Antiretroviral-naive and -treated HIV-1 patients can harbour more resistant viruses in CSF than in plasma

Objectives The neurological disorders in HIV-1-infected patients remain prevalent. The HIV-1 resistance in plasma and CSF was compared in patients with neurological disorders in a multicentre study. Methods Blood and CSF samples were collected at time of neurological disorders for 244 patients. The viral loads were >50 copies/mL in both compartments and bulk genotypic tests were realized. Results On 244 patients, 89 and 155 were antiretroviral (ARV) naive and ARV treated, respectively. In ARV-naive patients, detection of mutations in CSF and not in plasma were reported for the reverse transcriptase (RT) gene in 2/89 patients (2.2%) and for the protease gene in 1/89 patients (1.1%). In ARV-treated patients, 19/152 (12.5%) patients had HIV-1 mutations only in the CSF for the RT gene and 30/151 (19.8%) for the protease gene. Two mutations appeared statistically more prevalent in the CSF than in plasma: M41L (P = 0.0455) and T215Y (P = 0.0455). Conclusions In most cases, resistance mutations were present and similar in both studied compartments. However, in 3.4% of ARV-naive and 8.8% of ARV-treated patients, the virus was more resistant in CSF than in plasma. These results support the need for genotypic resistance testing when lumbar puncture is performe

A 1-Year Prospective French Nationwide Study of Emergency Hospital Admissions in Children and Adults with Primary Immunodeficiency.

PURPOSE: Patients with primary immunodeficiency (PID) are at risk of serious complications. However, data on the incidence and causes of emergency hospital admissions are scarce. The primary objective of the present study was to describe emergency hospital admissions among patients with PID, with a view to identifying "at-risk" patient profiles. METHODS: We performed a prospective observational 12-month multicenter study in France via the CEREDIH network of regional PID reference centers from November 2010 to October 2011. All patients with PIDs requiring emergency hospital admission were included. RESULTS: A total of 200 admissions concerned 137 patients (73 adults and 64 children, 53% of whom had antibody deficiencies). Thirty admissions were reported for 16 hematopoietic stem cell transplantation recipients. When considering the 170 admissions of non-transplant patients, 149 (85%) were related to acute infections (respiratory tract infections and gastrointestinal tract infections in 72 (36%) and 34 (17%) of cases, respectively). Seventy-seven percent of the admissions occurred during winter or spring (December to May). The in-hospital mortality rate was 8.8% (12 patients); death was related to a severe infection in 11 cases (8%) and Epstein-Barr virus-induced lymphoma in 1 case. Patients with a central venous catheter (n = 19, 13.9%) were significantly more hospitalized for an infection (94.7%) than for a non-infectious reason (5.3%) (p = 0.04). CONCLUSION: Our data showed that the annual incidence of emergency hospital admission among patients with PID is 3.4%. The leading cause of emergency hospital admission was an acute infection, and having a central venous catheter was associated with a significantly greater risk of admission for an infectious episode

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

Les nouvelles opportunités de l'ouverture internationale : la montée en puissance des pays émergents

International audienc

Le controle antidopage chez le cheval

National audienc

Les nouvelles opportunités de l'ouverture internationale : la montée en puissance des pays émergents

International audienc

MODÉLISATION : DE LA PHYSIQUE AU TRAITEMENT DU SIGNAL Modèles vibratoires dans les remontées mécaniques

International audienceLes remontées mécaniques, au même titre que l'aéronautique, ont un fort besoin de modélisation. À l'aide du traitement du signal, nous avons pu modéliser certains des phénomènes vibratoires apparaissant dans ces installations : passages de pylônes et entrées/sorties de gare des appareils débrayables

The Jahn-Teller theory of Mn3+ : Al2O3

Following the recent publication of infra-red measurements on crystals of Al2O3 containing Mn3+ ions, a detailed theoretical analysis of the system has been undertaken. From these results and our earlier APR measurements, it is shown by computer analysis that all the data for this 5E ion can be satisfactorily explained by a multimode lattice model of the Jahn-Teller effect. The values q = 0.50, r = 0.70 and p finite are found for the Jahn-Teller reduction factors, so that (2 q — p) is less than unity.Une étude expérimentale des ions Mn3+ par spectroscopie infrarouge (Aurbach et Richard) dans Al2O3 vient d'être publiée. Nous présentons ici une analyse théorique détaillée de ces résultats, ainsi que de ceux que nous avions obtenus en résonance paramagnétique acoustique. Nous montrons que tous les résultats expérimentaux connus à ce jour sur l'ion Mn3+ sont expliqués de manière satisfaisante à l'aide d'un effet Jahn-Teller sur l'ion dont le fondamental est un 5E. On obtient ainsi les paramètres de réduction Jahn-Teller q = 0,50, r = 0,70. p est différent de zéro, mais ne peut être déterminé. Ces résultats sont tels que 2 q - p < 1, et donc que le modèle de Cluster n'est pas valable