Myopericarditis complicated by pulmonary embolism in an immunocompetent patient with acute cytomegalovirus infection: a case report

Background Primary acute cytomegalovirus infection in immunocompetent patients is common worldwide. Infection is most often asymptomatic or occurs sub-clinically with a self-limited mononucleosis-like syndrome. More rarely, the infection may lead to severe organ complications with pneumonia, myocarditis, pericarditis, colitis and hemolytic anemia. Recent cases of cytomegalovirus-associated thrombosis have also been reported sporadically in the medical literature. Case presentation We report here a case of simultaneous myopericarditis and pulmonary embolism in a 30-year-old man with no medical history. The patient was not immunocompromised. We discuss the possible role of acute cytomegalovirus infection in the induction of vascular damage and review relevant cases in the literature. Conclusion Thrombosis in patients with acute cytomegalovirus infection may be more frequent than is generally thought. Physicians need to be aware of the possible association between acute cytomegalovirus and thrombosis in immunocompetent patients, especially in the presence of severe systemic infection, as our case illustrates

Study Protocol: Randomised Controlled Trial Assessing the Efficacy of Strategies Involving Self-Sampling in Cervical Cancer Screening

Objectives: The cervical cancer screening coverage remains moderate (60%) in France. The aim of the study is to evaluate the efficacy of two experimental invitation strategies (offer of urine or vaginal self-sampling kits) to reach under-screened populations and compare them with the current invitation strategy in rural departments (low medical density and low participation rate) in France.Methods: The study is a randomised controlled trial with three arms: a control arm (conventional invitation letter) and two experimental arms (mailing of a urine or vaginal self-sampling kit). The target population includes women aged 30–65 years, who had no screening test recorded since more than 4 years and who did not respond to an invitation letter within 12 months before. The primary outcome measure is the participation rate in each arm. A team of psychologists will also investigate attitudes and experiences by semi-structured/focus-group interviews with voluntary CapU4 participants and with health professionals.Result and conclusion: CapU4 will identify effective strategies to reach women not responding to current screening invitations and will generate information about acceptance of self-sampling among women and health professionals

Successful Treatment Using Simeprevir, Sofosbuvir and Rituximab of a Severe Form of Hepatitis C Virus-related Mixed Cryoglobulinemia with Cardiac Involvement

Numerous extrahepatic manifestations have been reported in hepatitis C virus (HCV) infection, particularly mixed cryoglobulinemia (MC). MC generally responds to clearance of HCV under pegylated-interferon plus ribavirin treatment. New direct-acting antiviral agents have been licensed for HCV under different combinations but have not been studied in severe forms of MC. Here, we present a case report describing a life-threatening form of MC with multivisceral involvement, which was successfully treated with concomitant rituximab, sofosbuvir and simeprevir. In light of the rapid clinical remission associated with sustained virological response and the excellent side-effect profile, this treatment should be considered as a first-line therapy in severe forms of MC

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Epidémiologie moléculaire du virus de l'hépatite B chez 1276 femmes enceintes au Cameroun

POITIERS-BU Médecine pharmacie (861942103) / SudocSudocFranceF

Le test HPV urinaire proposé comme alternative au frottis cervico-utérin (étude pilote dans le département du Maine et Loire)

Objectif : Actuellement en France, le dépistage du cancer du col de l'utérus repose sur l'examen cytologique d'un frottis cervico-utérin (FCU) chez les femmes âgées de 25 à 65 ans. Malheureusement, le taux de couverture du frottis est insuffisant. Dans le but d'augmenter la couverture de ce dépistage, nous avons mené une étude pilote dans le département du Maine et Loire dont l'objectif était de mesurer l'adhésion des femmes à un test HPV urinaire par rapport au frottis cervico-utérin. Méthodes : 5000 courriers proposant de faire un prélèvement urinaire pour évaluer une nouvelle méthode de dépistage du cancer du col ont été envoyés à des femmes de 40 à 65 ans réfractaires au FCU. Le prélèvement était analysé par une technique de PCR en temps réel (PCR TR) commercialisée par les laboratoires Abbott (Abbott Real Time High Risk HPV). Cette technique permet la détection des HPV de génotypes 16, 18 et de 12 autres HPV oncogènes (HPV HR). Résultats : 678 prélèvements ont été analysés. Parmi eux, 29 étaient positifs pour un HPV HR. Les FCU, réalisés chez toutes les femmes dont le test HPV était positif, ont révélé la présence de 3 HSIL dont deux lésions stade CIN3 confirmées. Conclusion : Notre étude montre l'adhésion plus facile au test HPV urinaire pour les femmes qui refusaient le FCU. Nous avons pu dépister des lésions cervicales de haut grade chez ces femmes qui n'étaient pas suivies régulièrement. Le test HPV urinaire pourrait être une alternative au dépistage classique par frottis ce qui permettrait d'étendre la couverture du dépistage du cancer du col en France.NANTES-BU Médecine pharmacie (441092101) / SudocSudocFranceF

Etude de la prévalence de la mutation G1896A de la région precore du virus de l hépatite B chez les donneurs de sang français

ANGERS-BU Médecine-Pharmacie (490072105) / SudocSudocFranceF

RETENTISSEMENT DE MUTATIONS DU GENE DE L'ADN POLYMERASE DU CYTOMEGALOVIRUS HUMAIN SUR L'ACTIVITE ENZYMATIQUE DE LA POLYMERASE ET SUR LA SENSIBILITE DU VIRUS AUX ANTIVIRAUX (DES BIOL. MED.)

PARIS-BIUM (751062103) / SudocCentre Technique Livre Ens. Sup. (774682301) / SudocSudocFranceF

Quantification de l'ADN de Papillomavirus humain dans les urines et le prélèvement cervico-vaginal par PCR en temps réel

ANGERS-BU Médecine-Pharmacie (490072105) / SudocSudocFranceF