[Vaccine coverage in the elderly]. / La couverture vaccinale du sujet âgé.

Elderly people are particularly exposed to infectious diseases, which also form a significant cause of death in this population. Vaccination is an essential preventative measure. Full vaccination coverage requires up-to-date universal vaccines, in addition to specific vaccinations for the elderly.

[What can we think about whole-body-vibration in elderly people?]. / Que faut-il penser de l'utilisation des plateformes vibrantes chez les sujets âgés?

Whole-body-vibration on oscillating platform is a recent type of physical therapy and its use has increased in the last years for elderly people. Whole-body-vibration enhances muscle strength and/or power, but this effect has been poorly studied, specifically in elderly people. The use of oscillating plateforms seems to improve gait stability and reduce the risk of fall, especially in frail and institutionalized elderly people. Oscillating plateforms may have an anti-osteoporotic effect in post-menopausal women. Whole-body-vibration on oscillating plateforms may improve postural stability and motor symptoms in Parkinson's disease. Maladjusted use of whole body vibration can lead to health problems especially on osteo-articular tissues.

Type I interferon subtypes produced by human peripheral mononuclear cells from one normal donor stimulated by viral and non-viral inducing factors.

Through the activation of Toll-like receptors (TLRs) or cytosolic RNA helicases, a large number of pathogenic or synthetic components can induce the transcription of genes coding for type I interferons (IFNs). This family of related cytokines includes notably, a single IFN-beta protein and 13 different IFN-alpha subtypes, whose biological activities are probably not the same. The aim of this study was to characterize the type I IFN subtypes produced in vitro by human peripheral blood mononuclear cells (PBMCs) in response to specific inducers. Thus, PBMCs obtained from a single donor, were exposed to various agents including Sendai virus, Herpes simplex virus-1 (HSV-1), poliovirus-IgG complexes and serum from a patient with systemic lupus erythematosus (SLE). Six hours later, mRNA was extracted and amplified by RT-PCR using primers which recognize IFN-B mRNA and the different IFN-A mRNA subtypes. IFN-A subtypes were identified by cloning and sequencing the amplification product. Antiviral activity was assayed in supernatant at 18 hours. Human PBMCs were found to express constitutively type I IFNs mRNA. Antiviral activity and expression of IFN-A and IFN-B mRNA increased with each inducing agent. Although almost all the IFN-A subtypes were detected, their relative abundance appeared to be dependent upon the inducing agent. Incubation of PBMCs with a neutralizing monoclonal antibody directed against the type I IFN receptor (IFNAR) did not affect the level of antiviral activity in the supernatant of induced PBMCs. Our results suggest that the level of IFN-alpha expressed by PBMCs cells is independent of IFNAR feedback signalling and that the nature of the inducing agent modifies the pattern of IFN-A subtypes preferentially expressed by these cells.

Outcome of and prognostic factors for herpes simplex encephalitis in adult patients: results of a multicenter study.

Management of herpes simplex encephalitis (HSE) has been considerably improved by the availability of acyclovir therapy and rapid polymerase chain reaction (PCR)-based diagnostic assays. Prognostic factors for this rare affliction are, however, misestimated. We conducted a large retrospective multicenter study that included 93 adult patients in whom HSE was diagnosed by PCR from 1991 through 1998 and who were treated with intravenous acyclovir. Among the 85 patients assessed at 6 months, 30 (35%) had a poor outcome, which led to death in 13 patients (15%) and severe disability in 17 (20%). The outcome was favorable for 55 patients (65%). A multivariate analysis identified 2 factors that were found to be independently associated with poor outcome: a Simplified Acute Physiology Score II >/=27 at admission and a delay of >2 days between admission to the hospital and initiation of acyclovir therapy. Early administration of antiviral therapy is the only parameter that can be modified to improve the prognosis of patients with HSE.