53 research outputs found
Toxic Shock Syndrome: A Literature Review
No full textToxic shock syndrome (TSS) is a rare, life-threatening, toxin-mediated infectious process linked, in the vast majority of cases, to toxin-producing strains of Staphylococcus aureus or Streptococcus pyogenes. The pathophysiology, epidemiology, clinical presentation, microbiological features, management and outcome of TSS are described in this review. Bacterial superantigenic exotoxins induces unconventional polyclonal lymphocyte activation, which leads to rapid shock, multiple organ failure syndrome, and death. The main described superantigenic exotoxins are toxic shock syndrome toxin—1 (TSST-1) and enterotoxins for Staphylococcus aureus and Streptococcal pyrogenic exotoxins (SpE) A, B, and C and streptococcal superantigen A (SsA) for Streptococcus pyogenes. Staphylococcal TSS can be menstrual or nonmenstrual. Streptococcal TSS is linked to a severe group A streptococcal infection and, most frequently, to a necrotizing soft tissue infection. Management of TSS is a medical emergency and relies on early detection, immediate resuscitation, source control and eradication of toxin production, bactericidal antibiotic treatment, and protein synthesis inhibiting antibiotic administration. The interest of polyclonal intravenous immunoglobulin G administration as an adjunctive treatment for TSS requires further evaluation. Scientific literature on TSS mainly consists of observational studies, clinical cases, and in vitro data; although more data on TSS are required, additional studies will be difficult to conduct due to the low incidence of the disease
Genesis of a Poetics of Silence
No full textThe concept of a poetics of silence has acquired a central place in literary theory in recent decades, with unreliable narration as defined by Booth (1961) playing an important part in the conceptualisation of an aesthetics of silence. Both silence and unreliable narration are key components of Kazuo Ishiguro’s writing strategy. I want to show that the poetics of silence that is so constitutive of his style was already at work at the very beginning of his writing. In order to achieve this goal, this paper studies one of Ishiguro’s first published short stories, “A Strange and Sometimes Sadness” (1981), in which a first-person narrator evokes memories of her time in Nagasaki during World War II. The narrator progressively turns out to be an unreliable one, due to the unspeakability of her traumatic experience. Her reluctance to report certain facts and to express some of her feelings is emphasised by the overabundance of details provided on safer subjects. The implied reader is compelled to try and fill the text’s blanks, which themselves shed light on the gap between narrator and implied author. This short story prefigures very clearly Ishiguro’s later novels, and deals with themes dear to him: memory, family, trauma and guilt, the atomic bomb as an absent centre. It also presents a very clear picture of the genesis of his writing style, centred around a poetics of silence, both at the diegetic and narratorial levels.Le concept de poétique du silence a acquis une importance centrale dans la recherche littéraire ces dernières décennies, tandis que la narration non fiable telle que Booth l’a définie en 1961 joue un rôle essentiel dans la conceptualisation d’une esthétique du silence. Narration non fiable et poétique du silence sont deux éléments clés de la stratégie d’écriture de Kazuo Ishiguro. Le but de cet article est de monter que la poétique du silence caractéristique du style d’Ishiguro était déjà à l’œuvre au tout début de sa carrière d’écrivain. A cet effet, cet article étudie l’une des premières nouvelles publiées d’Ishiguro, ‘A Strange and Sometimes Silence’ (1981), dans laquelle une narratrice à la première personne évoque des souvenirs de sa vie à Nagasaki pendant la guerre. La narratrice s’avère progressivement d’une fiabilité très limitée, du fait du caractère indicible de son traumatisme. Sa réticence à rapporter certains faits et exprimer ses sentiments est accentuée par la surabondance de détails qu’elle donne sur des sujets plus neutres. Le lecteur implicite est amené à combler les blancs du texte, qui mettent en lumière l’écart entre la narratrice et l’auteur implicite. Cette nouvelle préfigure clairement les romans plus tardifs d’Ishiguro, et aborde des thèmes qui lui sont chers : mémoire, famille, traumatisme et culpabilité, et la bombe atomique comme centre absent. Elle présente également un aperçu très clair de la genèse de son style, centré autour d’une poétique du silence, aussi bien au niveau diégétique que narratologique
Crack-damage quantification based on stochastic optimization of finite element models with data-driven features
No full textInternational audienceThe vibration-based Structural Health Monitoring plays a central role in ensuring the safe operation of infrastructures by monitoring their structural integrity based on data collected by sensors. While damage detection has reached maturity, the localization and the quantification of small-scale damage remain an open challenge. To address it, both the localization and the quantification of damage are often posed as an updating problem of a Finite Element Model (FEM) of the operating structure, minimizing the misfit between some features computed from response measurements of a faulty structure and its FEM in a reference, healthy condition. This paper investigates the choice of the features for the design of the objective function to quantify structural cracks. For this purpose, a FEM of a beam with a transverse crack is developed and parametrized by the second moment of area of the elements to locate and quantify the crack-related damage. Subsequently, the impact on the choice of the objective function is discussed based on a small-samples Monte Carlo study
Crack-damage quantification based on stochastic optimization of finite element models with data-driven features
No full textInternational audienceThe vibration-based Structural Health Monitoring plays a central role in ensuring the safe operation of infrastructures by monitoring their structural integrity based on data collected by sensors. While damage detection has reached maturity, the localization and the quantification of small-scale damage remain an open challenge. To address it, both the localization and the quantification of damage are often posed as an updating problem of a Finite Element Model (FEM) of the operating structure, minimizing the misfit between some features computed from response measurements of a faulty structure and its FEM in a reference, healthy condition. This paper investigates the choice of the features for the design of the objective function to quantify structural cracks. For this purpose, a FEM of a beam with a transverse crack is developed and parametrized by the second moment of area of the elements to locate and quantify the crack-related damage. Subsequently, the impact on the choice of the objective function is discussed based on a small-samples Monte Carlo study
Prise en charge médico-judiciaire des violences conjugales : des pratiques de la Justice à la pratique du médecin légiste. Une revue descriptive de la littérature
No full textThe aim of this thesis is to explore the medical and judicial management of domestic violence, through a descriptive review of the literature. Using the keywords "conjugal violence", "intimate partner violence", "justice", "legal consequences", 47 documents dealing with the legal management of conjugal violence were selected, as well as 32 documents on the epidemiology of conjugal violence. This medical thesis on a legal subject is divided into two parts. The first part deals with the judicial handling of domestic violence. It will analyze the place of conjugal violence in French law, and then discuss the judicial treatment of conjugal violence, from filing of complaint to sentence. In the second part, we discuss the medical management of domestic violence, looking at the role of healthcare establishments in assisting victims of domestic violence, as well as the role of the forensic pathologist in the medical and judicial treatment of victims and author of domestic violence, while developing a reflection on the evolution of practices in forensic medicine concerning the management of such violence. This thesis provides an overview of current forensic and medical practices in relation to domestic violence, compared with past practices.À travers ce travail de thèse, il s’agit de mener une réflexion autour de la prise en charge médico-judiciaire des violences conjugales, par le biais d’une revue descriptive de la littérature. À partir des mots-clés « violences conjugales », « violences partenaires intimes », « justice », « suites judiciaires », 47 documents traitant de la prise en charge judiciaire des violences conjugales ont été sélectionnés, ainsi que 32 documents à propos de l’épidémiologie des violences conjugales. Cette thèse de médecine traitant d’un sujet de droit se décompose en deux parties. Une première partie abordera la prise en charge judiciaire des violences conjugales. Il s’agira d’analyser la place des violences conjugales dans le droit français ; puis de discuter du traitement judiciaire des violences conjugales, du dépôt de plainte à la condamnation. Dans la seconde partie, nous parlerons de la prise en charge médicale des violences conjugales, en évoquant le rôle des établissements de santé dans l’accompagnement des victimes de violences conjugales, ainsi que de la place du médecin légiste dans le parcours médico-judiciaire des victimes et des auteurs, tout en développant une réflexion autour de l’évolution des pratiques en médecine légale concernant la prise en charge de ces violences. Cette thèse dresse donc un état des lieux chiffré et qualitatif des pratiques judiciaires et médicales actuelles, comparées aux pratiques anciennes, en matière de prise en charge des violences conjugales
Analysis of the Worldwide Diversity of Xanthomonas hortorum pv. carotae, the Agent of Bacterial Blight of Carrot, Reveals Two Distinct Populations
No full textXanthomonas hortorum pv. carotae is a pathogen responsible for the bacterial blight of carrot. Although it infects carrot fields worldwide, its diversity remains unknown. Here, we validated by PCR the identification as X. hortorum pv. carotae of most of the strains isolated from symptomatic carrots. We studied their diversity by sequencing seven housekeeping genes. The analysis confirmed the identity of most of the strains previously identified as X. hortorum pv. carotae and highlighted the presence of two clusters inside the pathovar carotae. The 18 non-X. hortorum pv. carotae have been identified as Xanthomonas from other species. As the X. hortorum pv. carotae strains clustered only in two groups by this analysis, a new multilocus variable number of tandem repeats analysis scheme was developed. It allowed us to validate the subclustering in two groups and observe diversity among them. At the same time, based on this study and data from the literature, we proposed the strain CFBP 7900 as the neopathotype strain of the pathovar. The strain should replace the holopathotype strain CFBP 4997, as it is no longer available in international collections. [Figure: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license
Evaluation of the AmplifyRP XRT+ Kit for the Detection of Xylella fastidiosa by Recombinase Polymerase Amplification
No full textXylella fastidiosa is a quarantine priority pest in Europe and several other countries as it represents a major threat to many cultivated and wild plants. Early detection of the pathogen is needed to reduce potential losses and to stop the bacterial dissemination. Very few molecular methods are available for rapid field detection to identify the pathogen. Here, we evaluated a new rapid commercial detection test called AmplifyRP, based on molecular recombinase polymerase amplification (RPA). The AmplifyRP test was compared with the quantitative PCR (qPCR) Harper's assay, which represents the standard method used in most laboratories all over the world. Specificity was tested in vitro on a panel of target and nontarget strains. Additionally, the sensitivity of the RPA test was tested on X. fastidiosa genomic DNA, and the selectivity was compared between different host plant matrices spiked with X. fastidiosa cell suspensions. Although the qPCR assay showed a higher sensitivity than the RPA test, the latter appeared to be a very specific, rapid, and portable technique for which no skills are required to proceed. These findings should enable growers and inspectors to choose an appropriate diagnostic method. [Figure: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license
Fatal invasive aspergillosis caused by Aspergillus niger after bilateral lung transplantation
No full textAspergillus niger is usually considered to be a low virulence fungus, not commonly reported to cause invasive infections. Invasive pulmonary aspergillosis due to Aspergillus niger was diagnosed in a 43-year-old woman following bilateral lung transplantation. Intravenous voriconazole failed to control progression of the disease. Despite salvage therapy with a combination of voriconazole and caspofungin for 23 days, the patient developed massive hemoptysis leading to death. The authors report the clinical features and treatment of this case
Gamma Knife radiosurgery as salvage therapy for gangliogliomas after initial microsurgical resection
No full textIntroduction: Gangliogliomas (GG) are considered WHO grade I rare tumors. While they commonly manifest as temporal lobe epilepsy, they can be located anywhere in the brain. Primary treatment is complete microsurgical resection. Remnant or recurrent GG can benefit from radiation therapy. Here, we present a series of GG who received Gamma Knife radiosurgery (GKR) after initial microsurgery. Methods: Between October 2009 and February 2020, four patients benefitted from such approach. The median age at surgery was 16 years (mean 17, 11-25) and at the time of GKR was 22.5 years (mean 23, 19-28). Initial clinical symptom was epilepsy in 3 cases and incidental in one. Biopsy was firstly performed in one case. One patient had stereotactic electroencephalography. The respective anatomical locations were right parieto-occipital, sylvian, left paraventricular and left inferior parietal. Results: Gamma Knife radiosurgery was performed after a median time of 3.5 years after initial gross total microsurgical resection (GTR). The median follow-up after GKR was 54 months (mean 58.5, 6-120). The median marginal dose was 18 Gy (mean 17.5, 16-18). The median target volume was 0.5 mL (mean 0.904, 0.228-2.3). The median prescription isodose volume was 0.6 mL (mean 0.9, 0.3-2.4). At last follow-up, GG majorly decreased in 3 patients, remained stable in one. Conclusion: Gamma Knife radiosurgery is safe and effective for remnant GG after GTR. Primary treatment remains microsurgical resection, especially in cases with symptomatic mass effect or with epilepsy. Single fraction GKR can be a valuable option for remnant or recurrent tumors after initial resection. (C) 2021 The Author(s). Published by Elsevier Ltd.LTS
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