Risque professionnel d'hépatite virale A au contact des eaux usées

La disponibilité depuis 1992 d'un premier vaccin contre l'hépatite virale A a soulevé la question de son indication chez le personnel exposé aux eaux usées. Nous avons évalué ce risque professionnel grâce à une étude transversale comparant les taux de prévalence des anticorps totaux (ou des IgG) anti-VHA chez 110 sujets exposés aux eaux usées appariés sur l'âge et le niveau de diplôme à 110 sujets non-exposés de la même entreprise. Chaque personne était interrogée sur ses antécédents d'ictère, la notion de voyages en zone d'endémie et la durée de l'exposition professionnelle. La prévalence des anticorps anti-VHA était globalement de 52,7 %, significativement plus élevée chez les exposés (60,9 %) que chez les non-exposés (44,S %) (p < 0,02). Cette séroprévalence augmentait avec l'âge, et apparaissait liée au niveau de diplôme dans les deux groupes. Ces résultats suggèrent fortement l'existence d'un risque professionnel d'infection par le VHA chez les travailleurs exposés aux eaux usées (risque relatif: 2,4; IC 95 % [1,6 - 3,1]). La vaccination du personnel exposé semble justifiée. La stratégie vaccinale à adopter est liée au coût élevé du vaccin et à la situation épidémiologique du VHA dans le pays.The availability of a first hepatitis A vaccine in 1992 raised the possibility of its use for workers exposed to sewage or sludge. This occupational risk was suspected because of the excretion of hepatitis A virus (HAV) in stools and its resulting presence in sewage, because of the resistance of HAV to environmental stresses, and because of the documented wastewater-mediated transmission of HAV in the general population. On the other hand, the decreased diffusion of HAV in industrialized countries probably results in less contamination of sewage. The aim of this study was to evaluate the possible risk of HAV infection from sewage exposure, which could lead to recommendations of vaccination for exposed workers. MethodsIn a large private company involved in water supply, anti HAV IgG were sought in sera from workers in contact with sewage and from workers not exposed to sewage. Subjects were individually matched for age and education level. Cases included workers involved with the wastewater collection network, workers who monitor drinking water distribution networks in Paris (located in sewer mains in Paris), personnel of a large research laboratory involved with wastewater and sludge, as well as a few workers involved with drinking water production who may be frequently exposed to raw Seine river, Marne river or Oise river water (that could be contaminated with sewage). Histories of jaundice, travels to areas of endemic incidence of hepatitis A, and the duration of occupational exposure were noted. Anti-HAV IgG was measured in serum by an enzyme-linked immunosorbent assay (ELISA) method.ResultsAt this time, 110 exposed workers and 110 non-exposed workers have been studied. Ages ranged from 20 to 58 years, with a mean value of 36.5 year. Cases and controls did not differ with respect to social class or travels in areas of endemic exposure. Duration of exposure ranged from 1 year to 36 years, with a mean value of 10.3, and was correlated to age in this company where workers are usually hired when young. The seroprevalence of anti HAV was globally 52.7 %, significantly higher in exposed workers ( 60.9 %) than in controls ( 44.5 % , p < 0.02 ). This seroprevalence varied widely according to age: for workers in their twenties it was 30.0 % vs. 27.5 %, in their thirties 68.0 % vs. 33.3%, in their forties 80.0 % vs. 54.8% and in their fifties 93.3 % vs. 86.7 %, respectively in exposed and non-exposed workers. The seroprevalence was related to education level in each group, but not to social class. History of jaundice was not correlated with anti HAV status, nor with sewage exposure. The relative risk of HAV infection in this matched range was 2.4, CI 95 % (1.6 - 3.1).These results emphasize the role of occupational exposure to sewage in HAV infection. Exposed workers should be vaccinated because of the frequency of the symptomatic form of hepatitis A in adults with severe and relapsing cases. The strategy of vaccination should take into account the high cost of the vaccine and the epidemiological situation of HAV in the country

Eta-Helium Quasi-Bound States

The cross section and tensor analysing power t_20 of the d\vec{d}->eta 4He reaction have been measured at six c.m. momenta, 10 < p(eta) < 90 MeV/c. The threshold value of t_20 is consistent with 1/\sqrt{2}, which follows from parity conservation and Bose symmetry. The much slower momentum variation observed for the reaction amplitude, as compared to that for the analogous pd->eta 3He case, suggests strongly the existence of a quasi-bound state in the eta-4He system and optical model fits indicate that this probably also the case for eta-3He.Comment: LaTeX, uses elsart.sty, 10 pages, 3 Postscript figures, Submitted to Physics Letters

Objective Measurement of the Visual Aspect of Dry Sausage Slices by Image Analysis

The visual aspect of food is a problem very often neglected for different reasons; one being the difficulty of modelling vision. However, it has been shown that , on simple synthetic images, automatic sorting in the same manner as human vision is possible. Distribution heterogeneity of spots within an image is one important parameter for its characterization. A new algorithm was tested over simple numerical pictures that gave good agreement with visual appreciation. Images of twenty dry sausage slices were analyzed and different factors corresponding to aspect structure were calculated. Principal component analyst:s based on these factors all owed discrimination between the different types of sausage. The results obtained when studying the meat part of the slices were well correlated with the visual aspect

Targeted hepatitis C antibody testing interventions: a systematic review and meta-analysis

Testing for hepatitis C virus (HCV) infection may reduce the risk of liver-related morbidity, by facilitating earlier access to treatment and care. This review investigated the effectiveness of targeted testing interventions on HCV case detection, treatment uptake, and prevention of liver-related morbidity. A literature search identified studies published up to 2013 that compared a targeted HCV testing intervention (targeting individuals or groups at increased risk of HCV) with no targeted intervention, and results were synthesised using meta-analysis. Exposure to a targeted testing intervention, compared to no targeted intervention, was associated with increased cases detected [number of studies (n) = 14; pooled relative risk (RR) 1.7, 95 % CI 1.3, 2.2] and patients commencing therapy (n = 4; RR 3.3, 95 % CI 1.1, 10.0). Practitioner-based interventions increased test uptake and cases detected (n = 12; RR 3.5, 95 % CI 2.5, 4.8; and n = 10; RR 2.2, 95 % CI 1.4, 3.5, respectively), whereas media/information-based interventions were less effective (n = 4; RR 1.5, 95 % CI 0.7, 3.0; and n = 4; RR 1.3, 95 % CI 1.0, 1.6, respectively). This meta-analysis provides for the first time a quantitative assessment of targeted HCV testing interventions, demonstrating that these strategies were effective in diagnosing cases and increasing treatment uptake. Strategies involving practitioner-based interventions yielded the most favourable outcomes. It is recommended that testing should be targeted at and offered to individuals who are part of a population with high HCV prevalence, or who have a history of HCV risk behaviour

Percutaneous Exposure Incidents of the Health Care Personnel in a Newly Founded Tertiary Hospital: A Prospective Study

BACKGROUND: Percutaneous exposure incidents (PEIs) and blood splashes on the skin of health care workers are a major concern, since they expose susceptible employees to the risk of infectious diseases. We undertook this study in order to estimate the overall incidence of such injuries in a newly founded tertiary hospital, and to evaluate possible changes in their incidence over time. METHODOLOGY/PRINCIPAL FINDINGS: We prospectively studied the PEIs and blood splashes on the skin of employees in a newly founded (October 2000) tertiary hospital in Athens, Greece, while a vaccination program against hepatitis B virus, as well as educational activities for avoidance of injuries, were taking place. The study period ranged from October 1, 2002 to February 28, 2005. Serologic studies for hepatitis B (HBV) and C virus (HCV) as well as human immunodeficiency virus (HIV) were performed in all injured employees and the source patients, when known. High-titer immunoglobulin (250 IU anti-HBs intramuscularly) and HBV vaccination were given to non-vaccinated or previously vaccinated but serologically non-responders after exposure. Statistical analysis of the data was performed using Mc Nemar's and Fisher's tests. 60 needlestick, 11 sharp injuries, and two splashes leading to exposure of the skin or mucosa to blood were reported during the study period in 71 nurses and two members of the cleaning staff. The overall incidence (percutaneous injuries and splashes) per 100 full-time employment-years (100 FTEYs) for high-risk personnel (nursing, medical, and cleaning staff) was 3.48, whereas the incidence of percutaneous injuries (needlestick and sharp injuries) alone per 100 FTEYs was 3.38. A higher incidence of injuries was noted during the first than in the second half of the study period (4.67 versus 2.29 per 100 FTEYs, p = 0.005). No source patient was found positive for HCV or HIV. The use of high-titer immunoglobulin after adjustment for the incidence of injuries was higher in the first than in the second half of the study period, although the difference was not statistically significant [9/49 (18.37%) vs 1/24 (4.17%), p = 0.15]. CONCLUSIONS/SIGNIFICANCE: Our data show that nurses are the healthcare worker group that reports most of PEIs. Doctors did not report such injuries during the study period in our setting. However, the possibility of even relatively frequent PEIs in doctors cannot be excluded. This is due to underreporting of such events that has been previously described for physicians and surgeons. A decrease of the incidence of PEIs occurred during the operation of this newly founded hospital

Photoproduction of phi(1020) mesons on the proton at large momentum transfer

The cross section for $\phi$ meson photoproduction on the proton has been measured for the first time up to a four-momentum transfer -t = 4 GeV^2, using the CLAS detector at the Thomas Jefferson National Accelerator Facility. At low four-momentum transfer, the differential cross section is well described by Pomeron exchange. At large four-momentum transfer, above -t = 1.8 GeV^2, the data support a model where the Pomeron is resolved into its simplest component, two gluons, which may couple to any quark in the proton and in the $\phi$.Comment: 5 pages; 7 figure

The e p -> e' p eta reaction at and above the S11(1535) baryon resonance

New cross sections for the reaction e p -> ep eta are reported for total center of mass energy W = 1.5--1.86 GeV and invariant momentum transfer Q^2 = 0.25--1.5 GeV^2. This large kinematic range allows extraction of important new information about response functions, photocouplings, and eta N coupling strengths of baryon resonances. Expanded W coverage shows sharp structure at W \~ 1.7 GeV; this is shown to come from interference between S and P waves and can be interpreted in terms of known resonances. Improved values are derived for the photon coupling amplitude for the S11(1535) resonance.Comment: 11 pages, RevTeX, 5 figures, submitted to Phys. Rev. Let

Objective comparison of particle tracking methods

Particle tracking is of key importance for quantitative analysis of intracellular dynamic processes from time-lapse microscopy image data. Because manually detecting and following large numbers of individual particles is not feasible, automated computational methods have been developed for these tasks by many groups. Aiming to perform an objective comparison of methods, we gathered the community and organized an open competition in which participating teams applied their own methods independently to a commonly defined data set including diverse scenarios. Performance was assessed using commonly defined measures. Although no single method performed best across all scenarios, the results revealed clear differences between the various approaches, leading to notable practical conclusions for users and developers

Glutathione Deficiency in Cardiac Patients Is Related to the Functional Status and Structural Cardiac Abnormalities

International audienceBACKGROUND: The tripeptide glutathione (L-gamma-glutamyl-cysteinyl-glycine) is essential to cell survival, and deficiency in cardiac and systemic glutathione relates to heart failure progression and cardiac remodelling in animal models. Accordingly, we investigated cardiac and blood glutathione levels in patients of different functional classes and with different structural heart diseases. METHODS: Glutathione was measured using standard enzymatic recycling method in venous blood samples obtained from 91 individuals, including 15 healthy volunteers and 76 patients of New York Heart Association (NYHA) functional class I to IV, undergoing cardiac surgery for coronary artery disease, aortic stenosis or terminal cardiomyopathy. Glutathione was also quantified in right atrial appendages obtained at the time of surgery. RESULTS: In atrial tissue, glutathione was severely depleted (-58%) in NYHA class IV patients compared to NYHA class I patients (P = 0.002). In patients with coronary artery disease, this depletion was related to the severity of left ventricular dysfunction (P = 0.006). Compared to healthy controls, blood glutathione was decreased by 21% in NYHA class I patients with structural cardiac disease (P<0.01), and by 40% in symptomatic patients of NYHA class II to IV (P<0.0001). According to the functional NYHA class, significant depletion in blood glutathione occurred before detectable elevation in blood sTNFR1, a marker of symptomatic heart failure severity, as shown by the exponential relationship between these two parameters in the whole cohort of patients (r = 0.88). CONCLUSIONS: This study provides evidence that cardiac and systemic glutathione deficiency is related to the functional status and structural cardiac abnormalities of patients with cardiac diseases. These data also suggest that blood glutathione test may be an interesting new biomarker to detect asymptomatic patients with structural cardiac abnormalities

Protein Hydrolysates Are Avoided by Herbivores but Not by Omnivores in Two-Choice Preference Tests

Background: The negative sensory properties of casein hydrolysates (HC) often limit their usage in products intended for human consumption, despite HC being nutritious and having many functional benefits. Recent, but taxonomically limited, evidence suggests that other animals also avoid consuming HC when alternatives exist. Methodology/Principal Findings: We evaluated ingestive responses of five herbivorous species (guinea pig, mountain beaver, gopher, vole, and rabbit) and five omnivorous species (rat, coyote, house mouse, white-footed mouse, and deer mouse; N = 16–18/species) using solid foods containing 20% HC in a series of two-choice preference tests that used a nonprotein, cellulose-based alternative. Individuals were also tested with collagen hydrolysate (gelatin; GE) to determine whether it would induce similar ingestive responses to those induced by HC. Despite HC and GE having very different nutritional and sensory qualities, both hydrolysates produced similar preference score patterns. We found that the herbivores generally avoided the hydrolysates while the omnivores consumed them at similar levels to the cellulose diet or, more rarely, preferred them (HC by the white-footed mouse; GE by the rat). Follow-up preference tests pairing HC and the nutritionally equivalent intact casein (C) were performed on the three mouse species and the guinea pigs. For the mice, mean HC preference scores were lower in the HC v C compared to the HC v Cel tests, indicating that HC’s sensory qualities negatively affected its consumption. However, responses were species-specific. For the guinea pigs, repeated exposure to HC or C (4.7-h sessions; N = 10) were found to increase subsequent HC preference scores in an HC v C preference test, which was interpreted in the light of conservative foraging strategies thought to typify herbivores. Conclusions/Significance: This is the first empirical study of dietary niche-related taxonomic differences in ingestive responses to protein hydrolysates using multiple species under comparable conditions. Our results provide a basis for future work in sensory, physiological, and behavioral mechanisms of hydrolysate avoidance and on the potential use of hydrolysates for pest management