Cholesterol and other cardiovascular risk factors in a working population in Ile-De-France (France): First results of the PCV-METRA study

In 1989, the French PCV-METRA Group (PCV-METRA = Prévention Cardio-Vasculaire en Médecine du Travail) started a large prospective survey of cardiovascular (CDV) morbidity and mortality and of CVD risk factors, especially cholesterol, in a working population in Ile-de-France, a region including Paris. This report presents the first results of this study, based on a sample of 5758 men and 2603 women, aged 18–65 years. The variables examined included the levels of total cholesterol (TC), High-density-lipooprotein cholesterol (HDL-C), low-density-lipoprotein cholesterol (LDL-C), and the other major CVD risk factors (smoking, sedentary way of life, hypertension, hypercholesterolemia, use of oral contraceptives and familial history of CVD risks). TC and LDL-C significantly increased with age. The changes with age were significantly different in men and women. The levels were similar in both sexes at less than 30 yrs, increased sharply for men after age 30 and were significantly higher in men than in women from 30 to 55 yrs. Beyond 55 yrs, no difference was obserbed between the two sexes. In contrast, HDL-C was higher in women at all age ranges. In the total sample, 35% of men and 21% of women were hypercholesterolemic (TC 2.4 g/ L). Our observations fully confirm and refine previous findings in the US and in other European countries. In addition, a substantial set of data on CVD risk factors for the working population in France, especially for female subjects for whom data are scanty, is now available.Corresponding author.     

Individual, household and community factors associated with HIV test refusal in rural Malawi

Objective To investigate individual, household and community factors associated with HIV test refusal in a counselling and testing programme offered at population level in rural Malawi. Methods HIV counselling and testing was offered to individuals aged 18–59 at their homes. Individual variables were collected by interviews and physical examinations. Household variables were determined as part of a previous census. Multivariate models allowing for household and community clustering were used to assess associations between HIV test refusal and explanatory variables. Results Of 2303 eligible adults, 2129 were found and 1443 agreed to HIV testing. Test refusal was less likely by those who were never married [adjusted odds ratio (aOR) 0.50 for men (95% CI 0.32; 0.80) and 0.44 (0.21; 0.91) for women] and by farmers [aOR 0.70 (0.52; 0.96) for men and 0.59 (0.40; 0.87) for women]. A 10% increase in cluster refusal rates increased the odds of refusal by 1.48 (1.32; 1.66) in men and 1.68 (1.32; 2.12) in women. Women counsellors increased the odds of refusal by 1.39 (1.00; 1.92) in men. Predictors of HIV test refusal in women were refusal of the husband as head of household [aOR 15.08 (9.39; 24.21)] and living close to the main road [aOR 6.07 (1.76; 20.98)]. Common reasons for refusal were fear of testing positive, previous HIV test, knowledge of HIV serostatus and the need for more time to think. Conclusion Successful VCT strategies need to encourage couples counselling and should involve participation of men and communities.     

Prevalence of Neutralizing Antibodies to Canine Distemper Virus and Response to Vaccination in Client-Owned Adult Healthy Dogs

Re-vaccinations against canine distemper virus (CDV) are commonly performed in 3-year intervals. The study’s aims were to determine anti-CDV antibodies in healthy adult dogs within 28 days of vaccination against CDV, and to evaluate factors associated with the presence of pre-vaccination antibodies and with the antibody response to vaccination. Ninety-seven dogs, not vaccinated within 1 year before enrollment, were vaccinated with a modified live CDV vaccine. A measurement of the antibodies was performed before vaccination (day 0), on day 7, and 28 after the vaccination by virus neutralization. A response to vaccination was defined as a ≥4-fold titer increase by day 28. Fisher’s exact test was used to determine factors associated with a lack of antibodies and vaccination response. In total, 94.8% of the dogs (92/97; CI 95%: 88.2–98.1) had antibodies (≥10) prior to vaccination. A response to vaccination was not observed in any dog. Five dogs were considered humoral non-responders; these dogs neither had detectable antibodies before, nor developed antibodies after vaccination. Young age (<2 years) was significantly associated with a lack of pre-vaccination antibodies (p = 0.018; OR: 26.825; 95% CI: 1.216–1763.417). In conclusion, necessity of re-vaccination in adult healthy dogs should be debated and regular vaccinations should be replaced by antibody detection.     

顾客让度价值理论在门诊护理工作中的应用

目的 从让度价值角度来认识门诊护理服务，提高门诊护理服务竞争力。方法 明确阐述让度价值理论知识，探讨让度价值理论对门诊护理服务的意义和运用。结论 以顾客让度价值理论认识门诊护理服务，用市场价值观给予新的定位，可以从另一个侧面加深对门诊护理工作的认识，从而以一种全新的管理模式提升门诊护理服务的价值。     

The serological response in dogs inoculated with canine distemper virus vaccine at the acupuncture point governing vessel-14: A randomized controlled trial

The improvement of immunity to vaccination has historically focused on manipulation of antigen presentation rather than the host. Immune modulation by stimulating specific acupuncture points along the Meridian System has been practiced in Traditional Chinese Medicine. The purpose of this study was to quantitatively determine whether acupoint vaccination, in which vaccine is administered at an acupuncture point in dogs, has the potential to enhance the immune response.A randomized controlled trial was conducted to compare the effectiveness of acupoint vaccination versus a conventional method, based on humoral immune response in dogs given Canine Distemper Vaccine (CDV). One hundred client-owned dogs were admitted to the study with following characteristics: (1) passed a routine physical exam, (2) aged between 1 and 10?years old, (3) had no history of chronic disease, and (4) were not on immunomodulating medications. Dogs were randomly assigned to either the Acupuncture group inoculated at the acupoint Governing Vessel (GV)-14, or to the Control group inoculated conventionally at a non-acupuncture site. Mean changes from Day0 to Day14 of the response to CDV vaccination, measured by serum neutralization (SN) titers with log-transformation for reducing outlier effects, were compared between groups. No significant difference was found between groups in age, weight, or sex (all p?>0.2). Both groups had significant increases of CDV SN titer post-vaccination (p?<?0.001). The mean increase in Acupuncture group (0.72; SD?=?0.79) was significantly greater than that of the Control group (0.36; SD?=?0.67); p?=?0.019. Inference on percentage of change in raw SN titer data further revealed that the effects in the Acupuncture group was significantly greater than the Control group (242% vs. 83%; p?=?0.02).This study demonstrated that Acupoint vaccination at GV-14 resulted in a significantly elevated humoral immune response to CDV vaccine compared to Controls, which suggests the potential of acupoint vaccination to enhance the immune response.     

Correlates of HIV testing among women in Malawi: results from the 2006 Multiple Indicator Cluster Survey

We report a study of women 15-49 years aimed at assessing correlates of HIV testing and having received test results in a nationally representative survey of women in Malawi. A total of 26 259 women were recruited into the study, of whom 3712 (14.1%) had ever been tested for HIV infection and received their results. We found that age and education were not significantly associated with HIV testing but marital status, wealth, region were. Contrary to our expectations that women who had delivered a child were more likely to have been ever tested when accessing prenatal and intra-partum care, we found that women who had delivered a child in the 2 years before the survey were less likely to have ever been tested. We suggest that by 2006 when the survey was conducted, prenatal and intra-partum care were not important avenues for HIV testing in Malawi.     

Early inhibitors of human cytomegalovirus: state-of-art and therapeutic perspectives

Human cytomegalovirus (HCMV) infection is associated with severe morbidity and mortality in immunocompromised individuals, mainly transplant recipients and AIDS patients, and is the most frequent cause of congenital malformations in newborn children. To date, few drugs are licensed for the treatment of HCMV infections, most of which target the viral DNA polymerase and suffer from many drawbacks, including long-term toxicity, low potency, and poor bioavailability. In addition, the emergence of drug-resistant viral strains is becoming an increasing problem for disease management. Finally, none of the current anti-HCMV drugs have been approved for the treatment of congenital infections. For all these reasons, there is still a strong need for new anti-HCMV drugs with novel mechanisms of action. The first events of the virus replication cycle, including attachment, entry, immediate-early gene expression, and immediate-early functions—in particular that of Immediate-Early 2 protein—represent attractive targets for the development of novel antiviral compounds. Such inhibitors would block not only the expression of viral immediate-early proteins, which play a key role in the pathogenesis of HCMV infection, but also the host immunomodulation and the changes to cell physiology induced by the first events of virus infection. This review describes the current knowledge on the initial phases of HCMV replication, their validation as potential novel antiviral targets, and the development of compounds that block such processes.     

Antiviral Screen against Canine Distemper Virus-Induced Membrane Fusion Activity

Canine distemper virus (CDV), a close relative of the human pathogen measles virus (MeV), is an enveloped, negative sense RNA virus that belongs to the genus Morbillivirus and causes severe diseases in dogs and other carnivores. Although the vaccination is available as a preventive measure against the disease, the occasional vaccination failure highlights the importance of therapeutic alternatives such as antivirals against CDV. The morbilliviral cell entry system relies on two interacting envelope glycoproteins: the attachment (H) and fusion (F) proteins. Here, to potentially discover novel entry inhibitors targeting CDV H, F and/or the cognate receptor: signaling lymphocyte activation molecule (SLAM) proteins, we designed a quantitative cell-based fusion assay that matched high-throughput screening (HTS) settings. By screening two libraries of small molecule compounds, we successfully identified two membrane fusion inhibitors (F2736-3056 and F2261-0043). Although both inhibitors exhibited similarities in structure and potency with the small molecule compound 3G (an AS-48 class morbilliviral F-protein inhibitor), F2736-3056 displayed improved efficacy in blocking fusion activity when a 3G-escape variant was employed. Altogether, we present a cell-based fusion assay that can be utilized not only to discover antiviral agents against CDV but also to dissect the mechanism of morbilliviral-mediated cell-binding and cell-to-cell fusion activity.