Circulation of bluetongue virus 8 in French cattle, before and after the re-emergence in 2015.

Bluetongue virus serotype 8 (BTV-8) re-emerged in Central France in August 2015. The viral strain identified is nearly identical to the one that circulated during the 2006/2009 massive outbreak throughout Europe. To address the question of an undetected BTV-8 circulation on the French territory, a serological study was conducted on young cattle along a transect of seven departments, three of them located in areas where the virus presence had been confirmed by RT-PCR by winter 2015/2016. Sera from 2,565 animals were collected during the winters preceding and following the re-emergence, with 414 animals being sampled in each of the two consecutive years. All samples were tested by competitive ELISA (IDVet) and, when enough serum was available, ELISA-positive samples were confirmed by seroneutralization tests. In areas with infected holdings, seropositive animals were found before the re-emergence (N = 14 of 511), significantly more on the following year (N = 17 of 257), and eight animals (N = 158) seroconverted over 2015. Seropositive animals were also detected as early as winter 2014/2015 in one department without known infected holdings (N = 12 of 150), and in winter 2015/2016 in three of them (N = 21 of 555), where seven animals (N = 154) seroconverted over 2015. These results suggest that BTV-8 may have spread at low levels before the re-emergence, even in areas considered virus-free. Unfortunately, whole blood from the seropositive animals was not available to definitely confirm the virus presence by RT-PCR.

Serological status for BTV-8 in French cattle prior to the 2015 re-emergence.

Undetected in Europe since 2010, bluetongue virus serotype 8 (BTV-8) re-emerged in August 2015 in Central France. To gain insight into the re-emergence on the French territory, we estimated the seroprevalence in cattle before the detection of BTV-8 in 2015, in areas differentially affected by the current outbreak. A retrospective survey based on the analysis of stored sera was thus conducted in the winter preceding the re-emergence in seven French departments including the one where the virus was first detected. A total of 10,066 sera were retrieved from animals sampled in 444 different herds in winter 2014/15. Between-herd seroprevalence revealed the presence of seropositive animals in almost all herds sampled (97.4%). The animal-level seroprevalence averaged at 44%, with a strong age pattern reflecting the cumulative exposure to both natural infection and to vaccination. A multivariable analysis allowed separating the respective effects of both exposures. A higher proportion of seropositivity risk was attributed to vaccination (67.4%) than to exposure to natural infection (24.2%). The evolution of seroprevalence induced by the two main risk factors in 74 mainland departments was reconstructed between the vaccination ban (2013) and the re-emergence (2015). We showed a striking decrease in seroprevalence with time after the vaccination ban, due to population renewal, which could have facilitated virus transmission leading to the current outbreak situation.

Risk assessment of slow or no-reflow phenomenon in aortocoronary vein graft percutaneous intervention.

Slow or no-reflow phenomenon (SNR) complicates 10%-15% of cases of percutaneous intervention (PCI) in aortocoronary saphenous vein grafts (SVG). At present, there are no uniform, effective strategies to predict or prevent this common and potentially serious complication. The purpose of our study was to characterize variables correlated with the risk of SNR in SVG PCI in the era of stenting and glycoprotein IIb/IIIa receptor inhibitors. We identified 2,898 consecutive patients who had PCI, of whom 163 underwent PCI of at least one SVG. The clinical and angiographic characteristics of patients who developed SNR (SNR group) were compared with those who did not (no-SNR group). A total of 23 patients experienced SNR and 140 did not. Using a stepwise multivariate logistic regression analysis, four independent predictors for SNR were detected: probable thrombus (OR 6.9; 95% CI, 2.1-23.9; P = 0.001), acute coronary syndromes (OR 6.4; 95% CI, 2.0-25.3; P = 0.003), degenerated vein graft (OR 5.2; 95% CI, 1.7-16.6; P = 0.003), and ulcer (OR 3.4; 95% CI, 0.99-11.6; P = 0.04). The risk of developing SNR could be estimated according to the number of predictors found: low-grade risk (1%-10%) if < or = one variable was present, moderate risk (20%-40%) if two variables were present, and high risk (60%-90%) if three or more variables were present. We identified and quantified current risk factors for SNR and concluded that the risk of developing SNR during PCI in SVG can be predicted by simple clinical and angiographic variables obtained before PCI. This information may be useful when the risk of PCI has to be balanced against alternative strategies such as medical therapy or redo-bypass surgery or in the selection of those patients that will most benefit from the use of protection devices during PCI.

Percutaneous intervention in saphenous venous grafts: in-stent restenosis lesions are safer than de novo lesions.

BACKGROUND: The histological appearance of stenosis in de novo saphenous venous grafts (DNSVG) consists of diffuse atherosclerosis that contains blood elements, necrotic debris and limited fibrocollagenous tissue. The friable nature of these lesions complicates percutaneous intervention (PCI) procedures. On the other hand, in-stent restenosis (ISR) of SVG is due primarily to atherosclerotic plaque or fibromuscular hyperplasia, with thrombus formation playing a secondary role. The purpose of this study is to compare the results of PCI in these two types of SVG lesions. METHODS: We reviewed our institutional interventional database from March 1996 through February 2000 and identified all consecutive patients who underwent PCI of at least one SVG. One hundred and ten patients were identified: 89 undergoing DNSVG intervention and 21 patients with ISR lesions. RESULTS: Acute coronary syndromes, degenerated and thrombus-containing lesions were more common in the DNSVG group. "Slow-, no-reflow" complicated 20% of the DNSVG lesions compared to none of the ISR lesions (p = 0.02). Post-procedural myocardial infarction was higher in the DNSVG group (13.5% versus 0%; p = 0.1) and correlated significantly with the occurrence of "slow-, no-reflow" (r = 0.43; p = 0.0001). Utilizing statistical modeling to adjust for baseline differences between the groups, ISR lesions were associated with a low risk of procedural complications (r = 0.22; p = 0.03). CONCLUSION: This study demonstrates that in this relatively high-risk population, PCI is safer in ISR lesions than in de novo SVG lesions.

[Availability and use of emergency services in Tunisia: principal results of an exhaustive national survey]. / L'offre et l'utilisation des services d'urgence en Tunisie : principaux résultats d'une enquête nationale exhaustive.

In order to assess hospital emergency rooms, a comprehensive national epidemiological investigation was conducted in all 155 public emergency structures in Tunisia. Here we present the main results of the levels of availability and use of emergency services. Coverage of the population by services is adequate (one emergency service per 60,000 people). Emergency wards admit about 2,500,000 patients every year (a quarter of the population of the country). The university hospital emergency services are the most heavily used (150 patients per day on average). Emergency services are sought for medical (60%), surgical (18%), paediatric (14%) and gynaecological reasons (5%). It would be useful to assess the quality of care delivered and the satisfaction of citizens and health workers.

[Availability and use of emergency services in Tunisia: main results of a comprihensive national survey]

In order to assess hospital emergency rooms, a comprehensive national epidemiological investigation was conducted in all 155 public emergency structures in Tunisia. Here we present the main results of the levels of availability and use of emergency services. Coverage of the population by services is adequate [one emergency service per 60,000 people]. Emergency wards admit about 2,500,000 patients every year [a quarter of the population of the country]. The university hospital emergency services are the most heavily used [150 patients per day on average]. Emergency services are sought for medical [60%], surgical [18%], paediatric [14%] and gynaecological reasons [5%]. It would be useful to assess the quality of care delivered and the satisfaction of citizens and health workers

[Comparative study of the immunizing ability of some attenuated strains of sheep pox virus and of a sensitizing vaccine]. / Etude comparative du pouvoir immunisant de quelques souches atténuées de virus de la clavelée et d'un vaccin sensibilisé.

The authors present the results of a study designed to compare the immunogenicity of several attenuated strains of sheep pox virus and a virus/immune serum vaccine. Two of the strains studied present immunogenic characteristics that make them particularly interesting for the manufacture of a vaccine. The first, named Djelfa, confers solid immunity to animals without provoking a vaccinal reaction; the second, known as Romania, can provide protection beyond twenty-four months, but causes persistent vaccinal lesions. In a country like Algeria, these two strains could be used for immunoprophylaxis of sheep pox: the first in those regions in which prevalence is low and sheep are vaccinated on a regular basis, and the second in regions of high prevalence where herds are moved to new pastures each season.

[Epidemiology of sheep pox in Algeria]. / Epidémiologie de la clavelée en Algérie.

Sheep pox constitutes a major animal health problem in Algeria, despite the implementation of various national control campaigns over several decades. On the basis of epidemiological data provided by the Veterinary Services of Algeria from 1984 to 1997, the authors performed a statistical survey to determine possible correlations between factors responsible for the persistence of sheep pox, in particular seasonal and climatic variables. The authors propose an explanation for the variations observed and recommend a control programme which would be more appropriate to the agro-pastoral and bioclimatic conditions of the country.

Serological and virological studies on the infectious bovine rhinotracheitis in Algeria.

Clinical cases of infectious bovine rhinotracheitis and infectious pustular vulvovaginitis were observed within the cattle population in Algeria. The isolation and identification of six bovine herpes virus type 1 strains from diseased cattle and the serological surveys undertaken in the central region of the country on 2948 sera revealed a 20.5% incidence of IBR infections in Algeria. The DNA restriction profiles of the isolated strains showed the existence of only the BHV1-2a subtype associated with the endemic infections in Algerian cattle. These results emphasized also the lack of correlation between the observed clinical symptoms and the DNA restriction pattern of the isolated herpes virus strain. The plans for disease control are based mainly on the application of strict control measures at the borders for avoiding the introduction of other BHV1 subtypes.

[Caprine arthritis-encephalitis in Algeria]. / Arthrite-encéphalite caprine en Algérie.

During an outbreak of caprine arthritis-encephalitis on an experimental farm, the virus responsible for this disease was isolated from imported animals. A serological survey was then carried out with the purpose of determining the prevalence of the disease among other imported herds of goats, local herds and mixed herds. Positive serological results were found at relatively high levels in both imported and mixed herds. All the local herds, however, yielded negative serological results, suggesting that caprine arthritis-encephalitis did not exist in Algeria before the importation of reproductive animals with a high genetic potential.

Echotomographic and serological population-based study of hydatidosis in central Tunisia.

A population-based echotomographic (ECT) and serological survey of hydatidosis was carried out in a high risk community located in Central Tunisia. 1434 subjects over 5 years of age (93.3% of the population in this age range) underwent an abdominal echotomography (ECT) and a serological test (ELISA with confirmation by counterelectrophoresis). The ECT prevalence rate was 3.5% and increased with age reaching 7.7% in the over 39 years age group. Most subjects (96.0%) had liver cyst(s). The serological prevalence rate was 2.9%. A strong agreement was found between ECT and serological results (Kappa test = 0.449). Taking ECT as a reference, the relative specificity and sensitivity of serology were 99.3 and 62.0 respectively. Most ECT positive seronegative subjects had calcified cysts. These results confirm the presence of highly endemic foci of hydatidosis in Central Tunisia, show a good agreement between serological and ECT results at a population level and demonstrate the high feasibility of ECT as a screening technique.

[Long-term outcome of surgically treated peptic ulcer. Review of a series of 419 patients operated for peptic ulcer]. / Le devenir lointain de l'ulcère gastro-duodénal opéré. Réflexions sur une série de 419 ulcéreux opérés.

The authors report an analysis of 419 cases of operated peptic ulcer. 68.78% of patients had a mean follow-up of 4 years. After clinical and endoscopic examination, the results of the survey were assessed on the basis of various parameters, which demonstrated that the results of surgery were related to socio-occupational problems, smoking, the site of the ulcer, the stage, the history of the ulcer prior to the operation, the conditions of the operation and obviously the surgical technique used.

[Hydatic cyst of the psoas muscle. Apropos of 3 cases]. / Le kyste hydatique du muscle psoas. A propos de trois cas.

In the three patients, the localization and the hydatic origin have been determined by preoperative ultrasonography in two instances, the diagnosis was confirmed by CT scan. Ultrasonography and computed tomography allowed a direct and simple surgical approach of the cyst.

Serological screening for hydatidosis in households of surgical cases in central Tunisia.

Household members of surgical cases of hydatidosis were screened for the disease in two high-risk districts in Central Tunisia. Seventy-four index cases were identified from the 1980-1984 surgical records of Sousse University Hospital. Household members over five years of age were tested by ELISA, and if positive by counterelectrophoresis (CEP) for detection of band 5. Positive subjects underwent a chest X-ray and echotomography (ECT). Eight of the 355 household members (2.2%) living in four different houses were serologically positive. All eight had a normal chest X-ray; a hepatic cyst was detected in seven of them. Five of the seven subjects in whom a cyst was diagnosed lived in two neighbouring houses (19 household members from the same family). Among these 19 subjects, six had been previously operated on for hydatidosis (cumulative rate: 11/19). The comparisons of these results with results obtained through community-based screening in the same area suggest that households members of patients are not at particularly high risk of hydatidosis.

[Epidemiology of hydatidosis in Tunisian children and adolescents]. / Epidémiologie de l'hydatidose chez l'enfant et l'adolescent tunisiens.

Analysis of the operative reports of hospitals in the central area of Tunisia allowed to define the epidemiology of echinococcosis in children and adolescents. Four hundred forty-three patients under 20 years of age were operated on between 1980 and 1985. In children less than 10 years of age, boys are more often concerned than girls, whereas prevalence in girls occurs after 10 years of age. Liver involvement is more frequent in girls, whatever their ages. Prevention programs should consider the high frequency in young children.

[Surgical incidence of hydatidosis in the Sahel and Central Tunisia]. / Incidence chirurgicale de l'hydatidose dans le Centre et le Sahel Tunisiens.

A retrospective hospital survey of patients having undergone surgery for hydatidosis was undertaken in order to evaluate hydatic endemicity in central Tunisia and the Sahel. The study made it possible to establish the following: an average prevalence of 22.8 cases per 100,000 inhabitants; a significant underregistration of the illness, only 51.5% of the cases being reported; certain high-risk rural areas are characterized by a prevalence exceeding 40 per 100,000 inhabitants; the disease is more frequent among women; surgical hydatidosis is not rare among the very young and the very old; among adults, the liver is the first organ affected, followed by the lungs; among children, it is the opposite. Hydatidosis thus represents a commonly-occurring disease that is frequently underestimated in official statistics. A preventive program must be conceived to control this scourge.

[Hodgkin's disease of the lung with cavitation and apparently primary. Apropos of a case]. / Maladie de Hodgkin à localisation pulmonaire excavée apparemment primitive. A propos d'un cas.

The authors report a rare and diagnostically difficult clinical case of primary pulmonary Hodgkin's disease, with cavitation. They stress the diagnostic difficulties which they encountered: Indeed four stages are described in this case in which different diagnoses were considered as follows, a primary or secondary lung cancer, non-specific pulmonary suppuration, atypical hydated disease (as is frequently seen in Algeria) and finally pulmonary tuberculosis. The diagnosis of Hodgkin's disease was not considered until post-mortem. A review of the literature has called attention to the great rarity of cavitating Hodgkin's disease (only 53 cases in the world published). A clinical, radiological and anatomical study of the principal case published enhances the commentary on this rare case. In addition the pathogenesis of this granulomatous necrosis in Hodgkin's disease is discussed.