Effet de la coccidiose sur certaines composantes sanguines chez la chèvre

L'étude hématologique chez les chèvres atteintes de coccidiose montre un net abaissement du taux des érythrocytes et du volume de l'hémoglobine, également suivi d'un accroissement tant de l'hématocrite que du volume corpusculaire moyen des globules rouges. Il existe une nette éosinophilie avec une augmentation importante des éosinophiles et une augmentation moins marquée des lymphocytes et des monocytes. L'étude des protéines sériques montre leur accroissement tant dans le sérum que dans sa fraction albumine qui se maintient à un niveau constant à partir du deuxième jour après l'infection jusqu'à la fin des observations. L'analyse des composants minéraux du sérum a montré une augmentation considérable du potassium, avec abaissements sensibles des taux de sodium et de phosphore, probablement dus à la déshydratation ainsi qu'à l'inaptitude de l'épithélium intestinal à absorber ces minéraux à la suite de lésions locales dues à la présence de mérozoïtes coccidien

Small-Molecule Protein-Protein Interaction Inhibitor of Oncogenic Rho Signaling

Uncontrolled activation of Rho signaling by RhoGEFs, in particular AKAP13 (Lbc) and its close homologs, is implicated in a number of human tumors with poor prognosis and resistance to therapy. Structure predictions and alanine scanning mutagenesis of Lbc identified a circumscribed hot region for RhoA recognition and activation. Virtual screening targeting that region led to the discovery of an inhibitor of Lbc-RhoA interaction inside cells. By interacting with the DH domain, the compound inhibits the catalytic activity of Lbc, halts cellular responses to activation of oncogenic Lbc pathways, and reverses a number of prostate cancer cell phenotypes such as proliferation, migration, and invasiveness. This study provides insights into the structural determinants of Lbc-RhoA recognition. This is a successful example of structure-based discovery of a small protein-protein interaction inhibitor able to halt oncogenic Rho signaling in cancer cells with therapeutic implications

Comparison between the BACTEC MGIT 960 system and the agar proportion method for susceptibility testing of multidrug resistant tuberculosis strains in a high burden setting of South Africa

BACKGROUND: The increasing problem of multi-drug-resistant (MDR) tuberculosis (TB) [ie resistant to at least isoniazid (INH) and rifampicin (RIF)] is becoming a global problem. Successful treatment outcome for MDR-TB depends on reliable and accurate drug susceptibility testing of first-line and second-line anti-TB drugs. METHOD: Consecutive M. tuberculosis isolates identified as MDR-TB during August 2007 to January 2008 using the BACTEC MGIT 960 systems and the agar proportion method were included in this study. Susceptibility testing of MDR-TB isolates against ethambutol (EMB) and streptomycin (STR) as well as two second-line anti-TB drugs, kanamycin (KAN) and ofloxacin (OFX) was performed using the BACTEC MGIT 960 systems at a routine diagnostic laboratory. The results were compared to those obtained by the agar proportion method. RESULT: The agreement between the BACTEC MGIT 960 system and the agar proportion method was 44% for EMB, 61% for STR and 89% for both KAN and OFX. The sensitivity and specificity of the BACTEC MGIT 960 system using the agar proportion method as a gold standard was 92% and 37% for EMB, 95% and 37% for STR, 27% and 97% for KAN and 84% and 90% for OFX, respectively. CONCLUSIONS: The BACTEC MGIT 960 system showed acceptable sensitivity for EMB, STR, and OFX; however, the BACTEC MGIT 960 system was less specific for EMB and STR and demonstrated a low sensitivity for KAN. The lower agreement found between the two methods suggests the unreliability of the BACTEC MGIT 960 system for the drugs tested. The reasons for the lower agreement between the two methods need to be investigated and further studies are needed in this setting to confirm the study finding.The project was supported by a grant from the NHLS.http://www.biomedcentral.com/1471-2334/12/369am2013ay201

Molecular characterization and second-line antituberculosis drug resistance patterns of multidrug-resistant mycobacterium tuberculosis isolates from the Northern Region of South Africa

Despite South Africa being one of the high-burden multidrug-resistant tuberculosis (MDR-TB) countries, information regarding the population structure of drug-resistant Mycobacterium tuberculosis strains is limited from many regions of South Africa. This study investigated the population structure and transmission patterns of drug-resistant M. tuberculosis isolates in a highburden setting of South Africa as well as the possible association of genotypes with drug resistance and demographic characteristics. A total of 336 consecutive MDR-TB isolates from four provinces of South Africa were genotyped using spoligotyping and mycobacterial interspersed repetitive-unit–variable number tandem repeat (MIRU-VNTR) typing. Drug susceptibility testing for ofloxacin, kanamycin, and capreomycin was performed using the agar proportion method. The results showed that 4.8% of MDR-TB isolates were resistant to ofloxacin, 2.7% were resistant to kanamycin, and 4.5% were resistant to capreomycin, while 7.1% were extensively drug resistant (XDR), and the remaining 83.6% were susceptible to all of the second-line drugs tested. Spoligotyping grouped 90.8% of the isolates into 25 clusters, while 9.2% isolates were unclustered. Ninety-one percent of the 336 isolates were assigned to 21 previously described shared types, with the Beijing family being the predominant genotype in the North-West and Limpopo Provinces, while the EAI1_SOM family was the predominant genotype in the Gauteng and Mpumalanga Provinces. No association was found between genotypes and specific drug resistance patterns or demographic information. The high level of diversity and the geographical distribution of the drug-resistant M. tuberculosis isolates in this study suggest that the transmission of TB in the study settings is not caused by the clonal spread of a specific M. tuberculosis strain.http://jcm.asm.org/am2013ay201

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Kvinnors upplevelser efter genomgången mastektomi : En litteraturöversikt av hur kvinnor erfar vardagslivet efter ett mastektomi ingrepp

Bröstcancer är den vanligaste cancerformen som drabbar kvinnor världen över och orsakar mest dödsfall. Mastektomi är den vanligaste ingreppet och en del i behandlingen i samband med bröstcancer. Att genomgå en mastektomi kan medföra både fysiska och psykosociala besvär, vilket leder till omställning i livet på olika sätt. Syftet med litteraturöversikten är att beskriva hur livet erfars av kvinnor efter mastektomi, ett till tio år efter ingreppet. I metoden används Fribergs (2017) modell för att utforma en litteraturöversikt. Totalt tio artiklar som består utav tre kvantitativa och sju kvalitativa användes i resultatet. Resultatet belyser kvinnors upplevelser av vardagslivet efter mastektomi ingreppet. Det visar att mastektomin leder till att de måste göra omorientering av sitt liv för att kunna hantera situationen. Mastektomin leder även till att kvinnorna upplever en förändrad självbild, vilket som konsekvens kan medföra negativa känslor och isolering. Två huvudkategorier identifierades: “en förändrad kropp” och “omorientering av livet”. Utifrån huvudkategorierna utformades sammanlagt sju underkategorier, upplevelsen av förändrad självbild, upplevelser av egna sexualiteten, upplevelser av partnerskap och sexualitet, utmaningar i vardagslivet, utmaningar i arbetslivet, utmaningar existentiellt samt närståendes betydelse. Slutsatserna belyser att god bemötande av mastektomerade kvinnor är viktigt för att bemöta varje kvinnas individuella behov. Det är betydelsefullt i vårdandet av patienter som tidigare i livet genomgått en mastektomi, att bemöta dem med lyhördhet och öppenhet gentemot deras berättelser i kontakt med hälso- och sjukvården. Detta kan leda till att god relation skapas med dessa kvinnor för att minimera oro och lidande

Metformin Therapy and Breast Cancer Incidence in the Ha&rsquo;il Region

Background: Metformin is a drug used to treat patients with type 2 diabetes, especially those who suffer from obesity. It is also used in the treatment of women with polycystic ovary syndrome (PCOS). This disease is related to insulin resistance and multiplied blood sugar ranges. Furthermore, it has been established that the use of metformin improves the menstrual cycles and ovulation rates of these women. Methods: A structured questionnaire was conducted to determine the prevalence of breast cancer among women using metformin in the Ha&rsquo;il region. Result: The incidence of breast cancer among women using metformin in the Ha&rsquo;il region is very low. Thus, it can be said that breast cancer cases declined among diabetics taking metformin. This means that metformin use is associated with a lower risk of breast cancer in women with type 2 diabetes, even in cases where these women have a family history of breast cancer. Conclusions: According to previous findings, metformin has been linked to lower breast cancer risk in women with type 2 diabetes. Furthermore, the findings of this study corroborate the literature on this subject by indicating that there is a substantial connection between metformin use and a lower risk of breast cancer in women with type 2 diabetes. However, further in vitro and in vivo experiments are crucial to investigate the protective effect of metformin against breast cancer and to confirm our findings

Evaluation of the GenoType (R) MTBDRsl assay for susceptibility testing of second-line anti-tuberculosis drugs

BACKGROUND: The GenoType® MTBDRsl assay (Hains, Lifesciences, Germany) is a new rapid assay for detection of resistance to second-line anti-tuberculosis drugs. METHOD: The MTBDRsl assay was evaluated on 342 MDR-TB isolates for ofloxacin (OFX), kanamycin (KAN), capreomycin (CAP) and ethambutol (EMB) resistance and results were compared to the agar proportion method. Discrepant results were tested by DNA sequencing. RESULT: The sensitivity and specificity of MTBDRsl assay was 70.3% and 97.7% for OFX, 25.0% and 98.7% for KAN, 21.2% and 98.7% for CAP and 56.3% and 56.0% for EMB, respectively. DNA sequencing identified mutation that were not detected by MTBDRsl assay including: 8/11 phenotypically OFX-resistant isolates had mutation in gyrA (2/8 had additional mutation in the gyrB gene), 1/11 had mutation only in the gyrB gene; 6/21 phenotypically KAN-resistant isolate had mutation in rrs gene; 7/26 and 20/26 phenotypically CAP-resistant isolates had mutation in the rrs and tlyA genes, respectively. CONCLUSION: The MTBDRsl assay showed a lower sensitivity as compared to previous studies. The assay performed favourably for OFX; however the assay was less sensitive for detection of KAN/CAP resistance and demonstrated low sensitivity and specificity for EMB resistance. It is recommended that the MTBDRsl assay should include additional genes to achieve a better sensitivity for all the drugs tested.A grant from the NHLS and Hains, Lifesciences.http://www.theunion.org/about-the-journal/about-the-journal.htm