Lymphogranuloma venereum in Quebec: Re-emergence among men who have sex with men.

BACKGROUND: Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by Chlamydia trachomatis genotypes L1, L2 and L3. This LGV is associated with significant morbidity and increased risk of HIV transmission. While fewer than two cases per year were reported in Quebec before 2005, LGV emerged in 2005-2006 with 69 cases, followed by a period of low incidence (2007-2012), and subsequent re-emergence since 2013. OBJECTIVES: To describe the incidence of LGV in Quebec and the characteristics of the affected population, including demographics and risk factors, clinical manifestations, laboratory tests, treatments and reinfection rates. METHODS: Descriptive data were collected from the notifiable diseases records through the Institut national de santé publique du Québec (INSPQ) infocentre portal. Questionnaires were obtained through the enhanced surveillance system and transmitted anonymously to the Quebec Ministry of Health. In-depth analysis was performed on cases from 2013 to 2016. RESULTS: There were 338 cases of LGV over the four-year period in Quebec. All cases were male, excluding one transsexual. Mean age was 41 years. Most lived in Montréal (81%) and were men who have sex with men (MSM; 99%). The majority (83%) reported four sexual partners or more in the last year, met mostly through the Internet (77%) and in saunas (73%). Frequency of sexual intercourse with out-of-province residents decreased in 2013-2016 (27%) compared with 2005-2012 (38%). History of STIs was frequent: 83% were HIV-infected, 81% reported previous syphilis and 78% previous gonorrhea. Recreational drug use was frequent (57%), reaching 71% in 2016. Most cases were symptomatic, a proportion which decreased in 2016 (68%) compared with 2013-2015 (82%; p=0.006). Clinical presentations included proctitis (86%), lymphadenopathy (13%) and ulcer/papule (12%). Reinfections, mostly within two years of first infection, occurred in 35 individuals (10%).Conclusion: The re-emergence of LGV in Quebec involves an urban subpopulation composed almost exclusively of MSM with STIs, who have a high number of partners and often use drugs.

Salmonella Thompson outbreak associated with consumption of chicken shawarma and the usefulness of genome sequencing in the investigation.

BACKGROUND: A sudden increase in Salmonella Thompson (S. Thompson) cases distributed throughout three border regions in the province of Quebec in November 2016 triggered a provincial investigation to identify a common source of contamination and to put the appropriate control measures into place. OBJECTIVE: To report on the outbreak and to describe the use of genomic sequencing to identify the salmonella serotype responsible. METHODS: A descriptive survey of all reported cases of Salmonella serogroup C1 that had occurred between October 1, 2016 and February 15, 2017 was conducted. A case definition was developed. Pulsed field gel electrophoresis supplemented by analyses of genome sequences using the single nucleotide variant phylogenomics method were used to demarcate and manage the outbreak. RESULTS: Eighteen cases of S. Thompson were identified through whole genome sequencing. The onset dates of symptoms for the 16 cases that presented enteric symptoms were November 21-December 2, 2016. Two cases that presented with atypical symptoms were not reported until February 2017. Among the 18 cases, 16 had eaten or probably eaten chicken shawarma at the same restaurant chain and nine of these cases ate it at the same restaurant. In total, five restaurants from this chain, spread throughout three border regions of Quebec, were identified. CONCLUSION: Outbreaks associated with chicken shawarma have been identified in the past. Efforts must be made to ensure that the owners of this type of restaurant know the contamination risk associated with this type of cooking and take the necessary steps to reduce this risk. The use of the genome sequencing method was very useful in defining the outbreak.

Electroformed pure iron as a new biomaterial for degradable stents: in vitro degradation and preliminary cell viability studies.

In the search for a metallic material showing moderate and uniform degradation for application as degradable cardiovascular stents, electroformed iron (E-Fe) was evaluated by in vitro degradation and cell viability tests. Static immersion and dynamic degradation were used to evaluate degradation rate and mechanism, while cell viability assay was used to assess cytotoxicity. The results were compared with those of iron fabricated by casting and thermomechanical treatment previously investigated as a stent material. Electroformed iron showed faster degradation than iron fabricated by casting (0.25 vs. 0.14 mm year(-1)), with a uniform degradation mechanism. Cell viability results showed that E-Fe did not result in a decrease in metabolic activity when exposed to primary rat smooth muscle cells. However, it caused a decrease in cell proliferation activity which could be beneficial for the inhibition of in-stent restenosis.

Electroformed iron as new biomaterial for degradable stents: development process and structure-properties relationship.

An electroforming technique was developed for fabricating iron foils targeted for application as biodegradable cardiovascular stent material. The microstructure, mechanical properties and corrosion of electroformed iron (E-Fe) foils were evaluated and compared with those of pure iron made by casting and thermomechanical treatment (CTT-Fe), with 316L stainless steel (316L SS) and with other candidate metallic materials for biodegradable stents. Electron backscattered diffraction revealed an average grain size of 4 microm for E-Fe, resulting in a high yield (360 MPa) and ultimate tensile strength (423 MPa) being superior to those of other metallic biodegradable stent materials. Annealing at 550 degrees C was found to improve the ductility of the E-Fe from 8% to 18%. The corrosion rate of E-Fe in Hanks' solution, measured by potentiodynamic polarization, was higher than that of CTT-Fe, which had been found to have a slow in vivo degradation. The results showed that E-Fe possesses fine-grain microstructure, suitable mechanical properties and moderate corrosion rate as a degradable stent material.

Modeling lipid uptake in expanded polytetrafluoroethylene vascular prostheses and its effects on mechanical properties.

The radial transport across the wall of expanded polytetrafluoroethylene (ePTFE) arterial prostheses has a significant effect on lipid uptake observed in prostheses implanted in humans, which has been postulated to be one of the causes associated with implant failure. The goal of this study was to stimulate radial transport on a lipidic dispersion across the wall of an ePTFE prosthesis and investigate its effects on the circumferential mechanical properties of the prosthesis. An in vitro model was developed to simulate the lipidic radial transport across the wall. Lipids contained in a phosphatidylcholine dispersion were used as the transported molecules. Lipid concentration profiles were obtained after exposing commercial ePTFE prostheses to various transmural pressure and/or lipidic concentration gradients. Phospholipids gradually accumulated up to the external reinforcing wrap of the prosthesis, which clearly acted as a rigid barrier against lipid infiltration. Tensile tests performed on the virgin samples showed that the wrap was much more rigid than the microporous part of the prosthesis. After the lipid simulation, the rigidity of the wrap decreased with respect to what was observed for the virgin prosthesis. Finally, some clinical implications of this phenomena are discussed.