Human pregnancy complicated by Chlamydia psittaci acquired from goat, a new zaonotic infection ?

Nous rapportons le cas d’une femme dont la grossesse s’est spontané ment interrompue à 32 semaines d’aménorrhée en raison d’une infection très sévère par Chlamydia psittaci. Cette infection est secondaire à un contact avec un troupeau de chèvres. Neuf cas d’infection materno-fœtale par Chlamydia psittaci d’origine animale sont décrits dans la littérature, il s’agit toujours d’une contamination par les brebis atteintes de chlamydiose abortive. La chèvre peut également être infectée par ce germe, mais la trans mission à la femme enceinte de la chlamydiose abortive caprine n’a pas été décrit jusqu’à présent.A case of chlamydial infection in pregnant woman is described. This infection was contracted from goat. The woman, who had contact with caprine abortion, spontaneously delivered a stillborn infant in the 32nd week of pregnancy. She developed dessiminated intravascular coagulation post partum with acute renal failure and pulmonary oedema. Nine cases of chlamydial infections in pregnant women have been reported in literature, in all cases, the infection was contracted from ewes suffering from enzootic abortion. Such an infection acquired from goat have not been previously described

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Infection materno-fœtale humaine par Chlamydia psittaci transmise par la chèvre : une nouvelle zoonose ?

Human pregnancy complicated by Chlamydia psittaci acquired from goat, a new zoonotic infection ? A case of chlamydial infection in pregnant woman is described. This infection was contracted from goat. The woman, who had contact with caprine abortion, spontaneously delivered a stillborn infant in the 32nd week of pregnancy. She developed dessiminated intravascular coagulation post partum with acute renal failure and pulmonary oedema. Nine cases of chlamydial infections in pregnant women have been reported in literature, in all cases, the infection was contracted from ewes suffering from enzootic abortion. Such an infection acquired from goat have not been previously described.Nous rapportons le cas d’une femme dont la grossesse s’est spontanément interrompue à 32 semaines d’aménorrhée en raison d’une infection très sévère par Chlamydia psittaci. Cette infection est secondaire à un contact avec un troupeau de chèvres. Neuf cas d’infection materno-fœtale par Chlamydia psittaci d’origine animale sont décrits dans la littérature, il s’agit toujours d’une contamination par les brebis atteintes de chlamydiose abortive. La chèvre peut également être infectée par ce germe, mais la transmission à la femme enceinte de la chlamydiose abortive caprine n’a pas été décrit jusqu’à présent.Bonneau Dominique, Berthier Michel, Malo Nicole, Magnin Guillaume, Bonneau Christian. Infection materno-fœtale humaine par Chlamydia psittaci transmise par la chèvre : une nouvelle zoonose ?. In: Bulletin de l'Académie Vétérinaire de France tome 144 n°3, 1991. pp. 301-307

Disease Occurrence and Risk Factors.

International audienceThe determinants of disease are usually considered under two broad headings—environmental and host factors. In the context of work-related asthma, all exposures encountered in the workplace, whether gaseous or airborne particulates of chemical or biological origin, physical stressors, or factors related to workplace organization are of interest as they are considered to be either the main cause of occupational asthma (OA). The increase in the frequency of OA among work-related lung diseases recognized by workers’ compensation boards and surveillance systems in Europe and North America occurred over a period (1970–1990). If the diagnostic procedures for occupational diseases can be standardized well with national guidelines, the data within the system can be reasonably comparable over time. Socioeconomic Status (SES), environmental, and lifestyle conditions may play an important role in asthma. SES is associated with various well-known asthma risk factors such as occupation and some lifestyle factors

An Official American Thoracic Society Workshop Report: Presentations and Discussion of the Sixth Jack Pepys Workshop on Asthma in the Workplace

The Sixth Jack Pepys Workshop on Asthma in the Workplace focused on six key themes regarding the recognition and assessment of work-related asthma and airway diseases: (1) cleaning agents and disinfectants (including in swimming pools) as irritants and sensitizers: how to evaluate types of bronchial reactions and reduce risks; (2) population-based studies of occupational obstructive diseases: use of databanks, advantages and pitfalls, what strategies to deal with biases and confounding?; (3) damp environments, dilapidated buildings, recycling processes, and molds, an increasing problem: mechanisms, how to assess causality and diagnosis; (4) diagnosis of occupational asthma and rhinitis: how useful are recombinant allergens (component-resolved diagnosis), metabolomics, and other new tests?; (5) how does exposure to gas, dust, and fumes enhance sensitization and asthma?; and (6) how to determine probability of occupational causality in chronic obstructive pulmonary disease: epidemiological and clinical, confirmation, and compensation aspects. A summary of the presentations and discussion is provided in this proceedings document. Increased knowledge has been gained in each topic over the past few years, but there remain aspects of controversy and uncertainty requiring further research

An Official American Thoracic Society Workshop Report: Presentations and Discussion of the Sixth Jack Pepys Workshop on Asthma in the Workplace

The Sixth Jack Pepys Workshop on Asthma in the Workplace focused on six key themes regarding the recognition and assessment of work-related asthma and airway diseases: (1) cleaning agents and disinfectants (including in swimming pools) as irritants and sensitizers: how to evaluate types of bronchial reactions and reduce risks; (2) population-based studies of occupational obstructive diseases: use of databanks, advantages and pitfalls, what strategies to deal with biases and confounding?; (3) damp environments, dilapidated buildings, recycling processes, and molds, an increasing problem: mechanisms, how to assess causality and diagnosis; (4) diagnosis of occupational asthma and rhinitis: how useful are recombinant allergens (component-resolved diagnosis), metabolomics, and other new tests?; (5) how does exposure to gas, dust, and fumes enhance sensitization and asthma?; and (6) how to determine probability of occupational causality in chronic obstructive pulmonary disease: epidemiological and clinical, confirmation, and compensation aspects. A summary of the presentations and discussion is provided in this proceedings document. Increased knowledge has been gained in each topic over the past few years, but there remain aspects of controversy and uncertainty requiring further research