20 results on '"Salvi, N"'
Search Results
2. Cyclic compositions and cycles of the hypercube.
- Author
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Ferrari, M. M. and Salvi, N. Zagaglia
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CYCLIC compounds , *HYPERCUBES , *CUBES , *CHARTS, diagrams, etc. , *GRAPHIC methods - Abstract
The partition graph of a positive integer n, Pn
, is the graph whose vertices are the cyclic compositions of n and two vertices are adjacent if one composition is obtained from the other one by replacing two cyclically consecutive parts by their sum. In this paper we introduce and investigate the notions of singular cyclic composition and singular edge of Pn . We associate with every singular edge and every cycle of Pn , whose vertices are aperiodic cyclic compositions of n, a cycle or a set of disjoint cycles of equal length of the hypercube Qn . [ABSTRACT FROM AUTHOR] - Published
- 2018
- Full Text
- View/download PDF
3. Particular cycles of a binary de Bruijn digraph
- Author
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Kramer, A. and Zagaglia Salvi, N.
- Abstract
Abstract: In this paper we investigate an isomorphism between a directed de Bruijn digraph and its converse, which is the digraph obtained from by reversing the direction of all its arcs. A cycle is said to be -self-converse when the cycle coincides with its converse. We determine a characterization of -self-converse cycles, distinguishing the cases of even and odd. Moreover we prove that, for even, there does not exist a Hamiltonian -self-converse cycle, while, for odd, we determine a constructive proof of the existence of a similar cycle. Finally we prove that for every there exists only one -self-converse cycle of length 4. [Copyright &y& Elsevier]
- Published
- 2010
- Full Text
- View/download PDF
4. On some properties of base-matroids
- Author
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Maffioli, F. and Zagaglia Salvi, N.
- Subjects
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COMBINATORICS , *GRAPH theory , *MATROIDS , *SET theory - Abstract
Abstract: Let be a rank-n matroid on a set E and B one of its bases. A closed set is saturated with respect to B, or B-saturated, when , where is the rank of . The collection of subsets I of E such that , for every closed B-saturated set , turns out to be the family of independent sets of a new matroid on E, called base-matroid and denoted by . In this paper we prove some properties of , in particular that it satisfies the base-axiom of a matroid. Moreover, we determine a characterization of the matroids M which are isomorphic to for every base B of M. Finally, we prove that the poset of the closed B-saturated sets ordered by inclusion is isomorphic to the Boolean lattice . [Copyright &y& Elsevier]
- Published
- 2006
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5. Correlated multiwavelength emission from the X-ray-bright Seyfert galaxy III Zw 2.
- Author
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Salvi, N. J., Page, M. J., Stevens, J. A., Wu, K., Mason, K. O., Aller, M. F., Aller, H. D., Teräsranta, H., Romero-Colmenero, E., Cordova, F. A., and Priedhorsky, W. C.
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X-ray astronomy , *SEYFERT galaxies , *X-ray spectroscopy - Abstract
Abstract The X-ray-bright Seyfert 1 galaxy III Zw 2 was observed with XMM–Newton in 2000 July. Its X-ray spectrum can be described by a power law of photon index Γ= 1.7 and an extremely broad (FWHM∼ 140 000 km s[sup -1] ) Fe Kα line at 6.44 keV. The iron line has an equivalent width of ∼800 eV. To study the long-term X-ray behaviour of the source we have analysed 25 yr of data, from 1975 to 2000. There is no evidence of significant intrinsic absorption within the source or of a soft X-ray excess in the XMM or archival data. We do not detect rapid X-ray variability (a few × 10[sup 3] s ) during any of the individual observations; however, on longer time-scales (a few years) the X-ray light curve shows 10-fold flux variations. We infer a black hole mass of ∼10[sup 9] M[sub ⊙] (from Hβ FWHM) for III Zw 2 which is much higher than some previous estimates. A comparison of X-ray variability with light curves at other wavelengths over a 25-yr period reveals correlated flux variations from radio to X-ray wavelengths. We interpret the variable radio to optical emission as synchrotron radiation, self-absorbed in the radio/millimetre region, and the X-rays mainly as a result of Compton up-scattering of low-energy photons by the population of high-energy electrons that give rise to the synchrotron radiation. [ABSTRACT FROM AUTHOR]
- Published
- 2002
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- View/download PDF
6. Indirect imaging of the accretion stream in eclipsing polars – IV. V895 Cen.
- Author
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Salvi, N., Ramsay, G., Cropper, M., Buckley, D.A.H., and Stobie, R.S.
- Subjects
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IMAGING systems in astronomy , *WHITE dwarf stars - Abstract
We present spectroscopic and high-speed photometric data of the eclipsing polar V895 Cen. We find that the eclipsed component is consistent with it being the accretion regions on the white dwarf. This is in contrast to Stobie et al. who concluded that the eclipsed component was not the white dwarf. Further, we find no evidence for an accretion disc in our data. From our Doppler tomography results, we find that the white dwarf has M≳0.7 M[sub ⊙]. Our indirect imaging of the accretion stream suggests that the stream is brightest close to the white dwarf. When we observed V895 Cen in its highest accretion state, emission was concentrated along field lines leading to the upper pole. There is no evidence for enhanced emission at the magnetic coupling region. [ABSTRACT FROM AUTHOR]
- Published
- 2002
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7. A case of successful pregnancy outcome in a patient born with cloacal malformation.
- Author
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Salvi, N. and Arthur, I.
- Subjects
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CASE studies , *GENITAL abnormalities , *PREGNANCY , *CESAREAN section , *ASPIRIN , *OBSTETRICS - Abstract
The article presents a case report of a successful pregnancy in a 33-year-old patient with a cloacal malformation consisting multiple anomalies, including a cloaca with an extremely short vagina, which are associated with difficulty in maintaining a pregnancy. The patient was in her sixth pregnancy, and was being managed with low dose aspirin and Fragmin daily from the first trimester. At 28+4 weeks gestation, she was delivered by caesarean section.
- Published
- 2008
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8. Étude pharmacogénétique de la réponse a la titration morphinique postopératoire au sein d’une population pédiatrique.
- Author
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Perier, A., Salvi, N., Taright, H., Lui, G., Bouazza, N., Treluyer, J.-M., and Orliaguet, G.
- Abstract
Introduction Des facteurs génétiques pourraient jouer un rôle pour expliquer la variabilité interindividuelle des besoins en morphine postopératoire. Nous avons recherché une association entre les polymorphismes génétiques ( single-nucleotid polymorphisms : SNP) parmi les plus étudiés actuellement chez l’adulte et la consommation de morphine postopératoire en salle de surveillance post-interventionnelle (SSPI) chez l’enfant. Matériel et méthodes Il s’agit d’une étude prospective monocentrique, approuvée par le CPP, menée de juillet 2011 à juillet 2013, incluant des enfants âgés de 0 à 18 ans recevant une titration morphinique postopératoire en SSPI, conformément au protocole validé dans l’étude Morphit [1] . Les données recueillies pendant le séjour en SSPI étaient l’âge, le sexe, le poids, la dose totale de morphine rapportée au poids, le nombre de bolus, le type de chirurgie, les scores de douleur (EVA ou FLACC) et le score de Ramsay. Après recueil du consentement éclairé signé des parents et si possible de l’enfant, un prélèvement buccal d’ADN était réalisé. Les résultats sont exprimés en médiane [écarts interquantiles]. Sept SNP ont été recherchés : rs1799971, rs1045642, rs4680, rs11568563, rs10841795, rs72552763, rs5275. Si les SNPs répondaient aux critères de contrôle (équilibre de Hardy-Weinberg, fréquence allélique : MAF > 0,05, % de génotype disponible > 95 %), ils étaient testés pour une étude d’association dans un modèle de régression linéaire. Résultats Cent trente-sept patients (53 % de filles) ont été inclus (âge médian : 7 ans [1,1–13,3]). La dose totale de morphine reçue était de 0,11 mg/kg [0,08–0,15] et le nombre de bolus de 4 [2–5]. Aucun des SNPs étudiés n’était significativement lié à la dose totale de morphine par kg ou au nombre de bolus, en analyse uni- ou multivariée. Seul le type de chirurgie semblait influencer la dose de morphine et le nombre de bolus : la chirurgie ORL/maxillo-faciale était liée à une dose totale de morphine et à un nombre de bolus plus importants, contrairement à la neurochirurgie associée à une administration de morphine moindre. Aucun des SNPs n’était significativement associé à l’évolution du score de douleur ou de Ramsay dans le temps, en uni- ou multivarié. Discussion Aucun des SNPs étudiés n’était indépendamment associé à la consommation de morphine postopératoire ni à la réponse au traitement (score de douleur ou Ramsay) en analyse multivariée. En revanche, ce travail confirme que le type de chirurgie est déterminant. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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9. Quelle technique d’anesthésie en ventilation spontanée pour l’intubation difficile?
- Author
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Salvi, N. and Orliaguet, G.
- Subjects
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ARTIFICIAL respiration , *TRACHEA intubation , *ENDOSCOPY , *INTRAVENOUS anesthesia , *INHALATION anesthesia , *PEDIATRICS , *TARGETED drug delivery - Abstract
Résumé: L‘intubation difficile chez l’enfant est une situation rare et souvent prévisible dès la consultation d’anesthésie. Cela permet d’établir une stratégie adaptée à l’âge de l’enfant et à sa pathologie pour pratiquer l’intubation trachéale sous fibroscopie en ventilation spontanée. Une bonne connaissance des particularités anatomiques et physiologiques de l’enfant, de la technique de fibroscopie chez l’enfant et le respect de quelques principes permet d’assurer la sécurité de cette procédure. Le premier principe est de n’utiliser qu’un seul médicament, qu’il soit inhalé ou intraveineux, afin de limiter la dépression de la ventilation. La technique d’anesthésie recommandée en pédiatrie pour cette procédure est l’anesthésie inhalatoire au sévoflurane. Mais il est tout à fait possible d’utiliser un agent intraveineux, comme le propofol, en débit massique (bolus de 0,5 à 1mg/kg jusqu’à obtention de l’effet recherché, puis un entretien à la dose de 0,1 à 0,3mg/kg) ou en mode à objectif de concentration (modèle de Schnider, concentration initiale au site effet de 2,5μg/mL) dès lors que l’on utilise un monitorage de la profondeur d’anesthésie. Quel que soit le médicament choisi, la dose doit être titrée afin d’éviter la perte de la ventilation spontanée. Le second principe est d’associer une technique d’anesthésie locale de la filière nasopharyngée et/ou laryngée à l’anesthésie générale afin de limiter la réactivité des voies aériennes, fréquente chez l’enfant. L’anesthésie locale du plan glottique par l’injection au moyen du canal opérateur du fibroscope de lidocaïne (1 à 2mL selon le poids, 2mg/kg en général) est réalisable quel que soit l’âge de l’enfant. Par ailleurs, on peut associer une anesthésie des fosses nasales par l’application de lidocaïne naphazolinée dès l’âge de 2ans. Enfin, le dernier principe est d’assurer une oxygénation correcte du patient. Plusieurs techniques sont possibles comme l’utilisation de masques faciaux pour fibroscopie ou de sondes nasopharyngées. On ne retiendra l’usage du masque laryngé que comme technique de secours, en cas de perte de la ventilation spontanée. Au total, il est important d’établir un algorithme de prise en charge dans chaque structure afin d’utiliser des techniques connues de tous, réalisables à tous moments et de les enseigner régulièrement. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
10. Long-term follow-up of children with haemophilia - low incidence of infections with central venous access devices.
- Author
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Harroche, A., Merckx, J., Salvi, N., Faivre, J., Jacqmarcq, O., Dazet, D., Makhloufi, M., Clairicia, M., Torchet, M.‐F., Aouba, A., and Rothschild, C.
- Subjects
- *
HAEMOPHILUS diseases , *FIBRINOLYSIS , *STAPHYLOCOCCUS aureus , *MEDICAL protocols , *MEDICAL care - Abstract
This study reports on 15 years of experience, in a single haemophilia care centre in France, with central venous access devices ( VADs) in children with haemophilia. Following the insertion of a central VAD, patients were requested to return to the hospital on a quarterly basis for a multidisciplinary appointment which included clinical examination, chest X-ray, cardiac and major vessels ultrasound and preventive fibrinolysis. The family was urged to return to the Haemophilia Care Centre if complications or problems occurred. The follow-up comprised 50 patients. Data were collected prospectively. The total number of days with a VAD was 86 461 days and the total number of times the VAD was used was 41 192 (approximately every other day). Mean duration of VAD placement was 1269 days (range 113-2794 days). There were 25 complications, of which 9 haematomas and 5 systemic infections. Two VADs, infected with Staphylococcus aureus, had to be replaced. The infection rate was calculated as 0.0578 infections/1000 catheter days. There were no cases of thrombosis. This study concluded that most VAD infections in children can be avoided, even in patients requiring intense, prolonged treatment. The very low infection rate was achieved through the efforts of a multidisciplinary team, combined with extensive training for all individuals involved, adherence to written protocols and specific monitoring measures. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
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11. Perfect matchings of a graph associated with a binary de Bruijn digraph
- Author
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Kramer, A., Lastaria, F., and Zagaglia Salvi, N.
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PERFECT graphs , *MATCHING theory , *DIRECTED graphs , *COMBINATORIAL set theory , *COMBINATORICS - Abstract
Abstract: Let be the binary de Bruijn digraph of order and the quotient set of the set of vertices of with respect to the equivalence relation of rotation. Let be the graph which has as the set of vertices and in which two elements and are adjacent when there exist a vertex of and a vertex of such that is an arc of . Recently the problem of establishing whether the graph has a perfect matching was posed. In this paper we answer in the positive to this problem in the case of odd. [Copyright &y& Elsevier]
- Published
- 2010
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12. The origin of the Fe K features in Markarian 205 and Markarian 509.
- Author
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Page, M. J., Davis, S. W., and Salvi, N. J.
- Subjects
- *
ACCRETION (Astrophysics) , *ASTROPHYSICS , *SUPERMASSIVE black holes , *GALAXIES , *SEYFERT galaxies - Abstract
ABSTRACT We examine the 3–10 keV EPIC spectra of Mrk 205 and 509 to investigate their Fe K features. The most significant feature in the spectra of both objects is an emission line at 6.4 keV. The spectra can be adequately modelled with a power law and a relatively narrow (σ < 0.2 keV) Fe Kα emission line. Better fits are obtained when an additional Gaussian emission line, relativistic accretion-disc line, or Compton reflection from cold material, is added to the spectral model. We obtain similar goodness of fit for any of these three models, but the model including Compton reflection from cold material offers the simplest, physically self-consistent solution, because it only requires one reprocessing region. Thus the Fe K spectral features in Mrk 205 and 509 do not present strong evidence for reprocessing in the inner, relativistic parts of accretion discs. [ABSTRACT FROM AUTHOR]
- Published
- 2003
- Full Text
- View/download PDF
13. Highly efficient bio-sorption of trivalent f-elements using wild type Rhizopus arrhizus dead fungus.
- Author
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Kishor, Preetam, Sengupta, Arijit, Adya, V., and Salvi, N.
- Subjects
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SORBENTS , *RHIZOPUS , *BIOMASS , *AMERICIUM , *EUROPIUM , *CHEMISORPTION , *LUMINESCENCE - Abstract
Wild type Rhizopus arrhizus biomass was demonstrated as highly efficient bio-sorbent for trivalent f-elements. Both Am and Eu were found to follow the Fruendlich isotherm through chemi-sorption. The sorption for Am was found be faster compared to Eu while both proceeded via pseudo-second order reaction. EDTA was found to be effective strippant whereas up to 500 kGy, the bio-sorbent showed high radiolytic stability. Luminescence employed for probing the local environment of metal ion on sorption which revealed the presence of single adsorbed species with no inner sphere water molecules. The covalency of metal-ligand bond enhanced on complexation with the bio-sorbent. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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14. Understanding the sorption behavior of tetra- and hexavalent plutonium on fungus Rhizopus arrhizus dead biomass.
- Author
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Kishor, Preetam, Adya, V., Sengupta, Arijit, and Salvi, N.
- Subjects
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PLUTONIUM , *RHIZOPUS , *BIOMASS , *LANGMUIR isotherms , *FREUNDLICH isotherm equation , *OXALIC acid - Abstract
An attempt was made to understand the sorption behaviour of Pu and PuO on Rhizopus arrhizus fungus. The sorption data were analyzed using Langmuir, Dubinin-Radushkevich, Freundlich isotherm and Tempkin isotherms, which revealed that the sorption proceeds via chemisorption through mono layer following Langmuir isotherm. the sorption kinetics were analyzed by different models revealing the predominance of pseudo 2nd order kinetics. Oxalic acid and sodium carbonate were used for effective stripping of Pu and PuO , respectively. This biomass was found to be radiolytically stable and finally was applied for processing of SHLW from RR and FBR origins. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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15. ON CIRCULAR DISARRANGED STRINGS OF SEQUENCES.
- Author
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Beggas, F., Ferrari, M. M., Kheddouci, H., and Salvi, N. Zagaglia
- Published
- 2016
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16. Mucormycosis as a rare cause of severe gastrointestinal bleeding after multivisceral transplantation.
- Author
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Irtan, S., Lamerain, M., Lesage, F., Verkarre, V., Bougnoux, M.‐E., Lanternier, F., Zahar, J.R., Salvi, N., Talbotec, C., Lortholary, O., Lacaille, F., and Chardot, C.
- Subjects
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MUCORMYCOSIS , *MYCOSES , *TRANSPLANTATION of organs, tissues, etc. , *ULCERS , *NUTRITION , *SURGERY - Abstract
Mucormycosis, an emerging fungal infection in solid organ transplant patients, is mostly located in rhino-orbito-cerebral, pulmonary, and cutaneous areas, or disseminated with poor prognosis. A 4-year-old girl with chronic intestinal pseudo-obstruction syndrome underwent a modified multivisceral transplantation, including half of the stomach, the duodeno-pancreas, the small bowel, and the right colon. On postoperative day 5, a digestive perforation was suspected. Surgical exploration found a small necrotic area on the native stomach, which was externally drained. The next day, massive gastric bleeding occurred. During the emergency laparotomy, 2 hemorrhagic ulcers were found and resected from the transplanted stomach. Pathology and fungal culture showed mucormycosis caused by Lichtheimia (formerly Absidia) ramosa in both the transplanted and native stomach. High-dose intravenous liposomal amphotericin B was immediately started. No other site of fungal infection was found. The child recovered, and 3 years after transplantation, is alive and well, off parenteral nutrition. The originality of this case is the very early presentation after transplantation, the unusual site, and the complete recovery after rapid medico-surgical management. The origin of the fungus and treatment are discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
17. Comparaison de 3 vidéo-laryngoscopes à la laryngoscopie directe : une étude expérimentale sur mannequin nourrisson.
- Author
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Orliaguet, G.A., Blot, R.-M., Bourdaud, N., Egan, M., Dogaru, E., Salvi, N., Gall, O., and Carli, P.
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ENDOTRACHEAL tubes , *LARYNGOSCOPY , *MANAKINS (Birds) , *LONGITUDINAL method , *INTUBATION , *PEDIATRICS , *COMPARATIVE studies - Abstract
Résumé: Objectif: L’objectif de cette étude expérimentale était de comparer les performances pour l’intubation trachéale de 3 vidéo-laryngoscopes (VL) comparativement à la laryngoscopie directe (LD). Type d’étude: Étude expérimentale sur mannequin nourrisson. Méthodes: Cette étude prospective, réalisée au sein de l’hôpital Necker-Enfants Malades, a inclus 77 opérateurs ayant une expérience variable de l’intubation pédiatrique. Ils ont réalisé chacun 10 tentatives d’intubation orotrachéale avec chaque dispositif : LD, GlideScope®, Airtraq® et McGrath®. Le critère de jugement principal était la durée totale d’intubation trachéale (DTIT). Les critères de jugement secondaires incluaient : la durée d’exposition glottique (DEG), la durée d’exposition glottique-intubation (DEI) et le taux d’échec d’intubation. Résultats: Il existait une décroissance significative des DTIT entre le 1er et le 10e essai avec tous les dispositifs (p <0,05). Cette décroissance n’était plus significative après le 3e essai pour les VL et après le 5e essai pour la LD. Au 10e essai, la DTIT était significativement plus courte avec l’Airtraq®, mais les différences avec les autres dispositifs étaient faibles (p <0,05). Les échecs prédominaient avec la LD (p <0,05), alors qu’ils étaient rares avec les autres dispositifs. Conclusion: Sur ce modèle de mannequin nourrisson, la courbe d’apprentissage des VL semble rapide, de l’ordre de 3 utilisations. L’Airtraq® semble le dispositif le plus performant, associant la durée totale d’intubation la plus courte et le taux d’échec le plus bas. Ces résultats obtenus sur mannequin nécessitent d’être confirmés par des études cliniques en pédiatrie. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
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18. Modified Rhizopus arrhizus biomass for sorption of Am and other radionuclides.
- Author
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Tripathi, S., Kannan, R., Dhami, P., Naik, P., Munshi, S., Dey, P., Salvi, N., and Chattopadhyay, S.
- Subjects
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MUCORACEAE , *BIOMASS , *ADSORPTION (Chemistry) , *AMERICIUM , *RADIOISOTOPES , *CALCIUM chloride , *SOLUTION (Chemistry) , *SODIUM compounds , *HYDROCHLORIC acid , *RADIOACTIVE wastes - Abstract
The improvement and the refinement of non-viable Rhizopus arrhizus biomass were investigated via immobilization. Immobilization was carried out by using sodium alginate/CaCl solution and formaldehyde/HCl cross-linking with dead Rhizopus arrhizus biomass and were used for the sorption of radionuclides from low level effluent wastes. The sodium alginate/CaCl immobilized biomass (ratio 1:2) showed about 86% sorption for Am activity but due to its soft nature and tendency to undergo distortion in shape, is unsuitable for practical applications. The biomass cross-linked with 15% formaldehyde/0.1 M HCl solution has a relatively high mechanical strength and rigidity. It was showing a sorption of >99% for Am activity and has the sorption capacity of ~65 mg/g for americium and uranium. Hence, it can be utilized for the removal of radionuclides from radioactive waste effluents. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
19. Highly symmetric generalized circulant permutation matrices
- Author
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Abreu, M., Labbate, D., Salvi, R., and Salvi, N. Zagaglia
- Subjects
- *
MATRICES (Mathematics) , *CATALECTICANT matrices , *CAYLEY-Hamilton theorem , *COMPLEX matrices - Abstract
Abstract: In this paper we investigate generalized circulant permutation matrices of composite order. We give a complete characterization of the order and the structure of symmetric generalized k-circulant permutation matrices in terms of circulant and retrocirculant block (0,1)-matrices in which each block contains exactly one or two entries 1. In particular, we prove that a generalized k-circulant matrix A of composite order n = km is symmetric if and only if either k = m −1 or k ≡0 or k ≡1mod m, and we obtain three basic symmetric generalized k-circulant permutation matrices, from which all others are obtained via permutations of the blocks or by direct sums. Furthermore, we extend the characterization of these matrices to centrosymmetric matrices. [Copyright &y& Elsevier]
- Published
- 2008
- Full Text
- View/download PDF
20. Traitement conservateur des infections à Staphylococcus aureus liées aux cathéters veineux centraux de longue durée en pédiatrie.
- Author
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Alby-Laurent, F., Lambe, C., Ferroni, A., Salvi, N., Lebeaux, D., Moulin, F., Nassif, X., Lortholary, O., Chalumeau, M., and Toubiana, J.
- Abstract
Introduction L’ablation précoce du cathéter veineux central (CVC) au cours des infections à Staphylococcus aureus liées aux CVC de longue durée est fortement recommandée par l’Infectious Diseases Society of America [Mermel 2009]. Chez l’enfant, les difficultés de voie d’abord veineuse peuvent inciter à s’écarter de ces recommandations et tenter un traitement “conservateur” associant antibiothérapie systémique, maintien du cathéter, verrous d’antibiotiques et surveillance. Il n’existe cependant à ce jour aucune donnée évaluant cette approche en pédiatrie. Matériels et méthodes Nous avons analysé rétrospectivement les caractéristiques et la prise en charge de toutes les infections à S . aureus liées aux CVC de longue durée entre 2010 et 2014 chez les enfants suivis dans un centre hospitalier universitaire. Nous avons défini un traitement conservateur comme le maintien du cathéter au-delà de la période initiale de prise en charge (≥ j3 de l’apparition des symptômes) et l’échec du traitement conservateur comme ≥ 1 hémoculture positive à S . aureus entre j4 et j28 ou l’apparition d’une complication locale ou systémique de l’infection. Résultats Pendant la période d’étude, 47 infections à S . aureus liées aux CVC de longue durée ont été identifiées chez 39 enfants, 62 % d’entre eux étaient en nutrition parentérale prolongée pour une entéropathie, 36 % avaient un déficit immunitaire congénital ou acquis. Six isolats (13 %) étaient résistants à la méthicilline. Au diagnostic, des signes inflammatoires locaux, un sepsis sévère ou une thrombophlébite étaient présents dans respectivement 28 %, 17 % et 6 % des cas. Un traitement conservateur a été choisi dans 37 (77 %) des cas, dont 11 (31 %) échecs. Aucun décès attribuable à l’infection n’a été constaté. La présence de sepsis sévère ( p = 0.04) ou d’une bactériémie polymicrobienne ( p = 0,03) au diagnostic, et une monothérapie empirique par daptomycine ( p = 0,01) étaient associés à un échec du traitement conservateur. Les 11 cas d’échec du traitement conservateur avaient tous initialement soit au moins un de ces facteurs, soit une complication systémique. Conclusion Le maintien du CVC au cours d’une infection à S . aureus liée au CVC longue durée était fréquent (77 %) dans le centre étudié mais ne permettait le maintien prolongé du CVC que dans 53 % des cas. L’application des recommandations de l’IDSA doit rester la règle lorsqu’une alternative d’abord vasculaire existe. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
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