Interstitial lung disease-related pneumomediastinum in COVID-19 patients

International audiencePneumomediastinum in severe #COVID19 presentations could be due to a lung parenchymal retractive process generated by intense inflammation as in acute exacerbation of idiopathic pulmonary fibrosis or MDA-5 acute interstitial lung disease

EXPERIMENTATION OF AN APPLICATION OF EARLY DIAGNOSIS AND INVENTORY OF SOYBEAN DISEASES (GLYCINE MAX (L.) MERR.) IN BURKINA FASO

<p>Glycine max (L.) Merr also known as soya or soybean plays an important role in legume production in Burkina Faso. Every year, the country produces an average of 30,000 tonnes of soybean. It is grown for its oilseeds, which are rich in protein, fat, minerals and vitamins, making it an important food and feed crop. In addition, soya production is profitable for growers because it provides a real source of income through marketing operations. The lack of fertile land, adequate rainfall and phytosanitary protection in soya cultivation are not conducive for efficient production. Ignorance and lack of knowledge of the diseases encountered in soya production make it even more difficult to protect the crop, which further limits production.In order to improve knowledge of soybean diseases in Burkina Faso, an inventory of diseases associated with this crop was carried out using a plant pathology diagnostic application. In this study, the Plantix-Crop Doctor application, based on artificial intelligence with deep learning, was used in an Alpha Lattice experimental device. A disease identification form from the  Quebec Agriculture and Agri-Food Research Centre  was used as a reference. Among the diseases identified were Septoria leaf spot, grey leaf spot, anthracnose, bacterial blight, soybean blight, sudden death syndrome, downy mildew, powdery mildew and soybean rust. This list provides a database of soybean diseases that must be controlled by methods that consider environmental protection. The Plantix - your crop doctor application can be relied on to diagnose soybean diseases so that they can be treated at an early stage.</p><p> </p&gt

International continence society white paper regarding female genital mutilation/cutting

Female genital mutilation/cutting (FGM/C)-also known as Female Genital Cutting or Mutilation-is defined as the partial or total removal of the female external genitalia for non-therapeutic reasons. This White Paper, prepared under the auspices of the International Continence Society (ICS), is intended by the ICS as a statement promoting the abandonment of this practice. The ICS also supports the respectful and evidence-based care or treatment of women and girls already affected by FGM/C, in keeping with the World Health Organization (WHO) Guidelines on the Management of Health Complications from Female Genital Mutilation. Our members specialize in pelvic floor disorders from perspectives within a range of specialties; we encounter and treat women living with FGM/C and its consequences-particularly incontinence, infections, voiding dysfunction, sexual dysfunction, chronic pelvic pain, and obstetric trauma. Understanding the ethical, sociocultural, medical and surgical factors surrounding FGM/C is central to caring for women and girls with a history of FGM/C. The ICS voices herein state strong opposition to FGM/C. We encourage members to apply their skills to improve prevention strategies and the management of those affected

Malnutrition: Percentage and Association with Prognosis in Patients Hospitalized for Coronavirus Disease 2019

International audiencePrevious studies have found a correlation between malnutrition and prognosis in respiratory infections. Our objectives were to determine (i) the percentage of malnutrition, and (ii) its prognosis in patients admitted for coronavirus disease 2019 (COVID-19). In this monocentric retrospective study, we consecutively included all adult patients presenting with acute COVID-19 between 9 April and 29 May 2020. Malnutrition was diagnosed on low body mass index (BMI) and weight loss ≥ 5% in the previous month and/or ≥ 10% in the previous six months. The Nutritional Risk Index (NRI) defined nutritional risk. Severe COVID-19 was defined as a need for nasal oxygen ≥ 6 L/min. We enrolled 108 patients (64 men, 62 ± 16 years, BMI 28.8 ± 6.2 kg/m2), including 34 (31.5%) with severe COVID-19. Malnutrition was found in 42 (38.9%) patients, and moderate or severe nutritional risk in 83 (84.7%) patients. Malnutrition was not associated with COVID-19 severity. Nutritional risk was associated with severe COVID-19 (p < 0.01; p < 0.01 after adjustment for C reactive protein), as were lower plasma proteins, albumin, prealbumin, and zinc levels (p < 0.01). The main cause of malnutrition was inflammation. The high percentage of malnutrition and the association between nutritional risk and COVID-19 prognosis supports international guidelines advising regular screening and nutritional support when necessary

Training and tool supply to enhance food safety behaviors among ready-to-eat chicken vendors in informal markets in Ouagadougou, Burkina Faso: a randomized-controlled trial

In Burkina Faso, street food vendors are key in ensuring food safety in urban markets, particularly within the poultry value chain. The sale of high-risk ready-to-eat chicken by these vendors poses substantial health hazards, emphasizing the urgency for capacity-building to enhance food safety practices. This study evaluated the effect of a participatory interactive three-day training program coupled with tool supply, on self-reported and observed behavior, and knowledge, attitudes, and cognitions vendors of street ready-to-eat chicken in Ouagadougou’s informal markets. A two-armed RCT was conducted, including pre- and post-training vendor surveys, along with direct outlet observations. Total sample size comprised 162 vendors, with 72 in the treatment group and 90 in the control group. Self-reported behavior - measured on a 5-point scale - significantly improved in the treatment group including higher frequency of mask wearing (1.8±0.8 vs 2.5±1.2, p<0.001) and inspecting nail hygiene (4.3±0.8 vs. 4.7±0.6, p<0.001). Treatment outlets improved on securing adequate evisceration platforms (1.3±0.6 vs. 1.0±0.5, p=0.054) regular carcass water renewal (61.8% vs. 36.4%, p=0.038), and handwashing during carcass management (1.1±0.5 vs. 0.9±0.3, p=0.008). Better adherence to handwashing (1.1±0.4 vs. 0.9±0.3, p=0.051), fork use (58.9% vs. 41.8%, p=0.029), proper handwashing facilities (38.4% vs. 20.9%, p=0.014), and waste management (64.4% vs. 37.8%, p<0.001) were observed in treatment outlets. Trained vendors scored significantly higher than controls on knowledge (effect size 0.75, p<0.001). Vendors rated the perceived usefulness and perceived ease of use, trust in materials/tools, measured on a 5-point scale, as high and perceived mean increased daily profits (21242 FCFA) and number of customers (8.3) following training. In conclusion, training combined with a tool package proved effective in fostering significant food safety behavior changes, underscoring its substantial impact beyond just knowledge enhancement. For lasting behavior changes, ongoing training and support, an enabling environment, and strong incentives that prioritize vendor food safety behaviors informal markets are crucial

The association of metabolic syndrome and COVID-19 deterioration

International audienceBackground and aimsTo evaluate the prevalence and prognostic value of metabolic syndrome (MetS) in patients admitted for coronavirus disease 2019 (COVID-19).Methods and resultsIn this monocentric cohort retrospective study, we consecutively included all adult patients admitted to COVID-19 units between April 9 and May 29, 2020 and between February 1 and March 26, 2021. MetS was defined when at least three of the following components were met: android obesity, high HbA1c, hypertension, hypertriglyceridemia, and low HDL cholesterol. COVID-19 deterioration was defined as the need for nasal oxygen flow ≥6 L/min within 28 days after admission.We included 155 patients (55.5% men, mean age 61.7 years old, mean body mass index 29.8 kg/m2). Fifty-six patients (36.1%) had COVID-19 deterioration. MetS was present in 126 patients (81.3%) and was associated with COVID-19 deterioration (no-MetS vs MetS: 13.7% and 41.2%, respectively, p < 0.01). Logistic regression taking into account MetS, age, gender, ethnicity, period of inclusion, and Charlson Index showed that COVID-19 deterioration was 5.3 times more likely in MetS patients (95% confidence interval 1.3–20.2) than no-MetS patients.ConclusionsOver 81.3% of patients hospitalized in COVID-19 units had MetS. This syndrome appears to be an independent risk factor of COVID-19 deterioration

Invasive Rhinosinusitis Caused by Alternaria infectoria in a Patient with Autosomal Recessive CARD9 Deficiency and a Review of the Literature

Phaeohyphomycoses comprise a heterogeneous group of fungal infections caused by dematiaceous fungi and have primarily been reported in patients with underlying acquired immunodeficiencies, such as hematological malignancies or solid-organ transplants. Over the past decade, a growing number of patients with phaeohyphomycosis but otherwise healthy were reported with autosomal recessive (AR) CARD9 deficiency. We report a 28-year-old woman who presented with invasive rhinosinusitis caused by Alternaria infectoria. Following a candidate gene sequencing approach, we identified a biallelic loss-of-function mutation of CARD9, thereby further broadening the spectrum of invasive fungal diseases found in patients with inherited CARD9 deficiency. In addition, we reviewed 17 other cases of phaeohyphomycosis associated with AR CARD9 deficiency. Physicians should maintain a high degree of suspicion for inborn errors of immunity, namely CARD9 deficiency, when caring for previously healthy patients with phaeohyphomycosis, regardless of age at first presentation

Etude d’incidence de la fièvre Q en Guyane 2007-2017 : hyperendémicité et facteurs de risque

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The African Network for Improved Diagnostics, Epidemiology and Management of common infectious Agents

Background!#!In sub-Saharan Africa, acute respiratory infections (ARI), acute gastrointestinal infections (GI) and acute febrile disease of unknown cause (AFDUC) have a large disease burden, especially among children, while respective aetiologies often remain unresolved. The need for robust infectious disease surveillance to detect emerging pathogens along with common human pathogens has been highlighted by the ongoing novel coronavirus disease 2019 (COVID-19) pandemic. The African Network for Improved Diagnostics, Epidemiology and Management of Common Infectious Agents (ANDEMIA) is a sentinel surveillance study on the aetiology and clinical characteristics of ARI, GI and AFDUC in sub-Saharan Africa.!##!Methods!#!ANDEMIA includes 12 urban and rural health care facilities in four African countries (Côte d'Ivoire, Burkina Faso, Democratic Republic of the Congo and Republic of South Africa). It was piloted in 2018 in Côte d'Ivoire and the initial phase will run from 2019 to 2021. Case definitions for ARI, GI and AFDUC were established, as well as syndrome-specific sampling algorithms including the collection of blood, naso- and oropharyngeal swabs and stool. Samples are tested using comprehensive diagnostic protocols, ranging from classic bacteriology and antimicrobial resistance screening to multiplex real-time polymerase chain reaction (PCR) systems and High Throughput Sequencing. In March 2020, PCR testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and analysis of full genomic information was included in the study. Standardised questionnaires collect relevant clinical, demographic, socio-economic and behavioural data for epidemiologic analyses. Controls are enrolled over a 12-month period for a nested case-control study. Data will be assessed descriptively and aetiologies will be evaluated using a latent class analysis among cases. Among cases and controls, an integrated analytic approach using logistic regression and Bayesian estimation will be employed to improve the assessment of aetiology and associated risk factors.!##!Discussion!#!ANDEMIA aims to expand our understanding of ARI, GI and AFDUC aetiologies in sub-Saharan Africa using a comprehensive laboratory diagnostics strategy. It will foster early detection of emerging threats and continued monitoring of important common pathogens. The network collaboration will be strengthened and site diagnostic capacities will be reinforced to improve quality management and patient care