Impact of Chikungunya Virus Infection on Health Status and Quality of Life: A Retrospective Cohort Study

BACKGROUND:Persistent symptoms, mainly joint and muscular pain and depression, have been reported several months after Chikungunya virus (CHIKV) infection. Their frequency and their impact on quality of life have not been compared with those of an unexposed population. In the present study, we aimed to describe the frequency of prolonged clinical manifestations of CHIKV infection and to measure the impact on quality of life and health care consumption in comparison with that of an unexposed population, more than one year after infection. METHODOLOGY/PRINCIPAL FINDINGS:In a retrospective cohort study, 199 subjects who had serologically confirmed CHIKV infection (CHIK+) were compared with 199 sero-negative subjects (CHIK-) matched for age, gender and area of residence in La Réunion Island. Following an average time of 17 months from the acute phase of infection, participants were interviewed by telephone about current symptoms, medical consumption during the last 12 months and quality of life assessed by the 12-items Short-Form Health Survey (SF-12) scale. At the time of study, 112 (56%) CHIK+ persons reported they were fully recovered. CHIK+ complained more frequently than CHIK- of arthralgia (relative risk = 1.9; 95% confidence interval: 1.6-2.2), myalgia (1.9; 1.5-2.3), fatigue (2.3; 1.8-3), depression (2.5; 1.5-4.1) and hair loss (3.8; 1.9-7.6). There was no significant difference between CHIK+ and CHIK- subjects regarding medical consumption in the past year. The mean (SD) score of the SF-12 Physical Component Summary was 46.4 (10.8) in CHIK+ versus 49.1 (9.3) in CHIK- (p = 0.04). There was no significant difference between the two groups for the Mental Component Summary. CONCLUSIONS/SIGNIFICANCE:More than one year following the acute phase of infection, CHIK+ subjects reported more disabilities than those who were CHIK-. These persistent disabilities, however, have no significant influence on medical consumption, and the impact on quality of life is moderate

Viruses

In this multicentre cohort study, we evaluated the risks of maternal ZIKV infections and adverse pregnancy outcomes among exposed travellers compared to women living in areas with ZIKV circulation (residents). The risk of maternal infection was lower among travellers compared to residents: 25.0% (n = 36/144) versus 42.9% (n = 309/721); aRR 0.6; 95% CI 0.5-0.8. Risk factors associated with maternal infection among travellers were travelling during the epidemic period (i.e., June 2015 to December 2016) (aOR 29.4; 95% CI 3.7-228.1), travelling to the Caribbean Islands (aOR 3.2; 95% CI 1.2-8.7) and stay duration \textbackslashtextgreater2 weeks (aOR 8.7; 95% CI 1.1-71.5). Adverse pregnancy outcomes were observed in 8.3% (n = 3/36) of infected travellers and 12.7% (n = 39/309) of infected residents. Overall, the risk of maternal infections is lower among travellers compared to residents and related to the presence of ongoing outbreaks and stay duration, with stays \textbackslashtextless2 weeks associated with minimal risk in the absence of ongoing outbreaks

an individual participant data meta-analysis

Background The impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. Methods A worldwide meta- analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. Results Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. Conclusions Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support

Impact en population de l'épidémie de Chikungunya à l'Ile de La Réunion

Le Chikungunya est une maladie infectieuse émergente due à un alphavirus (CHIKV) transmis par les moustiques Aedes. En 2004-2007, plusieurs épidémies de grande envergure ont touché la zone Océan Indien. Nos objectifs étaient d'évaluer l'impact de l'épidémie en population générale à l'île de La Réunion (séroprévalence post-épidémique 38,2%, 300.000 personnes infectées) en termes de morbidité perçue, de qualité de vie, d'identifier les facteurs pronostiques des douleurs musculosquelettiques (DMS) du rhumatisme chikungunya, enfin de déterminer le pronostic neurocognitif des enfants infectés à la naissance par transmission verticale du virus. Pour mesurer l'impact en population de l'épidémie, nous avons mené deux enquêtes téléphoniques sur deux échantillons aléatoires de la population de l'enquête de séroprévalence. Le CHIKV était impliqué dans un tiers des DMS, 10% des troubles neurologiques légers, 7,5% des troubles neurosensoriels, en moyenne dix huit mois après la fin de l'épidémie. La qualité de vie était peu altérée. Les facteurs prédictifs de DMS chroniques étaient un âge supérieur ou égal à 45 ans, des douleurs intenses à la phase aigue de la maladie, enfin une forte réponse humorale contre le CHIKV à sa phase de plateau (titres d'IgG spécifiques élevés). Pour mesurer le pronostic neurocognitif d'une infection materno-fœtale, nous avons suivi pendant deux ans une cohorte d'enfants infectés et non infectés. Plus de la moitié des enfants infectés avaient un retard pyschomoteur, lequel était corrélé à la gravité de la présentation initiale. Nos résultats originaux ouvrent des perspectives intéressantes pour mieux comprendre cette nouvelle maladie infectieuse chronique.Chikungunya is an emerging infectious disease caused by an alphavirus (CHIKV) transmitted by Aedes mosquitoes (Ae albopictus, Ae aegypti). In years 2004-2007, several large scale outbreaks have hit the Indian Ocean area. Our objectives were to assess the burden of the epidemic in the Reunion island community (post-epidemic seroprevalence rate: 38.2%, 300,000 persons infected) in terms of perceived morbidity, health-related quality of life (QoL), to identify the prognostic factors for musculoskeletal pain of chikungunya rheumatism (RMSP), and finally to determine the neurocognitive outcome of children infected at birth due to the vertical transmission of the virus. In the aim to measure the populational impact of the epidemic, we conducted two telephonic surveys using two random samples of the population of a seroprevalence survey. CHIKV was involved in a third of RMSP, 10% of light cerebral disorders, 7.5% of sensorineural impairments, on average eighteen months after the end of the outbreak. The Qol was slightly altered in CHIKV-infected subjects. Predictors of chronic RMSP were age greater or equal than 45 years, severe initial rheumatic involvement at the acute phase of infection, and finally a strong humoral response against the CHIKV at plateau phase (high specific IgG titres). To measure the neurocognitive outcome of perinatal infection, we followed-up during two years a cohort of infected and uninfected children. More than half of infected children had a psychomotor delay, which correlated with the severity of the initial presentation. Our original findings open very interesting perspectives for the understanding of this new chronic infectious diseasePARIS-BIUSJ-Biologie recherche (751052107) / SudocSudocFranceF

Nouveaux systèmes complexants et application à la préparation de composés amphiphiles dérivés (Synthèse et étude physicochimique)

Bien que présents dans l'organisme en quantités infinitésimales, les métaux de transition jouent un rôle physiologique essentiel. On les trouve généralement sous forme de chélates avec des coordinats biologiques de masse molaire élevée dont l'étude est particulièrement difficile. Il est cependant possible de modéliser les sites actifs de ces macromolécules à l'aide de petites molécules plus faciles à étudier. Nous avons synthétisé des pseudo-peptides à base d'histamine pour simuler les sites de coordination de protéines telles que la sérum albumine. Ces peptidoamines sont également intéressantes du fait de leur activité antioxydante. L'étude des propriétés complexantes de ces molécules vis-à-vis du Cu(II) et du Ni(II) a permis de mettre en évidence une variété de complexes parfois très différents par leur nature et leur stabilité. À partir des résultats précédents, nous avons proposé la synthèse de nouveaux tensioactifs possédant des propriétés complexantes par greffage d'un chaîne hydrophobe sur des peptides contenant l'histidine. Les têtes polaires correspondent aux pseudo-peptides peptides b-alanyl-histidine et glycyl-glycyl-histidine. Les concentrations micellaires critiques ont été déterminées par tensiométrie et fluorimétrie et les diagrammes de phase binaires ont été tracés. Les propriétés complexantes ont été démontrées et les diagrammes de répartition de espèces ont été déterminés à partir de molécules modèles à courte chaîne hydrophobe. Enfin des tensioactifs trimodulaires ont été préparés en greffant sur les molécules précédentes une partie de type polyoxyéthylène, pour augmenter l'hydrophilie.Although there are in infinitesimal quantities in the organism, transition metals have an essential physiological function. They are generally complexed by biological ligands of high molar mass whose study is particularly difficult. It is however possible to model the active sites of these macromolecules using small molecules easier to study. We synthesised histamine-containing pseudo-peptides to simulate the sites of coordination of proteins such as the serum albumin. These peptidoamines are also interesting because of their antioxydant activity. The study of the chelating properties of these molecules with Cu(II) and Ni(II) showed a variety of complexes sometimes very different by their nature and their stability. From these results, we propose new surfactants, with complexing properties, synthesized by connecting a hydrophobic tail to histidine-containing peptides. Polar head corresponds to the pseudo-peptides b-alanyl-histidine and glycyl-glycyl-histidine. Critical micellar concentrations were determined by tensiometry and fluorescence spectroscopy and the binary phase diagrams were plotted. Complexation properties were demonstrated and the species distribution diagrams were determined on model molecules with short hydrophobic chains. Finally, trimodular compounds have been prepared by grafting polyoxyethylene moiety in different parts of the previous molecules to increase hydrophily.NANCY1-SCD Sciences & Techniques (545782101) / SudocSudocFranceF

Planification du réseau d’aires protégées du Québec : Principes et méthodes de l’analyse écologique du territoire

Introduction  Une compréhension récente des relations de l’Homme avec sa planète et des pressions sans cesse plus grandes qu’il exerce sur les ressources et le territoire, commandent une perception nouvelle de la conservation , de la protection et de la gestion de l’environnement. Depuis la Conférence des Nations Unies sur l’environnement et le développement − dit « Sommet de la Terre » − tenue à Rio en 1992, le développement durable et la diversité biologique ou biodiversité sont devenus deu..

Thermosensitive and drug-loaded ordered mesoporous silica: a direct and effective synthesis using PEO-b-PNIPAM block copolymers

International audienc

Synthesis of double hydrophilic block copolymers by ATRP and their assembly induced by complexation

International audienc

Synthesis of poly(ethylene oxide)-b-poly(N-isopropylacrylamide) by RAFT polymerization and their utilization as structure directing agents for the preparation of functionalized mesoporous silica

International audienc

PIC micelles as versatile structuring agents: Correlation between the physical chemistry of electrostatic complexation and the properties of porous mesostructured materials

Polyion Complex (PIC) or Complex Coacervate Core (C3M) Micelles [1] have been used as structuring agents to template ordered mesostuctured porous silica materials [2]. PIC micelles assemble by electrostatic complexation of oppositely charged polyelectrolytes, one of them being a double hydrophilic block copolymer (DHBC). Compared to classical structuring agents obtained from amphiphilic molecules, PIC micelles offer several advantages: first, they can be recovered and reused in several mesoporous material synthesis cycles [2]. Secondly, they allow single step preparation of drug loaded porous materials [3]. Finally, tuning the characteristics of the porous material does no longer require the synthesis of new structuring agents: they can be adjusted by playing with the physico-chemical conditions, using a unique polyelectrolyte system. The present work aims at correlating the characteristics of the porous materials and the physico-chemical properties of the PIC micelles.Mesostructured materials have been prepared by condensation of TEOS in the presence of PIC micelles of polyethylene oxide-b-poly(acrylic acid) (POE-b-PAA) copolymer complexed with neomycin (NM) or oligochitosan (OC). TEM, sorption measurements and X-ray diffraction have shown that varying structures and pore sizes can be achieved by simply varying concentration and pH. On the other hand, using osmometry, specific ion potentiometry, elemental analysis and small angle X-ray scattering, the associative phase separation of poly(acrylic acid) in the presence of neomycin has been studied as a model system for the core of the PIC micelles.The hybrid materials obtained right after drying (without calcination) are porous. This is related to the high degree of swelling of the core of the PIC micelles that contains at least 50% of water in weight. The water content in the micelles varies with concentration because it is determined by osmotic equilibrium between the core and the suspending solution. This translates into variation of porous volume and allows fine tuning of the pore size in the hybrid material. These features are preserved after calcination. Finally, the pH of material synthesis has been shown to determine the drug loading: neomycin concentration in the hybrid porous material increases as pH increases.In conclusion, PIC micelles offer numerous advantages and opportunities in the domain of functional ordered mesostructured materials due to the sensitivity of their characteristics to physico-chemical parameters, allowing the reversibility of their assembling in water, the possible delivery of functional molecules and the possibility to control the swelling of PIC micelles core.References: [1] Voets, I. K.; de Keizer, A.; Stuart, M. A. C. Adv. Colloid Interface Sci., 2009, 147-48, 300-318.[2] Baccile, N.; Reboul, J.; Blanc, B.; Coq, B.; Lacroix-Desmazes, P.; In, M.; Gerardin, C. Angew. Chem. Int. Ed., 2008. 47(44), 8433-8437.[3] Molina, E.; Warnant, J.; Mathonnat, M.; Bathfield, M.; In, M.; Laurencin, D.; Jérôme, C.; Lacroix Desmazes, P.; Marcotte, N.; Gérardin, C. Langmuir, 2015. 31, 12839-12844