Evaluation of syndromic algorithms for detecting patients with potentially transmissible infectious diseases based on computerised emergency-department data.

BACKGROUND: The objective of this study was to ascertain the performance of syndromic algorithms for the early detection of patients in healthcare facilities who have potentially transmissible infectious diseases, using computerised emergency department (ED) data. METHODS: A retrospective cohort in an 810-bed University of Lyon hospital in France was analysed. Adults who were admitted to the ED and hospitalised between June 1, 2007, and March 31, 2010 were included (N=10895). Different algorithms were built to detect patients with infectious respiratory, cutaneous or gastrointestinal syndromes. The performance parameters of these algorithms were assessed with regard to the capacity of our infection-control team to investigate the detected cases. RESULTS: For respiratory syndromes, the sensitivity of the detection algorithms was 82.70%, and the specificity was 82.37%. For cutaneous syndromes, the sensitivity of the detection algorithms was 78.08%, and the specificity was 95.93%. For gastrointestinal syndromes, the sensitivity of the detection algorithms was 79.41%, and the specificity was 81.97%. CONCLUSIONS: This assessment permitted us to detect patients with potentially transmissible infectious diseases, while striking a reasonable balance between true positives and false positives, for both respiratory and cutaneous syndromes. The algorithms for gastrointestinal syndromes were not specific enough for routine use, because they generated a large number of false positives relative to the number of infected patients. Detection of patients with potentially transmissible infectious diseases will enable us to take precautions to prevent transmission as soon as these patients come in contact with healthcare facilities.

Ability of possible DMS precursors to release DMS during wine aging and in the conditions of heat-alkaline treatment.

The origin of dimethyl sulfide (DMS) produced during wine aging was examined through different assays. The production of DMS during the model aging of a wine and the concomitant decrease of residual potential DMS (PDMS), as DMS released by heat-alkaline treatment in 0.5 M sodium hydroxide at 100 degrees C for 1 h, were demonstrated. Then, dimethyl sulfoxide (DMSO), methionine sulfoxide (MSO), S-methylmethionine (SMM), and dimethylsulfonium propanoic acid (DMSPA), reported previously as possible DMS precursors, were investigated for their ability to be DMS precursors in wine in the conditions of this model aging and of the heat-alkaline treatment. The results showed that DMSO, MSO, and DMSPA could hardly be DMS precursors in the conditions used, whereas SMM appeared to be a good candidate. Finally, the use of [(2)H(6)]-DMSPA as an internal standard for PDMS determination was proposed, because it provided better reproducibility than [(2)H(6)]-DMS used as an external standard.

Contribution of dimethyl sulfide to the aroma of Syrah and Grenache Noir wines and estimation of its potential in grapes of these varieties.

The contribution of dimethyl sulfide (DMS) to the aroma of Syrah and Grenache Noir wines from the Rhone Valley of France was investigated by sensory analysis, and its levels in these wines were measured. The potential DMS in the corresponding grapes and wines, susceptible to release during wine aging, was evaluated. Free DMS and potential DMS assessed by a heat-alkaline treatment were measured in grape juices and wines by SPME-GC-MS using methods previously reported and slightly modified. A relationship between potential DMS from grapes and the total DMS levels in wine was demonstrated. Furthermore, a linear regression between the ratio of free DMS levels to these total DMS levels in wine and time of storage was found. Free and potential DMS levels in grapes and wines depended on grape variety, vintage, and vine location. DMS imparted a noticeable and complex contribution to the aroma of the wines investigated, depending on the mode of sensory perception used, either before or after glass swirling. It significantly enhanced the fruity notes of the wines, and additional truffle and black olive notes.