Rabies-Specific Antibodies: Measuring Surrogates of Protection against a Fatal Disease

Antibodies play a central role in prophylaxis against many infectious agents. While neutralization is a primary function of antibodies, the Fc- and complement-dependent activities of these multifunctional proteins may also be critical in their ability to provide protection against most viruses. Protection against viral pathogens in vivo is complex, and while virus neutralization—the ability of antibody to inactivate virus infectivity, often measured in vitro—is important, it is often only a partial contributor in protection. The rapid fluorescent focus inhibition test (RFFIT) remains the “gold standard” assay to measure rabies virus–neutralizing antibodies. In addition to neutralization, the rabies-specific antigen-binding activity of antibodies may be measured through enzyme-linked immunosorbent assays (ELISAs), as well as other available methods. For any disease, in selecting the appropriate assay(s) to use to assess antibody titers, assay validation and how they are interpreted are important considerations—but for a fatal disease like rabies, they are of paramount importance. The innate limitations of a one-dimensional laboratory test for rabies antibody measurement, as well as the validation of the method of choice, must be carefully considered in the selection of an assay method and for the interpretation of results that might be construed as a surrogate of protection

Travelers With Cutaneous Leishmaniasis Cured Without Systemic Therapy

Guidelines recommend wound care and/or local therapy as first-line treatment for cutaneous leishmaniasis. An analysis of a referral treatment program in 135 travelers showed that this approach was feasible in 62% of patients, with positive outcome in 83% of evaluable patient

Simple scoring system to predict in-hospital mortality after surgery for infective endocarditis

BACKGROUND: Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. METHODS AND RESULTS: Outcomes of 361 consecutive patients (mean age, 59.1\ub115.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m2 (odds ratio [OR], 1.79; P=0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P=0.032), and critical state (OR, 2.37; P=0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. CONCLUSIONS: A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE

New computation for a better estimation of the annual dissolved metal net fluxes. The case of the cadmium in the Gironde estuary

Despite major management efforts initiated in 1987 and 2007 and decreasing emissions in the Gironde watershed, cadmium (Cd) levels in oysters from the downstream Gironde estuary are still higher to the consumption limit (5 mg/kg, dw, EC). Dissolved Cd concentrations were measured in surface water collected in the Gironde estuary during nine cruises (2014 – 2015). The obtained theoretical (Cdd0) concentrations and the daily net Cdd fluxes, using the Boyle’s method, confirm a decadal stepping decrease of the Cd pollution corresponding to that observed in the oysters from the long term national monitoring for priority contaminants at the estuary mouth. As this observation invalidates the previous estimating methods for estimating annual net Cdd fluxes, we propose an original empirical model applicable for the four last decades. This model is based on four exponential functions with defined boundaries for low water discharges. Each of them is representative of one distinct situation of Cd pollution in the watershed relative to major remediation processes implemented in the last four decades. These results allow to develop a direct estimation of the annual net Cdd fluxes only based on the data of the annual mean discharge. Thus, this study demonstrates the strength of the field research in geochemistry to obtain a better quantification of the exportation of dissolved bioavailable pollutants from the continental watersheds to the coastal ocean.Malgré d’importants efforts d’aménagement initiés en 1987 et 2007 et la diminution consécutive des émissions issues du bassin versant de la Gironde, les teneurs en cadmium (Cd) présentent dans les huîtres de l’aval de la Gironde restent supérieures à la norme de consommation (5 mg/kg, p.s., CE). Des concentrations en cadmium dissous ont été mesurées dans les eaux de surface collectées dans l’estuaire de la Gironde au cours de neuf campagnes océanographiques (2014–2015). Les concentrations théoriques en cadmium dissous (Cdd0) et les flux nets journaliers de Cdd ont été obtenus, selon la méthode de Boyle. Ils confirment une diminution de la pollution en Cd par paliers décennaux, correspondant à celle observée dans les huîtres girondines grâce au réseau national de surveillance des contaminants prioritaires. Cette observation invalidant les précédentes méthodes d’estimation des flux nets annuels, nous proposons un modèle empirique original appliqué aux quatre dernières décennies et basé sur quatre fonctions exponentielles tronquées. Chaque fonction est représentative d’une situation distincte de la pollution du bassin versant relative aux principaux processus de remédiation entrepris au cours des quatre dernières décennies. Les résultats nous ont permis de proposer un abaque de quantification des flux nets annuels de Cdd utilisant uniquement les données de débit moyen annuel. Ainsi, cette étude démontre l’efficacité de la géochimie de terrain pour obtenir une meilleure quantification de l’exportation de polluants dissous et biodisponibles, des bassins continentaux vers l’océan côtier

Nouveau modèle analytique pour une meilleure estimation des flux nets annuels en métaux dissous. Cas du cadmium dans l’estuaire de la Gironde

International audienceNouveau modèle analytique pour une meilleure estimation des flux nets annuels en métaux dissous. Cas du cadmium dans l'estuaire de la Gironde New computation for a better estimation of the annual dissolved metal net fluxes. The case of the cadmium in the Gironde estuar

Management and prevention of imported malaria. 2018 update of the 2007 French clinical guidelines

International audienc

New guidelines for the prevention of imported malaria in France

International audienc