Mucormycoses (aspects clinico-biologiques et thérapeutiques)

LIMOGES-BU Médecine pharmacie (870852108) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

De la variole du singe à la Mpox ou la réémergence d’une ancienne zoonose

International audienceMonkeypox is a zoonotic disease caused by the Monkeypox virus (MPXV) of the Orthopoxvirus genus. The first human cases occurred in Africa in the 1970s and remained confined to the African continent for a long time until 2003, when several dozen cases occurred in the United States, following contamination by prairie dogs. Unprecedented transmission events have led to more than 80,000 reported cases worldwide between May 2022 and February 2023, primarily affecting men who have sex with men. The changing epidemiology of Mpox has raised concerns about its ability to become endemic beyond its traditional geographic areas. Confirmatory diagnosis is based on direct detection by molecular biology. Pre- or post-exposure smallpox vaccination was widely deployed in early summer 2022 to limit the spread of the disease. In case of severe forms, the use of antivirals can be considered, only tecovirimat being recommended in this indication. The current epidemic has had the merit of showing that a disease that was previously confined to regions of initial virus circulation can spread very rapidly in Western countries and of the need to reinforce the implementation of tools for the surveillance and control of communicable diseases

Knowledge and management of smoking-cessation strategies among cardiologists in France: A nationwide survey

SummaryBackgroundWhile cardiologists are very active in the prevention of cardiovascular disease, their attitudes towards patients’ smoking habits are poorly studied.AimsIn a nationwide French survey, we assessed cardiologists’ levels of knowledge and management of smoking cessation.MethodsWe sent out a questionnaire to a random sample of 1000 cardiologists.ResultsA total of 371cardiologists agreed to participate in the survey; 8.1% were current smokers and 32.4% were past smokers. Most classified smoking cessation as the top priority for patients with coronary artery disease (56.5%) and peripheral arterial disease (88.5%). Cardiologists routinely assessed active and passive smoking in 96.2% and 43% of their patients, respectively. Only 29.2% considered themselves well informed about smoking-cessation management. While 39.9% declared they knew about the minimal counselling 7.3% described it correctly. Only 17.5% used the Fagerström questionnaire. Smoking cessation was advised systematically by 85% but only 5.4% of cardiologists followed up their patients specifically on this issue. They referred smokers to either their general practitioner or to smoking-cessation centres and/or quitlines in 16.0% and 67.0% of cases, respectively; 31.8% never referred their patients to a smoking-cessation centre, and 25% declared being unaware of any such centre in their area. Cardiologists who smoked were less likely to ask about patients’ smoking status than non-smokers (90% vs 98.2%, p=0.039). Similarly, they were more passive in offering smoking-cessation counselling (23% vs 7%, p=0.011), and referred less frequently their patients to a smoking-cessation centre (37% vs 64%, p=0.028).ConclusionFrench cardiologists are rarely involved in the management of smoking cessation. Their own smoking status influences their attitudes towards the management of smoking cessation

[Community-acquired meningitis due to methicillin susceptible Staphylococcus aureus] : Méningites communautaires à Staphylococcus aureus méticilline sensible

ERMAInternational audienceUNLABELLED: Meningitis due to Staphylococcus aureus is infrequent. MRSA is mainly found after neurosurgery, but MSSA may be involved in community-acquired meningitis. However, this kind of infection is not widely reported, despite its severity. METHODS: We describe the characteristics of five patients hospitalized in our ward over a period of 18 months who presented with community-acquired meningitis due to MSSA. RESULTS: The patients were three men and two women with a mean age of 62 years. One patient was immunosuppressed. Neurological signs were present at the onset for only two patients. In all cases, there were extraneurological localizations of the infection, mainly in bones (spondylodiscitis, epidural abscess, arthritis) but also lung infection. Three patients with meningeal inflammation also presented with confusion. CSF analysis revealed less than 950 white blood cells, hyper-CSF-proteins, and hypo-CSF-glucose. Bacteraemia was present in all patients. The source of infection was never determined. The evolution was good for all patients with a prolonged antibiotic course. The analysis of genetic determinants for three strains revealed the presence of TSST-1 which could account for the severity of the disease. CONCLUSION: Community-acquired MSSA meningitis is a serious infection, occurring in patients without risk factors. Hematogenous dissemination leads to multiple tissue infection. A long course of antibiotics, with high doses, is needed to treat meningitis but also extraneurological localizations. The role of TSST-1 needs to be confirmed in other patients

E-03 Effets secondaires des antibiotiques au cours des endocardites

ERMANational audienc

Connaissance des Infections Sexuellement Transmissibles par 501 consultants d'un CDAG-CIDDIST

Congrès de la Société de Pathologie Infectieuse de Langue Française et du Collège des Universitaires de Maladies Infectieuses et Tropicales; ERMANational audienc

Méningites communautaires à Staphylococcus aureus meticilline sensible

Congrès de la Société de Pathologie Infectieuse de Langue Française et du Collège des Universitaires de Maladies Infectieuses et Tropicales; ERMANational audienc

Œdèmes acraux révélateurs d'une lèpre lépromateuse

ERMANational audienc

Cardiac Specific Increase in Aldosterone Production Induces Coronary Dysfunction in Aldosterone Synthase-Transgenic Mice

International audienceBackground-Elevated circulating aldosterone level is associated with impaired cardiovascular function. Although the mechanisms are not fully understood, aldosterone antagonists decrease total and cardiovascular mortality in heart failure and myocardial infarction. Aldosterone induces cardiac fibrosis in experimental models, and it is synthesized locally in rat heart. These observations suggest pathological effects of aldosterone in heart that remain unclear. Methods and Results-Transgenic mice (TG) that overexpress the terminal enzyme of aldosterone biosynthesis, aldosterone synthase (AS), in heart have been raised by gene targeting with the ␣-myosin heavy chain promoter. AS mRNA increased 100-fold and aldosterone concentration 1.7-fold in hearts of male TG mice relative to wild-type. No structural or myocardial alterations were evidenced, because ventricle/body weight, AT 1 and AT 2 receptor binding, and collagen content were unchanged in TG. No alteration in cardiac function was evidenced by echocardiography, isolated perfused heart, or whole-cell patch clamp experiments. In contrast, coronary function was impaired, because basal coronary flow was decreased in isolated perfused heart (Ϫ55% of baseline values), and vasodilatation to acetylcholine, bradykinin, and sodium nitroprusside was decreased by 75%, 60%, and 75%, respectively, in TG mice compared with wild-type, showing that the defect was not related to NO production. Conclusions-Increased cardiac aldosterone production in male mice induces a major coronary endothelium-independent dysfunction with no detectable alterations in cardiac structure and function. However, coronary dysfunction may be harmful for coronary adaptation to increased flow demand. (Circulation. 2004;110:1819-1825