A first response bag with standardized contents for medical emergencies on cruise ships

Background. There are no international rules regarding which medical supplies to bring when the nurseon- duty is called to emergencies outside a cruise ship's infirmary. Ideally, one First Response Bag should contain all that is needed to manage the initial 10–15 minutes of any medical emergency until the patient can be safely transported to the ship's infirmary. Royal Caribbean Cruises Ltd recently decided to establish a fleet-wide standardized First Response Bag for initial management of cardiac and other emergencies encountered by the nurse-on-duty outside the ship's infirmary. Material and methods. A prototype First Response Bag was tried out on one ship. A PowerPoint presentation of the bag with its contents was then circulated by e-mail to all 33 infirmaries of the fleet, and comments from all 181 medical staff members were invited. All responses were discussed fleet-wide for consensus. Results. Responses from 18 ships triggered eager discussions. The resulting First Response Bag was considered by all an improvement compared to the solutions practiced previously on most ships of the fleet. The bag is a lightweight combined roller and backpack with 12 compartments, and it has well-organized, easily accessible, fleet-wide standardized minimal supplies. It contains what is needed to manage the initial phase of a cardiac arrest and other emergencies. Conclusions. This initiative may inspire other companies in standardization efforts and trigger cruise industry-wide cooperation'with the ultimate goal of an internationally accepted first response bag standard. Int Marit Health 2010; 61, 1: 18-2

Dual infection with human immunodeficiency virus type 1 and type 2: impact on HIV type 1 viral load and immune activation markers in HIV-seropositive female sex workers in Abidjan, Ivory Coast

To determine the impact of dual infection with HIV-1 and HIV-2 on HIV-1 viral load and markers of immune activation among HIV-seropositive FSWs in Abidjan, we analyzed blood samples obtained from consenting HIV-seropositive FSWs attending a confidential clinic between September 1996 and June 1997 in Abidjan. Among HIV-1 and HIV-2 dually seropositive FSWs, polymerase chain reaction (PCR) testing with HIV-1 and HIV-2 primers was used to differentiate between FSWs who were PCR positive only for HIV-1 and those positive for both HIV-1 and HIV-2 (dually infected). Of the 203 FSWs, 151 (74%) were HIV-1 seropositive only (median age, 26 years), 4 (2%) were HIV-2 seropositive, and 48 (24%) were dually seropositive (median age, 30 years). Of the 48 dually seropositive FSWs, 33 (69%) were dually infected and 15 (31%) were dually seropositive. Median CD4+ T cell counts per microliter were not significantly different among the three groups (525 for HIV-1 positive only, 502 for dually infected, and 416 for dually seropositive) (p = 0.14). Median viral load (log10 copies/ml) was not significantly different among the HIV-1-only FSWs (4.8 log10 copies/ml) compared with the 32 dually infected FSWs (4.6 log10 copies/ml) and 14 dually seropositive FSWs (4.7 log10 copies/ml; p = 0.95). Median levels of HLA-DR immune activation were increased in both CD4+ and CD8+ T cells for the dually infected (n = 27) FSWs compared with those infected with HIV-1 only (n = 123) (p = 0.019 and p = 0.01, respectively). Dual infection does not appear to influence levels of HIV-1 viral load in vivo. However, levels of HLA-DR are higher among FSWs dually infected with HIV-1 and HIV-2 than among those infected with HIV-1 only

Differences in HIV-2 plasma viral load and immune activation in HIV-1 and HIV-2 dually infected persons and those infected with HIV-2 only in Abidjan, Côte d'Ivoire

Not the final published versionOBJECTIVE: To determine whether blood plasma levels of HIV-2 RNA viral loads and immune activation markers differ between persons infected with HIV-2 only and those dually infected with HIV-1 and HIV-2. METHODS: Between September 1996 and February 2000, we collected, analyzed and compared levels of HIV-2 RNA in plasma and immune activation markers among 52 persons infected with HIV-2 alone and 75 with confirmed dual infection. We also compared viral load and immune activation in patients who were infected with HIV-1 only and those who were dually infected. RESULTS: When we conducted a CD4 T-cell count-stratified multivariate analysis of HIV-2 viral load, controlling for difference in CD4 T-cell counts, age and sex: at 500 x 10/l, HIV-2 viral load was 0.9 log10 copies/ml higher in dually infected patients (P < 0.0001). Dually infected persons with undetectable HIV-2 viral loads had significantly higher median levels of CD8 T cells expressing CD38 (P < 0.001) and HLA-DR (P = 0.01) than HIV-2 only infected patients. CONCLUSION: These results suggest that in dual infection, the level of HIV-2 replication depends on the immune status of the patients, with HIV-1 out-replicating HIV-2 as disease progress

Lack of effect of chemokine receptor CCR2b gene polymorphism on HIV-1 plasma RNA viral load and immune activation among HIV-1 seropositive female sex workers in Abidjan, Côte d'Ivoire

The prevalence of the CCR2b-V64I mutation among human immunodeficiency virus (HIV)-seropositive and -seronegative female workers and the potential effect of heterozygosity of this mutation on HIV-1 plasma RNA viral load and markers of immune activation were assessed. CCR2b-V64I was detected by polymerase chain reaction, followed by restriction enzymes analysis; plasma viral load was measured by the Amplicor HIV-1 monitor assay and CD4(+) T-cell counts and markers of immune activation by standard three-color FACscan flow cytometry. Of the 260 female workers, 56 (21.5%) were heterozygous for CCR2b-V64I, and 8 (3%) were homozygous. Of the 99 HIV-seronegative female workers, 19 (19.2%) were heterozygous for the CCR2b-V64I mutation compared with 37 (23%) of the 161 HIV-seropositive FSW (P = 0.47). In a univariate analysis of viral load among HIV-seropositive FSW, no difference was noted between those heterozygous for or without the mutation; both groups had plasma viral loads of 5.0 log(10) copies/ml. After controlling for the effects of CD4(+) T-cell counts in a multivariate analysis, no significant difference was observed between the groups in viral load or in markers of immune activation. The data suggest that the presence of the CCR2b mutation has no effect on HIV-1 plasma viral load and markers of immune activation in our study population. The finding that the frequency of this mutation is similar in HIV-seropositive and -seronegative female workers suggests that its presence is not associated with increased risk of HIV infection

Organometallic Ruthenium Nanoparticles and Catalysis

International audienceDue to a high number of possible applications in various domains, metal nanoparticles are nowadays the subject of an extensive development. This interest in metal nanoparticles is related to their electronic properties at the frontier between those of molecular species and bulk compounds which are induced by their nanometric size. Regarding the field of catalysis, the growing attention for metal nanoparticles also results from the high proportion of surface atoms present in the upper layer of the metallic core which gives rise to numerous potential active sites. Thus, nanocatalysis (which involves the use of catalysts with at least one dimension at the nanoscale) has emerged in the field of modern catalysis as a domain on the borderline between homogeneous and heterogeneous catalysis. Present developments aim at multifunctionality which can be achieved by the proper design of complex nanostructures also named nanohybrids. In nanohybrid the term “hybrid” refers to the appropriate association between a metal core and a stabilizing shell such as a polymer, a ligand, an ionic liquid, or even a support (inorganic materials, carbon black, carbon nanotubes, etc.…). This association can be considered as crucial to tune the surface properties of nanostructures and consequently their catalytic performance. The main expectation for the scientific community is that precisely designed nanoparticles (in terms of size, shape, and composition including surface ligands) should offer the benefits of both homogeneous and heterogeneous catalysts, namely high efficiency and better selectivity