La borreliose canine à borrelia burgdorferi (actualisation des connaissances en France par une enquête auprès des cliniques vétérinaires)

La borréliose de Lyme est une zoonose due à Borrelia burgdorferi sensu lato. Maladie vectorielle la plus fréquente de l'hémisphère nord chez l'homme, elle est aujourd'hui bien connue en médecine humaine. Chez le chien, malgré son importance croissante, elle reste peu documentée en médecine vétérinaire. La première partie de ce document est une présentation actualisée de la maladie et de ses caractéristiques. La deuxième partie est une analyse de 605 questionnaires d'une enquête nationale, mettant en évidence que 33% des cliniques estiment avoir de faibles connaissances sur la borréliose de Lyme, malgré une augmentation nette des tiques en France. 33.9% des vétérinaires pensent en avoir diagnostiqué un cas ou plus chez le chien ces dix dernières années. 47.7% des cliniques utilisent toujours la sérologie pour la diagnostiquer (68.9% grâce à des kits de test rapide), 75.3% d'entre elles la traitent avec de la doxycycline. La prévalence globale moyenne de la borréliose de Lyme chez le chien au travers de cette enquête serait de 0.05 .NANTES-Ecole Nat.Vétérinaire (441092302) / SudocSudocFranceF

Using partial components to restore and use the concurrent validity of the Index of Readiness

In the presence of correlations among the dimensions of psychometric tests with summated scales, it is sometimes difficult to use the scores on the dimensions to predict their effects on various responses of interest through ordinary or generalized regression models, which can serve as concurrent validations. We will use the Index of Readiness (IR) as a case study to describe a statistical procedure to address this problem. Our solution will allow us to propose an optimal strategy of care to increase the adherence of HIV patients to treatments, as measured by a health indicator, by improving their readiness

Cocktails of endocrine disruptors in the different diets of French consumers

International audienceWith a view to identifying main endocrine disruptors (ED) mixtures to which French consumers are exposed through food, their main diets were modelled using an adapted dimension reduction method. Seven specific diets could be modelled for adults while only one overall diet was considered for children aged 3–17 years. The knowledge of the contamination levels of 78 known or suspected endocrine disrupting compounds in the foods constituting these diets, collected in the frame of the second French Total Diet Study, made it possible to explore the mixtures of EDs to which consumers are exposed. We have thus shown that the ED substances most present in mass concentration are comparable for the whole population, whatever the diet considered. However, a second approach made it possible to highlight, for a given diet, the substances whose exposure is statistically higher than in the diet of the general population. Thus, significantly different ED mixtures could be established for each diet. For example, diets with a high proportion of animal-based foods induce significantly higher exposures to some persistent organic pollutants (e.g., PCDD/F, brominated flame retardants), whereas these exposures are lower for Mediterranean-type diet. On the other hand, the latter, richer in fruits and vegetables, is the one for which pesticides represent a specific signature.These results now pave the way for studying the specific effects of these cocktails of endocrine disruptors, each of which is representative of a type of chronic exposure linked to specific diets

A multicenter randomized study comparing cyclosporin-A alone and antithymocyte globulin with prednisone for treatment of severe aplastic anemia

This article reports the results of a randomized multicentric study comparing the efficacy of antithymocyte globulin (ATG) with cyclosporin-A (CsA) as first line therapy for severe aplastic anemia (SAA). Patients were randomized to receive ATG and prednisone (PDN) or CsA; hematological response and toxicity were compared. At 3 months, patients who had no or minimal response received the alternative therapy in order to assess the value of a sequential immunosuppressive therapy for treatment of severe aplastic anemia. One hundred and sixteen patients were analysed, 60 received CsA and 56 received ATG PDN. The actuarial survival was 55% with a median follow-up time of 19 months. There was no significant difference in survival between the two groups. The main prognostic factor was the absolute neutrophil count (ANC) at entry: patients with ANC <0.2 × 109/L had a significantly lower survival when compared with patients with an ANC greater than 0.2 × 109/L (P = 0.0001). At 3 months, 16% of patients had a complete or partial response and a cross-over treatment was given to 68 patients. At 12 months, 77 patients were alive, with a complete or partial response in 47 patients. Patients who had responded to the first treatment. © 1992.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

One-Fifth of Children with Sickle Cell Anemia Show Exercise-Induced Hemoglobin Desaturation: Rate of Perceived Exertion and Role of Blood Rheology

International audienc

Brain injury pathophysiology study by a multimodal approach in children with sickle cell anemia with no intra or extra cranial arteriopathy

International audienceDespite its high prevalence in children with sickle cell anemia (SCA), the pathophysiology of silent cerebral infarcts (SCIs) remains elusive. The main objective of this study was to explore the respective roles of major determinants of brain perfusion in SCA children with no past or current history of intracranial or extracranial vasculopathy. We used a multimodal approach based notably on perfusion imaging Arterial spin labelling (ASL) MRI and Near Infra-Red Spectroscopy (NIRS), as well as biomarkers reflecting blood rheology and endothelial activation. Out of 59 SCA patients (mean age 11.4} 3.9 yrs), 8 (13%) had a total of 12 SCIs. Children with SCIs had a distinctive profile characterized by decreased blood pressure, impaired blood rheology, increased P-selectin levels, and marked anemia. Although ASL perfusion and oximetry values did not differ between groups, comparison of biological and clinical parameters according to the level of perfusion categorized in terciles showed an independent association between high perfusion and increased sP-selectin, decreased RBC deformability, low HbF level, increased blood viscosity and no alpha-thalassemia deletion. NIRS measurements did not yield additional novel results. Altogether, these findings argue for early MRI detection of SCIs in children with no identified vasculopathy and suggest a potential role for ASL as an additional screening tool. Early treatment targeting hemolysis, anemia and endothelial dysfunction should reduce the risk of this under diagnosed and serious complication