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1.
Eduarda Barreira André Novo Josiana A. Vaz Ana M.G. Pereira 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2018,50(10):590-610
Objectives
Evaluate the effectiveness of the implementation of independently or combined dietary and physical activity programs on the blood glucose values and lipid profile in patients with type 2 diabetes, including participants aged 60 years and over.Design
Systematic review.Data source
PubMed/Medline database, with language restrictions. Papers published between 2010 and 2016 were included.Study selection
A total of 30 randomised controlled trials were included that focused on physical activity and dietary interventions in patients with type 2 diabetes mellitus and include participants aged 60 years and over.Results
The selected articles have shown that the implementation of physical activity programs (aerobic, resistance, flexibility and combined exercises), and programs based on a higher intake of vegetables, grains, legumes, fruits, unsaturated fatty acids, as well as consumption of foods with low glycaemic index, calorie restriction, intake of probiotics, vitamin D supplementation and educational sessions about diabetes improves blood glucose levels, as well as the lipid profile, in patients with type 2 diabetes.Conclusions
Physical activity and dietary programs are fundamental in the treatment and metabolic control of type 2 diabetes mellitus. 相似文献2.
Alba Llop-Gironés Montse Vergara-Duarte Josep Anton Sánchez Gemma Tarafa Joan Benach 《Gaceta sanitaria / S.E.S.P.A.S》2018,32(4):369-372
Objective
To measure time trends in major day surgery rates according to hospital ownership and other hospital characteristics among the providers of the public healthcare network of Catalonia, Spain.Method
Data from the Statistics of Health Establishments providing Inpatient Care. A generalized linear mixed model with Gaussian response and random intercept and random slopes.Results
The greatest growth in the rate of major day surgery was observed among private for-profit hospitals: 42.9 (SD: 22.5) in 2009 versus 2.7 (SD: 6.7) in 1996. These hospitals exhibited a significant increase in major day surgery compared to public hospitals (coefficient 2; p-value <0.01)Conclusions
The comparative evaluation of hospital performance is a decisive tool to ensure that public resources are used as rationally and efficiently as possible. 相似文献3.
A. Grateau M. Le Maréchal H. Labussière-Wallet S. Ducastelle-Leprêtre F.-E. Nicolini X. Thomas S. Morisset M. Michallet F. Ader 《Médecine et maladies infectieuses》2018,48(3):202-206
Objectives
To study the management of chronic disseminated candidiasis (CDC) in patients presenting with acute leukemia.Patients and methods
Single-center retrospective study of acute leukemia patients (2006–2015) to investigate three aspects of CDC: its impact on the time interval between diagnosis and hematopoietic stem cell transplantation, when required (non-parametric Wilcoxon-Mann-Whitney test); its impact on overall survival (Cox proportional hazard regression model); antifungal therapeutic strategies implemented.Results
A total of 639 patients presenting with acute leukemia were included; 144 were transplanted and 29 developed CDC. CDC did not significantly increase the time interval between diagnosis and transplantation, nor did it impact the overall survival of recipients. An improved overall survival was observed in non-transplanted acute leukemia patients presenting with CDC.Conclusion
CDC should not postpone transplantation if antifungal treatment is optimized. 相似文献4.
Objectives
Although regularly looked for in blood donors, HTLV infections are very rare in Reunion. We aimed to describe HTLV infections locally.Patients and methods
HTLV infections were identified from the database of the Reunion University Hospital administrative database (PMSI) between 2000 and 2016. Diagnosis was performed with HTLV 1/2 enzyme immunoassay test and confirmed by Western blot.Results
We reported three asymptomatic and four symptomatic HTLV infections, including two tropical spastic paraparesis/HTLV-1 associated myelopathies (TSP/HAM) and two adult T-cell leukemia/lymphoma (ATLL), diagnosed between 2000 and 2016.Conclusion
Reunion is a low HTLV prevalence area, which could be explained by its settlement history. The present report underlines the local circulation of HTLV and symptomatic infections. 相似文献5.
D. Vandroux N. Allou J. Jabot G. Li Pat Yuen E. Brottet B. Roquebert O. Martinet 《Médecine et maladies infectieuses》2018,48(2):141-144
Background
Coronavirus OC43 infection causes severe pneumonia in patients presenting with comorbidities, but clinical signs alone do not allow for viral identification.Objectives
To analyze acute manifestations of Coronavirus OC43 infections and outcomes of patients admitted to an intensive care unit (ICU).Patients and methods
Retrospective and monocentric study performed during a Coronavirus OC43 outbreak. We used multiplex PCR to detect an OC43 outbreak in Reunion Island during the 2016 Southern Hemisphere's winter: seven admissions to the ICU.Results
Mean age of patients was 71 [67;76] years, SAPS II was 42 [28;53], pneumonia severity index 159 [139;182] vs 73 [40.5;107] for patients in medical wards, and 43% required mechanical ventilation. Comorbidities were diabetes mellitus (87%), chronic respiratory failure (57%), and chronic renal failure (29%). One patient died from Haemophilus influenzae co-infection.Conclusion
As for MERS Co-V infections, underlying comorbidities impacted the clinical outcomes of OC43 infections. 相似文献6.
A. Bouaziz I. Uçkay S. Lustig A. Boibieux D. Lew P. Hoffmeyer P. Neyret C. Chidiac T. Ferry 《Médecine et maladies infectieuses》2018,48(3):207-211
Objective
The long-term impact of treatment strategies proposed by the IDSA guidelines for patients presenting with methicillin-susceptible S. aureus (MSSA) prosthetic joint infection (PJI) is not well-known.Patients and methods
Retrospective (2000–2010) cohort study including patients presenting with MSSA hip or knee PJI. A univariate Cox analysis was performed to determine if the non-compliance with IDSA surgical guidelines was a risk factor for treatment failure.Results
Eighty-nine patients with a mean follow-up of 2.8 years were included. Non-compliance with IDSA surgical guidelines was associated with treatment failure (hazard ratio 2.157; 95% CI [1.022–4.7]). The American Society of Anesthesiologists score, inadequate antimicrobial therapy, and a rifampicin-based regimen did not significantly influence patient outcome.Conclusion
Based on the IDSA guidelines, if a patient presenting with MSSA PJI is not eligible for implant retention, complete implant removal is needed to limit treatment failure. 相似文献7.
N. Masdoua L. Boublenza H. Hassaine J. Ngou A. Nahet M. Segondy F. Razik D. Regagba N. Sadouki D. Mouhammedi 《Médecine et maladies infectieuses》2017,47(1):38-41
Objectives
We aimed to characterize HPV infections and cervical lesions in Western Algeria.Patients and methods
A total of 96 cervical samples obtained from women at risk of HPV infection (HIV-1-infected or presenting with a gynecological disease) were analyzed to characterize this infection and search for cytological abnormalities.Results
A total of 60% of women at risk had an HPV infection. The rate of high-risk HPV (HR-HPV) infection among these women was 84.5% and that of intraepithelial lesions was 29.3%. The frequency of HPV infection was significantly higher among HIV-1-infected patients. An association between the presence of HR-HPV and the polygamy of the partner was observed. An association between cytological abnormalities and the use of oral contraceptives was observed among HIV-1-infected women.Conclusion
Given the high frequency of HPV infection in this at risk population, close monitoring and regular gynecological screening are essential. 相似文献8.
H. Coignard-Biehler C. Rapp J.M. Chapplain B. Hoen D. Che P. Berthelot F. Cazenave-Roblot C. Rabaud P. Brouqui C. Leport 《Médecine et maladies infectieuses》2018,48(2):95-102
Context
In 2012, the French Infectious Diseases Society (French acronym SPILF) initiated the “Coordination of epidemic and biological risk” (SPILF-COREB - Emergences [SCE]) group to support the readiness and response of healthcare workers (HCWs) to new alerts.Objective
To present the SCE group, its functioning, and the main support it provided for frontline HCWs.Methods
A multidisciplinary group of heads of infectious disease departments from reference hospitals was created to build a network of clinical expertise for care, training, and research in the field of epidemic and biological risk (EBR). The network developed a set of standardized operational procedures (SOPs) to guide interventions to manage EBR-suspect patients.Results
A working group created the SOP aimed at frontline HCWs taking care of patients. Priority was given to the development of a generic procedure, which was then adapted according to the current alert. Five key steps were identified and hierarchized: detecting, protecting, caring for, alerting, and referring the EBR patient. The interaction between clinicians and those responsible for the protection of the community was crucial. The SOPs validated by the SPILF and its affiliates were disseminated to a wide range of key stakeholders through various media including workshops and the SPILF's website.Conclusion
SPILF can easily adapt and timely mobilize the EBR expertise in case of an alert. The present work suggests that sharing and discussing this experience, initiated at the European level, can generate a new collective expertise and needs to be further developed and strengthened. 相似文献9.
María Julia Ajejas Bazán María Isab Jiménez Trujillo Julia Wärnberg Silvia Domínguez Fernández Ana López de Andrés Napoleón Pérez Farinós 《Gaceta sanitaria / S.E.S.P.A.S》2018,32(5):477-480
Objective
To examine relevant differences in the prevalence of overweight and obesity in children aged 2-15 years according to different sets of criteria (Orbegozo Foundation, International Obesity Task Force and World Health Organization), and how their use affects the trends in obesity recorded for both sexes between 1995 and 2011 in Spain.Method
Cross-sectional study, a population between 2 and 15 years. Three diagnosis criteria of overweight and obesity were be used.Results
The boys according to the three criteria, showed higher values of overweight and obesity compared to the girls. The lowest levels of overweight and obesity were observed using the Orbegozo tables.Discussion
The prevalence of overweight and obesity varies significantly according to the criteria used to define overweight and obesity. The percentiles of the Foundation Orbegozo gave the lowest estimates and the standards of growth of the World Health Organization were higher. 相似文献10.
Anne Maitre Pascal Petit Marie Marques Claire Hervé Sarah Montlevier Renaud Persoons Dominique J. Bicout 《International journal of hygiene and environmental health》2018,221(2):334-346
Background
Millions of workers are exposed to polycyclic aromatic hydrocarbons (PAHs), a well-known family of carcinogens, but occupational exposure data about PAH mixture compositions are scarce.Objectives
To provide a detailed picture of airborne PAH exposures encountered in the French industrial landscape over the previous 20 years and to identify determinants driving exposures.Methods
Results from 1643 airborne samples of 16 gaseous and particulate PAHs implemented into the Exporisq HAP database from 1995 to 2014 were used to describe exposure levels and aerosol chemical composition in many industries and activities. Compliance of benzo[a]pyrene (BaP) levels with several existing occupational exposure limits for long-term exposure was assessed.Results
BaP levels were lower than those reported in the literature, but the level and composition of PAH mixtures were highly variable between and within industries. Numerous exposure determinants (e.g., product composition, type and temperature of process, ventilation and confinement) were assumed to explain these differences. The highest levels were found in industries using products derived from coal (aluminum, silicon, and coke production, manufacturing of carbon products and foundries), with mean BaP levels up to 23 times higher than the French recommended value of 150?ng/m3. Forty-seven percent of the occupational activities exceeded this value. Conversely, exposures resulting from petroleum-derived products were relatively low.Conclusions
As health effects depend on PAH levels but also on the composition of the mixture, exposure assessments must characterize the entire mixtures and record specific determinants to define homogeneous exposure groups and to accurately assess health risks. 相似文献11.
C. Vandererven A.-P. Bellanger J.-F. Faucher P. Marguet 《Médecine et maladies infectieuses》2017,47(4):261-265
Introduction
Tick bites, which may lead to Lyme disease, often prompt patients to consult their primary care physicians (PCPs). The aim of the present study was to assess how and how often PCPs in the Franche-Comté region of France manage tick bites.Material and methods
Standardized questionnaires were sent to a random sample of 400 PCPs in the Franche-Comté region, requesting their voluntary and anonymous participation. The questionnaires collected socio-demographic details and practice-related information about tick-bite prophylaxis, Lyme serology, and tick-borne encephalitis vaccination.Results
The crude response rate was 54.5% of the PCPs contacted. Tick-bite prophylaxis was prescribed as per current guidelines. However, Lyme serology seemed to be largely overprescribed for tick bites and in case of erythema migrans. A clear lack of knowledge about tick-borne encephalitis vaccination was also observed.Discussion
PCPs provide the first line of care for patients presenting with tick bites. This study showed that although PCPs of the Franche-Comté region manage tick bites as per current guidelines, they need further training on Lyme serology limitations and availability of tick-borne encephalitis vaccination. 相似文献12.
Xavier Continente Anna Pérez Albert Espelt Carles Ariza María José López 《Gaceta sanitaria / S.E.S.P.A.S》2017,31(4):332-335
Objective
We aimed to analyse the prevalence of having multiple lifestyle risk behaviours (LRB) and the potential relationship between excess weight (including overweight and obesity) and cumulative multiple LRB among adolescents in Barcelona, Spain.Methods
A cross-sectional study was performed among a representative sample of 3,114 secondary school students in Barcelona. Height and weight were objectively measured and excess weight was defined in accordance with World Health Organization criteria. Information on screen time, breakfast, physical activity and sleep duration was obtained through a self-administered questionnaire.Results
More than 80% of the students had at least two LRBs. In compulsory schooling, the adjusted prevalence ratio (aPR) of excess weight increased with a higher number of reported LRBs (four LRBs: aPR = 1.56; 95% confidence interval: 1.19-2.05).Conclusions
These results highlight the importance of a multiple-behaviour approach in preventive programmes aimed at reducing adolescent obesity. 相似文献13.
R. Spiga F. Subtil F. Grattard P. Fascia C. Mariat C. Auboyer F. Lucht B. Pozzetto P. Berthelot 《Médecine et maladies infectieuses》2018,48(2):136-140
Objective
To estimate the benefits of iterative prevalence surveys in detecting trends of hospital-acquired infections (HAIs).Methods
On the basis of the French protocol for national prevalence studies, HAI data of 15 consecutive annual surveys performed at the same period by the same group of investigators was gathered in a single database to describe the trend of HAIs in a University Hospital over a 15-year period.Results
A total of 20,401 patients were included. Overall, the prevalence of patients presenting with at least one HAI acquired in our University Hospital was 5.1% [95% CI, 4.8–5.4%]. The prevalence of HAIs and antimicrobial drug use significantly decreased over time (P < 0.01).Conclusion
Despite limitations, repeated prevalence surveys can be a useful tool for promoting control measures to better prevent HAIs. 相似文献14.
15.
E. Thomas A. Bertolotti A. Barreau J. Klisnick P. Tournebize G. Borgherini N. Zemali J. Jaubert G. Jouvion S. Bretagne S. Picot 《Médecine et maladies infectieuses》2018,48(4):278-285
Objective
Infections caused by dematiaceous fungi are more common in tropical and subtropical areas. We aimed to describe the clinical, microbiological and therapeutic aspects of case patients diagnosed at a University Hospital located on an Indian Ocean island.Patients and methods
We performed an observational retrospective study of infections caused by dematiaceous fungi diagnosed at the University Hospital of Saint-Pierre, Reunion, from 2000 to 2015. Mycological identifications were performed at the National Reference Center for Invasive Mycosis and Antifungal Agents (Paris).Results
The review of clinical and microbiological data of 11 patients identified revealed that five were infected by dematiaceous fungi. Two had cutaneous phaeohyphomycosis, two had cerebral phaeohyphomycosis and one had cutaneous chromoblastomycosis with brain and potentially medullary dissemination. Skin lesions and cerebral abscesses were quite varied.Conclusion
Infections caused by dematiaceous fungi are rare. Medullary and brain localizations are extremely rare, especially for chromoblastomycosis. Cutaneous manifestations of phaeohyphomycosis are varied; diagnosis is thus more difficult. It is therefore important, when confronted with a chronic tumor-like lesion in endemic areas, to perform a biopsy for pathology and fungal culture. While surgical excision is not always sufficient, medical treatment of these infections is not standardized, but relies on an azole, which can be associated with another antifungal agent. 相似文献16.
Background
Cervical cancer is a very common malignancy amongst women worldwide. Pap smear is an effective and inexpensive screening test in asymptomatic women. The aim of this paper was to assess the prevalence of Pap smear screening for cervical cancer among Lebanese women and to determine associated sociodemographic and psychosocial characteristics.Methods
This national survey included 2255 women, selected by multi-stage random cluster sampling across Lebanon. A questionnaire about practices and perceptions related to cervical cancer screening was developed based on the “Health Belief Model”.Results
The weighted national prevalence of “ever-use” of the Pap smear for screening purposes was 35%. Most important determinants of screening behavior were: residence within Greater Beirut, higher socio-economic status and educational attainment, marriage status, presence of a health coverage, awareness of Pap smear usefulness, knowing someone who had already done it, and a balance between perceived benefits and perceived barriers to Pap smear screening.Conclusion
Regular information campaigns regarding the availability and effectiveness of the test should be devised, targeting in priority the sexually vulnerable women in Lebanon. Moreover, healthcare providers should be encouraged to discuss with their patients the opportunity of obtaining a Pap smear. 相似文献17.
Objectives
To present a rare neurological complication of dengue fever.Patients and methods
We reported the case of a 17-year-old female who presented with optic neuritis approximately two weeks after dengue fever infection.Results
The ophthalmologic assessment indicated reduced visual acuity of the left eye (1/10). The electrophysiological examination revealed prolonged latencies (130 msec) of the P100 component and reduced amplitudes of visually evoked potentials (VEP) on the left eye. We concluded to a retrobulbar optic neuritis. Laboratory findings revealed positive IgM dengue serology. Treatment with intravenous pulse methylprednisolone and physiotherapy resulted in good clinical outcome.Conclusion
Dengue virus has not often been reported as a cause of optic neuritis. Clinicians must be aware of this to suggest adequate treatment to patients living in or coming from endemic areas. 相似文献18.
Ines Gonzalez-Casanova Aryeh D. Stein Albino Barraza-Villarreal Raquel Garcia Feregrino Ann DiGirolamo Leticia Hernandez-Cadena Juan A. Rivera Isabelle Romieu Usha Ramakrishnan 《International journal of hygiene and environmental health》2018,221(4):616-622
Background
Prenatal exposure to environmental pollutants such as mold, lead, pesticides, tobacco, and air pollutants has been suggested to impair cognitive development. Evidence is needed from longitudinal studies to understand their joint impact on child development across time.Objective
To study associations between exposure to indoor environmental pollutants or outdoor air pollution during pregnancy and offspring cognitive development trajectories through 7 years.Methods
We included 718 Mexican mother-child pairs. Prenatal exposure to indoor environmental pollutants (mold, ventilation, pesticides, tobacco smoke, and use of vidiartred clay pots) was self-reported by the mothers and integrated into an index, or objectively measured in the case of outdoor air pollutants (nitrogen oxides, benzene, toluene, and xylene). Child global cognitive development was measured at 12, 18, 60, or 84 months. Using Latent Class Growth Analysis, we identified three developmental trajectories (positive?=?108, average?=?362, low?=?248). We used multinomial logistic models to test associations between environmental pollutant score (EPS) or outdoor air pollutants, and cognitive development trajectories.Results
After adjustment for sociodemographic covariates, EPS was associated with the average (OR?=?1.26 95%CI?=?1.01, 1.55) and low (OR?=?1.41 95%CI?=?1.11, 1.79) trajectories compared to positive; where a unit increase in EPS means an additional prenatal exposure to a pollutant. There was no association between outdoor air pollutants and cognitive development trajectories.Conclusion
Children of women who reported higher exposure to indoor environmental pollutants during pregnancy were more likely to follow worse developmental trajectories through 7 years. These results support the development and testing of interventions to reduce exposure to environmental pollutants during pregnancy and early childhood as a potential strategy to improve long-term cognitive development. 相似文献19.
E. Laurent G. Gras J. Druon P. Rosset S. Baron A. Le-Louarn E. Rusch L. Bernard L. Grammatico-Guillon 《Médecine et maladies infectieuses》2018,48(4):256-262
Objectives
French reference centers for bone and joint infections (BJI) were implemented from 2009 onwards to improve the management of complex BJIs. This study compared BJI burden before and after the implementation of these reference centers.Patients and methods
BJI hospital stays were selected from the 2008 and 2013 national hospital discharge database using a validated algorithm, adding the new complex BJI code created in 2011. Epidemiology and economic burden were assessed.Results
BJI prevalence increased in 2013 (70 vs. 54/100,000 in 2008). Characteristics of BJI remained similar between 2008 and 2013: septic arthritis (50%), increasing prevalence with age and sex, case fatality 5%, mean length of stay 17.5 days, rehospitalization 20%. However, device-associated BJIs increased (34 vs. 26%) as well as costs (€421 million vs. €259 in 2008). Similar device-associated BJI characteristics between 2008 and 2013 were: septic arthritis (70%), case fatality (3%), but with more hospitalizations in reference centers (34 vs. 30%) and a higher cost per stay. Among the 7% of coded complex BJIs, the mean length of stay was 22.2 days and mean cost was €11,960.Conclusions
BJI prevalence highly increased in France. Complex BJI prevalence assessment is complicated by the absence of clinical consensus and probable undercoding. A validation of clinical case definition of complex BJI is required. 相似文献20.
Marcelo Leiva-Bianchi Felipe Cornejo Andrés Fresno Carolina Rojas Camila Serrano 《Gaceta sanitaria / S.E.S.P.A.S》2018,32(3):291-296