ABSTRACT
BACKGROUND: Tuberculosis prevention has been based on generalized BCG vaccination in France since 1949. The aim of this cross-sectional survey was to assess the impact of the change in BCG administration (in January 2006) and the end of compulsory vaccination (in July 2007). METHOD: A self-administered postal questionnaire was sent to a random sample of 2248 physicians practicing in 6 departments in the Rhône-Alpes region in 2008. RESULTS: Overall, 923 questionnaires were analyzed. The median age of the respondents was 52 years, 67 % were male, 93 % were general practitioners, and 91 % practiced in private practice offices. The median number of BCG vaccines administered on a quarterly basis was 5 (interquartile range [IQR], 3-10) before January 2006, one (IQR, 0-3) between January 2006 and July 2007, and zero (IQR, 0-1) after July 2007 (P<0.001). The rate of BCG vaccination was significantly lower for male physicians, physicians older than 50 years, general practitioners, practitioners working in private offices, and for some departments. Thirty-nine percent of the physicians were informed of the national program against tuberculosis 2007-2009, and 41 % wished to be trained in the practice of intradermal vaccination. CONCLUSION: This survey suggests that the withdrawal of Monovax and the lifting of generalized vaccination requirements were followed by a substantial decrease in the number of BCG vaccinations. The intradermal route constitutes an obstacle for BCG vaccination that might be overcome by specific training.
Subject(s)
BCG Vaccine/administration & dosage , Immunization Programs/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , Tuberculosis, Pulmonary/prevention & control , Adult , Age Factors , Aged , Child , Delivery of Health Care/statistics & numerical data , Family Practice/statistics & numerical data , Female , France , Health Surveys , Humans , Injections, Intradermal , Male , Middle Aged , Pediatrics/statistics & numerical data , Private Practice/statistics & numerical data , Sex Factors , Surveys and QuestionnairesABSTRACT
Five new cases of reciprocal translocation in the domestic pig are described. Three of them, rep(3;5)(p1.3;q2.3), rep(6;13)(p1.5;q4.1) and rep(13;17)(q4.1;q1.1) were found in boars with decreased litter size. The remaining two were identified in animals karyotyped before reproduction: a young boar, rep(4;6)(q2.1;q2.8), and a gilt, rep(2;14)(q1.3;q2.7). A parental origin by inheritance of the translocations was established in cases 1, 4, and 5. A decrease in prolificacy of 43% and 34% was estimated in cases 1 and 3, respectively.
Subject(s)
Swine/genetics , Translocation, Genetic , Animals , Chromosome Banding , Female , Karyotyping , Litter Size/genetics , MaleABSTRACT
Nine pigs with decreased litter size or sired by boars with decreased litter size were found to be reciprocal translocation carriers. Four Large White animals (two females and two males) demonstrated translocations involving chromosomes 1 and 9 (1p-;9p+), 11 and 13 (11q+;13q-), 3 and 13 (3;13)(p1.5;q3.1), and 15 and 17 (15;17)(q1.3;q2.1). Two Large White x Pietrain terminal boars demonstrated translocations involving chromosomes 11 and 16 (11;16)(p1.4;q1.4), and 6 and 14 (6;14)(q2.7;q2.1). The (9;15)(p2.4;q1.3) and (6;16)(q1.1;q1.1) translocations were found in a Large White x French Landrace boar, and in a commercial male line boar with decreased litter size, respectively. A Gascon breed boar with reduced prolificacy also had an abnormal karyotype, namely 38 XY, rcp(1;6)(q1.2;q2.2). Reduction in prolificacy was estimated accurately in cases 3, 5, 6, 7, and 9 (35%, 30%, 35%, 41%, and 56%, respectively). Rcp(1;6)(q1.2;q2.2) and rcp(6;16)(q1.1;q1.1) seemed to have been of de novo origin.
Subject(s)
Chromosome Mapping , Swine/genetics , Translocation, Genetic , Animals , Animals, Domestic , Crosses, Genetic , Female , Karyotyping , Litter Size , Male , Species SpecificityABSTRACT
Two cases of chronic urticaria associated with macroglobulinemia are reported, and the characteristics of 13 other cases are reviewed. This entity was described by Schnitzler in 1974 and has the following characteristics: chronic nonpruritic urticaria with leukocytoclastic vasculitis, bone pains with hyperostosis, intermittent fever, and a monoclonal IgM gammopathy. Liver, lymph node, and spleen enlargement may occur. Criteria for the diagnosis of Waldenström's disease are lacking (IgM level less than 10 gm/L, no overt lymphoid proliferation in bone marrow). Other immunologic findings (complement, C1 inhibitor, cryoglobulin, rheumatoid factor, antinuclear antibodies) are negative or normal. Evolution is long-term with a long follow-up period. In one case a lymphoplasmocytic lymphoma developed. No adequate treatment has yet been found. Pathogenesis is unclear but seems to be caused by skin deposits of the IgM paraprotein, as attested to by the direct cutaneous immunofluorescent findings in some cases.
Subject(s)
Urticaria/pathology , Waldenstrom Macroglobulinemia/pathology , Bone Diseases/pathology , Chronic Disease , Female , Humans , Male , Middle Aged , Syndrome , Tibia/pathologyABSTRACT
In patients with sleep apnoea syndrome abnormalities of the upper airways may play a major role in the genesis of apnoea. Three cases are presented which illustrate the part played by hypertrophy of the tonsils in a child and by stenosis of the pharynx in an adult and of the larynx in another adult. All three patients were cured by surgical correction of these abnormalities. The physiopathology of alveolar hypoventilation, present in one of the three patients, is discussed in relation to the effects of pure oxygen inhalation on the patient's ventilation.
Subject(s)
Airway Obstruction/complications , Sleep Apnea Syndromes/etiology , Adult , Child, Preschool , Constriction, Pathologic , Female , Humans , Hypoventilation/physiopathology , Laryngeal Diseases/complications , Male , Middle Aged , Pharyngeal Diseases/complications , Recurrence , Respiratory Function Tests , Sleep Apnea Syndromes/physiopathology , Tonsillitis/complicationsABSTRACT
A case of primary malignant fibrous histiocytoma of the lung is reported. The clinical course was divided into 2 periods: slow tumoral growth followed by rapid aggravation. The pathological aspects of the first localization and of the relapse are analyzed and discussed. Data from the literature are reviewed, with special attention to diagnostic and prognostic problems.
Subject(s)
Histiocytoma, Benign Fibrous/pathology , Lung Neoplasms/pathology , Neoplasm Recurrence, Local , Adult , Histiocytoma, Benign Fibrous/therapy , Humans , Lung Neoplasms/therapy , Male , PrognosisSubject(s)
Staphylococcal Scalded Skin Syndrome/epidemiology , Staphylococcal Skin Infections/epidemiology , Adolescent , Adult , Age Factors , Aged , Anti-Bacterial Agents/therapeutic use , Child , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Staphylococcal Scalded Skin Syndrome/diagnosis , Staphylococcal Scalded Skin Syndrome/drug therapyABSTRACT
Cerebrospinal fluid levels of fosfomycin were measured in 10 patients with bacterial meningitis. Fosfomycin 200 mg/kg/day was administered in three 4-hour intravenous infusions. The antibiotic was associated with amoxicillin in 9 patients and with cefotaxime in one. Cerebrospinal fluid was obtained on the 2nd and 5th days of treatment, 2 hours after the end of the infusion. The mean CSF fosfomycin levels were 31 mg/l on the 2nd day and 37.2 mg/l on the 5th day. These levels were higher than the MIC 90 for most bacteria encountered in meningitis. Fosfomycin could be used to treat some cases of bacterial meningitis, but always in association with another antibiotic.