Étude M2M thrombose (incidence des thromboses et des effets secondaires des anticoagulants chez les traumatisés du membre inférieur vus par les médecins de montagne)

Introduction : En stations de sports d hiver de nombreuses personnes sont victimes d un traumatisme du membre inférieur (MI). 90% sont traitées en ambulatoire. La prescription d une thromboprophylaxie est courante en traumatologie mais aucun anticoagulant ne dispose d autorisation de mise sur le marché dans cette indication. L objectif de l étude est d évaluer l incidence de la maladie thromboembolique veineuse (MTEV) après traumatisme du MI et des effets indésirables des anticoagulants. Matériels et méthodes : Etude de cohorte, prospective, multicentrique, non interventionnelle. 1628 patients inclus par 42 médecins de montagne (MdeM) pendant l hiver 2010/2011, 1498 suivis à 3 mois. Les données étaient recueillies à l inclusion sur un cahier électronique avec un rappel à 3 mois. Résultats : 40% des patients ont reçu une thromboprophylaxie. 1,13% des patients ont présenté un ETEV. 9 patients sur les 17 ayant eu un ETEV ont reçu un traitement thromboprophylactique. On a recensé un effet indésirable grave au traitement anticoagulant. Les facteurs de risque d ETEV significatifs (avec p < 0,10) étaient l âge, les ATCD de cancer et la prise d une pilule OP. Discussion : La prévalence des ETEV est faible dans cette population jeune en bonne santé. Le risque de MTEV semble lié aux facteurs de risque individuels, plus qu aux caractéristiques du traumatisme. Conclusion : 40% des patients ont reçu une thromboprophylaxie. Seulement 1,13% ont fait un ETEV à 3 mois, mettant en évidence une probable surprescription d anticoagulants. Il convient maintenant d aider les MdeM à modifier leurs habitudes de prescriptions et à suivre l évolution des pratiques en proposant un nouvel algorithme.GRENOBLE1-BU Médecine pharm. (385162101) / SudocSudocFranceF

Biting behaviour of Tabanidae on cattle in mountainous summer pastures

International audienceIn France, during the summer, cattle in mountainous pastures can be highly exposed to tabanid bites. The persistent biting behaviour of tabanids not only causes disturbance, but is also responsible for transmitting diseases, such as bovine besnoitiosis. The purpose of this study was to better identify the level of tabanid annoyance on cattle by means of insect trapping and direct observation of cows. Tabanids were active during the entire daily observation period (10:00–16:00), except for Haematopota sp., which were less active in the morning. The tabanids collected in Nzi traps were generally representative of those that landed on cattle, except for Haematopota sp., as Nzi traps were not very effective for these species. The preferred feeding sites for most species appeared to be cow's legs or udder. Leg stamping was the defensive reaction most related to a tabanid alighting on a host. Generalized linear mixed models showed that the parameters associated with tabanid landings on hosts were related to weather and altitude, but not to landscape structure. Increased landings were mostly associated with the higher temperatures and lower wind speeds at midday, but some differences were observed between species. The results indicate that cattle-protection measures should be taken during the peak of tabanid abundance when climatic conditions favour intense biting activity. Nzi traps set close to livestock were very effective to catch tabanids and could help in reducing the annoyance caused by horse flies

Olfactory responses of tabanids to octenol, phenols and aged horse urine

International audienceElectrophysiological and behavioural responses of females of two tabanid species, Tabanus bromius L. and Atylotus quadrifarius (Loew) (Diptera: Tabanidae), to ammonia, octenol (1‐octen‐3‐ol), phenols and aged horse urine were compared. Electroantennogram (EAG) responses in both species to octenol, 4‐methylphenol (4MP), 3‐propylphenol (3PP) and a phenol mixture (4MP and 3PP at a ratio of 16 : 1) increased in a dose‐dependent fashion. The most effective stimulus was 4MP and synergism between the two phenols may exist. Aged horse urine also elicited strong EAG responses in both species. Using gas chromatography–mass spectrometry (GC‐MS) analysis, we identified 29 compounds in horse urine, which included, in particular, ketones, fatty alcohols and phenols, among which 4MP was the most abundant component (˜ 80%). Trapping experiments were carried out using Nzi traps baited with various odours. Octenol and the phenol mixture in combination with ammonia increased catches of tabanids by 1.8–2.8 times relative to ammonia alone. Aged horse urine increased catches of T. bromius and A. quadrifarius by 2.2 and 4.1 times, respectively. The high attractiveness of aged horse urine, especially for A. quadrifarius, is not likely to derive from 4MP alone, but from the mixture of various active compounds used in host location

Chemical ecology for a better control of horse flies

International audienc

Severe relapse of SARS‐CoV‐2 infection in a kidney transplant recipient with negative nasopharyngeal SARS‐CoV‐2 RT‐PCR after rituximab

International audienceImmunocompromised patients may experience prolonged viral shedding after their initial SARS-CoV-2 infection, however, symptomatic relapses after remission currently remain rare. We herein describe a severe COVID-19 relapse case of a kidney transplant recipient (KTR) following rituximab therapy, 3 months after a moderate COVID-19 infection, despite viral clearance after recovery of the first episode. During the clinical relapse, the diagnosis was established on a broncho-alveolar lavage specimen (BAL) by RT-PCR. The infectivity of the BAL sample was confirmed on a cell culture assay. Whole genome sequencing confirmed the presence of an identical stain (Clade 20A). However, it had an acquired G142D mutation and a larger deletion of 3-amino-acids at position 143-145. These mutations located within the N-terminal domain are suggested to play a role in viral entry. The diagnosis of a COVID-19 relapse should be considered in the setting of unexplained persistent fever and/or respiratory symptoms in KTRs (especially for those after rituximab therapy), even in patients with previous negative naso-pharyngeal SARS-CoV-2 PCR