Observation of a maternal transmission of scrapie in sheep

A pregnant ewe with suspected scrapie was referred to the Regional Veterinary Laboratory in Limoges on 11 January 2002, in compliance with the French scrapie eradication program. Western Blot confirmed the diagnosis of scrapie. Ten days later, the ewe gave birth. As we had to help the ewe, we were able to isolate the ewe lamb before she had any contact with her mother, and especially no colostrum. The ewe lamb was fed with milk replacers and isolated to prevent all possibility of horizontal transmission of scrapie. In August 2002, the first symptoms of scrapie appeared in the ewe lamb. Euthanasia was decided on 18 December 2002, as the animal was no longer able to stand. Western Blot and immunohistochemistry tests confirmed natural scrapie in the ewe lamb. PrP genotyping of this lamb was ARQ/VRQ. This first confirmed case of maternal transmission of scrapie in sheep is associated with a particularly short incubation time (6 months) in natural conditions.Dans le cadre du programme d'éradication de la tremblante en France, nous avons reçu une brebis gestante suspecte de tremblante le 11 janvier 2002, au laboratoire vétérinaire départemental de Limoges (confirmée ultérieurement par un Western Blot). Dix jours plus tard, la brebis agnela avec difficulté et nous avons dû intervenir pour l'aider. Cette assistance à l'agnelage nous permit d'isoler immédiatement le nouveau-né, en évitant tout contact ultérieur avec sa mère, en particulier sans la possibilité d'absorber le colostrum. L'agnelle fut placée dans un endroit isolé sans qu'il n'y ait de possibilité de transmission horizontale de la tremblante et fut nourrie avec des lactoremplaceurs. En août 2002, les premiers symptômes de la tremblante sont apparus chez l'agnelle née de cette brebis. Du fait d'une évolution vers le décubitus, l'euthanasie de l'agnelle fut décidée le 18 décembre 2002. La confirmation d'une tremblante naturelle chez l'agnelle a été obtenue par le Western-Blot et les examens immunohistochimiques. Le génotype de l'agnelle était ARQ/VRQ. Cette première confirmation d'une transmission maternelle de la tremblante chez le mouton s'accompagne aussi d'un temps d'incubation particulièrement court (6 mois) dans les conditions naturelles

Emplacement of inflated Pāhoehoe flows in the Naude’s Nek Pass, Lesotho remnant, Karoo continental flood basalt province: use of flow-lobe tumuli in understanding flood basalt emplacement

Physical volcanological features are presented for a 710-m-thick section, of the Naude’s Nek Pass, within the lower part of the Lesotho remnant of the Karoo Large Igneous Province. The section consists of inflated pāhoehoe lava with thin, impersistent sedimentary interbeds towards the base. There are seven discreet packages of compound and hummocky pāhoehoe lobes containing flow-lobe tumuli, making up approximately 50% of the section. Approximately 45% of the sequence consists of 14 sheet lobes, between 10 and 52-m-thick. The majority of the sheet lobes are in two packages indicating prolonged periods of lava supply capable of producing thick sheet lobes. The other sheet lobes are as individual lobes or pairs, within compound flows, suggesting brief increases in lava supply rate. We suggest, contrary to current belief, that there is no evidence that compound flows are proximal to source and sheet lobes (simple flows) are distal to source and we propose that the presence of flow-lobe tumuli in compound flows could be an indicator that a flow is distal to source. We use detailed, previously published, studies of the Thakurvadi Formation (Deccan Traps) as an example. We show that the length of a lobe and therefore the sections that are ‘medial or distal to source’ are specific to each individual lobe and are dependent on the lava supply of each eruptive event, and as such flow lobe tumuli can be used as an indicator of relative distance from source

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Cancer du pénis: A propos de 6 cas avec Revue de la littérature

Objectif: Le but de notre travail était de rapporter l’état des lieux du cancer du pénis dans le service d'urologie au CHU de Rabat et d’évaluer les résultats à long terme du traitement chirurgical de ce cancer. Patients et méthodes: Entre 1989 et 2009 : 6 patients ont été traités pour cancer du pénis. Les 6 cas ont été revus rétrospectivement, et les données suivantes ont été relevées : mode de révélation, siège, bilan d'extension, stade TNM, traitement, évolution et survie. Résultats: L’âge moyen des patients était de 60.5 ans (48 - 81 ans). Tous les patients avaient des carcinomes épidermoïdes de la verge. Trois patients ont eu une amputation partielle du pénis, et deux patients ont subi une amputation totale. La taille médiane de la lésion était 4.4 cm (1.5-8 cm). Toutes les tumeurs avaient un siège distal (gland- Sillon balano-préputial), 4 étaient localisés et non invasives (PT1 – PT2) et 2 avaient infiltré l'urètre (PT3). Deux patients ont présenté une localisation ganglionnaire (N2 et N1). Un seul curage ganglionnaire bilatéral a été réalisé et s'est avéré positif d'un seul côté, avec un ganglion < 3 cm, et absence de dépassement capsulaire. Deux patients ont été adressés pour chimiothérapie, l'un à visée néo-adjuvante à base de (Bléomycine - Méthotréxate-Cisplatine) l'autre dans un objectif palliatif. La médiane de suivi était de 33 mois (6 -72mois). Deux patients sont décédés dont un qui s’était présenté d'emblée avec un mode métastatique et l'autre suite à une décompensation cardio-vasculaire. Quatre patients étaient vivants aux dernières nouvelles sans récidive locale ni ganglionnaire. Conclusion: Le cancer du pénis semble rare au Maroc si l'on se réfère au faible nombre pris en charge au sein de notre CHU. Son pronostic carcinologique et fonctionnel (sexuel et urinaire) dépend de la précocité de la prise en charge. La chirurgie d'exérèse avec curage ganglionnaire reste le traitement de référence

L\'uretrorraphie termino-terminale tardive dans la rupture post-traumatique de l\'uretre posterieur

Objectif: Analyser les résultats à long terme du traitement des ruptures post-traumatiques de l\'urètre postérieur par urétrorraphie termino-terminale tardive, et apprécier l\'efficacité et le bénéfice de cette technique. Patients et Méthodes: Entre Février 1989 et Février 2004, quinze patients ont subi une urétrorraphie termino-terminale tardive pour rupture post-traumatique de l\'urètre postérieur. L\'analyse des résultats a pris en considération la qualité de la miction, la continence et la fonction érectile. Résultats: Avec un recul moyen de trente quatre mois (12 à 72 mois), les 15 patients ayant bénéficié d\'une urétrorraphie termino-terminale tardive sont continents et urinent avec un jet satisfaisant. Chez 5 patients (33.3%) ce résultat était obtenu au prix d\'une urétrotomie interne. Seuls 4 patients (26.7%) ont rapporté des troubles de l\'érection. Conclusion: L\'urétrorraphie termino-termi-nale tardive demeure le \"gold standard\" dans le traitement de la rupture post-traumatique de l\'urètre postérieur. Cette technique, comparée aux autres méthodes de traitement de la sténose post traumatique de l\'urètre, permet d\'obtenir un succès durable avec peu de complications. Mots clés: urètre postérieur, rupture traumatique, fracture du bassin, urétroraphie Delayed End-to-End Anastomotic Repair of Post-Traumatic Posterior Urethral Rupture Objective: To analyse the long-term results of the treatment of post-traumatic posterior urethral rupture by delayed bulboprostatic anastomotic repair and to evaluate the efficacy and advantages of this technique. Patients and Methods: Between February 1989 and February 2004, 15 patients underwent delayed bulboprostatic anastomotic repair of post-traumatic posterior urethral ruptures. The results were evaluated taking into account the quality of micturition, continence and erectile function. Results: After an average follow-up period of 34 months (range: 12 – 72 months), all our 15 patients were continent and voided with a satisfactory flow. To achieve this result, 5 patients (33.3%) had to undergo internal ureterotomy. Only 4 patients (26.7%) reported erectile problems. Conclusion: Delayed bulboprostatic anastomotic repair remains the \"gold standard\" in the treatment of post-traumatic posterior urethral rupture. Compared to other methods of treatment of post-traumatic stenosis of the ureter, this technique allows for a long-term success with minimal complications. African Journal of Urology Vol.11(2) 2005: 95-10

Case Report: L\'uretère rétro-cave. A propos de deux cas

No abstract available African Journal of Urology Vol.11(1) 2005: 69-7