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1.
Paediatr Child Health ; 26(3): e145-e151, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33936344

RESUMO

OBJECTIVES: Celiac disease (CD) is an immune enteropathy caused by sensitivity to gluten affecting one per cent of the general population. Most people with CD are asymptomatic and some may be affected from childhood. Despite the latest recommendations of paediatric gastroenterology societies, targeted screening is still uncommon in clinical paediatric settings. A poor understanding of the asymptomatic population's opinions creates obstacles for broader implementation of CD screening. This study aims to fill this gap by reporting on the knowledge and opinions of adolescents and caregivers of children on CD screening. METHODS: Adolescents with absence of classical symptoms of CD and caregivers of presumably asymptomatic children were asked about their knowledge and opinions of CD through a self-administered questionnaire. RESULTS: There were 227 respondents including 76 adolescents and 151 caregivers. A minority of respondents (8% of caregivers and 23% of adolescents) were identified as having a CD-associated condition (such as hypothyroidism, type 1 diabetes, Down syndrome, etc.). A majority of caregivers (84%) and half of adolescents (49%) already knew about CD. Half of the respondents (46%) were in favour of screening asymptomatic paediatric populations and this agreement increased to 81.7% when they were confronted with hypothetical risks of 10%. CONCLUSION: This study reveals an increased willingness to screen when participants were faced with increasing hypothetical risks. This suggests that screening recommendations targeting high-risk populations, such as those of paediatric and non-paediatric gastroenterology societies, may be more widely accepted.

2.
Antimicrob Agents Chemother ; 57(10): 5060-6, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23917313

RESUMO

Carriage of extended-spectrum beta-lactamase-producing enterobacteria (ESBL-E) has increased in community settings. Little is known about their long-term evolution. French Guiana Amerindians living in a very remote village, already sampled in 2001 and 2006 for ESBL-E fecal carriage, were screened again in October 2010. Sociodemographic data and antibiotic intake data were collected during the previous year. ESBL-E strains collected in 2010 and their plasmid contents were typed. The results were compared to those of the previous campaigns. The prevalence of ESBL-E carriage in 2010 was 5.3%, whereas it was 8.0% and 3.2% in 2006 and 2001, respectively. As previously determined, no individual factor was associated with carriage, including personal antibiotic exposure. However, overall antibiotic use had decreased to a 0.67 treatments/subject/year in 2010 versus 1.09 in 2006 (P < 0.001), which supports the idea that population exposure to antibiotics impacts on ESBL-E community carriage rates. A wide diversity of ESBL Escherichia coli strains belonging to the A0, A1, B1, and D2 phylogroups and producing the CTX-M-1, CTX-M-2, and CTX-M-8 enzymes were isolated. Despite the overall genetic diversity of the strains evaluated by repetitive extragenic palindromic PCR (rep-PCR) and multilocus sequence typing, two CTX-M-1-producing clones were found to have spread. In contrast, similar ESBL-bearing I1/Iγ plasmids were present in various strains both within and between carriers, suggesting high rates of plasmid transfer. Our results suggest that overall antibiotic exposure affects ESBL-E fecal carriage in the community. ESBL-E spread may be the result of both strain dissemination and the transfer of plasmids in intestinal microbiota.


Assuntos
Antibacterianos/farmacologia , Escherichia coli/efeitos dos fármacos , Escherichia coli/enzimologia , Fezes/microbiologia , Adolescente , Adulto , Escherichia coli/classificação , Proteínas de Escherichia coli/metabolismo , Feminino , Humanos , Masculino , Filogenia , Fatores de Risco , Adulto Jovem , beta-Lactamases/metabolismo
3.
J Pediatr Gastroenterol Nutr ; 57(2): 236-9, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23568050

RESUMO

BACKGROUND AND OBJECTIVES: Many mathematical equations based on height have been developed to estimate the esophageal length (EL) in children. The aim of this study was to confirm whether the preexisting and most frequently used equation by Strobel et al is accurate in calculating the EL in our pediatric population. Our secondary goal was to evaluate whether a new formula could be developed using our nonsurgical and surgical populations' data for the correlation between patients' height and measured EL by esophageal manometry (EM). METHODS: From 2000 to 2009, 116 children between the ages of 3 and 18 years without previous esophageal surgery underwent EM (n = 31) at the Montreal Children's Hospital. During the same period, 55 EMs were performed on 34 children with a previous history of esophageal surgery. For both groups, we collected the following data: height, EL calculated by the Strobel formula, and EL measured by EM. RESULTS: The Strobel equation was inaccurate in predicting the EL. The calculated EL was 3.0 ±â€Š0.32 cm longer than the EM measurements (P < 0.001). The height (H) of nonsurgical children was found to be highly predictive of the lower esophageal sphincter location (L), and the derived linear regression equation is L = 0.216 (H) + 7.13 [r²â€Š= 0.85]. CONCLUSIONS: This study confirmed that the Strobel formula is not sufficiently accurate to predict EL in the pediatric population that is between 3 and 18 years old. A correlation exists between height and esophageal sphincter location position. If EM is unavailable, the use of a new mathematical equation like ours can be considered.


Assuntos
Monitoramento do pH Esofágico , Esôfago , Refluxo Gastroesofágico , Manometria/métodos , Conceitos Matemáticos , Adolescente , Estatura , Catéteres , Criança , Pré-Escolar , Eletrodos , Esfíncter Esofágico Inferior , Feminino , Refluxo Gastroesofágico/diagnóstico , Humanos , Concentração de Íons de Hidrogênio , Modelos Lineares , Masculino , Reprodutibilidade dos Testes
4.
J Pediatr Surg ; 57(1): 41-44, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34666898

RESUMO

PURPOSE: Recent studies have identified transanastomotic tubes (TATs) as a risk factor for the development of anastomotic strictures after repair of esophageal atresia with tracheoesophageal fistula (EATEF). We further investigated these findings in a multicenter study. METHODS: We conducted a retrospective cohort study at three university-affiliated hospitals in the province of Quebec. All patients with types C and D EATEF who underwent primary repair between January 1993 and August 2018 were included. Anastomotic stricture was defined as clinical symptoms of stricture with confirmation on esophagram or endoscopy. Multivariate logistic regression and the Wilcoxon Rank-Sum test were used to evaluate the primary outcome of stricture within one year of surgery and secondary outcome of duration of postoperative total parenteral nutrition (TPN). RESULTS: 244 patients were included, of which 234 (96%) were type C and 10 (4%) were type D. The anastomotic stricture rate at 1 year was 30%. TATs were utilized in 61% of patients. Thirty-six percent of patients with TATs developed a stricture within one year, as compared to 19% of patients without TATs (p = 0.005). TATs were associated with stricture on univariate analysis (OR 2.49, p = 0.004, 95% CI: 1.37-4.69). On multivariate analysis, after adjusting for gestational age, birth weight, leak, long gap, anastomotic tension, and daily acid suppression, patients with TATs had 2.72 times higher odds of developing a stricture as compared to patients without TATs (p = 0.006, 95% CI: 1.35-5.74). The median duration of TPN was 9 days in both groups (p = 0.139, IQR 6-14 in patients with TATs versus IQR 7-16 in patients without). CONCLUSION: Transanastomotic tubes are associated with a significantly higher risk of postoperative stricture following repair of esophageal atresia with tracheoesophageal fistula and do not shorten the duration of total parenteral nutrition. LEVEL OF EVIDENCE: III.


Assuntos
Atresia Esofágica , Estenose Esofágica , Fístula Traqueoesofágica , Anastomose Cirúrgica/efeitos adversos , Fístula Anastomótica , Constrição Patológica/cirurgia , Atresia Esofágica/cirurgia , Estenose Esofágica/etiologia , Estenose Esofágica/cirurgia , Humanos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Quebeque/epidemiologia , Estudos Retrospectivos , Fístula Traqueoesofágica/etiologia , Fístula Traqueoesofágica/cirurgia , Resultado do Tratamento
5.
J Clin Med ; 10(21)2021 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-34768428

RESUMO

The multidimensionality of chronic pain forces us to look beyond isolated assessment such as pain intensity, which does not consider multiple key parameters, particularly in post-operative Persistent Spinal Pain Syndrome (PSPS-T2) patients. Our ambition was to produce a novel Multi-dimensional Clinical Response Index (MCRI), including not only pain intensity but also functional capacity, anxiety-depression, quality of life and quantitative pain mapping, the objective being to achieve instantaneous assessment using machine learning techniques. Two hundred PSPS-T2 patients were enrolled in the real-life observational prospective PREDIBACK study with 12-month follow-up and received various treatments. From a multitude of questionnaires/scores, specific items were combined, as exploratory factor analyses helped to create a single composite MCRI; using pairwise correlations between measurements, it appeared to more accurately represent all pain dimensions than any previous classical score. It represented the best compromise among all existing indexes, showing the highest sensitivity/specificity related to Patient Global Impression of Change (PGIC). Novel composite indexes could help to refine pain assessment by informing the physician's perception of patient condition on the basis of objective and holistic metrics, and also by providing new insights regarding therapy efficacy/patient outcome assessments, before ultimately being adapted to other pathologies.

6.
J Clin Med ; 10(21)2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34768575

RESUMO

Persistent Spinal Pain Syndrome Type 2 (PSPS-T2) represents a main cause of work disruption. Beyond its societal consequences, occupational inactivity is responsible for a major decrease in physical/mental health in individuals but remains poorly analyzed. We designed a study to prospectively examine Professional Status (PS) evolution and its association with key bio-psychological markers. Data from 151 consecutively included working-age PSPS-T2 patients were analyzed to determine the proportion of professional inactivity and the relationships between PS and Social Gradient of Health (SGH), Numeric Pain Rating Scale (NPRS), EuroQol 5-Dimensional 5-Level (EQ-5D-5L), Oswestry Disability Index (ODI), Hospital Anxiety and Depression Scale (HADS), and Fear-Avoidance Belief Questionnaire work subscale (FABQ-W). Despite optimized medical management, 73.5% of PSPS-T2 patients remained inactive after 1 year of follow-up/p = 0.18. Inactive patients presented a low SGH/p = 0.002, higher NPRS/p = 0.048, lower EQ-5D-5L/p < 0.001, higher ODI/p = 0.018, higher HADS-D/p = 0.019 and higher FABQ-W/p < 0.001. No significant mediation effect of FABQ-W on SGH consequences regarding PS was observed in our structural model/p = 0.057. The link between unemployment and bio-psycho-social pain dimensions appears bidirectional and justifies intense collaboration with social workers. Optimizing therapeutical sequencing towards personalized professional plans implies restoring "Adapted Physical Function" as an initial goal, and tailoring an "Adapted Professional Activity", matching with patient expectations and capabilities, as a final objective.

7.
J Clin Med ; 10(13)2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34202362

RESUMO

The Social Gradient of Health (SGH), or position in the social hierarchy, is one of the major determinants of health. It influences the development and evolution of many chronic diseases. Chronic pain dramatically affects individual and social condition. Its medico-economic impact is significant and worldwide. Failed Back Surgery Syndrome or Persistent Spinal Pain Syndrome type 2 (PSPS-T2) represents one of its most fascinating and disabling conditions. However, the influence of SGH on PSPS-T2 has been poorly explored. We designed a prospective multicentric study (PREDIBACK study) to assess the SGH prevalence, and to examine its association with medical and psychological variables, in PSPS-T2 patients. This study included 200 patients to determine the SGH association with pain (NPRS), Quality of life (EQ-5D-5L), kinesiophobia (FABQ-Work), catastrophism (CSQ), and functional capacity (ODI). Around 85.3% of PSPS-T2 patients in our study had low SGH. Low SGH patients had a higher FABQ-Work and CSQ-Catastrophizing score than high SGH patients (p < 0.05). High SGH patients have a higher ODI score than low SGH patients (p < 0.10). Our results suggest that SGH is a relevant factor to guide prevention, research, and ultimately intervention in PSPS-T2 patients and could be more widely transposed to chronic pain.

8.
J Clin Med ; 10(20)2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34682799

RESUMO

Persistent Spinal Pain Syndrome Type 2 (PSPS-T2), (Failed Back Surgery Syndrome), dramatically impacts on patient quality of life, as evidenced by Health-Related Quality of Life (HRQoL) assessment tools. However, the importance of functioning, pain perception and psychological status in HRQoL can substantially vary between subjects. Our goal was to extract patient profiles based on HRQoL dimensions in a sample of PSPS-T2 patients and to identify factors associated with these profiles. Two classes were clearly identified using a mixture of mixed effect models from a clinical data set of 200 patients enrolled in "PREDIBACK", a multicenter observational prospective study including PSPS-T2 patients with one-year follow-up. We observed that HRQoL was more impacted by functional disability for first class patients (n = 136), and by pain perception for second class patients (n = 62). Males that perceive their work as physical were more impacted by disability than pain intensity. Lower education level, lack of adaptive coping strategies and higher pain intensity were significantly associated with HRQoL being more impacted by pain perception. The identification of such classes allows for a better understanding of HRQoL dimensions and opens the gate towards optimized health-related quality of life evaluation and personalized pain management.

9.
J Pediatr Gastroenterol Nutr ; 50(4): 394-6, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19841595

RESUMO

OBJECTIVES: Esophageal atresia with or without tracheo-esophageal fistula is a frequent malformation that occurs in about 1 of 3000 live births. It can be associated with other congenital malformations. The aim of this study was to measure the frequency of heterotopic pancreas (HP) in children with esophageal atresia (EA) and to evaluate possible linkage with other malformations. MATERIALS AND METHODS: All patients with EA were prospectively followed since 2005 at Hôpital Sainte-Justine and since 2006 at the Montreal Children's Hospital. We compared 91 patients who underwent gastroscopy during that period with 182 control patients who submitted to gastroscopy for other indications. The presence or the absence of HP and its localization were noted in both groups. The following data were also collected on patients with EA: sex, gestational age, EA type, and other malformations. RESULTS: Seventeen (18.7%) of the 91 patients with EA had gastric HP compared with 1 (0.5%) in the control group (OR 42, 95% confidence interval 7-249, P < 0.001). There were no differences between patients with or without HP regarding sex, prematurity, EA type, and the presence or absence of other congenital abnormalities. CONCLUSIONS: This study demonstrates, for the first time, that gastric HP is associated with EA irrespective of other malformations.


Assuntos
Anormalidades Múltiplas , Coristoma/epidemiologia , Atresia Esofágica , Pâncreas , Gastropatias/epidemiologia , Fístula Traqueoesofágica , Adolescente , Criança , Pré-Escolar , Feminino , Gastroscopia , Humanos , Lactente , Masculino , Prevalência , Estudos Prospectivos
10.
Environ Microbiol ; 10(8): 2132-7, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18459976

RESUMO

To investigate if the characteristics of human intestinal Escherichia coli are changing with the environment of the host, we studied intestinal E. coli from subjects having recently migrated from a temperate to a tropical area. We determined the phylogenetic group, the prevalence of the antibiotic resistance, the presence of integrons and the strain diversity in faecal isolates from 25 subjects originally from metropolitan France and expatriated to French Guyana. These characteristics were compared with those of 25 previously studied Wayampi Amerindian natives of French Guyana and from 25 metropolitan French residents. The three groups of subjects were matched for age and sex, had not taken antibiotics for at least 1 month, nor had been hospitalized within the past year. In all, the characteristics of intestinal E. coli from Expatriates were intermediate between those found in residents from metropolitan France and those found in natives of French Guyana. Prevalence of carriage of resistant Gram-negative bacteria in Expatriates was intermediate between French residents and Wayampi as were the prevalence of integrons in E. coli (12.3% versus 16.3% and 7.8% respectively), and the intra-host diversity of E. coli (2.3 strains/subject versus 1.9 and 3.1, respectively); lastly, in Expatriates, the prevalence of carriage of phylogenetic group B2 strains was lower than in French residents (16% versus 56%, P = 0.005), while carriage of phylogenetic group A strains was lower than in Wayampi (56% versus 88%, P = 0.03). Our results suggest that the composition of the commensal intestinal flora of humans is not static but changes dynamically in response to new environmental conditions.


Assuntos
Portador Sadio/microbiologia , Escherichia coli/classificação , Escherichia coli/genética , Trato Gastrointestinal/microbiologia , Farmacorresistência Bacteriana/genética , Emigração e Imigração , Escherichia coli/efeitos dos fármacos , Feminino , França , Guiana Francesa , Humanos , Indígenas Sul-Americanos/etnologia , Masculino , Testes de Sensibilidade Microbiana , Filogenia , Viagem
11.
Gene ; 396(1): 84-92, 2007 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-17433575

RESUMO

Crabs of the Bythograeidae family (Crustacea: Brachyura: Bythogreoidea) are the only endemic crab family living in hydrothermal fields. The hydrothermal environment is characterized by unique ecological parameters, such as the high temperature gradient around the hydrothermal chimney (2-350 degrees C), a fluid environment containing high levels of metals and numerous gases. The 70-kDa Heat Shock Protein (HSP70) group is the most-studied HSP, because it is ubiquitous, and a strong positive correlation has been found between the amounts of HSP70 produced in response to stress, and the ability of the organism to withstand stressful conditions. The 70-kDa heat shock protein genes from Bythograeids (species analyzed: Bythograea thermydron, Cyanagraea praedator and Segonzacia mesatlantica) were characterized. Our results revealed that Bythograeidae possess genes which are similar with those present in Xanthids (coastal crabs). The deduced protein sequences displayed motifs distinct from those in the other crustacean HSC70/HSP70s available in the databases. Phylogenetic analysis showed that these members of HSP70 family identified in Bythograeidae and Xanthidae constitute a new subgroup within this family.


Assuntos
Braquiúros/genética , Proteínas de Choque Térmico HSP70/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Proteínas de Choque Térmico HSP70/química , Íntrons/genética , Dados de Sequência Molecular , Filogenia
12.
Therap Adv Gastroenterol ; 10(11): 819-827, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29147133

RESUMO

BACKGROUND: Thiopurines, azathioprine (AZA) and 6-mercaptopurine (6-MP) are common maintenance medications for inflammatory bowel disease (IBD). Excessive methylation via thiopurine methyltransferase (TPMT) frequently causes therapeutic failure. Allopurinol reduces excessive 6-methyl-mercaptopurine (6-MMP) while enhancing 6-thioguanine (6-TGN) levels. The aim of this study was to evaluate clinical, metabolic and endoscopic impact of allopurinol in combination with low-dose thiopurine in IBD. METHODS: Retrospective review of consecutive cases treated with allopurinol. Metabolites and their ratios (6-MMP/6-TGN) were compared pre- and post-allopurinol. Clinical and endoscopic remission were assessed. RESULTS: Allopurinol (n = 66) reduced mean dose of AZA by 70% (p < 0.01). Baseline levels (SD) 6-TGN, 6-MMP and 6-MMP/6-TGN were 165 (64), 9388 (5234) and 59.8 (30.3), respectively. These values improved on allopurinol to 297 (102), 896 (1031) and 3.4 (4.0), respectively (p < 0.0001). Therapeutic 6-TGN level (>235) was achieved in 49/58 cases on allopurinol combination therapy, versus 9/58 monotherapy (p = 0.0001). Among the thiopurine failure group (40 patients), clinical remission or response was observed in 65% and 22% of patients, respectively. In the asymptomatic group with excessive 6-MMP, 11/14 achieved sustained remission on allopurinol. Repeat colonoscopy (n = 28) showed mostly endoscopic remission (67.9%) or improvement (17.8%). Few had unimproved lesions (14.3%). Importantly, 46% of cases had complete mucosal healing. Two patients had cancer on combination therapy (de novo pancreatic cancer and fatal recurrence of metastatic testicular cancer). Elevated transaminases were reduced on allopurinol (48.2 versus 6.9%) (p < 0.001); no change in leukopenic or infectious events occurred. CONCLUSION: Allopurinol in combination with low-dose thiopurine corrected excessive 6-MMP levels, resulting in clinical remission and mucosal healing in the majority of cases. The potential cancer risk of allopurinol and thiopurine combination therapy needs further research.

13.
Philos Trans R Soc Lond B Biol Sci ; 372(1728)2017 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-28717022

RESUMO

In this study, we investigated the responses of Phaeodactylum tricornutum cells acclimated to 300 µmol m-2 s-1 photon flux density to an increase (1000 µmol m-2 s-1) or decrease (30 µmol m-2 s-1) in photon flux densities. The light shift occurred abruptly after 5 days of growth and the acclimation to new conditions was followed during the next 6 days at the physiological and molecular levels. The molecular data reflect a rearrangement of carbon metabolism towards the production of phosphoenolpyruvic acid (PEP) and/or pyruvate. These intermediates were used differently by the cell as a function of the photon flux density: under low light, photosynthesis was depressed while respiration was increased. Under high light, lipids and proteins accumulated. Of great interest, under high light, the genes coding for the synthesis of aromatic amino acids and phenolic compounds were upregulated suggesting that the shikimate pathway was activated.This article is part of the themed issue 'The peculiar carbon metabolism in diatoms'.


Assuntos
Dióxido de Carbono/metabolismo , Diatomáceas/metabolismo , Luz , Fotossíntese , Carbono/metabolismo , Diatomáceas/efeitos da radiação
14.
Int J Antimicrob Agents ; 48(1): 51-55, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27236843

RESUMO

This study investigated the clinical epidemiology and resistance mechanisms of Acinetobacter baumannii and characterised the clonal diversity of carbapenem-resistant A. baumannii (CRAB) during an ICU-associated outbreak at Cayenne Hospital, French Guiana. All non-duplicate A. baumannii isolates from 2008 to 2014 were tested for antibiotic susceptibility by disk diffusion. Multilocus sequence typing, pulsed-field gel electrophoresis (PFGE) and characterisation of carbapenemase-encoding genes were performed on CRAB. Of the 441 A. baumannii isolates, most were from males (54.0%) and were detected mainly from the ICU (30.8%) and medicine wards (21.8%). In the ICU, strains were mainly isolated from the respiratory tract (44.1%) and bloodstream (14.0%), whereas in medicine wards they mainly were from wound/drainage (36.5%) and bloodstream (25.0%). A. baumannii showed the greatest susceptibility to piperacillin/tazobactam (92.7%), imipenem (92.5%), colistin (95.6%) and amikacin (97.2%), being lower in the ICU and medicine wards compared with other wards. An outbreak of OXA-23-producing CRAB occurred in the 13-bed ICU in 2010. CRAB strains were more co-resistant to other antimicrobials compared with non-CRAB. Molecular genetics analysis revealed five sequence types [ST78, ST107 and ST642 and two new STs (ST830 and ST831)]. Analysis of PFGE profiles indicated cross-transmissions of CRAB within the ICU, between the ICU and one medicine ward during transfer of patients, and within that medicine ward. This study provides the first clinical and molecular data of A. baumannii from French Guiana and the Amazon basin. The ICU was the highest risk unit of this nosocomial outbreak of OXA-23-producing CRAB, which could subsequently disseminate within the hospital.


Assuntos
Infecções por Acinetobacter/epidemiologia , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/efeitos dos fármacos , Carbapenêmicos/farmacologia , Surtos de Doenças , Resistência beta-Lactâmica , Acinetobacter baumannii/enzimologia , Acinetobacter baumannii/genética , Acinetobacter baumannii/isolamento & purificação , Adulto , Proteínas de Bactérias/genética , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Eletroforese em Gel de Campo Pulsado , Feminino , Guiana Francesa/epidemiologia , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Tipagem de Sequências Multilocus , Estudos Retrospectivos , Adulto Jovem , beta-Lactamases/genética
15.
Trans R Soc Trop Med Hyg ; 110(12): 705-713, 2016 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-28938048

RESUMO

Background: Identifying patients at risk of developing severe dengue is challenging. The objective of the present study was to determine the incidence of hypotension and its predictive factors during the Dengue 2 epidemic in 2013. Methods: In 2013, a longitudinal study was performed using data from all confirmed cases of dengue seen in Cayenne General Hospital. The analysis used Cox proportional modeling to obtain adjusted hazards ratios for hypotension. Results: A total of 806 confirmed patients were included 78 (9.6%) of whom developed hypotension. Extensive purpura, cutaneomucous hemorrhage, serous effusion and age 1-15 years were associated with subsequent hypotension whereas 'aches' and a rash were associated with a lower incidence of hypotension. The biological variables independently associated with hypotension were: increase of hematocrit, low protein concentrations, low sodium concentration and lymphocytes over 1400/ml. A risk score was computed from the scaled Cox model coefficient. Conclusions: From a clinician's perspective, extensive purpura, cutaneomucous hemorrhage, serous effusion, age 1-15 years, hematocrit increase, low protein, low sodium, lymphocytosis and the absence of aches or of a rash, may be important warning signs to predict subsequent hypotension and shock. Over half of the patients with the highest risk score subsequently developed hypotension. The prognostic score had a 48.2% sensitivity with less than 10% of false positives. This score requires external validation before its impact on clinical practice is evaluated.


Assuntos
Dengue/diagnóstico , Dengue/epidemiologia , Epidemias , Hipotensão/diagnóstico , Hipotensão/epidemiologia , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Dengue/fisiopatologia , Exantema/patologia , Feminino , Guiana Francesa/epidemiologia , Hematócrito , Humanos , Hipotensão/fisiopatologia , Incidência , Lactente , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Modelos de Riscos Proporcionais , Púrpura/patologia , Adulto Jovem
16.
Environ Sci Pollut Res Int ; 22(22): 17303-16, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25613800

RESUMO

This study assessed the responses of molecular biomarkers and heavy metal levels in Cerastoderma glaucum exposed for 1 week to two industrial effluents (1%) discharged into the Tunisian coastal area, F1 and F2, produced by different units of production of a phosphate treatment plant. A significant uptake of metals (Cd, Cu, Zn, and Ni) was observed in exposed cockles compared to controls, with an uptake higher for F1 than for F2. A decrease in LT50 (stress on stress test) was also observed after an exposure to the effluent F1. Treatments resulted in different patterns of messenger RNA (mRNA) expression of the different genes tested in this report. Gene transcription monitoring performed on seven genes potentially involved in the tolerance to metal exposure showed that for both exposures, mechanisms are rapidly and synchronically settled down to prevent damage to cellular components, by (1) handling and exporting out metal ions through the up-regulation of ATP-binding cassette xenobiotic transporter (ABCB1) and metallothionein (MT), (2) increasing the mRNA expression of antioxidant enzymes (catalase (CAT), superoxide dismutases, CuZnSOD and MnSOD), (3) protecting and/or repairing proteins through the expression of heat shock protein 70 (HSP70) mRNAs, and (4) increasing ATP production (through the up-regulation of cytochrome c oxidase 1 (CO1)) to provide energy for cells to tolerate stress exposure. The tools developed may be useful both for future control strategies and for the use of the cockle C. glaucum as a sentinel species.


Assuntos
Cardiidae/efeitos dos fármacos , Resíduos Industriais , Poluentes Químicos da Água/toxicidade , Animais , Transporte Biológico , Biomarcadores/metabolismo , Cardiidae/genética , Cardiidae/metabolismo , Metais Pesados/metabolismo , Metais Pesados/toxicidade , RNA Mensageiro/metabolismo , Poluentes Químicos da Água/metabolismo
17.
Environ Sci Pollut Res Int ; 22(22): 17290-302, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25523290

RESUMO

This study investigates cadmium effects on key messenger RNA (mRNA) expression (MT, MnSOD, CuZnSOD, CAT, ABCB1, HSP70, and CO1) by qPCR in the cockle Cerastoderma glaucum after chronic exposure to two high but environmentally relevant concentrations of CdCl2 (50 µg/L and 5 mg/L) for 12 h to 18 days. Cd accumulation measured in cockles' tissues is significantly higher in both treatment conditions compared to controls and in a dose-dependent manner. Stress on stress tests performed at different times of the experiment clearly demonstrated that exposure to both concentrations of Cd significantly affects cockle survival time in air. Important changes in gene transcription were also highlighted. In particular, MT, HSP70, CAT, and CuZnSOD seem to be relevant biomarkers of Cd exposure because (1) their mRNA levels increase upon exposure and (2) they are highly correlated to Cd accumulation in tissues. Results may be useful for control strategies and for the use of cockles as sentinel organisms.


Assuntos
Cádmio/toxicidade , Cardiidae/efeitos dos fármacos , Cardiidae/genética , Estresse Fisiológico/efeitos dos fármacos , Estresse Fisiológico/genética , Transcrição Gênica/efeitos dos fármacos , Poluentes Químicos da Água/toxicidade , Animais , Biomarcadores/metabolismo , Cardiidae/metabolismo , Cardiidae/fisiologia , Relação Dose-Resposta a Droga , Tunísia
18.
Environ Health Perspect ; 111(16): 1952-7, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14644672

RESUMO

Remote coastal populations that rely on seafood for subsistence often receive unusually high doses of organochlorines and methyl mercury. Immunosuppression resulting from prenatal exposure to organochlorines has been reported in wildlife species and humans. In this study, we assessed lymphocyte activation and associated cytokine secretion in 47 newborns from a remote maritime population living on the Mid and Lower North Shore regions of the St. Lawrence River (Québec, Canada; subsistence fishing group) and 65 newborns from nearby urban settings (reference group). Cord blood samples were collected for organochlorine and mercury analyses and also to isolate cord blood mononuclear cells (CBMCs) for the in vitro assessment of cytokine production and expression of surface markers after mitogenic stimulation (CD4(+)CD45RO(+), CD8(+)CD45RO(+), CD3(+)CD25(+), and CD8(+)HLA-DR(+)). Blood mercury and plasma concentrations of polychlorinated biphenyls (PCBs), 1,1-dichloro-2,2-bis(4-chlorophenyl)ethylene (p,p'-DDE), and hexachlorobenzene (HCB) were significantly higher in the subsistence fishing group than in the reference group (p < 0.001). No difference was observed between the two groups regarding subsets of lymphocytes showing markers of activation. In vitro secretion of cytokines by CBMCs after mitogenic stimulation was lower in the subsistence fishing group than in the reference group (p < 0.05). Moreover, we found an inverse correlation between tumor necrosis factor-alpha (TNF-alpha) secretion and plasma PCB, p,p'-DDE, and HCB concentrations (p < 0.05). Our data support a negative association between TNF-alpha secretion by CBMCs and prenatal organochlorine exposure. If the relationship between organochlorine and TNF-alpha secretion is causal, it would suggest a role for this important proinflammatory cytokine in mediating organochlorine-induced immunotoxicity in infants developmentally exposed to these compounds.


Assuntos
Citocinas/metabolismo , Monitoramento Ambiental/métodos , Sangue Fetal/metabolismo , Inseticidas/sangue , Leucócitos Mononucleares/metabolismo , Compostos de Metilmercúrio/sangue , População Rural/estatística & dados numéricos , Adulto , Peso Corporal , Monitoramento Epidemiológico , Feminino , Contaminação de Alimentos/análise , Humanos , Sistema Imunitário/metabolismo , Indígenas Norte-Americanos/estatística & dados numéricos , Recém-Nascido , Masculino , Exposição Materna/estatística & dados numéricos , Vigilância da População , Gravidez , Quebeque/epidemiologia , Alimentos Marinhos/análise , Fumar/epidemiologia , População Branca/estatística & dados numéricos
19.
J Zoo Wildl Med ; 34(2): 159-62, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12885133

RESUMO

Individuals of two porcupine species (Coendou prehensilis and Coendou melanurus) were translocated during the flooding of a forest at a hydroelectric dam site in French Guiana. Blood samples were collected for 11 mo to determine hematologic and serum chemistry reference mean values and ranges and to look for blood parasites. Male C. prehensilis had significantly higher hemoglobin levels, packed cell volumes, and creatinine and potassium values than did females of the same species. Coendou prehensilis had significantly lower amylase levels but higher creatinine, calcium, lactate dehydrogenase, and gamma glutamyl transferase levels than C. melanurus.


Assuntos
Animais Selvagens/sangue , Análise Química do Sangue/veterinária , Testes Hematológicos/veterinária , Roedores/sangue , Animais , Feminino , Guiana Francesa , Masculino , Valores de Referência , Fatores Sexuais , Especificidade da Espécie
20.
Philos Trans R Soc Lond B Biol Sci ; 369(1640): 20130241, 2014 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-24591721

RESUMO

Diatoms are especially important microorganisms because they constitute the larger group of microalgae. To survive the constant variations of the light environment, diatoms have developed mechanisms aiming at the dissipation of excess energy, such as the xanthophyll cycle and the non-photochemical chlorophyll (Chl) fluorescence quenching. This contribution is dedicated to the relaxation of the latter process when the adverse conditions cease. An original nonlinear regression analysis of the relaxation of non-photochemical Chl fluorescence quenching, qN, in diatoms is presented. It was used to obtain experimental evidence for the existence of three time-resolved components in the diatom Phaeodactylum tricornutum: qNf, qNi and qNs. qNf (s time-scale) and qNs (h time-scale) are exponential in shape. By contrast, qNi (min time-scale) is of sigmoidal nature and is dominant among the three components. The application of metabolic inhibitors (dithiothreitol, ammonium chloride, cadmium and diphenyleneiodonium chloride) allowed the identification of the mechanisms on which each component mostly relies. qNi is linked to the relaxation of the ΔpH gradient and the reversal of the xanthophyll cycle. qNs quantifies the stage of photoinhibition caused by the high light exposure, qNf seems to reflect fast conformational changes within thylakoid membranes in the vicinity of the photosystem II complexes.


Assuntos
Clorofila/metabolismo , Diatomáceas/fisiologia , Luz , Complexo de Proteína do Fotossistema II/metabolismo , Tilacoides/metabolismo , Cloreto de Amônio , Cádmio , Clorofila/efeitos da radiação , Ditiotreitol , Fluorescência , Cinética , Oniocompostos , Análise de Regressão , Fatores de Tempo , Xantofilas/metabolismo
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