Comments on the article by Tabache F. et al. "Acute polyarthritis after influenza A H1N1 immunization", Joint Bone Spine, 2011, doi:10.1016/j.jbs.2011.02.007: Primary Sjögren's syndrome occurring after influenza A H1N1 vaccine administration.

International audienc

Improving the performance of community health workers in Swaziland: findings from a qualitative study

Background: The performance of community health workers (CHWs) in Swaziland has not yet been studied despite the existence of a large national CHW program in the country. This qualitative formative research study aimed to inform the design of future interventions intended to increase the performance of CHW programs in Swaziland. Specifically, focusing on four CHW programs, we aimed to determine what potential changes to their program CHWs and CHW program managers perceive as likely leading to improved performance of the CHW cadre. Methods: The CHW cadres studied were the rural health motivators, mothers-to-mothers (M2M) mentors, HIV expert clients, and a community outreach team for HIV. We conducted semi-structured, face-to-face qualitative interviews with all (15) CHW program managers and a purposive sample of 54 CHWs. Interview transcripts were analyzed using conventional content analysis to identify categories of changes to the program that participants perceived would result in improved CHW performance. Results: Across the four cadres, participants perceived the following four changes to likely lead to improved CHW performance: i) increased monetary compensation of CHWs, ii) a more reliable supply of equipment and consumables, iii) additional training, and iv) an expansion of CHW responsibilities to cover a wider array of the community’s healthcare needs. The supervision of CHWs and opportunities for career progression were rarely viewed as requiring improvement to increase CHW performance. Conclusions: While this study is unable to provide evidence on whether the suggested changes would indeed lead to improved CHW performance, these views should nonetheless inform program reforms in Swaziland because CHWs and CHW program managers are familiar with the day-to-day operations of the program and the needs of the target population. In addition, program reforms that agree with their views would likely experience a higher degree of buy-in from these frontline health workers

New technologies for examining neuronal ensembles in drug addiction and fear

Correlational data suggest that learned associations are encoded within neuronal ensembles. However, it has been difficult to prove that neuronal ensembles mediate learned behaviours because traditional pharmacological and lesion methods, and even newer cell type-specific methods, affect both activated and non-activated neurons. Additionally, previous studies on synaptic and molecular alterations induced by learning did not distinguish between behaviourally activated and non-activated neurons. Here, we describe three new approaches—Daun02 inactivation, FACS sorting of activated neurons and c-fos-GFP transgenic rats — that have been used to selectively target and study activated neuronal ensembles in models of conditioned drug effects and relapse. We also describe two new tools — c-fos-tTA mice and inactivation of CREB-overexpressing neurons — that have been used to study the role of neuronal ensembles in conditioned fear

Evaluation des auto-questionnaires d'activité dans la polyarthrite rhumatoïde (étude transversale sur 200 patients avec le Rapid3 et le Radai5 et évaluation de poussée)

BESANCON-BU Médecine pharmacie (250562102) / SudocSudocFranceF

Investigation of the neuropharmacological mechanisms of barbiturate reinforcement using the conditioned place preference paradigm

Drugs of abuse are thought to have the common action of increasing dopaminergie transmission in the mesolimbic dopamine (DA) pathway, specifically in the nucleus accumbens (NAc). However, sedative-hypnotics, including the barbiturates, are anomalous in that they appear to stimulate DA release from the NAc at doses that are generally lower than their reinforcing doses. The fact that barbiturates have a long history of abuse in humans and are potent reinforcers in laboratory animals, but are behaviourally reinforcing only at doses that decrease DA release from the NAc, raises questions about the neuropharmacological mechanism of reinforcement in these drugs. Indeed, of the numerous studies that have examined the reinforcing properties of barbiturates, none have examined the pharmacological basis of their reinforcing effects.The conditioned place preference (CPP) paradigm is a widely used behavioural test that assesses the reinforcing capacity of stimuli by the ability of conditioned stimuli to evoke an approach response. Using this paradigm, systemic administration of pentobarbital (15 mg/kg) induced a significant place preference. Furthermore, pretreatment with GABAA, DA, and opioid receptor antagonists blocked the pentobarbital-induced place preference. Sodium barbital, a longer-acting barbiturate also induced a significant CPP when systemically administered (8 and 24 mg/kg). Moreover, the reinforcing effect of this place preference is centrally mediated, assessed by the significant CPP obtained with intracerebroventricular (ICV) injections of barbital (240 and 480 mug).A number of different brain sites are involved in the reinforcing effects of drugs of abuse. Microinjections of barbital into the periaqueductal gray (25 mug) or posterior ventral tegmental area (VTA; 15 mug), but not into other areas, such as the amygdala and anterior VTA, produced a place preference. Furthermore, opioid (naloxone methiodide) and GABAA receptor (SR 95531) antagonists administered into these areas blocked the ICV barbital place preference. Given these findings, barbiturate reinforcement appears to be mediated by the same neural substrates and neurochemical systems as other drugs of abuse, such as opiates and ethanol. The implications of these results and the use of barbital in the place preference paradigm to investigate the neuropharmacological mechanisms of barbiturate reinforcement are discussed

Addition of Mannitol to Hyaluronic Acid may Shorten Viscosupplementation Onset of Action in Patients with Knee Osteoarthritis: Post-Hoc Analysis of A Double-blind, Controlled Trial

International audienc

Occurrence of Psoriatic Arthritis during Interferon Beta 1a Treatment for Multiple Sclerosis

Interferon beta (IFN-β) is the first line therapy of relapsing-remitting multiple sclerosis. IFN-β is a cytokine that can contribute to the development of systemic autoimmune disease including psoriasis. The development or the exacerbation of psoriasis during IFN-β treatment has been previously observed. We report the occurrence of arthritis and dactylitis in a multiple sclerosis patient with preexisting psoriasis diagnosed as a psoriatic arthritis. The IL-23/Th17 pathway is involved in psoriasis and psoriatic arthritis and it has been suggested that IFN-β therapy in patients with Th17-mediated disease may be detrimental. Together with previous similar reports, our case suggests that IFN-β should certainly be used with caution in patients with concomitant systemic autoimmune disease with IL-23/Th17 involvement

The role of law in public health: The case of family planning in the Philippines

Compared to neighboring countries, the Philippines has high fertility rates and a low prevalence of modern-method contraception use. The Philippine government faces political and cultural barriers to addressing family planning needs, but also legal barriers erected by its own policies. We conducted a review of laws and policies relating to family planning in the Philippines in order to examine how the law may facilitate or constrain service provision. The methodology consisted of three phases. First, we collected and analyzed laws and regulations relating to the delivery of family planning services. Second, we conducted a qualitative interview study. Third, we synthesized findings to formulate policy recommendations. We present a conceptual model for understanding the impact of law on public health and discuss findings in relation to the roles of health care provider regulation, drug regulation, tax law, trade policies, insurance law, and other laws on access to modern-method contraceptives.Philippines Law Public health Family planning Contraception

[Spondylarthropathy with Behçet's disease: response to infliximab]

National audienc

Acute gouty arthritis after intraarticular hyaluronate injection.

International audienc