Anxiety in Mice: A Principal Component Analysis Study

Two principal component analyses of anxiety were undertaken investigating two strains of mice (ABP/Le and C57BL/6ByJ) in two different experiments, both classical tests for assessing anxiety in rodents. The elevated plus-maze and staircase were used for the first experiment, and a free exploratory paradigm and light-dark discrimination were used for the second. The components in the analyses produced definitions of four fundamental behavior patterns: novelty-induced anxiety, general activity, exploratory behavior, and decision making. We also noted that the anxious phenotype was determined by both strain and experimental procedure. The relationship between behavior patterns and the use of specific tests plus links with the genetic background are discussed

Le carboplatine dans l'association radio-chimiothérapie concomitante en traitement d'induction des cancers du col utérin localement avancés (Evaluation rétrospective de 27 patientes traitées au Centre Paul Strauss à Strasbourg de 1996 à 2003)

STRASBOURG-Medecine (674822101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Intoxications à la Bita dans le bassin du Maroni en 2011 (série de 4 cas, aspects cliniques et paracliniques, botaniques et de santé publique)

INTRODUCTION : La Guyane est un département d'outre mer français d'une grande diversité culturelle dont certains groupes, comme les Bushinengués, utilisent la pharmacopée de la forêt amazonienne. Descendants des esclaves français et hollandais ayant fuiche les plantations avec leur savoir ancestral, ces derniers subissent une acculturation certaine qui semble génératrice d'erreurs de reconnaissance botanique et par conséquent responsable d'épidémies d'intoxications. Des séries de cas sévères, parfois mortels, ont été observées en 2009 et 2010 suite à la consommation d'une préparation locale, la Bita, une macération amère aux vertus fortifiantes. Ces séries n'ont pas permis de définir précisément les symptômes ni d'identifier l'agent toxique qui semble être un alcaloïde aux actions antimitotiques puissantes. METHODE : Cette étude descriptive concerne l'investigation d'une série de 4 patients ayant consommé une Bita frelatée et pris en charge au Centre Hospitalier de l'Ouest Guyanais en 2011. Elle comporte leur description clinique et la mise en évidence de la stéréotypie de leurs symptômes ainsi que l'analyse botanique, chimique et pharmacognosique de l'agent causal. RESULTATS : Les signes cliniques sont digestifs (initialement mucite, vomissements puis constipation), cutanés (épidermite periscrotale puis alopécie et tardivement desquamation palmoplantaire et hyperpigmentation) et neurologiques (syndrome méningé, paresthésies, hypoesthésie et aréflexie puis parésie sévère). Les signes paracliniques sont à type de cytopénies (leucopénie, thrombopénie puis anémie), de cytolyse (élévation des LDH puis cytolyse hépatique) et inflammatoire (élévation précoce de la CRP). L'investigation a permis de mettre en cause de façon certaine l'arbre Stryphnodendron Polystachium, totalement inconnu de la science dont les analyses chimiques, pharmacognosiques et toxicologiques sont pour l'instant négatives. DISCUSSION : Ces analyses ouvrent de nombreuses possibilités d'études quant à l'origine de la toxicité avec notamment la suspicion de la présence d'une mycotoxine alcaloïde. Ces recherches ne seront possibles qu'avec un dépistage et une prise en charge précoce des probables cas futurs. Ainsi une nouvelle définition des cas a permis de proposer des protocoles de surveillance et d'investigation à l'institut de veille sanitaire. Ces conséquences de l'acculturation prouvent la nécessité de l'aide à l'intégration des différentes cultures et de lutter contre leur assimilation.LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Fever in hospitalized HIV-infected patients in Western French Guiana: first think histoplasmosis

International audienceIn Western French Guiana there was a dramatic increase in HIV-prevalence between 1990 and 2000. The present study describes the causes of fever among HIV patients hospitalized in the medical ward of the only hospital in the western part of French Guiana. A retrospective descriptive study was conducted between January 1st 2008 and June 30th 2010 in the department of medicine of Saint Laurent du Maroni Hospital. The main characteristics of 67 patients having presented with fever in the first 48 hours of hospitalization were described. Among patients with CD4<200/mm3 the main febrile opportunistic infection was disseminated histoplasmosis (41.1%). Among patients with CD4 counts <50/mm3 and fever without focal points 85.7% had disseminated histoplasmosis. Three patients died and all had disseminated histoplasmosis. Disseminated histoplasmosis is the most common febrile opportunistic infection in western French Guiana. Primary prophylaxis with itraconazole among immunocompromised patients seems warranted

Population movements and the HIV cascade in recently diagnosed patients at the French Guiana -Suriname border

International audienceBorder areas are particular “hot spots” generating high levels of HIV vulnerability and facing great challenges to control epidemics. The objective of this study is to describe the sociodemographic, clinical and biological profiles of newly HIV diagnosed people at the French Guiana - Suriname border, to construct an HIV care cascade and compare it with the Surinamese one. HIV-patients aged over 15 years newly diagnosed in western French Guiana in 2011 and 2012 were included in a retrospective cohort study. Patients were identified using different sources (n=121). The male-to-female ratio was 0.8, 85% of the patients were of foreign origin, 72% were undocumented migrants, 21% were living in Suriname and 48% had baseline CD4 cell counts <200 cells/mm3. After one year, 34% were lost to follow-up, 54% received treatment, 34% had controlled viremia and 6% died. We observed a disappointing HIV cascade, like that of Suriname, requiring to develop a coordinated healthcare offer on both sides of the border. Targeted efforts through a bi-national collaboration are needed to address the specific issues of cross-border patients to reach the 90*3 UNAIDS’s diagnosis, link to care and treatment targets and better control the local epidemi

Disseminated Histoplasmosis in HIV-Infected Patients: A Description of 34 Years of Clinical and Therapeutic Practice

Disseminated histoplasmosis is the main AIDS-defining infection of French Guiana. We aim to describe our therapeutic experience for 349 patients with disseminated histoplasmosis between 1 January 1981 and 10 January 2014 in French Guiana. Survival, delays for treatment initiation, duration of induction therapy, and associated initial treatments are described. The death rate was 14.9 per 100 person-years, with an early drop in survival. Among those who died, &gt;1/3 died within a year of HIV diagnosis, and &frac34; of all patients with histoplasmosis had been diagnosed for HIV within a year. As induction treatment, 29% received liposomal amphotericin B, 12.9% received deoxycholate amphotericin B, 54% received itraconazole alone, and 21.8% received liposomal amphotericin B and itraconazole. The median delay between symptoms-onset and hospitalization was 19.5 days (IQR = 5&ndash;105). Liposomal amphotericin B or itraconazole was initiated shortly after admission. Treatment initiation was often presumptive for liposomal amphotericin B (27%) and itraconazole (20%). The median duration of liposomal amphotericin B treatment was 7 days (IQR = 5&ndash;11 days). The present study shows that &frac34; of the patients were profoundly immunocompromised and had been diagnosed for HIV within the past year. Antifungal treatment was often initiated presumptively on admission. Over time there was a significant gradual decline in early death

Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana

We aimed to describe the ways patients with disseminated histoplasmosis&mdash;a multifaceted and often lethal disease&mdash;present themselves and are explored. A retrospective, observational, multicentric study spanned the period between 1 January 1981 and 1 October 2014. Principal component analysis was performed for the sampling sites and for the clinical signs and symptoms. The factor loadings of the principal components were selected for eigenvalues &gt; 1. The most frequent signs and symptoms were an alteration of the WHO general performance status, fever, digestive tract, respiratory signs and symptoms and lymphadenopathies. The most common sites sampled were bone marrow, respiratory tract, blood, lymph node and liver biopsies, with significant variations in the number of sites from which samples were taken to try to identify the pathogen. The principal component analysis clinical signs and symptoms leading to the diagnosis showed four main lines of variation. The factor loadings of the four main components were compatible with four broad types of clinical presentations and four types of exploration strategies. Extracting simple algorithms was difficult, emphasizing the importance of clinical expertise when diagnosis depends on obtaining a sample where Histoplasma can be seen or grown. Histoplasma antigen detection tests will help simplifying the algorithms

A hospital-wide intervention replacing ceftriaxone with cefotaxime to reduce rate of healthcare-associated infections caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in the intensive care unit

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Gastrointestinal disseminated histoplasmosis in HIV-infected patients: A descriptive and comparative study.

Disseminated histoplasmosis is one the main AIDS-defining opportunistic infections in HIV-infected patients, notably in Latin America. The non-specific and proteiform clinical presentation leads to diagnostic delays that may lead to fatal outcomes. This retrospective multicentric study aimed to describe the frequency and manifestations of gastrointestinal histoplasmosis in French Guiana, and to compare patients with disseminated histoplasmosis with or without gastrointestinal involvement. Between January 1, 1981 and October 1, 2014 co-infections with HIV and histoplasmosis were enrolled. Inclusion criteria were: age >18 years, confirmed HIV infection; first proven episode of histoplasmosis. Among 349 cases of disseminated histoplasmosis, 245 (70%) had a gastrointestinal presentation. Half of patients with gastrointestinal signs had abdominal pain or diarrhea, mostly watery. Half of patients with abdominal pain had diarrhea (63/124) and half of those with diarrhea (63/123) had abdominal pain. A significant proportion of patients also had hepatomegaly and, to a lesser degree, splenomegaly. After adjusting for potential confounding, the presence of lymphadenopathies >2cm (AOR = 0.2, IC95 = 0.04-0.7, P = 0.01), Haitian origin (AOR = 0.04, IC95 = 0.004-0.4, P = 0.006) were associated with a lower prevalence of gastrointestinal signs and positive gastrointestinal presence of H. capsulatum. Persons with a gastrointestinal H. capsulatum were more likely to have a decreased prothrombin time, lower ferritin, lower liver enzymes, and lower concentrations of LDH than those without gastrointestinal signs and symptoms. They also had a shorter interval between symptoms onset and diagnosis. Patients with a positive gastrointestinal identification of H. capsulatum were less likely to die at 1 month than those without a gastrointestinal presentation (respectively, 4.6% vs 18.5%, P = 0.01). Subacute or chronic gastrointestinal presentations are very frequent during disseminated histoplasmosis, they seem less severe, and should lead to suspect the diagnosis in endemic areas. There were populational or geographic differences in the frequency of gastrointestinal manifestations that could not be explained

Les leucémies et lymphomes induits par le virus HTLV-1 en Guyane : données de vie réelle de 2009 à 2019

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