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Rozé B, Najioullah F, Fergé JL, Dorléans F, Apetse K, Barnay JL, Daudens-Vaysse E, Brouste Y, Césaire R, Fagour L, Valentino R, Ledrans M, Mehdaoui H, Abel S, Leparc-Goffart I, Signate A, Cabié A, Aïm V, Arrigo A, Cabre P, Chabartier C, Colombani S, Cuziat J, Deligny C, Desbois N, Dessoy AL, Dunoyer G, Duvauferrier R, Duc N, Edimonana M, Garrigou P, Gaucher S, Gourgoudou S, Guitteaud K, Hochedez P, Ivanes G, Jacquens Y, Julié S, Jean-Etienne A, Jeannin S, Julien J, Jérémie P, Lamaignère JL, Laudarin I, Le Gall M, Legris-Allusson V, Mejdoubi M, Michel C, Michel F, Miossec C, Moinet F, Minerva C, Olive C, Olive P, Pailla K, Paysant C, Pierre-François S, Pircher M, Polomat K, Putot A, René-Corail P, Resiere D, Richer C, Risson JR, Rome K, Sabia M, Schloesser M, Simonnet-Vigeral P, Théodose R, Vilain R. Guillain-Barré Syndrome Associated With Zika Virus Infection in Martinique in 2016: A Prospective Study. Clin Infect Dis 2018; 65:1462-1468. [PMID: 29020245 DOI: 10.1093/cid/cix588] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [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: 02/23/2017] [Accepted: 07/06/2017] [Indexed: 11/14/2022] Open
Abstract
Background Guillain-Barré syndrome (GBS) has been reported to be associated with Zika virus (ZIKV) infection in case reports and retrospective studies, mostly on the basis of serological tests, with the problematic cross-reacting antibodies of the Flavivirus genus. Some GBS cases do not exhibit a high level of diagnostic certainty. This prospective study aimed to describe the clinical profiles and the frequency of GBS associated with ZIKV during the ZIKV outbreak in Martinique in 2016. Methods We recorded prospective data from GBS meeting levels 1 or 2 of diagnostic certainty for the Brighton Collaboration, with proof of recent ZIKV infection and negative screening for etiologies of GBS. Results Of the sample of 34 patients with suspected GBS during the outbreak, 30 had a proven presence of GBS, and 23 had a recent ZIKV infection. The estimated GBS incidence rate ratio (2016 vs 2006-2015) was 4.52 (95% confidence interval, 2.80-7.64; P = .0001). Recent ZIKV infection was confirmed by urine reverse-transcription polymerase chain reaction (RT-PCR) analysis in 17 cases and by serology in 6 cases. Patients, 65% of whom were male, had a median age of 61 years (interquartile range, 56-71 years) and experienced severe GBS. Electrophysiological tests were consistent with the primary demyelinating form of the disease. Conclusions ZIKV infection is usually benign, when symptomatic, but in countries at risk of ZIKV epidemics, adequate intensive care bed capacity is required for management of severe GBS cases. Arbovirus RNA detection by RT-PCR should be part of the management of GBS cases.
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Affiliation(s)
- Benoît Rozé
- Infectious and Tropical Diseases Unit, University Hospital of Martinique.,Intensive Care Unit, University Hospital of Martinique
| | - Fatiha Najioullah
- Laboratory of Virology, University Hospital of Martinique, Université des Antilles EA4537, Fort de France
| | | | - Frédérique Dorléans
- French National Public Health Agency, Regional Unit Antilles Guyane, Saint-Maurice
| | | | | | - Elise Daudens-Vaysse
- French National Public Health Agency, Regional Unit Antilles Guyane, Saint-Maurice
| | | | - Raymond Césaire
- Laboratory of Virology, University Hospital of Martinique, Université des Antilles EA4537, Fort de France
| | - Laurence Fagour
- Laboratory of Virology, University Hospital of Martinique, Fort de France
| | | | - Martine Ledrans
- French National Public Health Agency, Regional Unit Antilles Guyane, Saint-Maurice
| | | | - Sylvie Abel
- Infectious and Tropical Diseases Unit, University Hospital of Martinique
| | | | | | - André Cabié
- Infectious and Tropical Diseases Unit, University Hospital of Martinique, Université des Antilles, EA4537, INSERM CIC1424, Fort de France, France
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Di Paolo J, Paumier C, Pollet C, Duc N, Augeraud E. Programme d’éducation thérapeutique ARSIMED ® : première évaluation du module destiné aux familles. Eur Psychiatry 2015. [DOI: 10.1016/j.eurpsy.2015.09.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Le programme d’éducation thérapeutique ARSIMED® est indiqué pour les patients souffrant de troubles psychotiques. Il comprend un module destiné aux Familles de ces patients, visant à leur faire acquérir trois habiletés : une connaissance de la maladie et des traitements, une meilleure communication avec leur proche (utilisation d’une méthode basée sur l’écoute et l’empathie), une meilleure gestion de leurs propres pensées et émotions (utilisation d’une méthode basée sur la Pleine Conscience). Depuis 2012, ce module a été suivi par cinq groupes de familles, soit 40 participants. L’objectif est de réaliser une première évaluation de son efficacité en analysant les résultats de questionnaires individuels effectués avant et après avoir suivi la totalité du module (10 séances). Trois outils d’évaluation ont été utilisés : Questionnaire de santé GHQ-28, Questionnaire des facultés de communication inspiré du questionnaire de Cungi, Echelle d’acceptation de la maladie et des traitements (auto-évaluation, score de 0 à 10). Les scores des questionnaires GHQ-28 réalisés après les séances ont été statistiquement supérieurs aux scores initiaux (n = 40, t-Student = 1,88, p < 0,05, test unilatéral), même si l’écart moyen est faible (5 points). Il n’y a pas de différence significative concernant les questionnaires de communication. Selon les familles, l’acceptation de la maladie par leur proche a augmenté entre le début (score moyen : 3,9) et la fin (score moyen : 6,1) du programme (n = 31, t-Student = 4,61, p < 0,05, test unilatéral). Une réévaluation des différents questionnaires sera réalisée à distance des séances pour tous les participants ; en effet, des bénéfices supérieurs pourraient être attendus sur un plus long terme car du temps est nécessaire pour l’acquisition des habiletés. D’autre part, les questionnaires seront modifiés afin de mesurer le ressenti des participants sur leur évolution avant et après le programme.
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Donnet-Hughes A, Duc N, Serrant P, Vidal K, Schiffrin EJ. Bioactive molecules in milk and their role in health and disease: the role of transforming growth factor-beta. Immunol Cell Biol 2000; 78:74-9. [PMID: 10651932 DOI: 10.1046/j.1440-1711.2000.00882.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Human breast milk is rich in nutrients, hormones, growth factors and immunoactive molecules, which influence the growth, development and immune status of the newborn infant. Although several of these factors are also present in bovine milk, the greater susceptibility of the formula-fed infant to infection and disease and the development of allergy is often attributed to the reduced level of protective factors in milk formulas. Nevertheless, modifying manufacturing processes may preserve the biological activity of some bioactive molecules in end products. Transforming growth factor (TGF)-beta is one such molecule. TGF-beta is a polypeptide, which has been described in both human and bovine milk. It is implicated in many processes, including epithelial cell growth and differentiation, development, carcinogenesis and immune regulation. The present article discusses the biological activity of TGF-beta2 that has been preserved and activated in a cow's milk-based product. More specifically, it addresses possible mechanisms of action in the intestinal lumen and speculates on how milk products containing naturally occurring TGF-beta2 could be exploited in functional foods for the infant or as therapies for specific intestinal diseases.
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Affiliation(s)
- A Donnet-Hughes
- Department of Immunology, Nestec Limited, Nestlé Research Centre, Vers-chez-les-Blanc, Lausanne, Switzerland.
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