[Fecal microbiota transplantation: from the evidence to the realty of the field]. / Transplantation de microbiote fécal : de l'évidence aux réalités du terrain.

In clinical practice, fecal microbiota transplantation (FMT) has been established as an unparalleled therapy to date for multiple recurrent Clostridioides difficile infections (CDI). The implementation of the FMT in practice requires a significant investment to meet legal, security and financial requirements. Research on the microbiota is booming and multiple investigations on FMT in indications other than CDI are ongoing.

En pratique clinique, la transplantation de microbiote fécal (TMF) s'est établie comme une thérapie sans équivalent à ce jour pour les infections à Clostridioides difficile (C. difficile) multirécidivantes. La mise en place de la TMF en pratique demande un investissement important pour répondre aux exigences légales, sécuritaires et financières. La recherche sur le microbiote est en plein essor et de multiples recherches sur la TMF dans d'autres indications que pour l'infection à C. difficile sont en cours.

Predictors of mortality of influenza virus infections in a Swiss Hospital during four influenza seasons: Role of quick sequential organ failure assessment.

BACKGROUND: Influenza infections have been associated with high morbidity. The aims were to determine predictors of mortality among patients with influenza infections and to ascertain the role of quick Sequential Organ Failure Assessment (qSOFA) in predicting poor outcomes. METHODS: All adult patients with influenza infection at the Hospital of Jura, Switzerland during four influenza seasons (2014/15 to 2017/18) were included. Cepheid Xpert Xpress Flu/RSV was used during the first three influenza seasons and Cobas Influenza A/B and RSV during the 2017/18 season. RESULTS: Among 1684 influenza virus tests performed, 441 patients with influenza infections were included (238 for influenza A virus and 203 for B). The majority of infections were community onset (369; 83.7%). Thirty-day mortality was 6.0% (25 patients). Multivariate analysis revealed that infection due to A virus (P 0.035; OR 7.1; 95% CI 1.1-43.8), malnutrition (P < 0.001; OR 25.0; 95% CI 4.5-138.8), hospital-acquired infection (P 0.003; OR 12.2; 95% CI 2.3-65.1), respiratory insufficiency (PaO2/FiO2 < 300) (P < 0.001; OR 125.8; 95% CI 9.6-1648.7) and pulmonary infiltrate on X-ray (P 0.020; OR 6.0; 95% CI 1.3-27.0) were identified as predictors of mortality. qSOFA showed a very good accuracy (0.89) equivalent to other more specific and burdensome scores such as CURB-65 and Pneumonia Severity Index (PSI). CONCLUSION: qSOFA performed similarly to specific severity scores (PSI, CURB-65) in predicting mortality. Infection by influenza A virus, respiratory insufficiency and malnutrition were associated with worse prognosis.

Dance therapy combined with patient education improves quality of life of persons with obesity: A pilot feasibility study for a randomised controlled trial.

OBJECTIVE: To assess the effect of dance therapy combined with patient education on quality of life, functional capacity (lower limb power and endurance) and physical activity level in obese individuals. METHODS: Thirty-three obese patients were randomised to a control group (structured patient education ambulatory program), and 34 to an intervention group (structured patient education ambulatory program combined with weekly sessions of dance therapy). Patients' quality of life, physical function and physical activity level were assessed at baseline and after 16 weeks. RESULTS: Almost only women were willing to enrol in the study. Participants of the intervention group significantly improved their quality of life (p=0.023), and particularly self-esteem (p=0.014). However, dance therapy added to a patient educational program did not produce statistically significant higher effects than a patient education program alone on functional capacities and patients' physical activity level. CONCLUSION: A 16 week structured patient educational program combined with dance therapy seems to have a positive effect on the quality of life of obese people, but no effect on functional capacities and physical activity. PRACTICE IMPLICATION: Dance therapy combined with structured patient education is an interesting approach to improve quality of life of obese people.