La méthode kangourou et les facteurs liés à la triade bébé-parents-infirmier influençant son application en néonatologie: travail de Bachelor

La méthode kangourou (MK), dont les bénéfices ont été démontrés par de nombreuses études, n'est toujours pas appliquée de manière systématique à travers le monde. Le but de cette revue de littérature est de décrire les facteurs liés à la triade bébé-parents-infirmier influençant l'application de la MK en néonatologie. Ce travail de bachelor est rédigé sous forme de revue de littérature comportant 9 articles, sélectionnés dans les bases de données Pubmed et JBI. Les résultats ont été analysés selon le modèle de la conservation de Myra Levine

Evaluating the impact of varying expired carbon monoxide thresholds on smoking relapse identification: insights from the E3 trial on e-cigarette efficacy for smoking cessation

Objectives Expired carbon monoxide (ECO) is often used in smoking cessation trials to biochemically validate self-reported smoking status. The optimal ECO threshold to distinguish individuals who smoke from those who do not is debated.Design The data from the ‘Evaluating the Efficacy of E-Cigarette use for Smoking Cessation (E3) Trial’ were used; the E3 trial was a randomised controlled trial that examined e-cigarettes efficacy for smoking cessation.Settings Participants were recruited from 17 Canadian sites across 4 provinces.Participants This substudy included data from participants who returned for at least one of the clinical visits at week 4 (291), 12 (257) or 24 (218) and provided both self-reported smoking status and ECO measures. Analyses were based on 766 paired measures (ie, self-reported smoking status with corresponding ECO).Results The ability of ECO measurements to discriminate between adults who reported smoking and those who reported abstinence varied with the threshold used. ECO thresholds of 6, 7, 8 and 9 parts per million (ppm) yielded the greatest area under the receiver operating characteristic curve (0.84). These thresholds produced sensitivities of 84%, 82%, 78% and 76% and specificities of 84%, 87%, 90% and 91%, respectively. However, at a threshold of 6 ppm, intersecting sensitivity (84%) and specificity (84%) were maximised with respect to each other. Biochemical validation had the highest agreement with self-report at an ECO threshold of 6 ppm (κ=0.57; 95% CI, 0.51 to 0.64).Conclusion The classification of participants’ smoking status depends on the ECO threshold used for biochemical validation. We recommend that future smoking cessation trial investigators analyse and report the impact that varying ECO thresholds has on trial results.Trial registration number NCT02417467

MediHandTrace : un dispositif intégré utile à la recherche interventionnelle sur l’hygiène des mains

International audienc

Hand Hygiene Analyzed by Video Recording

International audienceObjective : The aim of this study is to evaluate the hand hygiene and isolation precaution adhesion of the healthcare workers in routine cares.Methods : In an infectious diseases care unit of a university hospital in Marseille, France, we designed an observational study at evaluating the hand hygiene and isolation precaution adhesion of the healthcare workers in routine cares by remote video recording. The care team including nurses, assistant nurses, housekeepers and physicians was monitored from November 30th (2012) to February 13th (2013). From a video camera was placed inside patient room, healthcare workers paths were recorded from entrance to exit of the patient’s room. Hand hygiene disinfection as well as gloves and mask wearing in isolation precautions were observed. A video camera was placed inside patient room. Healthcare workers paths were recorded from entrance to exit of the patient’s room. A nurse and a sociologist analyzed further videos. Hand hygiene disinfection as well as gloves and mask wearing in isolation precaution were observed.Results : A total of 756 videos were captures. 249 were rejected because they were not contributive and 507 videos (811 Healthcare workers paths) were analyzed. Healthcare workers had hand disinfection at least one time in the path in 28.2%. Hand disinfection at entrance and exit of the bedroom is respected in 6.2%. The meal tray delivery is associated with a lower hand hygiene practice. The glove wearing adhesion is 51.2% in Clostridium difficile contact precaution, and conformity to protocol is 17.5%. Wearing gloves impairs hand disinfection especially in situation where gloves are not part of the protocol (38.7%). Adhesion to mask wearing in airborne precaution is 90.7%

Hygiène des mains chez les soignants en milieu hospitalier : étude observationnelle par vidéo

L’hygiène des mains est un moyen efficace qui permet de limiter la transmission d’agents pathogènes. Malgré les nombreuses interventions, la non observance à l’hygiène des mains est en moyenne de 40 % [1]. Les audits interventionnels tels que préconisés par l’OMS basés sur le nombre d’opportunités de se désinfecter les mains présentent quelques biais. Notamment celui de la présence physique de l’auditeur qui a une influence directe sur le comportement des soignants (effet Hawthorne). MédiHandTrace® (MHT®) est un outil de traçabilité électronique automatisé par radio basse fréquence qui permet une identification des parcours des soignants en temps réel. Il permet aussi d’enregistrer les prises de solutions hydro-alcooliques par les personnels soignants à l’intérieur et à l’extérieur de la chambre.A l’occasion de la vérification de l’efficacité du système MHT® [2], nous avons utilisé la vidéo comme comparateur. Nous vous rapportons ici les résultats de l’étude des comportements tel qu’ils ont été observés par la vidéo.L’utilisation de la vidéo a pour objectif de comprendre, d’analyser les pratiques de soins, la désinfection des mains mais aussi d’identifier les facteurs qui en influencent la non observance

A Retrospective Study on the Onset of Menopause after Chemotherapy: Analysis of Data Extracted from the Jean Perrin Comprehensive Cancer Center Database Concerning 345 Young Breast Cancer Patients Diagnosed between 1994 and 2012

International audienceYoung breast cancer (BC) patients receiving chemotherapy are at risk of chemotherapy-induced menopause (CIM). We sought to define the incidence rate of premature menopause after chemotherapy and to retrospectively investigate factors related to the onset of menopause

Experimental determination of organelle targeting peptide cleavage sites using transient expression of GFP translational fusions

The majority of nuclear-encoded organellar proteins contain a cleavable presequence which is necessary for protein targeting and import into the correct cellular compartment. Knowledge about targeting-peptide cleavage sites is essential for the structural and functional characterization of the mature organellar proteins as well as for a deeper understanding of the import process. Because of the low consensus and high variability of presequences, bioinformatics of targeting-peptide cleavage fails to predict the length of the targeting peptide with high confidence. Therefore, we have developed a rapid and robust method to experimentally determine the cleavage site of the transit peptide for proteins imported into mitochondria or plastids. The protein precursor with GFP fused to its C-terminus is transiently expressed in cells (for animal proteins) or protoplasts (for plant proteins), allowing translocation into organelles, and removal of the transit peptide. After lysis, the matured protein is immunopurified using an anti-GFP antibody coupled to magnetic beads. The N-terminal amino sequence is then determined by Edman microsequencing or mass spectrometry. The method has been validated using proteins with known targeting peptide sequences and is suitable for animal and plant organelle-targeted proteins

Homozygous MFN2 variants causing severe antenatal encephalopathy with clumped mitochondria

International audiencePathogenic variants in the MFN2 gene are commonly associated with autosomal dominant (CMT2A2A) or recessive (CMT2A2B) Charcot-Marie-Tooth disease, with possible involvement of the CNS. Here, we present a case of severe antenatal encephalopathy with lissencephaly, polymicrogyria and cerebellar atrophy. Whole genome analysis revealed a homozygous deletion c.1717-274_1734 del (NM_014874.4) in the MFN2 gene, leading to exon 16 skipping and in-frame loss of 50 amino acids (p.Gln574_Val624del), removing the proline-rich domain and the transmembrane domain 1 (TM1). MFN2 is a transmembrane GTPase located on the mitochondrial outer membrane that contributes to mitochondrial fusion, shaping large mitochondrial networks within cells. In silico modelling showed that the loss of the TM1 domain resulted in a drastically altered topological insertion of the protein in the mitochondrial outer membrane. Fetus fibroblasts, investigated by fluorescent cell imaging, electron microscopy and time-lapse recording, showed a sharp alteration of the mitochondrial network, with clumped mitochondria and clusters of tethered mitochondria unable to fuse. Multiple deficiencies of respiratory chain complexes with severe impairment of complex I were also evidenced in patient fibroblasts, without involvement of mitochondrial DNA instability. This is the first reported case of a severe developmental defect due to MFN2 deficiency with clumped mitochondria