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Mendibil A, Jost D, Thiry A, Garcia D, Trichereau J, Frattini B, Dang-Minh P, Maurin O, Margerin S, Domanski L, Tourtier JP. Laboratory study on the kinetics of the warming of cold fluids-A hot topic. Anaesth Crit Care Pain Med 2016; 35:337-342. [PMID: 27157476 DOI: 10.1016/j.accpm.2015.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 10/09/2015] [Accepted: 12/15/2015] [Indexed: 10/21/2022]
Abstract
OBJECTIVES In case of mild therapeutic hypothermia after an out-of-hospital cardiac arrest, several techniques could limit the cold fluid rewarming during its perfusion. We aimed to evaluate cold fluid temperature evolution and to identify the factors responsible for rewarming in order to suggest a prediction model of temperature evolution. EQUIPMENT AND METHODS This was a laboratory experimental study. We measured temperature at the end of the infusion line tubes (ILT). A 500ml saline bag at 4°C was administered at 15 and 30ml/min, with and without cold packs applied to the cold fluid bag or to the ILT. Cold fluid temperature was integrated in a linear mixed model. Then we performed a mathematical modelization of the thermal transfer across the ILT. RESULTS The linear mixed model showed that the mean temperature of the cold fluid was 1°C higher (CI 95%: [0.8-1.2]) with an outflow rate of 15 versus 30ml/min (P<0.001). Similarly, the mean temperature of the cold fluid was 0.7°C higher (CI 95%: [0.53-0.9]) without cold pack versus with cold packs (P<0.001). Mathematical modelization of the thermal transfer across the ILT suggested that the cold fluid warming could be reduced by a shorter and a wider ILT. As expected, use of CP has also a noticeable influence on warning reduction. The combination of multiple parameters working against the rewarming of the solution should enable the infusion of a solute with retained caloric properties. CONCLUSIONS By limiting this "ILT effect," the volume required for inducing mild therapeutic hypothermia could be reduced, leading to a safer and a more efficient treatment.
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Affiliation(s)
- Alexandre Mendibil
- Paris Fire Brigade Emergency Medical Department, BMU, BSPP, 1, place Jules Renard, 75017 Paris, France.
| | - Daniel Jost
- Paris Fire Brigade Emergency Medical Department, BMU, BSPP, 1, place Jules Renard, 75017 Paris, France
| | - Aurélien Thiry
- Fire engineering section, Physics and fire engineering division at the Central Laboratory of the Prefecture of Police of Paris (LCPP), 39 bis, rue de Dantzig, 75015 Paris, France
| | - Delphine Garcia
- Fire engineering section, Physics and fire engineering division at the Central Laboratory of the Prefecture of Police of Paris (LCPP), 39 bis, rue de Dantzig, 75015 Paris, France
| | - Julie Trichereau
- Paris Fire Brigade Emergency Medical Department, BMU, BSPP, 1, place Jules Renard, 75017 Paris, France
| | - Benoit Frattini
- Paris Fire Brigade Emergency Medical Department, BMU, BSPP, 1, place Jules Renard, 75017 Paris, France
| | - Pascal Dang-Minh
- Paris Fire Brigade Emergency Medical Department, BMU, BSPP, 1, place Jules Renard, 75017 Paris, France
| | - Olga Maurin
- Paris Fire Brigade Emergency Medical Department, BMU, BSPP, 1, place Jules Renard, 75017 Paris, France
| | - Sylvie Margerin
- Paris Fire Brigade Emergency Medical Department, BPIB, BSPP, 1, avenue Guy Moquet, 94460 Valenton, France
| | - Laurent Domanski
- Paris Fire Brigade Emergency Medical Department, BMU, BSPP, 1, place Jules Renard, 75017 Paris, France
| | - Jean-Pierre Tourtier
- Paris Fire Brigade Emergency Medical Department, BMU, BSPP, 1, place Jules Renard, 75017 Paris, France
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Pommier de Santi V, Girod R, Mura M, Dia A, Briolant S, Djossou F, Dusfour I, Mendibil A, Simon F, Deparis X, Pagès F. Epidemiological and entomological studies of a malaria outbreak among French armed forces deployed at illegal gold mining sites reveal new aspects of the disease's transmission in French Guiana. Malar J 2016; 15:35. [PMID: 26801629 PMCID: PMC4722744 DOI: 10.1186/s12936-016-1088-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 01/10/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In December 2010, a Plasmodium vivax malaria outbreak occurred among French forces involved in a mission to control illegal gold mining in French Guiana. The findings of epidemiological and entomological investigations conducted after this outbreak are presented here. METHODS Data related to malaria cases reported to the French armed forces epidemiological surveillance system were collected during the epidemic period from December 2010 to April 2011. A retrospective cohort study was conducted to identify presumed contamination sites. Anopheles mosquitoes were sampled at the identified sites using Mosquito Magnet and CDC light traps. Specimens were identified morphologically and confirmed using molecular methods (sequencing of ITS2 gene and/or barcoding). Anopheles infections with Plasmodium falciparum and P. vivax were tested by both enzyme-linked immunosorbent assay and real-time PCR. RESULTS Seventy-two P. vivax malaria cases were reported (three were mixed P. falciparum/P. vivax infections), leading to a global attack rate of 26.5% (72/272). Lack of compliance with vector control measures and doxycycline chemoprophylaxis was reported by patients. Two illegal gold mining sites located in remote areas in the primary forest were identified as places of contamination. In all, 595 Anopheles females were caught and 528 specimens were formally identified: 305 Anopheles darlingi, 145 Anopheles nuneztovari s.l., 63 Anopheles marajoara and 15 Anopheles triannulatus s.l. Three An. darlingi were infected by P. falciparum (infection rate: 1.1%) and four An. marajoara by P. vivax (infection rate: 6.4%). DISCUSSION The main drivers of the outbreak were the lack of adherence by military personnel to malaria prevention measures and the high level of malaria transmission at illegal gold mining sites. Anopheles marajoara was clearly implicated in malaria transmission for the first time in French Guiana. The high infection rates observed confirm that illegal gold mining sites must be considered as high level malaria transmission areas in the territory. CONCLUSIONS Illegal gold mining activities are challenging the control of malaria in French Guiana. Collaboration with neighbouring countries is necessary to take into account mobile populations such as gold miners. Malaria control strategies in the French armed forces must be adapted to P. vivax malaria and sylvatic Anopheles species.
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Affiliation(s)
- Vincent Pommier de Santi
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Camp Militaire de Sainte Marthe, BP 40026, 13568, Marseille Cedex 02, France.
- Direction Interarmées du Service de Santé en Guyane, Quartier La Madeleine, BP 6019, 97306, Cayenne Cedex, French Guiana.
| | - Romain Girod
- Medical Entomology Unit, Institut Pasteur de la Guyane, 23 Avenue Pasteur, BP 6010, 97306, Cayenne Cedex, French Guiana.
| | - Marie Mura
- Institut de Recherche Biomédicale des Armées, BP 73, 91223, Brétigny sur Orge Cedex, France.
| | - Aissata Dia
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Camp Militaire de Sainte Marthe, BP 40026, 13568, Marseille Cedex 02, France.
| | - Sébastien Briolant
- Direction Interarmées du Service de Santé en Guyane, Quartier La Madeleine, BP 6019, 97306, Cayenne Cedex, French Guiana.
- Institut de Recherche Biomédicale des Armées, BP 73, 91223, Brétigny sur Orge Cedex, France.
- Laboratory of Parasitology, Institut Pasteur de la Guyane, 23 Avenue Pasteur, BP 6010, 97306, Cayenne Cedex, French Guiana.
| | - Félix Djossou
- Unit of Infectious and Tropical Diseases, Andrée Rosemon Hospital, Avenue des Flamboyants, Cayenne, French Guiana.
| | - Isabelle Dusfour
- Medical Entomology Unit, Institut Pasteur de la Guyane, 23 Avenue Pasteur, BP 6010, 97306, Cayenne Cedex, French Guiana.
| | - Alexandre Mendibil
- Antenne médicale de Castres, Quartier Fayolle - 68 avenue J. Desplat, CS 50025, 81108, Castres Cedex, France.
| | - Fabrice Simon
- Department of Infectious Diseases and Tropical Medicine, Laveran Military Teaching Hospital, 34 Boulevard Laveran, BP 50, 13013, Marseille, France.
| | - Xavier Deparis
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Camp Militaire de Sainte Marthe, BP 40026, 13568, Marseille Cedex 02, France.
| | - Frédéric Pagès
- Cire Océan Indien, Institut de Veille Sanitaire, 2 bis, av Georges Brassens, CS 61002, 97743, Saint-Denis Cedex 9, Réunion, France.
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Lefort H, Mendibil A, Margerin S, Cuquel AC, Jost D, Tazarourte K, Domanski L, Tourtier JP. [Storing succinylcholine in prehospital settings following the recommendations of the French National Agency for the safety of medicines]. ACTA ACUST UNITED AC 2014; 33:395-9. [PMID: 24930762 DOI: 10.1016/j.annfar.2014.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 05/14/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The French National Pharmaceuticals Agency (ANSM) has recommanded in July 2012 not to break the cold chain before using succinylcholine (Celocurine®). RESEARCH OBJECTIVE to understand the pre-clinical evolution of the conservation modes of this curare. RESEARCH TYPE Descriptive study before (year 2011) and after (year 2012). PATIENTS AND METHOD Online survey to French Samu/Smur. DATA COLLECTED SMUR location, conservation method at clinical base, in the mobile unit (UMH) and at the patient. Principal decision criteria: evolution of the conservation modes before and after the recommendation (qualitatives variables compared with a Fisher test). RESULTS Out of 101 SAMU/SMUR, 62 answered. Conservation modes of succinylcholine vials were significantly different (P<0.001). Proper conservation was observed in 26 % of the cases before and 43 % after. Mobile units (UMH) equipped with a fridge increased from one out of two to 77 %. The lack of conservation modes passive or active on UMH went from 31 % to 3.4 % with isotherms bags with ice when a fridge was not available. The destruction of capsules at current temperature in a 24-hour period increased: 22 % before, 47 % after (P=0.04). CONCLUSION After recommendations from ANSM, conservation modes and destruction of succinylcholine in a prehospital environment were significantly impacted.
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Affiliation(s)
- H Lefort
- Service médical d'urgence, brigade de sapeurs-pompiers de Paris, 3, rue Darmesteter, 75013 Paris, France.
| | - A Mendibil
- Service médical d'urgence, brigade de sapeurs-pompiers de Paris, 3, rue Darmesteter, 75013 Paris, France
| | - S Margerin
- Service médical d'urgence, brigade de sapeurs-pompiers de Paris, 3, rue Darmesteter, 75013 Paris, France
| | - A-C Cuquel
- Pharmacie centrale, hôpital d'Instruction des Armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
| | - D Jost
- Service médical d'urgence, brigade de sapeurs-pompiers de Paris, 3, rue Darmesteter, 75013 Paris, France
| | - K Tazarourte
- Samu Smur de Melun, rue Fréteau-de-Pény, 77011 Melun, France
| | - L Domanski
- Service médical d'urgence, brigade de sapeurs-pompiers de Paris, 3, rue Darmesteter, 75013 Paris, France
| | - J-P Tourtier
- Service médical d'urgence, brigade de sapeurs-pompiers de Paris, 3, rue Darmesteter, 75013 Paris, France
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Minh PD, Frattini B, Galinou N, Maurin O, Mendibil A, Lanoë V, Lemoine F, Travers S, Jost D, Tourtier JP, Domanski L. What about therapeutic hypothermia in out-of-hospital cardiac arrest, in a two-tiered emergency system? An observational study. Resuscitation 2014. [DOI: 10.1016/j.resuscitation.2014.03.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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de Laval F, Oliver M, Rapp C, Pommier de Santi V, Mendibil A, Deparis X, Simon F. The challenge of diagnosing Plasmodium ovale malaria in travellers: report of six clustered cases in French soldiers returning from West Africa. Malar J 2010; 9:358. [PMID: 21143962 PMCID: PMC3017537 DOI: 10.1186/1475-2875-9-358] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 12/10/2010] [Indexed: 11/10/2022] Open
Abstract
Background Plasmodium ovale is responsible for 5% of imported malaria in French travellers. The clinical and biological features of six clustered cases of P. ovale malaria in an army unit of 62 French soldiers returning from the Ivory Coast are reported. Case report All patients were symptomatic and developed symptoms on average 50 days after their return and 20 days after the end of chemoprophylaxis (doxycycline). Clinical features included fever (6/6), mostly tertian (4/6), aches (6/6), nausea (3/6), abdominal pain (2/6), diarrhoea (2/6), or cough (2/6). Thrombocytopaenia was lower than 100,000/mm3 in half the cases only, and the haemoglobin count was normal for all patients. The diagnosis was made after at least three thick and thin blood smear searches. Parasitaemia was always lower than 0.5%. All rapid diagnostic tests were negative for HRP2 and pLDH antigens. Discussion Plasmodium ovale malaria is currently a problem to diagnose in travellers, notably in French soldiers returning from the Ivory Coast. Early attempts at diagnosis are difficult due to the lack of specific clinical features, the rarity of biological changes and the poor sensitivity of diagnostic tools to detect low parasitaemia. Thus, the diagnosis is commonly delayed or missed. Physicians should be aware of this diagnostic challenge to avoid relapses and provide prompt and adequate treatment with chloroquine and radical cure with primaquine.
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Affiliation(s)
- Franck de Laval
- Department of Infectious Diseases and Tropical Medicine, Laveran Military Teaching Hospital, Marseille, France
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Mendibil A, Buziaux L, Rogier C. [International conference on tropical medicine "Medicine and health in the Tropics" September 11 to 15 2005. Urban malaria]. Med Trop (Mars) 2005; 65:408-10. [PMID: 16465791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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