86 research outputs found
SemSorGrid4Env Architecture
No full textThis document specifies, designs, and validates the Semantic Sensor Grid Rapid Application Development for Environmental Management (SemSorGrid4Env) software architecture. The architecture enables the publication and querying of both stored (e.g. database) and streaming (e.g. sensor) data to support the rapid development of applications for environmental monitoring. Significant benefits are provided by the use of semantic technology for service discovery and data integration. The infrastructural backbone of the architecture is provided by four service-oriented services: Stored Data Service for the publication of databases, Streaming Data Service for the publication of sensor data, Registration and Discovery Service to enable resources to found, and Integration and Querying Service to enable multiple data sources to be accessed through a single model. These services will be supplemented with application domain specific services which may offer RESTful interfaces
New Agents in Development for Sepsis: Any Reason for Hope?
No full textSepsis is a syndrome which is defined as a dysregulated host response to infection leading to organ failure. Since it remains one of the leading causes of mortality worldwide, numerous drug candidates have already been tested, and continue to be developed, as potential adjunct therapies. Despite convincing mechanisms of action and robust pre-clinical data, almost all drug candidates in the field of sepsis have failed to demonstrate clinical efficacy in the past two decades. Accordingly, the development of new sepsis drugs has markedly decreased in the past few years. Nevertheless, thanks to a better understanding of sepsis pathophysiology and pathways, new promising drug candidates are currently being developed. Instead of a unique sepsis profile as initially suspected, various phenotypes have been characterised. This has resulted in the identification of multiple targets for new drugs together with relevant biomarkers, and a better understanding of the most appropriate time to intervention. Within the entire sepsis drugs portfolio, those targeting the immune response are probably the most promising. Monoclonal antibodies targeting either cytokines or infectious agents are undoubtedly part of the potential successful therapeutic classes to come
Iconography of the gorgons on temple decoration in Sicily and western Greece
Get PDFThis paper provides a concise analysis of the Gorgon image as it has been featured on temples throughout the Greek world. The Gorgons, also known as Medusa and her two sisters, were common decorative motifs on temples beginning in the eighth century B.C. and reaching their peak of popularity in the sixth century B.C. Their image has been found to decorate various parts of the temple across Sicily, Southern Italy, Crete, and the Greek mainland. By analyzing the city in which the image was found, where on the temple the Gorgon was depicted, as well as stylistic variations, significant differences in these images were identified. While many of the Gorgon icons were used simply as decoration, others, such as those used as antefixes or in pediments may have been utilized as apotropaic devices to ward off evil
Contribution of abnormal central blood pressure to left ventricular filling pressure during exercise in patients with heart failure and preserved ejection fraction
No full textBackground Hypertension is ubiquitous in patients with heart failure and preserved ejection fraction (HFpEF) and contributes to arterial and ventricular stiffening. Exertional dyspnea may result from diastolic dysfunction with exercise; however, the association of central bloodpressure (BP) to left ventricular filling pressure during exercise has not been assessed in this population and was the aim of this study. Methods Fifteen patients with HFpEF and 15 age-matched and sex-matched controls were studied at rest, during submaximal and immediately after maximal exercise. Simultaneous echocardiography and radial tonometry was performed to measure E/e’ and central BP, defined by central augmented pressure (C_AP) and augmentation index (AIx). Results Patients with HFpEF had higher E/e’ (PU0.020) and peripheral and central BP (P0.05). There was a large increase in E/e’ with exercise in patients (PU0.012) but no change in C_AP or AIx. Importantly, the change in E/e’ from rest to submaximal exercise was significantly and independently associated with DC_AP (rU0.559; PU0.030) and DAIx (rU0.654; PU0.008) in patients with HFpEF. In contrast with the controls, E/e’, C_AP and AIx decreased with exercise and there were no associations between exercise E/e’ and central or peripheral BP (P>0.05 for all). Conclusion Indices of central BP are associated with the left ventricular diastolic response to exercise in patients with HFpEF. Arterial function and central hemodynamics may be important targets for treating symptoms associated with raised left ventricular filling pressure with exertion
Shotgun metagenomics for microbiome and resistome detection in septic patients with urinary tract infection
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Post-kyphoplasty cement embolism migrating to the peritoneum through the right ventricle
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Spontaneous community-acquired PVL-producing Staphylococcus aureus mediastinitis in an immunocompetent adult – a case report
No full textInternational audienceBackground: Mediastinitis caused by hematogenous spread of an infection is rare. We report the first known case of community-acquired mediastinitis from hematogenous origin in an immunocompetent adult. This rare invasive infection was due to Panton-Valentine Leucocidin-producing (PVL+) methicillin-susceptible Staphylococcus aureus (MSSA). Case presentation: A 22-year-old obese man without other medical history was hospitalized for febrile precordial chest pain. He reported a cutaneous back abscess 3 weeks before. CT-scan was consistent with mediastinitis and blood cultures grew for a PVL+ MSSA. Intravenous clindamycin (600 mg t.i.d) and cloxacillin (2 g q.i.d.), secondary changed for fosfomycin (4 g q.i.d.) because of a related toxidermia, was administered. Surgical drainage was performed and confirmed the presence of a mediastinal abscess associated with a fistula between the mediastinum and right pleural space. All local bacteriological samples also grew for PVL+ MSSA. In addition to clindamycin, intravenous fosfomycin was switched to trimethoprim-sulfamethoxazole after 4 weeks for a total of 10 weeks of antibiotics. Conclusions: We present the first community-acquired mediastinitis of hematogenous origin with PVL+ MSSA. Clinical evolution was favorable after surgical drainage and 10 weeks of antibiotics. The specific virulence of MSSA PVL+ strains played presumably a key role in this rare invasive clinical presentation
High prevalence of infections in non-COVID-19 patients admitted to the Emergency Department with severe lymphopenia
No full textInternational audienceBackground: In the Emergency Department (ED), early and accurate recognition of infection is crucial to prompt antibiotic therapy but the initial presentation of patients is variable and poorly characterized. Lymphopenia is commonly associated with bacteraemia and poor outcome in intensive care unit patients. The objective of this retrospective study was to assess the prevalence of community-acquired infection in a cohort of unselected patients admitted to the ED with undifferentiated symptoms and severe lymphopenia.Methods: This is a retrospective single-center study conducted over a 1 year-period before the COVID-19 pandemic. Consecutive adult patients admitted to the ED with severe lymphopenia (lymphocyte count < 0.5 G/L) were studied. Patients with hematological or oncological diseases, HIV infection, hepato-cellular deficiency, immunosuppression, or patients over 85 years old were excluded. Diagnoses of infection were validated by an independent adjudication committee. The association between various parameters and infection was assessed using a multivariate logistic regression analysis.Results: Of 953 patients admitted to the ED with severe lymphopenia, 245 were studied (148 men; mean age: 63 ± 19 years). Infection was confirmed in 159 patients (65%) (bacterial: 60%, viral: 30%, other: 10%). Only 61 patients (25%) were referred to the ED for a suspected infection. In the univariate analysis, SIRS criteria (OR: 5.39; 95%CI: 3.04-9.70; p < 0.001) and temperature ≥ 38.3 °C (OR: 10.95; 95%CI: 5.39-22.26; p < 0.001) were strongly associate with infection. In the multivariate analysis, only SIRS criteria (OR: 2.4; 95%CI: 1.48-3.9; p < 0.01) and fever (OR: 3.35; 95%CI: 1.26-8.93; p = 0.016) were independently associated with infection.Conclusions: The prevalence of underlying infection is high in patients admitted to the ED with lymphopenia, irrespective of the reason for admission. Whether lymphopenia could constitute a valuable marker of underlying infection in this clinical setting remains to be confirmed prospectively in larger cohorts
Community-acquired Staphylococcus aureus bacteriuria: a warning microbiological marker for infective endocarditis?
No full textInternational audienceBACKGROUND:Urinary tract infection (UTI) is frequently diagnosed in the Emergency Department (ED). Staphylococcus aureus (SA) is an uncommon isolate in urine cultures (0.5-6% of positive urine cultures), except in patients with risk factors for urinary tract colonization. In the absence of risk factors, community-acquired SA bacteriuria may be related to deep-seated SA infection including infective endocarditis. We hypothesized that SA bacteriuria could be a warning microbiological marker of unsuspected infective endocarditis in the ED.METHODS:This is a retrospective chart review of consecutive adult patients between December 2005 and February 2018. All patients admitted in the ED with both SA bacteriuria (104 CFU/ml SA isolated from a single urine sample) and SA bacteremia, without risk factors for UT colonization (i.e., < 1 month UT surgery, UT catheterization) were analyzed. Diagnosis of infective endocarditis was based on the Duke criteria.RESULTS:During the study period, 27 patients (18 men; median age: 61 [IQR: 52-73] years) were diagnosed with community-acquired SA bacteriuria and had subsequently documented bacteremia and SA infective endocarditis. Only 5 patients (18%) had symptoms related to UT infection. Median delay between ED admission and SA bacteriuria identification was significantly shorter than that between ED admission and the diagnosis of infective endocarditis (1.4 ± 0.8 vs. 4.3 ± 4.2 days: p = 0.01). Mitral and aortic valves were most frequently involved by infective endocarditis (93%). Mortality on day 60 reached 56%.CONCLUSIONS:This study suggests that community-acquired SA bacteriuria should warn the emergency physician about a potentially associated left-sided infective endocarditis in ED patients without risk factors for UT colonization
La estructura de las revoluciones científicas según Thomas Kuhn en el análisis de la historia del arte
Get PDFEste texto plantea problemas teórico metodológicos relativos a una particular investigación sobre paisajismo moderno y contemporáneo. En él se trazan algunas cuestiones relativas a procesos dinámicos de cambios teóricos, epistemológicos y de forma en las artes visuales S. XX-XXI. El análisis, basado en el estructuralismo de las revoluciones científicas de Thomas Kuhn, tiene contenidos que responden al cuestionamiento sobre la articulación de paradigmas según Kuhn en historia de la ciencia, en vez de articulación de estilos según Heinrich Wölfflin, Meyer Schapiro o, entre otros, Ernst Gombrich en historia del arte, dado que ciencia y arte son empresas de distinta naturaleza. El acercamiento de Kuhn a la historia del arte, particularmente a la obra de Gombrich, nos llevó a trazar un paralelismo de ciencia y arte en Kuhn y al estudio de textos en los que trata la posibilidad de articulación de paradigmas en historia del arte.</jats:p
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