Leptospirosis in Franche-Comté (FRANCE): clinical, biological, and therapeutic data.

Objectives And Method: We report the patient data in 77 cases of leptospirosis confirmed by PCR and/or serology (micro-agglutination), observed between 1994 and 2008 at the Besançon teaching hospital. Our aim was to compare the epidemiological, clinical, biological, and therapeutic characteristics of leptospirosis in the Franche-Comté region, to those reported in other regions.

Results: The median age was 42years and 95% were male patients.

[Role of cyclic nucleotide phosphodiesterases type 3 and 4 in cardiac excitation-contraction coupling and arrhythmias].

Cyclic nucleotide phosphodiesterases (PDE) represent a superfamily of enzymes specialised in the degradation of cAMP and cGMP. In heart, PDE3 and PDE4 are the two major families involved in the regulation of cAMP levels and the control of inotropism. Both families are encoded by several genes, and the recent analysis of the cardiac phenotype of mice lacking these different genes provided new insights into the way they regulate excitation-contraction coupling (ECC).

Automatic administration of propofol and remifentanil guided by the bispectral index during rigid bronchoscopic procedures: a randomized trial.

Background: Anesthesia for rigid bronchoscopic procedures is a demanding procedure. Automatic titration of propofol and remifentanil to maintain the bispectral index (BIS) within the recommended range (40-60) has been reported during routine surgical procedures. The aim of the present study was to evaluate its use during rigid bronchoscopy.

Impact of MenBvac, an outer membrane vesicle (OMV) vaccine, on the meningococcal carriage.

The aim of the study was to analyze the impact of MenBvac, an outer membrane vesicle (OMV) vaccine against P1.7,16 strains, on meningococcal carriage. During a B:14:P1.

[Guidelines for the probabilistic treatment of community-acquired pneumonia: compared experience between internal medicine and emergency departments in the University Hospital of Besançon, France].

Introduction: The objective of this study was to assess the application of local and national recommendations in the management of community-acquired pneumonia in an internal medicine department with an antibiotic referent physician and in an emergency department.

Patients And Methods: This was a retrospective single-center study including patients admitted with community-acquired pneumonia in the internal medicine department of the University Hospital of Besançon after an initial admission in the emergency department.

Results: One hundred patients (58 women and 42 men) were included.

Phosphodiesterase-2 is up-regulated in human failing hearts and blunts β-adrenergic responses in cardiomyocytes.

Objectives: This study investigated whether myocardial phosphodiesterase-2 (PDE2) is altered in heart failure (HF) and determined PDE2-mediated effects on beta-adrenergic receptor (β-AR) signaling in healthy and diseased cardiomyocytes.

Background: Diminished cyclic adenosine monophosphate (cAMP) and augmented cyclic guanosine monophosphate (cGMP) signaling is characteristic for failing hearts. Among the PDE superfamily, PDE2 has the unique property of being able to be stimulated by cGMP, thus leading to a remarkable increase in cAMP hydrolysis mediating a negative cross talk between cGMP and cAMP signaling.

MAGNAMOSIS IV: magnetic compression anastomosis for minimally invasive colorectal surgery.

Background And Study Aims: MAGNAMOSIS forms a compression anastomosis using self-assembling magnetic rings that can be delivered via flexible endoscopy. The system has proven to be effective in full-thickness porcine small-bowel anastomoses. The aim of this study was to show the feasibility of the MAGNAMOSIS system in hybrid endoscopic colorectal surgery and to compare magnetic and conventional stapled anastomoses.

No-scar transanal total mesorectal excision: the last step to pure NOTES for colorectal surgery.

Hypothesis: Because of the concerns over the operative platform, accidental organ injury, and viscerotomy closure, natural orifice transluminal endoscopic surgery (NOTES) currently remains an experimental technique. Transanal NOTES for colorectal surgery overcomes all of these issues; however, all of the reports to date have used hybrid laparoscopic techniques. We demonstrate herein the first case, to our knowledge, of pure transanal NOTES colorectal surgery.

Living related liver transplantation in an adult patient with hepatocellular adenoma and carcinoma 13 years after bone marrow transplantation for Fanconi anemia: A case report.

Fanconi anemia (FA) is an inherited bone marrow failure syndrome due to defective DNA inter-strand cross-link repair. Hematopoietic stem cell transplantation (HSCT) is curative for pancytopenia, but may not prevent the development of non-hematological malignancies. We describe a 26-year-old male patient with FA and Marfan syndrome who in 1994 underwent successful HSCT with bone marrow stem cells from his human leukocyte antigen (HLA)-identical sister.

A new technique of laparoscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction.

Study Objective: To show a new technique of laparoscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction, a technique particularly suited for treatment of bowel endometriosis.

Design: Step-by-step explanation of the technique using videos and pictures (educative video).

Setting: Endometriosis may affect the bowel in 3% to 37% of all endometriosis cases.

A diet enriched in linoleic acid compromises the cryotolerance of embryos from superovulated beef heifers.

Dietary rumen-protected fat rich in linoleic acid may affect the superovulatory response and embryo yield; however, its effects on in vivo embryo cryotolerance are unknown in zebu cattle. The present study evaluated the production and cryotolerance after freezing or vitrification of embryos from Nelore heifers supplemented with rumen-protected polyunsaturated fatty acids (PUFA). Forty heifers kept in pasture were randomly distributed into two groups according to the type of feed supplement (F, supplement with rumen-protected PUFA, predominantly linoleic; C, control fat-free supplement with additional corn).

Antibiotic prescription in nursing homes for dependent elderly people: a cross-sectional study in Franche-Comté.

Objectives: We had for objective to determine the rate of patients treated with antibiotics and the determinants of antibiotic stewardship in nursing homes for dependent elderly people (French acronym EHPAD), of a French region (Franche-Comté).

Patients And Methods: A representative sample of EHPAD, in Franche-Comté, was included in a cross-sectional study made between April and June 2012. An external auditor and the EHPAD head physician collected data on the facility and on residents receiving antibiotics on the study day.

Laparoscopic sigmoidectomy for endometriosis with transanal specimen extraction.

Study Objective: To describe a more conservative and less invasive surgical approach to laparoscopic colorectal segmental resection for treatment of endometriosis.

Design: Video of elective sigmoidectomy to treat colorectal endometriosis.

Setting: Tertiary referral center for laparoscopic gynecologic surgery at the University Hospitals of Strasbourg, France.

Safety and immunogenicity of yellow fever 17D vaccine in adults receiving systemic corticosteroid therapy: an observational cohort study.

Objective: To assess the safety and immunogenicity of live attenuated yellow fever (YF) 17D vaccine in adults receiving systemic corticosteroid therapy.

Methods: All adult travelers on systemic corticosteroid therapy who had received the YF17D vaccine in 24 French vaccination centers were prospectively enrolled and matched with healthy controls (1:2) on age and history of YF17D immunization. Safety was assessed in a self-administered standardized questionnaire within 10 days after immunization.

Mutation of the iron-sulfur cluster assembly gene IBA57 causes severe myopathy and encephalopathy.

Two siblings from consanguineous parents died perinatally with a condition characterized by generalized hypotonia, respiratory insufficiency, arthrogryposis, microcephaly, congenital brain malformations and hyperglycinemia. Catalytic activities of the mitochondrial respiratory complexes I and II were deficient in skeletal muscle, a finding suggestive of an inborn error in mitochondrial biogenesis. Homozygosity mapping identified IBA57 located in the largest homozygous region on chromosome 1 as a culprit candidate gene.

The Oportunidades program's fortified food supplement, but not improvements in the home diet, increased the intake of key micronutrients in rural Mexican children aged 12-59 months.

Mexico's Oportunidades program provides conditional cash transfers, nutrition education, health services, and fortified food supplements for the young children of poor families. We have documented the effects of the program on growth and reduction of anemia. To better understand the impact pathways and disentangle the relative effects on dietary intake of the food supplements compared with other program components, we analyzed data from a randomized effectiveness evaluation of the Oportunidades program in rural children aged 12-59 mo.

Alternatives to carbapenems in ESBL-producing Escherichia coli infections.

Objectives: The authors had for objective to assess the activity of a wide panel of antibiotics on extended-spectrum-β-lactamase producing Escherichia coli isolates (ESBL-Ec), because of the sharp increase of their frequency, leading to an increased use of carbapenems.

Material And Methods: We selected 100 ESBL-Ec in which ESBLs were identified by PCR and sequencing, between 2009 and 2010. We determined the MICs of amoxicillin-clavulanate, piperacillin-tazobactam, temocillin, mecillinam, cefoxitin, cefotaxime, ceftazidime, aztreonam, tigecycline, nitrofurantoin, and fosfomycin using reference methods.

Quantitative polymerase chain reaction detection of circulating DNA in serum for early diagnosis of mucormycosis in immunocompromised patients.

Background: The aim of our study was to assess the detection of circulating DNA from the most common species of Mucorales for early diagnosis of mucormycosis in at-risk patients.

Methods: We retrospectively evaluated a combination of 3 quantitative polymerase chain reaction (qPCR) assays using hydrolysis probes targeting Mucor/Rhizopus, Lichtheimia (formerly Absidia), and Rhizomucor for circulating Mucorales detection. Serial serum samples from 10 patients diagnosed with proven mucormycosis (2-9 samples per patient) were analyzed.

Cash and in-kind transfers lead to excess weight gain in a population of women with a high prevalence of overweight in rural Mexico.

There is a growing concern that food or cash transfer programs may contribute to overweight and obesity in adults. We studied the impact of Mexico's Programa de Apoyo Alimentario (PAL), which provided very poor rural households with cash or in-kind transfers, on women's body weight. A random sample of 208 rural communities in southern Mexico was randomly assigned to 1 of 4 groups: food basket with or without health and nutrition education, cash with education, or control.

A mutation causes MuSK reduced sensitivity to agrin and congenital myasthenia.

Congenital myasthenic syndromes (CMSs) are a heterogeneous group of genetic disorders affecting neuromuscular transmission. The agrin/muscle-specific kinase (MuSK) pathway is critical for proper development and maintenance of the neuromuscular junction (NMJ). We report here an Iranian patient in whom CMS was diagnosed since he presented with congenital and fluctuating bilateral symmetric ptosis, upward gaze palsy and slowly progressive muscle weakness leading to loss of ambulation.

[Safety update on vaccination during pregnancy].

During influenza A pandemia, the vaccination on pregnant women has raised many questions. Pandemia, easiness of travelling, and insufficient vaccinal coverage, expose these patients to infection which may have serious consequences on their pregnancy and on the child to born. On pregnant women, the precautionary principle is a priority and the evaluation of epidemiological risk is essential, in order to prevent adverses events.

Oocyte developmental failure in response to elevated nonesterified fatty acid concentrations: mechanistic insights.

Elevated plasma nonesterified fatty acid (NEFA) concentrations are associated with negative energy balance and metabolic disorders such as obesity and type II diabetes. Such increased plasma NEFA concentrations induce changes in the microenvironment of the ovarian follicle, which can compromise oocyte competence. Exposing oocytes to elevated NEFA concentrations during maturation affects the gene expression and phenotype of the subsequent embryo, notably prompting a disrupted oxidative metabolism.

Appropriate use of carbapenems in the Besançon university hospital.

Introduction: The excessive and inappropriate use of carbapenems is responsible for the development of resistance. The scientific community has been requiring caution and using these agents in specific cases only.

Objectives: The authors had for aim to evaluate the appropriate use of carbapenems in a French university hospital.