Direct antimicrobial susceptibility testing (AST) from positive blood cultures using Microscan system for early detection of bacterial resistance phenotypes.

Antimicrobial Susceptibility Testing is mandatory for Bloodstream Infections management in order to establish appropriate antimicrobial therapy. Herein we evaluated new approach based on AST results directly from positive blood cultures, using Microscan WA to carry out rapid phenotypical profile of antibiotic resistance. Our investigations allow to reduce time versus traditional results.

Use of pre-ART laboratory screening to identify renal, hepatic and haematological abnormalities in Côte d'Ivoire.

BACKGROUND: High demand for HIV-services and extensive clinical guidelines force health systems in low-resource settings to dedicate resources to service delivery at the expense of other priorities. Simplifying services may reduce the burden on health systems and pre-antiretroviral therapy (ART) laboratory screening is among the services under consideration for simplification. METHODS: We assessed the frequencies of conditions linked to ART toxicities among 34,994 adult, ART-naïve patients with specimens referred to the RETRO-CI laboratory in Abidjan, Côte d'Ivoire between 1998 and 2017. Screening included tests for serum creatinine, alanine aminotransferase (ALT) and haemoglobin (Hb) to identify renal dysfunction (estimated glomerular filtration rate < 50 mL/min), hepatic abnormalities (ALT > 5× upper limit of normal) and severe anaemia (Hb < 6.5 g/dL), respectively. We considered screening results across four eras and identified factors associated with the conditions in question. RESULTS: The prevalence of renal dysfunction, hepatic abnormalities and severe anaemia were largely unchanged over time and just 8.4% of patients had any of the three conditions. Key factors associated with renal dysfunction and severe anaemia were age > 50 years (adjusted odds ratio (aOR): 2.53; 95% confidence interval (CI): 2.19-2.92; P < 0.001) and CD4 < 100 cells/µl (aOR: 2.57; 95% CI: 2.30-2.88; P < 0.001). CONCLUSION: The relative infrequency of conditions linked to toxicity in Côte d'Ivoire supports the notion that simplification of pre-ART laboratory screening may be undertaken with limited negative impact on identification of adverse events. Targeted screening may be a feasible strategy to balance detection of conditions associated with ART toxicities with simplification of services.

CONTEXTE: La forte demande de services VIH et les directives cliniques détaillées obligent les systèmes de santé des pays à faibles ressources à consacrer des ressources à la prestation de services au détriment d'autres priorités. La simplification des services peut réduire la charge pesant sur les systèmes de santé et les analyses de laboratoire avant la thérapie antirétrovirale (ART) fait partie des services envisagés pour la simplification. MÉTHODES: Nous avons évalué la fréquence des conditions liées aux toxicités dues à l'ART chez 34.994 patients adultes naïfs pour l'ART avec des échantillons référés au laboratoire RETRO-CI à Abidjan, en Côte d'Ivoire entre 1998 et 2017. Les analyses comprenaient les tests de créatinine sérique, d'alanine aminotransférase (ALT) et d'hémoglobine (Hb) pour identifier respectivement la dysfonction rénale (débit de filtration glomérulaire estimé <50 mL/min), les anomalies hépatiques (ALT >5x la limite supérieure normale) et l'anémie sévère (Hb <6,5 g/dL). Nous avons examiné les résultats des analyses sur quatre époques et identifié les conditions associées aux conditions en question. RÉSULTATS: La prévalence de la dysfonction rénale, des anomalies hépatiques et de l'anémie sévère est restée largement inchangée au fil du temps et seulement 8,4% des patients présentaient l'une des trois conditions. Les facteurs clés associés à la dysfonction rénale et à l'anémie sévère étaient l'âge >50 ans (odds ratio ajusté (aOR): 2,53; intervalle de confiance (IC) à 95%: 2,19 à 2,92; p <0,001) et les CD4 <100 cellules/µl (aOR: 2,57; IC95%: 2,30 à 2,88; P < 0,001). CONCLUSION: La relativement faible fréquence des conditions liées à la toxicité en Côte d'Ivoire soutient la notion selon laquelle une simplification des analyses de laboratoire pré-ART peut être entreprise avec un impact négatif limité sur l'identification des événements adverses. Le ciblage des analyses peut être une stratégie réalisable pour aligner la détection des conditions associées aux toxicités ART à la simplification des services.

Elevated hepcidin at HIV diagnosis is associated with incident tuberculosis in a retrospective cohort study.

Hepcidin inhibits ferroportin-mediated iron efflux, leading to intracellular macrophage iron retention, possibly favoring Mycobacterium tuberculosis iron acquisition and tuberculosis (TB) pathogenesis. Plasma hepcidin was measured at human immunodeficiency virus (HIV) diagnosis in a retrospective HIV-prevalent, antiretroviral-naïve African cohort to investigate the association with incident pulmonary and/or extra-pulmonary TB. One hundred ninety-six participants were followed between 5 August 1992 and 1 June 2002, with 32 incident TB cases identified. Greater hepcidin was associated with significantly increased likelihood of TB after a median time to TB of 6 months. Elucidation of iron-related causal mechanisms and time-sensitive biomarkers that identify individual changes in TB risk are needed.

[Resistance of the the coraco-clavicular ligaments to traction: clinical application]. / Etude de la résistance à la traction des ligaments coraco-claviculaires: applications cliniques.

One method for treating chronic incapacitating acromioclavicular dislocation is to resect the external extremity of the clavicle and to stabilise the stump by ligamentoplastic procedures, using the coracoclavicular ligament. The purpose of this work was to evaluate the mechanical quality of the ligamentoplastic approach. Twelve fresh cadavers, average age 80 years, were studied. The samples taken were 24 coracoclavicular ligaments, 24 coraco-acromial ligaments, 9 tendons from the palmaris longus muscle and 9 iliotibial tracts. The ligaments removed were tested in a Instron traction machine at a speed of 10 cm/mn. The mechanical properties of the coracoclavicular and coraco-acromial ligaments were studied. For comparison, those of the tendon of the palmaris longus muscle and the iliotibial tract were also studied. The results show the pre-rupture resistance of the coraco-acromial ligament to be 50% lower than that of the trapezoid and conoid parts of the coracoclavicular ligaments taken together. These results suggest the validity of ligamentoplastic treatment using the coraco-acromial ligament, but that reinforcement, using a tendon from the palmaris longus muscle or a piece of the iliotibial tract, may also be necessary, especially for subjects taking part in sports or with well-developed musculature.

[Analysis of restraint of the femur head. Experimental study of allograft of cold bone and autoclaved bone to kill the HIV virus]. / Analyse des contraintes de l'extrémité supérieure du fémur. Etude expérimentale allogreffes os congelés - os autoclaves en vue de la destruction du virus H.I.V.

The retrovirus S.I.A.D. grown in marrow bone and iatrogenic infections may be possible after bone graft in following total hip arthroplasties. Previous investigators proposed several methods to kill the virus, but without bacteriological safety. They found 20 to 55% of loss on mechanical properties. The present study reports the response of autoclaved femoral heads compression testing on material machine Model 1026 Instron. The stress response of marrow bone to stains showed a classic peak and with linear regression study we saw a relationship between autoclaved bone and cold bone. The cortical bone resists to strains highly 12% of load.

Deletion polymorphism in the gene for angiotensin converting enzyme is associated with elevated fasting blood glucose levels.

The frequency and distribution of angiotensin converting enzyme insertion/deletion (ACE I/D) polymorphism, and its association with other known risk factors for coronary atherosclerosis, has been studied, in a normal south Italian population. Subjects homozygous for deletion showed elevated fasting blood glucose levels when compared with subjects homozygous for insertion. The difference was consistent with an increased number of type 2 diabetics among the former group of subjects.