COVID-19 vaccine hesitancy among healthcare workers.

OBJECTIVE: To characterize healthcare workers' (HCWs) intention to receive the COVID-19 vaccine by the beginning of the vaccine campaign in France. METHODS: Data were collected on a self-administered questionnaire through the website of a tertiary care center (February 9-18, 2021). RESULTS: Among 1,965 respondents, 1,436 (73.1%), 453 (23.1%), and 76 (3.9%) declared themselves in favor, hesitant, or against the COVID-19 vaccine: <60% of auxiliary nurses and technicians intended to be vaccinated, as compared to 60-79% of nurses and support staff, and>80% of medical staff. On multivariate analysis, age, occupation, flu vaccine history, and controversy over the AstraZeneca vaccine tolerability were independently associated with COVID-19 vaccine intention. CONCLUSIONS: Patterns of vaccine hesitancy related to the COVID-19 and influenza vaccines are similar among HCWs. Media communication on vaccine side effects have a dramatic effect on vaccine hesitancy. Efforts are requested to inform HCWs about the risk/benefit balance of COVID-19 vaccines.

Impact of a targeted monitoring on data-quality and data-management workload of randomized controlled trials: A prospective comparative study.

AIMS: Monitoring risk-based approaches in clinical trials are encouraged by regulatory guidance. However, the impact of a targeted source data verification (SDV) on data-management (DM) workload and on final data quality needs to be addressed. METHODS: MONITORING was a prospective study aiming at comparing full SDV (100% of data verified for all patients) and targeted SDV (only key data verified for all patients) followed by the same DM program (detecting missing data and checking consistency) on final data quality, global workload and staffing costs. RESULTS: In all, 137 008 data including 18 124 key data were collected for 126 patients from 6 clinical trials. Compared to the final database obtained using the full SDV monitoring process, the final database obtained using the targeted SDV monitoring process had a residual error rate of 1.47% (95% confidence interval, 1.41-1.53%) on overall data and 0.78% (95% confidence interval, 0.65-0.91%) on key data. There were nearly 4 times more queries per study with targeted SDV than with full SDV (mean ± standard deviation: 132 ± 101 vs 34 ± 26; P = .03). For a handling time of 15 minutes per query, the global workload of the targeted SDV monitoring strategy remained below that of the full SDV monitoring strategy. From 25 minutes per query it was above, increasing progressively to represent a 50% increase for 45 minutes per query. CONCLUSION: Targeted SDV monitoring is accompanied by increased workload for DM, which allows to obtain a small proportion of remaining errors on key data (<1%), but may substantially increase trial costs.

Periodontal status and serum biomarker levels in HFE haemochromatosis patients. A case-series study.

AIM: To investigate the association between periodontal status and serum biomarkers in patients with HFE haemochromatosis. MATERIAL AND METHODS: This clinical case series included 84 HFE-C282Y homozygous patients. Periodontal evaluation was performed using clinical attachment level, probing depth, gingival bleeding index, visible plaque index and gingival index. Serum markers of iron metabolism were collected from medical records. The relationship between serum biomarkers of iron burden and the severity of periodontitis was investigated. RESULTS: The study population consisted of 47 men and 37 women, routinely treated in the Unit of Hepatology, University Hospital, Rennes. All patients presented with periodontitis (mild: n = 1, moderate: n = 37 and severe: n = 46). There was a positive association between transferrin saturation >45% and the severity of periodontitis (adjusted odds ratio = 5.49, p = .002). CONCLUSION: Severe periodontitis is associated with the severity of iron burden in patients with HFE-related hereditary haemochromatosis. Dental examination should be included in the initial assessment of all these patients.

Opinion of French nephrologists on renal replacement therapy: survey on their personal choice.

BACKGROUND: In France, like in most developed countries, peritoneal dialysis (PD) is less used than haemodialysis (HD). This is not based on medical evidence supporting HD superiority. As the practitioner's opinion is important to patients and may influence their treatment choice, we conducted a survey among French nephrologists to determine which renal replacement therapy (RRT) they would choose if they had end-stage renal disease (ESRD). METHODS: We e-mailed a self-administered questionnaire to all members of the French-speaking Nephrology Society between 19 October 2008 and 12 January 2009. We then selected from the French Renal Epidemiology and Information Network (REIN) registry a reference population of 20- to 64-year-old patients with ESRD who began RRT [HD, PD or pre-emptive transplantation, (PT)] in 2008. RESULTS: The survey response rate was 17.8%. Results showed that 59.6% of respondents chose early inscription on the transplantation waiting list in view of PT, 20.2% selected HD and 20.2% selected PD. When dialysis was the only choice, 50.2% chose HD and 49.8% chose PD. Younger nephrologists (≤44 years old) selected PD more frequently than older nephrologists (≥45 years old) (58.9 versus 40.5%; P < 0.01). Similarly, PD was chosen more often by nephrologists from regions with 'more PD' than from regions with 'less PD' (79.0 versus 48.8%; P < 0.05). The nephrologists' choices were different from the RTT distribution among the reference population: 81.7% HD, 10.1% PD and 8.2% PT. CONCLUSION: Our survey on the theoretical choice of RTT suggests that the low PD rate in France cannot be explained by a negative opinion of PD among French nephrologists.

Obsessive compulsive disorder networks: positron emission tomography and neuropsychology provide new insights.

BACKGROUND: Deep brain stimulation has shed new light on the central role of the prefrontal cortex (PFC) in obsessive compulsive disorder (OCD). We explored this structure from a functional perspective, synchronizing neuroimaging and cognitive measures. METHODS AND FINDINGS: This case-control cross-sectional study compared 15 OCD patients without comorbidities and not currently on serotonin reuptake inhibitors or cognitive behavioural therapy with 15 healthy controls (matched for age, sex and education level) on resting-state (18)FDG-PET scans and a neuropsychological battery assessing executive functions. We looked for correlations between metabolic modifications and impaired neuropsychological scores. Modifications in glucose metabolism were found in frontal regions (orbitofrontal cortex and dorsolateral cortices), the cingulate gyrus, insula and parietal gyrus. Neuropsychological differences between patients and controls, which were subtle, were correlated with the metabolism of the prefrontal, parietal, and temporal cortices. CONCLUSION: As expected, we confirmed previous reports of a PFC dysfunction in OCD patients, and established a correlation with cognitive deficits. Other regions outside the prefrontal cortex, including the dorsoparietal cortex and the insula, also appeared to be implicated in the pathophysiology of OCD, providing fresh insights on the complexity of OCD syndromes.

Effect of an anesthesia with propofol compared with desflurane on free radical production and liver function after partial hepatectomy.

Propofol has shown antioxidant properties, but no study has focused on liver resection surgery. The aim of this study was to investigate the effect of an anesthesia with propofol compared with desflurane on oxidative stress and hepatic function during and after partial hepatectomy. This was a prospective randomized study performed on two parallel groups. The primary endpoint was malondialdehyde (MDA) plasma concentration 30 min after hepatic vascular unclamping. Hepatic damages were evaluated by plasma levels of alpha-glutathione S-transferase (α-GST) 120 min after hepatic vascular unclamping and of aminotransferases at 120 min and on days 1, 2, 5, and 10. Liver function recovery was assessed by monoethylglycinexylidide (MEGX) formation 15 min after lidocaine injection on day 2 and by prothrombin time and plasma factor V at 120 min and on days 1, 2, 5, and 10. Thirty patients were analyzed (propofol group: 17; desflurane group: 13). There was no significant difference between groups for MDA plasma concentration 30 min after hepatic vascular unclamping (mean ± standard-deviation: 1.28 ± 0.40 and 1.21 ± 0.29 in propofol and desflurane groups, respectively, P = 0.608). Plasma levels of α-GST at 120 min were lower in propofol than in desflurane group (142.2 ± 75.4 vs. 205.7 ± 66.5, P = 0.023), and MEGX on day 2 was higher (0.092 ± 0.096 vs. 0.036 ± 0.020, P = 0.007). No differences between groups were observed with regard to plasma levels of aminotransferases, prothrombin time, and plasma factor V. Our study showed that in patients undergoing partial hepatectomy, propofol did not reduce MDA formation but seemed to display a protective effect on hepatic damages and liver function when compared to desflurane.