Clinical presentation of invasive disease caused by Neisseria meningitidis serogroup Y in Sweden, 1995 to 2012.

Over the period 1995-2012, the incidence of invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup Y (NmY) increased significantly in Sweden. This is mainly due to the emergence of a predominant cluster named strain type YI subtype 1, belonging to the ST-23 clonal complex (cc). The aim of this study was to examine the clinical picture of patients with invasive disease caused by NmY and to analyse whether the predominant cluster exhibits certain clinical characteristics that might explain the increased incidence. In this retrospective observational study, the medical records available from patients with IMD caused by Nm serogroup Y in Sweden between 1995 and 2012 were systematically reviewed. Patient characteristics, in-hospital findings and outcome were studied and differences between the dominating cluster and other isolates were analysed. Medical records from 175 of 191 patients were retrieved. The median age was 62 years. The all-cause mortality within 30 days of admission was 9% (15/175) in the whole material; 4% (2/54) in the cohort with strain type YI subtype 1 and 11% (12/121) among patients with other isolates. Thirty-three per cent of the patients were diagnosed with meningitis, 19% with pneumonia, 10% with arthritis and 35% were found to have bacteraemia but no apparent organ manifestation. This survey included cases with an aggressive clinical course as well as cases with a relatively mild clinical presentation. There was a trend towards lower mortality and less-severe disease in the cohort with strain type YI subtype 1 compared with the group with other isolates.

[Performance and Compatibility of Self Polymerizing Prime and Bond NT Adhesive and the Composite LuxaCore]. / Performances et compatibilite de l'adhesif prime & bond nt auto polymerisable et du composite LuxaCore a traitement dual.

AIM: To evaluate the performance of bond strength and the compatibility of Prime &Bond NT self etching adhesive resins without activator on dentin surface with dual composite resin LuxaCore, and verify the contribution of a coactivator. MATERIAL AND METHODS: twenty-four human teeth without decay, molars or pre-molar are used. The dental crowning is cut with diamond disc mounted on a hand piece; the roof surface is flattened and well humidified. Each tooth is embedded in cold self-etching resin (Plexil Excil). Samples are divided into two groups of 12. in the first group, self-etching Prime &Bond NT resin adhesive without activator is supplied on the flat mesial dentin roots, then dual cure composite resin LuxaCore) is bonded. The second group was subject to the same treatment but with addition of co-activator the Prime &Bond NT self-etching adhesive resin. Debonding was achieved with Universal testing machine and mean shear bond strengths were determined for each test group. The data were subjected to ANOVA (p < 0001). RESULT: Bond strength obtained with self-etching Prime &Bond NT without activator is 10.635 MPa. With addition of activator it is 15.185 MPa CONCLUSION: supplementing with an activator has significantly improved bonding strength.

[Appraisal of snakebite incidence in Senegal, West Africa]. / Evaluation de l'incidence des morsures de serpent au Sénégal.

Surveys were carried out in four savannah areas of Senegal. The studied zones had different climatic, economic and demographic characteristics. Two types of studies were performed: on the one hand, a retrospective survey carried out in health centres and, on the other, household surveys in the corresponding areas; all households were questioned in Niakhar, but only selected households in other areas following WHO method of cluster survey for vaccine coverage. Questions involved the circumstances of the bite, symptoms and treatment. The retrospective survey reported very few cases of snakebites over the prospected period. In addition, two zones of surveys were population study areas under observation since more than 20 years and, it has been possible to check certain information in the data base. In the first zone, Thies, a sub-urban area (population density higher than 150 inhabitants per km2), primarily occupied by fruit plantations (mangos, oranges, lemons) and gardens, the annual incidence of snakebites (i.e. all snakebites including those without any symptoms) reached 43 bites per 100,000 and mortality was 1.8 deaths per 100,000. In the study zone of Niakhar, located in the groundnut culture area of Senegal which is also highly populated (130 inhabitants per km2), the incidence of snakebites was 23 bites per 100,000 and mortality was close to 1.8 deaths per 100,000 a year. The area of Nioro du Rip is a mixed agricultural area (food producing and revenue agriculture) and less populated (100 inhabitants per km2). The annual incidence was roughly of 304 per 100,000 and the mortality 3.6 per 100,000. Finally, the fourth area, Bandafassi in the extreme South-East of Senegal is a mountainous zone exclusively occupied by bush and food producing agriculture, and sparsely populated (20 inhabitants per km2). The incidence was 915 per 100,000 and the mortality 11 deaths per 100,000. The population at risk involved males from 15 to 45 years. Pastoral work (agriculture and breeding) was at the origin of the majority of the accidents. The recourse to traditional practitioners was systematic, which explained why the data from the health centers were not relevant enough to evaluate the importance of the envenoming.