Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 126
Filtrar
1.
Equine Vet J ; 52(1): 112-119, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31033041

RESUMO

BACKGROUND: Horses are one of the potential reservoirs of antimicrobial resistance (AMR) determinants that could be transferred to human subjects. OBJECTIVE: To describe the AMR patterns of major bacteria isolated from diseased horses in France. STUDY DESIGN: Retrospective observational study. METHODS: Data collected between 2012 and 2016 by RESAPATH, the French national surveillance network for AMR, were analysed. Only antimicrobials relevant in veterinary and human medicine for the isolated bacteria were considered. Mono- and multidrug resistance were calculated. The resistance proportions of major equine diseases were assessed and compared. Where data permitted, resistance trends were investigated using nonlinear analysis (generalised additive models). RESULTS: A total of 12,695 antibiograms were analysed. The five most frequently isolated bacteria were Streptococcus spp., Escherichia coli, Pseudomonas spp., Staphylococcus aureus, Pantoea spp. and Klebsiella spp. The highest proportions of resistance to gentamicin were found for S. aureus (22.1%) and Pseudomonas spp. (26.9%). Klebsiella spp. and E. coli had the highest proportions of resistance to trimethoprim-sulfamethoxazole (15.5 and 26.2%, respectively). Proportions of resistance to tetracycline were among the highest for all the bacteria considered. Resistance to third-generation cephalosporins was below 10% for all Enterobacteriaceae. The highest proportions of multidrug resistance (22.5%) were found among S. aureus isolates, which is worrying given their zoonotic potential. From 2012 to 2016, resistance proportions decreased in Pseudomonas spp. isolates, but remained the same for S. aureus. For Streptococcus spp. and E. coli, resistance proportions to trimethoprim-sulfamethoxazole increased. MAIN LIMITATIONS: Since antibiograms are not systematic analyses, any selection bias could impact the results. CONCLUSIONS: Such studies are essential to estimate the magnitude of the potential threat of AMR to public health, to design efficient control strategies and to measure their effectiveness. These findings may also guide the initial empirical treatment of horse diseases.


Assuntos
Antibacterianos/farmacologia , Infecções Bacterianas/veterinária , Farmacorresistência Bacteriana Múltipla , Doenças dos Cavalos/microbiologia , Animais , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , França/epidemiologia , Doenças dos Cavalos/epidemiologia , Cavalos , Saúde Pública , Estudos Retrospectivos
2.
Neurochirurgie ; 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31863744

RESUMO

BACKGROUND: Population aging raises questions about extending treatment indications in elderly patients with aneurysmal subarachnoid hemorrhage (aSAH). We therefore assessed functional status 1 year after treatment. METHODS: This study involved 310 patients, aged over 70 years, with ruptured brain aneurysm, enrolled between 2008 and 2014 in a prospective multicentre trial (FASHE study: NCT00692744) but considered unsuitable for randomisation and therefore analysed in the observational arms of the study: endovascular occlusion (EV), microsurgical exclusion (MS) and conservative treatment. The aims were to assess independence, cognition, autonomy and quality of life (QOL) at 1 year post-treatment, using questionnaires (MMSE, ADLI, IADL, EORTC-QLQ-C30) filled in by independent nurses after discharge. RESULTS: The 310 patients received the following treatments: 208 underwent EV (67.1%), 54 MS (17.4%) and 48 were conservatively managed (15.5%). At 1 year, independence rates for patients admitted with good clinical status (WFNS I-III) were, according to the aneurysm exclusion procedure (EV, MS or conservative), 58.9%, 50% and 12.1% respectively. MMSE score was pathological in 26 of the 112 EV patients (23.2%), 10 of the 25 MS patients (40%) and 4 of the 9 patients treated conservatively (44%), without any statistically significant difference [Pearson's Chi2 test, F ratio=4.29; P=0.11]. Regarding QoL, overall score was similar between the EV and MS cohorts, but significantly lower with conservative treatment. CONCLUSION: Elderly patients in good clinical condition with aSAH should be treated regardless of associated comorbidities. Curative treatment (EV or MS) reduced mortality without increasing dependence, in comparison with conservative treatment.

3.
Neurochirurgie ; 65(2-3): 55-62, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31104846

RESUMO

BACKGROUND: Outcomes of petroclival meningiomas (PCM) (morbidity, permanent cranial nerves deficit, tumor removal and recurrence) are inconsistent in the literature, making it a challenge to predict surgical morbidity. METHODS: A multicenter study of patients with PCMs larger than 2.5cm between 1984 and 2017 was conducted. The authors retrospectively reviewed the patients' medical records, imaging studies and pathology reports to analyze presentation, surgical approach, neurological outcomes, complications, recurrence rates and predictive factors. RESULTS: There were 154 patients. The follow-up was 76.8 months on average (range 8-380 months). Gross total resection (GTR) was achieved in 40 (26.0%) patients, subtotal resection (STR) in 101 (65.6%), and partial resection in 13 (8.3%). Six (2.6%) perioperative deaths occurred. The 5-year, 10-year and 15-year progression-free survival (PFS) of GTR and STR with radiation therapy (RT) was similar (100%, 90% and 75%). PFS of STR without adjuvant radiation was associated with progression in 71%, 51% and 31%, respectively. Anterior petrosectomy and combined petrosectomy were associated with higher postoperative CN V and CN VI deficits compared to the retrosigmoid approach. The latter had a significantly higher risk of CN VII, CN VIII and LCN deficit. Temporal lobe dysfunction (seizure and aphasia) were significantly associated with the anterior petrosectomy approach. CONCLUSIONS: Our study shows that optimal subtotal resection of PCMs associated with postoperative RT or stereotactic radiosurgery results in long-term tumor control to equivalent radical surgery. Case selection and appropriate intraoperative judgement are required to reduce the morbidity.


Assuntos
Meningioma/cirurgia , Neoplasias da Base do Crânio/cirurgia , Adolescente , Adulto , Idoso , Criança , Fossa Craniana Posterior/patologia , Fossa Craniana Posterior/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Meningioma/patologia , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/etiologia , Exame Neurológico , Procedimentos Neurocirúrgicos , Osso Petroso/patologia , Osso Petroso/cirurgia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/psicologia , Intervalo Livre de Progressão , Recidiva , Estudos Retrospectivos , Neoplasias da Base do Crânio/patologia , Resultado do Tratamento , Adulto Jovem
5.
J Dairy Sci ; 102(6): 5379-5388, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30981487

RESUMO

Surveillance and control of Mycoplasma spp. responsible for contagious agalactia (CA) in caprine herds are important challenges in countries with a large small-ruminant dairy industry. In the absence of any clinical signs, being able to determine the potential circulation of mycoplasmas within a herd could help to prevent biosecurity issues during animal exchanges between farms and improve health management practices. The objective of this study was to determine whether regular sampling of bulk tank milk was suitable for such surveillance. Twenty farms were sampled once a month for 2 yr and CA-responsible mycoplasmas were detected by real-time PCR on DNA extracted from milk, using 3 different DNA extraction methods. The pattern of mycoplasma excretion in bulk tank milk was assessed over time and several herd characteristics were recorded together with any event occurring within the herds. In general, the results obtained with the different detection methods were comparable and mainly agreed with the culture results. Several patterns of excretion were observed but were not related to herd characteristics (size, breed, and so on). Recurrence of the same (sub)species and same pulsed-field gel electrophoresis subtype during the 2-yr period is indicative of the considerable persistence of mycoplasmas. This persistence was associated with intermittent excretion. In conclusion, bulk tank milk sampling could be valuable for controlling CA in caprine herds provided it is repeated several times, yet to be defined, per year and analyzed using an appropriate methodology and the right cut-off for interpretation.


Assuntos
Doenças das Cabras/microbiologia , Leite/microbiologia , Infecções por Mycoplasma/veterinária , Mycoplasma agalactiae/isolamento & purificação , Animais , Indústria de Laticínios , Feminino , Doenças das Cabras/prevenção & controle , Cabras , Infecções por Mycoplasma/microbiologia , Mycoplasma agalactiae/genética , Reação em Cadeia da Polimerase em Tempo Real/veterinária
6.
Epidemiol Infect ; 147: e121, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30868979

RESUMO

Antimicrobial-resistant bacteria in dogs can be transmitted to humans and close contact between dogs and people might foster dissemination of resistance determinants. The aim of our study was to describe the antimicrobial resistance (AMR) pattern of the major causative agents of canine otitis - one of the most common diseases in dogs - isolated in France. Data collected between 2012 and 2016 by the French national surveillance network for AMR, referred to as RESAPATH, were analysed. Resistance trends were investigated using non-linear analysis (generalised additive models). A total of 7021 antibiograms were analysed. The four major causative agents of canine otitis in France were coagulase-positive staphylococci, Pseudomonas aeruginosa, Proteus mirabilis and streptococci. Since 2013, resistance to fluoroquinolones has been on the decrease in both P. aeruginosa and Staphylococcus pseudintermedius isolates. For P. aeruginosa, 19.4% of isolates were resistant to both enrofloxacin and gentamicin. The levels of multidrug resistance (acquired resistance to at least one antibiotic in three or more antibiotic classes) ranged between 11.9% for P. mirabilis and 16.0% for S. pseudintermedius. These results are essential to guide prudent use of antibiotics in veterinary medicine. They will also help in designing efficient control strategies and in measuring their effectiveness.

8.
Psychiatry Res ; 270: 587-594, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30368165

RESUMO

Emerging research have investigated the factor structure of major depressive disorder (MDD) symptoms based on DSM-5 nomenclature. However, to date, results have been inconsistent on what symptom-structure best represent MDD. This study examines the best fitting MDD among four competing models in a sample of overseas Filipino domestic helpers (N = 232). The results show that a two-factor model (Model 2b; Krause et al., 2010) provided the best fit. The model consist of two factors: somatic and non-somatic/affective symptoms. Somatic component includes sleep difficulties, fatigue, appetite changes, concentration difficulties, and psychomotor agitation/retardation while non-somatic/affective component covers anhedonia, depressed mood, feelings of worthlessness, and thoughts of death. Further, the results reveal a pattern where PHQ-15 somatic symptom-items have a higher significant relationship with MDD's somatic symptoms than with the MDD's non-somatic/affective symptoms. These findings suggest that the items of model 2b are appropriately embedded in their respective factors. Differentiating MDD factors have important clinical implications, particularly in the diagnosis and treatment of depression among overseas Filipino domestic helpers.


Assuntos
Transtorno Depressivo Maior/etnologia , Transtorno Depressivo Maior/psicologia , Transtornos Somatoformes/etnologia , Transtornos Somatoformes/psicologia , Migrantes/psicologia , Adulto , China , Transtornos Cognitivos , Transtorno Depressivo Maior/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Filipinas/etnologia , Psicometria , Distúrbios do Início e da Manutenção do Sono , Transtornos Somatoformes/diagnóstico , Adulto Jovem
9.
Neurochirurgie ; 64(6): 395-400, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30340777

RESUMO

BACKGROUND: Current aging of the population with good physiological status and the increasing incidence of subarachnoid hemorrhage (SAH) in elderly patients has enhanced the benefit of treatment in terms of independence and long-term quality of life (QoL). METHODS: From November 1, 2008 to October 30, 2012, 351 patients aged 70 years or older with aneurysmal SAH underwent adapted treatment: endovascular coiling (EV) for 228 (65%) patients, microsurgical clipping (MS) for 75 (29.3%) or conservative treatment for 48 (13.7%). Forty-one of these were randomized to EV (n=20) or to MS (n=21). The objectives were to determine the proportion of patients with modified Rankin Scale score≤2 (independence) at 1 year, and, secondarily, to compare cognitive function on the Mini-Mental State Examination (MMSE), autonomy on the Activities of Daily Living Index (ADLI) and Instrumental Activities of Daily Living scale (IADL), and QoL, in the prospective and randomized arms, at 1 year. RESULTS: At 1 year, with 1 loss to follow-up in the EV arm, 11 patients (55%) were independent after EV occlusion and 8 (38.1%) after MS exclusion, without significant difference (P=0.29). Mortality was higher after MS during the first 2 postoperative months, and thereafter the difference between MS and EV ceased to be significant. Cognitive function and autonomy scores were similar in both arms. CONCLUSION: In elderly patients treated for aneurysmal SAH, approximately 50% were independent at 1 year, with conserved cognition and autonomy. EV and MS are valid procedures in this population, with similar results at 1 year in terms of independence, cognition, autonomy, and QoL.


Assuntos
Atividades Cotidianas/psicologia , Envelhecimento/fisiologia , Cognição/fisiologia , Qualidade de Vida , Hemorragia Subaracnóidea/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Projetos de Pesquisa , Hemorragia Subaracnóidea/fisiopatologia , Resultado do Tratamento
10.
Zoonoses Public Health ; 65(1): e86-e94, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29110404

RESUMO

Antimicrobial resistance (AMR) among bacteria isolated from food-producing animals is a growing concern with implications for public health. AMR surveillance is essential to identify resistance trends and help in the design of effective and efficient control strategies. The aim of the study was to describe the antimicrobial susceptibility of pathogenic Escherichia coli isolated from three livestock productions in France (cattle, swine and poultry). The trend in resistance to the most commonly prescribed antibiotics in animal health was analysed as follows: amoxicillin (penicillin), spectinomycin or streptomycin (aminoglycoside), tetracycline and trimethoprim-sulfamethoxazole/Enrofloxacin and ceftiofur were also taken into account as members of critically important antimicrobial families in human and veterinary medicine, that is fluoroquinolones and third-generation cephalosporins, respectively. Data collected between 2002 and 2015 by the French national surveillance network of AMR referred to as RESAPATH were analysed. Resistance trends were investigated using non-linear analysis (generalized additive models) applied to time-series stratified by livestock production and antibiotic. Irrespective of the species and the antibiotic considered, resistance signals over time showed no significant annual cycle. Resistance to third-generation cephalosporins emerged during the period of the study, with a peak at 22% [20.5; 24.0] in poultry in 2010, decreasing afterwards, while it remained consistently below 10% for the other species. The proportion of resistance to fluoroquinolones was broadly similar between species and remained under 30%, with a slight decreasing trend after 2009. Resistances to tetracycline and amoxicillin remained high, between 90% and 40% over time in cattle and swine. After 2010, there was a decrease in resistance to these antibiotics for all species, especially to tetracycline for poultry with a drop from 84% in 2009 to 43% in 2015. These results contribute to risk assessment and constitute objective evidence on which to evaluate the efficacy of control measures implemented to limit AMR occurrence.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Infecções por Escherichia coli/veterinária , Gado/microbiologia , Animais , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , França/epidemiologia , Fatores de Tempo
11.
Prev Vet Med ; 144: 158-166, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28716197

RESUMO

The development of antimicrobial resistance has made it necessary to measure antimicrobial usage in animal production sectors. France is a major European producer of white veal calves, but few data were previously available for that sector, even though these young animals are particularly susceptible to infection and considered as a reservoir of antimicrobial resistance. A cross-sectional study was conducted on 186 batches of French calves to estimate the exposure of white veal calves to antimicrobials and identify the potential risk factors related to antimicrobial usage. An indicator of calf exposure was calculated as a count of the number of antimicrobial treatments per calf. The indicator was based on veterinary prescriptions (products, quantity dispensed and dosage prescribed) and the estimated weight of calves at treatment, using the dates of treatment collected from farm registers. The study showed that calves were exposed to an average of 8.55 antimicrobial treatments (SD: 2.21, range: 2.75-15.86) over the five to six months of the fattening process. Group treatments were predominant (95.8%) and administered by the oral route. The "starting treatments", given during the first two weeks of the fattening period, were administered systematically (to all the calves in all the farms) and accounted for a third of all treatments. Tetracyclines, polypeptides and macrolides were the most widely used antimicrobials, with respectively 4.32, 1.59 and 1.01 treatments per calf. Only rare uses of 3rd and 4th generation cephalosporins and fluoroquinolones, considered as critically important in human medicine, were reported. Despite low variability of exposure between farms, a linear mixed-effects model highlighted a higher variability between farmers (ICC=0.14) or veterinarians (ICC=0.12), than between integrators (ICC=0.06). The number of calves per pen, introduced as a fixed effect in the model, was also significant: calves housed in pens of 6-10 and fed in buckets had on average 2.55 more antimicrobial treatments per calf than calves housed in pairs with the same feeding system. The model also highlighted an increase of 1.48 treatments per calf for farms with more than five percent of mortality, versus those with two percent or less. The present study showed that antimicrobial treatments are numerous in veal calf fattening farms, particularly at the arrival of the animals. Taking into account the development of resistance to antimicrobials, the necessity and the effectiveness of some of these treatments should be re-evaluated.


Assuntos
Criação de Animais Domésticos , Animais Recém-Nascidos , Antibacterianos/administração & dosagem , Doenças dos Bovinos/tratamento farmacológico , Farmacorresistência Bacteriana , Bem-Estar do Animal , Animais , Antibacterianos/uso terapêutico , Bovinos , Doenças dos Bovinos/prevenção & controle , Estudos Transversais , França
12.
PLoS One ; 12(5): e0174851, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28467422

RESUMO

We report here where the most recent common ancestor (MRCA) of bonobos (Pan paniscus) ranged and how they dispersed throughout their current habitat. Mitochondrial DNA (mtDNA) molecular dating to analyze the time to MRCA (TMRCA) and the major mtDNA haplogroups of wild bonobos were performed using new estimations of divergence time of bonobos from other Pan species to investigate the dispersal routes of bonobos over the forest area of the Congo River's left bank. The TMRCA of bonobos was estimated to be 0.64 or 0.95 million years ago (Ma). Six major haplogroups had very old origins of 0.38 Ma or older. The reconstruction of the ancestral area revealed the mitochondrial ancestor of the bonobo populations ranged in the eastern area of the current bonobos' habitat. The haplogroups may have been formed from either the riparian forests along the Congo River or the center of the southern Congo Basin. Fragmentation of the forest refugia during the cooler periods may have greatly affected the formation of the genetic structure of bonobo populations.


Assuntos
DNA Mitocondrial/genética , Evolução Molecular , Haplótipos , Pan paniscus/genética , Animais , Filogenia
13.
Psychiatr Q ; 88(1): 9-23, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-26921207

RESUMO

The recent changes in posttraumatic stress disorder (PTSD) symptomatology in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) call for a re-examination of PTSD's latent factor structure. The present study assessed six competing models of PTSD based on DSM-5 symptomatology using confirmatory factor analysis in a sample of young adult Filipino survivors of typhoon Haiyan, one of the strongest typhoons in the world ever recorded at the time of its landfall (N = 632). Furthermore, the differential relationships of the factors of the best-fitting model with posttraumatic cognitions were also investigated. Results showed the 7-factor hybrid model of PTSD comprised of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal, to be the best fitting model. In addition, the varying degrees of relationship with posttraumatic cognitions support the distinctiveness of each factor. These findings are pertinent in light of the changes in DSM-5 PTSD symptomatology, as well as in understanding the underlying dimensions of PTSD among Asian, particularly Filipino, survivors of a natural disaster.


Assuntos
Cognição , Tempestades Ciclônicas , Desastres , Transtornos de Estresse Pós-Traumáticos/psicologia , Sobreviventes/psicologia , Adolescente , Afeto , Anedonia , Ansiedade , Nível de Alerta , Aprendizagem da Esquiva , Manual Diagnóstico e Estatístico de Transtornos Mentais , Sonhos , Análise Fatorial , Feminino , Humanos , Masculino , Modelos Psicológicos , Filipinas , Adulto Jovem
14.
Ann Surg Oncol ; 23(Suppl 5): 1005-1011, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27531307

RESUMO

BACKGROUND: The benefit of thoracic lymphadenectomy in the treatment of resectable non-small cell lung cancer (NSCLC) continues to be debated. We hypothesized that the number of lymph nodes (LNs) removed for patients with pathologic node-negative NSCLC would correlate with survival. METHODS: The National Cancer Data Base (NCDB) was queried for resected, node-negative, NSCLC patients treated between 2004 and 2014. Patients were grouped according to the number of LNs removed (1-4, 5-8, 9-12, 13-16, and ≥17). Patients with <10 LNs removed were also compared with those with ≥10 LNs removed. A Cox regression analysis was performed and hazard ratios (HRs) calculated, with 95 % confidence intervals (CIs). RESULTS: Of 1,089,880 patients with NSCLC reported to the NCDB during the study period, 98,970 (9.0 %) underwent resection without evidence of pathologic nodal involvement. Lobectomy was performed in 83.9 %, sublobar resection was performed in 12.7 % and pneumonectomy was performed in 2.8 % of patients. The number of LNs removed correlated with increasing tumor size and extent of resection. On multivariate analysis, increasing age, male sex, white ethnicity, high tumor grade, larger tumor size, pneumonectomy, and positive surgical margins were all negatively correlated with overall survival. The number of LNs removed and lobectomy/bi-lobectomy correlated with improved survival. The removal of <10 LNs was associated with a 12 % increased risk of death (HR: 1.12, 95 % CI 1.09-1.14; p < 0.001). CONCLUSION: Survival of early-stage NSCLC patients is associated with the number of LNs removed. The surgical management of early-stage NSCLC should include thoracic lymphadenectomy of at least 10 nodes.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/cirurgia , Excisão de Linfonodo/estatística & dados numéricos , Linfonodos/cirurgia , Adulto , Idoso , Carcinoma Pulmonar de Células não Pequenas/etnologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Bases de Dados Factuais , Feminino , Humanos , Neoplasias Pulmonares/etnologia , Neoplasias Pulmonares/patologia , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Neoplasia Residual , Pneumonectomia/estatística & dados numéricos , Modelos de Riscos Proporcionais , Fatores Sexuais , Taxa de Sobrevida , Tórax , Carga Tumoral , Estados Unidos/epidemiologia
15.
J Appl Microbiol ; 120(5): 1208-18, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26835882

RESUMO

AIMS: Mycoplasma agalactiae is responsible for Contagious Agalactia, a severe syndrome affecting small ruminants worldwide and resulting in significant economic losses in countries with an important dairy industry. The aim of this study was to examine the antimicrobial susceptibility patterns of M. agalactiae isolates in France, their evolution over the last 25 years and their relationships with the genetic diversity of isolates and their origin (geographical and animal host). METHODS AND RESULTS: Susceptibility patterns were determined by measuring minimal inhibitory concentrations (MICs) of several antimicrobials used against mycoplasmas. Caprine M. agalactiae strains showed increased MICs over time for most of the antimicrobials tested, except fluoroquinolones. This susceptibility loss was homogeneous despite the considerable genetic and geographical heterogeneity of the isolates. In contrast, all the ovine isolates originating from a single clone and the same region showed increased MICs only to some macrolides. CONCLUSIONS: MICs have evolved differently depending on the origin of the isolates but the overall loss in susceptibility has remained far more moderate than that of Mycoplasma bovis, a cattle pathogen closely related to M. agalactiae. SIGNIFICANCE AND IMPACT OF THE STUDY: Several hypotheses are proposed to explain the differences in susceptibility patterns, such as local, specific, nonmycoplasma-targeting antibiotic treatments and the genetic background of isolates in connection with their animal host.


Assuntos
Antibacterianos/farmacologia , Doenças das Cabras/microbiologia , Infecções por Mycoplasma/veterinária , Mycoplasma agalactiae/efeitos dos fármacos , Doenças dos Ovinos/microbiologia , Animais , Biodiversidade , Bovinos , Fluoroquinolonas/farmacologia , França , Cabras , Macrolídeos/farmacologia , Testes de Sensibilidade Microbiana , Infecções por Mycoplasma/microbiologia , Mycoplasma agalactiae/genética , Mycoplasma agalactiae/isolamento & purificação , Ovinos , Carneiro Doméstico
16.
Eur Ann Otorhinolaryngol Head Neck Dis ; 133(1): 47-50, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26654695

RESUMO

INTRODUCTION: Space occupying lesions in the retropharyngeal space are rare. CASE REPORT: Here, we present a rare case of a retropharyngeal neurofibroma treated surgically through an open cervical approach without any complication. DISCUSSION: Neurofibromas are benign, slowly growing neoplasms that could be associated or not with neurofibromatosis. They are derived from peripheral nerves. Diagnostic work-up should include CT-scan and MRI as well as a biopsy to confirm the diagnosis. Treatment of localized and diffuse neurofibromas is often surgical resection, which may require sacrifice of the nerve. Malignant transformation of these lesions, without association to NF-1, is rare and exceptionally documented in the literature. CONCLUSION: We presented a rare case of solitary neurofibroma of the retropharyngeal space. Complete resection of the lesion was performed without any complication. We also presented a brief review of the literature about neurofibromas.


Assuntos
Neurofibroma/patologia , Neurofibroma/cirurgia , Neoplasias Faríngeas/patologia , Neoplasias Faríngeas/cirurgia , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Neurofibroma/diagnóstico por imagem , Neoplasias Faríngeas/diagnóstico por imagem
17.
Sci Rep ; 5: 18285, 2015 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-26687099

RESUMO

Our objective was to study the ability of a syndromic surveillance system to identify spatio-temporal clusters of drops in the number of calvings among beef cows during the Bluetongue epizootic of 2007 and 2008, based on calving seasons. France was partitioned into 300 iso-populated units, i.e. units with quite the same number of beef cattle. Only 1% of clusters were unlikely to be related to Bluetongue. Clusters were detected during the calving season of primary infection by Bluetongue in 28% (n = 23) of the units first infected in 2007, and in 87% (n = 184) of the units first infected in 2008. In units in which a first cluster was detected over their calving season of primary infection, Bluetongue was detected more rapidly after the start of the calving season and its prevalence was higher than in other units. We believe that this type of syndromic surveillance system could improve the surveillance of abortive events in French cattle. Besides, our approach should be used to develop syndromic surveillance systems for other diseases and purposes, and in other settings, to avoid "false" alarms due to isolated events and homogenize the ability to detect abnormal variations of indicator amongst iso-populated units.


Assuntos
Aborto Animal/epidemiologia , Bluetongue/epidemiologia , Doenças dos Bovinos/epidemiologia , Aborto Animal/fisiopatologia , Animais , Bluetongue/complicações , Bluetongue/fisiopatologia , Bovinos , Feminino , França , Gravidez
18.
Neurochirurgie ; 61(5): 304-11, 2015 Oct.
Artigo em Francês | MEDLINE | ID: mdl-26254124

RESUMO

INTRODUCTION: Due to the increase in the number of French neurosurgeon residents the neurosurgical workforce is changing. The main objective of this survey was to assess working conditions and perspectives for young French neurosurgeons. METHOD: An on-line survey was sent to young French neurosurgeons based on a mailing-list (219 mail addresses of Residents and Fellows obtained during previous meetings). The form contained questions about career, amount of work, salary, quality of life, teaching and university work. RESULTS: We received 78 replies from January to March 2014. A total of 56% from fellows saying they had undergone difficulties in obtaining a fellowship, although 78% were satisfied. Fellows considered a private career more often than residents. Overall, young neurosurgeons were worried about future employment. Some 33% admitted contemplating a different career from one they originally wanted. The average weekly working time of 76.8 hours was deemed to be excessive. Security rests after overnight shifts were lacking or incomplete in 91% of cases. The work atmosphere was good overall (3.7/5), and so was the quality of life (3.2/5). Theoretical teaching was unsatisfactory (2.43/5) as well as the time allowed for academic work (approximately 1.58 half-days per month). However, practical teaching was considered rewarding (3.63/5). CONCLUSION: This study provides some guidance for upcoming reforms, and should be considered again at a later date to evaluate progress.


Assuntos
Atitude do Pessoal de Saúde , Neurocirurgiões , Qualidade de Vida , Inquéritos e Questionários , Trabalho , Adulto , Fatores Etários , Escolha da Profissão , Feminino , França , Humanos , Masculino
19.
Epidemiol Infect ; 143(12): 2559-69, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25566974

RESUMO

The objective of this study was to assess the performance of several algorithms for outbreak detection based on weekly proportions of whole carcass condemnations. Data from one French slaughterhouse over the 2005-2009 period were used (177 098 slaughtered cattle, 0.97% of whole carcass condemnations). The method involved three steps: (i) preparation of an outbreak-free historical baseline over 5 years, (ii) simulation of over 100 years of baseline time series with injection of artificial outbreak signals with several shapes, durations and magnitudes, and (iii) assessment of the performance (sensitivity, specificity, outbreak detection precocity) of several algorithms to detect these artificial outbreak signals. The algorithms tested included the Shewart p chart, confidence interval of the negative binomial model, the exponentially weighted moving average (EWMA); and cumulative sum (CUSUM). The highest sensitivity was obtained using a negative binomial algorithm and the highest specificity with CUSUM or EWMA. EWMA sensitivity was too low to select this algorithm for efficient outbreak detection. CUSUM's performance was complementary to the negative binomial algorithm. The use of both algorithms on real data for a prospective investigation of the whole carcass condemnation rate as a syndromic surveillance indicator could be relevant. Shewart could also be a good option considering its high sensitivity and simplicity of implementation.


Assuntos
Algoritmos , Surtos de Doenças/veterinária , Indicadores Básicos de Saúde , Vigilância de Evento Sentinela/veterinária , Matadouros , Fatores Etários , Animais , Bovinos , Simulação por Computador , França/epidemiologia , Projetos Piloto , Estudos Retrospectivos , Sensibilidade e Especificidade , Fatores Sexuais
20.
Minerva Anestesiol ; 81(6): 628-35, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25263024

RESUMO

BACKGROUND: Stroke volume variation (SVV) during mechanical ventilation predicts preload responsiveness. We hypothesized that the prone position would alter the performance of this dynamic indicator. METHODS: Two parallel groups of ventilated neurosurgical patients with low tidal volume (6-8 ml.kg-1) were studied before surgical incision. SVV was measured at T0, T15 and T30 min during a fluid volume expansion (250 mL hetastarch 6% over 30 min) with patients in either the supine (N.=29; Supine group) or prone position (N.=23; Prone group). Fluid responsiveness was defined as an increase in the stroke volume index (SVI) of ≥20% at T30. Receiver-operating characteristics (ROC) curves were generated for SVV. RESULTS: Prone positioning significantly increased SVV. Volume expansion in the Prone group increased SVI but led to a decline in SVV from 16% (12-22; median, 25-75th percentile) at T0 to 9% (8-13%) at T30. These effects on SVI and SVV were more pronounced compared to those obtained in the Supine group (P ≤0.05). Fluid responsiveness was predicted by SVV >12% at T0 (sensitivity 88%, specificity 62%) in the Supine group. In the Prone group, the area under the ROC curve of SVV (0.53; 95% confidence interval 0.27-0.79) did not allow the determination of a threshold SVV value. CONCLUSION: In ventilated patients with low tidal volume, a prone position may have a direct effect on the heart that alters the performance of SVV in predicting fluid responsiveness. External factor such as prone position renders difficult the interpretation of SVV as a dynamic indicator of cardiac preload.


Assuntos
Hidratação/métodos , Procedimentos Neurocirúrgicos/métodos , Decúbito Ventral , Volume Sistólico , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Respiração Artificial , Decúbito Dorsal , Volume de Ventilação Pulmonar
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA