may be worsened by early systemic insults. We aimed to investigate the association of early systemic insults with outcomes of critically ill patients with severe SAE.

Methods: We performed a retrospective analysis using data from the French OUTCOMEREA prospective multicenter database.

Rectal cancer - French intergroup clinical practice guidelines for diagnosis, treatment, and follow-up (TNCD, SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, SFP, RENAPE, SNFCP, AFEF, SFR, and GRECCAR).

Background: This article summarizes the French intergroup guidelines regarding rectal adenocarcinoma (RA) management published in September 2023, available on the French Society of Gastroenterology website.

Methods: This work was supervised by French medical and surgical societies involved in RA management. Recommendations were rated from A to C according to the literature until September 2023.

Risk factors for flap dehiscence and/or necrosis following standard rotational flap in cranial vault osteomyelitis without intracranial involvement: A retrospective study.

Objectives: The study aimed to estimate the incidence of flap dehiscence and/or necrosis (FD/N) following standard rotational flap (SRF) surgery for cranial vault osteomyelitis without intracranial involvement (CVO) and to identify factors associated with these complications.

Methods: A retrospective study was conducted using chart reviews of patients who underwent SRF to cover CVO defects over a 10-year period. Twenty-one predictor variables were analysed, categorised into demographic, health status, anatomic, and surgical factors.

The VEntriculostomy-Related Infection Score: An Antibiotic Stewardship Tool in Ventriculostomy-Related Infections.

Background And Objectives: Diagnosing ventriculostomy-related infection (VRI), a common complication after external ventricular drainage (EVD), is challenging and often associated with delayed initiation of antibiotic therapy. We aimed to develop a stewardship score to help in the decision of antibiotic therapy initiation when VRI is suspected.

Methods: This retrospective, single-center cohort study included patients admitted to the intensive care unit after EVD placement who were suspected of having healthcare-associated ventriculitis and/or meningitis between January 1, 2012, and August 31, 2022.

Intranasal Fentanyl Versus Morphine in Fracture Reduction in a Pediatric Trauma Center.

Purpose: Pain management in orthopaedic manipulation in the emergency department (ED) is crucial to decrease fracture reduction performed in the operating room. This study compared intranasal fentanyl (INF) with oral morphine in time of care and effectiveness on pain during the reduction of bone fractures in a pediatric trauma center.

Methods: A before-and-after INF implementation study was conducted in a pediatric ED with a trauma center on children with a confirmed displaced closed fracture on radiographs with reduction and casting performed in the ED.

Impact of the thresholds of surgical volume on mortality in oncological digestive surgery: A French National Cohort.

Objective: To report the 90-day mortality benefit associated with the implementation of the new regulatory reform on oncological surgical digestive authorizations.

Summary Background Data: New thresholds in digestive cancer surgery were applied in 2023, accrediting centers for major interventions. No evidence has been provided to support their justification.

The Rising Concern of Ethanol Intoxication from Easy Access to Hand Sanitizers: A Case Report.

BACKGROUND Ethanol intoxication is very common, and several forms of alcohol intoxication can lead to emergency department visits. Excessive alcohol users, when in withdrawal, might seek replacement alcoholic beverages; one of the common sources of ethanol is hand sanitizer, which contains 45-95% alcohol. It becomes even more challenging to deal with alcohol use disorder patients when they seek these replacement products inside hospital premises, and medical clinics and hospitals have increased their use of ethanol-based hand sanitizer since the start of the COVID-19 pandemic.

Effect of the 1-h bundle on mortality in patients with suspected sepsis in the emergency department: a stepped wedge cluster randomized clinical trial.

Purpose: The efficacy of the 1-h bundle for emergency department (ED) patients with suspected sepsis, which includes lactate measurement, blood culture, broad-spectrum antibiotics administration, administration of 30 mL/kg crystalloid fluid for hypotension or lactate ≥ 4 mmol/L, remains controversial.

Methods: We carried out a pragmatic stepped-wedge cluster-randomized trial in 23 EDs in France and Spain. Adult patients with Sepsis-3 criteria or a quick sequential organ failure assessment (SOFA) score ≥ 2 or a lactate > 2 mmol/L were eligible.

Comparison of juvenile and adult myasthenia gravis in a French cohort with focus on thymic histology.

Myasthenia gravis (MG) is an autoimmune disease characterized by muscle fatigability due to acetylcholine receptor (AChR) autoantibodies. To better characterize juvenile MG (JMG), we analyzed 85 pre- and 132 post-pubescent JMG (with a cutoff age of 13) compared to 721 adult MG patients under 40 years old using a French database. Clinical data, anti-AChR antibody titers, thymectomy, and thymic histology were analyzed.

Guidelines for the assessment and management of residual sleepiness in obstructive apnea-hypopnea syndrome: Endorsed by the French Sleep Research and Medicine Society (SFRMS) and the French Speaking Society of Respiratory Diseases (SPLF).

Excessive daytime sleepiness (EDS) is frequent among patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and can persist despite the optimal correction of respiratory events (apnea, hypopnea and respiratory efforts), using continuous positive airway pressure (CPAP) or mandibular advancement device. Symptoms like apathy and fatigue may be mistaken for EDS. In addition, EDS has multi-factorial origin, which makes its evaluation complex.

Marian apparitions: A multidisciplinary approach. The case of Île Bouchard.

Discussing Marian apparitions in the light of current knowledge in neuroscience is a challenge: the testimonies are often old and indirect, and the "visionaries" could not be questioned or even examined according to current neurological or psychiatric standards. In doing so, we are not unaware of the heterogeneity of seers and the facts they reported: there is not necessarily a single hypothesis. It is the appearances of Île Bouchard that will be discussed here.

Immune Checkpoint Inhibitor Use During Pregnancy and Outcomes in Pregnant Individuals and Newborns.

Importance: With the widespread use of immune checkpoint inhibitors (ICIs), concerns about their pregnancy outcomes through maternal exposure have emerged, and clinical comparative data are lacking.

Objective: To assess the risk of pregnancy-, fetal-, and/or newborn-related adverse outcomes associated with exposure to ICIs compared with exposure to other anticancer agents.

Design, Setting, And Participants: In this cohort study, all reports mentioning a pregnancy-related condition and an antineoplastic agent (Anatomical Therapeutic Chemical classification group L01) used for a cancer indication registered in the World Health Organization international pharmacovigilance database VigiBase up to June 26, 2022, were extracted.