Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux dis...Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux disease(GERD)is the one produced by the Lyon Consensus.Recently an updated second version has been released.Mean nocturnal baseline impedance(MNBI)was proposed by the first Consensus to act as supportive evidence for GERD diagnosis.Originally a cut-off of 2292 Ohms was proposed,a value revised in the second edition.The updated Consensus recommended that an MNBI<1500 Ohms strongly suggests GERD while a value>2500 Ohms can be used to refute GERD.The proposed cut-offs move in the correct direction by diminishing the original cut-off,nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value±2SD and not in symptomatic patients.However,data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity(RH)show lower MNBI values in comparison to normal subjects or patients with functional heartburn(FH).Moreover,according to the data,MNBI,even among symptomatic patients,is affected by age and body mass index.Also,various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one proposed.Finally,no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now exist.Therefore,even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH,its values should be interpreted with caution.展开更多
Photochemical aging of volatile organic compounds(VOCs)in the atmosphere is an important source of secondary organic aerosol(SOA).To evaluate the formation potential of SOA at an urban site in Lyon(France),an outdoor ...Photochemical aging of volatile organic compounds(VOCs)in the atmosphere is an important source of secondary organic aerosol(SOA).To evaluate the formation potential of SOA at an urban site in Lyon(France),an outdoor experiment using a Potential Aerosol Mass(PAM)oxidation flow reactor(OFR)was conducted throughout entire days during JanuaryFebruary 2017.Diurnal variation of SOA formations and their correlation with OH radical exposure(OHexp),ambient pollutants(VOCs and particulate matters,PM),Relative Humidity(RH),and temperature were explored in this study.Ambient urban air was exposed to high concentration of OH radicals with OHexp in range of(0.2-1.2)×10^12 molecule/(cm^3·sec),corresponding to several days to weeks of equivalent atmospheric photochemical aging.The results informed that urban air at Lyon has high potency to contribute to SOA,and these SOA productions were favored from OH radical photochemical oxidation rather than via ozonolysis.Maximum SOA formation(36μg/m^3)was obtained at OHexp of about 7.4×10^11 molecule/(cm^3·sec),equivalent to approximately 5 days of atmospheric oxidation.The correlation between SOA formation and ambient environment conditions(RH&temperature,VOCs and PM)was observed.It was the first time to estimate SOA formation potential from ambient air over a long period in urban environment of Lyon.展开更多
Background and Objective: Despite the costs generated in the diagnosis of cardiac pathologies by the use of ultrasound, the ECG indices have demonstrated a high performance in the studies of developed countries in the...Background and Objective: Despite the costs generated in the diagnosis of cardiac pathologies by the use of ultrasound, the ECG indices have demonstrated a high performance in the studies of developed countries in the diagnosis of these pathologies, but the data of these in sub-Saharan Africa are limited. The objective of this study is to evaluate the performance of the Peguero-Lo Presti index in the diagnosis of LVH among Congolese in order to make it a means of LVH diagnosis in an under-equipped environment. Methods: Cross-sectional and analytical study including 413 patients followed and hospitalized at the CIMAK Hospital Center during the period from February 2019 to June 2021. Sociodemographic parameters, history, biology, ultrasound and ECG parameters were studied. The performance of the Peguero-Lo Presti Index was validated by the Youden Index reinforced by the Area under the ROC curve. Results: Of the 413 patients admitted to the study, 69.5% were men versus 30.5% women, i.e. a sex ratio of 2M/1F;the mean age of the patients was 51.1 ± 11.6 years. The frequency of LVH found by echocardiography was 55.9%, it was 50.8% using the Peguero-Lo Presti index, 22% and 10.2% using the Peguero-Lo Presti index, respectively. Sokolow-Lyon and Cornell (p 0.001). The Peguero-Lo Presti curve is higher than the Sokolow-Lyon and Cornell curves. The area under the curve was 0.80 for Peguero-Lo Presti, 0.73 for Sokolow-Lyon and 0.66 for cornell. Conclusion: The newly proposed Peguero-Lo Presti index provides high sensitivity and specificity for the diagnosis of LVH in black Africans as also reported in the European and American population.展开更多
文摘Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux disease(GERD)is the one produced by the Lyon Consensus.Recently an updated second version has been released.Mean nocturnal baseline impedance(MNBI)was proposed by the first Consensus to act as supportive evidence for GERD diagnosis.Originally a cut-off of 2292 Ohms was proposed,a value revised in the second edition.The updated Consensus recommended that an MNBI<1500 Ohms strongly suggests GERD while a value>2500 Ohms can be used to refute GERD.The proposed cut-offs move in the correct direction by diminishing the original cut-off,nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value±2SD and not in symptomatic patients.However,data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity(RH)show lower MNBI values in comparison to normal subjects or patients with functional heartburn(FH).Moreover,according to the data,MNBI,even among symptomatic patients,is affected by age and body mass index.Also,various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one proposed.Finally,no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now exist.Therefore,even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH,its values should be interpreted with caution.
基金the Institute for Research on Catalysis and the Environment of Lyon(IRCELYON)supported by the"Investissement d’Avenir"PEPS Program Project(ASTRAL)of the University of Lyon and French National center for Scientific Research(French:center national de la recherche scientifique,CNRS)as part of the ANR-11-IDEX-0007 programby the European Research Council under the Horizon 2020 Research and Innovation Program Project of the European Union under Convention N°690958(MARSU)。
文摘Photochemical aging of volatile organic compounds(VOCs)in the atmosphere is an important source of secondary organic aerosol(SOA).To evaluate the formation potential of SOA at an urban site in Lyon(France),an outdoor experiment using a Potential Aerosol Mass(PAM)oxidation flow reactor(OFR)was conducted throughout entire days during JanuaryFebruary 2017.Diurnal variation of SOA formations and their correlation with OH radical exposure(OHexp),ambient pollutants(VOCs and particulate matters,PM),Relative Humidity(RH),and temperature were explored in this study.Ambient urban air was exposed to high concentration of OH radicals with OHexp in range of(0.2-1.2)×10^12 molecule/(cm^3·sec),corresponding to several days to weeks of equivalent atmospheric photochemical aging.The results informed that urban air at Lyon has high potency to contribute to SOA,and these SOA productions were favored from OH radical photochemical oxidation rather than via ozonolysis.Maximum SOA formation(36μg/m^3)was obtained at OHexp of about 7.4×10^11 molecule/(cm^3·sec),equivalent to approximately 5 days of atmospheric oxidation.The correlation between SOA formation and ambient environment conditions(RH&temperature,VOCs and PM)was observed.It was the first time to estimate SOA formation potential from ambient air over a long period in urban environment of Lyon.
文摘Background and Objective: Despite the costs generated in the diagnosis of cardiac pathologies by the use of ultrasound, the ECG indices have demonstrated a high performance in the studies of developed countries in the diagnosis of these pathologies, but the data of these in sub-Saharan Africa are limited. The objective of this study is to evaluate the performance of the Peguero-Lo Presti index in the diagnosis of LVH among Congolese in order to make it a means of LVH diagnosis in an under-equipped environment. Methods: Cross-sectional and analytical study including 413 patients followed and hospitalized at the CIMAK Hospital Center during the period from February 2019 to June 2021. Sociodemographic parameters, history, biology, ultrasound and ECG parameters were studied. The performance of the Peguero-Lo Presti Index was validated by the Youden Index reinforced by the Area under the ROC curve. Results: Of the 413 patients admitted to the study, 69.5% were men versus 30.5% women, i.e. a sex ratio of 2M/1F;the mean age of the patients was 51.1 ± 11.6 years. The frequency of LVH found by echocardiography was 55.9%, it was 50.8% using the Peguero-Lo Presti index, 22% and 10.2% using the Peguero-Lo Presti index, respectively. Sokolow-Lyon and Cornell (p 0.001). The Peguero-Lo Presti curve is higher than the Sokolow-Lyon and Cornell curves. The area under the curve was 0.80 for Peguero-Lo Presti, 0.73 for Sokolow-Lyon and 0.66 for cornell. Conclusion: The newly proposed Peguero-Lo Presti index provides high sensitivity and specificity for the diagnosis of LVH in black Africans as also reported in the European and American population.
