A systematic review of experimental infections with enterotoxigenic \u3ci\u3eEscherichia coli\u3c/i\u3e (ETEC)

Volunteer challenge with enterotoxigenic Escherichia coli (ETEC) has been used for four decades to elucidate the pathogenesis and immune responses and assess efficacy of various interventions. We performed a systematic review of these studies and a meta-analysis of individual patient-level data (IPD) from a subset of studies using standard methodology. We identified 27 studies of 11 ETEC strains administered to 443 naive subjects at doses from 1 × 106 to 1 × 1010 colony forming units (cfu). Diarrhea attack rates varied by strain, dose and enterotoxin. Similar rates were seen at doses of 5 × 108 to 1 × 1010 cfu with the three most commonly used strains B7A, E24377A, H10407. In IPD analysis, the highest diarrhea attack rates were seen with strains B7A, H10407 and E24377A. The H10407 induced significantly higher stool output than the other strains. Additionally, the rate of output was different across strains. The risk of diarrhea, abdominal cramps, nausea and headaches differed significantly by ETEC strain. An increased risk of nausea, abdominal cramps and headaches was seen for females. Baseline anti-LT IgG titers appeared to be associated with a decrease risk of diarrhea outcomes, a trend not seen with anti-LT IgA or seen consistently with anti-colonization factor antibodies. Neither early antibiotic treatment nor diarrhea duration significantly affected the frequency or magnitude of serologic responses. These studies have served as an invaluable tool in understanding disease course, pathogenicity, innate immune responses and an early assessment of product efficacy. When designing and planning experimental ETEC infection studies in this age of increased ethical scrutiny and growing appreciation of post-infectious sequelae, better understanding of available data is essential

Technological Services in Shared Housing: Needs Elicitation Method from Home to Living Lab

International audienceHousing under a shared housing organisation enables frail elderly persons to live in a semi autonomous way, thanks to cooperation between residents and an assistant. The social organization of this new type of housing also has an impact on the social participation of users. This article is based on a pilot study and deals with the benefits of digital technologies and “ambient intelligence” used to answer the needs of such a way of living. The pilot study was carried out in a house shared by 6 co-tenants. The qualitative method used first consisted in a characterisation of the 6 inhabitants. This was followed by semi-structured interviews about their sensed needs, and a focus group, with 5 of the 6 co-tenants, in order to gain an initial consensus about needs. This result was confronted to the demands of the assistants, collected through interviews. A usage scenario was developed in a smart home (Maison Intelligente de Blagnac). This scenario was performed by three of the inhabitants and followed by a second focus group and a narrative interview with the assistants and the designers of the shared house. This article reports the method which was carried out and the needs expressed by the co-tenants

Substance Misuse among a Diverse Psychiatric Inpatient Sample: Suicidal Thoughts and Behaviors and Motivation to Change

Suicidal thoughts and behaviors (STBs) are among the most common reasons for admission to psychiatric inpatient units and a large percentage of these patients also engage in substance misuse. Yet, no known studies have examined whether patients with STBs admitted to inpatient psychiatry units are motivated to change their substance misuse and, if so, whether they benefit from MET-CBT for substance misuse while on the inpatient unit. This study assesses the relationship between STB and motivation to improve substance misuse among 321 (61.1% male, = 35.3 years, 59.8% non-Hispanic/Latin White) patients admitted to an inpatient psychiatric unit with a substance use disorder (SUD) or substance misuse who attended at least one group MET-CBT session, 50.2% of whom were admitted to an inpatient unit for STBs. Patients admitted for STBs reported greater motivation to reduce substance misuse than patients admitted without documented STB, and they did not differ from patients without documented STBs on the number of MET-CBT sessions attended, or ratings of session helpfulness (which were high). Patients admitted for STBs reported significantly increased motivation to change substance misuse after attending MET-CBT for SUD. These findings indicate that psychiatric inpatients with STBs report motivation to change substance misuse as well as willingness to attend MET-CBT for their SUD

Eficiência do laser diodo 980 nm em comparação à da glicose a 75% na oclusão de veias da orelha de coelhos The efficiency of the diode laser 980 nm compared to glucose 75% in occlusion of the veins in rabbit ears

CONTEXTO: Por ser o laser um método novo no tratamento das varizes, há muitos mitos e dúvidas com relação à sua eficácia; assim, surgiu a necessidade de compará-lo a substância esclerosante mais utilizada em nosso meio (glicose hipertônica). OBJETIVO: Comparar a eficiência do laser diodo 980 nm à glicose 75% na oclusão de veias em orelha de coelho. MÉTODOS: Ensaio aleatório em animais de laboratório por 21 dias. A amostra consistiu de orelhas de coelhos machos adultos. Grupo L (laser): 15 orelhas tratadas com laser; grupo G (glicose 75%): 15 orelhas tratadas com glicose a 75%. Variáveis primárias: veias esclerosadas e/ou ocluídas. Variáveis complementares: volume da substância administrada, complicações e peso. O tamanho da amostra foi estimado em 30 orelhas. Foi realizado o teste exato de Fisher associado ao Risco Relativo (RR), calculando-se o intervalo de confiança (IC) de 95% para as variáveis acima. RESULTADOS: A incidência de esclerose ou oclusão venosa no grupo G foi de 53% (8/15; IC95%: 27-79) e no grupo L, 20% (3/15; IC95%: 4-49). O p bicaudal foi de 0,1281, o RR usando a aproximação de Katz foi de 2,66; IC95%: 0,87-8,15. CONCLUSÃO: A eficiência do laser diodo 980 nm em comparação à da glicose 75% na oclusão de veias para o modelo experimental estudado foi equivalente.<br>BACKGROUND: The laser is a new treatment to varicose veins and there is several myths and doubts in relation to its efficacy; then, there is the need to compare it with the most commonly sclerosing solution (hypertonic glucose) used in our specialty. OBJECTIVE: To compare the efficiency of the diode laser 980nm to the glucose 75% in the occlusion of veins from the ear of rabbits. METHODS: Aleatory trial in laboratory animals during 21 days. The sample consisted of ears from male adult rabbits. Group L (laser): 15 ears treated with laser; group G (glucose 75%): 15 ears treated with glucose 75%. Primary variables: sclerotic and/or occluded veins. Complementary variables: volume of the managed substance, complications and weight of rabbit. The sample size was estimated in 30 ears. The statistical analysis was carried out by Fisher''s exact test associated to the Relative Risk (RR), calculating the confidence interval of 95% for the mentioned variables. RESULTS: The incidence of sclerosis or venous occlusion in group G was 53% (8/15; 95%CI: 27-79) and in group L was 20% (3/15; 95% CI: 4-49). Two-tailed p was 0.1281, RR using the approximation of Katz was 2.66; 95%CI: 0.87-8.15. CONCLUSION: The efficiency of the diode laser 980 nm in comparison to glucose 75% in occlusion of veins in this experimental model was equivalent