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Epidemiology and Prognostic Factors Associated With Mold-Positive Blood Cultures: 10-Year Data From a French Prospective Surveillance Program (2012–2022)
No full textInternational audienceBackground While invasive fusariosis and lomentosporiosis are known to be associated with fungemia, overall data on mold-related fungemia are limited, hampering early management. This study aimed to describe the epidemiology of mold-positive blood cultures. Methods Epidemiological and clinical data on mold-positive blood cultures from 2012 to 2022 were obtained from the RESSIF database. Pseudofungemia was excluded using modified Duthie and Denning criteria. Univariable and multivariable Firth logistical regression was used to study factors associated with 90-day mortality. Results Fusarium spp accounted for 67.5% of the 80 events, involving predominantly Fusarium fujikuroi spp complex (FFSC), Neocosmospora spp, and Fusarium oxysporum spp complex (FOSC). Lomentospora prolificans was the second most frequent (10%), followed by Trichoderma spp, Aspergillus spp, and Mucorales (5% each). Most patients had a history of hematological malignancy (HM) (70%). Forty-three percent had undergone allogeneic hematopoietic stem cell transplantation. Cutaneous and pulmonary lesions were common (43% each). Median time to blood culture positivity was 72 hours. HM and neutropenia were commonly reported in patients with FFSC, Neocosmospora spp, and L. prolificans fungemia. Pulmonary lesions were frequent in cases of L. prolificans fungemia. Patients with gastrointestinal conditions were frequently diagnosed with FOSC molds. HM (75%), particularly acute myeloblastic leukemia, was frequent in patients with Aspergillus spp fungemia. All patients with Trichoderma spp fungemia were exposed to corticosteroids. Day 90 mortality was 53%. Independent predictive factors of day 90 mortality included L. prolificans (odds ratio [OR], 33.3), Aspergillus spp fungemia (OR, 14.2), and corticosteroid exposure (OR, 7.85). Conclusions Underlying conditions and clinical presentation vary between genera and could be considered to guide early management
Validity of the Uninjured Limb as a Control for Preoperative Assessment in Anterior Cruciate Ligament Reconstruction
No full textInternational audienceMonitoring muscle atrophy in patients undergoing anterolateral cruciate ligament reconstruction is pivotal for optimizing postoperative recovery. Conventionally, the uninjured contralateral limb serves as the control. However, its relevance in patients with prolonged physical activity hiatus due to knee instability remains uncertain. Our objectives were to compare limbs within a control group by assessing combined force measurements, cross-sectional areas (CSAs), and neuromuscular activation. In addition, we compared the contralateral limb of the surgery group preoperatively to the control group. This prospective controlled study (evidence level 2) included 40 healthy subjects (HG) and 30 patients scheduled for ACL surgery (SG). Both groups underwent identical assessments. The two HG limbs were compared to establish the standard difference for all assessed variables, whereas SG contralateral limb was compared with the mean of the control limbs. For HG, the comparisons between limbs showed no significant differences in muscle strength, CSA area, or electromyographic parameters. Similarly, comparisons between the SG contralateral limb and the mean of HG limbs revealed no significant differences in isometric and dynamic strength for the quadriceps and hamstrings (2.5 ± 0.5 and 2.6 ± 0.9 N.m/kg, and 1.7 ± 0.3 and 1.7 ± 0.4 N.m/kg, respectively). Neuromuscular activation and fatigue patterns were also comparable between groups. CSAs discrepancies were attributed to differences in body mass index between groups. These findings indicate that the contralateral limb in ACL_injured patients is functionally similar to that of healthy controls, supporting its use as a valid reference for monitoring postoperative recovery
Multicenter inter‐laboratory quality control of monocyte HLA‐DR expression by flow cytometry
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Efficacy of using a mechanical insufflation-exsufflation versus manual respiratory physiotherapy on cough peak flow in hospitalised older adults in French hospitals: a protocol for a single-blind randomised clinical trial
No full textInternational audienceIntroduction Ageing impairs the respiratory system, increasing hospitalisation rates for respiratory problems in older adults. In cases of bronchial congestion, a weak cough in older inpatients challenges respiratory physiotherapy. Mechanical insufflation-exsufflation (MI-E) is one of the promising solutions. However, its effects have not yet been evaluated in this population. Therefore, we aim to compare the effects of MI-E and manual respiratory physiotherapy on cough peak flow (CPF), spirometry measures, dyspnoea and session discomfort in hospitalised older adults. Methods and analysis We will conduct a multicentre randomised controlled trial in four hospitals in France. A total of 120 older inpatients with bronchial congestion and a weak cough will be recruited from either intensive care units or conventional wards. All participants will receive three sessions of respiratory physiotherapy over one and a half days: MI-E for the experimental group and conventional manual respiratory therapy for the control group. Assessments will include CPF, forced vital capacity (FVC), maximum inspiratory and expiratory pressures, forced expiratory volume in one second (FEV1), FEV1/FVC ratio and the modified Borg scale for dyspnoea, measured before and immediately after each session. Discomfort will be assessed using a numerical (0–10) scale immediately after each session. Between-group comparisons will be performed using a linear mixed model for continuous outcomes and a generalised linear model for categorical variables. Ethics and dissemination The study was approved by the referred ethics committee ( Comité de Protection des Personnes Ile de France XI, Identifier: 24.04832.000282) on 27 November 2024. Study results will be disseminated in peer-reviewed publications and at scientific meetings. Trial registration number NCT06730217
Characterization of representative plasticizer exposures in NICU neonates using non-negative matrix factorization: a data-driven approach to assess endocrine disruption risk in mixtures.
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Partition coefficient for pharmaceutical applications: measurements and simulations.
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Development of a method for the quantification of bacterial endotoxins in parenteral vitamin-lipid emulsion preparations using the recombinant C factor.
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L’analyse du cycle de vie des produits de santé : pourquoi ? Comment ?
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