[Clinical presentation and performance of urine dipstick for diagnosis of urinary infection in geriatric population]. / Présentation clinique et performance de la bandelette urinaire pour le diagnostic d'infection urinaire en population gériatrique.

BACKGROUND: Urinary tract infections (UTI) are the second cause of community-acquired bacterial infections in the elderly. Distinguishing symptomatic UTI from asymptomatic bacteriuria is problematic, as older adults are less likely to present with localized urinary symptoms. We evaluated characteristics of patients presenting UTI among elderly with sepsis. Moreover, we aimed to evaluate the sensibility and specificity of urine dipstick tests in the diagnosis of UTI in geriatric population. PATIENTS AND METHOD: We led a prospective, monocentric, observational study between April 2017 and January 2018. We included patients hospitalized in geriatric wards, who were prescribed urine culture for UTI symptoms or/and infection without primary sites for which a urine culture was prescribed. Dipstick urinalyses were performed for all patients. Clinical and biological characteristics of all patients were compared according to the final diagnosis of UTI. Moreover, results of dipstick tests were evaluated for the diagnosis of UTI in this population. RESULTS: Among 165 patients, 67 (40.6 %) had a UTI and 98 (59.4 %) had another diagnosis. These two groups were comparable for age and daily-living activities. In the UTI group, the proportion of women was higher than in the other group (P<0.05), and mean MMSE score was lower (P<0.05). Positive urine dipstick test for leukocytes and/or nitrites had high sensitivity (92 %), but low specificity (50 %). Negative predictive value of this test was high (91 %). CONCLUSION: For suspicion of UTI among elderly, few criteria are specific. Negative dipstick tests can suggest an absence of UTI due to its high negative predictive value.

Hydrophobicity engineering to facilitate surface display of heterologous gene products on Staphylococcus xylosus.

Protein engineering has been employed to investigate the effect of specific amino acid changes on the targeting of heterologous proteins to the outer cell surface of the Gram-positive bacterium Staphylococcus xylosus. Three different variants, corresponding to a 101 amino acid region of the major glycoprotein (G protein) of human respiratory syncytial virus (RSV), were generated in which multiple hydrophobic phenylalanine residues were either substituted or deleted. The different G protein fragments were expressed as one part of recombinant receptors designed for surface display on S. xylosus cells. The engineered variants of the RSV G protein hybrid receptors were, in contrast to a non-engineered fragment, efficiently targeted to the outer cell surface of recombinant S. xylosus cells as determined by different methods, including fluorescence-activated cell sorting. In addition, immunization of mice with live recombinant S. xylosus demonstrated that surface exposure was required to generate receptor-specific antibodies. The present strategy of hydrophobic engineering should be of general interest in surface-display applications and for secretion of proteins otherwise difficult to translocate through host cell membranes.

Harmaline effects on the sensory-motor reactivity: modifications of the acoustic startle pattern.

The effects of harmaline, an indoleamine and a MAOI, were tested on the acoustic startle pattern. EMG measures of the startle reflex, the pinna reflex as well as the characters of the vertex evoked responses to brief intense tone bursts (60 msec, 110 dB, 8000 Hz) were simultaneously studied in 4 alert guinea-pigs. The basic experimental design was a 4 by 4 latin square, with the treatments being given at 2 day intervals. The four harmaline-HCl treatments were isotonic saline, 0.25, 5.0, and 10.0 mg/kg. Compared with saline baselines, all the doses resulted, throughout the 60 min session, in overall high significant depressions of the startle reflex, the pinna reflex and the initial wave of the acoustic evoked potential at the vertex. In contrast, harmaline had little or no influence on amplitude and latency of the late wave of the vertex response. The effects of harmaline on the general behavior of the guinea-pig are also reported. These results may support an involvement of serotonergic systems in the modulation of the sensory-motor reactivity at the brainstem level. Nevertheless, the probably more complex cortical processes involved in startle responsiveness do not appear univocally affected by the indoleamine drugs such as harmaline.

[Frequency of use of school cafeterias in middle and high schools in 3 French districts]. / Fréquentation des restaurants scolaires dans les collèges et lycées de trois départements français.

Reports from the French Ministry of Education warn of a decrease in the use of school food services, especially in sensitive urban areas. They also suggest that this decline has led to cases of malnutrition. This article describes the characteristics of the current supply of school meals and measures the evolution of demand observed between 1992 and 1996 in relation to the economic situation of students' families. The study was carried out in 3 departments in France: Doubs, Herault, and Val de Marne. The administrators of all public and private middle and high schools in the 3 departments received a questionnaire asking them to describe the services offered in their cafeterias and to provide the corresponding statistical and accounting data. External food services near the schools were also taken into account. Seventy-nine percent of schools responded to the survey. Concerning the services offered, 91% of schools have their own cafeterias, of which 81% are managed by the schools. Concerning the evolution of utilisation, a significant decrease in the number of meals served in seen in middle schools. On the other hand, high schools have observed stable utilisation. The positive changes in utilisation are linked, in middle schools, to characteristics of the schools' internal food services (self-service, choice of main courses, modulation of seats). In high schools, positive changes in the utilisation of school services are linked to the lack of external food services near the schools. As middle schools and high schools control the logistics and management of food services offered to students, they are potentially in a position to influence a policy on this issue. The evolution in utilisation is very different among departments and between middle and high schools. While economic precariousness has a negative structural effect on utilisation, it doesn't seem to be a major factor in the evolution of the decrease observed over the past few years.