[Social connection: a report of the SFGM-TC on the maintaining social and family connections during Hematopoietic Stem Cell Transplantation]. / Lien social: maintien du lien social et familial pendant l'allogreffe de CSH.

OBJECTIVE: To set up the minimal conditions necessary to ensure that the social and familial network of the patient is preserved during the hospital stay for allogeneic hematopoïetic stem cell transplantation. MATERIAL AND METHODS: A national survey was conducted to increase knowledge about the conditions of hospital stay of adult and pediatric stem cell recipients. Then a multidisciplinary panel of health workers including doctors and nurses met to establish recommendations for maintaining the social and familial relationships optimally during the HSCT procedure. RESULTS: Practices and policies are very heterogeneous among the transplant centers. No consensus has been established and the literature data are scarce. The panel has thus established a list of recommendations to maintain optimal relationships between the patient and his relatives and friends during the hospital stay. The objective is to ensure a better acceptation of the isolation conditions and to facilitate the return home after D30. CONCLUSION: Since there is no established scientific background for drastic isolation conditions, a multi-disciplinary approach in relationship with patients associations should allow softening of the procedures without impairing the quality of care.

[Genetic diversity of a rare hepatitis A virus genotype]. / Diversité génétique d'un génotype rare du virus de l'hépatite A.

PURPOSE OF THE STUDY: Very few is known on genotype II hepatitis A virus (HAV) since it is rarely isolated. From 2002 to 2007, the French observatory of HAV identified six sub-genotype IIA strains of which one from a patient having travelled to West Africa. To investigate the possible African origin of sub-genotype IIA, we determined its prevalence among French travellers in 2008 and characterised its genetic variability. PATIENTS AND METHODS: The 2008 mandatory notification records were screened for travel to Africa. Viral genotype was determined on the nucleotide sequencing of the VP1/2A junction region. The P1 region coding for capsid proteins was used to compare the genetic diversity of IIA isolates to those of other genotypes. RESULTS: In 2008, five out of 54 patients returning from West Africa were infected by IIA strains and an additional "autochthonous" case was identified. Two more African cases were identified in 2009. A total of 14 IIA isolates (eight African and six "autochthonous") were analysed. Nucleotide and amino-acid variability of IIA sequences was lower than that of the other genotypes. Phylogenetic analysis revealed the clustering of two "autochthonous" cases with African isolates whereas the other ones belonged to a different lineage. CONCLUSION: Most IIA strains isolated in France are imported by travellers returning from West Africa. However, the unexplained contamination mode of some "autochthonous" cases suggests another geographical origin to discover or a French reservoir to explore.

Cluster of cases of hepatitis A with a travel history to Egypt, September-November 2008, France.

Since September 2008, 26 cases of hepatitis A with a history of travel to Egypt have been reported in France. Investigations indicate that a common source of contamination linked to Nile river cruises is the most likely explanation of the increase in the number of cases reported in France as well as in several other European Union countries.

Embolic risk of the different stages of carotid bifurcation balloon angioplasty: an experimental study.

PURPOSE: Embolic events during carotid angioplasty are a challenging problem. This experimental study was undertaken to determine the embolic risk after each stage of carotid angioplasty procedure. METHODS: Five ex vivo carotid artery balloon angioplasties were performed on fresh carotid specimens. The carotid specimens were obtained from five patients who underwent an internal carotid artery bypass for stenosis >75%. Before the endovascular maneuvers and after each stage of the procedures, the specimens were flushed with 20 mL of saline solution. Small particulate emboli (diameter, <60 microm) were searched in all the effluents according to the Coulter technique. After this procedure, each effluent was also submitted to scanning electron microscopy. RESULTS: When the stenosis was crossed with the guidewire or the balloon catheter, the number and the mean diameter of embolic particles did not change with three plaques (CP1, CP2, and CP3) and were increased with two plaques (CP4 and CP5). The maximal size of particles was 220 microm (CP5). After balloon angioplasty, the number and the mean diameter of particles increased with CP1, CP2, and CP3. With CP4 and CP5, the number of particles decreased, but their size increased. The maximal size of particles was 1100 microm (CP4). CONCLUSION: Carotid balloon angioplasty generates embolic particles after each stage of the procedure. Techniques of prevention should then be effective from the initial step of the angioplasty procedure, and the selection of patients for carotid angioplasty remains crucial.

Resistance of antibiotic-bonded gelatin-coated polymer meshes to Staphylococcus aureus in a rabbit subcutaneous pouch model.

This study examines the efficacy of the bonding of rifampicin, vancomycin or gentamicin to gelatin-coated knitted polymer meshes to prevent perioperative infection. Antibiotic bonding was obtained by soaking the meshes for 15 min in a solution containing 20 mg ml(-1) of rifampicin or 10 mg ml(-1) of vancomycin or gentamicin. A polymer mesh was implanted in a subcutaneous pouch in 16 rabbits: four received a rifampicin-soaked mesh, four received a vancomycin-soaked mesh, four received a gentamicin-soaked mesh, and four received an untreated mesh (control group). At the time of implantation, all the meshes were contaminated locally with 10(8) colony forming units of Staphylococcus aureus. Meshes were harvested one week later and submitted to bacterial counts. At the time of explantation, none of the antibiotic-soaked meshes were infected, whereas all the untreated meshes were infected. These results show that antibiotic soaking evidently prevents perioperative infection of gelatin-coated knitted polymer meshes in this model.

[Cancer of the larynx in Ecuador]. / Cáncer de laringe en Ecuador.

A retrospective review was made of 75 cases of laryngeal cancer evaluated and treated at the Social Security Hospital of Quito (Ecuador). No exclusively supraglottic lesions were found; 67% of cases, were glottic or glottic-supraglottic. Thirty-two per cent of cases were T1 and T2 and 23% had palpable lymph nodes in neck. Most T1 and T2 tumors were treated with radiotherapy (RT) and most T3 and T4 tumors with a combination of surgery and RT. The 5 and 10-year overall survival rates were 55% and 47%, respectively. The 5-year survival rates were: 81% for T1 and T2 tumors and 36% for T3 and T4 tumors (p = 0.0008), 76% for N- and 42% for N+, 53% for well-differentiated and 58% for moderately or poorly differentiated tumors, 85% for T1 and T2 lesions treated with RT and 67% for T1 and T2 lesions treated with partial surgery, and 14% for T3 and T4 lesions treated with RT and 49% for T3 and T4 lesions treated surgically (non-significant differences).

Comparative assessment of cell/substratum static adhesion using an in vitro organ culture method and computerized analysis system.

The trypsin sensitivity of chick embryo cellular layers cultivated by an in vitro organ culture method toward different biomaterials has been analysed. Monolayer cells grown on to tested samples were enzymatically dissociated in 5 min - 1 h. Cumulative cell numbers, expressed as the percentage of the totally detached cell number, were plotted versus time, thus permitting the calculation of the function. The mathematical treatment by a computerized system of this function represents the trypsin sensitivity. This value modulated by the migration cell number is the static adhesion modulated index (SAMI). The trypsin sensitivity expressed according to this index allowed the establishment of an abacus wherein several zones, A, B, C and D, define cell adhesion behaviour on different biomaterials. Scanning electron microscopy analysis performed on dissociation steps showed the selective activity of trypsin on cells toward different substrata, revealing the role of an extracellular matrix and cytoskeleton in the adhesion behaviour.