Role of high-risk antibiotic use in incidence of health-care-associated Clostridioides difficile infection in Quebec, Canada: a population-level ecological study.

Background: The incidence of health-care-associated Clostridioides difficile infections has been declining in the Canadian province of Quebec since 2015. We examined whether changes in high-risk antibiotic use could account for this decrease, as reported in other jurisdictions.

Methods: We did a retrospective interrupted time-series analysis of 12 hospitals in the Canadian province of Quebec, representing a quarter of all health-care-associated C difficile infections in this region between April 1, 2012, and March 31, 2017.

Occurrence and severity of cocaine-induced hallucinations: Two distinct phenotypes with shared clinical factors but specific genetic risk factors.

Unlabelled: Cocaine-induced transient hallucinations (CIH) are a frequent complication following cocaine intake that is associated with addiction severity.

Methods: Two hundred and forty-two non-psychotic and Caucasian lifetime cocaine users were included in a French multicentric study. Clinical variables and dopamine pathway genotype data were extracted and tested with CIH scores using a zero-inflated binomial model, which allows for the exploration of factors associated with occurrence and severity separately.

Increased Community-Associated Clostridioides difficile Infections in Quebec, Canada, 2008-2015.

The annual incidence rate of community-associated Clostridioides difficile infections in Quebec, Canada, has increased by 33.3%, from 0.51 (2008) to 0.

Changes in vascular accesses and in incidence rates of dialysis-related bloodstream infections in Québec, Canada, 2011-2017.

Objective: Surveillance of dialysis-related bloodstream infections (DRBSIs) has been mandatory in Québec since April 2011. The aim of this study was to describe the epidemiology of DRBSIs in Québec.

Methods: Cohort study of prevalent patients undergoing chronic dialysis in the 36 facilities that participated without interruption in the provincial surveillance, between April 2011 and March 2017.

Healthcare-associated bloodstream infection trends under a provincial surveillance program.

Objective: BACTOT, Quebec's healthcare-associated bloodstream infection (HABSI) surveillance program has been operating since 2007. In this study, we evaluated the changes in HABSI rates across 10 years of BACTOT surveillance under a Bayesian framework.

Design: A retrospective, cohort study of eligible hospitals having participated in BACTOT for at least 3 years, regardless of their entry date.

[Gambling and money games disorder].

Gambling and money games disorder. Pathological gambling was recently re-categorized, in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), into the group of substance-related and addictive disorders and renamed « gambling disorder ». This change confirms the conceptualization of gambling disorder as an addiction.

A ten-year review of healthcare-associated bloodstream infections from forty hospitals in Québec, Canada.

Objective: Healthcare-associated bloodstream infections (HABSI) are a significant cause of morbidity and mortality worldwide. In Québec, Canada, HABSI arising from acute-care hospitals have been monitored since April 2007 through the Surveillance des bactériémies nosocomiales panhospitalières (BACTOT) program, but this is the first detailed description of HABSI epidemiology.

Methods: This retrospective, descriptive study was conducted using BACTOT surveillance data from hospitals that participated continuously between April 1, 2007, and March 31, 2017.

Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Bloodstream Infections in Québec: Impact of Guidelines.

OBJECTIVE We examined the impact of methicillin-resistant Staphylococcus aureus (MRSA) guidelines in Québec adult hospitals from January 1, 2006, to March 31, 2015, by examining the incidence rate reduction (IRR) in healthcare-associated MRSA bloodstream infections (HA-MRSA), using central-line associated bloodstream infections (CLABSIs) as a comparator. METHODS In this study, we utilized a quasi-experimental design with Poisson segmented regression to model HA-MRSA and CLABSI incidence for successive 4-week surveillance segments, stratified by teaching status. We used 3 distinct periods with 2 break points (April 1, 2007, and January 3, 2010) corresponding to major MRSA guideline publications and updates.

[Sleep disorders in Internet addiction].

Background: The relationship between sleep disorders and Internet addiction has been little work. Given the importance of these disorders, we felt it appropriate to make a synthesis of available data and to establish causality or accountability between Internet addiction and the onset of sleep disorders.

Methods: A literature review was then performed.

Molecular epidemiology and antimicrobial susceptibility profiles of methicillin-resistant Staphylococcus aureus blood culture isolates: results of the Quebec Provincial Surveillance Programme.

The objectives of this study were to characterize methicillin-resistant Staphylococcus aureus (MRSA) blood culture isolates and to determine their relative importance in both nosocomial and community-acquired infections. A total of 535 MRSA blood culture isolates were analysed. In vitro susceptibility to 14 agents was determined.

Human parainfluenza type 4 infections, Canada.

During the fall/winter season of 2004–05, we found 9 respiratory specimens positive for human parainfluenza virus type 4 (HPIV-4) in our laboratory (43% of all HPIVs) from patients with mild to moderate respiratory illnesses. Sequencing studies identified 8 different HPIV-4A strains and 1 HPIV-4B strain.

Virological features and clinical manifestations associated with human metapneumovirus: a new paramyxovirus responsible for acute respiratory-tract infections in all age groups.

The virological features and clinical findings associated with the new human metapneumovirus (HMPV) were examined retrospectively in Canadian patients hospitalized for various respiratory conditions since 1993. Thirty-eight previously unidentified respiratory viruses isolated from rhesus monkey kindey (LLC-MK2) cells were found to be positive for HMPV by reverse-transcription polymerase chain reaction, and those strains clustered in 2 phylogenetic groups. Children aged <5 years and elderly subjects aged >65 years represented 35.

Childhood trauma and personality disorder in 43 women with panic disorder.

Among 43 women with panic disorder (38 with agoraphobia), 23 reported histories of childhood sexual abuse associated with high incidence of other early adverse experiences. The finding that subjects reporting childhood sexual and physical abuse were more likely to receive an Axis II diagnosis than those who did not confirms prior work.

MMPI indices of childhood trauma among 110 female outpatients.

This study investigated MMPI characteristics of adult female outpatients in a behavior therapy clinic (N = 110). Those reporting histories of childhood sexual or physical abuse or both differed from those who did not on global Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1943) indices of psychopathology and on Scales F, K, L, 4, 7, and 8. Subjects reporting abuse also reported high rates of other early traumas: witnessing family violence, parental alcohol abuse, and parental divorce.

The Psychological Maltreatment Inventory: development of a measure of psychological maltreatment in childhood for use in adult clinical settings.

Development of a 25-item Psychological Maltreatment Inventory, based on five categories of psychological maltreatment found in the literature on child development, is described. Two major factors emerged from a factor analytic study of the responses of 118 clinical outpatients. Reported childhood experiences of Emotional Neglect and Hostile Rejection were related to several measures of psychological dysfunction among adult outpatients.

[Complications and contraindications of corticotherapy].

In a review of the classical complications of corticotherapy the aouthors tried, in the light of the literature, to take into consideration the ideas received as compared with the numerical conclusions of statistical studies on large series. Then they presented the patient treated with corticoids, faced with the surgical intervention. They tried to demonstrate that adrenal insufficiency, if present, is only exceptional and that all of the incidents, observed during and immediately after surgery must not be attributed to it.

[Infectious problems in reoperations in abdominal surgery. Apropos of 104 operations].

Analysis of the problems with infection in a series of 104 reinterventions, enables one to accentuate the importance of infestation from intraperitoneal foci (70 p. 100 of the cases). Extra-peritoneal entry pathways are difficult to prove.

[Preparation of the patient for reoperation].

The preparation of patients for reintervention should aim at the correction of: - states of shock and collapse, found in one out of three patients; - hydroelectrolytic disturbances (sodium depletion, hypochloremia, dyskaliemia); - and finally, re-establishment of the acid-base balance.

[Evaluation of 1200 venous catheterizations in reanimation].

The authors present a series of 1247 venous catheterizations during resuscitation, the latter being carried out under particularly strict aseptic conditions. This series contains especially: - 364 internal jugular catheterizations; - 223 subclavian catheterizations; - 130 femoral catheterizations. The total number of days of infusion is 6300, of which 3,619 were of prolonged parenteral feeding.

[General anesthesia for electroshock therapy].

Those are a few reflexions to be pondered by psychiatrists, to remind them what are the dangers connected with anesthesia for electroshock-therapy. Some of those risks are well-known: inhalation of gastric liquids, recess in ventilation. Others are somehow more obscure: hyperkalemia, extended curarization after injection of succinylcholine.

[Antidepressives and anesthesia].

Anesthesia and anti-depressors have a bad name: is their reputation justified? In the opinion of the Anesthesiologist, it is justified in a large part concerning the IMAO, because there is no absolutely secure solution in large scale surgery. On the other hand, the value of accidents must be reset in its proper place. Only the hypertensive increase is very worrying, not so the drop in tension, and it is often the therapeutical gesture which induces the catastrophe.