Pseudo-méningite inaugurale révélatrice d’une chondrocalcinose articulaire

Le syndrome de la dent couronnée (SDC) est une étiologie peu connue des cervicalgies aiguës. Il est lié le plus souvent à la chondrocalcinose articulaire (CCA), dont il constitue une des localisations atypiques. L'expression clinique du SDC, à type de cervicalgies fébriles, pose en pratique courante, la problématique d'étiologies diverses dont en particulier les infections  susceptibles d'égarer le diagnostic. Nous rapportons un cas de SDC révélé par un tableau de pseudo-méningite

Opportunistic infections in immunosuppressed patients with juvenile idiopathic arthritis: analysis by the Pharmachild Safety Adjudication Committee

Background To derive a list of opportunistic infections (OI) through the analysis of the juvenile idiopathic arthritis (JIA) patients in the Pharmachild registry by an independent Safety Adjudication Committee (SAC). Methods The SAC (3 pediatric rheumatologists and 2 pediatric infectious disease specialists) elaborated and approved by consensus a provisional list of OI for use in JIA. Through a 5 step-procedure, all the severe and serious infections, classified as per MedDRA dictionary and retrieved in the Pharmachild registry, were evaluated by the SAC by answering six questions and adjudicated with the agreement of 3/5 specialists. A final evidence-based list of OI resulted by matching the adjudicated infections with the provisional list of OI. Results A total of 772 infectious events in 572 eligible patients, of which 335 serious/severe/very severe non-OI and 437 OI (any intensity/severity), according to the provisional list, were retrieved. Six hundred eighty-two of 772 (88.3%) were adjudicated as infections, of them 603/682 (88.4%) as common and 119/682 (17.4%) as OI by the SAC. Matching these 119 opportunistic events with the provisional list, 106 were confirmed by the SAC as OI, and among them infections by herpes viruses were the most frequent (68%), followed by tuberculosis (27.4%). The remaining events were divided in the groups of non-OI and possible/patient and/or pathogen-related OI. Conclusions We found a significant number of OI in JIA patients on immunosuppressive therapy. The proposed list of OI, created by consensus and validated in the Pharmachild cohort, could facilitate comparison among future pharmacovigilance studies

Challenges and Facilitating Factors in Sustaining Community-Based Participatory Research Partnerships: Lessons Learned from the Detroit, New York City and Seattle Urban Research Centers

In order to address the social, physical and economic determinants of urban health, researchers, public health practitioners, and community members have turned to more comprehensive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received considerable attention over the past decade, and numerous publications have described theoretical underpinnings, values, principles and practice. Issues related to the long-term sustainability of partnerships and activities have received limited attention. The purpose of this article is to examine the experiences and lessons learned from three Urban Research Centers (URCs) in Detroit, New York City, and Seattle, which were initially established in 1995 with core support from the Centers for Disease Control and Prevention (CDC). The experience of these Centers after core funding ceased in 2003 provides a case study to identify the challenges and facilitating factors for sustaining partnerships. We examine three broad dimensions of CBPR partnerships that we consider important for sustainability: (1) sustaining relationships and commitments among the partners involved; (2) sustaining the knowledge, capacity and values generated from the partnership; and (3) sustaining funding, staff, programs, policy changes and the partnership itself. We discuss the challenges faced by the URCs in sustaining these dimensions and the strategies used to overcome these challenges. Based on these experiences, we offer recommendations for: strategies that partnerships may find useful in sustaining their CBPR efforts; ways in which a Center mechanism can be useful for promoting sustainability; and considerations for funders of CBPR to increase sustainability

Linking surface hydrodynamics to planktonic ecosystem: the case study of the ichthyoplanktonic assemblages in the Central Mediterranean Sea

Oceanographic processes play a key role in influencing the structure of the marine planktonic ecosystems. Taking advantage of the quasi-simulta-neous collection of a large ichthyoplanktonic dataset in different regions of the Central Mediterranean Sea (Italian/Maltese, Tunisian and Libyan waters), this study aimed at the identification of the main environ-mental drivers that control the structure of the larval fish assemblages. Spatial distribution and taxa com-position were related to physical forcings (geostrophic currents and wind stress) and environmental condi-tions (bottom depth, temperature, salinity, chlorophyll-a concentration). ANOSIM and SIMPER identified contribution of fish taxa to the average Bray–Curtis dissimilarity among regions. In Italian and Libyan waters, two assemblages (neritic and oceanic) were identified, while a mixed assemblage characterized only some stations. Two neritic and one oceanic assemblages were discriminated in Tunisian waters. Random Forest classification model high-lighted the essential role of the bathymetry, while Lagrangian simulations evidenced the action of the hydrodynamics in mixing neritic and oceanic assem-blages in the Italian/Maltese and partially in Libyan waters. These findings highlighted the importance of the multidisciplinary approach and shed light on the potential value of the ichthyoplanktonic surveys for the assessment of the state of the marine ecosystem and the conservation of the fishery resources