[Analysis of success rates of uretroplasty for adult male bulbar urethral stricture: A systematic review]. / Analyse des taux de succès des urétroplasties pour sténoses de l'urètre bulbaire chez l'homme adulte : revue systématique de la littérature.

Male urethral stricture disease is prevalent and has an important impact on quality of life. Direct visual urethrotomy and dilatations have high rates of recurrence. OBJECTIVES: The aim of this review of literature was to evaluate the success rates of different techniques of urethroplasty for strictures of the bulbar urethra. METHODS: We performed a systematic review of the MEDLINE literature from 2004 to 2015 following the PRISMA's statement recommendations. Key words were: urethroplasty, urethral reconstruction, onlay, graft, urethral stricture. Inclusion criteria were original articles describing the results of urethroplasty for bulbar urethral stricture in an adult male population. A minimum follow-up of 24 months was required. RESULTS: From 891 articles of the literature, 20 are studied in this review. Only 3 studies were prospective. The success rate of anastomotic urethroplasty varied from 68.7 to 98.8% for strictures from 1 to 3.5cm, from 60 to 96.9% for augmented urethroplasty performed for strictures from 4.2 to 4.7cm. Substitution urethroplasty with grafts presented from 75 to 89.8% of success for strictures from 2.6 and 4.36cm. Overall, 19/20 studies used buccal mucosal graft. CONCLUSION: The success rate of urethroplasty for bulbar urethral stricture is high; the surgical technique should be adapted to the length of the stricture.

Stability of airborne microbes in the Louvre Museum over time.

The microbial content of air has as yet been little described, despite its public health implications, and there remains a lack of environmental microbial data on airborne microflora in enclosed spaces. In this context, the aim of this study was to characterize the diversity and dynamics of airborne microorganisms in the Louvre Museum using high-throughput molecular tools and to underline the microbial signature of indoor air in this human-occupied environment. This microbial community was monitored for 6 month during occupied time. The quantitative results revealed variations in the concentrations of less than one logarithm, with average values of 10(3) and 10(4) Escherichia coli/Aspergillus fumigatus genome equivalent per m(3) for bacteria and fungi, respectively. Our observations highlight the stability of the indoor airborne bacterial diversity over time, while the corresponding eukaryote community was less stable. Bacterial diversity characterized by pyrosequencing 454 showed high diversity dominated by the Proteobacteria which represented 51.1%, 46.9%, and 38.4% of sequences, for each of the three air samples sequenced. A common bacterial diversity was underlined, corresponding to 58.4% of the sequences. The core species were belonging mostly to the Proteobacteria and Actinobacteria, and to the genus Paracoccus spp., Acinetobacter sp., Pseudomonas sp., Enhydrobacter sp., Sphingomonas sp., Staphylococcus sp., and Streptococcus sp.

Associations between overweight, obesity, health measures and need for recovery in office employees: a cross-sectional analysis.

BACKGROUND: With both a high need for recovery (NFR) and overweight and obesity being a potential burden for organizations (e.g. productivity loss and sickness absence), the aim of this paper was to examine the associations between overweight and obesity and several other health measures and NFR in office workers. METHODS: Baseline data of 412 office employees participating in a randomised controlled trial aimed at improving NFR in office workers were used. Associations between self-reported BMI categories (normal body weight, overweight, obesity) and several other health measures (general health, mental health, sleep quality, stress and vitality) with NFR were examined. Unadjusted and adjusted linear regression analyses were performed and adjusted for age, education and job demands. In addition, we adjusted for general health in the association between overweight and obesity and NFR. RESULTS: A significant positive association was observed between stress and NFR (B= 18.04, 95%CI:14.53-21.56). General health, mental health, sleep quality and vitality were negatively associated with NFR (p<0.001). Analyses also showed a significant positive association between obesity and NFR (B=8.77, 95%CI:0.01-17.56), but not between overweight and NFR. CONCLUSIONS: The findings suggest that self-reported stress is, and obesity may be, associated with a higher NFR. Additionally, the results imply that health measures that indicate a better health are associated with a lower NFR. TRIAL REGISTRATION: The trial is registered at the Dutch Trial Register (NTR) under trial registration number: NTR2553.

Earlier introduction of aguitas is associated with higher risk of stunting in infants and toddlers in the Western Highlands of Guatemala.

BACKGROUND: In many cultures, simple herbal infusions, thin gruels, or sweetened water (agüitas in Guatemalan parlance) are given to infants and toddlers. Formative research has shown that the use of agüitas in early child feeding is deeply embedded in Guatemalan culture. OBJECTIVE: We examined the prevalence and timing of the introduction of agüitas during early life in a low-income population of metropolitan Quetzaltenango in relation to stunting in children. DESIGN: Responses from 456 mothers of children aged 5-23 mo were analyzed by using logistic regression to explore relations between linear growth (stunting), diarrhea, and age at the first introduction of agüitas. RESULTS: A total of 358 of 456 infants (79%) were agüita users independent of sex or ethnicity. Of infants given agüitas, one-fourth of subjects were introduced to agüitas within the first 2.9 wk of age, and one-half of subjects were introduced to agüitas within the first 9 wk of age. Subjects introduced to agüitas before 2.9 wk of age were 1.8 times more likely to be stunted (95% CI: 1.1, 2.8; P = 0.03) irrespective of ethnicity. Children who had ever been given agüitas were twice as likely to have also had diarrhea (OR: 2.1; 95% CI: 1.3, 3.3) and more likely to have needed medical attention for diarrhea (OR: 2.1; 95% CI: 1.1, 4.2), but diarrheal experience was independent of stunting. CONCLUSION: Because of the early introduction of agüitas and the high prevalence of stunting in Guatemala, longitudinal studies are urgently needed to clarify the causal relations. This trial was registered at Nederlands Trial register as NTR3273 for 5-mo-olds and Nederlands Trial register as NTR3292 for infants ≥6 mo.

Positive associations between respiratory outcomes and fungal index in rural inhabitants of a representative sample of French dwellings.

Our study aims at estimating exposure to molds at home, based on microbial Volatile Organic Compounds (MVOCs) assessment, and evaluating its effect on respiratory diseases in a representative sample of dwellings. In the framework of a national campaign, indoor pollution was monitored in a sample of the 24 million dwellings of metropolitan France (n=567). 727 subjects answered to a standardized questionnaire on respiratory diseases and had MVOCs sampled in their bedrooms and a fungal index (FI) defined. Among the 431 dwellings with complete data, one out of three was contaminated by molds as assessed by a positive FI: 27.0% in urban, 38.2% in periurban and 34.9% in rural dwellings respectively. Positive associations were observed between fungal index and current asthma (8.6%) and chronic bronchitis-like symptoms (8.4%), especially in rural areas (OR=2.95, 95%CI (1.10; 7.95) and 3.35, 95%CI (1.33; 8.48) respectively). Our study, based on objective assessments of fungal contamination, is in agreement with previous results suggesting mold-related respiratory effects. Moreover associations found among rural population could indicate specific pollution and impact in this environment.

Development of a pilot-scale 1 for Legionella elimination in biofilm in hot water network: heat shock treatment evaluation.

AIMS: (i) To develop an analytical tool in order to evaluate the effectiveness of anti-Legionella treatment in biofilm and (ii) study the fate of Legionella populations in water and biofilm after applying a heat shock treatment. METHODS AND RESULTS: A pilot-scale unit simulating a hot water system was built and designed by the Scientific and Technical Building Centre (CSTB, France). At the end of the contamination period, a stable cultivable Legionella spp. concentration of 5x10(5) CFU l(-1) was obtained. Two heat shock treatments (70 degrees C for 30 min) were applied. The results showed that the first treatment had a transitional effect on the abatement of Legionella concentrations, while the second treatment had no detectable effect on Legionella populations in water and biofilm. The DAPI (4',6'-diamidino-2-phenylindole), Legionella PCR and GVPC (glycocolle vancomycin pyrophosphate cycloheximide) counts measured in the dead leg water of the Test Loop were 1, 2 and 2 log units higher than results found in the Test Loop water. Moreover, Legionella spp. count in tap water was about 10(4) GU l(-1). These analyses revealed that they are responsible for the rapid recolonization as well as the uncomplete destroyed biofilm. In addition, a resistance test was conducted and showed that Legionella in the second heat shock treatment was not thermo-resistant but thermo-acclimated. CONCLUSION: Thermal disinfection does not seem to be efficient enough to eliminate Legionella when it is used as a curative treatment. SIGNIFICANCE AND IMPACT OF THE STUDY: This work could help water managers for a better management of water network and for a better control of Legionella.

Model for end-stage liver disease score versus Child score in predicting the outcome of surgical procedures in patients with cirrhosis.

AIM: To determine factors affecting the outcome of patients with cirrhosis undergoing surgery and to compare the capacities of the Child-Turcotte-Pugh (CTP) and model for end-stage liver disease (MELD) score to predict that outcome. METHODS: We reviewed the charts of 195 patients with cirrhosis who underwent surgery at two teaching hospitals over a five-year period. The combined endpoint of death or hepatic decompensation was considered to be the primary endpoint. RESULTS: Patients who reached the endpoint had a higher MELD score, a higher CTP score and were more likely to have undergone an urgent procedure. Among patients undergoing elective surgical procedures, no statistically significant difference was noted in the mean MELD (12.8 +/- 3.9 vs 12.6 +/- 4.7, P = 0.9) or in the mean CTP (7.6 +/- 1.2 vs 7.7 +/- 1.7, P = 0.8) between patients who reached the endpoint and those who did not. Both mean scores were higher in the patients reaching the endpoint in the case of urgent procedures (MELD: 22.4 +/- 8.7 vs 15.2 +/- 6.4, P = 0.0007; CTP: 9.9 +/- 1.8 vs 8.5 +/- 1.8, P = 0.008). The performances of the MELD and CTP scores in predicting the outcome of urgent surgery were only fair, without a significant difference between them (AUC = 0.755 +/- 0.066 for MELD vs AUC = 0.696 +/- 0.070 for CTP, P = 0.3). CONCLUSION: The CTP and MELD scores performed equally, but only fairly in predicting the outcome of urgent surgical procedures. Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis.

Kinetics of bacterial survival on polymer coatings with particular reference to indoor air quality.

The goal of the present study was to assess the bactericidal properties of various polyester coatings (PES) with and without anti-bacterial additives such as silver or polymer compounds. Under the experimental conditions used, the release of anti-bacterial additives was not an appreciable factor. The survival rate of Enterococcus faecalis mainly depended on environmental factors such as the relative humidity and the presence of nutrients. Based on the experimental points and the mathematics of disinfection, it was possible to model the survival kinetics of airborne bacteria after settling on polymer coatings. On clean materials, the coatings displayed an anti-bacterial property. Nevertheless, this was not sufficient, first, to ensure hygiene and indoor air quality and, secondly, to be adapted in domestic appliances or in hospitals. Indeed, most of the bacterial population still survived after several days' exposure. This weak effect of the anti-bacterial additives could be explained by their accessibility at the coating/bacteria interface.

Survival of a Pseudomonas fluorescens and Enterococcus faecalis aerosol on inert surfaces.

The aim of the work presented here is to study airborne bacteria survival on three inert supports (glass, polyvinyl chloride, and stainless steel). Two Pasteur Institute bacteria were selected: Enterococcus faecalis 10.30.15 and Pseudomonas fluorescens 56.90. We have observed that bacterial aerosol lethality increased proportionally with the relative humidity of the environment, the gram-negative rod appearing more fragile than the cocci. A significant difference in survival rate is measured dependent on the supports tested, the greatest lethality being observed on the PVCs.