Mistaking plastic for zooplankton: Risk assessment of plastic ingestion in the Mediterranean sea.

Floating plastic debris is a pervasive pollutant in seas and oceans, affecting a wide range of animals. In particular, microplastics (<5 mm in size) increase the possibility that marine species consume plastic and enter the food chain. The present study investigates this potential mistake between plastic debris and zooplankton by calculating the plastic debris to zooplankton ratio over the whole Mediterranean Sea. To this aim, in situ data from the Tara Mediterranean Expedition are combined with environmental and Lagrangian diagnostics in a machine learning approach to produce spatially-explicit maps of plastic debris and zooplankton abundance. We then analyse the plastic to zooplankton ratio in regions with high abundances of pelagic fish. Two of the major hotspots of pelagic fish, located in the Gulf of Gabès and Cilician basin, were associated with high ratio values. Finally, we compare the plastic to zooplankton ratio values in the Pelagos Sanctuary, an important hotspot for marine mammals, with other Geographical Sub-Areas, and find that they were among the larger of the Western Mediterranean Sea. Our results indicate a high potential risk of contamination of marine fauna by plastic and advocate for novel integrated modelling approaches which account for potential trophic transfer within the food chain.

Heparin desensitisation prior to cardiopulmonary bypass in a patient with alpha-gal allergy.

This case report describes the implementation of a heparin desensitisation strategy for a patient with confirmed galactose-alpha-1,3-galactose (alpha-gal) allergy, prior to cardiac surgery. We describe the pre-, intra- and postoperative management. We believe this report can enhance the limited data currently in existence on alternative strategies for heparin utilisation in cardiopulmonary bypass in a previously intolerant patient population.

Patterns of invasive ctenophore Mnemiopsis leidyi distribution and variability in different recipient environments of the Eurasian seas: A review.

Harmful invader ctenophore Mnemiopsis leidyi's expansions in the Eurasian Seas, its spatio-temporal population dynamics depending on environmental conditions in recipient habitats have been synthesized. M. leidyi found suitable temperature, salinity and productivity conditions in the temperate and subtropical environments of the semi-enclosed seas, in the coastal areas of open basins and in closed water bodies, where it created autonomous populations. M. leidyi changes its phenology depending on seasonal temperature regime in different environments. We assessed ranges of sea surface temperature, sea surface salinity and sea surface chlorophyll values, sufficient for M. leidyi general occurrence and reproduction based on comprehensive long-term datasets, contributed by co-authors. This assessment revealed that there are at least two eco-types (Southern and Northern) in the recipient seas of Eurasia with features specific for their donor areas. The range of thresholds for M. leidyi establishment, occurrence and life cycle in both eco-types depends on variability of environmental parameters in their native habitats.

Pediatric angiostrongyliasis.

Angiostrongyliasis, the leading cause worldwide of eosinophilic meningitis, is an emergent disease due to Angiostrongylus cantonensis larvae, transmitted accidentally to humans. Contamination of children usually occurs by direct contact with an infected mollusk. Eosinophilic meningoencephalitis is the major clinical feature of this parasitic infection in humans. It is usually benign for adults, but more severe for children. Clinical symptoms usually combine fever, meningitis, and neurological signs (somnolence, moaning, hypotonia, convulsions, and increased intracranial pressure). Presumptive diagnosis of human angiostrongyliasis is based on epidemiologic characteristics, clinical symptoms, medical history, and laboratory findings, in particular, hypereosinophilia in blood and cerebrospinal fluid. Treatment is based on corticosteroids associated with anthelmintics. This work reviews the diagnosis and treatment of this life-threatening (especially in children) parasitic disease and the need for preventive action.

Looking at hospitalized persons throughout the prism of the handicap.

OBJECTIVE: To describe the disability status of non-selected hospitalized persons. METHODS AND FINDINGS: We conducted a cross-sectional survey to assess activity limitations of every person older than 18 years hospitalized in a regional university hospital covering all medical fields. Evaluators rated, on a scale from 0 to 4, 22 selected items of the International Classification of Functioning (ICF), covering the 6 following domains: learning and applying knowledge, general tasks and demands, communication, mobility, self-care, and interpersonal interactions and relationships. Univariate and multivariate analyses were performed to analyze the prevalence, severity and profile of the handicap in terms of sociodemographic characteristics and care pathways. RESULTS: Among 1572 eligible persons, 1267 (81%) were surveyed (mean age 62.7±20.4years; 655 males [51.7%]). Overall, 82% showed at least one activity limitation. For 52%, disability was severe or total for at least one ICF item. Prevalence of disabilities was higher for mobility (75%) and self-care domains (63%). Disability was strongly related to age: age older than 80years versus 18 to 44years (OR=12.8 95% CI 6.4-27.9]; P<0.01). Disability was associated with hospitalization in rehabilitation units (96%; OR=4.3 [95% CI 2.2-5.3]; P<0.01). Severe disability was associated with hospitalization in critical care units (OR=6.7 [CI 3.2-15.1]; P<0.001) and psychiatry units (OR=5.3 [CI 2.7-11.4]; P<0.001). CONCLUSION: Handicap was common in hospitalized persons, involving all 6 tested ICF activity domains, particularly mobility and self-care. This study alerts care givers, hospital administrators, and in general, people influencing health policies about the need to plan actions to reduce activity limitations of hospitalized persons, whatever the cause of the hospitalization.

Group B streptococci in milk and late neonatal infections: an analysis of cases in the literature.

BACKGROUND: The source for late-onset neonatal infections (LONI) due to group B Streptococcus (GBS) has not been fully explored. We reviewed GBS LONI cases associated with contaminated breast milk to determine whether breast milk was a possible route for neonatal infection. DATA SOURCES: A PubMed search from January 1977 to March 2013 was performed with MeSH words "Streptococcus agalactiae", "group B Streptococcus", "infection", "milk", "human", "late-onset infection" and/or "neonate"; relevant cross references were also reviewed. RESULTS: Forty-eight documented cases of GBS LONI matched our search criteria and were retrieved from the literature. When performed, molecular typing identified clonal isolates in the neonate and milk samples taken after LONI in all cases, with the hypervirulent sequence type 17 (ST-17) clone identified in two of these cases. Caesarean delivery combined with the absence of GBS recovery from maternal samples other than milk was noted for four cases. The rate of recurrent infections was high (35%) and, together with the data reviewed, points to a potential role of breast milk in GBS LONI. CONCLUSIONS: The cases reviewed here, together with the evidence of breast milk transmission for other pathogens, suggest that breast milk, which would account for repeated GBS transmission to the neonate, may favour gut translocation and subsequent LONI. Further investigations are nevertheless needed to study the relative importance of this contamination route compared with persistent postnatal gut colonisation and the dynamics of milk and neonatal gut colonisation.

A randomized controlled trial of health information exchange between human immunodeficiency virus institutions.

CONTEXT: In order for patients to benefit from a multidisciplinary treatment approach, diverse providers must communicate on patient care. OBJECTIVE: We sought to examine the effect of information exchange across multidisciplinary human immunodeficiency virus (HIV) care providers on patient health outcomes. DESIGN: Randomized controlled trial, randomized at the patient level. SETTING: Six infectious disease clinics paired with 9 ancillary care settings (eg, HIV case management). PARTICIPANTS: Two hundred fifty-four patients with HIV receiving care at the infectious disease clinics. INTERVENTION: Health information was exchanged for 2 years per patient between medical and ancillary care providers using electronic health records and printouts inserted into charts. Medical care providers gave ancillary care providers HIV viral loads, CD4 values, current medications, and appointment attendance. Ancillary care providers gave medical providers the information on medication adherence and major changes (eg, loss of housing). MAIN OUTCOME MEASURES: We abstracted from medical records HIV viral loads, CD4 counts, and antiretroviral medication prescriptions before and during the intervention. From 0-, 12-, and 24-month patient surveys, we assessed hospitalizations, emergency department use, and health-related quality of life measured by the Medical Outcomes Study Short Form-36 (SF-36). RESULTS: No statistically significant differences between cases and controls were found across time for the following: proportion with suppressed viral load, changes in viral load or CD4 values, patients being prescribed antiretroviral medication, hospitalizations, emergency department visits, or any scale of the SF-36. Trends were mixed but leaned toward better health for control participants. CONCLUSIONS: The exchange of this specific set of information between HIV medical and ancillary care providers was neutral on a variety of patient health outcomes.

[Videophone assistance and home hospitalization: the ViSaDom program]. / Téléassistance en hospitalisation b domicile: le programme ViSaDom.

OBJECTIVE: The purpose of this project was to study the clinical feasibility of videophone-based communication between patients in their homes, and the care teams who work in the Home Hospitalization department (HH). METHODS: This pilot study of videophone users compared them with a group of control patients also in HH. They came from either the adult, maternity or pediatric departments. Patients who met the inclusion criteria and consented to participate in the study were randomly assigned to one of two groups: those who had a videophone installed in their homes (telemedicine group), and those who received the standard HH care (control group). Sixteen patients in the telemedicine group were matched with 16 from the control group, according to age, Karnofsky Index score, and the reason for HH admission. RESULTS: The mean videophone call lasted six minutes, and patients averaged 23 calls each over the study period (0.7 calls per patient per working day). The videophone enabled better follow-up of wounds: for example, the nurse could transmit photos from the patient's home for real-time coordination. It was also useful for following patients suffering from pain, for technical nursing care, and for educating patients and their caregivers. Anxiety (measured with the Hospital Anxiety and Depression Scale) diminished during the study period for the telemedicine patients, compared with the control group (p=0.048). Within the telemedicine group, all patients and their families were very satisfied or satisfied with their care and with the communication (15/15), although the staff's level of satisfaction was slightly lower (14/16); there were no significant differences between groups. CONCLUSION: The ViSaDom program indicates that videophone communication is feasible and acceptable and could be a useful tool for improving the quality, efficiency and effectiveness of care.

Differential basal synthesis of Hsp70/Hsc70 contributes to interindividual variation in Hsp70/Hsc70 inducibility.

The source of intraspecies variation in the expression of heat shock proteins (HSPs) remains unresolved but could shed light on differential stress tolerance and disease susceptibility. This study investigated the influence of variable basal HSP synthesis on differential inducibility of HSP synthesis. Basal and heat-induced synthesis of the major HSP families in peripheral blood monocytes from healthy donors (n = 42) were analysed using biometabolic labelling and densitometry. Basal Hsp70/Hsc70 synthesis and percentage induction of Hsp70/Hsc70 synthesis were significantly correlated (r = -0.57, p < 0.0001), and described most accurately by an exponential decay equation (R = 0.68, R2 = 0.46). This regression equation suggests that increasing levels of basal Hsp70/Hsc70 synthesis are accompanied by an exponential decrease in the percentage induction of Hsp70/Hsc70 synthesis. The model fits data from European and non-European population groups independently, although both coefficients in the regression equation were larger for non-Europeans. This implies population group as an additional factor influencing differential HSP expression. The differential inducibility of Hsp70/Hsc70 due to variable basal synthesis of Hsp70/Hsc70 and based upon population group may contribute to differential stress tolerance or disease susceptibility.

[Adenoma of the choledochus]. / Les adénomes du cholédoque.

Two patients with signs of an obstructed main bile duct underwent surgery. Choleductectomy was performed followed by Mirizzi exploration. Extemporaneous pathology examination of the intra-ductal tissue revealed benign adenoma of the main bile duct. Resection of the main bile duct with hepato-duodenal anastomosis was performed in the first patient and resection with end-to-end anastomosis in the second.

[Choledochoduodenal fistula: an unusual complication of duodenal ulcer]. / Fistule cholédocoduodénale: complication rare de i'ulcère duodénal.

We report a case of choledochoduodenal fistula in a patient with a duodenal ulcer and poor compliance to treatment. The fistula tract was demonstrated on a plain abdominal X-ray (presence of air in the biliary tract), and was confirmed by a fistulography from the site of the ulcer (opacification of the bile duct). A Finsterer type 2/3 gastrectomy was performed in this patient, leading to the treatment of the ulcer and disappearance of the fistula following a gastrojejunal shunt of the duodenum. Clinical outcome was excellent.

[Intraindividual double-blind comparative study of the immediate ocular tolerability of the Na+ and Mg++ salts of N-acetyl-aspartylglutamic acid (NAAGA)]. / Etude comparative intra-individuelle en double-insu de la tolérance oculaire immédiate des sels de Na+ et de Mg++ de l'acide N-acétyl-aspartyl-glutamique (NAAGA).

A good immediate ocular tolerance of eye-drops is paramount for the patient's compliance, and therefore for the therapeutic success. The tolerance of a new formula of NAAXIA, an anti-allergic eye-drop, whose sole modification was the replacement of the Mg++ ion by the Na+ ion, was compared with the previous formula. One drop of each preparation was instilled in one eye so as to make an intraindividual comparison. Just after instillation, each subject was asked to express what he felt, and which eye-drop he preferred. The answers, reported on a sequential analysis graph, clearly show that in all three groups (healthy adults, red-eyed adults, red-eyed children) the slight alteration of the formula led to a marked improvement in immediate tolerance.

[Multiple wounds in children. Apropos of 76 cases]. / Les enfants polytraumatisés. A propos de 76 observations.

Polytraumatisms in the child are relatively unfrequent, less severe, and get a lower rate of deaths compared with polytraumatisms in the adult. The indirect traumatism, being most frequent, is explained by projection and ejection. Direct traumatism is scacre. A classification in 4 types is proposed: type I: visceral polytraumatised child, type II: multiple fractured one, type III: mixed visceral and multiple fractured one, type IV: the crippled one. Cranial trauma has to be noticed as being a constant one. The relative unfrequency of spine, belly and thoracic injuries; the most frequent happening of peripheral traumatisms; the severeness of mutilations are emphasised. Multiple fractured children are healed with very remaining mutilations; the social and economic load is heavy; the pophylactics hypothetical.

[Traumatic pulmonary evisceration in a child. Apropos of 2 cases]. / L'éviscération pulmonaire traumatique chez l'enfant. A propos de 2 cas.

Two cases of pulmonary traumatic evisceration are reported. The question is about exceptional lesions very spectacular and good tolerated.

Body surface area of the Chacma baboon (Papio ursinus).

The body surface area (BSA) of 11 Chacma Baboons has been determined by a coating method using plaster of Paris. The relationship between BSA (Cm2) and mass (g) is adequately described by the simple Meeh formula A = (12.7) M2/3. The inclusion of an additional variable, such as length, is not indicated by the data. The difference in K values between species and individuals is postulated to be determined by variations in body density rather than other factors.