[Neonates exposure to parabens through medicines administered to inpatients]. / Exposition des nouveau-nés aux parabènes via les médicaments administrés durant leur hospitalisation.

OBJECTIVES: The objective of this study was to quantify parabens intake due to drug administration in neonates during hospitalization following their birth. METHOD: A monocentric prospective study was performed into a neonatalogy unit to collect all drug prescriptions. An exhaustive list of parabens containing medicines commercialized in France was completed from Theriaque® database. This list was combined with drug prescription to establish an exposure profile to parabens. For each paraben containing medicines, a HPLC-UV assay was performed to determine the average daily intake of paraben received by hospitalized neonates. RESULTS: More than 300 medicines commercialized in France contain at least one paraben. A combination of methylparaben and propylparaben was found in most cases. All hospitalized neonates (n=22) were exposed at least once to methylparaben and propylparaben through medicines while 50 % were exposed to ethylparaben. The average daily intake was higher in term newborns (572,0±249,0 versus 414,6±294,1µg/kg/j for methylparaben) but frequency was higher in prematures (65,0 versus 78,6% for methylparaben) as well as cumutives doses (1421,5±758,8 versus 8618,7±7922,3). These doses are lower than toxicological reference values but these latter do not take into account endocrine disrupting effects of these compounds. CONCLUSIONS: These results highlight medicines as a high source of exposure to parabens in hospitalized neonates. It should encourage pharmaceutical companies and health professionnal to prioritize therapeutic cares without parabens.

Comparative field evaluation of HIV rapid diagnostic assays using serum, urine, and oral mucosal transudate specimens.

BACKGROUND: Comparative field utility of selected HIV-1 assays using homologous collections of serum, urine and oral mucosal transudate (OMT) was determined in adult populations from a tuberculosis hospital and STD clinic in Djibouti, East Africa. STUDY DESIGN: Enzyme immunoassay with confirmatory Western blot was performed on all serum specimens for comparison with rapid, instrument-free assays (SUDS HIV-1, Murex: TestPack HIV-1/2. Abbott; and COMBAIDS HIV 1 + 2, SPAN Diagnostics) using various specimen sources. Delayed (48 h post-collection) testing was also performed on urine. Sensitivity and specificity for the rapid assays, in descending order, were as follows: serum SUDS HIV-1 assay (100%, 98.3%), serum COMBAIDS HIV-1/2 assay (98.4%, 99.6%), and OMT SUDS HIV-1 assay (98.4%, 94.5%). RESULTS: The OMT EIA optical density cutoff value was modified resulting in an improved specificity from 89.1 to 99.6%, however, sensitivity decreased from 100 to 98.5%. Urine EIA and rapid assays demonstrated unacceptable test performance for use as a screening test.

Clinical features associated with HIV-1 infection in adult patients diagnosed with tuberculosis in Djibouti, Horn of Africa.

PIP: The US Naval Medical Research Unit headed up a retrospective study of all adult patients diagnosed in 1991 with tuberculosis (TB) at the Paul Faure Hospital Center in Djibouti city. 92% (1844) of the medical records had complete information on demographics, clinical, and radiological characteristics associated with TB and HIV serological status. 106 (5.7%) patients had HIV-1 infection. Two patients had both HIV-1 and HIV-2 infection. Clinical predictors for HIV seropositivity included peritonitis (odds ratio [OR] = 5.08; p = 0.0164) and pleural effusion (OR = 2.15; p = 0.0037). Ethiopian nationality also predicted HIV infection among TB patients (OR = 2.13; p = 0.0002). The high percentage of glandular TB in this area of Africa, even before the HIV epidemic, may account for the lack of statistical association between HIV positivity and peripheral lymphadenopathy. These findings indicate that newly diagnosed TB adult patients with peritonitis or pleural effusion are rather likely to also have HIV infection. Physicians should suspect HIV infection in such patients, since they may be at high risk of exposure to body fluids during surgery for peritonitis and drainage of pleural effusion. The high variance makes peritonitis and pleural effusion relatively poor predictors of HIV infection, however.^ieng