Le risque de toxi-infection alimentaire lié aux salariés manipulant des aliments (recommandations pour la surveillance médicale des salariés)

En France, de 2006 à 2010, 268 foyers de toxi infections alimentaires survenus en restaurant d'entreprise ont été déclarés, affectant 4 344 salariés. Le médecin du travail est compétent pour assurer la surveillance médicale des salariés manipulant des denrées alimentaires destinées à être consommées par personnel de l'entreprise à laquelle ils appartiennent (restaurant d'entreprise). Le médecin du travail vérifie ainsi qu'ils ne sont pas atteints d'une affection dangereuse pour les autres travailleurs. Cette thèse développe des recommandations basées sur des preuves scientifiques pour assurer la surveillance de ces salariés manipulant des aliments et pour prévenir la survenue de toxi infection alimentaire. Evaluation du risque de toxi infection alimentaire : L'essentiel (41 à 80%) des étiologies des épisodes de toxi infection alimentaire reste inconnu. Les virus représentent près de la moitié des cas pour lesquels une espèce a été identifiée. La voie de contamination la plus fréquente est fécale-orale, par défaut d'hygiène des mains. Gestion du risque de toxi infection alimentaire : On recommande de suspendre la pratique d'un dépistage systématique de pathogènes digestifs chez les salariés manipulant des aliments et de mettre en place des postes sans contact alimentaire accessibles en cas d'auto-déclaration de symptômes digestifs. On recommande également de faire un état des lieux des besoins de formation en hygiène alimentaire et de mettre en place une action au long cours par l'équipe pluridisciplinaire directement sur le milieu de travail afin de soutenir l'application des bonnes pratiques d'hygiène. Discussion : Concernant la prévention des toxi infections alimentaires, l'évaluation du risque a mis en évidence la pertinence d'une action sur le milieu de travail plutôt que la pratique systématique d'un examen médical.ROUEN-BU Médecine-Pharmacie (765402102) / SudocSudocFranceF

A specialist toxicity database (TRACE) is more effective than its larger, commercially available counterparts

A comparison of the retrieval precision and recall of a specialist bibliographic toxicity database (TRACE) with that of a wide range of commercial on-line databases indicated that the larger size and resources of the commercial databases did not, for a series of test queries, assure superior retrieval of relevant papers. The specialist database, in which document selection and indexing is undertaken by the same (in this case) expert toxicologists who subsequently use the database in their day-to-day work, achieved markedly better retrieval, using simpler search strategies, than the commercial databases. Small specialist databases may offer a valuable alternative to existing commercial databases

Environmental benzene exposure assessment for parent-child pairs in Rouen, France

International audienceThere is a lack of data on environmental benzene exposure in children. In this study, we compared personal benzene exposure and inhalation uptake in a group of children to those of their parents. We also compared levels of urinary benzene metabolites, trans, trans-muconic acid (MA) and hydroquinone (HQ), for those two groups, and assessed the correlation between personal benzene exposure and urinary MA and HQ concentrations. The study was performed on 21, 2-3-year-old children and their parents recruited on a voluntary basis among non-smokers from the three largest day-care centers of the town of Rouen in France. Average benzene concentrations were measured over 5 consecutive days with diffusive. samplers. The following simultaneous measurements were carried out: personal exposure of the parents, concentrations inside and outside the day care centers, and inside the volunteer's bedrooms. Morning and evening urine samples were collected during the same period. Benzene personal exposure levels were 14.4 +/- 7.7 mug/m(3) and 11.09 +/- 6.15 mug/m(3) in parents and children, respectively. Benzene inhalation uptake estimates were 2.51 +/- 1.23 mug/kg/day in the group of parents and 5.68 +/- 3.17 mug/kg/day in the group of children. Detectable levels of MA and HQ were found in 85% and 100% of the samples, respectively. Intra-individual variation of urinary MA and HQ concentrations expressed as a coefficient of variation (CV) ranged from 63 to 232% and from 13 to 144%, respectively. Mean values of MA and HQ (in mg/g creatinine) were 1.6- and 1.8-fold higher in the group of children than in the group of parents (P=0.008 and P<0.0001, respectively). Significant correlations between metabolites levels and benzene were not found

Eradication of common pathogens at days 2, 3 and 4 of moxifloxacin therapy in patients with acute bacterial sinusitis

BACKGROUND: Acute bacterial sinusitis (ABS) is a common infection in clinical practice. Data on time to bacteriologic eradication after antimicrobial therapy are lacking for most agents, but are necessary in order to optimize therapy. This was a prospective, single-arm, open-label, multicenter study to determine the time to bacteriologic eradication in ABS patients (maxillary sinusitis) treated with moxifloxacin. METHODS: Adult patients with radiologically and clinically confirmed ABS received once-daily moxifloxacin 400 mg for 10 days. Middle meatus secretion sampling was performed using nasal endoscopy pre-therapy, and repeated on 3 consecutive days during treatment. Target enrollment was 30 bacteriologically evaluable patients (pre-therapy culture positive for Streptococcus pneumoniae, Haemophilus influenzae or Moraxella catarrhalis and evaluable cultures for at least Day 2 and Day 3 during therapy visits), including at least 10 each with S. pneumoniae or H. influenzae. RESULTS: Of 192 patients enrolled, 42 were bacteriologically evaluable, with 48 pathogens isolated. Moxifloxacin was started on Day 1. Baseline bacteria were eradicated in 35/42 (83.3%) patients by day 2, 42/42 (100%) patients by day 3, and 41/42 (97.6%) patients by day 4. In terms of individual pathogens, 12/18 S. pneumoniae, 22/23 H. influenzae and 7/7 M. catarrhalis were eradicated by day 2 (total 41/48; 85.4%), and 18/18 S. pneumoniae and 23/23 H. influenzae were eradicated by day 3. On Day 4, S. pneumoniae was isolated from a patient who had negative cultures on Days 2 and 3. Thus, the Day 4 eradication rate was 47/48 (97.9%). Clinical success was achieved in 36/38 (94.7%) patients at the test of cure visit. CONCLUSION: In patients with ABS (maxillary sinusitis), moxifloxacin 400 mg once daily for 10 days resulted in eradication of baseline bacteria in 83.3% of patients by Day 2, 100% by Day 3 and 97.6% by Day 4

On the robustness of the h-index

The h-index (Hirsch, 2005) is robust, remaining relatively unaffected by errors in the long tails of the citations-rank distribution, such as typographic errors that short-change frequently-cited papers and create bogus additional records. This robustness, and the ease with which h-indices can be verified, support the use of a Hirsch-type index over alternatives such as the journal impact factor. These merits of the h-index apply to both individuals and to journals.Comment: 10 pages, 4 tables, 1 figur

A Non-Invasive Thermal Drift Compensation Technique Applied to a Spin-Valve Magnetoresistive Current Sensor

A compensation method for the sensitivity drift of a magnetoresistive (MR) Wheatstone bridge current sensor is proposed. The technique was carried out by placing a ruthenium temperature sensor and the MR sensor to be compensated inside a generalized impedance converter circuit (GIC). No internal modification of the sensor bridge arms is required so that the circuit is capable of compensating practical industrial sensors. The method is based on the temperature modulation of the current supplied to the bridge, which improves previous solutions based on constant current compensation. Experimental results are shown using a microfabricated spin-valve MR current sensor. The temperature compensation has been solved in the interval from 0 °C to 70 °C measuring currents from −10 A to +10 A

What do evidence-based secondary journals tell us about the publication of clinically important articles in primary healthcare journals?

BACKGROUND: We conducted this analysis to determine i) which journals publish high-quality, clinically relevant studies in internal medicine, general/family practice, general practice nursing, and mental health; and ii) the proportion of clinically relevant articles in each journal. METHODS: We performed an analytic survey of a hand search of 170 general medicine, general healthcare, and specialty journals for 2000. Research staff assessed individual articles by using explicit criteria for scientific merit for healthcare application. Practitioners assessed the clinical importance of these articles. Outcome measures were the number of high-quality, clinically relevant studies published in the 170 journal titles and how many of these were published in each of four discipline-specific, secondary "evidence-based" journals (ACP Journal Club for internal medicine and its subspecialties; Evidence-Based Medicine for general/family practice; Evidence-Based Nursing for general practice nursing; and Evidence-Based Mental Health for all aspects of mental health). Original studies and review articles were classified for purpose: therapy and prevention, screening and diagnosis, prognosis, etiology and harm, economics and cost, clinical prediction guides, and qualitative studies. RESULTS: We evaluated 60,352 articles from 170 journal titles. The pass criteria of high-quality methods and clinically relevant material were met by 3059 original articles and 1073 review articles. For ACP Journal Club (internal medicine), four titles supplied 56.5% of the articles and 27 titles supplied the other 43.5%. For Evidence-Based Medicine (general/family practice), five titles supplied 50.7% of the articles and 40 titles supplied the remaining 49.3%. For Evidence-Based Nursing (general practice nursing), seven titles supplied 51.0% of the articles and 34 additional titles supplied 49.0%. For Evidence-Based Mental Health (mental health), nine titles supplied 53.2% of the articles and 34 additional titles supplied 46.8%. For the disciplines of internal medicine, general/family practice, and mental health (but not general practice nursing), the number of clinically important articles was correlated withScience Citation Index (SCI) Impact Factors. CONCLUSIONS: Although many clinical journals publish high-quality, clinically relevant and important original studies and systematic reviews, the articles for each discipline studied were concentrated in a small subset of journals. This subset varied according to healthcare discipline; however, many of the important articles for all disciplines in this study were published in broad-based healthcare journals rather than subspecialty or discipline-specific journals