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1.
Int J Equity Health ; 21(1): 150, 2022 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-36289543

RESUMO

BACKGROUND: COVID-19 constitutes a global health emergency of unprecedented proportions. Preventive measures, however, have run up against certain difficulties in low and middle-income countries. This is the case in socially and geographically marginalized communities, which are excluded from information about preventive measures. This study contains a dual objective, i) to assess knowledge of COVID-19 and the preventive measures associated with it concerning indigents in the villages of Diebougou's district in Burkina Faso. The aim is to understand if determinants of this understanding exist, and ii) to describe how their pathways to healthcare changed from 2019 to 2020 during the COVID-19 pandemic. METHODS: The study was conducted in the Diebougou healthcare district, in the south-west region of Burkina Faso. We relied on a cross-sectional design and used data from the fourth round of a panel survey conducted among a sample of ultra-poor people that had been monitored since 2015. Data were collected in August 2020 and included a total of 259 ultra-poor people. A multivariate logistic regression to determine the factors associated with the respondents' knowledge of COVID-19 was used. RESULTS: Half of indigents in the district said they had heard about COVID-19. Only 29% knew what the symptoms of the disease were. The majority claimed that they protected themselves from the virus by using preventive measures. This level of knowledge of the disease can be observed with no differences between the villages. Half of the indigents who expressed themselves agreed with government measures except for the closure of markets. An increase of over 11% can be seen in indigents without the opportunity for getting healthcare compared with before the pandemic. CONCLUSIONS: This research indicates that COVID-19 is partially known and that prevention measures are not universally understood. The study contributes to reducing the fragmentation of knowledge, in particular on vulnerable and marginalized populations. Results should be useful for future interventions for the control of epidemics that aim to leave no one behind.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Acessibilidade aos Serviços de Saúde , Estudos Transversais , Burkina Faso/epidemiologia , Pandemias/prevenção & controle , Pobreza
2.
Rev Epidemiol Sante Publique ; 70(3): 109-116, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35491335

RESUMO

INTRODUCTION: Three months after the first appearance of the new coronavirus (COVID-19), Senegal recorded its first case on March 2, 2020. Faced with this pandemic, the State reacted quickly with public measures : instituting a curfew, placing a ban on travel between regions, and closing shops and places of worship. This research aims to study the acceptability of these non-pharmaceutical measures by the Senegalese population. METHOD: This study was a cross-sectional and analytical survey conducted in June and July 2020 among Senegalese over 18 years old. Sampling by the representative quota method was distributed proportionally to age, gender and region. We constructed the questionnaire using the theoretical framework of acceptability of health interventions. Through a telephone call center synchronised to an internet server, we collected data on personal characteristics, knowledge of the disease, trust in information sources, trust in government, concern about the pandemic, and the seven dimensions of acceptability. We performed descriptive analysis and structural equation with R software version 4.0.2. RESULTS: This study included a total of 813 individuals. The average age was 34.7 years ( ± 14.2 years). They were predominantly male (54.6 %), with no education (42.6 %). The increased level of knowledge of the disease was associated with confidence in national media information sources provided by the administrative and health authorities (ß=0.11, p<0.01). The increase in the level of trust in the government in response to COVID-19 was positively related to the acceptability of curfew (ß=0.16, p<0.001), travel ban between regions (ß=0.11, p<0.001), and closure of places of worship (ß=0.1, p<0.01) and markets (ß=0.09, p<0.01). CONCLUSION: In Senegal, the acceptability of the measures depended on knowledge of the disease, perception of the risk of the disease, and trust in the government. There is a need to strengthen awareness and risk communication of COVID-19.


Assuntos
COVID-19 , Adolescente , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Feminino , Governo , Humanos , Masculino , Pandemias/prevenção & controle , Senegal/epidemiologia , Inquéritos e Questionários
3.
BMC Public Health ; 21(1): 1490, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34340668

RESUMO

BACKGROUND: In early March 2020, the COVID-19 pandemic hit West Africa. In response, countries in the region quickly set up crisis management committees and implemented drastic measures to stem the spread of the SARS-CoV-2 virus. The objective of this article is to analyse the epidemiological evolution of COVID-19 in seven Francophone West African countries (Benin, Burkina Faso, Côte d'Ivoire, Guinea, Mali, Niger, Senegal) as well as the public health measures decided upon during the first 7 months of the pandemic. METHODS: Our method is based on quantitative and qualitative data from the pooling of information from a COVID-19 data platform and collected by a network of interdisciplinary collaborators present in the seven countries. Descriptive and spatial analyses of quantitative epidemiological data, as well as content analyses of qualitative data on public measures and management committees were performed. RESULTS: Attack rates (October 2020) for COVID-19 have ranged from 20 per 100,000 inhabitants (Benin) to more than 94 per 100,000 inhabitants (Senegal). All these countries reacted quickly to the crisis, in some cases before the first reported infection, and implemented public measures in a relatively homogeneous manner. None of the countries implemented country-wide lockdowns, but some implemented partial or local containment measures. At the end of June 2020, countries began to lift certain restrictive measures, sometimes under pressure from the general population or from certain economic sectors. CONCLUSION: Much research on COVID-19 remains to be conducted in West Africa to better understand the dynamics of the pandemic, and to further examine the state responses to ensure their appropriateness and adaptation to the national contexts.


Assuntos
COVID-19 , Pandemias , África Ocidental/epidemiologia , Benin , Burkina Faso , Controle de Doenças Transmissíveis , Côte d'Ivoire , Guiné , Humanos , Mali/epidemiologia , Níger , SARS-CoV-2 , Senegal/epidemiologia
4.
Hum Reprod ; 35(12): 2755-2762, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33083823

RESUMO

STUDY QUESTION: How does a history of dramatic weight loss linked to bariatric surgery impact IVF outcomes? SUMMARY ANSWER: Women with a history of bariatric surgery who had undergone IVF had a comparable cumulative live birth rate (CLBR) to non-operated patients of the same BMI after the first IVF cycle. WHAT IS KNOWN ALREADY: In the current context of increasing prevalence of obesity in women of reproductive age, weight loss induced by bariatric surgery has been shown to improve spontaneous fertility in obese women. However, little is known on the clinical benefit of bariatric surgery in obese infertile women undergoing IVF. STUDY DESIGN, SIZE, DURATION: This exploratory retrospective multicenter cohort study was conducted in 10 287 IVF/ICSI cycles performed between 2012 and 2016. We compared the outcome of the first IVF cycle in women with a history of bariatric surgery to two age-matched groups composed of non-operated women matched on the post-operative BMI of cases, and non-operated severely obese women. PARTICIPANTS/MATERIALS, SETTING, METHODS: The three exposure groups of age-matched women undergoing their first IVF cycle were compared: Group 1: 83 women with a history of bariatric surgery (exposure, mean BMI 28.9 kg/m2); Group 2: 166 non-operated women (non-exposed to bariatric surgery, mean BMI = 28.8 kg/m2) with a similar BMI to Group 1 at the time of IVF treatment; and Group 3: 83 non-operated severely obese women (non-exposed to bariatric surgery, mean BMI = 37.7 kg/m2). The main outcome measure was the CLBR. Secondary outcomes were the number of mature oocytes retrieved and embryos obtained, implantation and miscarriage rates, live birth rate per transfer as well as birthweight. MAIN RESULTS AND THE ROLE OF CHANCE: No significant difference in CLBR between the operated Group 1 patients and the two non-operated Groups 2 and 3 was observed (22.9%, 25.9%, and 12.0%, in Groups 1, 2 and 3, respectively). No significant difference in average number of mature oocytes and embryos obtained was observed among the three groups. The implantation rates were not different between Groups 1 and 2 (13.8% versus 13.7%), and although lower (6.9%) in obese women of Group 3, this difference was not statistically significant. Miscarriage rates in Groups 1, 2 and 3 were 38.7%, 35.8% and 56.5%, respectively (P = 0.256). Live birth rate per transfer in obese patients was significantly lower compared to the other two groups (20%, 18%, 9.3%, respectively, in Groups 1, 2 and 3, P = 0.0167). Multivariate analysis revealed that a 1-unit lower BMI increased the chances of live birth by 9%. In operated women, a significantly smaller weight for gestational age was observed in newborns of Group 1 compared to Group 3 (P = 0.04). LIMITATIONS, REASONS FOR CAUTION: This study was conducted in France and nearly all patients were Caucasian, questioning the generalizability of the results in other countries and ethnicities. Moreover, 950 women per group would be needed to achieve a properly powered study in order to detect a significant improvement in live birth rate after bariatric surgery as compared to infertile obese women. WIDER IMPLICATIONS OF THE FINDINGS: These data fuel the debate on the importance of pluridisciplinary care of infertile obese women, and advocate for further discussion on whether bariatric surgery should be proposed in severely obese infertile women before IVF. However, in light of the present results, infertile women with a history of bariatric surgery can be reassured that surgery-induced dramatic weight loss has no significant impact on IVF prognosis. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by unrestricted grants from FINOX-Gédéon Richter and FERRING Pharmaceuticals awarded to the ART center of the Clinique Mathilde to fund the data collection and the statistical analysis. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: NCT02884258.


Assuntos
Cirurgia Bariátrica , Infertilidade Feminina , Coeficiente de Natalidade , Estudos de Coortes , Feminino , Fertilização in vitro , França , Humanos , Recém-Nascido , Infertilidade Feminina/terapia , Nascido Vivo , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Injeções de Esperma Intracitoplásmicas
5.
Trop Med Int Health ; 25(10): 1226-1234, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32686252

RESUMO

OBJECTIVE: To assess the effect of a free healthcare policy for children under five years old implemented in Burkina Faso since April 2016, on the use of health care of non-malarial febrile illnesses (NMFI). METHODS: To assess the immediate and long-term effect of the free healthcare policy in place, we conducted an interrupted time series analysis of routinely collected data on febrile illnesses from three urban primary health centres of Ouagadougou between 1 January 2015 and 31 December 2016. RESULTS: Of the 39 046 febrile cases reported in the study period, 17 017 NMFI were included in the study. Compared to the period before the intervention, we observed an immediate, non-statistically significant increase of 7% in the number of NMFI (IRR = 1.07; 95% CI = 0.75, 1.51). Compared to the trend that would have been expected in absence of the intervention, the results showed a small but sustained increase of 6% in the trend of monthly number of NMFI during the intervention period (IRR = 1.06; 95%CI = 1.01, 1.12). CONCLUSION: Our study highlighted an increase in the uptake of healthcare services, specifically for NMFI by children under five years of age, after the implementation of a free care policy. This analysis contributes to informing decision makers on the need to strengthen the capacities of healthcare centres and to anticipate the challenges of the sustainability of this policy.


OBJECTIF: Evaluer l'effet d'une politique de gratuité des soins pour les enfants de moins de cinq ans mise en œuvre au Burkina Faso depuis avril 2016, sur l'utilisation des soins de santé des maladies fébriles non paludiques (MFNP). MÉTHODES: Pour évaluer l'effet immédiat et à long terme de la politique de gratuité des soins en place, nous avons mené une analyse des données de séries chronologiques interrompues collectées en routine sur les maladies fébriles dans trois centres de santé primaires urbains de Ouagadougou entre le 1er janvier 2015 et le 31 décembre 2016. RÉSULTATS: Sur les 39.046 cas fébriles signalés au cours de la période d'étude, 17.017 MFNP ont été inclus dans l'étude. Par rapport à la période précédant l'intervention, nous avons observé une augmentation immédiate et non statistiquement significative de 7% du nombre de MFNP (IRR = 1,07; IC95%: 0,75 à 1,51). Par rapport à la tendance à laquelle on aurait pu s'attendre en l'absence d'intervention, les résultats ont montré une augmentation faible mais soutenue de 6% de la tendance du nombre mensuel de MFNP pendant la période d'intervention (TRI = 1,06; IC95%: 1,01 à 1,12 ). CONCLUSION: Notre étude a mis en évidence une augmentation de l'utilisation des services de santé, en particulier pour les MFNP pour les enfants de moins de cinq ans, après la mise en œuvre d'une politique de gratuité des soins. Cette analyse contribue à informer les décideurs sur la nécessité de renforcer les capacités des centres de santé et d'anticiper les enjeux de la pérennité de cette politique.


Assuntos
Serviços de Saúde da Criança/estatística & dados numéricos , Política de Saúde , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Convulsões Febris/epidemiologia , Burkina Faso/epidemiologia , Pré-Escolar , Utilização de Instalações e Serviços , Feminino , Humanos , Lactente , Recém-Nascido , Análise de Séries Temporais Interrompida , Masculino , Convulsões Febris/etiologia , População Urbana
6.
Rev Epidemiol Sante Publique ; 67(6): 375-382, 2019 Nov.
Artigo em Francês | MEDLINE | ID: mdl-31645291

RESUMO

BACKGROUND: Community-based interventions have proven effective in several Latin American countries in controlling dengue vector Aedes aegypti and reducing the burden of the disease. However, we did not find any study reporting the assessment or implementation of such interventions in Sub-Saharan Africa. This article presents local communities' preferences for activities as part of the implementation of a community-based intervention for dengue prevention in Ouagadougou (Burkina Faso) where dengue epidemics are recurrent during the rainy season. METHODS: A mixed-method study combining qualitative and quantitative data collection was conducted. Information from 983 households and their preferences for community-based activities for dengue prevention were collected in five neighborhoods of the city using a quantitative questionnaire. Then, 15 qualitative focus groups were organized in one of the neighborhoods that was randomly selected to receive a community-based intervention for dengue prevention. These groups were made up of 216 people representing the different socio-cultural categories: community leaders, men, women, young girls and boys. RESULTS: More than 95% of household respondents to the quantitative questionnaire found community-based interventions acceptable and/or useful: to raise awareness of mosquito-borne disease transmission, to identify and remove the mosquito breeding sites and areas favorable to the development of the adult vectors. Most participants in the focus groups, preferred outreach activities such as video/debate sessions, school and home education sessions, focus groups. They also preferred the implementation of community working groups, responsible for identifying and eliminating mosquito breeding sites in the neighborhood. However, many participants had reservations about sending preventive text messages to residents. They found it feasible but not useful since most people cannot read. CONCLUSION: This study shows that it is important to get the local communities involved in the formulation of health prevention activities in sub-Saharan Africa where some interventions are often implemented using strategies from other continents.


Assuntos
Participação da Comunidade , Dengue/epidemiologia , Dengue/prevenção & controle , Medicina Preventiva , Aedes/virologia , Animais , Burkina Faso/epidemiologia , Cidades , Participação da Comunidade/métodos , Epidemias/prevenção & controle , Características da Família , Grupos Focais , Humanos , Ciência da Implementação , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Insetos/métodos , Controle de Insetos/organização & administração , Mosquitos Vetores/virologia , Preferência do Paciente , Medicina Preventiva/métodos , Medicina Preventiva/organização & administração , Recidiva , Características de Residência/estatística & dados numéricos , Estações do Ano , Inquéritos e Questionários
7.
Epidemiol Infect ; 146(14): 1771-1776, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29880073

RESUMO

The objective was to evaluate the distribution of coagulase-negative staphylococci (CNS) involved in periprosthetic-joint infections (PJIs) and to describe their susceptibility profile to antibiotics. We conducted a multicentre retrospective study in France, including 215 CNS PJIs between 2011 and 2015. CNS PJIs involved knees in 54% of the cases, hips in 39%, other sites in 7%. The distribution of the 215 strains was: Staphylococcus epidermidis 129 (60%), Staphylococcus capitis 24 (11%), Staphylococcus lugdunensis 21 (10%), Staphylococcus warneri 8 (4%), Staphylococcus hominis 7 (3%), Staphylococcus haemolyticus 7 (3%). More than half of the strains (52.1%) were resistant to methicillin, 40.9% to ofloxacin, 20% to rifampicin. The species most resistant to antibiotics were S. hominis, S. haemolyticus, S. epidermidis, with 69.7% of the strains resistant to methicillin and 30% simultaneously resistant to clindamycin, cotrimoxazole, ofloxacin and rifampicin. No strain was resistant to linezolid or daptomycin. In this study on CNS involved in PJIs, resistance to methicillin is greater than 50%. S. epidermidis is the most frequent and resistant species to antibiotics. Emerging species such S. lugdunensis, S. capitis and Staphylococcus caprae exhibit profiles more sensitive to antibiotics. The antibiotics most often active in vitro are linezolid and daptomycin.


Assuntos
Antibacterianos/farmacologia , Coagulase/análise , Farmacorresistência Bacteriana , Infecções Relacionadas à Prótese/epidemiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Instituições de Assistência Ambulatorial , Feminino , França/epidemiologia , Hospitais Universitários , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Prevalência , Infecções Relacionadas à Prótese/classificação , Infecções Relacionadas à Prótese/microbiologia , Estudos Retrospectivos , Infecções Estafilocócicas/classificação , Infecções Estafilocócicas/microbiologia , Staphylococcus/classificação , Staphylococcus/fisiologia
10.
Ann Oncol ; 28(11): 2773-2779, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-28945826

RESUMO

BACKGROUND: Breast cancer (BC) patients with comparable prognostic features have heterogeneous outcomes, party related to a possible radiotherapy resistance leading to local-regional recurrences (LRR). The objective of the present study was to identify predictive molecular biomarkers of LRR of BC. PATIENTS AND METHODS: Genetic profile of 146 BC patients' tumours included in the ProfiLER clinical trial (NC01774409) between 2013 and 2016 were analysed using next-generation-sequencing and comparative-genomic-hybridization tests. Patients and tumour characteristics were retrospectively collected and analysed for association with genomic rearrangements (mutations, amplification, deletions). Only gene alterations observed in >3% of the tumours were selected. RESULTS: A total of 193 genomic rearrangements were identified, and 16 were observed in >3% of tumours. One was statistically correlated to the risk of local relapse. A median loco-regional progression-free survival (LRPFS) of 23.6 years was reported for PIK3CA mutation carriers (n = 31, 21.2%) versus 9.9 years for PIK3CA wild-type patients (HR 0.27, 95% CI 0.12-0.65, P = 0.002 in univariate analysis). PIK3CA mutation was identified as an independent protective factor on LRR using multivariate analysis (HR 0.29, 95% CI 0.09-0.99, P = 0.047). All other mutations, amplifications or deletions were not found associated with LRPFS. CONCLUSION: PIK3CA mutation was associated with a lower risk of local relapse in this population of BCs. This is consistent with recent studies suggesting PIK3CA to be part of biological pathways impacting the radiosensitivity.


Assuntos
Biomarcadores Tumorais/genética , Neoplasias da Mama/genética , Carcinoma Ductal de Mama/genética , Carcinoma Lobular/genética , Rearranjo Gênico , Recidiva Local de Neoplasia/genética , Tolerância a Radiação/genética , Adulto , Neoplasias da Mama/patologia , Neoplasias da Mama/radioterapia , Carcinoma Ductal de Mama/radioterapia , Carcinoma Ductal de Mama/secundário , Carcinoma Lobular/radioterapia , Carcinoma Lobular/secundário , Classe I de Fosfatidilinositol 3-Quinases/genética , Terapia Combinada , Feminino , Seguimentos , Genômica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Mutação , Invasividade Neoplásica , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/radioterapia , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Taxa de Sobrevida
11.
Infection ; 45(5): 703-704, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28337666

RESUMO

The genus Raoultella has been separated from the genus Klebsiella in 2001. Two main species are responsible for human infections: R. ornithinolytica and R. planticola. The most frequent infections due to R. planticola include cystitis, pneumonia and bacteremia (mostly in immunocompromised hosts). To date, no joint or bone infection has been reported. We describe the first case of septic arthritis due to R. planticola following an arthroscopy with intra-articular injection of corticosteroids. Evolution was favorable after arthroscopic lavage and antibiotic therapy with quinolones. Raoultella planticola has been described rarely in human infection. It is mainly deemed responsible for cystitis, pneumonia and bacteremia (mostly in immunocompromised hosts) [1-3]. To our knowledge no case of bone or joint infection has been reported. We described here the first case of infective arthritis due to R. planticola involving a native knee joint following synovectomy and intra-articular injection of corticosteroids during arthroscopy.


Assuntos
Artrite Infecciosa/diagnóstico , Artrite Infecciosa/tratamento farmacológico , Infecções por Enterobacteriaceae/diagnóstico , Infecções por Enterobacteriaceae/tratamento farmacológico , Enterobacteriaceae/isolamento & purificação , Corticosteroides/administração & dosagem , Artrite Infecciosa/microbiologia , Artroscopia , Infecções por Enterobacteriaceae/microbiologia , Humanos , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Sinovectomia , Resultado do Tratamento , Triancinolona/administração & dosagem
12.
Infect Dis Now ; 54(1): 104832, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37952582

RESUMO

In march 2020, the International Working Group on the Diabetic Foot (IWGDF) published an update of the 2015 guidelines on the diagnosis and management of diabetic foot infection (DFI). While we (the French ID society, SPILF) endorsed some of these recommendations, we wanted to update our own 2006 guidelines and specifically provide informative elements on modalities of microbiological diagnosis and antibiotic treatment (especially first- and second-line regiments, oral switch and duration). The recommendations put forward in the present guidelines are addressed to healthcare professionals managing patients with DFI and more specifically focused on infectious disease management of this type of infection, which clearly needs a multidisciplinary approach. Staging of the severity of the infection is mandatory using the classification drawn up by the IWGDF. Microbiological samples should be taken only in the event of clinical signs suggesting infection in accordance with a strict preliminarily established protocol. Empirical antibiotic therapy should be chosen according to the IWGDF grade of infection and duration of the wound, but must always cover methicillin-sensitive Staphylococcus aureus. Early reevaluation of the patient is a fundamental step, and duration of antibiotic therapy can be shortened in many situations. When osteomyelitis is suspected, standard foot radiograph is the first-line imagery examination and a bone biopsy should be performed for microbiological documentation. Histological analysis of the bone sample is no longer recommended. High dosages of antibiotics are recommended in cases of confirmed osteomyelitis.


Assuntos
Diabetes Mellitus , Pé Diabético , Osteomielite , Humanos , Pé Diabético/diagnóstico , Pé Diabético/tratamento farmacológico , Osteomielite/diagnóstico , Osteomielite/tratamento farmacológico , Antibacterianos/uso terapêutico , Staphylococcus aureus , Gerenciamento Clínico , Diabetes Mellitus/tratamento farmacológico
13.
Phys Rev Lett ; 110(17): 172701, 2013 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-23679716

RESUMO

Distributions of the largest fragment charge, Zmax, in multifragmentation reactions around the Fermi energy can be decomposed into a sum of a Gaussian and a Gumbel distribution, whereas at much higher or lower energies one or the other distribution is asymptotically dominant. We demonstrate the same generic behavior for the largest cluster size in critical aggregation models for small systems, in or out of equilibrium, around the critical point. By analogy with the time-dependent irreversible aggregation model, we infer that Zmax distributions are characteristic of the multifragmentation time scale, which is largely determined by the onset of radial expansion in this energy range.

14.
Cancer Radiother ; 27(2): 163-169, 2023 Apr.
Artigo em Francês | MEDLINE | ID: mdl-35995719

RESUMO

Radiation plexitis, also known as radiation-induced brachial neuropathy is a rare toxicity following axillary, breast, cervical or thoracic radiotherapy, first described in 1966 by Stoll and Andrew. Although improvements in radiotherapy techniques have greatly reduced its risk over the past seventy years, its severe form remains a dreaded complication that is difficult to manage in patients with increased life expectancy. This article summarizes the epidemiological elements, risk factors, diagnostic methods, doses and constraints to be respected in radiotherapy and the treatment strategies of radiation plexitis.


Assuntos
Neuropatias do Plexo Braquial , Plexo Braquial , Lesões por Radiação , Humanos , Neuropatias do Plexo Braquial/diagnóstico , Neuropatias do Plexo Braquial/epidemiologia , Neuropatias do Plexo Braquial/etiologia , Lesões por Radiação/diagnóstico , Lesões por Radiação/epidemiologia , Lesões por Radiação/etiologia , Fatores de Risco
15.
Infect Dis Now ; 53(5): 104706, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37030627

RESUMO

BACKGROUND: Histopathology is one of the diagnostic criteria for prosthetic joint infection (PJI) proposed by all academic societies. The aim of this study was to compare histopathological and microbiological results from samples taken intraoperatively at the same site in patients with suspected or proven PJI. PATIENTS AND METHODS: We conducted a monocenter retrospective study including all patients having undergone surgery from 2007 to 2015 with suspected or proven PJI. During surgery, both histopathological and microbiological samples were taken. Patients with a history of antimicrobial treatment 2 weeks prior to surgery were excluded. We considered as major criteria and gold standard for PJI diagnosis the presence of a sinus tract communication and/or the same microorganism in at least two cultures. RESULTS: Finally, 181 patients who underwent 309 surgeries were included. The median number of samples per surgery was 4 (interquartile range (IQR) = 3-5) for histopathology and 5 (IQR = 4-6) for microbiology. Major criteria were observed in 177 patients (57.3%), while positive histology in at least one intraoperative sample was present in 119 (38.5%). The concordance was 74%. The sensitivity and specificity of histopathology were 61% and 92% respectively. Available "histopathology-culture" sample pairs numbered 1247. Among them, positive histopathology was found in 292 samples (23%) and culture in 563 (45%). Concordance was 64%. The highest correlation was observed for very early infection (<1 month) (OR: 9.1, 95% CI: 3.6-23) and for virulent microorganisms, such as Staphylococcus aureus (OR: 7.8, 95% CI: 5.2-11.8), Streptococci (OR:7.8; 95% CI: 4-15.2) or Enterobacterales (OR: 7.4; 95% CI: 4.2-13.1). CONCLUSION: Histopathologic examination is a valuable criterion for PJI diagnosis, but it may lack sensitivity for chronic infections or due to low-virulence pathogens.


Assuntos
Artrite Infecciosa , Infecções Relacionadas à Prótese , Infecções Estafilocócicas , Humanos , Estudos Retrospectivos , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/microbiologia , Artrite Infecciosa/diagnóstico , Sensibilidade e Especificidade , Infecções Estafilocócicas/diagnóstico
16.
Infect Dis Now ; 53(3): 104647, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36690329

RESUMO

These guidelines are an update of those made in 2007 at the request of the French Society of Infectious Diseases (SPILF, Société de Pathologie Infectieuse de Langue Française). They are intended for use by all healthcare professionals caring for patients with disco-vertebral infection (DVI) on spine, whether native or instrumented. They include evidence and opinion-based recommendations for the diagnosis and management of patients with DVI. ESR, PCT and scintigraphy, antibiotic therapy without microorganism identification (except for emergency situations), therapy longer than 6 weeks if the DVI is not complicated, contraindication for spinal osteosynthesis in a septic context, and prolonged dorsal decubitus are no longer to be done in DVI management. MRI study must include exploration of the entire spine with at least 2 orthogonal planes for the affected level(s). Several disco-vertebral samples must be performed if blood cultures are negative. Short, adapted treatment and directly oral antibiotherapy or early switch from intravenous to oral antibiotherapy are recommended. Consultation of a spine specialist should be requested to evaluate spinal stability. Early lifting of patients is recommended.


Assuntos
Antibacterianos , Coluna Vertebral , Humanos , Adulto , Antibacterianos/uso terapêutico
17.
Phys Rev Lett ; 108(12): 122701, 2012 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-22540578

RESUMO

An atomic clock based on x-ray fluorescence yields has been used to estimate the mean characteristic time for fusion followed by fission in reactions 238U + 64Ni at 6.6 MeV/A. Inner shell vacancies are created during the collisions in the electronic structure of the possibly formed Z=120 compound nuclei. The filling of these vacancies accompanied by a x-ray emission with energies characteristic of Z=120 can take place only if the atomic transitions occur before nuclear fission. Therefore, the x-ray yield characteristic of the united atom with 120 protons is strongly related to the fission time and to the vacancy lifetimes. K x rays from the element with Z=120 have been unambiguously identified from a coupled analysis of the involved nuclear reaction mechanisms and of the measured photon spectra. A minimum mean fission time τ(f)=2.5×10(-18) s has been deduced for Z=120 from the measured x-ray multiplicity.

18.
Hum Vaccin Immunother ; 17(11): 3907-3912, 2021 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-34280070

RESUMO

This research aims to understand the level and determinants of people's willingness to participate in a vaccine trial for COVID-19 in Senegal. We conducted a telephone survey among a marginal quota sample of 607 people over 18 years of age. Only 44.3% of the participants wanted to participate in a vaccine trial for COVID-19, with females intending to participate more than males (AOR = 1.82, 95% CI [1.22-2.72]). Participants who intended to be vaccinated against COVID-19 (AOR = 6.48, 95% CI [4.12-10.4]) and who thought that being infected with the coronavirus would have a significant impact on their health (AOR = 2.34, 95% CI [1.57, 3.51]) were more likely to agree to take part in the COVID-19 vaccine trial. Confidence in the vaccine, health personnel, and the government in the fight against the pandemic are key factors in participants' willingness to participate in a vaccine trial in Senegal.


Assuntos
COVID-19 , Vacinas , Adolescente , Adulto , Vacinas contra COVID-19 , Feminino , Humanos , Masculino , SARS-CoV-2 , Senegal/epidemiologia , Confiança
19.
Cancer Radiother ; 25(5): 494-501, 2021 Jul.
Artigo em Francês | MEDLINE | ID: mdl-33903009

RESUMO

The world has now been facing the coronavirus disease 2019 (COVID-19) pandemic due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since over a year. If most of clinical presentations are benign, fragile patients are at greater risk of developing severe or fatal lung disease. Many therapies have been explored with very low impact on mortality. In this context, Kirkby et Mackenzie have published in April 2020 a report reminding the anti-inflammatory properties of low-dose radiotherapy (delivering less than 1Gy) and its use in the treatment of viral and bacterial pneumopathies before antibiotics era. Large in vivo and in vitro data have demonstrated the biological rationale and anti-inflammatory activity of low-dose radiotherapy in many pathologies. Over the past year, three phase I/II clinical trials have been published, as well as one randomized controlled trial, reporting the feasibility and the clinical and biological improvement of a 0.5 to 1Gy treatment dose to the entire lung. 13 other studies, including a randomized phase III trial, are currently ongoing worldwide. These studies may provide data in the effect of low-dose radiotherapy in the treatment of SARS-CoV-2 pneumonia. This article explains biological rationale of low-dose radiotherapy, and reports already published or ongoing studies on low-dose radiotherapy for SARS-CoV-2 pneumonia.


Assuntos
COVID-19/radioterapia , COVID-19/fisiopatologia , Ensaios Clínicos como Assunto , Humanos , Dosagem Radioterapêutica
20.
Phys Rev Lett ; 104(23): 232701, 2010 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-20867230

RESUMO

Nuclear stopping has been investigated in central nuclear collisions at intermediate energies by analyzing kinematically complete events recorded with the help of the 4π multidetector INDRA for a large variety of symmetric systems. It is found that the mean isotropy ratio defined as the ratio of transverse to parallel momenta (energies) reaches a minimum near the Fermi energy, saturates or slowly increases depending on the mass of the system as the beam energy increases, and then stays lower than unity, showing that significant stopping is not achieved even for the heavier systems. Close to and above the Fermi energy, experimental data show no effect of the isospin content of the interacting system. A comparison with transport model calculations reveals that the latter overestimates the stopping power at low energies.

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