PubMed – Le renouveau

Gaetan du blogue CISMeF, nous dévoile la nouvelle interface PubMed : http://preview.ncbi.nlm.nih.gov/pubmed

Chouette!

On est pas les seuls…

Ruralization of health professional education in the UK faces substantial challenges. More may need to be done to increase recruitment of rural-interested students, foster rural career interest during courses, recruit rural role models, develop rural curricula and establish the infrastructure to support rural clinical placements. These initiatives will require greater political will and some investment by education, heath and community development agencies.

Perceptions of UK medical students on rural clinical placements. Deaville JA, Wynn-Jones J, Hays RB, Coventry PJ, McKinley RK, Randall-Smith J. Rural Remote Health. 2009 Apr-Jun;9(2):1165. Epub 2009 Jun 2

Lectures Hors-Série “ventilator-associated pneumonia AND acute respiratory distress syndrome”

• Zaydfudim, V., L. A. Dossett, et al. (2009). “Implementation of a real-time compliance dashboard to help reduce SICU ventilator-associated pneumonia with the ventilator bundle.” Archives of surgery (Chicago, Ill : 1960) 144(7): 656-62.
• Zambon, M. and J. L. Vincent (2008). “Mortality rates for patients with acute lung injury/ARDS have decreased over time.” Chest 133(5): 1120-7.
• Zahar, J. R., M. Nguile-Makao, et al. (2009). “Predicting the risk of documented ventilator-associated pneumonia for benchmarking: Construction and validation of a score.” Crit Care Med.
• Vidaur, L., B. Gualis, et al. (2005). “Clinical resolution in patients with suspicion of ventilator-associated pneumonia: a cohort study comparing patients with and without acute respiratory distress syndrome.” Crit Care Med 33(6): 1248-1253.
• Valencia, M. and A. Torres (2009). “Ventilator-associated pneumonia.” Curr Opin Crit Care 15(1): 30-5.
• Trouillet, J. L., A. Vuagnat, et al. (2002). “Pseudomonas aeruginosa ventilator-associated pneumonia: comparison of episodes due to piperacillin-resistant versus piperacillin-susceptible organisms.” Clin Infect Dis 34(8): 1047-54.
• Trouillet, J. L., J. Chastre, et al. (1998). “Ventilator-associated pneumonia caused by potentially drug-resistant bacteria.” Am J Respir Crit Care Med 157(2): 531-9.
• Trouillet, J. L. (2009). QFP – Pneumopathie acquise sous ventilation mécanique. Miscellaneous.
• Torres, A., S. Ewig, et al. (2009). “Defining, treating and preventing hospital acquired pneumonia: European perspective.” Intensive Care Medicine 35(1): 9-29.
• Tolentino-DelosReyes, A. F., S. D. Ruppert, et al. (2007). “Evidence-based practice: use of the ventilator bundle to prevent ventilator-associated pneumonia.” Am J Crit Care 16(1): 20-7.
• Society, A. T. and I. D. S. o. America (2005). “Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia.” Am J Respir Crit Care Med 171(4): 388-416.
• Shorr, A. F., A. Combes, et al. (2006). “Methicillin-resistant Staphylococcus aureus prolongs intensive care unit stay in ventilator-associated pneumonia, despite initially appropriate antibiotic therapy.” Crit Care Med 34(3): 700-6.
• Seidenfeld, J. J., D. F. Pohl, et al. (1986). “Incidence, site, and outcome of infections in patients with the adult respiratory distress syndrome.” Am Rev Respir Dis 134(1): 12-6.
• Rotstein, C., G. Evans, et al. (2008). “Clinical practice guidelines for hospital-acquired pneumonia and ventilator-associated pneumonia in adults.” Can J Infect Dis Med Microbiol 19(1): 19-53.
• Robert, R., G. Grollier, et al. (2003). “Colonization of lower respiratory tract with anaerobic bacteria in mechanically ventilated patients.” Intensive Care Med 29(7): 1062-1068.
• Ramírez, P., M. Ferrer, et al. (2009). “Systemic inflammatory response and increased risk for ventilator-associated pneumonia: a preliminary study.” Crit Care Med 37(5): 1691-5.
• Protti, A., D. Chiumello, et al. (2009). “Relationship between gas exchange response to prone position and lung recruitability during acute respiratory failure.” Intensive Care Med 35(6): 1011-7.
• Pingleton, S. K., J. Y. Fagon, et al. (1992). “Patient selection for clinical investigation of ventilator-associated pneumonia. Criteria for evaluating diagnostic techniques.” Chest 102(5 Suppl 1): 553S-556S.
• Phua, J., T. E. Stewart, et al. (2008). “Acute respiratory distress syndrome 40 years later: time to revisit its definition.” Crit Care Med 36(10): 2912-2921.
• Phua, J., J. R. Badia, et al. (2009). “Has mortality from acute respiratory distress syndrome decreased over time?: A systematic review.” Am J Respir Crit Care Med 179(3): 220-227.
• Petrucci, N. and W. Iacovelli (2007). “Lung protective ventilation strategy for the acute respiratory distress syndrome.” Cochrane Database Syst Rev(3): CD003844.
• Panchabhai, T. S., N. S. Dangayach, et al. (2009). “Oropharyngeal cleansing with 0.2% chlorhexidine for prevention of nosocomial pneumonia in critically ill patients: an open-label randomized trial with 0.01% potassium permanganate as control.” Chest 135(5): 1150-6.
• Nieszkowska, A., Q. Lu, et al. (2004). “Incidence and regional distribution of lung overinflation during mechanical ventilation with positive end-expiratory pressure.” Crit Care Med 32(7): 1496-503.
• Morris, A. C., K. Kefala, et al. (2009). “Evaluation of the effect of diagnostic methodology on the reported incidence of ventilator-associated pneumonia.” Thorax 64(6): 516-22.
• Michaud, S., S. Suzuki, et al. (2002). “Effect of design-related bias in studies of diagnostic tests for ventilator-associated pneumonia.” Am J Respir Crit Care Med 166(10): 1320-5.
• Mercat, A., J. C. Richard, et al. (2008). “Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: a randomized controlled trial.” JAMA 299(6): 646-55.
• Meduri, G. U., R. C. Reddy, et al. (1998). “Pneumonia in acute respiratory distress syndrome. A prospective evaluation of bilateral bronchoscopic sampling.” Am J Respir Crit Care Med 158(3): 870-875.
• Meduri, G. U., G. L. Mauldin, et al. (1994). “Causes of fever and pulmonary densities in patients with clinical manifestations of ventilator-associated pneumonia.” Chest 106(1): 221-35.
• Meduri, G. U. and J. Chastre (1992). “The standardization of bronchoscopic techniques for ventilator-associated pneumonia.” Chest 102(5 Suppl 1): 557S-564S.
• Meduri, G. U. (2002). “Clinical review: a paradigm shift: the bidirectional effect of inflammation on bacterial growth. Clinical implications for patients with acute respiratory distress syndrome.” Crit Care 6(1): 24-9.
• Markowicz, P., M. Wolff, et al. (2000). “Multicenter prospective study of ventilator-associated pneumonia during acute respiratory distress syndrome. Incidence, prognosis, and risk factors. ARDS Study Group.” Am J Respir Crit Care Med 161(6): 1942-1948.
• Magnotti, L. J., T. J. Schroeppel, et al. (2009). “Efficacy of monotherapy in the treatment of Pseudomonas ventilator-associated pneumonia in patients with trauma.” The Journal of trauma 66(4): 1052-8; discussion 1058-9.
• Luyt, C. E., V. Guerin, et al. (2005). “Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumonia.” Am J Respir Crit Care Med 171(1): 48-53.
• Luyt, C. E., A. Combes, et al. (2008). “Usefulness of procalcitonin for the diagnosis of ventilator-associated pneumonia.” Intensive Care Med 34(8): 1434-40.
• Luyt, C. E., A. Combes, et al. (2009). “Aerosolized antibiotics to treat ventilator-associated pneumonia.” Curr Opin Infect Dis 22(2): 154-8.
• Luyt, C. E., J. Chastre, et al. (2004). “Value of the clinical pulmonary infection score for the identification and management of ventilator-associated pneumonia.” Intensive Care Med 30(5): 844-52.
• Lisboa, T., E. Diaz, et al. (2008). “The ventilator-associated pneumonia PIRO score: a tool for predicting ICU mortality and health-care resources use in ventilator-associated pneumonia.” Chest 134(6): 1208-1216.
• Linden, V. B., M. K. Lidegran, et al. (2009). “ECMO in ARDS: a long-term follow-up study regarding pulmonary morphology and function and health-related quality of life.” Acta Anaesthesiol Scand 53(4): 489-95.
• Lemaire, F. and F. Jardin (2005). “Quelle(s) définition(s) pour le syndrome de détresse respiratoire aiguë ?” Réanimation 14(5): 333-335.
• Kollef, M., D. Pittet, et al. (2006). “A randomized double-blind trial of iseganan in prevention of ventilator-associated pneumonia.” Am J Respir Crit Care Med 173(1): 91-7.
• Jung, B., M. Sebbane, et al. (2007). “[Ventilator-associated pneumonia: follow the guidelines!].” Ann Fr Anesth Reanim 26(10): 844-9.
• Hilbert, G., D. Gruson, et al. (1997). “Sequential use of noninvasive pressure support ventilation for acute exacerbations of COPD.” Intensive Care Med 23(9): 955-61.
• Hayon, J., C. Figliolini, et al. (2002). “Role of serial routine microbiologic culture results in the initial management of ventilator-associated pneumonia.” Am J Respir Crit Care Med 165(1): 41-6.
• Guerin, C., S. Gaillard, et al. (2004). “Effects of systematic prone positioning in hypoxemic acute respiratory failure: a randomized controlled trial.” JAMA 292(19): 2379-87.
• Gruson, D., G. Hilbert, et al. (1998). “Sequential production of leukaemia inhibitory factor by blood cell culture in patients with ARDS.” Intensive Care Med 24(4): 366-8.
• Goldstein, I., J. Chastre, et al. (2006). “Novel and innovative strategies to treat ventilator-associated pneumonia: optimizing the duration of therapy and nebulizing antimicrobial agents.” Semin Respir Crit Care Med 27(1): 82-91.
• Geerts, L., P. G. Jorens, et al. (2001). “Natural inhibitors of neutrophil function in acute respiratory distress syndrome.” Critical Care Medicine 29(10): 1920-4.
• Gattinoni, L., P. Caironi, et al. (2006). “Lung recruitment in patients with the acute respiratory distress syndrome.” N Engl J Med 354(17): 1775-86.
• Frank, J. A., P. E. Parsons, et al. (2006). “Pathogenetic significance of biological markers of ventilator-associated lung injury in experimental and clinical studies.” Chest 130(6): 1906-14.
• Fagon, J. Y., J. Chastre, et al. (2000). “Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia. A randomized trial.” Ann Intern Med 132(8): 621-30.
• Fagon, J. Y., J. Chastre, et al. (2007). “Is bronchoalveolar lavage with quantitative cultures a useful tool for diagnosing ventilator-associated pneumonia?” Crit Care 11(2): 123.
• Fagon, J. Y., J. Chastre, et al. (1996). “Mortality due to ventilator-associated pneumonia or colonization with Pseudomonas or Acinetobacter species: assessment by quantitative culture of samples obtained by a protected specimen brush.” Clin Infect Dis 23(3): 538-42.
• Fagon, J. Y. and J. Chastre (2003). “Diagnosis and treatment of nosocomial pneumonia in ALI/ARDS patients.” Eur Respir J Suppl 42: 77s-83s.
• Fagon, J. Y. and J. Chastre (2000). “Management of Suspected Ventilator-Associated Pneumonia.” Ann Intern Med 133(12): 1009.
• Esteban, A., P. Fernández-Segoviano, et al. (2004). “Comparison of clinical criteria for the acute respiratory distress syndrome with autopsy findings.” Ann Intern Med 141(6): 440-5.
• Delclaux, C., E. Roupie, et al. (1997). “Lower respiratory tract colonization and infection during severe acute respiratory distress syndrome: incidence and diagnosis.” Am J Respir Crit Care Med 156(4 Pt 1): 1092-1098.
• Croce, M. A., T. C. Fabian, et al. (1995). “Using bronchoalveolar lavage to distinguish nosocomial pneumonia from systemic inflammatory response syndrome: a prospective analysis.” J Trauma 39(6): 1134-9; discussion 1139-40.
• Croce, M. A. (2000). “Diagnosis of acute respiratory distress syndrome and differentiation from ventilator-associated pneumonia.” Am J Surg 179(2A Suppl): 26S-29S; discussion 30S.
• Craven, D. E., A. Chroneou, et al. (2009). “Ventilator-associated tracheobronchitis: the impact of targeted antibiotic therapy on patient outcomes.” Chest 135(2): 521-8.
• Combes, A., C. E. Luyt, et al. (2004). “Impact of methicillin resistance on outcome of Staphylococcus aureus ventilator-associated pneumonia.” Am J Respir Crit Care Med 170(7): 786-92.
• Combes, A., C. E. Luyt, et al. (2007). “Early predictors for infection recurrence and death in patients with ventilator-associated pneumonia.” Crit Care Med 35(1): 146-54.
• Combes, A., C. E. Luyt, et al. (2006). “Impact of piperacillin resistance on the outcome of Pseudomonas ventilator-associated pneumonia.” Intensive Care Med 32(12): 1970-8.
• Combes, A., C. Figliolini, et al. (2002). “Incidence and outcome of polymicrobial ventilator-associated pneumonia.” Chest 121(5): 1618-23.
• Combes, A., C. Figliolini, et al. (2003). “Factors predicting ventilator-associated pneumonia recurrence.” Crit Care Med 31(4): 1102-7.
• Cochrane, C. G., R. G. Spragg, et al. (1983). “The presence of neutrophil elastase and evidence of oxidation activity in bronchoalveolar lavage fluid of patients with adult respiratory distress syndrome.” Am Rev Respir Dis 127(2): S25-7.
• Chiumello, D., E. Carlesso, et al. (2008). “Lung stress and strain during mechanical ventilation for acute respiratory distress syndrome.” Am J Respir Crit Care Med 178(4): 346-55.
• Chien, J., P. Hsueh, et al. (2009). “The evolution of drug-resistant microorganisms in patients with prolonged mechanical ventilation.” American Journal of Infection Control 37(3): 231-6.
• Chastre, J., R. Wunderink, et al. (2008). “Efficacy and safety of intravenous infusion of doripenem versus imipenem in ventilator-associated pneumonia: a multicenter, randomized study.” Crit Care Med 36(4): 1089-96.
• Chastre, J., M. Wolff, et al. (2003). “Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.” JAMA 290(19): 2588-98.
• Chastre, J., J. L. Trouillet, et al. (1998). “Nosocomial pneumonia in patients with acute respiratory distress syndrome.” Am J Respir Crit Care Med 157(4 Pt 1): 1165-72.
• Chastre, J., C. E. Luyt, et al. (2006). “New diagnostic and prognostic markers of ventilator-associated pneumonia.” Curr Opin Crit Care 12(5): 446-51.
• Chastre, J., C. E. Luyt, et al. (2006). “Use of quantitative cultures and reduced duration of antibiotic regimens for patients with ventilator-associated pneumonia to decrease resistance in the intensive care unit.” Clin Infect Dis 43 Suppl 2: S75-81.
• Chastre, J. and J. Y. Fagon (2007). “Diagnosis of ventilator-associated pneumonia.” N Engl J Med 356(14): 1469; author reply 1470-1.
• Chastre, J. and J. Y. Fagon (2002). “Ventilator-associated pneumonia.” Am J Respir Crit Care Med 165(7): 867-903.
• Chastre, J., A. Combes, et al. (2005). “The invasive (quantitative) diagnosis of ventilator-associated pneumonia.” Respir Care 50(6): 797-807; discussion 807-12.
• Chastre, J. (2008). “Preventing ventilator-associated pneumonia: could silver-coated endotracheal tubes be the answer?” JAMA 300(7): 842-4.
• Chastre, J. (2006). “Ventilator-associated pneumonia: what is new?” Surg Infect (Larchmt) 7 Suppl 2: S81-5.
• Chastre, J. (2005). “Conference summary: ventilator-associated pneumonia.” Respir Care 50(7): 975-83.
• Chastre, J. (2005). “Antibiotic prescribing for ventilator-associated pneumonia: get it right from the beginning but be able to rapidly deescalate.” Intensive Care Med 31(11): 1463-5.
• Bernard, G. R., A. Artigas, et al. (1994). “The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination.” Am J Respir Crit Care Med 149(3 Pt 1): 818-24.
• Bell, R. C., J. J. Coalson, et al. (1983). “Multiple organ system failure and infection in adult respiratory distress syndrome.” Ann Intern Med 99(3): 293-8.
• Bauer, T. T., M. Valencia, et al. (2005). “Respiratory microbiology patterns within the first 24 h of ARDS diagnosis: influence on outcome.” Chest 128(1): 273-9.
• Andrews, C. P., J. J. Coalson, et al. (1981). “Diagnosis of nosocomial bacterial pneumonia in acute, diffuse lung injury.” Chest 80(3): 254-8.
• Anand, N. J., S. Zuick, et al. (2009). “Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in BAL fluid of patients with pulmonary infiltrates in the ICU.” Chest 135(3): 641-7.
• American Thoracic Society and I. D. S. o. America (2005). “Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia.” Am J Respir Crit Care Med 171(4): 388-416.

Fraicheur…

Roberts LW. Wise Advice (from an Unlikely Source) for the Profession of Academic Psychiatry. Acad Psychiatry. 2008 Sep-Oct;32(5):345 via Sexe, drogue, mensonges et sciences !
C’est frais, un peu trop mignon, mais ça se lit plus vite qu’un édito d’Intensive Care Medicine…

Lectures Hors-Série “Patient capacity in decision making”

Un panel d’articles nécessaires à la rédaction de ce cas clinique d’éthique centré sur la compétence du patient et son évaluation dans le cadre de la décision médicale.

• White et al. Decisions to limit life-sustaining treatment for critically ill patients who lack both decision-making capacity and surrogate decision-makers. Crit Care Med (2006) vol. 34 (8) pp. 2053-9
• Lautrette et al. Surrogate decision makers for incompetent ICU patients: a European perspective. Curr Opin Crit Care (2008) vol. 14 (6) pp. 714-9
• Ferrand et al. Decision-making capacity and surrogate designation in French ICU patients. Intensive Care Medicine (2001) vol. 27 (8) pp. 1360-4
• Heyland et al. The seriously ill hospitalized patient: preferred role in end-of-life decision making?. Journal of critical care (2003) vol. 18 (1) pp. 3-10
• Johnston et Liddle. The Mental Capacity Act 2005: a new framework for healthcare decision making. Journal of Medical Ethics (2007) vol. 33 (2) pp. 94-7
• Upadya et al. Patient, physician, and family member understanding of living wills. American journal of surgery (2002) vol. 166 (11) pp. 1430-5
• Shickle. The Mental Capacity Act 2005. Clinical medicine (London, England) (2006) vol. 6 (2) pp. 169-73
• Nys et al. Patient capacity in mental health care: legal overview. Health care analysis : HCA : journal of health philosophy and policy (2004) vol. 12 (4) pp. 329-37; discussion 265-72
• Nelson et al. Brain dysfunction: another burden for the chronically critically ill. Arch Intern Med (2006) vol. 166 (18) pp. 1993-9
• Appelbaum. Clinical practice. Assessment of patients’ competence to consent to treatment. The New England journal of medicine (2007) vol. 357 (18) pp. 1834-40
• Burchardi. A surrogate for decision-making in the ICU. Intensive Care Medicine (2001) vol. 27 (8) pp. 1243-4

Lectures #8

Brut et sans blabla

• Karmakar et al. Real-time ultrasound-guided paramedian epidural access: evaluation of a novel in-plane technique. Br J Anaesth (2009)
• Huber-Wagner et al. Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study. Lancet (2009) vol. 373 (9673) pp. 1455-1461
• Segal. Aspergillosis. The New England journal of medicine (2009) vol. 360 (18) pp. 1870-84
• Orban et Ichai. Hierarchisation des traitements de l’hypertension intracranienne chez le traumatise cranien grave. Ann Fr Anesth Reanim (2007) vol. 26 (5) pp. 440-444

Lectures #7

Pas de biblio cette semaine pour cause de:

• trop de sommeil en retard (post depuis iPhone, au fond du lit…)
• projet en pré-préparation

Lectures #6

Pour cette semaine, une série de papiers, très axés Neuroréa. Je me jette enfin dans la lecture de ces papiers car je vois la fin de mon stage arriver et mes lacunes persister…

• Une intéressante mise à jour sur l’hémorragie sous-arachnoïdienne: Diringer. Management of aneurysmal subarachnoid hemorrhage. Critical Care Medicine (2009) vol. 37 (2) pp. 432-40 qui complète utilement les 2 références SFAR de 1998 et de 2005
• mannitol vs. salé hyper? Je ne sais jamais quoi décider au lit du patient: Francony et al. Equimolar doses of mannitol and hypertonic saline in the treatment of increased intracranial pressure. Critical Care Medicine (2008) vol. 36 (3) pp. 795-800
• Après le débat mannitol vs. salé hyper, l’équipe niçoise propose un alternative à base de lactate demi-molaire: Ichai et al. Sodium lactate versus mannitol in the treatment of intracranial hypertensive episodes in severe traumatic brain-injured patients. Intensive Care Medicine (2009) vol. 35 (3) pp. 471-9
• En continuant dans les notins de base qu’il me manque, un point sur le Syndrome de perte de sel: Cerdà-Esteve et al. Cerebral salt wasting syndrome: review. Eur J Intern Med (2008) vol. 19 (4) pp. 249-54
• De même pour le traitement du vasospasme: Tavernier et al. [Systemic treatments of the vasospasm]. Annales françaises d’anesthésie et de réanimation (2007) vol. 26 (11) pp. 980-4
• Et pour l’hypothermie: Bruder et al. [Hypothermia for intracranial hypertension.]. Annales Francaises d’Anesthesie et de Reanimation (2009), doi:10.1016/j.annfar.2009.03.001
• Pour finir, depuis le temps qu’ils trainaient dans ma pile “urgente” : le rapport d’expert sur les états de mal épileptiques et la conférence de consensus sur les méningites bactériennes

Lectures #6 sur CiteULike.org
Si vous êtes déjà sur CiteULike, n’hésitez pas à rejoindre le groupe 7HO Réa

Lectures #5

Sélection de la semaine

Sur CiteULike
Bien sûr les résultats NICE-SUGAR du NEJM. Moins un point pour Van Den Berghe (van den Berghe et al. Intensive insulin therapy in the critically ill patients. N Engl J Med (2001) vol. 345 (19) pp. 1359-1367). Suivi d’une mise au point sur l’antibiothérapie dans chez les brûlés (stocké – non lu) et de 2 papiers de NeuroRéa sur l’HTIC que je voudrais bien comprendre un peu mieux.

• NICE-SUGAR Study Investigators et al. Intensive versus conventional glucose control in critically ill patients. The New England journal of medicine (2009) vol. 360 (13) pp. 1283-97
• Société française d’étude et de traitement des brûlures (SFETB). [Guidelines for use of antibiotics in burn patient at the acute phase - Long text.]. Annales Francaises d’Anesthesie et de Reanimation (2009) pp.
• Ichai et al. Sodium lactate versus mannitol in the treatment of intracranial hypertensive episodes in severe traumatic brain-injured patients. Intensive Care Medicine (2009) vol. 35 (3) pp. 471-9
• Lavinio et al. The relationship between the intracranial pressure-volume index and cerebral autoregulation. Intensive Care Medicine (2009) vol. 35 (3) pp. 546-9

je ne parle ici que de papiers que j’ai pu obtenir en “full text”

Lectures #4

Je continue la série “Lectures # ” qui a pour but de regrouper ce que j’aurais du lire ces derniers temps. Essentiellement des articles généralistes, tous horizons. Comme précédemment, je me réserve des petits “hors-séries” en fonction de mes collectes, topos, envies…

• Liste de lecture dimanche 29 Mars 2009
  

Petite nouveauté, si certains souhaitent des textes intégraux qu’ils laissent un comentaire…