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Background: Persons with a diagnosis of severe mental illness have a life expectancy that is 20 years lower than the general population, and they are disproportionately affected by cardiovascular disorders. Improving the management of cardiovascular risk is one of the main challenges for the public health system. In the care pathway of persons with a diagnosis of severe mental illness, a better understanding of limiting and facilitating factors is required. The objective was to include persons with a diagnosis of severe mental illness, carers, and primary and mental health professionals in the creation and evaluation (feasibility) of a health promotion program designed to improve cardiovascular risk management through empowerment., Methods: This study combines a mixed methodology with qualitative and quantitative components. A multicenter prospective qualitative study was conducted in seven mental health units in France and was coordinated by a steering committee composed of persons with a diagnosis of severe mental illness, carers, and primary and mental health professionals., Results: This health promotion program must enable persons with a diagnosis of severe mental illness to assert their right to self-determination and to exercise greater control over their lives, beyond their diagnosis and care. Following a preliminary feasibility study, the effectiveness of this new tool will be evaluated using a randomized controlled trial in a second study., Conclusions: The findings can be used by health organizations as a starting point for developing new and improved services for persons with a diagnosis of severe mental illness. Trial registration Clinical Trials Gov NCT03689296. Date registered September 28, 2018., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2019.)

The authors report the general epidemiologic features of Mediterranean spotted fever (MSF) in the Marseille area (South France). Age was a risk factor, increasing after 50 years, and annual incidence seemed positively correlated with the average temperature of the preceding year and negatively correlated with the number of days with frost of the preceding year. However, correlations were not significant.

The authors report a case of bacteriemia with Bacillus licheniformis in a pregnant woman with coagulation disorders (acute fibrinolysis). Eight blood cultures were positive. Recovery rapidly occurred. The origin of this affection is discussed : a venous mode of entry is possible, either by the use of contaminated infusion fluid, or following several catheterizations.

A pharmacokinetic study of amikacin was carried out in 12 neonates hospitalized in the intensive care unit. Serum amikacin levels were measured using a bacteriological method after one of several intramuscular injections of 7.5 micrograms/kg. Serum levels were greater than 10 micrograms/ml during the first three hours in 11 cases with values greater than or equal to 30 micrograms/ml. during the first two hours in five cases. The half life was measured in five patients and varied between three and eight hours. The plasma clearance was between 8.9 and 14 mil per minute per 1.73 m2. There is an unpredictable accumulation of this antibiotic especially in premature babies aged less than five days with a birth weight less than two kg. This accumulation is transitory when the clinical evolution of the case is favorable but it can be prolonged in unfavorable cases. The elimination of amikacin depends mainly on a patient's renal function. So, because of the risk of ototoxicity, the dosage should be reduced to 10 mg per kg-1 per 24 h-1, with measurements of the serum peak level and the level just before the following injection.

Seven of 142 cases (5%) of Mediterranean spotted fever admitted to hospital in Marseilles in 1983 and 1984 were severe. All of them were confirmed by specific laboratory tests. The disease resembles Rocky Mountain spotted fever with purpuric exanthem, confusion, renal insufficiency, hypoxaemia, thrombocytopenia, hyponatraemia and hypocalcaemia. Two patients died. The predisposing factors for severity were old age, alcoholism, heavy smoking, respiratory insufficiency and glucose-6-phosphate dehydrogenase deficiency.