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Contrat de performance avec une administration sanitaire provinciale: cas du Nord Kivu en République Démocratique du Congo
No full textClara cell protein in bronchoalveolar lavage fluid: a predictor of ventilator-associated pneumonia?
No full textINTRODUCTION: Clara cell protein 10 (CC-10) has been associated with inflammatory and infectious pulmonary diseases. This study evaluates CC-10 concentrations in bronchoalveolar lavage (BAL) fluid as a potential marker of ventilator-associated pneumonia (VAP). METHODS: Between January 2003 and December 2007, BAL fluid samples obtained from critically ill patients at the intensive care unit of the Maastricht University Medical Centre clinically suspected of having VAP were included. Patients were divided into two groups: (1) microbiologically confirmed VAP (the VAP group) and (2) microbiologically unconfirmed VAP (the non-VAP group). The concentration of CC-10 was measured by means of a commercially available enzyme-linked immunosorbent assay kit, and retrospective analysis was performed. Areas under the curve of receiver operating characteristic curves were calculated for CC-10 concentrations. RESULTS: A total of 196 patients (122 men, 74 women) were included. A total of 79 (40%) of 196 cases of suspected VAP were microbiologically confirmed. The median CC-10 concentration in the VAP group was 3,019 ng/mL (range, 282 to 65,546 ng/mL) versus 2,504 ng/mL (range, 62 to 30,240 ng/mL) in the non-VAP group (P = 0.03). There was no significant difference in CC-10 concentrations between patients treated with or without corticosteroids (P = 0.26) or antibiotic therapy (P = 0.9). The CC-10 concentration did not differ significantly between patients with Gram-positive versus Gram-negative bacteria that caused the VAP (P = 0.06). However, CC-10 concentrations did differ significantly between the late-onset VAP group and the non-VAP group. CONCLUSIONS: The CC-10 concentration in BAL fluid yielded low diagnostic accuracy in confirming the presence of VAP
Trichinella referentie methode. Trichinella reference method. Méthode de référence Trichinella [CD-ROM]
No full textAntiretroviral treatment-associated tuberculosis in a prospective cohort of HIV-infected patients starting ART
No full textAge-stratified Bayesian analysis to estimate sensitivity and specificity of four diagnostic tests for the detection of Cryptosporidium spp. oocysts in neonatal calves
No full textThere is no gold standard diagnostic test for the detection of bovine cryptosporidiosis. Infection is usually the highest in two-week-old calves and these calves also excrete high numbers of oocysts. These factors may give rise to variations in the sensitivity and specificity of the various diagnostic tests used to detect infection in calves of varying ages. An age-stratified Bayesian analysis was carried out to determine the optimum diagnostic test to identify asymptomatic and clinical Cryptosporidium spp. infection in neonatal calves. Fecal samples collected from 82 calves at one week, two weeks, three weeks and four weeks of age were subjected to the following tests, microscopic examination of smears stained with either phenol-auramine O or FITC conjugated anti-Cryptosporidium monoclonal antibody, nested-PCR and quantitative real-time PCR. The results confirmed a high prevalence of Cryptosporidium spp. infection as well as a high level of oocysts excretion in two-week-old calves. The sensitivity of all the tests varied with the age of the calves. Quantitative real-time PCR proved to be the most sensitive and specific test for detecting infection irrespective of the age of the calf. The microscopic techniques were the least sensitive and only exhibited moderate efficiency with two-week-old calves excreting large numbers of oocysts and the majority of which were diarrheic. It was concluded that, when interpreting the results of routine tests for bovine cryptosporidiosis, cognisance should be taken of the sensitivity of the tests in relation to the age of the calves and stage of infection
Rhipicephalus (Boophilus) microplus: a most successful invasive tick species in West-Africa
No full textThe cattle tick Rhipicephalus (Boophilus) microplus is known to be a highly reproductive and efficient vector of Babesia bovis, two characters which make this tick a threat to livestock keeping in many continents. The authors identified this tick in Ivory Coast, West Africa, in 2007, and hypothesized the spread to be minimal, as this tick was not observed in previous years. To determine the extent of its distribution and to a lesser extent the possible impact of the tick on the livelihoods of Ivorian smallholders, a cross-sectional survey was carried out in the Abidjan and Agboville Departments of Ivory Coast, in April 2008. The results of the study reveal that the newly introduced tick has almost completely displaced all indigenous Rhipicephalus (Boophilus) species in the study area and gave rise to unsuccessful tick control, inappropriate pesticide use, loss of milk production and even increased mortality in dairy cattle
Essential actions for caterers to promote healthy eating out among European consumers: results from a participatory stakeholder analysis in the HECTOR project
No full textOBJECTIVE: To identify and assess actions by which the catering sector could be engaged in strategies for healthier eating out in Europe. DESIGN: A SWOT analysis was used to assess the participation of the catering sector in actions for healthier eating out. Caterers subsequently shortlisted essential actions to overcome threats and weaknesses the sector may face when engaging in implementing these actions. SETTING: Analysis undertaken in the European Union-supported HECTOR project on 'Eating Out: Habits, Determinants and Recommendations for Consumers and the European Catering Sector'. SUBJECTS: Thirty-eight participants from sixteen European countries reflecting a broad multi-stakeholder panel on eating out in Europe. RESULTS: The catering sector possesses strengths that allow direct involvement in health promotion strategies and could well capitalise on the opportunities offered. A focus on healthy eating may necessitate business re-orientations. The sector was perceived as being relatively weak in terms of its dependency on the supply of ingredients and lack of financial means, technical capacity, know-how and human resources. To foster participation in strategies for healthier eating out, caterers noted that guidelines should be simple, food-based and tailored to local culture. The focus could be on seasonal foods, traditional options and alternative dishes rather than just on 'healthy eating'. Small-to-medium-sized enterprises have specific concerns and needs that should be considered in the implementation of such strategies. CONCLUSIONS: The study highlights a number of possible policy actions that could be instrumental in improving dietary intake in Europe through healthier eating out
Comparison of phenotypic and genotypic tropism determination in triple-class-experienced HIV patients eligible for maraviroc treatment
No full textBackground Determination of HIV-1 tropism is a pre-requisite to the use of CCR5 antagonists. This study evaluated the potential of population genotypic tropism tests (GTTs) in clinical practice, and the correlation with phenotypic tropism tests (PTTs) in patients accessing routine HIV care. Methods Forty-nine consecutive plasma samples for which an original Trofile(TM) assay was performed were obtained from triple-class-experienced patients in need of a therapy change. Viral tropism was defined as the consensus of three or more tropism calls obtained from the combination of two independent population PTT assays (Trofile Biosciences, San Francisco, CA, USA, and Virco, Beerse, Belgium), population GTTs and GTTs based on ultra-deep sequencing. If no consensus was reached, a clonal PTT was performed in order to finalize the tropism call. This two-step approach allowed the definition of a reference tropism call. Results According to the reference tropism result, 35/49 samples were CCR5 tropic (R5) (patients eligible for maraviroc treatment) and 14/49 were assigned as non-R5 tropic. The non-R5 samples [patients not eligible for maraviroc treatment according to the FDA/European Medicines Agency (EMEA) label] group included both the CXCR4 (X4) samples and the dual and mixed CCR5/CXCR4 (R5/X4) samples. Compared with Trofile(TM) population PTTs, population GTTs showed a higher sensitivity (97%) and a higher negative predictive value (91%), but almost equal specificity and an equal positive predictive value. Conclusions In line with recent reports from clinical trial data, our data support the use of population genotypic tropism testing as a tool for tropism determination before the start of maraviroc