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Background Whereas 5415 Intensive Care Unit (ICU) beds were initially available, 7148 COVID-19 patients were hospitalised in the ICU at the peak of the outbreak. The present study reports how the French Health Care system created temporary ICU beds to avoid being overwhelmed. Methods All French ICUs were contacted for answering a questionnaire focusing on the available beds and health care providers before and during the outbreak. Results Among 336 institutions with ICUs before the outbreak, 315 (94%) participated, covering 5054/5531 (91%) ICU beds. During the outbreak, 4806 new ICU beds (+95% increase) were created from Acute Care Unit (ACU, 2283), Post Anaesthetic Care Unit and Operating Theatre (PACU & OT, 1522), other units (374) or real build-up of new ICU beds (627), respectively. At the peak of the outbreak, 9860, 1982 and 3089 ICU, ACU and PACU beds were made available. Before the outbreak, 3548 physicians (2224 critical care anaesthesiologists, 898 intensivists and 275 from other specialties, 151 paediatrics), 1785 residents, 11,023 nurses and 6763 nursing auxiliaries worked in established ICUs. During the outbreak, 2524 physicians, 715 residents, 7722 nurses and 3043 nursing auxiliaries supplemented the usual staff in all ICUs. A total number of 3212 new ventilators were added to the 5997 initially available in ICU. Conclusion During the COVID-19 outbreak, the French Health Care system created 4806 ICU beds (+95% increase from baseline), essentially by transforming beds from ACUs and PACUs. Collaboration between intensivists, critical care anaesthesiologists, emergency physicians as well as the mobilisation of nursing staff were primordial in this context.

Comparison between brain imaging techniques used for the first brain imaging after admission. (PDF 76 kb)

Characteristics and management of the three patients who underwent decompressive craniectomy. (PDF 345 kb)

Detailed characteristics of the patients admitted to ICUs for HSE during the study period. (PDF 81 kb)

Literature review for adult case reports and series of patients undergoing decompressive hemicraniectomy for severe herpes simplex encephalitis. (PDF 57 kb)

Le Padel est un sport de raquette très répandu dans les pays hispaniques. Ces dernières années, il est de plus en plus pratiqué en France de part sa facilité de prise en main et son coté très ludique. Ainsi de plus en plus de débutants se lancent dans cette pratique, et sont donc plus soumis aux risques de blessures.Dans la pratique quotidienne de l’exercice du pharmacien, nous rencontrons une recrudescence de patients se présentant au comptoir, désireux de conseils lors de traumatismes légers ou de blessures. Il est important que le pharmacien puisse apporter une réponse adaptée à chaque demande. Pour cela, une mise à jour régulière de ses connaissances est essentielle pour délivrer les bons conseils et recommandations à suivre selon l’état de santé du patient. C’est dans ce contexte que nous allons travailler sur cette thèse. Le sport en général étant un facteur de risque de blessure nous allons étudier comment anticiper, prévenir et traiter ces blessures.Dans une première partie nous allons revoir des rappels d’anatomies et de physiopathologies. Tout d’abord concernant le squelette, véritable « charpente » du corps humain ainsi que le système articulaire, en nous attardant essentiellement sur les articulations synoviales sollicitées dans la pratique sportive. Nous verrons également les différences entre les tendons et les ligaments ainsi que le système musculaire, notamment le fonctionnement des muscles striés squelettiques mis en jeu lors des mouvements. Ensuite, nous nous intéresserons au Padel, de son origine par la création du jeu de paume, aux différentes modifications qui lui ont été apporté jusqu’à aujourd’hui.

Comparison between brain imaging techniques used for the first brain imaging after admission. (PDF 76 kb)

Characteristics and management of the three patients who underwent decompressive craniectomy. (PDF 345 kb)

Literature review for adult case reports and series of patients undergoing decompressive hemicraniectomy for severe herpes simplex encephalitis. (PDF 57 kb)

Detailed characteristics of the patients admitted to ICUs for HSE during the study period. (PDF 81 kb)

Bone loss is a complication for patients with liver diseases and after transplantation, which results in increased fracture risk. The aim of this study was to determine the incidence of osteoporotic vertebral fractures following liver transplantation.We performed a prospective study of patients who were awaiting liver transplantation. Patients were seen at baseline (visit 1) and one year after transplantation (visit 2). At each visit, risk factors of osteoporosis were collected, biochemical tests were performed and bone mineral density with Vertebral Fracture Assessment was assessed.One hundred and fifteen patients were in the pre-transplant group and 33 patients were in the post-transplant group. In the pre-transplant group, the prevalence of vertebral fractures was 23.5%. The prevalence of densitometric osteoporosis was higher at the lumbar spine than at the femoral neck. In the post-transplant group, the prevalence of vertebral fractures at visit 1 and visit 2 was 33.3% and 60.6% respectively with an incidence of 23.1 fractures per 100 patient-years.Bone fragility was highly prevalent before transplantation and worsens one year after transplantation. Bone status should be evaluated in patients with liver diseases before transplantation to identify patients at high risk of fracture and help clinicians to prescribe appropriate preventive care.