Determinants of COVID-19 vaccine hesitancy in French hospitals.

OBJECTIVES: COVID-19 vaccines have become the new hope for stemming the pandemic. We aimed to assess pre-launch vaccine acceptance among hospital workers in the Auvergne-Rhône-Alpes Administrative Region of France. METHODS: We performed a cross sectional study involving all hospital workers in 11 Auvergne-Rhône-Alpes hospitals in December 2020. Univariate and multivariate analyses were performed to identify factors associated with vaccine hesitancy. RESULTS: We analyzed completed questionnaires from 1,964 respondents (78% women, mean age 42 years, 21.5% physicians, 41% private care centers). A total of 1,048 (53%) hospital workers were in favor of COVID-19 vaccination. Vaccine hesitancy was associated with: female gender; young age; paramedical, technical, and administrative professions (i.e., all non-medical professions); no prior flu vaccination; and employment in the private medical care sector (p<0.05). Distrust of health authorities and pharmaceutical lobbying were the main obstacles to vaccination. Inversely, creating herd immunity and protecting patients and household members were the most frequently cited reasons in favor of vaccination. More than two-thirds of participants feared that the clinical and biological research was too rapid and worried about serious adverse effects. Most participants were interested in written information on the available vaccines, but the most vaccine-hesitant categories preferred oral information. Only 35% supported mandatory vaccination. CONCLUSIONS: Targeted written and oral information campaigns will be necessary to improve vaccination coverage among hospital workers who show a surprisingly high hesitancy rate. Imposing mandatory vaccination could be counterproductive.

Normal calves produced after transfer of in vitro fertilized embryos cultured with an antiviral compound.

Bovine viral diarrhea virus (BVDV) replicates in embryo co-culture systems and remains associated with developing IVF bovine embryos, despite washing and trypsin treatment. Previous research demonstrated that 2-(4-[2-imidazolinyl]phenyl)-5-(4-methoxyphenyl)furan (DB606) inhibits replication of BVDV in cultured cells. The objective of this study was to evaluate the capability of IVF embryos to develop into normal, weaned calves after exposure to antiviral concentrations of DB606 during IVC. Oocytes were obtained from cows via transvaginal, ultrasound-guided follicular aspiration. Presumptive zygotes (n = 849) that resulted from fertilization of these oocytes were cultured for 7 d in medium supplemented with 0.4 microM DB606 or medium lacking antiviral agent. All blastocysts (n = 110) were transferred individually into the uterus of a synchronized recipient. The pregnancy status of recipients was determined using transrectal ultrasonography at 21-23 d after embryo transfer. Additional pregnancies as controls (n = 21) were initiated by natural breeding. Developing fetuses and resulting calves were evaluated every 27-34 d. Blastocyst development, pregnancies per transferred embryo, pregnancies maintained per pregnancies established, gestation length, gender ratio, birth weights, viability of neonates, complete blood counts, and serum chemistry profiles at 3 mo of age and adjusted 205 d weaning weights were compared for research treatments. Development to weaning after exposure to DB606 did not differ significantly from controls. In conclusion, bovine embryo cultures can be safely supplemented with antiviral concentrations of DB606; addition of DB606 agent might prevent viral transmission if BVDV were inadvertently introduced into the embryo culture system.

1H- and 2H-NMR studies of a fragment of PMP1, a regulatory subunit associated with the yeast plasma membrane H(+)-ATPase. Conformational properties and lipid-peptide interactions.

PMP1 is a 38-residue polypeptide associated with the yeast plasma membrane H(+)-ATPase, found to regulate the enzyme activity. To investigate the molecular basis of the PMP1 biological function, the conformational properties of a synthetic PMP1 fragment, A18-F38, comprising the predicted C-terminal cytoplasmic domain and a part of the transmembrane anchor have been studied by 1H- and 2H-NMR spectroscopies. High resolution 1H-NMR experiments showed that, in deuterated DPC micelles, the A18-G34 segment adopts a well defined helix conformation. Our data suggest that the whole PMP1 molecule forms a unique helix whose axis might be slightly tilted with respect to the bilayer normal. Protonated DPC, DMPC and DMPS were incorporated in deuterated micelles containing the PMP1 fragment for studying lipid-peptide interactions. Unusually strong and selective intermolecular NOEs between lipid chain and peptide side chain protons, especially those of the unique Trp residue, were observed. Solid state 2H-NMR experiments performed on pure deuterated POPC and mixed deuterated POPC:POPS (5:1) bilayers revealed that the PMP1 fragment specifically interacts with negatively charged PS lipids.

Influence of pH and temperature on kinetics of ceftiofur degradation in aqueous solutions.

The objective of this study was to evaluate the stability of ceftiofur (1 mg mL(-1)) in aqueous solutions at various pH (1, 3, 5, 7.4 and 10) and temperature (0, 8, 25, 37 and 60 degrees C) conditions. The ionic strength of all these solutions was maintained at 0.5 M. Ceftiofur solutions at pH 5 and 7.4 and in distilled water (pH = 6.8) were tested at all the above temperatures. All other solutions were tested at 60 degrees C. Over a period of 84 h, the stability was evaluated by quantifying ceftiofur and its degradation product, desfuroylceftiofur, in the incubation solutions. HPLC was used to analyse these compounds. At 60 degrees C, the rate of degradation was significantly higher at pH 7.4 compared with pH 1, 3, 5 and distilled water. At both 60 degrees C and 25 degrees C, degradation in pH 10 buffer was rapid, with no detectable ceftiofur levels present at the end of 10 min incubation. Degradation rate constants of ceftiofur were 0.79+/-0.21, 0.61+/-0.03, 0.44+/-0.05, 1.27+/-0.04 and 0.39+/-0.01 day(-1) at pH 1, 3, 5, 74 and in distilled water, respectively. Formation of desfuroylceftiofur was the highest (65%) at pH 10. The rate of degradation increased in all aqueous solutions with an increase in the incubation temperature. At pH 7.4 the degradation rate constants were 0.06+/-0.01, 0.06+/-0.01, 0.65+/-0.17, and 1.27+/-0.05 day(-1) at 0, 8, 25, 37 and 67 degrees C, respectively. The energy of activation for ceftiofur degradation was 25, 42 and 28 kcal mol(-1) at pH 5, 7.4 and in distilled water, respectively. Desfurylceftiofur formation was the greatest at alkaline pH compared with acidic pH. Ceftiofur degradation accelerated the most at pH 7.4 and was most rapid at pH 10. The results of this study are consistent with rapid clearance of ceftiofur at physiological pH.

Gastrointestinal motility and disease in large animals.

An understanding of the relationship between gastrointestinal (GI) motility and disease is imperative for the proper treatment of large animal patients, especially as new therapeutic agents become available. However, the abundance of information that has become available in the last 2 decades makes gaining this understanding a formidable task. This article summarizes the changes in GI motility caused by some common diseases and conditions encountered in large animal practice, such as GI obstruction, postoperative ileus, resection and anastomosis, diarrhea, endotoxemia, GI parasitism, hypocalcemia, and pregnancy.

Platelet function defect in a 5-day-old Simmental calf.

A 5-day-old Simmental Heifer was evaluated for excessive bleeding from the skin following horse fly bites. A coagulation profile and platelet numbers were normal. In vitro platelet function, measured by whole blood aggregometry, was found to be abnormal when compared with age-matched controls. Therefore, this defect in hemostasis was attributed to a qualitative defect in platelet function.

Catheterization of the auricular vein in cattle: 68 cases (1991-1994).

OBJECTIVE: To evaluate the use of auricular vein catheters (AVC) in cattle in a clinical setting. DESIGN: Case series. ANIMALS: 57 cattle. PROCEDURE: 68 AVC were placed in cattle for the administration of drugs or rehydration fluids. Catheter size, quantity of fluids administered, duration of administration, drugs administered, duration of catheter maintenance, and problems were recorded. RESULTS: The AVC ranged in size from 20 to 14 gauge, with the latter being the predominate size. A maximum flow rate of 7.7 L/h was achieved, and the flow rate was satisfactory in all but 1 case. The maximum duration of maintenance was > 96 hours. Problems occurred in 29 of 68 (43%) catheterizations; the most frequent problem was occlusion of the catheter, which occurred 16 times (24%). No serious complications occurred. CLINICAL IMPLICATIONS: Auricular vein catheters were a convenient, safe, and low-cost alternative to jugular vein catheters.

Analysis of first gastric compartment fluid collected via percutaneous paracentesis from healthy llamas.

OBJECTIVE: To evaluate the safety and efficacy of percutaneous paracentesis for fluid collection from the first gastric compartment of healthy llamas and to describe characteristics of that fluid. DESIGN: Prospective study. ANIMALS: 10 healthy adult llamas. PROCEDURE: Physical examinations were performed prior to sample collection and for 14 days afterwards. A CBC was performed prior to sample collection and 5 days later. A 16-gauge, 7.5-cm stainless steel needle, positioned approximately 20 cm caudal to the costochondral junction of the last rib, was pointed in a dorsocraniomedial direction and pushed through the abdominal wall into the lumen of the first gastric compartment. Fluid was aspirated and analyzed immediately for color, odor, consistency, pH, methylene blue reduction (MBR) time, protozoa, and bacteria. RESULTS: Fluid samples were obtained from 9 of 10 llamas. Mean volume was 4.1 ml, mean pH was 6.67, and mean MBR time was 173 seconds. Odor was slightly acidic, color was light brown-green to light yellow-green, and consistency was moderate. Small protozoa with variable iodine staining and gram-negative bacteria were commonly detected. With few exceptions, results of physical examinations and CBC remained within reference ranges. CLINICAL IMPLICATIONS: Fluid samples from the first gastric compartment can be successfully obtained by percutaneous paracentesis. Fluid characteristics were similar to those of fluid collected via orogastric tube in llamas and cattle.

Alterations in acid-base balance and serum electrolyte concentrations in cattle: 632 cases (1984-1994).

OBJECTIVE: To determine typical alterations in acid-base balance and serum electrolyte concentrations in cattle grouped on the basis of age, breed type, hydration status, clinical signs, and underlying disease. DESIGN: Retrospective study. ANIMALS: 632 cattle. PROCEDURE: Information on blood pH, PVO2, PVCO2, HCO3-concentration, and base excess (BE) as well as serum or plasma sodium, potassium, chloride, and total carbon dioxide concentrations was obtained. Values for calves (ie, cattle < 1 month old) were compared with values for cattle > or = 1 month old. Within each age-group, values were compared for cattle grouped on the basis of breed type, previous treatment, and hydration status. Proportions of cattle with various disorders for which values were within, greater than, or less than reference ranges were determined. RESULTS: BE, pH, and HCO3- concentration were significantly higher and PVCO2 and sodium, potassium, and chloride concentrations were significantly lower among cattle > or = 1 month old than calves. Base excess and HCO3- concentration were significantly lower among dairy than beef calves. Sodium and potassium concentrations were significantly lower among dairy than beef cattle > or = 1 month old. A higher proportion of cattle that did not survive had a high anion gap than cattle that did survive. Sodium, potassium, and chloride concentrations were significantly lower among dehydrated cattle than cattle that were not dehydrated. CLINICAL IMPLICATIONS: Because certain alterations were consistently found in some groups of cattle, it may be possible to make reasonable predictions of alterations in acid-base balance and serum electrolyte concentrations when laboratory evaluations are not available.

Differentiation of gastrointestinal diseases in adult cattle.

Many of the common gastrointestinal disorders of adult cattle may be diagnosed by a careful physical examination, whereas other disturbances require the use of diagnostic testing. It is important to differentiate the causes of gastrointestinal disturbances to make better treatment decisions and have a clearer prognosis for the specific animal or herd of cattle.

Internal parasite control strategies.

To maintain the general health of small ruminants, owners, managers, and clinicians should be familiar with the body condition-scoring [table: see text] methods, general health, and overall appearance of the animals in their care. Any changes in the overall health of individual animals or the flock should be noted immediately, the cause determined, and immediate measures should be taken to correct any problems. Parasite management in small ruminants is a difficult and arduous task. When a program that reduces parasite infestation is discovered, it should be carefully implemented, maintained with vigilance, and constantly "tweaked" to maximize its effectiveness.

Differentiation of gastrointestinal diseases of calves.

With a complete history, careful physical examination, and targeted diagnostics, the practitioner can differentiate the causes of gastrointestinal diseases in calves. The authors hope that this article helps the practitioner in this regard. Armed with a diagnosis, he or she can then proceed with proper treatment and prevention, which is the ultimate goal.

[Hypersensitivity to glucocorticoids: reflections on a published case report sample]. / Hypersensibilités aux glucocorticoïdes: réflexions à partir d'un échantillon de cas rapportés dans la littérature.

Hypersensitivity reactions associated with glucocorticoid treatment are rare but well known; the purpose of this study was to identify the responsible constituent (the excipient or the glucocorticoid). 32 cases published from 1970 have been analysed. In 75 per cent of cases, the patients received the glucocorticoid (hydrocortisone and methylprednisolone principally) by the intravenous route. Clinical manifestations reported were respiratory or cutaneous, with a short interval to onset. Skin tests were performed in 20 patients, but cutaneous challenge identified an agent responsible for hypersensitivity in only three cases. The heterogeneity of the test results in these 32 cases makes it difficult to identify a unifying explanation for the reactions, or propose a therapeutic schedule.

[Anxiety and medicine: what is the role of the psychiatrist?]. / Anxiété et médecine: quelle place pour le psychiatre?

The relationship between medicine and psychiatry is complex and sometimes a little difficult. Anxiety is frequently met in somatic medicine units and particularly in General Hospital where psychiatrists are often required for crisis situations. So, anxiety disorder becomes a link between physicians and psychiatrists looking after same inpatients. Epidemiological high comorbidity too is demonstrated between anxiety and somatic disorders. More and more frequently, psychiatrists are engaged for care of post traumatic stress disorders. In fact, in modern medicine, the psychiatrist is collecting medical, psychosocial and humanist points of view. His missions of clinician, teacher, and researcher seem really important for the future evolution of medicine.

A comparison of surface and rectal temperatures between sheared and non-sheared alpacas (Lama pacos).

The objective of this research was to determine if whole-body shearing would effect gross thermoregulation in alpacas. Eight mature, intact male alpacas were randomly assigned to one of two groups and maintained in outdoor pastures with adequate artificial shade from June through August (summer climate) in east central Alabama, USA. Group one animals (N=4) were sheared to remove all fiber to within 2cm of their skin. Group 2 animals (N=4) were left non-sheared. Sheared alpacas tended to have lower rectal temperatures during high ambient temperatures than did non-sheared alpacas (P=0.06). Thermographic studies of the scrotum revealed cooler surface temperatures in sheared versus non-sheared alpacas (P=0.05). Temperatures in the right medial thigh of sheared animals were 0.9 degrees C cooler than the thigh region of non-sheared animals in the morning (P<0.03). Right medial thigh temperatures were 1.6 degrees C cooler in sheared alpacas in the afternoon (P<0.01). Significant positive correlations were found in non-sheared animals between ambient temperature and rectal temperature in the morning (r=0.612, P=0.014). In sheared animals during the morning significant positive correlations were established between the Heat Stress Index (HSI) and the right medial thigh surface temperatures (r=0.648, P=0.003), the HSI and rectal temperature (r=0.729, P=0.0003), the ambient temperature and right medial thigh surface temperature (r=0.485, P=0.04), and the ambient temperature and the rectal temperature (r=0.823, P<0.0001). In the afternoon a significant positive correlation was found in the sheared alpacas between the HSI and the right medial thigh surface temperature, rectal temperature and surface scrotal temperature (r=0.538, P=0.02, r=0.543, P=0.019 and r=0.522, P=0.045), respectively. These data indicate that whole-body shearing of alpacas could have a beneficial effect on thermoregulation when used as a preventative measure against heat stress. Shearing may assist heat dissipation resulting in a cooler surface body temperature and rectal temperature in alpacas when challenged by the heat and humidity experienced in the summer months in the southeastern United States.

A comparison of physical examination and clinicopathologic parameters between sheared and nonsheared alpacas (Lama pacos).

The purpose of this study was to determine the physiological changes associated with chronic heat stress in sheared versus nonsheared alpacas. Fourteen intact male adult alpacas were randomly assigned to one of the two groups: Group S alpacas were sheared to within 2cm of their skin; Group NS alpacas were not sheared. These animals were maintained from June through August in east central Alabama. Data collected in the morning, every two weeks, included vital signs, body weight, body condition score, complete blood counts, serum chemistries and electrolytes, whole blood selenium, and plasma cortisol. S and NS groups were contrasted using the repeated measures analysis of variance, and pertinent correlations with weather parameters were calculated. Clinical heat stress was not evident in any animals during the study. Significant differences between treatment groups were seen in rectal temperature (P=0.0095), sodium concentration (P=0.0219), and blood urea nitrogen (BUN) (P=0.0189). The mean rectal temperature of the NS group was above the normal range on five sampling times compared to only once for the S group. However, mean sodium and serum urea nitrogen levels were within normal limits in both groups at all sampling times. Rectal temperature of only the S group was positively correlated to weather parameters. Sodium of both S and NS groups and BUN of the NS group were negatively correlated with weather parameters. This study indicates that there are differences between sheared and nonsheared alpacas in physical examination and clinicopathologic parameters that can be correlated with changes in ambient conditions. These differences suggest that nonsheared alpacas are less heat tolerant than sheared alpacas. Therefore, shearing is recommended for animals exposed to similar conditions.

[Patients in a state of agitation at the admission service of a Rouen hospital emergency department]. / Les patients agités au service d'accueil et d'urgence du CHU de Rouen.

OBJECTIVE: To determine the incidence and causes of agitation states in patients presenting at the Rouen University Hospital emergency room and to analyze the management scheme. PATIENTS AND METHOD: A prospective study was conducted over a 9 month period in 100 consecutive patients presenting a state of agitation assessed using the Overt Aggression Scale. A pre-planned management protocol was applied. RESULTS: The incidence of states of agitation was 0.56%. There were 43 women and 57 men, mean age 33 years. Most of the agitated patients were admitted between 6 p.m. and 4 a.m. (69%). Over the 9 month period, 2 patients were admitted twice for agitation and 2 absconded. Low glucose level was the cause of agitation in 4 cases. Alcohol and/or drug use concerned 73% of the agitated patients and was the most frequently observed triggering factor (17%). Only 6% of the patients had a regular employment. Physical restraining measures and sedation were required in 86% and 84% of the cases respectively. Among 67 patients given loxapine for sedation, 2 developed acute dyskinesia and 9 low blood pressure. One out of 4 patients were referred to a psychiatric unit. CONCLUSION: Patients in a state of agitation are young, often female, and in a difficult socio-economic situation. Hypoglycemia is the main differential diagnosis. A triggering factor can often be identified. A state of agitation is not a repetitive condition but occurs as a short-lived episode in the patientís history. Such patients need rapid care to avoid further aggravation and disruption of the emergency room activity, and to prevent the patient from fleeing. Loxapine provides effective sedation but requires regular monitoring of blood pressure and can provoke acute dyskinesia in young subjects.

[Diagnosis and management of anxiety in victims of psychological trauma]. / Diagnostic et prise en charge de l'anxiété chez les victimes de psychotraumatismes.

Management of psychic injury has been developing in France recently. Community catastrophies like wars or natural events, individual's stress are more and more related. Physicians are qualified for the treatment of their psychic consequences. Family doctors know people and local geographic situations and are often the first medical managers on the scene of the disaster.

Gastrointestinal nematode infection and performance of weaned stocker calves in response to anthelmintic control strategies.

Gastrointestinal nematode (GIN) parasite control recommendations are in a state of flux because of the increase in anthelmintic resistant cattle parasites, such as Cooperia spp. In addition, Cooperia spp. infection is typically high in warm-season grass pastures and can affect growth performance of grazing stocker calves in the Gulf Coast Region. This study evaluated the effects of moxidectin pour-on, oxfendazole oral suspension, or a combination of the two given at separate times on infection and performance of weaned beef calves grazing summer forages. Steers (n=42) and heifers (n=31) were stratified by sex, d-11 fecal egg count (FEC), and d-1 shrunk body weight (BW) to one of 10 pastures with four anthelmintic treatments and one control. Treatments included: (1) oxfendazole given on d 0 and moxidectin on d 73 (O+M), (2) moxidectin given on d 0 and oxfendazole on d 73 (M+O), (3) moxidectin given on d 0 (M), (4) oxfendazole given on d 0 (O) and (5) no anthelmintic given (CON). Calves grazed for d-110 beginning May 27th. Response variables were FEC (collected on d-11, 14, 31, 45, 59, 73, 87 and 108), coprocultures (evaluated for d 87 and 108), final shrunk BW, shrunk BW gain, average daily gain (ADG), and full BW gain (collected on d 31, 59, 73, 87, and 108). Calves treated with either oxfendazole (O+M and O) or moxidectin (M+O and M) on d 0 had significantly lower (P<0.001) FEC than the CON calves on d 14, 31 and 45. However, the M+O treated calves had significantly higher (P<0.001) FEC than both oxfendazole treated groups. In addition, calves treated with a second dewormer on d 73 (O+M and M+O) had significantly lower (P<0.001) FEC by d 87 than the CON or M treated calves. Shrunk BW gain and ADG were significantly greater (P=0.005) for the O+M compared to the M treated and CON calves, but comparable with the M+O and O treated calves, respectively. Coprocultures sampled on d 87 and 108 for calves not receiving a second dewormer were predominantly Cooperia spp. and Ostertagia spp. On d 87, no larvae were recovered from the M+O treated calves, whereas the O+M treated calves had 94% Cooperia spp. and 3% Ostertagia spp. recovered. Providing a benzimidazole with a macrocyclic lactone given at two different periods may provide better GIN parasite control and improve animal gains for stocker calves grazing warm-season grass pastures.