Bed bug infestation in a French university hospital: control strategy, financial impact and perspectives.

BACKGROUND: With the increase in international travel and development of insecticide resistance, a re-emergence of the bed bug has been observed since the 2000s and it is becoming a worldwide public health problem. Hospitals and other medical settings have not been spared, while the cases reported remain limited. However, there are no specific recommendations for the healthcare settings in the literature. AIM: To report our experience of a bed bug infestation in a medical unit, in the French University Hospital Centre of Brest, caused by the admission of a patient carrier in October 2020. We described the practical methods used to control bed bugs infestation, evaluated the cost of this episode and created a specific procedure to take care of at-risk patients or known carriers of bed bugs. FINDINGS: The decision to close the unit for global treatment was taken after the investigations using a sniffer dog revealed that four rooms were infested. The closure lasted 24 days. We estimated the total cost of the infestation to be approximately US$400,000. No other wave of infestation occurred. We created a specific protocol of care for patients who were known carriers or at risk of carriage of bed bugs to graduate a strategy of control. CONCLUSION: Bed bug infestations in health facilities have a major impact on the care of patients and relevant economic consequences. Prevention and education policies are an essential starting point to respond to the scale of the phenomenon.

[Prognosis of extensive vertebral arthrodesis for scoliosis using Harrington's rods. Initial evaluation]. / L'avenir des grandes arthrodèses vertébrales pour scoliose réalisées avec le matériel de Harrington. Une première évaluation.

The authors have studied the technical results and the social status of patients operated on for scoliosis with Harrington rods. Only 137 of the first 330 patients, now adults, could be located and questioned. The scoliosis was idiopathic in nearly all cases. Correction of angulation was comparable to that found in the international literature. The aesthetic results were fair. Most of the patients are still young, and lead active lives without any noticeable loss of function or discomfort, except for low back pain whose frequency is discussed. Scoliosis, therefore, is thought to influence the social and professional future of these patients very little. Their problems have been analysed by the use of a questionnaire. The follow-up period for this early assessment is still short and needs to be completed by a further review in 10 to 15 years. It is likely that these results will not then be applicable to scoliosis of the future whose management will be likely to have altered.

[Spinal cord complications in the surgery of spinal deviations. Apropos of 24 cases]. / Les complications médullaires de la chirurgie des déviations rachidiennes. A propos de 24 observations.

The authors review 24 medullary complications which they encountered while treating scoliosis and kyphosis over a period of 8 years. They studied separatly the complications encountered in the pure kyphosis and those encountered in the scoliosis. 7 medullary complications occured while treating pure kyphosis, 5 Potts disease, 1 achondroplasia and 1 Morquio disease. All the kyphosis were of importance with a mean curve over 100 degrees. In 6 cases the medullary symptoms occurred during elongation prior any surgery. The authors distinguished between Pott disease where the symptoms occurred after minimal reductions and the chondrodysplasia where the symptoms occurred after important reductions. Thus the stiff Pott kyphosis where elongation results in medullary symptoms because of medullar compression before any correction, appears to be different from reductible kyphosis where the strong medullary tension is responsible for the symptoms. Two complications occurred after a vertebral osteotomy one immediatly and one after an elongation of a pelvic halo.