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1.
Infect Dis Now ; 53(4): 104673, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36775065

RESUMEN

OBJECTIVES: While persistent symptoms have been reported after the coronavirus disease-2019 (COVID-19), long-term data on outpatients with mild COVID-19 are lacking. The objective was to describe symptoms persisting for 12 months. METHODS: This prospective cohort study on 1767 sailors of an aircraft carrier in which a Covid-19 outbreak occurred during a mission in April 2020 described predefined self-reported symptoms of Long-COVID at 6, 9 and 12 months. Logistic-regression analyses were used to identify correlates for Long-COVID at months 6, 9 and 12. RESULTS: Among the 641 participants, 619 (35%) completed at least one follow-up questionnaire (413 COVID-positive and 206 COVID-negative). Symptoms of Long-COVID were reported by 53.7%, 55.2% and 54.3% of COVID-positive participants vs 31.2%, 23.3% and 40.0% in COVID-negative patients, at 6 (p <.002), 9 (p <.002) and 12 months (p =.13), respectively. The most frequent symptoms reported were concentration and memory difficulties, asthenia and sleep disorders. CONCLUSION: In this study more than half of COVID-positive outpatients reported persistent symptoms up to 12 months post-quarantine. These findings suggests that all patients, including those with mild disease, can be affected by Long-COVID. A lack of difference at 12 months with COVID-negative patienys prompts caution. The symptoms of Long-COVID are so non-specific that they may be viewed as the consequence of multiple intercurrent factors.


Asunto(s)
COVID-19 , Personal Militar , Humanos , COVID-19/epidemiología , SARS-CoV-2 , Síndrome Post Agudo de COVID-19 , Estudios Prospectivos , Brotes de Enfermedades , Aeronaves
2.
Occup Med (Lond) ; 62(2): 141-4, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22084311

RESUMEN

BACKGROUND: Occupational exposure to blood and body fluids (BBFs) is a hazard of many occupations, particularly hospital-based health care providers. However, non-hospital-based health care workers (HCWs) and other personnel not providing health care are also at risk. AIMS: To present the results of surveillance of accidental exposure to BBFs among non-hospital-based French military personnel between 2007 and 2009, comparing different occupational categories. METHODS: The study population included all French military personnel subjected to occupational BBF exposure in a non-hospital setting. BBF exposure was defined as any percutaneous (needlestick injury, scalpel cut, etc.) or mucocutaneous (splash to mucosa, eyes or non-intact skin) exposure to blood, a biological fluid contaminated with blood or a fluid known to transmit blood-borne pathogens. RESULTS: Between 1 January 2007 and 31 December 2009, 704 occupational BBF exposures were reported in non-hospital-based French military personnel. Annualized BBF exposure incidence rates were statistically different among health care workers in non-hospital settings, firefighters, 'gendarmes' and other military personnel, with respectively 38.7, 5.4, 0.8 and 0.1 exposures per 1000 persons per year. Among the 97 cases of HIV post-exposure prophylaxis (PEP) initiated, the source patient's HIV status was unknown in 78 cases (84%). CONCLUSIONS: These results suggest that the appropriateness of HIV PEP initiation in the French military should be reviewed. Adapting French guidelines for managing BBF exposure, for non-hospital-based environments should be considered.


Asunto(s)
Patógenos Transmitidos por la Sangre , Líquidos Corporales/microbiología , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/estadística & datos numéricos , Exposición Profesional/análisis , Femenino , Bomberos , Francia , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Personal de Salud , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Masculino , Personal Militar , Lesiones por Pinchazo de Aguja/epidemiología , Personal de Hospital , Profilaxis Posexposición , Medición de Riesgo
3.
Public Health ; 126(1): 70-6, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22137096

RESUMEN

OBJECTIVES: In September 2009, an increase in seasonal influenza vaccine adverse events (VAE), compared with reports for previous years, was detected among the French armed forces in the setting of an extended immunization campaign. This work presents the results of this investigation. STUDY DESIGN: VAE were surveyed among all French military personnel from 2008 to 2009 by Epidemiological Departments of the French Military Health Service. For each case, a notification form was completed, providing patient and clinical information. METHODS: Case definitions were derived from the French drug vigilance guidelines. Three types of VAE were considered: non-serious, serious and unexpected. Incidence rates were calculated by relating VAE to the number of vaccine doses injected. RESULTS: Forty-seven seasonal influenza VAE were reported in continental France: 18 in 2008 and 29 in 2009. The annual reporting rate was higher in 2009 (31.6 vs 16.6 VAE per 100,000 injections, respectively). The highest monthly incidence was observed in September 2009 (60.8 events per 100,000 injections). Two other peaks were observed in February 2008 and March 2009. The incidence in September 2009 was not significantly different from the incidences in February 2008 and March 2009. It was observed that incidence peaks occurred during influenza epidemic periods. One serious neurological VAE was observed. CONCLUSIONS: The increase in seasonal influenza VAE in late 2009 mainly involved non-serious events, and could reflect stimulated reporting in the context of the A(H1N1)pdm09 pandemic. VAE reporting rates were highest during influenza epidemic periods, which could be explained by VAE being wrongly attributed to the vaccine when symptoms could reflect coincident background cases of viral infection.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Subtipo H1N1 del Virus de la Influenza A , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Personal Militar/estadística & datos numéricos , Adolescente , Adulto , Femenino , Francia/epidemiología , Humanos , Incidencia , Masculino , Estaciones del Año , Vacunación , Adulto Joven
4.
Encephale ; 38(6): 453-9, 2012 Dec.
Artículo en Francés | MEDLINE | ID: mdl-23200610

RESUMEN

INTRODUCTION: Second-generation antipsychotics have improved living conditions of patients affected by severe mental illness. Some of them can induce weight gain with metabolic complications. Furthermore, they are prescribed to vulnerable patients, with comorbidity and high cardiovascular mortality rate. Prevention of a metabolic syndrome by simple measures improves patient's physical health. General practitioners are privileged partners for psychiatrists. OBJECTIVES: This study was conducted to assess the prevention and management of a metabolic syndrome in patients treated with antipsychotics in general practice. With this in mind, at first we needed to explore how general practitioners prescribe antipsychotics. METHODS: To assess the general practice, we interviewed 204 general practitioners in the Hauts-de-Seine. Our database was the yellow pages of this area (September 2007). We then conducted a random draw using random digits. We called 507 general practitioners, 410 of whom were sent a questionnaire. We received the return of 204 questionnaires. Each questionnaire consisted of four parts: the general practitioner's profile, psychiatry in his/her practice, the prescription of antipsychotics and the management of metabolic syndromes in patients treated with antipsychotics. RESULTS: The general practitioner's response rate was 49.7%. The results show that although they prescribe antipsychotics, general practitioners need more information on these molecules and on their side effects. Indeed 57% of them feel they are not given enough information on antipsychotics, but 69% have already initiated antipsychotic treatment and 17% do so regularly. Furthermore, a metabolic syndrome is insufficiently detected by general practitioners, although they know of its prevalence after the introduction of antipsychotic treatment. Thus, 81% reported having been confronted with this problem, but only 54% of them calculated the body mass index of patients taking antipsychotics, and 26% measured waist circumference. These results are consistent with studies tracking metabolic syndrome performed in all patients, so, general practitioners do not conduct specific monitoring of patients on antipsychotics. However, they are faced with difficulties related to adherence to treatment because of weight gain. In such cases, 16% of respondents start a new treatment, without a psychiatrist's opinion. These results confirm the results of previous studies on the risks of such prescriptions in general practice, when not supervised. CONCLUSION: In conclusion, we suggest that information of general practitioners about their role in prevention of metabolic syndromes should be improved, and psychiatrists and general practitioners should be informed on the necessity of joint care of patients affected by severe mental illness.


Asunto(s)
Antipsicóticos/efectos adversos , Antipsicóticos/uso terapéutico , Medicina General/normas , Síndrome Metabólico/inducido químicamente , Pautas de la Práctica en Medicina/estadística & datos numéricos , Trastornos Psicóticos/tratamiento farmacológico , Adulto , Anciano , Enfermedades Cardiovasculares/inducido químicamente , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/prevención & control , Conducta Cooperativa , Recolección de Datos , Educación Médica Continua , Femenino , Francia , Medicina General/educación , Humanos , Comunicación Interdisciplinaria , Masculino , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/prevención & control , Persona de Mediana Edad , Derivación y Consulta/estadística & datos numéricos , Factores de Riesgo , Encuestas y Cuestionarios , Aumento de Peso/efectos de los fármacos
5.
Eur J Clin Microbiol Infect Dis ; 30(8): 1023-6, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21311937

RESUMEN

Since the start of 2010 there has been a flare-up of measles in France, following on the resurgence observed in 2008. The aim of this study was to present results of the epidemiological surveillance of measles in the French armed forces and to describe the increase in incidence. Measles was surveyed from 1992 to 2010. Criteria for report were those used for French national compulsory notification. The data, concerning active military personnel, were provided by the physicians in the armed forces using anonymous data collection forms. Between 1992 and July 2010, 689 cases of measles were notified. Since 2002, the mean incidence rate was 1 case per 100,000. A significant increase has been observed for 2010 (13.9 cases per 100,000 in 2010 versus 1.8 in 2009). The 28 cases reported in 2010 involved five clusters and three isolated cases. The mean age of affected subjects was 27 years. Only 30% of cases had been vaccinated. The epidemic resurgence of measles observed in 2010 in the French armed forces follows the same pattern as that observed nationally and at European level, and can be seen as the likely consequence of inadequate vaccination cover.


Asunto(s)
Enfermedades Transmisibles Emergentes/epidemiología , Sarampión/epidemiología , Adulto , Análisis por Conglomerados , Femenino , Francia/epidemiología , Humanos , Incidencia , Masculino , Vacuna Antisarampión/administración & dosificación , Personal Militar , Vacunación/estadística & datos numéricos
6.
Public Health ; 125(8): 494-500, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21767855

RESUMEN

OBJECTIVES: An outbreak of novel A(H1N1) virus influenza, detected in Mexico in April 2009, spread worldwide in 9 weeks. The aim of this paper is to present the monitoring results of this influenza outbreak among French armed forces. STUDY DESIGN: The period of monitoring by the Military Influenza Surveillance System (MISS) was 9 months, from May 2009 to April 2010. METHODS: The main monitored events were acute respiratory infection (ARI), defined by oral temperature ≥38.5 °C and cough, and laboratory-confirmed influenza. Weekly incidence rates were calculated by relating cases to the number of servicepersons monitored. RESULTS: In continental France, the incidence of ARI increased from September 2009, with a weekly maxima of 401 cases per 100,000 in early December 2009 according to MISS. Estimations of the incidence of consultations which could be related to novel A(H1N1) influenza ranged from 48 to 57 cases per 100,000. CONCLUSIONS: The trends observed by MISS are compatible with French national estimations. The incidence of consultations which could be related to A(H1N1) influenza at the peak of the epidemic (194 cases per 100,000) was much lower than the national estimate (1321 cases per 100,000). This may be due to servicepersons who consulted in civilian facilities and were not monitored. Other explanations are the healthy worker effect and the younger age of the military population.


Asunto(s)
Brotes de Enfermedades , Subtipo H1N1 del Virus de la Influenza A/aislamiento & purificación , Gripe Humana/epidemiología , Vigilancia de la Población , Cartilla de ADN/química , Francia , Humanos , Incidencia , Gripe Humana/virología , Medicina Militar , Personal Militar/estadística & datos numéricos , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
7.
J Exp Med ; 166(5): 1536-47, 1987 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-2445890

RESUMEN

A cytotoxic T lymphocyte (CTL) characteristically kills target cells one after the other by releasing toxic granules that contain one or more cytolytic components. To determine how CTLs avoid destroying themselves when they release granules and lyse target cells, 7 murine CD8+ CTL cell lines were compared with 19 other cell lines for susceptibility to lysis by the isolated toxic granules. Murine CD8+ CTLs were clearly the most resistant cells: granules did not lyse them even after they were exposed to azide, cyanide, and 2-deoxyglucose, conditions that were found to enhance the susceptibility of all the other cells tested, including other T cells. Thus, resistance of CD8+ CTLs to cytotoxic granules appears to be independent of cellular ATP. To reconcile these findings with other observations that, under some circumstances, CTLs can be lysed by other CTLs, we suggest a model in which a CTL releases only a limited proportion of its toxic granules at each antigen-specific encounter with a target cell; the amount released is sufficient to kill most target cells but to leave the CTL undamaged and with enough granules to attack other target cells.


Asunto(s)
Gránulos Citoplasmáticos/inmunología , Citotoxicidad Inmunológica , Glicoproteínas de Membrana , Linfocitos T Citotóxicos/inmunología , Adenosina Trifosfato/metabolismo , Animales , Línea Celular , Membrana Celular/inmunología , Fibroblastos/inmunología , Hemólisis , Canales Iónicos/fisiología , Células Asesinas Naturales/inmunología , Proteínas de la Membrana/fisiología , Ratones , Perforina , Proteínas Citotóxicas Formadoras de Poros , Linfocitos T Citotóxicos/ultraestructura , Linfocitos T Colaboradores-Inductores/inmunología , Células Tumorales Cultivadas
8.
J Exp Med ; 167(2): 514-27, 1988 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-2450162

RESUMEN

To investigate the destruction of target cells by murine CTLs, we examined intracellular Ca2+ concentrations ([Ca2+]i) and DNA fragmentation in target cells. Changes in [Ca2+]i were followed by flow cytometry by loading the cells with indo-1, a Ca2+-binding fluorescent dye, and determining the ration of fluorescence intensities at 405 nm (emission maximum for Ca2+-bound dye) over 480 nm (emission maximum for the free dye). Within minutes after interacting with the cytolytic granule fraction that had been isolated from CTLs, [Ca2+]i in target cells was strikingly increased. A pronounced increase in [Ca2+]i was also observed in target cells when they were specifically recognized by intact CTLs. Since ionomycin, a Ca2+ ionophore, caused a similar increase in [Ca2+]i and lysed cells (provided that extracellular Ca2+ was present), it appears that a sustained high level of [Ca2+]i is cytolytic. In contrast with other cells, CTLs, which have been shown to be refractory to granule-mediated lysis and to be poor targets for other CTLs, did not manifest an elevation in [Ca2+]i when they were similarly loaded with indo-1 and treated with isolated granules. The characteristic cleavage of target cell DNA into nucleosome-sized fragments was also induced by isolated granules as well as by valinomycin, a K+ ionophore, but not by ionomycin. The results support the view that lysis of most target cells by cloned CTLs is due primarily to target cell membrane changes that are fundamentally equivalent to the formation of nonspecific ion channels. The resulting large increase in [Ca2+]i is probably responsible for target cell lysis; and changes in intracellular ion concentrations also appear to be responsible for DNA fragmentation, probably by activating endogenous target cell endonucleases.


Asunto(s)
Calcio/metabolismo , Citotoxicidad Inmunológica , Daño del ADN , Linfocitos T Citotóxicos/metabolismo , Animales , Comunicación Celular , Fraccionamiento Celular , Células Clonales/inmunología , Células Clonales/metabolismo , Células Clonales/fisiología , Gránulos Citoplasmáticos/inmunología , Gránulos Citoplasmáticos/metabolismo , Gránulos Citoplasmáticos/fisiología , Citometría de Flujo , Canales Iónicos/inmunología , Canales Iónicos/metabolismo , Ratones , Ratones Endogámicos BALB C , Linfocitos T Citotóxicos/inmunología
9.
J Exp Med ; 167(2): 528-40, 1988 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-3126252

RESUMEN

Target cell lysis by most murine cytotoxic T lymphocytes appears to be mediated by a complement (C9)-like protein called perforin, contained in high-density cytoplasmic granules. These granules also contain high levels of serine esterase activity, which may also play a role in cytolysis. Analysis of 17 cloned human cytotoxic T lymphocytes revealed the presence of serine esterase that is very similar to its murine counterpart in substrate and inhibitor specificities, pH optimum, and molecular mass; dot blot hybridization with synthetic oligonucleotides corresponding to the active sites of two known murine CTL esterases suggests homology to the murine enzyme HF. However, serine esterase was present at only approximately 10% of the level found in murine CTLs, and was not secreted during CTL-target cell interaction; moreover, hemolytic activity could not be detected in any of the seven cell lines tested. The results suggest that the human CTLs examined here kill their target cells by a mechanism different from that used by most cloned murine CTLs.


Asunto(s)
Células Clonales/enzimología , Citotoxicidad Inmunológica , Esterasas/metabolismo , Hemólisis , Linfocitos T Citotóxicos/enzimología , Línea Celular , Centrifugación por Gradiente de Densidad , Células Clonales/inmunología , Células Clonales/metabolismo , Clonación Molecular , Electroforesis en Gel de Poliacrilamida , Esterasas/antagonistas & inhibidores , Esterasas/genética , Humanos , Concentración de Iones de Hidrógeno , Isoflurofato/metabolismo , Lisina/análogos & derivados , Lisina/metabolismo , Linfocitos T Citotóxicos/inmunología , Linfocitos T Citotóxicos/metabolismo
10.
Ann Dermatol Venereol ; 136(5): 412-8, 2009 May.
Artículo en Francés | MEDLINE | ID: mdl-19442796

RESUMEN

BACKGROUND: Servicemen constitute a group at risk for exposure to sexually transmitted diseases (STD) and for this reason specific surveillance of STD and human immunodeficiency virus (HIV) seroconversion has been conducted in the French Armed Forces since 1996. METHODS: All cases of STD and HIV seroconversion occurring in military personnel and corresponding to the notification criteria are reported by a military doctor, wherever the diagnosis is made. Incidence rates are calculated based on numbers of military personnel provided by the Ministry of Defence Social Observatory. RESULTS: In 2006, 67 cases of STD and 10 of HIV seroconversion due to sexual contamination were reported in the French Forces. The incidence of STD and HIV seroconversion was respectively 19.2 and 2.8 cases per 100,000. Gonorrhoea was the principal notified STD, with half of the cases of HIV seroconversion involving acute HIV infection. 59.7% of STD and 70.0% of HIV seroconversion were contracted in metropolitan France. DISCUSSION: STD and HIV seroconversion remain a subject of concern for the French Medical Forces despite low rates of incidence.


Asunto(s)
Infecciones por VIH/transmisión , Enfermedades de Transmisión Sexual/transmisión , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/transmisión , Femenino , Francia/epidemiología , Gonorrea/epidemiología , Infecciones por VIH/epidemiología , Seropositividad para VIH/epidemiología , Humanos , Masculino , Personal Militar/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Sífilis/epidemiología
11.
Clin Exp Rheumatol ; 26(3): 430-5, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18578964

RESUMEN

BACKGROUND: Cartilage destruction in osteoarthritis (OA) involves excessive degradation and increased synthesis of cartilage matrix macromolecules including type II collagen and proteoglycans. Cartilage biomarkers exist for the measurement of cartilage matrix turnover and may reveal differences in patients with OA. OBJECTIVE: To determine whether there are detectable differences in and relationships between biomarkers of type II collagen (CII) degradation (C2C, C1, 2C) and synthesis (CP II) in patients with only hip OA (OHOA) and those suffering from multiple sites OA (MSOA). PATIENTS AND METHODS: Fifty-six patients classified as MSOA or OHOA. Minimum hip joint space width (Min JSW) measured by computer from standard radiographs. Serum measurement of CII synthesis C-propeptide (CPII) and cleavage of type II (C2C) and types I and II (C1, 2C) collagens. Aggrecan metabolism was assessed by serum CS 846 assay. Step to step logistic regression to determine the effect of the quantitative data on the assignment to each subgroup. RESULTS: Twenty-four subjects were classified with MSOA. Among the 32 OHAO patients, 15 had bilateral hip OA and 17 had unilateral hip OA. The latter were classified with "Isolated hip OA" (IHOA). CPII levels were significantly lower in patients with MSOA than in those with OHOA (99.9+/-50.3ng/mL versus 141.9+/-81.2ng/mL, p=0.04. OR= 0.18 for CPII >120 ng/mL, p<0.005). C2C levels were also lower in MSOA (9.7+/-2.3ng/mL) versus OHOA (11.4+/-3.2ng/mL, p=0.03. OR= 0.26 for C2C >10 ng/mL, p=0.02). There was an inverse correlation between min JSW and C2C only in patients with IHOA (r=0.50, p= 0.02). CONCLUSION: Hip OA, in patients with MSOA, might be related to alteration in CII metabolism which may result in a deficient type II collagen repair process. The significant relationship between C2C and JSW in IHOA suggests that this marker is of value in assessing cartilage degradation patients with involvement of a single joint.


Asunto(s)
Proteínas de Unión al Calcio/sangre , Colágeno Tipo II/sangre , Osteoartritis de la Cadera/sangre , Osteoartritis de la Cadera/fisiopatología , Osteoartritis/sangre , Osteoartritis/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Agrecanos/metabolismo , Biomarcadores/sangre , Cartílago Articular/metabolismo , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Osteoartritis/patología , Osteoartritis de la Cadera/patología , Proteoglicanos/metabolismo
12.
Eur J Obstet Gynecol Reprod Biol ; 136(2): 189-93, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17499418

RESUMEN

OBJECTIVE: To investigate the maternal perception of pain before and after amniocentesis (AC) or transabdominal chorionic villus sampling (TA-CVS). STUDY DESIGN: Three hundred women were divided into groups of 100 participants destined to undergo three different fetal sampling procedures: amniocentesis (group 1), transabdominal chorionic villus sampling (CVS) with a 19 gauge Blache needle (group 2) and transabdominal CVS with a 20 gauge needle (group 3). The visual analog scale (VAS) was used to quantify the patient's pre-sampling expected pain level and the real pain level was measured immediately after the sampling procedure. The factors liable to influence the VAS score after the sampling procedure were studied by single and multivariate analysis and concerned either the sampling procedure or patient demographic data. RESULTS: The VAS scores obtained before the procedure were not significantly different for the three sampling groups. When performed with a 19 gauge Blache needle TA-CVS is significantly more painful than the other sampling procedures (p=0.0002): VAS score of 3.62 (group 2), 2.49 (group 3) and 2.68 (group 1) for CVS with 20 gauge needle and amniocentesis. Multivariate analysis identified a group of patients for which the perception of pain induced by sampling was higher compared to the other patients: nulliparous patients, having undergone 19 gauge Blache needle CVS, with a high pre-sampling VAS score. CONCLUSION: Transabdominal chorionic villus sampling with a 19 gauge Blache needle seems to be the most painful sampling procedure. We question the need to use a 19 gauge needle as acceptable results are obtained with a 20 gauge needle.


Asunto(s)
Dolor Abdominal/etiología , Amniocentesis/efectos adversos , Muestra de la Vellosidad Coriónica/efectos adversos , Dolor Abdominal/psicología , Adulto , Muestra de la Vellosidad Coriónica/instrumentación , Femenino , Humanos , Agujas , Dimensión del Dolor , Proyectos Piloto , Embarazo , Estudios Prospectivos
14.
Med Trop (Mars) ; 67(6): 601-6, 2007 Dec.
Artículo en Francés | MEDLINE | ID: mdl-18300523

RESUMEN

Management of type II diabetes in sub-Saharan Africa presents a number of aspects that must be analyzed successively. Regarding the continent of Africa, implementing a strategy to control diabetes will require extensive information and education campaigns not only for health care workers but also for the general population as well as the creation of adequate infrastructure to optimize the availability of treatment. Regarding care modalities in Africa, the overall principles of management are the same as anywhere in the world. However these modalities must be adapted to the sociocultural environment of the patient. Objectives must be simplified without compromising the scientific requirements. Regarding patients, African perceptions about the disease are very different from those taught in Western schools. The different ethnocultural components of the disease must be recognized in order to optimize overall patient management.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/prevención & control , Adulto , África del Sur del Sahara/epidemiología , Complicaciones de la Diabetes/prevención & control , Femenino , Política de Salud , Humanos , Hipertensión/epidemiología , Masculino , Educación del Paciente como Asunto , Prevención Primaria
15.
Int J Epidemiol ; 35(2): 479-87, 2006 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-16434429

RESUMEN

Since 1993, many studies on the health of Persian Gulf War Veterans (PGWV) have been undertaken. These studies have concluded that there has been an increased mortality due to external causes, no excess of recognized diseases, and no effect on PGWV children. When compared with the non-deployed, PGWV have reported a higher frequency of infertility as well as different symptoms, but a specific Gulf War syndrome was not identified. In October 2000, the French government asked an independent working group to analyse the scientific literature on PGWV health. The group concluded that an exhaustive study of French PGWV was to be undertaken. The objectives of this study were to describe the exposures of PGWV in the operations theatre, to report on the symptoms and diseases that occurred in PGWV and their children during and after the military campaign, and to explore the possibility of a Gulf War syndrome. This exhaustive cross-sectional study, which included all civilians and troops who served in the Gulf from August 1990 to July 1991, began in January 2002. Data were collected by postal self-administered questionnaires. A standardized clinical evaluation was performed by 27 clinics of occupational diseases and nine military hospitals. Symptoms and diseases which appeared after the campaign are described. To date, among 20,261 PGWV, 5,666 participated in the study (28%). The most frequent symptoms described since the return from the Gulf were headaches (83%), neurological or psychological symptoms, and back pain. Apart from well-known symptoms associations (respiratory, neurocognitive, psychological and musculo-skeletal syndromes), no other cluster was highlighted by our analysis.


Asunto(s)
Guerra del Golfo , Personal Militar/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Síndrome del Golfo Pérsico/epidemiología , Adulto , Dolor de Espalda/epidemiología , Dolor de Espalda/etiología , Métodos Epidemiológicos , Femenino , Francia/epidemiología , Trastornos de Cefalalgia/epidemiología , Trastornos de Cefalalgia/etiología , Humanos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/etiología , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/epidemiología , Enfermedades del Sistema Nervioso/etiología , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Exposición Profesional/análisis , Síndrome del Golfo Pérsico/etiología , Veteranos
16.
Rev Epidemiol Sante Publique ; 54(5): 433-41, 2006 Oct.
Artículo en Francés | MEDLINE | ID: mdl-17149164

RESUMEN

BACKGROUND: Hepatitis A is a public health problem specially for migrants or travellers from industrialized countries with a low hepatitis A endemic level. French armed forces adopted an immunization strategy which first targeted overseas forces and subsequently was extended to all armed forces. In this work we studied the impact of this policy. METHODS: Epidemiological surveillance data from 1990 to 2004 was analyzed by Poisson regression and exponential models of decrease used to forecast future rates. RESULTS: From the 826 cases of hepatitis A reported during the study period, 266 (32.2%) occurred in overseas forces and 560 (67.8%) in forces stationed in France. Three periods could be identified in the decline of annual incidence: before 1994, with an average rate of 23.2 per 100,000; from 1994 to 1998: 10.2; and after 1998: 1.2 for all French armed forces. For overseas armed forces, the average rate was 117 per 100,000 before 1994 and 17.1 from 1994 to 1998 (p<0.001). For armed forces stationed in France, the average rate was 12.2 per 100,000 before 1998 and 0.9 after (p<0.001). For overseas armed forces, models clearly described the declining incidence subsequent to targeted immunization in 1995 and for armed forces stationed in France, the decline with generalized immunization starting in 1998. DISCUSSION: The impact of immunization against hepatitis A virus was significant both in an overseas population and in a population staying in France where the risk level can be considered low due to the low endemic rate in France. These results suggest that immunization should be proposed not only for travellers but also for the general population based on real knowledge of the situation and cost-effectiveness analyses.


Asunto(s)
Vacunas contra la Hepatitis A/administración & dosificación , Hepatitis A/prevención & control , Personal Militar , Predicción , Francia/epidemiología , Encuestas Epidemiológicas , Hepatitis A/epidemiología , Humanos , Incidencia , Medicina Militar/tendencias , Distribución de Poisson
17.
J Appl Physiol (1985) ; 121(1): 66-77, 2016 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-27103651

RESUMEN

Aeroatelectasis has developed in aircrew flying routine peacetime flights on the latest generation high-performance aircraft, when undergoing excessive oxygen supply. To single out the effects of hyperoxia and hypergravity on lung tissue compression, and on ventilation and perfusion, eight subjects were studied before and after 1 h 15 min exposure to +1 to +3.5 Gz in a human centrifuge. They performed the protocol three times, breathing air, 44.5% O2, or 100% O2 and underwent functional and topographical imaging of the whole lung by ultrasound and single-photon emission computed tomography combined with computed tomography (SPECT/CT). Ultrasound lung comets (ULC) and atelectasis both increased after exposure. The number of ULC was <1 pre protocol (i.e., normal lung) and larger post 100% O2 (22 ± 3, mean ± SD) than in all other conditions (P < 0.001). Post 44.5% O2 differed from air (P < 0.05). Seven subjects showed low- to medium-grade atelectasis post 100% O2 There was an effect on grade of gas mixture and hypergravity, with interaction (P < 0.001, respectively); 100% O2, 44.5% O2, and air differed from each other (P < 0.05). SPECT ventilation and perfusion were always normal. Ultrasound concurred with CT in showing normal lung in the upper third and ULC/atelectasis in posterior and inferior areas, not for other localizations. In conclusion, hyperoxia and hypergravity are independent risk factors of reversible atelectasis formation. Ultrasound is a useful screening tool. Together with electrical impedance tomography measurements (reported separately), these findings show that zones with decreased ventilation prone to transient airway closure are present above atelectatic areas.


Asunto(s)
Hiperoxia/fisiopatología , Pulmón/fisiopatología , Atelectasia Pulmonar/etiología , Atelectasia Pulmonar/fisiopatología , Adulto , Humanos , Hipergravedad , Hiperoxia/metabolismo , Pulmón/metabolismo , Masculino , Oxígeno/metabolismo , Atelectasia Pulmonar/metabolismo , Respiración , Factores de Riesgo , Tomografía Computarizada de Emisión de Fotón Único/métodos , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía/métodos
18.
Biochim Biophys Acta ; 1430(1): 141-8, 1999 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-10082942

RESUMEN

In previous studies, we isolated and identified a mu-calpain-PKCalpha complex from rabbit skeletal muscle. At the same time we pointed out that an association between mu-calpain and PKCalpha could occur at the level of the plasma membrane of muscle cells, and that PKCalpha could thus be considered as a potential mu-calpain substrate. In the present study, using the mu-calpain-PKCalpha complex as a model, we report that mu-calpain is activated in the combined presence of physiological calcium concentrations (less than 1 microM) and phosphatidylserine. Furthermore our data also show that: (1) there exists a correlation between the appearance of autolyzed mu-calpain forms and PKCalpha hydrolysis which leads to the formation of PKMalpha; (2) in certain experimental conditions, autolyzed mu-calpain forms are able to hydrolyze PKMalpha independently of the presence of diacylglycerol.


Asunto(s)
Calpaína/química , Precursores Enzimáticos/química , Proteína Quinasa C/química , Animales , Calcio , Cationes Bivalentes , Diglicéridos , Activación Enzimática , Músculo Esquelético/enzimología , Fragmentos de Péptidos/química , Conejos , Temperatura , Factores de Tiempo
19.
Sante Publique ; 17(1): 47-56, 2005 Mar.
Artículo en Francés | MEDLINE | ID: mdl-15835215

RESUMEN

At the request of the Service of Academic Preventative Medicine (APM) in Bordeaux, this study was carried out in the year 2000 and aimed to identify the health information needs of the university's student population. The questionnaire, which was completed by the students themselves, mainly explored health information needs, health status and the students' living conditions. Of the 370 total students coming from all University disciplines who participated in this study, a majority of them were women (61%), with the median age of 21 years old. The majority of students (69%) said that they were stressed and/or depressed and more than one-third were tired. Nearly 20% of the students were smokers, 9% declared that they regularly drank alcohol and 7% of them reported that they never consulted a physician. When asked specifically about their health information needs, they expressed a preference for receiving information on sexually transmitted diseases, how to stay in good health and on issues like psychology, depression and suicide. These themes differed according to gender and risk behaviour. These results permitted a better understanding of the students' health information needs and provided the knowledge necessaryin order to streamline and appropriately adapt the APM's activities for the following academic year in order to be more focused to respond to these needs.


Asunto(s)
Servicios de Información , Evaluación de Necesidades , Servicios de Salud para Estudiantes , Adulto , Comunicación , Femenino , Francia , Promoción de la Salud , Encuestas Epidemiológicas , Humanos , Masculino , Servicios de Salud Mental , Educación del Paciente como Asunto , Fumar , Universidades
20.
FEBS Lett ; 359(1): 60-4, 1995 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-7851531

RESUMEN

A mu-calpain-PKC complex was isolated from rabbit skeletal muscle by ultracentrifugation and by anion-exchange chromatography. The PKC associated to mu-calpain was stimulated by calcium, phosphatidylserine and diacylglycerol, and corresponds to a conventional PKC (cPKC). This complex presents an apparent molecular mass close to 190 kDa and is composed of one mu-calpain molecule and of one cPKC molecule. Using monoclonal antibodies specific for the different cPKC isoforms, the isoenzyme associated to mu-calpain was identified as cPKC alpha. Immunofluorescence staining reveals a co-localization of mu-calpain and cPKC alpha on the muscle fibre plasma membranes.


Asunto(s)
Calpaína/aislamiento & purificación , Calpaína/metabolismo , Músculo Esquelético/enzimología , Proteína Quinasa C/aislamiento & purificación , Proteína Quinasa C/metabolismo , Animales , Calcio/farmacología , Calpaína/química , Cromatografía por Intercambio Iónico , Diglicéridos/farmacología , Técnica del Anticuerpo Fluorescente , Sustancias Macromoleculares , Masculino , Peso Molecular , Fosfatidilserinas/farmacología , Proteína Quinasa C/química , Conejos , Ultracentrifugación
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