Influence of Bacille Calmette-Guérin Vaccination on Size of Tuberculin Skin Test Reaction: To What Size?

Background. Previous bacillus Calmette-Guérin (BCG) vaccination can confound the results of a tuberculin skin test (TST). We sought to determine a cutoff diameter of TST induration beyond which the influence of BCG vaccination was negligible in evaluating potential Mycobacterium tuberculosis infection in a population of health care workers with a high vaccination rate and low incidence of tuberculosis. Methods. From 1991 through 1998, all new employees at the University Hospital of Lausanne, Switzerland, underwent a 2-step TST at entry visit. We also gathered information on demographic characteristics, along with factors commonly associated with tuberculin positivity, including previous BCG vaccination, history of latent M. tuberculosis infection, and predictors for M. tuberculosis infection. Results. Among the 5117 investigated subjects, we found that influence of BCG vaccination on TST results varied across categories of age (likelihood ratio test, 0.0001). Prior BCG vaccination had a strong influence on skin test results of ⩽18 mm in diameter among persons <40 years old, compared with the influence of factors predictive of M. tuberculosis infection. Prior latent M. tuberculosis infection and travel or employment in a country in which tuberculosis is endemic also had significant influences. Conclusions. Interpretation of TST reactions of ⩽18 mm among BCG-vaccinated persons <40 years of age must be done with caution in areas with a low incidence of tuberculosis. In such a population, except for persons who have never been vaccinated, TST reactions of ⩽18 mm are more likely to be the result of prior vaccination than infection and should not systematically lead to preventive treatmen

A Longitudinal Study of Parental Depressive Symptoms and Coparenting in the First 18 Months.

Although the negative impact of postpartum depression on parenting behaviors has been well established-albeit separately-for mothers and fathers, the respective and joint impact of both parents' mood on family-group interactive behaviors, such as coparenting support and conflict behaviors between the parents, have not yet been investigated. The aim of this study was to examine the association between parental depressive symptoms and coparenting behaviors in a low-risk sample of families with infants, exploring reciprocity between the variables, as well as gender differences between mothers and fathers regarding these links. At 3 (T1), 9 (T2), and 18 months postpartum (T3), we assessed both parents' depressive symptoms with a self-report questionnaire and observed coparenting support and conflict during triadic mother-father-child interactions. The results revealed that higher maternal depressive symptoms at T1 were associated with lower support at T1 and T2. Conflict at T3 was associated with higher maternal depressive symptoms at T3 and, more surprisingly, with less depressive symptoms in mothers at T2 and fathers at T3. Cross-lagged associations suggested that parental depressive symptoms were more likely to influence coparenting than the reverse. Moreover, maternal depressive symptoms were more likely to be linked to coparenting behaviors than were paternal depressive symptoms. These results confirm that parental-mostly maternal-depressive symptoms, even of mild intensity, may jeopardize the development of healthy family-level relations, which previous research has shown to be crucial for child development

Rickettsia mongolotimonae: a rare pathogen in France.

We report a second case of laboratory-confirmed infection caused by Rickettsia mongolotimonae in Marseille, France. This rickettsiosis may represent a new clinical entity; moreover, its geographic distribution may be broader than previously documented. This pathogen should be systematically considered in the differential diagnosis of atypical rickettsioses, especially rashless fevers with lymphangitis and lymphadenopathy, in southern France and perhaps elsewhere

Status of Uncooled Infrared Detector Technology at ULIS, France

The high level of accumulated expertise by ULIS and CEA/LETI on uncooled microbolometers made from amorphous silicon enables ULIS to develop uncooled IRFPA with 17 µm pixel-pitch to enable the development of small power, small weight and power (SWaP) and high performance IR systems. Key characteristics of amorphous silicon based uncooled IR detector is described to highlight the advantage of this technology for system operation. A full range of products from 160 x 120 to 1024 x 768 has been developed and we will focus the paper on the ¼ VGA with 17 µm pixel pitch. Readout integrated circuit (ROIC) architecture is described highlighting innovations that are widely on-chip implemented to enable an easier operation by the user. The detector configuration (integration time, windowing, gain, scanning direction), is driven by a standard I²C link. Like most of the visible arrays, the detector adopts the HSYNC/VSYNC free-run mode of operation driven with only one master clock (MC) supplied to the ROIC which feeds back pixel, line and frame synchronisation. On-chip PROM memory for customer operational condition storage is available for detector characteristics. Low power consumption has been taken into account and less than 60 mW is possible in analogue mode at 60 Hz. A wide electrical dynamic range (2.4V) is maintained despite the use of advanced CMOS node. The specific appeal of this unit lies in the high uniformity and easy operation it provides. The reduction of the pixel-pitch turns this TEC-less ¼ VGA array into a product well adapted for high resolution and compact systems. Noise equivalent temperature difference (NETD) of 35 mK and thermal time constant of 10 ms have been measured leading to 350 mK.ms figure of merit. We insist on NETD trade-off with wide thermal dynamic range, as well as the high characteristics uniformity and pixel operability, achieved thanks to the mastering of the amorphous silicon technology coupled with the ROIC design. This technology node associated with advanced packaging technique, paves the way to compact low power system.Defence Science Journal, 2013, 63(6), pp.545-549, DOI:http://dx.doi.org/10.14429/dsj.63.5753

HIV-Infektion : Update 2009 für Hausärzte. Teil 1

Quintessenz: In der Schweiz werden jährlich >750 HIV-Infektionen neu diagnostiziert. Die Ansteckung geschieht via Blut oder Sex, und nicht bei alltäglichen sozialen Kontakten. Die CD4-Lymphozytenzahl ist bestens etabliert zur Messung der Immunsuppression. Die grösste Gefahr opportunistischer Infekte droht bei CD4-Werten <200/μl. Dank antiretroviraler Therapie (ART) sollten viele HIV-infizierte Patienten in der Schweiz eine quasi normale Lebenserwartung haben. Momentan ist eine ART bei CD4-Werten <350/μl indiziert. Die HIV-Diagnose wird auch in der Schweiz häufig zu spät gestellt. Hausärzte spielen bei der frühzeitigen Diagnosestellung (grosszügiges Anbieten von HIV-Tests) und bei der Prävention von Immundefizienz und opportunistischen Komplikationen eine entscheidende Rolle. P Bei HIV-Neudiagnose soll der Patient einem HIV-Spezialisten zugewiesen werden, um weitere Abklärungen durchzuführen und die Indikation zum ART-Beginn zu stellen

New genotyping method discovers sustained nosocomial Pseudomonas aeruginosa outbreak in an intensive care burn unit.

Pseudomonas aeruginosa is a leading cause of healthcare-associated infections in the intensive care unit (ICU). To investigate an unexplained increase in the incidence of P. aeruginosa recovered from clinical samples in the ICU over a two-year period. After unsuccessful epidemiological investigation by conventional tools, P. aeruginosa clinical isolates of all patients hospitalized between January 2010 and July 2012 were typed by a novel double-locus sequence typing (DLST) method and compared to environmental isolates recovered during the investigation period. In total, 509 clinical isolates from 218 patients and 91 environmental isolates were typed. Thirty-five different genotypic clusters were found in 154 out of 218 patients (71%). The largest cluster, DLST 1-18, included 23 patients who were mostly hospitalized during overlapping periods in the burn unit. Genotype DLST 1-18 was also recovered from floor traps, shower trolleys and the shower mattress in the hydrotherapy rooms, suggesting environmental contamination of the burn unit as the source of the outbreak. After implementation of appropriate infection control measures, this genotype was recovered only once in a clinical sample from a burned patient and twice in the environment, but never thereafter during a 12-month follow-up period. The use of a novel DLST method allowed the genotyping of a large number of clinical and environmental isolates, leading to the identification of the environmental source of a large unrecognized outbreak in the burn unit. Eradication of the outbreak was confirmed after implementation of a continuous epidemiological surveillance of P. aeruginosa clones in the ICU

Ultrathin silica films on Pd(111): Structure and adsorption properties

We studied the preparation of thin silica films on Pd(111) using low energy electron diffraction (LEED), infrared reflection-absorption spectroscopy (IRAS), and scanning tunneling microscopy (STM). The films grow from the onset as a double-layer (bilayer) silicate and show no long-range ordering as judged by LEED, thus bearing close similarities to the silicate films grown on a Pt(111) support. The results provide further evidence that the principal structure (monolayer vs bilayer) of ultrathin silica films on metal substrates is primarily governed by the affinity of a metal substrate to oxygen. Individual adsorption of CO and D2 on the prepared films showed that both molecules penetrate through the film and chemisorb on the Pd(111) surface. Density functional theory (DFT) calculations showed that CO bonding on Pd(111) underneath the silica film becomes weaker as compared to the bare Pd(111) surface, but the vibrational frequencies remain unaffected, that is in nice agreement with the experimental results

Calculation of thermal parameters of SiGe microbolometers

The thermal parameters of a SiGe microbolometer were calculated using numerical modeling. The calculated thermal conduction and thermal response time are in good agreement with the values found experimentally and range between 2x10$^-7$ and 7x10$^-8$ W/K and 1.5 and 4.5 ms, respectively. High sensitivity of microbolometer is achieved due to optimization of the thermal response time and thermal conduction by fitting the geometry of supporting heat-removing legs or by selection of a suitable material providing boundary thermal resistance higher than 8x10$^-3$ cm$^2$K/W at the SiGe interface.Comment: 11 pages, 6 figure

Serial monitoring of pancreatic stone protein for the detection of sepsis in intensive care unit patients with complicated abdominal surgery: A prospective, longitudinal cohort study.

The objective of this study was to assess the performance of pancreatic stone protein (PSP) monitoring for the detection of sepsis, prediction of outcome and distinction between bacterial and fungal infections in intensive care unit (ICU) patients with complicated abdominal surgery. In this prospective multicenter cohort study, patients with complicated abdominal surgery had serial PSP measurements during their ICU stay. Infectious episodes were classified as bacterial, fungal or mixed. PSPmax (maximal PSP value within 48 h of the diagnosis of infection) and ΔPSP (difference between PSPmax and the preceding PSP value) were used for analyses. PSPmax was obtained for 118 infectious episodes (68 patients). ΔPSP was available for 73 episodes (48 patients). Both PSPmax and ΔPSP were significantly higher in patients with sepsis and in patients with a fatal outcome. A PSPmax ≥124 ng/ml and a ΔPSP ≥34 ng/ml could detect sepsis with a sensitivity/specificity of 84%/54% and 69%/76%, respectively. There was no significant difference of PSPmax or ΔPSP between patients with bacterial/mixed versus fungal infections. Serial PSP monitoring may be an additional tool for the early detection of sepsis in patients with complicated abdominal surgery who are at high risk of severe infections

Common skin infection due to Panton-Valentine leucocidin-producing Staphylococcus aureus strains in asylum seekers from Eritrea: a genome-based investigation of a suspected outbreak

Since late 2014, multiple cases of abscesses and boils due to methicillin-susceptible Staphylococcus aureus (MSSA) expressing the Panton-Valentine leucocidin (PVL) were observed in Eritrean asylum seekers in Lausanne, Switzerland. Strains isolated from infected Eritrean and non-Eritrean patients were compared by whole genome sequencing to determine whether these numerous cases result from an outbreak. The genome of S. aureus PVL-producing strains were sequenced and compared. Clinical and epidemiological characteristics of patients infected by PVL-producing strains were investigated. This work reports 15 cases of infections due to PVL-producing strains affecting mostly asylum seekers (n = 10), people working with refugees and/or exposed to Africans (n = 3). Most infections were due to closely related strains of CC152 (n = 8) and CC15 (n = 3), two distantly related (&gt;34 000 core single nucleotide polymorphisms) clonal complexes. An epidemiological link between the 15 cases could be ruled out by whole genome sequencing (33 to 172 core single nucleotide polymorphisms between the different strains of a given complex). Altogether, these results reflect the probable high incidence of CC15 and CC152 PVL-producing strains in eastern Africa. Clinicians facing unusual skin infections in African refugees (or in any person returning from this region of high endemicity) should consider S. aureus PVL-producer before suspecting rare infections such as leishmaniasis or rickettsiosis. Clinicians should also remember that PVL are frequently expressed by MSSA in some regions of the world and that antibiotics that are efficient on toxin expression, such as clindamycin, represent the best therapeutic option