Search

Summary: Invasive pneumococcal diseases were reduced after introduction of pneumococcal conjugate vaccine, but infections due to non-vaccine serotypes persisted. The pneumococcal origin of community-acquired pneumonia remains difficult to affirm, but high procalcitonin and C-reactive protein blood levels and duration of fever 48h or less after initial antibiotic treatment are excellent predictors of pneumococci. Among 259 patients under 7 years of age hospitalized from 2003 to 2008 for community-acquired pneumonia, 47 met these criteria, including 27 of 141 hospitalized between 2006 (date of vaccine generalization) and 2008. Of these 27, 21 had previously received pneumococcal conjugate vaccine and 19 of 21 were attendees of nursery school or day care centers versus only 2 in 2003–2006. These data show that pneumococcal pneumonias are possible in immunized children cared for in-group settings. [Copyright &y& Elsevier]

Abstract: In this work, we are interested in the contact between a self-affine fractal surface pressed against a smooth and perfectly rigid plane. The purpose is to analyze the influence of both sampling interval and sampling length , on the determination of surface roughness parameters, contact areas and viscous and diffusive flow through the aperture field resulting from the contact under load. To accomplish this analysis, fractal surfaces used in this work are obtained from numerical simulations. Models for synthesizing a fractal surface, computing mechanical deformation of asperities as well as determining viscous and diffusive flow are briefly presented. At the macroscopic scale, viscous and diffusive flow are fully characterized by the transmissivity K and effective diffusivity D tensors, respectively. Results show that fractal dimension and arithmetic roughness are almost insensitive to and L under conditions that are discussed. Contact areas are invariant whatever L and become increasingly sensitive to while decreasing the arithmetic roughness Ra. The impact of L and in the determination of transport properties also increases K and D decrease, i.e. for small Ra and large average contact pressure Pca. [Copyright &y& Elsevier]

Abstract: In this work, we analyze diffusion and viscous flow through the aperture field of a contact between rough surfaces pressed against each other. The purpose of our study is to validate the use of synthesized rough surfaces instead of real ones for surfaces exhibiting fractal properties. Models for mechanical deformation of asperities as well as for transport resulting from a pressure gradient or a species concentration gradient are presented. At the macroscopic scale, viscous and diffusive transports only depend on transmissivity and diffusivity , respectively. Both tensors and are intrinsic, which means that they can be entirely determined from the aperture field. Two kinds of surfaces obtained from two different machining processes—lapping and sand-blasting—are considered. The dependence of the global contact area, distribution of local contact areas, and upon the average contact pressure is compared for real surfaces and their analogue synthesized surfaces. The comparison over a wide range of contact pressures leads to the conclusion that a fractal representation is a robust representation for the contact mechanics as well as for transport properties for this class of surfaces. This validates the overall procedure described in this work. [Copyright &y& Elsevier]

Abstract: Using a Before/During/After sampling protocol, the effects of the Le Havre harbour extension, which was started at the end of 2001, on the macrobenthic and suprabenthic communities in the eastern Bay of Seine (English Channel) were examined. As the construction phase has not yet been completed, the results presented here reflect only the data collected before and during the operations (September 2000 and 2002 for benthos sampling and March 2001, September 2001, October 2002 and March 2003 for suprabenthos sampling). Although bio-sedimentary changes did occur at the mouth of the Seine river, an analysis of benthic assemblages reveals that the dredging and construction operations do not seem to have influenced assemblage structure or the spatial distribution of organisms. Comparisons of the suprabenthic assemblages at each sampling date indicate that seasonal dynamics was mainly responsible for determining species distribution. We conclude that, 1 year into the harbour management plan, the observed changes in benthic and suprabenthic assemblage abundance do not exceed the range of spatial variability that exists naturally in the Seine estuary. Despite this compensatory actions designed to protect the aquatic habitats and to preserve a sustainable and healthy ecosystem have been added to the infrastructure development plan. [Copyright &y& Elsevier]

Children without chronic or serious medical conditions are at increased risk for hospitalization during influenza seasons, mainly with respiratory tract infections. But influenza virus infections frequently remain undiagnosed, even in hospitalized patients. We prospectively studied the rate of concomitant and preceding influenza infections in children hospitalized with a community acquired pneumonia (CAP).Population and methods. – All 1–15-year-old children with CAP requiring hospitalization between 1st April 2000 and 2002 had nasopharyngeal aspirate for viruses, immunoflorescence and serologies for respiratory pathogens. The peak of influenza IgG measured by complement fixation (CF) is transient, and a titer of 1/64 or more indicates an acute influenza infection in the preceding weeks. Children with chronic disease were excluded and a control group of patients from outpatient clinic was measured.Results. – Among 33 previously healthy children (age 4.9 years, range 1.2–14 years), 8 had a pneumococcal pneumonia, 10 a pneumonia caused by Mycoplasma pneumoniae (MP), 1 by Chlamydia pneumonia, and 8 of unknown origin. In six patients immunoflorescence was positive: Respiratory Syncitial Virus, 2, Adenovirus, 1 and Influenza A, 3 (including a patient with concomitant MP infection). Thirteen of the 33 children (39.4%) had evidence of a recent influenza A infection with CF ab ≥ 1/64: with pneumococcal pneumonia, 5/10 with MP pneumonia, 3/8 with unknown origin pneumonia, 9/13 of these previous influenza infections being clinically inapparent. Only 1/30 children of control group (3.3%) had CF ab ≥ 1/64.Conclusion. – In this study, influenza infection is the direct cause of CAP of children in 12% of cases. In other children with CAP, 39.4% of patients had an influenza infection in the preceding weeks which leads to secondary infection caused by Streptococcus pneumoniae or by MP or other pathogens. [Copyright &y& Elsevier]

Summary: An unusual multi-drug-resistant Pseudomonas aeruginosa (MDR-PA) was isolated in four patients whilst hospitalized in a French teaching hospital between May and August 2011. All four patients had undergone an oesophago-gastro-duodenoscopy with the same gastroscope over a five-month period. This endoscope was associated with a culture positive for the MDR-PA. Observations of endoscope reprocessing identified deviations from the agreed processes: insufficient initial cleaning, shortening of the immersion time and brushing time, insufficient channel flushing, and inadequate drying prior to storage. Since withdrawing the gastroscope and institution of strict adherence to the agreed processes, no other MDR-PA cases have been isolated. [ABSTRACT FROM AUTHOR]

Abstract: Human Bocavirus (HboV) was recently cloned by a systematic screening of nasopharyngeal samples from children hospitalized for respiratory tract infections. This virus, genus Bocavirus, family Parvoviridae, was identified by screening for its DNA in 5% of nasopharyngeal aspirates, as reported in several studies. It may be responsible for upper and lower respiratory tract infections of young children under five years with a peak rate in winter. Because of a high rate of viral co-infections, its pathogenic role in these infections should be documented. Further studies are required to determine the role of this possibly systemic virus in other affections. [Copyright &y& Elsevier]

Probiotics are microorganisms such as bacteria or yeast that can be added to the food with the purpose of regulating the intestinal flora of the host (Parker 1974). Probiotics have been used therapeutically in the treatment of diarrhea or prophylactically in humans and animals to minimize drift in the composition of the intestinal microflora associated with antibiotherapy or traveler’s gastroenteritis (Barrows and Deam 1985, Lestradet 1995, Van De Kerkove 1979). More recently, probiotics have also been found to have beneficial effects on the health of the host (Fuller 1989). The mechanisms are not completely understood, but they could be due to the ability of probiotics to act as regulators of the intestinal microflora as a source of digestive enzymes and/or stimulating factors on the immune system (Lestradet 1994). This is the rationale behind the use of probiotics in the feed of farm animals, i.e., to improve their breeding performance despite all of the stresses (high animal concentration, early weaning or rapid growth) associated with modern husbandry (Lestradet 1994). Weaning, a new home and dietary changes are all conditions that are known to affect the intestinal microflora of dogs and for which probiotics might be beneficial. Probiotics might also be of benefit to dogs living in a large colony or sold in pet shops in which animal concentration, pressure of infection and stress can significantly affect animal resistance to disease. Paciflor is a patented strain of Bacillus recorded at the Pasteur Institute under the number CIP 5832 and marketed as a feed additive in animal nutrition (Lestradet 1995). The bacillus is commercialized in its sporulated form, allowing a better resistance to heat and better stability over time. Bacillus CIP 5832 has been shown to have beneficial effects on the survival of mice infected with Klebsiella pneumoniae and on the breeding performances of rabbits, pigs, chickens, turkeys, ducks, calves and horses (Lestradet 1995). Bacillus CIP 5832 is also the active ingredient in Bactisubtil (Merrell, Neuilly-sur-Seine, France) a drug approved in France in the 1950s and recommended in infants against antibiotic-induced diarrhea (Lestradet 1995). A series of pilot studies were undertaken to evaluate the feasibility of including a probiotic in dry dog foods, to determine the kinetics of Bacillus CIP 5832 in vivo in dogs and to assess its effects on diet digestibility. Materials and methods. Bacillus CIP 5832 is commercially available in its sporulated form as a powder (Paciflor, Prodeta, Vannes, France) at the concentration of 1010 colony forming units (CFU)/g. The recommended dosage in the food is 106 CFU/g. A first set of experiments was planned to assess the feasibility of including Bacillus CIP 5832 in a dry dog food. In the first experiment, the probiotic was added to the meal of a commercial diet [RCCI M25 (protein 250 g/kg, fat 120 g/kg, minerals 70 g/kg and dietary fibers 65 g/kg), Royal Canin, Aimargues, France] before expansion-extrusion at a dose of 106 CFU/g of meal. Spore survival was evaluated in the meal and the expanded diet. In a second experiment, survival was evaluated with the probiotic added to a powder (500 g/kg brewers yeast-500 g/kg lactalbumen) to obtain a final concentration 108 CFU/g of powder. This powder was then coated (10 g/kg of diet) on four batches of a pilot diet (protein 320 g/kg, fat 240 g/kg, minerals 69 g/kg and dietary fiber 55 g/kg) after expansion-extrusion and drying. Samples of these four batches were then followed over 1 y to evaluate Bacillus survival over time. Bacillus CIP 5832 concentration on five samples of each diet was determined in 10 g of ground diet as described in Michard and Levesque (1989). For the survival study, samples of the batches were kept in commercial packaging at room temperature in a dry, well-ventilated warehouse. Spore survival was evaluated after 0, 6, 9 and 12 mo. In the second set of experiments, the kinetics of Bacillus CIP 5832 in dogs was evaluated. Five female spayed dogs (2 German Pointers and 3 German Shepherds, age 5–10 y, weight 24 ± 3 kg) belonging to the dog colony of the Royal Canin Research Center were used. The colony is approved and regularly inspected by veterinarians of the French “Direction des Services Vétérinaires.” For all of the studies, Bacillus CIP 5832 was mixed at a concentration of 1.5 × 108 CFU/g to a powder made by grinding the same commercial diet as the one used for feeding the dogs (RCCI M25, Royal Canin, Aimargues, France). Bacillus concentrations in the mix were checked before, during and after the study as described above. To evaluate the delay of appearance and disappearance of Bacillus CIP 5832 in the feces, 5 g of the mix was added or no longer added to the daily meal (493 ± 28 g of kibbles/d, thus ± 1.5 × 106 CFU/g diet). All feces were collected 1 d before and 7 d after Bacillus CIP 5832 supplementation or removal. Fecal samples were individually frozen (-18°C) pending analysis, and Bacillus concentration was determined before (spores 1 vegetative forms) and after heat treatment (80°C for 10 min, spores only) as described in Michard and Levesque (1989). Before the disappearance study, dogs had been supplemented for 3 wk with the Bacillus CIP 5832. For the Bacillus CIP 5832 balance study, the diet of the dogs was supplemented with 5 g of the probiotic mix as described above, all feces were collected and pooled for each dogs over a 5-d period and frozen pending analysis. Dogs had been supplemented with Bacillus CIP 5832 for 2 wk before the study. Dry matter, protein, lipid and energy digestibility studies were conducted according to the American Association of Feed Control Officials (AAFCO 1997) protocol without or with the daily addition of 7.5 × 108 CFU of Bacillus CIP 5832. All results are expressed as the mean 6 standard error (SEM). Digestibility results were compared using a paired Student’s t test; P < 0.05 was considered to be significant. Results and discussion. The first set of experiments was intended to prove that Bacillus CIP 5832 could be added to a dry dog food and to evaluate the loss of viable spores over a 12-mo shelf life. Resistance of Bacillus CIP 5832 to expansion-extrusion and drying. Bacillus CIP 5832 concentration in the meal and in the expanded product was 1.10 ± 0.04 × 106 and 0.02 ± 0.05 × 106 CFU/g, respectively. The extrusion-expansion and drying process resulted thus in the loss of .99 % of the spores. Bacillus CIP 5832 should thus not be included in the diet before the extrusion- expansion and drying process. Resistance of Bacillus CIP 5832 when applied as a powder coating. After powder coating, the observed level of spores was 660% of the expected levels in four different batches (Table 1). These relatively high losses may be due in part to spores trapped within the lipid fraction of the diet when the ground food is mixed in 0.2% sodium hydroxide as the first step of the bacteriological count. However, despite these apparent losses, powder coating remains an efficient and convenient way to add Bacillus CIP 5832 to the diet. Spore survival over time. Follow-up of four different batches over a 12-mo period was associated with a loss of spores of ,25% compared with the bacteriological count just after processing (Table 1). These three pilot studies confirmed that addition of Bacillus CIP 5832 to a dry dog food is feasible. The second set of experiments was intended to prove that Bacillus CIP 5832 could survive in the gastrointestinal tract of dogs as well as to determine the time required for its appearance and disappearance in the feces. Dogs consumed all of their food as well as the mix containing the spores in all studies. Delay of appearance of Bacillus CIP 5832 in the feces. When the probiotic was added to the diet, spores and vegetative forms were detected in the feces within 24 h and reached a plateau within 2 and 4 d, respectively (Fig. 1). Delay of disappearance of Bacillus CIP 5832 from the feces. When the probiotic was withdrawn from the diet, spores and vegetative forms could not longer be detected after 3 d (Fig. 2). Bacillus CIP 5832 balance. The balance study showed that 29.6 ± 5.6% of the Bacillus CIP 5832 ingested was found in the feces of the five dogs; 69.9 ± 3.5% was in vegetative form. As expected from studies in other species, Bacillus CIP 5832 will thus survive and germinate in the gastrointestinal tract of dogs but will not persist if not fed continuously (Lestradet 1995). Effect of Bacillus CIP 5832 on dry matter, protein, lipid and metabolizable energy digestibility. Although the digestibilities appeared slightly improved with the probiotic, the difference were not significant (Table 2). In summary, these studies demonstrated that the addition of Bacillus CIP 5832 to a dry dog food was feasible under certain circumstances and that Bacillus CIP 5832 will survive and germinate in the gastrointestinal tract of dogs. [ABSTRACT FROM AUTHOR]

Introduction La bronchiolite du nourrisson est responsable de nombreuses hospitalisations saisonnières. La durée d’hospitalisation, difficilement prévisible, occasionne des difficultés d’organisation dans les services. L’oxygénothérapie est le principal facteur conditionnant la durée d’hospitalisation. L’objectif de notre étude est de déterminer si le score de Wang peut prédire la durée d’oxygénothérapie de nourrissons hospitalisés pour une bronchiolite. Matériels et méthodes Il s’agit d’une étude prospective observationnelle entre octobre 2015 et février 2016 au CHU de Rennes incluant des nourrissons de moins de 2 ans hospitalisés pour un premier ou deuxième épisode de bronchiolite. Le score de Wang était réalisé à l’admission et la durée d’oxygénothérapie relevée à la fin du séjour. D’autres facteurs pouvant moduler la durée d’oxygénothérapie étaient recherchés. Une analyse de corrélation de Pearson et des courbes ROC ont été effectuées. Résultats Cent cinq nourrissons d’âge moyen 91 jours ont été inclus (48,57 % de garçons). Quarante et un enfants (39 %) avaient moins de 6 semaines. Durée moyenne d’oxygénothérapie 82 heures. Le coefficient de Pearson entre le score de Wang et la durée d’oxygénothérapie était à 0,111. La durée d’oxygénothérapie était liée à la saturation percutanée à l’admission ( p = 0,000141) et à l’âge de l’enfant ( p = 0,00745). Un score de Wang inférieur à 8 était corrélé à une durée d’oxygénothérapie inférieure à 24 heures (sensibilité : 86,2 %, VPN : 84,6 %). Une saturation inférieure à 97 % (sensibilité : 93,1 %, VPN : 94,6 %) ainsi que la fréquence respiratoire supérieure à 44 par minute (sensibilité : 62,1 %, VPN : 81,4 %) à l’admission étaient corrélées à une durée d’oxygénothérapie supérieure à 24 heures. Conclusion Le score de Wang n’est pas prédictif d’une durée d’oxygénothérapie, la saturation et la fréquence respiratoire à l’entrée paraissent intéressantes pour estimer cette durée. [ABSTRACT FROM AUTHOR]

Abstract Lyme neuroborreliosis is a bacterial infection caused by the dissemination and proliferation of a Borrelia species in the central nervous system. Neuroborreliosis occurs after transmission of the pathogen from an infected tick to a human host during a tick bite. We report nine cases of pediatric neuroborreliosis collected by the National Observatory of Pediatric Bacterial Meningitis in France between 2001 and 2012. The nine children, aged 4–13 years, were identified in northern and eastern France and had the following clinical features: meningeal irritation alone or with facial palsy, or isolated facial palsy. All cases showed anti- Borrelia antibodies in cerebrospinal fluid or serum, or with a positive Borrelia PCR in the CSF. The outcome was favorable in all cases after a 2- to 3-week course of third-generation cephalosporin. On the basis of these nine pediatric cases, this study provides an update on the epidemiology, pathophysiology, diagnostic strategy, and treatment of neuroborreliosis, with insight into the specific features of pediatric neuroborreliosis and the difficulties encountered in the diagnosis of this infection. [ABSTRACT FROM AUTHOR]

Abstract: Cystic fibrosis is the most common lethal autosomal recessive disease among the Caucasian population. It is caused by defects in the CFTR gene (Cystic Fibrosis Transmembrane Conductance Regulator). Although over 1600 disease-causing mutations in the CFTR gene have been described, the highly variable disease phenotype in cystic fibrosis cannot be explained on the basis of this gene alone. Both the environment and other non-CFTR genes are likely to be important. The increased understanding of pathophysiological processes in the cystic fibrosis lung has led to several studies on genes in these pathways. One of the major aims of such studies is to produce targets for novel drug developments. [Copyright &y& Elsevier]

Summary: Among 76 children fully vaccinated with 7-valent conjugate vaccine and subsequently hospitalized from 2006 to 2009 for community-acquired pneumonia, isolated or with empyema or pleuritis, 10 had confirmed pneumococcal infections. All pneumococci isolated with blood or pleural culture were non vaccine serotypes (1, 5, 7F, and 19A). The proportion of pneumococcal pneumonias was similar to that in two series from the same hospital before the vaccine era. These data show that the 13-valent conjugate vaccine could be useful in prevention of community-acquired pneumonia and that bacteriologic survey of community-acquired pneumonia remains necessary. [ABSTRACT FROM AUTHOR]

Summary: During the months of October and November 2006–2008, norovirus was detected in the stools of 14 children hospitalized with acute diarrhea (no sapovirus). Nine of these noroviruses belonged to a unique GGII4 strain, which produced severe clinical symptoms, present only in 2007 and 2008 and absent in 2006. This strain, identified in Europe mainly in the elderly, seems to be on the rise in children in the Paris area over the past few years. [ABSTRACT FROM AUTHOR]

Doxorubicin is an antineoplasic agent active against sarcoma pulmonary metastasis, but its clinical use is hampered by its myelotoxicity and its cumulative cardiotoxicity, when administered systemically. This limitation may be circumvented using the isolated lung perfusion (ILP) approach, wherein a therapeutic agent is infused locoregionally after vascular isolation of the lung. The influence of the mode of infusion (anterograde (AG): through the pulmonary artery (PA); retrograde (RG): through the pulmonary vein (PV)) on doxorubicin pharmacokinetics and lung distribution was unknown. Therefore, a simple, rapid and sensitive high-performance liquid chromatography method has been developed to quantify doxorubicin in four different biological matrices (infusion effluent, serum, tissues with low or high levels of doxorubicin). The related compound daunorubicin was used as internal standard (I.S.). Following a single-step protein precipitation of 500 μl samples with 250 μl acetone and 50 μl zinc sulfate 70% aqueous solution, the obtained supernatant was evaporated to dryness at 60 °C for exactly 45 min under a stream of nitrogen and the solid residue was solubilized in 200 μl of purified water. A 100 μl-volume was subjected to HPLC analysis onto a Nucleosil 100–5 μm C18 AB column equipped with a guard column (Nucleosil 100–5 μm C6H5 (phenyl) end-capped) using a gradient elution of acetonitrile and 1-heptanesulfonic acid 0.2% pH 4: 15/85 at 0 min→50/50 at 20 min→100/0 at 22 min→15/85 at 24 min→15/85 at 26 min, delivered at 1 ml/min. The analytes were detected by fluorescence detection with excitation and emission wavelength set at 480 and 550 nm, respectively. The calibration curves were linear over the range of 2–1000 ng/ml for effluent and plasma matrices, and 0.1 μg/g–750 μg/g for tissues matrices. The method is precise with inter-day and intra-day relative standard deviation within 0.5 and 6.7% and accurate with inter-day and intra-day deviations between −5.4 and +7.7%. The in vitro stability in all matrices and in processed samples has been studied at −80 °C for 1 month, and at 4 °C for 48 h, respectively. During initial studies, heparin used as anticoagulant was found to profoundly influence the measurements of doxorubicin in effluents collected from animals under ILP. Moreover, the strong matrix effect observed with tissues samples indicate that it is mandatory to prepare doxorubicin calibration standard samples in biological matrices which would reflect at best the composition of samples to be analyzed. This method was successfully applied in animal studies for the analysis of effluent, serum and tissue samples collected from pigs and rats undergoing ILP. [Copyright &y& Elsevier]