Sainte-Foy-lès-Lyon, France
Sainte-Foy-lès-Lyon, France

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PubMed | Paris Center, Center Hospitalier Des Alpes, Montpellier University, University Paris - Sud and 3 more.
Type: Journal Article | Journal: Clinical and experimental immunology | Year: 2016

Hereditary angioedema (HAE) is a rare disease associated with either a quantitative or qualitative deficiency in C1-inhibitor (C1-INH) or normal C1-INH. HAE with normal C1-INH is associated in 20% of cases with mutations in the gene for factor XII (FXII) or FXII-HAE. A recent review described 41 families, including 14 German and 15 Spanish families. We have constructed a register of French patients and their characteristics. A national survey was launched through the French National Center of Reference for Angioedema (CREAK) to study the clinical, biological and therapeutic characteristics of patients with HAE linked to a mutation of FXII gene. Fifty-seven patients were identified from 24 different families. In most cases they were young women (mean age at diagnosis: 31 years, mean age at first symptom: 21 years, female/male ratio: 76%). Twenty-one per cent of the patients experienced angioedema attacks only during pregnancy or when on oestrogen contraception. Sixty-three per cent had attacks at all times, but they were more severe during these same periods. Male carriers of the mutation were more frequently asymptomatic than females (P=0003). C1-INH concentrate and icatibant were both effective for treating attacks. The prophylactic use of tranexamic acid led to a 64% decrease in the number of attacks. This is one of the largest series reported of HAE patients with FXII mutation. The therapeutic management appeared to be identical to that of HAE with C1-INH deficiency.


Valdes V.,Service de neonatologie | Legagneur H.,Service de biologie medicale | Watrin V.,Service de biologie medicale | Paris L.,Groupe hospitalier Pitie Salpetriere | Hascoet J.-M.,Service de neonatologie
Archives de Pediatrie | Year: 2011

Reinfection with Toxoplasma gondii is exceptional but can lead to transmission to the fetus when it occurs during pregnancy. We present a case of congenital toxoplasmosis in a young baby born to an immunocompetent mother who had been immunized against toxoplasmosis before pregnancy. The presence of residual IgG-specific antibodies does not always mean an absolute protection against a new toxoplasma infection. During the pregnancy, the patient was advised to follow the hygienic and dietary preventive measures even though the previous test results were consistent with past toxoplasma infection. © 2011 Elsevier Masson SAS.


PubMed | groupe hospitalier Pitie Salpetriere, Service de biologie medicale and University Pierre and Marie Curie
Type: Journal Article | Journal: Journal of travel medicine | Year: 2016

Travel and aquatic activities are increasing in tropical regions. The risk and the spectrum of marine envenomation are unknown in travellers. This work aims to evaluate the prevalence and the characteristics of marine envenomations in returning travellers.We retrospectively studied the medical charts of all returning travellers presenting with a health problem in a French tropical disease unit between 2008 and 2013, with focus on travellers complaining of marine envenomation. Characteristics of each type of envenomation are described.Of the 3315 travellers seen during the study period, 43 consulted for a presumed marine envenomation. Six patients were excluded, leaving 37 cases of confirmed marine envenomation. It corresponds to a prevalence of 1.1%. Sex ratio was balanced with 18 men and 19 women. Median age was 42 years (range 25-68 years). Median travel duration was 14 days (range: 6-62 days). The main travel destination was Southeast Asia in 10 cases, followed by islands of East Africa in seven cases. Median elapsed time between envenomation and consultation was 14 days (range: 2-130 days). The purpose of travel was tourism in all cases. The main clinical aspects were oedema, sting marks, cellulitis and flagellations. Eleven cases were presumably caused by corals, 10 by stonefish, 8 by jellyfish, 2 by weever fish, 2 by starfish, 2 by stingray, 1 by lionfish and 1 by sea anemone.Prevalence of marine envenomation is low in returning travellers. They are mostly caused by corals, stonefish and jellyfish.


PubMed | Aix - Marseille University, Hopital Sainte Marguerite and Service de biologie medicale
Type: | Journal: Trials | Year: 2015

International recommendations in favor of screening for vaginal infection in pregnancy are based on heterogeneous criteria. In most developed countries, the diagnosis of bacterial vaginosis is only recommended for women with high-risk of preterm birth. The Nugent score is currently used, but molecular quantification tools have recently been reported with a high sensitivity and specificity. Their value for reducing preterm birth rates and related complications remains unexplored. This trial was designed to assess the cost-effectiveness of a systematic screen-and-treat program based on a point-of-care technique for rapid molecular diagnosis, immediately followed by an appropriate antibiotic treatment, to detect the presence of abnormal vaginal flora (specifically, Atopobium vaginae and Gardnerella vaginalis) before 20 weeks of gestation in pregnant women in France. We hypothesized that this program would translate into significant reductions in both the rate of preterm births and the medical costs associated with preterm birth.A multicenter, open-label randomized controlled trial (RCT) will be conducted in which 20 French obstetrics and gynecology centers will recruit eligible pregnant women at less than 20 weeks gestation with singleton pregnancy and with a low-risk factor for preterm birth. Interventions will include a) an experimental group that will receive a systematic rapid screen-and-treat program from a point-of-care analysis using a molecular quantification method and b) a control group that will receive usual care management. Randomization will be in a 1:1 allocation ratio. The primary endpoint that will be assessed over a period of 12 months will be the incremental cost-effectiveness ratio (ICER) expressed as cost per avoided preterm birth before 37 weeks. Secondary endpoints will include ICER per avoided preterm birth before 24, 28 and 32 weeks, obstetrical outcomes, neonatal outcomes, rates of treatment failure and recurrence episodes for positive women. Uncertainty surrounding these estimates will be addressed using nonparametric bootstrapping and represented using cost-effectiveness acceptability curves. A total of 6,800 pregnant women will be included.This appropriate randomized controlled design will provide insight into the cost-effectiveness and therefore the potential cost savings of a rapid screen-and-treat strategy for molecular abnormal vaginal flora in pregnant women. National and international recommendations could be updated based on the findings of this study.ClinicalTrials.gov: NCT02288832 (registration date: 30 October 2014); Eudract: 2014-001559-22.


Larreche S.,Service de Biologie Medicale | Imbert P.,Service de Maternite pediatrie | Mornand P.,Service de Maternite pediatrie | Andriamanantena D.,Service des Maladies Infectieuses et Tropicales | And 2 more authors.
Travel Medicine and Infectious Disease | Year: 2013

Snakebites are an infrequent but real risk for travelers. We report a case of envenomation by Bothrops atrox in a traveler to Manaus, Brazil. Rapid administration of specific antivenom prevented the expected systemic disorders. This case gives opportunity to review prevention and first aid measures of snakebites in travelers. © 2013 Elsevier Ltd. All rights reserved.


Merens A.,Service de Biologie Medicale | Servonnet A.,Service de Biologie Medicale
Revue Francophone des Laboratoires | Year: 2010

Quinolones are potent antibacterial agents that specifically target bacterial DNA gyrase and topoisomerase IV. They are one of the largest classes of antimicrobial agents used wordwide, which explains the rise of the bacterial quinolone resistance. This resistance arises by mutations in the chromosomal genes of the quinolones targets, but also by changes in expression of efflux pumps and porins. More recently, plasmid mediated resistance mechanisms, involving three differents families of genes have been described in enterobacteria (target protection, quinolone acetylation and quinolone specific efflux). This article describes the different mechanisms of quinolone resistance, and the trends in fluoroquinolones resistance for the most common pathogens in human medicine (enterobacteria, Pseudomonas, Neisseria gonorrhoeae, S. aureus, S. pneumoniae, M. tuberculosis). © 2010-Elsevier Masson SAS-Tous droits réserv́s.


Janvier F.,Service de biologie medicale | Delacour H.,Service de biologie medicale | Larreche S.,Service de biologie medicale | Abdalla S.,Service de chirurgie viscerale et vasculaire | And 2 more authors.
Pathologie Biologie | Year: 2013

Propionibacteria are organisms of low pathogenicity and only a minority of clinical Propionibacterium isolates is clinically significant. Herein, we report a rare case of Propionibacterium avidum abdominal wall and intra-peritoneal abscess that developed in 46-year-old woman after abdominal parietoplasty. © 2013 Elsevier Masson SAS.


Janvier F.,Service de biologie medicale | Merens A.,Service de biologie medicale | Delaune D.,Service de biologie medicale | Soler C.,Service de biologie medicale | Cavallo J.-D.,Service de biologie medicale
Pathologie Biologie | Year: 2011

Objectives: The aim of this work was to evaluate the fecal carriage of third generation cephalosporins resistant Enterobacteriaceae in nonhospitalized asymptomatic young adults. Methods: A total of 517 normal fecal samples were spread onto plates agar containing cefotaxime. Isolated strains were identified and studied with agar disk diffusion antibiogram, minimal inhibition concentration in liquid medium and phenotypic and molecular study. Data were compared with a previous study realised in the same conditions in 1999. Results: In 2009, the prevalence of cefotaxime resistant enterobacteria was 4.2%. Of these 22 Enterobacteriaceae, 11 harboured overexpressed cephalosporinase and 11 produced extended-spectrum-betalactamase (ESBL). Among ESBL, six E. coli produced CTX-M from group 1 (n=6), group 2 (n=1), group 9 (n=2), one E. coli produced SHV-12 and one Klebsiella pneumoniae produced CTX-M from group 1. All ESBL were multiresistant. In 1999, all the CTX resistant isolates recovered produced a cephalosporinase and no ESBL was found. Conclusions: This study highlights the increasing prevalence of fecal carriage of ESBL-producing enterobacteria in asymptomatic young patients in the community (0% in 1999 versus 2.1% in 2009; P< 0.001). E. Coli with CTX-M from group 1 was the most frequent ESBL identified, while fecal carriage of Enterobacteteriaceae overproducing cephalosporinase was similar (2.1%). © 2010 Elsevier Masson SAS.


PubMed | University of Federal Defense Munich, Directorate General of Armaments and Service de Biologie Medicale
Type: Journal Article | Journal: Genome announcements | Year: 2014

We report here the draft sequence of strain CEB14_0017, alias HIAD_DUP, recovered from a human patient and initially identified as Yersinia pestis by mass spectrometry analysis. Genotyping based on tandem repeat polymorphism assigned the strain to Yersinia pseudotuberculosis sequence type 42 (ST42). The total assembly length is 4,894,739bp.


PubMed | Service des maladies infectieuses et tropicales and Service de biologie medicale
Type: Case Reports | Journal: La Revue de medecine interne | Year: 2014

Mycoplasma pneumonia (MP) infection may be associated with several neurological complications. Encephalitis, which affects children and rarely young adults, is the most frequent.A 23-year-old man was admitted for pneumonia with encephalitis. Mycoplasma pneumoniae infection was documented by serology, and polymerase chain reaction in the cerebrospinal fluid. Despite serious initial presentation, outcome was favourable with levofloxacin treatment.MP infection should be considered as a potential aetiology in acute encephalitis in young people and in individuals with respiratory symptoms. Antibiotic therapy (fluoroquinolones or macrolides) should be used if MP is strongly suspected or in case of severe acute meningo-encephalitis.

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