Emprego em serviços domésticos e acidentes de trabalho não fatais

OBJECTIVE: To estimate the annual incidence of non-fatal work injuries according to sociodemographic and occupational variables among housemaids. METHODS: A community-based survey was conducted in a population of 1,650 women aged 10 to 65 years who reported a paid occupation randomly selected in a household sample of the city of Salvador, Brazil. Data was collected through individual questionnaires on living and work conditions and health status. Fisher Exact test was performed for frequency analysis. RESULTS: It was estimated an overall annual incidence of non-fatal work injuries in the study population of 5.0%, which was statistically significant (pOBJETIVO: Estimar a incidência anual de acidentes não fatais de acordo com variáveis sociodemográficas e ocupacionais entre empregadas em serviços domésticos. MÉTODOS: Inquérito de base comunitária conduzido com 1.650 mulheres de 10 a 65 anos de idade, que referiram ter atividade remunerada e que compunham uma amostra aleatória por conglomerados dos domicílios da cidade de Salvador, capital da Bahia. Os dados foram obtidos por meio de questionários individuais sobre condições de vida, trabalho e saúde. Foi utilizado o teste Exato de Fisher para diferenças de freqüências. RESULTADOS: Estimou-se a incidência anual de acidentes de trabalho não fatais em 5,0%, maior entre as empregadas em serviços domésticos (7,3%) do que entre as demais trabalhadoras (4,5%), diferença estatisticamente significante (

Molecular monitoring of plasmodium falciparum drug susceptibility at the time of the introduction of artemisinin-based combination therapy in Yaoundé, Cameroon: Implications for the future

<p>Abstract</p> <p>Background</p> <p>Regular monitoring of the levels of anti-malarial resistance of <it>Plasmodium falciparum </it>is an essential policy to adapt therapy and improve malaria control. This monitoring can be facilitated by using molecular tools, which are easier to implement than the classical determination of the resistance phenotype. In Cameroon, chloroquine (CQ), previously the first-line therapy for uncomplicated malaria was officially withdrawn in 2002 and replaced initially by amodiaquine (AQ) monotherapy. Then, artemisinin-based combination therapy (ACT), notably artesunate-amodiaquine (AS-AQ) or artemether-lumefantrine (AL), was gradually introduced in 2004. This situation raised the question of the evolution of <it>P. falciparum </it>resistance molecular markers in Yaoundé, a highly urbanized Cameroonian city.</p> <p>Methods</p> <p>The genotype of <it>pfcrt </it>72 and 76 and <it>pfmdr1 </it>86 alleles and <it>pfmdr1 </it>copy number were determined using real-time PCR in 447 <it>P. falciparum </it>samples collected between 2005 and 2009.</p> <p>Results</p> <p>This study showed a high prevalence of parasites with mutant <it>pfcrt </it>76 (83%) and <it>pfmdr1 </it>86 (93%) codons. On the contrary, no mutations in the <it>pfcrt </it>72 codon and no samples with duplication of the <it>pfmdr1 </it>gene were observed.</p> <p>Conclusion</p> <p>The high prevalence of mutant <it>pfcrt </it>76T and <it>pfmdr1 </it>86Y alleles might be due to the choice of alternative drugs (AQ and AS-AQ) known to select such genotypes. Mutant <it>pfcrt </it>72 codon was not detected despite the prolonged use of AQ either as monotherapy or combined with artesunate. The absence of <it>pfmdr1 </it>multicopies suggests that AL would still remain efficient. The limited use of mefloquine or the predominance of mutant <it>pfmdr1 </it>86Y codon could explain the lack of <it>pfmdr1 </it>amplification. Indeed, this mutant codon is rarely associated with duplication of <it>pfmdr1 </it>gene. In Cameroon, the changes of therapeutic strategies and the simultaneous use of several formulations of ACT or other anti-malarials that are not officially recommended result in a complex selective pressure, rendering the prediction of the evolution of <it>P. falciparum </it>resistance difficult. This public health problem should lead to increased vigilance and regular monitoring.</p

Outbreak of Leishmania braziliensis cutaneous leishmaniasis, Saül, French Guiana [letter]

New World cutaneous leishmaniasis (CL), a zoonotic disease, is increasingly seen among travelers returning from Latin American countries, particularly from Bolivia, Belize, and French Guiana (1). The epidemiology of CL in the Americas is heterogeneous and has complex variations in transmission cycles, reservoir hosts, and sandfly vectors. Changing human activities that affect these factors may have resulted in the emergence of species with distinct pathogenic potentials and responses to therapy. In the Guianan ecoregion complex, leishmaniasis is endemic, and 5 coexisting Leishmania parasite species are known to infect humans: L. guyanensis, L. braziliensis, L. amazonensis, L. naiffi, and L. lainsoni. Among these species, L. guyanensis accounts for ≈85% of CL cases (2). We report an outbreak of 7 cases of L. braziliensis CL that occurred among 24 scientists who participated in a field mission at Limonade Creek in Saül, French Guiana, during October 10–25, 2013. Saül is an isolated village in the Amazonian rainforest (3°55′18′′N, 53°18′02′′W)

Evidence for the Contribution of the Hemozoin Synthesis Pathway of the Murine Plasmodium yoelii to the Resistance to Artemisinin-Related Drugs

Plasmodium falciparum malaria is a major global health problem, causing approximately 780,000 deaths each year. In response to the spreading of P. falciparum drug resistance, WHO recommended in 2001 to use artemisinin derivatives in combination with a partner drug (called ACT) as first-line treatment for uncomplicated falciparum malaria, and most malaria-endemic countries have since changed their treatment policies accordingly. Currently, ACT are often the last treatments that can effectively and rapidly cure P. falciparum infections permitting to significantly decrease the mortality and the morbidity due to malaria. However, alarming signs of emerging resistance to artemisinin derivatives along the Thai-Cambodian border are of major concern. Through long-term in vivo pressures, we have been able to select a murine malaria model resistant to artemisinins. We demonstrated that the resistance of Plasmodium to artemisinin-based compounds depends on alterations of heme metabolism and on a loss of hemozoin formation linked to the down-expression of the recently identified Heme Detoxification Protein (HDP). These artemisinins resistant strains could be able to detoxify the free heme by an alternative catabolism pathway involving glutathione (GSH)-mediation. Finally, we confirmed that artemisinins act also like quinolines against Plasmodium via hemozoin production inhibition. The work proposed here described the mechanism of action of this class of molecules and the resistance to artemisinins of this model. These results should help both to reinforce the artemisinins activity and avoid emergence and spread of endoperoxides resistance by focusing in adequate drug partners design. Such considerations appear crucial in the current context of early artemisinin resistance in Asia

Etude du profil des leucocytes alvéolaires au cours de l'infection par Pneumocystis jirovecii

La pneumocystose est une pathologie de l'alvéole pulmonaire opportuniste et cosmopolite liée à un champignon : Pneumocystis jirovecii. C'est une cause fréquente de mortalité chez les patients immunodéprimés présentant un déficit immunitaire congénital ou acquise (VIH ou traitement par médicaments immunosuppresseurs). Peu de données existent sur les modifications cytokiniques et cellulaires présentes dans l'alvéole pulmonaire au cours de la pneumocystose. A partir de 64 lavages bronchoalvéolaires de patients immunodéprimés et infectés par Pneumocystis, nous avons montré l'existence de différences sur les concentrations alvéolaires de macrophages, de lymphocytes et d'IL-6. Cette étude suggère aussi qu'il existe une corrélation entre la charge en P. jirovecii et le degré d'immunodépression intra-alvéolaire.TOULOUSE3-BU Santé-Centrale (315552105) / SudocSudocFranceF

Caractérisation des plaques d'athérosclérose intra coronaires par tomodensitométrie spiralée multicoupes au cours du syndrome coronarien aigu (analyse comparative à l'échographie endocoronaire)

BORDEAUX2-BU Santé (330632101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Evaluation du spectromètre de masse Matrix Assisted Laser Desorption Ionization-Time Of Flight (MALDI-TOF) Vitek® MS dans le laboratoire de mycologie médicale du centre hospitalier universitaire de Toulouse

BORDEAUX2-BU Santé (330632101) / SudocSudocFranceF

Evaluation péri-opératoire du remplacement valvulaire pulmonaire dans la Tétralogie de Fallot chez l'adulte (expérience monocentrique du CHU de Bordeaux)

INTRODUCTION : le remplacement valvulaire pulmonaire chirurgical est la méthode de référence de la prise en charge des complications tardives de la voie d'éjection du VD et en particulier de l'IP, dans le cadre du suivi des patients ayant une Tétralogie de Fallot corrigée dans l'enfance. Les indications de RVP restent débattues et peu de données sont disponibles sur la morbidité périopératoire et son impact sur l'évolution à moyen terme. METHODES : Nous avons étudié de manière transversale 30 patients ayant bénéfécié d'un remplacement valvulaire pulmonaire et recueilli les données cliniques, biologiques et d'imagerie en préopératoires et à un an, ainsi que l'ensemble des données du monitoring effectué en post-opératoires immédiats dans l'unité de réanimation chirurgicale. Nous nous sommes particulièrement attachés à définir des facteurs prédictifs de syndrome de bas débit cardiaque et à en étudier les conséquences tardives à 1 an. RESULTATS : 85 % des patients ont bénéficié d'une xénogreffe stentless Freestyle MEDTRONIC ; 16 remplacements valvulaires ont été effectués à coeur battant. La chirurgie apporte un bénéfice significatif à un an sur la symptomatologie clinique et la morphologie ventriculaire droite (volume télédiastolique diminué de 152 ml à 109 ml/m2 avec même une normalisation du volume télédiastolique chez 7 patients et télésystolique chez 4 patients. La mortalité post-opératoire est de 6.6 % à 90 jours. Les complications post-opératoires sont peu fréquentes (6 % de tachycardies ventriculaires ; 6 % de ventilation mécanique > 24 H ; 10 % de complications rénales), en dehors du syndrome de bas débit cardiaque (46 %). La durée de CEC > 80 min et l'absence de chirurgie à coeur battant favorise le bas débit cardiaque de manière significative. Les complications post-opératoires ne modifient pas dans notre étude le devenir des patients à un an. Cependant le rôle de l'ischémie périopératoire sur le devenir à un an est suggéré par un pic de troponine post-opératoire moins important de manière significative chez les patients ayant normalisé leur volume ventriculaire télédiastolique. CONCLUSION : cette étude montre l'impact positif du RVP sur l'évolution à court terme. Bien que le faible effectif de l'étude ne permette pas de définir des critères précis pour stratifier le risque opératoire, les données de CEC et de réanimation mettent en lumière l'importance de la protection myocardique dans le remplacement valvulaire pulmonaire des Tétralogies de Fallot corrigées. La durée de CEC < 80 min et l'utilisation de la technique à coeur battant est prédictive d'une diminution du risque de survenue du syndrome de bas débit cardiaque. Le LCOS est fréquent mais l'anticipation systématique par un soutien hémodynamique centré sur le VD permet une évolution souvent favorable. La survenue de complications post-opératoires précoces ne semble pas altérer le pronostic des patients à 1 an.BORDEAUX2-BU Santé (330632101) / SudocSudocFranceF

Static and Dynamic Evaluation of an UWB Localization System for Industrial Applications

International audienc