111 research outputs found

    Novel Virus Influenza A (H1N1sw) in South-Eastern France, April-August 2009

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    BACKGROUND: In April 2009, the first cases of pandemic (H1N1)-2009 influenza [H1N1sw] virus were detected in France. Virological surveillance was undertaken in reference laboratories of the seven French Defence Zones. METHODOLOGY/PRINCIPAL FINDINGS: We report results of virological analyses performed in the Public Hospitals of Marseille during the first months of the outbreak. (i) Nasal swabs were tested using rapid influenza diagnostic test (RIDT) and two RT-PCR assays. Epidemiological characteristics of the 99 first suspected cases were analyzed, including detection of influenza virus and 18 other respiratory viruses. During three months, a total of 1,815 patients were tested (including 236 patients infected H1N1sw virus) and distribution in age groups and results of RIDT were analyzed. (ii) 600 sera received before April 2009 and randomly selected from in-patients were tested by a standard hemagglutination inhibition assay for antibody to the novel H1N1sw virus. (iii) One early (May 2009) and one late (July 2009) viral isolates were characterized by sequencing the complete hemagglutinine and neuraminidase genes. (iiii) Epidemiological characteristics of a cluster of cases that occurred in July 2009 in a summer camp were analyzed. CONCLUSIONS/SIGNIFICANCE: This study presents new virological and epidemiological data regarding infection by the pandemic A/H1N1 virus in Europe. Distribution in age groups was found to be similar to that previously reported for seasonal H1N1. The first seroprevalence data made available for a European population suggest a previous exposure of individuals over 40 years old to influenza viruses antigenically related to the pandemic (H1N1)-2009 virus. Genomic analysis indicates that strains harbouring a new amino-acid pattern in the neuraminidase gene appeared secondarily and tended to supplant the first strains. Finally, in contrast with previous reports, our data support the use of RIDT for the detection of infection in children, especially in the context of the investigation of grouped cases

    Determinants of compliance with anti-vectorial protective measures among non-immune travellers during missions to tropical Africa

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    International audienceThe effectiveness of anti-vectorial malaria protective measures in travellers and expatriates is hampered by incorrect compliance. The objective of the present study was to identify the determinants of compliance with anti-vectorial protective measures (AVPMs) in this population that is particularly at risk because of their lack of immunity

    COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

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    Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≀ 18 years: 69, 48, 23; 85%), older adults (≄ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

    Methods for handling missing data in epidemiology : application in oncology

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    La problĂ©matique de la gestion des donnĂ©es manquantes dans les Ă©tudes Ă©pidĂ©miologiques est un sujet qui intĂ©ressera tous les chercheurs impliquĂ©s dans l’analyse des donnĂ©es recueillies et dans l’interprĂ©tation des rĂ©sultats issus de ces analyses. Et mĂȘme si la question de la gestion des donnĂ©es manquantes et de leur impact sur la validitĂ© des rĂ©sultats obtenus est souvent discutĂ©e, cesont souvent les mĂ©thodes de traitement des donnĂ©es manquantes les plus simples mais pas toujours les plus valides qui sont utilisĂ©es en pratique. L’utilisation de chacune de ces mĂ©thodes suppose un certain nombre d’hypothĂšses sous lesquelles les rĂ©sultats obtenus sont valides, mais il n’est pas toujours possible de tester ces hypothĂšses. L’objectif de ce travail Ă©tait (i) de proposer une revue des diffĂ©rentes mĂ©thodes de traitement des donnĂ©es manquantes utilisĂ©es en Ă©pidĂ©miologie en discutant les avantages et les limites de chacune de ces mĂ©thodes, (ii) de proposer une stratĂ©gie d’analyse afin d’étudier la robustesse des rĂ©sultats obtenues via les mĂ©thodes classiques de traitement des donnĂ©es manquantes Ă  l’écart aux hypothĂšses qui, bien que non testables, sont nĂ©cessaires Ă  la validitĂ© de ces rĂ©sultats, et (iii) de proposer quelques applications sur des donnĂ©es rĂ©elles des diffĂ©rents point discutĂ©s dans les deux premiĂšres parties.The issue of how to deal with missing data in epidemiological studies is a topic which concerns every researcher involved in the analysis of collected data and in the interpretation of the results produced by these analyses. And even if the issue of the handling of missing data and of their impact on the validity of the results is often discussed, simple, but not always appropriate methods to deal with missing data are commonly used. The use of each of these methods is based on some hypotheses under which the obtained results are valid, but it is not always possible to test these hypotheses. The objective of this work was (i) to propose a review of various methods to handle missing data used in the field of epidemiology, and to discuss the advantages and disadvantages of each of these methods, (ii) to propose a strategy of analysis in order to study the robustness of the results obtained via classical methods to handle missing data to the departure from hypotheses which are required for the validity of these results, although they are not testable, and (iii) to propose some applications on real data of the issues discussed in the first two sections

    Psychometric properties of a French version of a Dutch scale for assessing breast and body image (BBIS) in healthy women.

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    International audienceBACKGROUND: Genetic testing among women for BRCA1/2 mutation can have various psychological effects, such as those focusing on body image. The aim of this study was to examine the psychometric properties of a generic scale assessing breast and body image (BBIS) in healthy women tested for BRCA1/2 mutations. METHODS: A Dutch body image scale focusing on both general and breast-related body image was translated into French. It was presented to a French cohort of female cancer-free BRCA1/2 mutation carriers and non-carriers (N = 568). The psychometric properties of the scale were studied by assessing its dimensional and factorial structure, internal consistency, construct-related validity, and external validity. RESULTS: The scale was found to be a satisfactory psychometric tool for assessing both body image and breast image. The three main dimensions which emerged were classified under the headings "values attached to body image", "satisfaction with body image and perceived attractiveness", and "satisfaction with breasts". The BBIS scores were not significantly associated with the participants' socio-demographic characteristics or their BRCA1/2 mutation carrier status, but significant associations were observed between these scores and the women's medical and behavioural characteristics. CONCLUSIONS: The BBIS is a generic tool which can be used to assess body image in either affected or unaffected women. The scale will have to be administered to other populations in order to confirm its validity

    Preliminary results of synergy between norepinephrine and terlipressin during septic shock

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    The hidden side of oral thrombin inhibitors

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