RESUMEN
OBJECTIVES AND METHOD: We conducted a prospective study in 2013 to compare the whole-cell versus acellular pertussis vaccines effectiveness and duration of protection, following the occurrence of pertussis clusters. RESULTS: During seven school outbreaks, we identified 102 clinical pertussis cases, including 10 cases biologically confirmed by Bordetella pertussis specific PCR, among a cohort of 305 children in 2nd to 6th grade. The risk of pertussis when vaccinated with an acellular vaccine alone was 1.6 (RR=1.6; 95% CI=1.1-2.5) times higher than when vaccinated with a whole-cell vaccine or using a combined schedule. CONCLUSIONS: The limited duration of protection conferred by the acellular vaccine reinforces the 2013 introduction of the pertussis booster at six years old.
Asunto(s)
Brotes de Enfermedades , Vacuna contra la Tos Ferina/inmunología , Tos Ferina/epidemiología , Tos Ferina/prevención & control , Niño , Preescolar , Francia/epidemiología , Humanos , Lactante , Estudios Prospectivos , Instituciones Académicas , Vacunas AcelularesRESUMEN
During summer 2016, all the conditions for local mosquito-borne transmission of Zika virus (ZIKV) are met in mainland France: a competent vector, Aedes albopictus, a large number of travellers returning from ZIKV-affected areas, and an immunologically naive population. From 1 January to 15 July 2016, 625 persons with evidence of recent ZIKV infection were reported in mainland France. We describe the surveillance system in place and control measures implemented to reduce the risk of infection.
Asunto(s)
Aedes/virología , Líquidos Corporales/virología , Inmunoglobulina M/sangre , Vigilancia de Guardia , Viaje , Infección por el Virus Zika/epidemiología , Virus Zika/aislamiento & purificación , Adolescente , Adulto , Anciano , Animales , Niño , Preescolar , Notificación de Enfermedades , Brotes de Enfermedades/prevención & control , Femenino , Francia/epidemiología , Humanos , Insectos Vectores/virología , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Adulto Joven , Virus Zika/genética , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/transmisiónRESUMEN
During the summer of 2014, all the pre-requisites for autochthonous transmission of chikungunya virus are present in southern France: a competent vector, Aedes albopictus, and a large number of travellers returning from the French Caribbean islands where an outbreak is occurring. We describe the system implemented for the surveillance of chikungunya and dengue in mainland France. From 2 May to 4 July 2014, there were 126 laboratory-confirmed imported chikungunya cases in mainland France.
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Infecciones por Alphavirus/epidemiología , Dengue/epidemiología , Vigilancia de Guardia , Viaje , Aedes/virología , Infecciones por Alphavirus/transmisión , Animales , Fiebre Chikungunya , Virus Chikungunya , Dengue/transmisión , Brotes de Enfermedades , Francia/epidemiología , Humanos , Insectos Vectores , Notificación ObligatoriaAsunto(s)
Infecciones por Alphavirus/epidemiología , Virus Chikungunya/aislamiento & purificación , Brotes de Enfermedades , Infecciones por Alphavirus/prevención & control , Animales , Región del Caribe/epidemiología , Fiebre Chikungunya , Europa (Continente)/epidemiología , Femenino , Humanos , Incidencia , Insectos Vectores , Masculino , Vigilancia de la PoblaciónRESUMEN
In October 2013, autochthonous dengue fever was diagnosed in a laboratory technician in Bouches-du-Rhone, southern France, a department colonised by Aedes albopictus since 2010. After ruling out occupational contamination, we identified the likely chain of local vector-borne transmission from which the autochthonous case arose. Though limited, this second occurrence of autochthonous dengue transmission in France highlights that efforts should be continued to rapidly detect dengue virus introduction and prevent its further dissemination in France.
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Antígenos Virales/sangre , Virus del Dengue/aislamiento & purificación , Dengue/diagnóstico , Adulto , Dengue/transmisión , Virus del Dengue/genética , Virus del Dengue/inmunología , Ensayo de Inmunoadsorción Enzimática , Femenino , Francia , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Exposición Profesional , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , SerotipificaciónRESUMEN
OBJECTIVE: A prospective observation study was undertaken in seven medical centers, in the French region Alpes-Maritime, to assess nail hygiene of healthcare professionals and how often they wear hand jewellery. METHOD: Seven hundred and six healthcare workers in seven medical centers were interviewed from March to April 2008. RESULTS: Among the 706 professionals, 306 (43%) were wearing one or several pieces of jewellery. The nails of 81 (11.5%) were non-standard according to guidelines. Three hundred and forty-four health care professionals (49%) were wearing one or several pieces of jewellery and/or presented with non-standard nails. In univariate analysis, the wearing of jewellery was linked to the medical centre (P<0.001), to the professional category (p<0.001), to the number of times people washed their hands or used hand gel per day (ABHR) by categories (<10 times per day or ≥10 times per day) (P<0.017). In the multivariate analysis, the risk factors linked to the wearing of jewellery were the medical centers, the professional category, and the age. CONCLUSION: There are still too many healthcare professionals who do not comply to French recommendations on hand hygiene concerning the wearing of jewellery and nail hygiene standards.
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Adhesión a Directriz/estadística & datos numéricos , Personal de Salud/estadística & datos numéricos , Joyas/estadística & datos numéricos , Cosméticos , Francia , Mano , Desinfección de las Manos , Humanos , Higiene , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Uñas , Personal de Hospital/estadística & datos numéricos , Guías de Práctica Clínica como Asunto , Estudios Prospectivos , Factores de Riesgo , Encuestas y CuestionariosAsunto(s)
Brotes de Enfermedades/estadística & datos numéricos , Notificación Obligatoria , Virus del Sarampión/aislamiento & purificación , Sarampión/diagnóstico , Sarampión/epidemiología , Vacunación/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Niño , Preescolar , Infección Hospitalaria , Femenino , Francia/epidemiología , Personal de Salud , Humanos , Incidencia , Lactante , Masculino , Sarampión/prevención & control , Sarampión/virología , Vacuna Antisarampión/administración & dosificación , Virus del Sarampión/genética , Persona de Mediana Edad , Vigilancia de la Población , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Distribución por Sexo , Adulto JovenRESUMEN
At the end of May 2003, the Marseilles Hospital Centre's virology laboratory informed the French public heath institute of 5 cases of confirmed measles among young adults living in Marseilles. An investigation was conducted, consulting different community and hospital health services, to determine the virus circulation in the Provence-Alpes-Côte d'Azur (PACA) region by the southern interregional epidemiological cell. The investigation identified 259 cases: 183 clinical, 74 serologically confirmed and 2 epidemiologically linked cases. The first cases were identified during the first six months of 2003, with a peak in April. This outbreak of measles in the PACA region was favoured by poor vaccination coverage, which created groups of susceptible population. The real number of cases was probably higher than the number identified. This investigation has outlined the limitations of the measles surveillance system in France: the sentinel network had not detected any case for this period. France needs to reach the WHO objective of measles elimination by 2010 and the surveillance tools used must be those already used in the most countries that are furthest advanced in the elimination process. To reach this goal, the Direction Générale de la Santé has nominated a working group to be in charge of proposing a national plan to interrupt indigenous measles transmission in France.
Asunto(s)
Brotes de Enfermedades/estadística & datos numéricos , Sarampión/diagnóstico , Sarampión/epidemiología , Adolescente , Adulto , Niño , Preescolar , Femenino , Francia/epidemiología , Humanos , Incidencia , Lactante , Masculino , Persona de Mediana EdadRESUMEN
At the end of May 2003, the Marseilles Hospital Centre's virology laboratory informed the French public heath institute of 5 cases of confirmed measles among young adults living in Marseilles. An investigation was conducted, consulting different community and hospital health services, to determine the virus circulation in the Provence-Alpes-Côte d'Azur (PACA) region by the southern interregional epidemiological cell. The investigation identified 259 cases: 183 clinical, 74 serologically confirmed and 2 epidemiologically linked cases. The first cases were identified during the first six months of 2003, with a peak in April. This outbreak of measles in the PACA region was favoured by poor vaccination coverage, which created groups of susceptible population. The real number of cases was probably higher than the number identified. This investigation has outlined the limitations of the measles surveillance system in France: the sentinel network had not detected any case for this period. France needs to reach the WHO objective of measles elimination by 2010 and the surveillance tools used must be those already used in the most countries that are furthest advanced in the elimination process. To reach this goal, the Direction Générale de la Santé has nominated a working group to be in charge of proposing a national plan to interrupt indigenous measles transmission in France.
RESUMEN
AIM OF THE STUDY: To assess the diagnostic value of RT-PCR on amniotic fluid (AF) for prenatal diagnosis of congenital rubella infection. MATERIAL AND METHODS: RT-PCR on AF was compared to specific IgM antibody detection in foetuses and/or newborns in 45 pregnant women with confirmed primary infection. RESULTS: specificity of RT-PCR was 100% and sensitivity ranged between 83 and 95%. CONCLUSION: RT PCR may be considered as a valuable tool for prenatal diagnosis of foetal rubella infection.
Asunto(s)
Líquido Amniótico/virología , Diagnóstico Prenatal , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Virus de la Rubéola/genética , Rubéola (Sarampión Alemán)/diagnóstico , Femenino , Humanos , Recién Nacido , Embarazo , Reproducibilidad de los Resultados , Virus de la Rubéola/aislamiento & purificaciónRESUMEN
In the pre-vaccination era, rubella was regarded as only a mild exanthematous acute viral infection of children. The devastating effects of the disease were first identified in the early 1940s by an Australian ophthalmologist, and further confirmed during the 1962-65 rubella pandemic in Europe and the United States. They result from the transmission of the virus by infected pregnant women to their fetus. The resulting congenital rubella syndrome (CRS) comprises a lengthy list of abnormalities. The most common ones are deafness, ocular and cardiac defects and mental retardation. The objective of rubella vaccination, to which France has subscribed, is the elimination of CRS.
Asunto(s)
Vacuna contra la Rubéola , Rubéola (Sarampión Alemán)/prevención & control , Adolescente , Adulto , Niño , Preescolar , Femenino , Francia , Humanos , Lactante , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & controlRESUMEN
In the pre-vaccination era, rubella was regarded as only a mild exanthematous acute viral infection of children. The devastating effects of the disease were first identified in the early 1940s by an Australian ophthalmologist, and further confirmed during the 1962-65 rubella pandemic in Europe and the United States. They result from the transmission of the virus by infected pregnant women to their fetus. The resulting congenital rubella syndrome (CRS) comprises a lengthy list of abnormalities. The most common ones are deafness, ocular and cardiac defects and mental retardation. The objective of rubella vaccination, to which France has subscribed, is the elimination of CRS [1].
RESUMEN
Liquid or supercritical carbon dioxide (scCO(2)) is a versatile reaction medium for ring-opening metathesis polymerization (ROMP) and ring-closing olefin metathesis (RCM) reactions using well-defined metal catalysts. The molybdenum alkylidene complex 1 and ruthenium carbenes 2 and 3 bearing PCy(3) or N-heterocyclic carbene ligands, respectively, can be used and are found to exhibit efficiency similar to that in chlorinated organic solvents. While compound 1 is readily soluble in scCO(2), complexes 2 and 3 behave like heterogeneous catalysts in this reaction medium. Importantly, however, the unique properties of scCO(2) provide significant advantages beyond simple solvent replacement. This pertains to highly convenient workup procedures both for polymeric and low molecular weight products, to catalyst immobilization, to reaction tuning by density control (RCM versus acyclic diene metathesis polymerization), and to applications of scCO(2) as a protective medium for basic amine functions. The latter phenomenon is explained by the reversible formation of the corresponding carbamic acid as evidenced by (1)H NMR data obtained in compressed CO(2). Together with its environmentally and toxicologically benign character, these unique physicochemical features sum up to a very attractive solvent profile of carbon dioxide for sustainable synthesis and production.
RESUMEN
OBJECTIVE: To investigate the impact of HIV infection on the prevalence, incidence and short-term prognosis of squamous intraepithelial lesions (SIL), in a prospective study with 1-year follow-up. METHODS: Between 1993 and 1995, 271 HIV-positive and 171 HIV-negative women at high risk of HIV infection were recruited, 365 (82.6%) of whom completed the 1-year follow-up. The women underwent a Papanicolaou smear test at inclusion and at 6 and 12 months. Human papillomavirus (HPV) was detected at inclusion by Southern blot and PCR. RESULTS: The SIL prevalence ranged from 7.5% for HIV-negative to 31.3% for HIV-positive women with CD4 cell counts < 500 x 10(6)/l (P < 0.001). Other factors associated independently and significantly with SIL prevalence were HPV-16, 18, 33 and related types, HPV-31, -35, -39 and related types, lifetime number of partners, younger age, past history of SIL and lack of past cervical screening. The SIL incidence ranged from 4.9% in HIV-negative women to 27% in HIV-positive women with CD4 cells < 500 x 10(6)/l (P < 0.001). Progression from low- to high-grade SIL during follow-up was detected in 38.1% of HIV-positive women with CD4 cells < or = 500 x 10(6)/l but in no HIV-negative nor HIV-positive women with CD4 cells > 500 x 10(6)/l. HPV-16, 18, 33 and related types were also associated with higher incidence of SIL and progression from low- to high-grade SIL. CONCLUSION: HIV-induced immunodeficiency is associated with high prevalence, incidence and persistence/progression of SIL. A pejorative influence of HIV infection without marked immunodeficiency is less clear. HIV-positive women with SIL may thus benefit from early treatment when a useful immune response is still present.
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Infecciones por VIH/complicaciones , Neoplasias de Células Escamosas/complicaciones , Neoplasias de Células Escamosas/epidemiología , Displasia del Cuello del Útero/complicaciones , Displasia del Cuello del Útero/epidemiología , Adulto , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Prevalencia , Pronóstico , Estudios Prospectivos , Factores de RiesgoRESUMEN
The authors report the case of a 32 year old woman who was shot with a shotgun. Acute inferior wall infarction was detected fortuitously on electrocardiography and coronary angiography showed occlusion of the right coronary artery with lead shot. The single coronary lesion, absence, of other cardiac complications (haemopericardium, cardiac perforation, ...) and the favourable outcome with conservative medical treatment has not been previously reported to the authors' knowledge.
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Infarto del Miocardio/etiología , Traumatismos Torácicos/complicaciones , Heridas por Arma de Fuego/complicaciones , Adulto , Angiografía Coronaria , Trombosis Coronaria/diagnóstico , Trombosis Coronaria/etiología , Vasos Coronarios/lesiones , Electrocardiografía , Urgencias Médicas , Femenino , Humanos , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/terapia , Pronóstico , Traumatismos Torácicos/cirugía , Resultado del Tratamiento , Heridas por Arma de Fuego/cirugíaRESUMEN
The authors report the case of a 72-year-old man with new but vague epigastric pain. CT scan and selective coeliac trunk angiography demonstrated a common hepatic artery aneurysm (HAA). He was treated surgically by ligation and excision without revascularization. Asymptomatic hepatic aneurysm should be treated aggressively because the natural course seems to be progression to rupture associated with a high mortality rate. The authors discuss the clinical scenario of patients with HAA and stress the importance of the early treatment. In addition the therapeutic options are explored.
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Aneurisma/diagnóstico por imagen , Arteria Hepática , Anciano , Aneurisma/cirugía , Angiografía , Arteria Hepática/cirugía , Humanos , Masculino , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
A residual mass after treatment of Hodgkin's disease points to the diagnosis of fibrotic residue or of persistent disease. Radiological and radionuclide imaging, although helpful, cannot differentiate between both conditions with absolute certainty. Thus, residual masses are followed up: stable or regressive masses strengthen the hypothesis of fibrotic residue, while enlarging masses evoke relapsing disease. We report on a patient with an enlarging residual mass after completion of therapy, which proved to be a benign thymic hyperplasia after histological analysis. Previously reported similar observations are reviewed.
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Enfermedad de Hodgkin/diagnóstico por imagen , Neoplasias del Mediastino/diagnóstico por imagen , Adulto , Biopsia , Terapia Combinada , Femenino , Enfermedad de Hodgkin/terapia , Humanos , Neoplasias del Mediastino/terapia , Neoplasia Residual/diagnóstico por imagen , Neoplasia Residual/patología , Timo/citología , Tomografía Computarizada por Rayos XRESUMEN
The authors are reporting the case of a 74 year old man, presenting a renal artery aneurysm. Regarding clinical aspects, medical treatment was elected. The most frequent cause of renal infarct is embolisation arising from the heart, followed by large vessels emboli that are more exceptional. Embolisation arising from the renal artery aneurysms is not very common. Unless contra-indications, surgical cure of the aneurysm is necessary, except those that are non complicated, with a diameter of less than 1.5 cm.
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Aneurisma/complicaciones , Infarto/etiología , Riñón/irrigación sanguínea , Arteria Renal , Anciano , Aneurisma/diagnóstico , Aneurisma/tratamiento farmacológico , Diagnóstico por Imagen , Humanos , Infarto/tratamiento farmacológico , Masculino , Inhibidores de Agregación Plaquetaria/uso terapéuticoRESUMEN
A Mycobacterium marinum panaris-like cutaneous injury was observed in a 5-year old child. Such an affection may require surgical advice. Lack of its knowledge may lead to serious therapeutic mistakes and complications. The authors emphasize the epidemiologic, clinical and paraclinical data allowing the diagnosis and leading to the right treatment. They also point out the place of surgical therapy in these lesions.
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Infecciones por Mycobacterium no Tuberculosas/microbiología , Micobacterias no Tuberculosas , Enfermedades Cutáneas Infecciosas/microbiología , Preescolar , Diagnóstico Diferencial , Humanos , Masculino , Infecciones por Mycobacterium no Tuberculosas/cirugía , Paroniquia/diagnóstico , Enfermedades Cutáneas Infecciosas/diagnóstico , Enfermedades Cutáneas Infecciosas/cirugíaRESUMEN
Bone metastases in the hand and foot bone (acrometastases) are rarely observed. The authors report two new cases. The first case is chiefly interesting because of its multifocal appearance and its particularly rare origin (oesophagus). The second case is remarkable as it is the initial expression of a lung neoplasm. They propose a review of the literature on this subject and emphasize the origin, the mechanisms of spread the prognosis and treatment of this disease. The difficulty of the diagnosis is also stressed.