Arbovirus infections and viral haemorrhagic fevers in Uganda : a serological survey in Karamoja district, 1984

Présentation des résultats de l'enquête effectuée sur 132 habitants du district de Karamoja en Ouganda, qui ont été examinés pour la recherche d'anticorps contre certains arbovirus dont la fièvre hémorragiqu

Proposal of a Noninvasive Method to Reduce Injection-Related Bruising in Aesthetic Medicine: Transillumination

Background: Hyaluronic acid (HA) injections involve a risk of vascular complications. Transillumination (TL) is a noninvasive technique that appears to allow preliminary detection of superficial vascular structures of the face to avoid intravascular HA injection. The purpose of our study was to test the efficacy of TL in terms of its sensitivity to locate vessels in the areas undergoing treatment and to reduce post-injection vascular complications. Material and Methods: We conducted a prospective study enrolling 72 patients who consulted for HA injections to treat facial wrinkles. We used TL on one side of the face to obtain a vascular mapping of the face. The area undergoing testing was randomized for the TL technique. The primary study endpoint was sensitivity for identifying subcutaneous veins and the differences in complication rates between the side of the face where TL was used to guide the injection and the side of the face where no vascular exploration method was used. Results: TL sensitivity for locating the superficial temporal vein was 100%, 91% for the supratrochlear, supraorbital and infraorbital veins, and 95% for the dorsal nasal veins (p < 0.01). The complication rate was higher on the side of the face where no vascular exploration method was used (22.2% vs 2.7%; p = 0.010046). Conclusions: Our preliminary findings validate our hypothesis concerning the advantage of using TL to identify superficial veins before performing injections. This method is simple and affordable, and the learning curve is small. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

Synergy of the antibiotic colistin with echinocandin antifungals in Candida species.

International audienceOBJECTIVES: Candida albicans is the most prevalent fungal pathogen of humans, causing a wide range of infections from harmless superficial to severe systemic infections. Improvement of the antifungal arsenal is needed since existing antifungals can be associated with limited efficacy, toxicity and antifungal resistance. Here we aimed to identify compounds that act synergistically with echinocandin antifungals and that could contribute to a faster reduction of the fungal burden. METHODS: A total of 38 758 compounds were tested for their ability to act synergistically with aminocandin, a β-1,3-glucan synthase inhibitor of the echinocandin family of antifungals. The synergy between echinocandins and an identified hit was studied with chemogenomic screens and testing of individual Saccharomyces cerevisiae and C. albicans mutant strains. RESULTS: We found that colistin, an antibiotic that targets membranes in Gram-negative bacteria, is synergistic with drugs of the echinocandin family against all Candida species tested. The combination of colistin and aminocandin led to faster and increased permeabilization of C. albicans cells than either colistin or aminocandin alone. Echinocandin susceptibility was a prerequisite to be able to observe the synergy. A large-scale screen for genes involved in natural resistance of yeast cells to low doses of the drugs, alone or in combination, identified efficient sphingolipid and chitin biosynthesis as necessary to protect S. cerevisiae and C. albicans cells against the antifungal combination. CONCLUSIONS: These results suggest that echinocandin-mediated weakening of the cell wall facilitates colistin targeting of fungal membranes, which in turn reinforces the antifungal activity of echinocandins

Evaluation de la santé et de l hygiène de vie (sport, alimentation et poids, sommeil, activités de temps libre) de la population de MED 3 des facultés de médecine du Nord-Pas-de-Calais en septembre 2013

Contexte Plusieurs études ont décrit une dégradation de l état de santé des étudiants. Peu ont ciblé les étudiants en médecine, futurs acteurs de santé. Cette étude, séparée en deux parties, décrivait l attitude des étudiants en médecine du Nord Pas de Calais vis-à-vis de leur santé et hygiène de vie (sport, alimentation, poids, sommeil et activités de temps libre). Méthode L étude incluait les étudiants en médecine de MED-3 du Nord Pas de Calais à la rentrée 2013 soit 609 étudiants. Un questionnaire anonyme LimeSurvey® auto-administré (items sociodémographiques, sur le rapport aux soins, la santé et les comportements à risque) était diffusé via internet à 3 reprises, entre Septembre et Novembre 2013. Résultats 79% (483) des étudiants ont participé à l étude. 40% (191) des étudiants consultaient leur médecin traitant rarement à jamais, et seuls 25% (121) n avaient pas consulté de spécialistes non généralistes depuis le début des études. Les hommes semblaient consulter moins fréquemment le médecin traitant (54% (104) contre 32% (92) p<0,0001) et les spécialistes non généralistes (75% (91) contre 29% (105) p<0,0001). 85% (409) des étudiants se déclaraient en excellente santé cependant 83% (400) trouvaient les études stressantes.13% (62) des étudiants avaient déjà renoncé à des soins et trouvaient plus souvent l accès au soin difficile (29% (18) contre 6% (26) p<0,0001), provenaient majoritairement de Lille 2 (94% (58) contre 82% (345) p=0,0218) et se situaient loin du médecin traitant (53% (33) contre 35% (145) p=0,0053). Il existait une diminution de la pratique sportive depuis le début des études (p<0,001) et une aggravation du déséquilibre alimentaire pour 38% (183) des étudiants. 63% (303) des MED-3 ont présenté une variation de poids et 80% (384) ont modifié leur temps de sommeil. 3% (13) des étudiants n avaient aucune activité de temps libre. Une analyse par cluster d hygiène de vie retrouvait une bonne hygiène de vie pour 61% (294) des étudiants. Le groupe avec mauvaise hygiène de vie révélait une majorité d étudiants de l Institut Catholique de Lille (22% (41) contre 13% (38) p=0,0102) et d étudiants stressés par les études (89% (167) contre 79% (232) p=0,0049). Un modèle prédictif de risque de mauvaise hygiène de vie n a pas pu être défini (taux d erreur 42%). Conclusion Les étudiants en médecine étaient globalement en bonne santé avec quelques nuances concordant avec leur statut d étudiant et de précarité socio-économique.LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion

In April 2005, an outbreak of Chikungunya fever occurred on the island of Réunion in the Indian Ocean. During winter 2005, six patients developed meningoencephalitis and acute hepatitis due to Chikungunya virus. Our objectives were to determine the incidence and mortality of atypical Chikungunya viral infections and to identify risk factors for severe disease. A hospital-based surveillance system was established to collect data on atypical Chikungunya cases. Case reports, medical records and laboratory results were reviewed and analysed. We defined an atypical case as one in which a patient with laboratory-confirmed Chikungunya virus infection developed symptoms other than fever and arthralgia. We defined a severe atypical case as one which required maintenance of at least one vital function. We recorded 610 atypical cases of Chikungunya fever: 222 were severe cases, 65 affected patients died. Five hundred and forty-six cases had underlying medical conditions (of which 226 suffered from cardiovascular, 147 from neurological and 150 from respiratory disorders). Clinical features that had never been associated with Chikungunya fever were recorded, such as bullous dermatosis, pneumonia, and diabetes mellitus. Hypertension, and underlying respiratory or cardiological conditions were independent risk factors for disease severity. The overall mortality rate was 10·6% and it increased with age. This is the first time that severe cases and deaths due to Chikungunya fever have been documented. The information presented in this article may assist clinicians in identifying the disease, selecting the treatment strategy, and anticipating the course of illness

Épidémiologie de terrain. Sept études de cas

2e éditionNational audienceDepuis plus de trente ans, le cours international d’épidémiologie appliquée (IDEA) forme les futurs cadres de la santé publique à l’épidémiologie de terrain. Sa renommée doit beaucoup aux nombreuses études de cas originales développées, testées et enrichies au fil des années. Fruits de l’expérience de professionnels de l’épidémiologie issus d’horizons divers, elles ont fait découvrir les multiples facettes de la pratique de l’épidémiologie à des générations d’épidémiologistes.Les sept études de cas présentées ici sont toutes fondées sur des faits réels. Elles traitent de problématiques variées, de l’investigation de toxi-infections alimentaires à l’émergence de nouveaux pathogènes tels que le SRAS, en passant par le dépistage de la toxoplasmose chez la femme enceinte.L’ouvrage est conçu comme un manuel en deux parties. La première rassemble les énoncés des études de cas, assortis de questions destinées à guider les étudiants dans la démarche de résolution de problèmes. La seconde fournit des réponses détaillées à ces questions, des compléments d’information et des commentaires pédagogiques

Surpoids et obésité chez les élèves de sixième scolarisés dans les collèges publics du département de la Haute-Savoie, septembre 2003

info:eu-repo/semantics/publishe

Differences and Commonalities of National Field Epidemiology Training Programmes in Europe

From 1994 to 2009, national field epidemiology training programmes (FETP) have been installed in Spain, Germany, Italy, France and Norway. During their two year duration, different components of the FETP are devised as follows: 63-79 weeks are spent on projects in hosting institutes, 2-26 weeks in outside projects, 9-30 weeks in courses and modules, and 1-2 weeks in scientific conferences. A considerable proportion of the Spanish FETP has is provided conventional class room training . The content of the modules is very similar for all programmes. Except from the Italian programme, all focus on infectious disease epidemiology. The German and Norwegian programmes are so called EPIET-associated programmesas their participants are integrated in the modules and the supervision offered by EPIET, but salaries, facilitators, and training sites are provided by the national programme. These EPIET-associated programmes require strong communications skills in English. Alumni of all five FETP are generally working within the public health work force in their respective countries or at international level, many of them in leading functions. Although three new FETP have been installed since the last published Euroroundup in Eurosurveillance on European FETP in 2001, the progress with respect to the establishment of national FETP or EPIET-associated programmes has been slow. Member States should be aware of how much support EPIET can offer for the establishment of national FETP or EPIET-associated programmes. However, they also need to be ready to provide the necessary resources, the administrative environment and long-term dedication to make field epidemiology training work