Evolution of anti-SARS-CoV-2 immune response in a cohort of French healthcare workers followed for 7 months.

OBJECTIVES: We aimed to understand the immune response among healthcare workers (HCWs) following SARS-CoV-2 infection, and to determine the infection prevalence during the first wave of the pandemic among workers in our hospital. METHODS: Determination of the serological status against SARS-CoV-2 (nucleocapsid) was offered to all HCWs. All HCWs with positive SARS-CoV-2 serology were proposed to be included in a longitudinal medical and serological follow-up (anti-spike) for 7months. RESULTS: We included 3062 HCWs; 256 (8.4%) were positive for anti-SARS-CoV-2 nucleocapsid IgG. Among them, early decrease in the anti-nucleocapsid antibody index was observed between the first (S1) and second (S2) serology samplings in 208 HCWs (84.2%). The initial anti-nucleocapsid IgG index seemed to be related to the HCWs' age. Seventy-four HCWs were included in the 7-month cohort study. Among them, 69 (90.5%) had detectable anti-spike IgG after 7months and 24 (32.4%) reported persistent symptoms consistent with post-acute COVID-19 syndrome diagnosis. CONCLUSION: The prevalence of serological positivity among HCWs was 6.7%. Infection should be followed by vaccination because of antibody decrease.

Sonographic landmarks to differentiate "false labor" and "early true labor" as a possible new application of ultrasound in labor ward.

OBJECTIVE: To evaluate discrimination of clinical parameters and ultrasound examination to differentiate "false labor" and "true labor". METHODS: In a prospective study during a period of 6 months, a total of 178 patients in term (37-41 weeks) consulting our obstetric unit for uterine contraction, were enrolled. Patients were examined separately by a midwife and a resident and separated into "true labor group" and "false labor group". The clinical characteristics of true versus false labor patients were compared. ROC curves were developed to determine an optimal cervical length and uterocervical angle for prediction of true labor. RESULTS: The prevalence of real labor was 57.3%. Patients who were in true labor had more painful and more frequent contractions. The "true labor" group had shorter cervical length and larger uterocervical angle. The optimal CL cut-off was 1.4mm with a specificity of 73% (RR 4.3, sensibility 63%, PPV 14%, NPV 95%). The optimal UCA cut off was 123° (RR 6.7, sensitivity 50%, specificity of 83%, PPV 10%, NPV 96%). The best performance was demonstrated by combined testing, yielding LHR+ that rich 13. CONCLUSION: In this study, we reported a new application of ultrasound to identify false labor and avoid unnecessary hospitalization with obstetric and adverse economic impacts.

[Relevance of first trimester serum markers to predict pregnancy complications: A Tunisian preliminary study]. / Pertinence des marqueurs sériques du premier trimestre pour prédire les complications de la grossesse : étude prospective tunisienne.

OBJECTIVES: Identify applications and utility of serum markers dosed in the first trimester in predicting, early diagnosis and management of various complications of pregnancy. METHODS: Eight hundred and eighty patients were included in this prospective regional study performed in the governorate of Bizerte in northern Tunisia in collaboration between the private and public sectors. Serum markers of the first quarter, PAPP A and ßhCG, were measured in the same laboratory. The performance of these markers was studied in the prediction of adverse pregnancy complications. RESULTS: The prevalence of various pregnancy complications was 8.6% for birth prematurely, 9.2% for hypertension or preeclampsia, IUGR 5.8% and 7.3% for loss pregnancy. PAPP A levels were lower in fetal loss group (P=0.005), vascular disease group (P=0.001) and preterm delivery group (P=0.001). In addition, a lower rate of ßhCG was associated with the occurrence of placental pathologies such as growth retardation (P=0.037) and hypertension (P=0.034) and appears to have no predictive value in the occurrence of preterm birth (P=0.76) and fetal loss (P=0.189). Logistic regression analysis showed a significant predictive value of these markers. CONCLUSION: Serum markers of the first trimester appear to have adequate predictive validity of adverse pregnancy complications. A risk predictive model could be designed based on these markers and involving maternal and ultrasound features in order to target prophylactically a high risk population.

[Feasibility and diagnostic value of hysterosonography performed in bleeding time in the exploration of abnormal uterine bleeding]. / Faisabilité et valeur diagnostique de l'hystérosonographie réalisée en période de saignement dans l'exploration des saignements utérins anormaux.

OBJECTIVES: The aim of our study is to evaluate the feasibility, safety and diagnostic value of hysterosonography performed in an emergency setting among patients consulting for active abnormal uterine bleeding. MATERIALS AND METHODS: In this prospective study, we included 216 patients visiting our emergency department for abnormal uterine bleeding. All patients had a transvaginal ultrasound with doppler study and an hysterosonography. Secondly, the patients, in whom we diagnosed a suspected organic lesion, were addressed to an endoscopic or surgical procedure with pathological examination. Initially, we evaluated the feasibility and the safety of hysterosonography and secondly, we compared the two techniques (EEV and hysterosonography), sensitivity, specificity, LHR+and LHR-. RESULTS: The hysterosonography was performed in 98.1 % of patients and its realization has resulted in an additional period of 1.2minutes on average (extreme: 6-12) compared to ultrasound. The tolerance of the hysterosonographic examination was very good in 73.5 % of patients and good in 23.1 % of them. For the 167 patients who had been diagnosed with presumed organic lesions, pathological examination found an endometrial hyperplasia in 34.7 % of cases, polyps in 40.1 % of cases, sub-mucosal fibroids in 11.3 % of cases, endometrial cancer in 0.7 % of cases and other lesions in 13.2 % of cases. The diagnostic value of hysterosonography was superior to ultrasound in the detection of polyps (AUC: 0.894 vs 0.778, P=0.003) and fibromas (AUC: 1.000 vs 0.716, P=0.001) while the two methods showed no significant difference in the detection of hyperplasia. CONCLUSION: The purpose of our study was to focus on a particular context of use of the hysterosonography consisting on hemorrhagic period and on its realization in the emergency room. We were able to demonstrate that hysterosonography is compatible with the emergency situation as to its feasibility and its diagnostic value and that its realization would contribute to the sorting of patients to guide them immediately to a surgical or endoscopic procedure if necessary.

[Value of ultrasonography to predict the endometrial cancer in postmenopausal bleeding]. / Valeur de l'échographie pour prédire le cancer de l'endomètre dans les métrorragies post-ménopausiques.

OBJECTIVE: To build mathematical models for evaluating the individual risk of endometrial malignancy in women with postmenopausal bleeding and a thick endometrium using clinical data, sonographic endometrial thickness and power Doppler ultrasound findings. METHODS: A total of 117 patients underwent transvaginal two-dimensional gray-scale and power Doppler ultrasound examination of the endometrium before getting endometrial biopsy. Inclusion criteria were post-menopausal bleeding and a thick endometrium greater than 5mm. The ultrasound image showing the most vascularized section through the endometrium as assessed by power Doppler was frozen to estimate endometrial thickness and features. The vascularity index was calculated using computer software. A structured history was taken to collect clinical information. Multivariate logistic regression analysis was used to create mathematical models to predict endometrial malignancy. RESULTS: There were 31 (26.4%) malignant and 86 (74.6%) benign endometria… Women with a malignant endometrium were older (median age 61 vs 56 years, P=0.036) and had a thicker endometrium (median thickness 18.8mm vs 12.5; P=0.002) and higher values for vascularity index. When using only clinical data to build a model for estimating the risk of endometrial malignancy, a model including the variables age had the largest area under the receiver-operating characteristics curve (AUC), with a value of 0.69 (95% confidence interval [CI], 0.59-0.79). A model including age and endometrial thickness had an AUC of 0.72 (95% CI, 0.50-0.96), and one including age, endometrial thickness and vascularity index had an AUC of 0.91 (95% CI, 0.62-0.97). Using a risk cut-off of 12%, the latter model had sensitivity 89%, specificity 74%, positive likelihood ratio 3.42 and negative likelihood ratio 0.14. DISCUSSION: Postmenopausal bleeding is a frequent cause of consultation in gynecological particularly in peri- or post-menopausal period. They are the main alarm sign of endometrial carcinoma. Vaginal ultrasound has become the "gold standard" in the initial exploration. It is a powerful tool to estimate the individual risk of malignancy in symptomatic postmenopausal women in order to optimize the management. The diagnostic performance of models predicting endometrial cancer increases substantially when sonographic and power Doppler information are added to clinical variables. This model seems to be clinically useful but need to be prospectively validated.

An experimental model of gastroschisis using fetoendoscopy: preliminary results and technical considerations.

BACKGROUND: The aim of this study was to show the feasibility of an experimental model of gastroschisis using fetoendoscopic surgery on sheep fetuses, and also to perform amnioinfusion until delivery using an in-dwelling intraamniotic catheter. METHODS: We analyzed the data from 18 pregnant ewes having 26 fetuses, which underwent surgery at 80 days of gestation (full term, 145 days). The fetendo technique was used to create a gastroschisis in 15 fetuses. The fetal abdominal wall was opened on the left side of the cord using scissors. The omentum and the intestinal loops were eviscerated using atraumatic forceps. Eleven fetuses were used as a control group. Twenty-one fetuses underwent amnioinfusion; a simple exteriorized catheter was used in seven cases and an intraamniotic catheter with an implantable port was used in the other 14. All ewes and fetuses were killed at the end of the experiment by an intravenous injection of pentotal; thereafter, the fetuses underwent necropsy. RESULTS: Twelve fetuses died and 14 survived (53.8%); seven of the 15 that underwent gastroschisis survived (46.7%). An amniotic infection occurred in nine fetuses (34.6%); of these, six died and three that were administered antibiotics survived. CONCLUSIONS: Our experience shows that this experimental model of gastroschisis is feasible and reproducible, and that a repeated amnioinfusion can be performed with an in-dwelling catheter in pregnant ewes. The use of an implantable port is safer than a simple exteriorized catheter.

[Multifocal hydatid cysts in children]. / Les kystes hydatiques multifocaux de l'enfant.

From 1981 to 1983, 112 children have been operated on for hydatidosis, 26 of them presented multifocal hydatid cysts. In half cases the lung was affected, in association with an abdominal affect. In 6 cases it was a bilateral pulmonary localisation. The check-up is essentially with two exams: thoracal radiology, front and side view; and abdominal echography. The hydatic serology confirms the parasitic origin. 40 surgical operations have been necessary for 21 children carried 171 hydatid cysts. The particular characters of the echinococcosis in the childhood authorized surgical technical which, without being radicals, can avoid the long morbidity of this affection. We have to deplore in the period after operation: a small abundance hemoptysis (4 days after operation), 2 lungs abscess (10 and 12 days in postoperative period), a forgotten cyst on the liver, discovered by echography in the 30 days after surgery.

Scattering analysis of slanted fiber gratings.

The diffraction efficiency of a tilted in-core fiber grating is analyzed with the scattering formalism and the first Born approximation. Without any prior physical assumptions about the shape or direction of the scattered wave, it is shown that diffraction occurs when the so-called Bragg conditions are nearly satisfied and the interaction process can be described by a pair of coupled first-order differential equations that are exactly the same as those obtained through the coupled-mode analysis.

Measurement of the extensional and flexural rigidities of a subcellular structure: marginal bands isolated from erythrocytes of the newt.

The elastic properties of marginal band, a microtubular structure isolated from the newt (notophthalmus viridescens) have been measured. Bands were isolated using Triton X-100 and pepsin at pH 6.8 according to the method of Cohen (1978). Isolated bands were manipulated with a glass microhook in a buffer-filled chamber under the microscope. Single bands were stretched between the hook and a thin glass fiber. The fiber was calibrated so that the force on the band could be calculated from the displacement of the fiber. The data pairs of force versus band deflection were analyzed according to the theoretical work of Libai and Simmonds (1983) to obtain the flexural and extensional rigidities of the band. Band dimensions calculated from the data were consistent with microscopically determined values. The average flexural rigidity of the bands (EI) was 5.3 X 10(-13) dyn X cm2 and the average extensional rigidity (EA) was 0.017 dyn. Compared to the cell membrane, the marginal band is nearly inextensible and has a much greater resistance to bending, indicating that the band makes an important contribution to the deformability of the circulating cell.