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M Valette

Publications and source records attributed to M Valette.

At least 19 recordsLinked to original sources
PubMed2005

[General practice and surveillance: the example of influenza in France].

UNLABELLED: Data registration by the GROG national network (Regional Group for the Surveillance of Influenza) since 1984 has helped to identify methodological problems. The choice of sentinels and the selection of indicators depend on the analysis of actual influenza consequences. Various sentinels may be concerned: health insurance companies, private companies, schools, physicians, pharmacists. Health care organization modifies the validity of indicators. In France, for instance, home visits were an excellent indicator for early warning before 1995 but this indicator is no longer as efficient as before. The virological detection of Influenza depends on the organization of transportation (samples, results). The predictive value of cases definitions depends on the incidence of infection. The level of choice between specificity and sensibility modifies the perception of outbreaks. Sentinel participation rate influences the sample representativity. The farther this rate is from 100%, the more result validity decreases (in the same way that patients lost to follow-up compromise the validity of results in clinical trials). The publication of results can modify health expenses and behaviors. CONCLUSION: The GROG network stresses the important role that general practitioners play in health surveillance; it also raises questions in the field of mathematics, statistics, professional organization, training, education, and politics.

Disease Outbreaks↗
PubMed2002

Antigenic and genetic diversity among swine influenza A H1N1 and H1N2 viruses in Europe.

Three subtypes of influenza A viruses, H1N1, H1N2 and H3N2, co-evolve in pigs in Europe. H1N2 viruses isolated from pigs in France and Italy since 1997 were closely related to the H1N2 viruses which emerged in the UK in 1994. In particular, the close relationship of the neuraminidases (NAs) of these viruses to the NA of a previous UK H3N2 swine virus indicated that they had not acquired the NA from H3N2 swine viruses circulating in continental Europe. Moreover, antigenic and genetic heterogeneity among the H1N2 viruses appeared to be due in part to multiple introductions of viruses from the UK. On the other hand, comparisons of internal gene sequences indicated genetic exchange between the H1N2 viruses and co-circulating H1N1 and/or H3N2 subtypes. Most genes of the earlier (1997-1998) H1N2 isolates were more closely related to those of a contemporary French H1N1 isolate, whereas the genes of later (1999-2000) isolates, including the HAs of some H1N2 viruses, were closely related to those of a distinct H1N1 antigenic variant which emerged in France in 1999. In contrast, an H3N2 virus isolated in France in 1999 was closely related antigenically and genetically to contemporary human A/Sydney/5/97-like viruses. These studies reveal interesting parallels between genetic and antigenic drift of H1N1 viruses in pig and human populations, and provide further examples of the contribution of genetic reassortment to the antigenic and genetic diversity of swine influenza viruses and the importance of the complement of internal genes in the evolution of epizootic strains.

Animals↗
PubMed2002

Quality control assessment of influenza and RSV testing in Europe: 2000-01 season.

The Quality Control Assessment (QCA) was initiated to evaluate the quality of the influenza and respiratory syncytial virus (RSV) testing in the national reference centres belonging to the European Influenza Surveillance Scheme (EISS) network. Samples were coded and sent in two panels of 12 samples within a two week interval to 16 laboratories during the 2000-01 winter season. The antibodies titration by HI test was reported by 60% of the laboratories (n=16), and the results were correct for 56% of them. One false detection of influenza B antibodies was reported by one laboratory, and for the others the sensitivity varied widely. The sensitivity of the tests for the detection of influenza virus varied for A(H3N2) from 10 to 100,000 TCID50/ml. The influenza A subtyping was performed by 87% of the laboratories, and 31% gave correct results. The characterisation of the variants was undertaken by six laboratories and half of them fully achieved it. Fifty six percent of the laboratories used RT-PCR for the diagnosis; the results were specific and the sensitivity equivalent to the cell culture.

Antigens, Viral↗
PubMed2001

Rifampicin-ofloxacin oral regimen for the treatment of mild to moderate diabetic foot osteomyelitis.

Seventeen diabetic patients with moderate to mild foot lesions associated with 20 osteomyelitic bones diagnosed by both bone scan and bone biopsy received rifampicin plus ofloxacin for a median duration of 6 months. Cure was defined as disappearance of all signs and symptoms of infection at the end of the treatment and absence of relapse during follow up. At the end of the treatment period, cure was achieved in 15 patients (88.2%) and was maintained in 13 patients (76.5%) at the end of an average post-treatment follow-up of 22 months. No serious drug-related adverse events were recorded.

Administration, Oral↗
PubMed2001

[Availability of antiretroviral agents in the city: a 1-year assessment in the Lille metropolitan area].

OBJECTIVES: Dispensing antiretroviral drugs in private pharmacies has been allowed in France since October 1997. One year after this measure was implemented, we conducted a survey of patients and pharmacists in the Lille metropolitan area to assess its impact. METHOD: Structured interviews with a representative sample of private pharmacists and HIV infected patients in the Lille metropolitan area were carried out. RESULTS: 100 pharmacists were interviewed. Most worked in urban areas and their main clientele were from the neighbourhood. Most felt that HIV infection was a common disease and were interested in dispensing antiretroviral drugs as a public health service despite the marginal income from these sales. Two-thirds had received training on HIV infection and most knew the importance of adhering to the treatment. However, the number of antiretroviral drugs and the classes of these drugs that were available were not well known. Among the 97 patients followed by the Service of Infectious Diseases of the Tourcoing Hospital, 22% received their medications from the local private pharmacy, 62% got them from the hospital pharmacy and 16% got them from both places. However, 39% received at least one drug that was only available from the hospital pharmacy. The patients going to private pharmacies described an improved quality of life and mostly chose their regular pharmacist to get their medications. Most preferred to get their medications openly, as opposed to secretly. Many patients going to the hospital pharmacy made their choice based on better confidentiality. Private pharmacists also expressed the fear of lack of confidentiality. Private pharmacies were seen as friendlier with quicker service, but slightly less competent than the hospital pharmacy. Finally, the topic of adhering to this form of HIV treatment is rarely discussed in private pharmacies. CONCLUSIONS: Both the patients and private pharmacists appreciate the fact that these drugs can be dispensed in private pharmacies, but the impact of this measure is limited by the number of drugs that are only available at the hospital pharmacy. Private pharmacists do not often discuss the importance of adhering to the therapy and progress is needed in this area.

Adult↗
PubMed2000

A TritonX-100-split virion influenza vaccine is safe and fulfills the committee for proprietary medicinal products (CPMP) recommendations for the European Community for Immunogenicity, in Children, Adults and the Elderly.

Influenza epidemics are an important cause of morbidity and mortality throughout the world. Current recommendations from Health Authorities emphasize annual immunization of people who are particularly at risk from an influenza virus infection; however, vaccination of working adults and of school children also has been shown to provide public health benefits. To give it a more advantageous reactogenicity profile than the diethylether-split influenza vaccines available previously, a split virion influenza vaccine has been produced with TritonX-100. In a series of clinical trials, Aventis Pasteur (formerly, Pasteur Mérieux Connaught) tested both the safety and immunogenicity of this TritonX-100-split virion influenza vaccine in 566 subjects (42 children, 296 adults, and 228 elderly adults) during three influenza seasons (1991, 1993, and 1995). The TritonX-100-split virion vaccine was well tolerated: no serious adverse events were recorded during the 21 days following immunization. Among the local reactions observed, mild pain, redness, or induration at the injection site were the most frequently reported. Fever (38.0 to 38.5 degrees C) was noted in five adults or elderly subjects (1%), and in two children (5%). Immunogenicity was determined by measuring serum haemagglutinin antibody titres specific to each vaccine virus strain. In each of the three vaccination campaigns, the TritonX-100-split virion influenza vaccine fulfilled the Notes for Guidance on Harmonization of Requirements for Influenza Vaccines outlined by the Committee for Proprietary Medicinal Products (CPMP) of the European Community for an influenza virus vaccine (i.e., seroprotection, seroconversion, or increase of geometric mean titre) in all age groups.

Adolescent↗
PubMed1999

Comparison of two nested PCR, cell culture, and antigen detection for the diagnosis of upper respiratory tract infections due to influenza viruses.

Influenza surveillance requires sensitive and rapid diagnostic methods. Different diagnostic procedures have been evaluated on a selected set of nasal swabs sample collected from patients presenting with acute respiratory infection. One hundred fifty-four samples collected during the peak of the influenza epidemic recorded during winter of 1997-1998 in the south of France were processed for influenza detection using antigen detection (ELISA-immunocapture assay), two different nested RT-PCR assays (targeting M and HA genes), and cell culture. Among 154 samples, 93 (60.4%) were positive for influenza detection. Forty specimens (26%) were positive by ELISA, 77 (50%) by culture, 88 (57.1%) using the multiplex HA-PCR and 76 (49.4%) using the M-PCR. Multiplex HA-PCR was thus the most sensitive test. The PCR assay offers an alternative to culture for influenza detection. Nevertheless, culture is efficient for influenza diagnosis and is the only technique that allows the reference centres to collect viral strains and characterise fully new variants.

Antigens, Viral↗
PubMed1999

Incidence of upper respiratory tract Mycoplasma pneumoniae infections among outpatients in Rhône-Alpes, France, during five successive winter periods.

In this prospective study, nasal swab samples from patients with acute respiratory infections were evaluated for the presence of Mycoplasma pneumoniae. This PCR-plus-hybridization-based detection was associated with the detection of other viral agents. During the five winter surveillance periods, 3,897 samples were collected by 75 medical practitioners participating in the Groupe Régional d'Observation de la Grippe surveillance network in Rhône-Alpes (France). M. pneumoniae was detected in 283 samples (7.3%); its rate of detection ranged from 10.1 to 2.0% over the five periods, and it was the second most frequently isolated pathogen during the survey, after influenza A. Three high-prevalence winters were observed, yielding an early winter peak of M. pneumoniae infection which was observed in all age groups. No statistically significant difference was detected between rates of infections in the different age groups, but M. pneumoniae infection was significantly related to lower respiratory tract infection during periods of high prevalence. This study defined the frequency of M. pneumoniae detection from nasal swab specimens in patients with acute respiratory infections, confirming its high prevalence and the presence of large outbreaks due to this pathogen.

Adolescent↗
PubMed1998

Tolerance, compliance and psychological consequences of post-exposure prophylaxis in health-care workers.

Our objectives were to evaluate tolerance and compliance of post-exposure triple therapy in health-care workers (HCWs) by retrospective observational study. Structured telephone interview of HCWs identified through data from antiretroviral prescribing centres. Twenty HCWs who received triple prophylaxis were identified over one year. Sixteen agreed to participate in the study. All but one source patient had documented HIV infection. Half HCWs were not aware of post-exposure therapy. Most HCWs received a zidovudine, lamivudine and indinavir combination. All completed at least 4 weeks of therapy. Only 50% received their first dosage less than 4 h after exposure. Nearly all experienced adverse events, mostly digestive (nausea and abdominal pain n=15) or psychological (anxiety and depression n=15), none resulting in therapy discontinuation. Most events occurred 2 to 7 days after therapy initiation. Most modified their sexual life with abstinence or condom use. Compliance was excellent. Half HCWs did not miss any tablet, 4 forgot one dosing a month and 4 one dosing a week. Follow up is over 6 months in all but one HCW. No HIV seroconversion has been observed to date. In France, post-exposure triple antiretroviral therapy is widely available 24 h a day in every emergency room but further training and development of HCWs is needed to decrease consulting time and increase referral to specialized physicians. Notable moderate adverse events, both physical and psychological are noted, however, compliance is excellent.

Adult↗
PubMed1997

Impact of protease inhibitors on AIDS-defining events and hospitalizations in 10 French AIDS reference centres. Fédération National des Centres de Lutte contre le SIDA.

OBJECTIVE: To assess the clinical and economic consequences of the use of protease inhibitors in the treatment of HIV infection. DESIGN: Multicentric, observational, retrospective cohort study. SETTING: Ten AIDS reference centres in France. PATIENTS: All patients followed in each centre from September 1995 through October 1996. MAIN OUTCOME MEASURES: AIDS-defining events, death, health-care resources use, administration of antiretroviral therapy. RESULTS: Data from 7749 patients in 10 centres showed a drop in hospitalization days by 35%, new AIDS cases by 35%, and deaths by 46%. In the same period, the proportion of patients receiving antiretrovirals rose from 36 to 53% including highly active antiretroviral therapy (HAART), which rose from 0.3 to 18%. Overall cost evaluation showed a slight increase of monthly treatment cost of US$ 12 per patient. Comparison of the three centres that used HAART earliest to the three centres that used it latest showed a clear benefit to early HAART with a drop in hospitalization days by 41%, new AIDS cases by 41% and deaths by 69%. The proportion of patients with HAART rose to 27% and monthly health-care cost decreased by US$ 248852 (i.e., by US$ 101 per patient per month). Late prescribing centres experienced a less marked effect with a drop in hospitalization days by 22%, new AIDS cases by 31%, and deaths by 32.5%. Proportion of patients with HAART rose to 12% and monthly health-care costs increased by US$ 113578 (i.e., by US$ 38 per patient per month). CONCLUSIONS: This study supports the extensive use of HAART in HIV-infected patients.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Surveillance of community-acquired viral infections due to respiratory viruses in Rhone-Alpes (France) during winter 1994 to 1995.

Nasal swab from patients with acute flu-like illness were evaluated for the presence of respiratory viruses in the Rhone-Alpes region of France from 1 October 1994 through 2 May 1995. The relative frequencies and seasonal distributions of the specific viruses were assessed. In addition, virus type was correlated with specific clinical signs and symptoms. During the study, 962 samples were collected by 75 medical practitioners participating in the Groupe Regional d'Observation de la Grippe surveillance network. One or more viruses were detected from 348 samples (36.1%), including 108 respiratory syncytial virus (RSV), 64 influenza virus A type H3N2, 47 influenza virus B, 64 coronavirus, 35 rhinovirus, 22 adenovirus, 5 enterovirus, and 3 parainfluenza-fluenza strains. There were 16 mixed infections. RSV infections peaked in the early winter, and influenza viruses A and B infections peaked during the late winter and early spring. There were two peaks of coronavirus infections (late fall and late winter). Other viruses were detected at lower levels throughout the study period. Patients from whom adenovirus was isolated were significantly more likely to have a fever of > 39.5 degrees C than were patients with other detectable viruses (P < 0.001). Furthermore, there was a significant correlation between influenza and cough (P < 0.01) and RSV and bronchiolitis (P < .001). Thus, the current study defined the overall and relative frequencies of respiratory virus detection from nasal swab specimens in patients with an acute flu-like illness in the Rhone-Alpes region of France during a 7-month period. Correlation with clinical signs and symptoms and provisional conclusions regarding seasonality were also determined.

Adenovirus Infections, Human↗
PubMed1994

Isolation of two H1N2 influenza viruses from swine in France.

Samples collected in 1987 and 1988 in Brittany from influenza-infected swine made it possible to isolate and antigenically characterize two H1N2 recombinant viruses (Sw/France/5027/87 and Sw/France/5550/88). The former virus was cloned and reinoculated to swine to allow reproduction of the disease and reisolation of a strain similar to the original one. The serodiagnostic tests carried out on both the original sera and those from the experimentally infected animals confirmed that the virus was actually type Sw/H1N2.

Animals↗
PubMed1994

[Plurifocal alveolar pneumonia in a patient with AIDS: disseminated Mycobacterium avium intracellulare infection with difficult diagnosis].

In patients with the acquired immunodeficiency syndrome (AIDS), manifestations of generalized Mycobacterium avium intracellulare infection are non-specific and pneumopathy is rarely encountered. We report a case of a patient with AIDS who had clinical and radiological manifestations of multifocal alveolar pneumopathy which was found on autopsy to be due to disseminated Mycobacterium avium intracellulare.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Susceptibilities to rimantadine of influenza A/H1N1 and A/H3N2 viruses isolated during the epidemics of 1988 to 1989 and 1989 to 1990.

Clinical isolates of influenza A viruses identified during outbreaks in two winters were tested for their rimantadine susceptibilities by an enzyme-linked immunosorbent assay modified from that described previously by Belshe et al. (R. B. Belshe, B. Burk, F. Newman, R. L. Cerruti, and I. S. Sim, J. Virol. 62:1508-1512, 1988). The infectivity titer and the 50% inhibitory concentration of rimantadine were calculated for each virus. Of 105 influenza virus A isolates tested, 28 influenza A/H1N1 isolates from the 1988 and 1989 outbreak and 77 influenza A/H3N2 isolates from the outbreak in following year, were susceptible to the antiviral action of rimantadine.

Animals↗
PubMed1990

Antigenic properties and protective capacity of a cyclic peptide corresponding to site A of influenza virus haemagglutinin.

Two cyclic peptide analogues corresponding to residues 139-146 (site A) of influenza A virus haemagglutinin (strain X31) were synthesized. The ability of these peptides to react with anti-influenza virus antibodies was found to depend on the conformation of the loop and on the orientation in which the peptide was presented to antibodies. Antibodies raised to the peptides were able to bind in ELISA with influenza virus antigen that had been allowed to dry on the microtitre plate. When OF1 mice were immunized with cyclic peptides, approximately 80% of the animals were protected against an intranasal challenge with influenza virus.

Amino Acid Sequence↗
PubMed1988

Prophylactic and therapeutic effects of murabutide in OF1 mice infected with influenza A/H3N2 (A/Texas/1/77) virus.

The antiviral activity of a novel biological response modifier (murabutide MDP derivative) has been investigated in 3-week-old OF1 mice infected with influenza (A/Texas/1/77) virus. In each experimental and control group, 10 mice were infected intranasally with a viral dose producing 50% mortality in 5 days and received murabutide via the subcutaneous or intranasal route at various doses either in a simple or in daily repeated administration. All experiments were done in triplicate. Significant prophylactic or therapeutic effects were observed when murabutide was administered the same day as virus, 4 days or 2 days before virus, and 2 days later. These effects varied with the route of administration and the doses of the compound.

Acetylmuramyl-Alanyl-Isoglutamine↗