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Vauloup-Fellous C, Peyronnet V, Portet-Sulla V, Picone O. [How I do … interpret CMV serology during pregnancy?]. Gynecol Obstet Fertil Senol 2024:S2468-7189(24)00116-8. [PMID: 38556132 DOI: 10.1016/j.gofs.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Christelle Vauloup-Fellous
- Service de virologie, Inserm U 1193, hôpital Paul-Brousse, AP-HP, université Paris-Saclay, Villejuif, France; Centre national de référence des virus de la rougeole, de la rubéole et des oreillons (laboratoire associé), Villejuif, France; Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Inserm, CEA, université Paris-Saclay, Fontenay-aux-Roses (92), France; Groupe de recherche sur les infections pendant la grossesse (GRIG), Vélizy-Villacoublay, France.
| | - Violaine Peyronnet
- Service de gynécologie-obstétrique, IAME Inserm U1137, hôpital Louis-Mourier, AP-HP, université de Paris, 177, rue des Grenouillets, 92700 Colombes, Paris, France
| | - Vincent Portet-Sulla
- Service de virologie, Inserm U 1193, hôpital Paul-Brousse, AP-HP, université Paris-Saclay, Villejuif, France; Centre national de référence des virus de la rougeole, de la rubéole et des oreillons (laboratoire associé), Villejuif, France; Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Inserm, CEA, université Paris-Saclay, Fontenay-aux-Roses (92), France; Groupe de recherche sur les infections pendant la grossesse (GRIG), Vélizy-Villacoublay, France
| | - Olivier Picone
- Groupe de recherche sur les infections pendant la grossesse (GRIG), Vélizy-Villacoublay, France; Service de gynécologie-obstétrique, IAME Inserm U1137, hôpital Louis-Mourier, AP-HP, université de Paris, 177, rue des Grenouillets, 92700 Colombes, Paris, France.
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Sakhi H, Chavarot N, Attias P, El Karoui K, Anglicheau D. [COVID-19 vaccination in dialysis and kidney transplant patients]. Nephrol Ther 2021; 17:208-213. [PMID: 34305020 PMCID: PMC8245347 DOI: 10.1016/j.nephro.2021.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 01/04/2023]
Abstract
Au cours de la COVID-19, la dialyse et la transplantation rénale ont été identifiées comme d’importants facteurs de risque de développer une forme sévère de la maladie. La réponse immunitaire humorale post-infection est durable. Cependant, après vaccination, celle-ci apparaît plus limitée, tant en termes de taux de réponse (séropositivité post-vaccination) qu’en termes de taux quantitatif d’anticorps. Alors que les patients dialysés ont un taux de réponse de 80–95 % en fonction des études, la réponse est particulièrement faible chez les patients transplantés rénaux, avec des taux de séropositivité de 30–50 %, et notamment s’ils sont traités par bélatacept (environ 5 % de réponse). Ces éléments ont poussé à proposer des schémas vaccinaux alternatifs en France, avec notamment l’utilisation d’une 3e injection de vaccin ARNm. Malgré ces résultats, de nombreuses questions sur la vaccination des insuffisants rénaux restent en suspens, concernant notamment la qualité des réponses cellulaires (encore peu étudiées), la durabilité des réponses post-vaccinales, et surtout l’efficacité clinique des vaccins.
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Affiliation(s)
- Hamza Sakhi
- Service de néphrologie et transplantation, fédération hospitalo-universitaire « Innovative therapy for immune disorders », centre de référence maladie rare « syndrome néphrotique idiopathique », hôpitaux universitaires Henri-Mondor, Créteil, France; Équipe 21, institut national de la santé et de la recherche médicale (Inserm) U955, institut Mondor de recherche biomédicale (IMRB), université Paris-Est-Créteil, Créteil, France
| | - Nathalie Chavarot
- Service de néphrologie et transplantation, centre de référence Maladie rare MAREHA, hôpitaux universitaires Necker-Enfants malades, Paris, France
| | - Philippe Attias
- Department of nephrology and dialysis, hôpital privé Nord Parisien, Sarcelles, France
| | - Khalil El Karoui
- Service de néphrologie et transplantation, fédération hospitalo-universitaire « Innovative therapy for immune disorders », centre de référence maladie rare « syndrome néphrotique idiopathique », hôpitaux universitaires Henri-Mondor, Créteil, France; Équipe 21, institut national de la santé et de la recherche médicale (Inserm) U955, institut Mondor de recherche biomédicale (IMRB), université Paris-Est-Créteil, Créteil, France.
| | - Dany Anglicheau
- Service de néphrologie et transplantation, centre de référence Maladie rare MAREHA, hôpitaux universitaires Necker-Enfants malades, Paris, France
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Frikh M, Mrimar N, Kasouati J, Hamzaoui A, Maleb A, Lemnouer A, Choukairi O, Barkiyou M, El Ouennass M. [Prevalence and role of IgG anti-Chlamydia trachomatis in a population of infertile men in Morocco]. Prog Urol 2019; 29:612-618. [PMID: 31473105 DOI: 10.1016/j.purol.2019.08.261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 06/03/2019] [Accepted: 08/06/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Infertility is a global public health problem that affects 15% of couples of childbearing age. Male infertility is involved in 20 to 50% of cases. These figures are sharply increasing around the world. Several factors may be responsible for this infertility with especially hormonal, genetic, toxic or infectious factors. The latter are dominated mainly by Chlamydia infection. Among the most serious complications of this infection are infertility related to urethritis, epididymitis and irreversible total azoospermia in men and tubal obstructions and ectopic pregnancies in women. STUDY OBJECTIVE To determine the prevalence of IgG anti-Chlamydia trachomatis in men consulting for infertility and the association between previous contact with this bacterium and the impairment of sperm quality and sperm function. MATERIAL AND METHODS Prospective study over 26months of 143 patients referred to the service for infertility assessment of the couple. Demographic data, primary or secondary character of infertility, risk factors (tobacco, inguinal hernia, varicocele and history of urogenital infections), semen parameters (volume, mobility, pH, vitality and morphological abnormalities) were studied as well as the determination of the anti-C. trachomatis IgG titer. The prevalence of Chlamydia infection and the association of the infection and alteration of the various parameters of the semen were analyzed. RESULTS The average age of patients was 38.5±8.55. Infertility was primary in 72% of patients. Among the patients, 54.5% had an abnormal spermogram. Chlamydia IgG antibodies were positive in 37.1% of patients whose 58.5% had abnormal spermogram. Analysis of sperm parameters of patients with and without IgG C. trachomatis showed an altered vitality in Chlamydia positive patients with an OR at 2.41, P=0.02, (95% CI: 1.15-5.06). CONCLUSION The prevalence of Chlamydia infection is high in infertile male. C. trachomatis IgG antibodies may be associated with an alteration of spermatozoa vitality without significant impairment of other semen parameters. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- M Frikh
- Service de bactériologie, hôpital militaire d'instruction Mohammed V, faculté de médecine et pharmacie, université Mohammed V, avenue des FAR, Hay Riad, 10100 Rabat, Maroc.
| | - N Mrimar
- Service de bactériologie, hôpital militaire d'instruction Mohammed V, faculté de médecine et pharmacie, université Mohammed V, avenue des FAR, Hay Riad, 10100 Rabat, Maroc.
| | - J Kasouati
- Service d'hygiène et de médecine de collectivité, hôpital militaire d'instruction Mohamed V Rabat, université Mohammed V, Rabat, Maroc.
| | - A Hamzaoui
- Service de bactériologie, hôpital militaire d'instruction Mohammed V, faculté de médecine et pharmacie, université Mohammed V, avenue des FAR, Hay Riad, 10100 Rabat, Maroc.
| | - A Maleb
- Faculté de médecine, université Mohammed Premier, Oujda, Maroc.
| | - A Lemnouer
- Service de bactériologie, hôpital militaire d'instruction Mohammed V, faculté de médecine et pharmacie, université Mohammed V, avenue des FAR, Hay Riad, 10100 Rabat, Maroc.
| | - O Choukairi
- Laboratoire d'histo-embryologie et cytogénétique, faculté de médecine et de pharmacie, université Mohamed V, Rabat, Maroc.
| | - M Barkiyou
- Laboratoire d'histo-embryologie et cytogénétique, faculté de médecine et de pharmacie, université Mohamed V, Rabat, Maroc.
| | - M El Ouennass
- Service de bactériologie, hôpital militaire d'instruction Mohammed V, faculté de médecine et pharmacie, université Mohammed V, avenue des FAR, Hay Riad, 10100 Rabat, Maroc. elouennassm.@yahoo.fr
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Abstract
Lyme disease diagnosis is currently based on serology - an indirect diagnostic method - as laboratory cultures are fastidious. The only direct diagnostic method that can be useful with some specimens (cutaneous biopsies or aspiration fluid) is PCR. We aimed to detail the main limitations of serology and PCR testing in the diagnosis of bacterial infections. Limitations are supported by examples from the recent history of microbiology. The main limitation of bacterial serology is the presence of numerous cross-reactions due to many genes that are common to various bacterial species. Some serological techniques, such as those used for the diagnosis of rickettsioses mainly, have even been based on the existence of cross-reactions. The main limitation of PCR testing is the potential presence of laboratory contaminations. PCR-performing laboratories must therefore be certified for the use of this technique. PCR testing also does not inform on the viability of the identified bacterium and should therefore be interpreted in light of the clinical presentation. These limitations highlight that all diagnostic test results should not be interpreted on their own; the clinical and epidemiological contexts should always be taken into consideration.
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Feyeux D, Fantin B. [Insights on the management of Lyme disease]. Rev Med Interne 2018; 40:226-231. [PMID: 30587410 DOI: 10.1016/j.revmed.2018.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/26/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
Lyme disease is currently a hot topic in France due to a high incidence in some areas. Its clinical polymorphism can lead to misdiagnosis on one hand and to unjustified treatment on the other hand. Clinical symptoms vary considerably according to involved organs (skin, central and/or peripheral nervous system, joints, heart, eyes) and may be limited to or associated with general non-specific signs. Biological exams must be guided by clinical symptoms to help diagnosis and treatment decision according to clinical history, presentation, time of onset and duration of symptoms. However, to date, no serologic test can discriminate between past and active disease. The role of the internist is two-fold: make a diagnosis when faced with general or focal symptoms and avoid inappropriate attribution to Lyme disease of symptoms related to alternate diagnoses.
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Affiliation(s)
- D Feyeux
- Service de médecine interne, hôpital Beaujon, AP-HP, 100, boulevard du Général-Leclerc, 92110 Clichy, France
| | - B Fantin
- Service de médecine interne, hôpital Beaujon, AP-HP, 100, boulevard du Général-Leclerc, 92110 Clichy, France.
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Vauloup-Fellous C. [Genital herpes and pregnancy: Serological and molecular diagnostic tools. Guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF)]. ACTA ACUST UNITED AC 2017; 45:655-663. [PMID: 29132769 DOI: 10.1016/j.gofs.2017.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe serological and molecular tools available for genital and neonatal herpes, and their use in different clinical situations. METHODS Bibliographic investigations from MedLine database and consultation of international clinical practice guidelines. RESULTS Virological confirmation of genital herpes during pregnancy or neonatal herpes must rely on PCR (Professional consensus). HSV type-specific serology (IgG) will allow determining the immune status of a patient (in the absence of clinical lesions). However, there is currently no evidence to justify universal HSV serological testing during pregnancy (Professional consensus). In case of genital lesions in a pregnant woman that do not report any genital herpes before, it is recommended to perform a virological confirmation by PCR and HSV type-specific IgG in order to distinguish a true primary infection, a non-primary infection associated with first genital manifestation, from a recurrence (Grade C). HSV IgM is useless for diagnosis of genital herpes (Grade C). If a pregnant woman has personal history of genital herpes but no lesions, whatever the gestational age, it is not recommended to perform genital sampling nor serology (Professional consensus). In case of recurrence, if the lesion is characteristic of herpes, virological confirmation is not necessary (Professional Agreement). However, if the lesion is not characteristic, virological confirmation by PCR should be performed (Professional consensus). At birth, HSV PCR samples should be collected as soon as neonatal herpes is suspected (symptomatic neonate) (best before beginning antiviral treatment but must not delay the treatment), or after 24hours of life in case of asymptomatic neonate born to a mother with herpes lesions at delivery (Professional consensus). Clinical samples for virological confirmation should include at least blood and a peripheral location. In case of clinical manifestations of herpes in the neonate, first samples PCR positive, preterm birth, or maternal primary infection or non-primary infection associated with first genital manifestation at delivery, CSF should also be collected as well as samples of lesions in the neonate if present (Professional consensus). Sampling should be repeated in case of PCR negative but strong evidence of neonatal herpes (Professional consensus). HSV serology is useless for diagnosis of neonatal herpes (Grade C). CONCLUSIONS Virological confirmation for diagnosis of genital herpes during pregnancy or neonatal herpes must rely on PCR. PCR assays available in France are very reliable. Specific IgG are dedicated to restricted indications.
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Affiliation(s)
- C Vauloup-Fellous
- Laboratoire de virologie, hôpital Paul-Brousse, groupe hospitalier universitaire Paris-Sud, 12, rue Paul-Vaillant-Couturier, 94800 Villejuif, France.
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Dahyot S, Lemee L, Pestel-Caron M. [Description and role of bacteriological techniques in the management of lung infections]. Rev Mal Respir 2017; 34:1098-1113. [PMID: 28688757 PMCID: PMC7134997 DOI: 10.1016/j.rmr.2016.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/28/2016] [Indexed: 01/07/2023]
Abstract
Les pneumopathies aiguës recouvrent des contextes cliniques variés et les étiologies bactériennes impliquées le sont tout autant. Aucun outil microbiologique n’est 100 % sensible ni 100 % spécifique et malgré les investigations, plus de 30 % des pneumopathies restent sans étiologie identifiée. Si aucun prélèvement n’est indiqué pour les patients traités en ambulatoire, les prélèvements respiratoires non invasifs sont à privilégier pour les pneumopathies aiguës hospitalisées (communautaires ou associées aux soins), tandis que les prélèvements invasifs sont indiqués en seconde ligne pour les pneumopathies aiguës communautaires en réanimation, et en première ligne pour les pneumopathies aiguës de l’immunodéprimé. La culture microbiologique garde une place importante, à condition que le malade soit prélevé avant instauration de l’antibiothérapie. Certains contextes peuvent justifier le recours aux hémocultures, à la recherche d’antigènes urinaires ou aux sérologies. Les PCR rendent déjà service au quotidien mais l’avenir à court terme appartient probablement aux panels moléculaires multiplex capables de détecter de nombreux micro-organismes en quelques heures, surtout dans les pneumopathies communautaires sévères de réanimation et les pneumopathies aiguës de l’immunodéprimé. Le séquençage nucléotidique haut débit révolutionnera bientôt le diagnostic microbiologique, en pneumologie comme dans les autres domaines de l’infectiologie.
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Affiliation(s)
- S Dahyot
- UNIROUEN, GRAM EA2656, laboratoire de bactériologie, CHU de Rouen, Normandie université, 76000 Rouen, France.
| | - L Lemee
- UNIROUEN, GRAM EA2656, laboratoire de bactériologie, CHU de Rouen, Normandie université, 76000 Rouen, France
| | - M Pestel-Caron
- UNIROUEN, GRAM EA2656, laboratoire de bactériologie, CHU de Rouen, Normandie université, 76000 Rouen, France
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Bouvet D, Gaudy-Graffin C, Garot D, Sunder S, De Gialluly C, Goudeau A. Diagnosis of community-acquired acute respiratory illness: From conventional microbiological methods to molecular detection (multiplex). ACTA ACUST UNITED AC 2015; 63:69-73. [PMID: 25596173 PMCID: PMC7126571 DOI: 10.1016/j.patbio.2014.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 12/04/2014] [Indexed: 11/17/2022]
Abstract
Investigations of the etiologic agents of community-acquired acute respiratory illness may lead to better treatment decisions and patient outcomes. In a routine care setting, we assessed the diagnostic performance of a multiplex PCR assay with respect to conventional microbiological methods, in a continuous series of adult cases of community-acquired acute respiratory illness. We enrolled 279 adult patients hospitalised for community-acquired acute respiratory illness at Tours University Hospital during the winter of 2011–2012. Respiratory samples (mostly nasopharyngeal aspirates) were studied prospectively by indirect immunofluorescence assay and multiplex PCR, that enable detection of 8 viruses and 21 respiratory pathogens respectively. In total, 255 of the 279 (91.4%) samples had interpretable results by both methods. At least one respiratory pathogen was detected by multiplex PCR in 171 specimens (65%). Overall, 130 (76%) of the 171 positive samples were positive for only one respiratory pathogen, 37 (22%) samples were positive for two pathogens and four (2%) were positive for three pathogens. With indirect immunofluorescence assay, a respiratory virus was detected in 27 of the 255 (11%) specimens. Indirect immunofluorescence assay detected some of the influenza virus A (15/51, 29%) infections identified by multiplex PCR and some (7/15, 47%) human metapneumovirus and (5/12, 42%) respiratory syncytial virus infections, but it did not detect all the adenovirus infections. Thus, access to multiplex molecular assays improves the diagnostic spectrum and accuracy over conventional methods, increasing the frequency of identification of the respiratory pathogens involved in community-acquired acute respiratory illness.
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Affiliation(s)
- D Bouvet
- Service de bactériologie et virologie, hôpital Bretonneau, CHRU, 2, boulevard Tonnellé, 37044 Tours cedex, France; Faculté de médecine, université François-Rabelais, 37000 Tours, France
| | - C Gaudy-Graffin
- Service de bactériologie et virologie, hôpital Bretonneau, CHRU, 2, boulevard Tonnellé, 37044 Tours cedex, France; Faculté de médecine, université François-Rabelais, 37000 Tours, France.
| | - D Garot
- Service de réanimation médicale, hôpital Bretonneau, CHRU, 37000 Tours, France
| | - S Sunder
- Service de médecine interne et maladies infectieuses, hôpital Bretonneau, CHRU, 37000 Tours, France
| | - C De Gialluly
- Laboratoire de bactériologie et hygiène hospitalière, hôpital Trousseau, CHRU, 37000 Tours, France
| | - A Goudeau
- Service de bactériologie et virologie, hôpital Bretonneau, CHRU, 2, boulevard Tonnellé, 37044 Tours cedex, France; Faculté de médecine, université François-Rabelais, 37000 Tours, France
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Pouget T, Garcia-Hejl C, Bouzard S, Roche C, Sailliol A, Martinaud C. [Assessment of malaria screening management in blood donation control in the French Military Blood Institute]. Transfus Clin Biol 2014; 21:103-6. [PMID: 24948206 DOI: 10.1016/j.tracli.2014.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 05/14/2014] [Indexed: 11/16/2022]
Abstract
The French Military Blood Institute is responsible for the entire blood supply chain in the French Armed Forces. Considering, the high exposition rate of military to malaria risk, blood donation screening of plasmodium infection must be as efficient as possible. The main aim of our study was to assess our malaria testing strategy based on a single Elisa test compared with a two-step strategy implying immunofluorescence testing as confirmation test. The second goal was to describe characteristic of malaria Elisa positive donors. We conducted a prospective study: every malaria Elisa positive test was implemented by immunofluorescence testing and demographical data were recorded as usual by our medical software. We showed a significant risk of malaria ELISA positive tests among donor born in endemic area and we estimate the number of abusively 3-year rejected donors. However, based on our estimations, the two-step strategy is not relevant since the number of additionally collected blood products will be low.
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Affiliation(s)
- T Pouget
- Centre de transfusion sanguine des armées, 1, rue du Lieutenant-Batany, 92140 Clamart, France
| | - C Garcia-Hejl
- Fédération de biologie médicale, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - S Bouzard
- Centre de transfusion sanguine des armées, 1, rue du Lieutenant-Batany, 92140 Clamart, France
| | - C Roche
- Centre de transfusion sanguine des armées, 1, rue du Lieutenant-Batany, 92140 Clamart, France
| | - A Sailliol
- Centre de transfusion sanguine des armées, 1, rue du Lieutenant-Batany, 92140 Clamart, France
| | - C Martinaud
- Fédération de biologie médicale, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart, France.
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