[Community-Based Testing and Factors Associated with HIV among Men Who Have Sex with Men (MSM) in Haiti between 2015 and 2018]. / Dépistage communautaire et facteurs associés au VIH d'hommes ayant des relations sexuelles avec des hommes (HSH) en Haïti entre 2015 et 2018.

Men who have sex with men (MSM) are an HIV key population in Haiti. However, little data exists on that population and on factors associated with this infection. Our study carried out the factors associated with HIV-positive screening among MSM in a community-based rapid testing program in Haiti between 2015 and 2018. Among the 1416 MSM screened, a third reported that it was their very first HIV test and 7.0% had an HIV-positive test. With a median age of 25 years old [21-29], over half of them were living in urban areas (60.7%) and were in financial precarious conditions (68.6%). Multivariate analysis showed that two factors were significantly associated with an HIVpositive result: having had an STI in the last 12 months, strengthened by psychoactive drug use; transactional sex practice in the last 12 months, strengthened by the age between 18 and 20 years old. These results should be taken into account when developing and implementing targeted and comprehensive HIV prevention programs and services for young MSM in Haiti.

Les hommes ayant des relations sexuelles avec des hommes (HSH) constituent une population clé du virus de l'immunodéficience humaine (VIH) en Haïti. Cependant, peu de données existent sur cette population et les facteurs associés à cette infection. Notre étude s'intéresse aux facteurs liés à un test rapide positif au VIH chez les HSH dans le cadre d'un dispositif de dépistage communautaire en Haïti entre 2015 et 2018. Parmi les 1 416 HSH dépistés, un tiers déclaraient leur premier test VIH et 7,0 % avaient un résultat positif. Avec un âge médian de 25 ans [21­29], plus de la moitié d'entre eux vivaient en milieu urbain (60,7 %) et étaient en situation de précarité financière (68,6 %). Une analyse multivariée a montré que deux facteurs étaient significativement associés à un résultat positif au VIH : avoir eu une infection sexuellement transmissible dans les 12 derniers mois, facteur accentué lorsqu'il est combiné à une consommation de produits psychoactifs ; la pratique du sexe transactionnel dans les 12 derniers mois, facteur accentué par l'appartenance à la classe d'âge des 18­20 ans. Ces résultats doivent se traduire dans la mise en place de futurs programmes et services de prévention du VIH vers les jeunes HSH en Haïti.

Symbiotic N2 fixation activity in relation to C economy of Pisum sativum L. as a function of plant phenology.

The relationships between symbiotic nitrogen fixation (SNF) activity and C fluxes were investigated in pea plants (Pisum sativum L. cv. Baccara) using simultaneous 13C and 15N labelling. Analysis of the dynamics of labelled CO2 efflux from the nodulated roots allowed the different components associated with SNF activity to be calculated, together with root and nodule synthetic and maintenance processes. The carbon costs for the synthesis of roots and nodules were similar and decreased with time. Carbon lost by turnover, associated with maintenance processes, decreased with time for nodules while it increased in the roots. Nodule turnover remained higher than root turnover until flowering. The effect of the N source on SNF was investigated using plants supplied with nitrate or plants only fixing N2. SNF per unit nodule biomass (nodule specific activity) was linearly related to the amount of carbon allocated to the nodulated roots regardless of the N source, with regression slopes decreasing across the growth cycle. These regression slopes permitted potential values of SNF specific activity to be defined. SNF activity decreased as the plants aged, presumably because of the combined effects of both increasing C costs of SNF (from 4.0 to 6.7 g C g-1 N) and the limitation of C supply to the nodules. SNF activity competed for C against synthesis and maintenance processes within the nodulated roots. Synthesis was the main limiting factor of SNF, but its importance decreased as the plant aged. At seed-filling, SNF was probably more limited by nodule age than by C supply to the nodulated roots.

Root and nodule growth in Pisum sativum L. in relation to photosynthesis: analysis using 13C-labelling.

The effect of the nitrogen source (gaseous nitrogen, N2, or nitrate ions, NO3-) on the use of carbon (C) for root and nodule growth of pea (Pisum sativum L.) was investigated using 13C-labelling of assimilated CO2 at various stages of growth. Nitrate supply and growing conditions (sowing dates, air CO2 concentration) were varied to alter photosynthetic rates. Nodules are the sink with the highest demand for C in both the vegetative and flowering stages, growing at the expense of shoot and root in the vegetative stage, but only at the expense of roots at flowering. Until flowering, the addition of C into root and nodule biomass was linearly related to pre-existing biomass, thus determining net sink strengths which decreased with root and nodule age. Nodule growth patterns did not depend on the N source, whereas root growth was increased by nitrate when nodule biomass was low. At seed filling, the increase in C of biomass of the root system was no longer related to pre-existing biomass and C was preferentially diverted to roots of plants assimilating nitrate, or to nodules for plants fixing N2.

Seasonal patterns of 13C partitioning between shoots and nodulated roots of N2- or nitrate-fed Pisum sativum L.

The effect of nitrogen source (N(2) or nitrate) on carbon assimilation by photosynthesis and on carbon partitioning between shoots and roots was investigated in pea (Pisum sativum L. 'Baccara') plants at different growth stages using (13)C labelling. Plants were grown in the greenhouse on different occasions in 1999 and 2000. Atmospheric [CO(2)] and growth conditions were varied to alter the rate of photosynthesis. Carbon allocation to nodulated roots was unaffected by N source. At the beginning of the vegetative period, nodulated roots had priority for assimilates over shoots; this priority decreased during later stages and became identical to that of the shoot during seed filling. Carbon allocation to nodulated roots was always limited by competition with shoots, and could be predicted for each phenological stage: during vegetative and flowering stages a single, negative exponential relationship was established between sink intensity (percentage of C allocated to the nodulated root per unit biomass) and net photosynthesis. At seed filling, the amount of carbon allocated to the nodulated root was directly related to net photosynthesis. Respiration of nodulated roots accounted for more than 60 % of carbon allocated to them during growth. Only at flowering was respiration affected by N supply: it was significantly higher for strictly N(2)-fixing plants (83 %) than for plants fed with nitrate (71 %). At the vegetative stage, the increase in carbon in nodulated root biomass was probably limited by respiration losses.

Airway compression in children due to congenital heart disease: value of flexible fiberoptic bronchoscopic assessment.

OBJECTIVE: To evaluate the frequency and severity of airway compression due to congenital heart disease in children and validate the use of the fiberoptic bronchoscope to assess them. DESIGN: A retrospective study. SETTING: A single-institutional study in a university hospital. PARTICIPANTS: Seventy-two children with congenital heart disease. INTERVENTIONS: Airway endoscopy was performed in an awake child in cases of clinical and/or radiologic respiratory signs or in cases of preoperative assessment of a cardiac abnormality that is known to accompany airway compression. MEASUREMENTS AND MAIN RESULTS: Endoscopy was well tolerated; 71% of the children had endoscopic abnormalities and 50% had airway compression. The locations of these compressions are the same as those described in the literature in the cases of vascular rings and left-to-right shunts. The other endoscopic findings were laryngeal and bronchial abnormalities, tracheobronchial malacia, respiratory signs of gastroesophageal reflux, and positive bacteriologic sputum samples. CONCLUSION: Endoscopy in an awake patient is the only way to evaluate the functional component of a compression due to malacia; the resulting collapse of the airway can cause trapping of air and secretions. Furthermore, fiberoptic bronchoscopy offers a complete examination of the airways and can help detect airway abnormalities that are potential causes of complications. Fiberoptic bronchoscopy is a suitable and well-tolerated examination that is easy to perform at the bedside of the child. This technique optimizes the preoperative assessment of children with congenital heart disease.

[Value of fiberoptic bronchoscope in children with epiglottitis]. / Intérêt de l'utilisation du bronchoscope à tube souple en cas d'épiglottite chez l'enfant.

Acute epiglottitis is an infectious disease causing a severe respiratory distress. Any attempt to move the child in the horizontal position or to examine his throat can result in cardiac arrest. Diagnosis, endotracheal intubation as well as decision making of the optimal time for extubation are greatly facilitated by the use of a fiberoptic bronchoscope. The device is a paediatric model (external diameter 3.6 mm with an operating channel). It is inserted through the nare in the child in the sitting position. Oxygen is delivered through a nasal tube. The examination is performed under local anaesthesia (lidocaine 0.5%). Midazolam is sometimes added via the rectal or i.v. route. The clinical signs are monitored as well as the heart rate and SpO2. The diagnosis of epiglottitis as it is visual, is very easy and rapid once the epiglottis is observed through the fibreoptic bronchoscope. The advantage of the examination under fibreoptic bronchoscope is to allow visualization without aggression or stimulation of the pharyngolaryngeal structures and without modification of the child's position. Endotracheal intubation, which is always required, is facilitated as the child is breathing spontaneously. The expiratory flow blows bubbles of saliva, which guide the bronchoscope to the glottis. When the internal diameter of the endotracheal tube is larger than 4 mm, the bronchoscope is used as a guide. When it is less than 4 mm. the bronchoscope is inserted in the trachea with a guide wire slipped in the operating channel; the bronchoscope, but not the wire is withdrawn and the endotracheal tube is inserted over the guide wire.(ABSTRACT TRUNCATED AT 250 WORDS)

[Bisalbuminemia (author's transl)]. / Les bisalbuminémies.

After a review of first two causes of bisalbuminemia: genetic mutation and overdosage during antibiotherapy with beta-lactamines, the authors underline the importance of searching for a bisalbuminemia during the course of pancreatic disease or when confronted with a serous collection, particularly an ascite of undetermined origin. Effectively, the finding of a bisalbuminemia in these two circumstances, after having eliminated the first two etiologies, permits the confirmation of the diagnostic of a pancreatic fistula. This diagnostic should imply exploratory surgery, even without other confirmation, and a per-op. wirsungography if the fistula is not visible macroscopically. The surgical correction of the fistula cures the patient and the bisalbuminemia disappears in several hours.