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Background. Little is known on headaches long-term persistence after bacterial meningitis and on their impact on patients’ quality of life. Methods. In an ancillary study of the French national prospective cohort of community-acquired bacterial meningitis in adults (COMBAT) conducted between February 2013 and July 2015, we collected self-reported headaches before, at onset, and 12 months (M12) after meningitis. Determinants of persistent headache (PH) at M12, their association with M12 quality of life (SF 12), depression (Center for Epidemiologic Studies Depression Scale) and neuro-functional disability were analysed. Results. Among the 277 alive patients at M12 87/274 (31.8%), 213/271 (78.6%) and 86/277 (31.0%) reported headaches before, at the onset, and at M12, respectively. In multivariate analysis, female sex (OR: 2.75 [1.54–4.90]; p

To estimate the incidence of influenza infection with a rapid diagnostic test in patients hospitalized in an intensive care unit (ICU) during the epidemic periods of two consecutive winters (2005-2006).This study tested nasal aspirate of all patients admitted to the ICU for acute respiratory failure during the influenza epidemic period with the QuickVue influenza rapid diagnostic test.The study included 39 patients: 22 men and 17 women. Their mean age was 69.7+/-13 years, their mean SAPS II score 54+/-21, their mean length of stay 14.7+/-20 days, and 43.5% had been vaccinated against influenza. The mortality rate was 33.3% (n=13). Four patients (10.2%) had a positive QuickVue test and were considered to have influenza associated with their primary diagnosis: pneumococcal pneumonia, haemophilus pneumonia, acute bronchitis, and acute bronchitis with acute cardiogenic edema. These patients were older than those with a negative test (80+/-7 versus 68+/-13 years, p=0.02). Their SAPS II, length of stay and mortality rate did not differ statistically from those with negative results. Chronic heart failure (but not COPD or non-vaccination) was more frequent in these patients (p=0.01).Several published studies report a satisfactory specificity and sensitivity for QuickVue. With this test, we estimated the incidence of influenza in patients hospitalized in our ICU for acute respiratory failure during flu epidemics at around 10%, close to that reported in previous studies.

Noninvasive positive-pressure ventilation (NIPPV) is widely used to treat acute respiratory failure, the goal being to avoid exposing patients to the morbidity associated with tracheal intubation. NIPPV may reduce the rates of intubation, morbidity, and mortality in selected patient subgroups. Although time-consuming for physicians and nurses, NIPPV is fairly easy to use, and few severe complications have been reported. Esophageal perforation is a well-recognized complication of tracheal intubation but has not been described in association with NIPPV. We report a case of fatal esophageal perforation associated with NIPPV after a surgical procedure.

Introduction: Venous thromboembolism is still the second leading cause of direct maternal mortality, which makes its prevention essential. The main objective was to check whether guidelines of French Society Anesthesia and Intensive Care and French National College of Gynaecologist and Obstetricians are on line with the low molecular weight heparin thromboprophylaxis prescribed in practice during postpartum.Methods: A quantitative and retrospective obstetrical record study over 300 patients who delivered between October 25th and December 9th 2019, has been led in the Sud-Francilien Hospital in Corbeil-Essonnes. The recommended and actually prescribed post-partum thromboprophylaxis were then analyzed and compared.Results: In this way, we have been able to underline that the agreement, between low molecular weight heparin thromboprophylaxis actually prescribed and the recommendations, was only within 30 to 40%. This gap was in excess for cesareans sections and in default for vaginal deliveries.Conclusion: A special attention should be paid to venous thromboembolism’s risks factors for each patient, whatever the mode of delivery.; Introduction : La prévention des maladies thromboemboliques veineuses est essentielle car celles-ci restent encore la deuxième cause directe de mortalité maternelle. Notre objectif était de vérifier l’adéquation entre la thromboprophylaxie par héparine de bas poids moléculaire prescrite en pratique en post-partum avec, d’un côté, les recommandations de la Société Française d’Anesthésie et de Réanimation et de l’autre, celles du Collège National des Gynécologues et Obstétriciens Français.Méthode : Une étude quantitative et rétrospective par recueil de données sur 300 patientes ayant accouché entre le 25 octobre et le 9 décembre 2019, a été menée au Centre Hospitalier Sud-Francilien à Corbeil-Essonnes. Les thromboprophylaxies prescrites en post-partum ont été analysées et comparées avec celles recommandées.Résultats : Nous avons pu ainsi montrer qu’il n’y avait une concordance que de l’ordre de 30 à 40% entre la thromboprophylaxie par héparine de bas poids moléculaire prescrite en pratique et celle selon les recommandations. Il ressort que cet écart était globalement en excès pour les césariennes et en défaut pour les voies basses.Conclusion : Une vigilance accrue devrait être portée aux facteurs de risque de maladie thromboembolique veineuse de chaque patiente, quelle que soit la voie d’accouchement.