Actus Santé

Sclérose Tubéreuse de Bourneville

HAS - Recommandations et guides - mer, 20/10/2021 - 13:01

Ce protocole national de diagnostic et de soins (PNDS) explicite aux professionnels concernés la prise en charge diagnostique et thérapeutique optimale et le parcours de soins d’un patient atteint d’une Sclérose Tubéreuse de Bourneville. Il a été élaboré par le Centre de Référence des Epilepsies Rares du CHU de Lille et de Necker Enfants Malades à l’aide d’une méthodologie proposée par la HAS. Il n’a pas fait l’objet d’une validation par la HAS qui n’a pas participé à son élaboration.

Catégories: Actus Santé

Sclérose Tubéreuse de Bourneville

HAS - Recommandations et guides - mer, 20/10/2021 - 13:01

Ce protocole national de diagnostic et de soins (PNDS) explicite aux professionnels concernés la prise en charge diagnostique et thérapeutique optimale et le parcours de soins d’un patient atteint d’une Sclérose Tubéreuse de Bourneville. Il a été élaboré par le Centre de Référence des Epilepsies Rares du CHU de Lille et de Necker Enfants Malades à l’aide d’une méthodologie proposée par la HAS. Il n’a pas fait l’objet d’une validation par la HAS qui n’a pas participé à son élaboration.

Catégories: Actus Santé

Campagne d'information et de sensibilisation autour du don de gamètes

Agence de la Biomédecine - mer, 20/10/2021 - 12:00
Afin d'accompagner les changements apportés par la nouvelle loi du 2 août 2021 relative à la bioéthique, l'Agence de la biomédecine lance une nouvelle campagne de communication à destination du grand public.

La loi du 2 août 2021 relative à la bioéthique fait évoluer le cadre juridique de l'assistance médicale à la procréation (AMP) [également dénommée procréation médicalement assistée (PMA)], en élargissant son accès aux couples de femmes et aux femmes non mariées. Par ailleurs, elle ouvre un droit nouveau aux enfants issus d'une AMP avec don de gamètes, en leur donnant la possibilité d'accéder, s'ils en font la demande, à leur majorité, à l'identité de leur donneur, ainsi qu'à des informations non identifiantes le concernant. Afin de renforcer l'effort de mobilisation en faveur du don de gamètes et d'informer sur les nouveaux droits ouverts par la loi, l'Agence de la biomédecine lance une grande campagne de communication.

UNE CAMPAGNE DE COMMUNICATION EN DEUX VOLETS

Afin de répondre aux nouveaux besoins et de diversifier les profils de donneurs et des donneuses, l'Agence de la biomédecine poursuit et intensifie son travail de sensibilisation et de pédagogie, commencé en 2008. Pour cela, une vaste campagne de communication en deux volets est lancée le 21 octobre prochain, en étroite collaboration avec les professionnels de santé.

1. Une nouvelle campagne à destination des donneurs potentiels
La campagne de communication a pour objectif de faire connaître les évolutions de la loi et de sensibiliser autour de la problématique du don de gamètes et de l'assistance médicale à la procréation. À destination des donneurs potentiels et d'un public large, cette campagne a pour but d'augmenter le nombre de dons annuels afin de répondre aux besoins des receveurs, dans toute leur diversité.

2. Une campagne de communication spécifique sur le droit d'accès aux origines
Une campagne spécifique est également menée pour informer sur le nouveau droit d'accès aux origines, institué par la loi au bénéfice des personnes issues de don de gamètes ou d'embryons.
Cette campagne a pour objectif de rassurer les donneurs sur les motivations de ces enfants nés d'une AMP avec don de gamètes : « Je suis né(e) grâce à un don de spermatozoïdes / d'ovocytes. Aujourd'hui, je ne cherche pas un parent ; mais des réponses ».

Pour toute question concernant les relations presse :
Agence de la biomédecine :
Hélène Duguet - presse@biomedecine.fr - 06 16 35 91 80
Agence TBWA\CORPORATE :
Violaine Bourquin - violaine.bourquin@tbwa-corporate.com - 06 07 46 34 89
Blanche Bobin-Parra - blanche.bobin-parra@tbwa-corporate.com - 06 48 40 75 16
Catégories: Actus Santé

Anomalies du développement liées aux variants de CDH1

HAS - Recommandations et guides - mer, 20/10/2021 - 11:23

Ce protocole national de diagnostic et de soins (PNDS) explicite aux professionnels concernés la prise en charge diagnostique et thérapeutique optimale et le parcours de soins d’un patient atteint d’une anomalie du développement liée à CDH1. Il a été élaboré par le Centre de référence des anomalies du développement et syndromes malformatifs de l'inter région Nord-Ouest à l’aide d’une méthodologie proposée par la HAS. Il n’a pas fait l’objet d’une validation par la HAS qui n’a pas participé à son élaboration.

Catégories: Actus Santé

Anomalies du développement liées aux variants de CDH1

HAS - Recommandations et guides - mer, 20/10/2021 - 11:23

Ce protocole national de diagnostic et de soins (PNDS) explicite aux professionnels concernés la prise en charge diagnostique et thérapeutique optimale et le parcours de soins d’un patient atteint d’une anomalie du développement liée à CDH1. Il a été élaboré par le Centre de référence des anomalies du développement et syndromes malformatifs de l'inter région Nord-Ouest à l’aide d’une méthodologie proposée par la HAS. Il n’a pas fait l’objet d’une validation par la HAS qui n’a pas participé à son élaboration.

Catégories: Actus Santé

Ségur de la santé - Investir pour la santé de tous, partout

Consultez le dossier de presse "Ségur de la santé - Investir pour la santé de tous, partout"
pdf Dossier de presse | Ségur de la santé - Investir pour la santé de tous, (...) Téléchargement (496.9 ko)
Catégories: Actus Santé

L’analyse des évènements indésirables associés aux soins (EIAS) : mode d’emploi

HAS - Recommandations et guides - mer, 20/10/2021 - 08:44

Apporter aux professionnels un guide méthodologique simple et didactique

  • Améliorer la qualité des analyses d’EIAS
  • Développer la culture sécurité des professionnels du soin et de l’accompagnement
  • Proposer une approche fondée sur une analyse objective, une culture juste et positive de l’EI (apprendre de ses erreurs)
Catégories: Actus Santé

L’analyse des évènements indésirables associés aux soins (EIAS) : mode d’emploi

HAS - Recommandations et guides - mer, 20/10/2021 - 08:44

Apporter aux professionnels un guide méthodologique simple et didactique

  • Améliorer la qualité des analyses d’EIAS
  • Développer la culture sécurité des professionnels du soin et de l’accompagnement
  • Proposer une approche fondée sur une analyse objective, une culture juste et positive de l’EI (apprendre de ses erreurs)
Catégories: Actus Santé

Evidence of transmission from fully vaccinated individuals in a large outbreak of the SARS-CoV-2 Delta variant in Provincetown, Massachusetts

Multiple summer events, including large indoor gatherings, in Provincetown, Massachusetts (MA), in July 2021 contributed to an outbreak of over one thousand COVID-19 cases among residents and visitors. Most cases were fully vaccinated, many of whom were also symptomatic, prompting a comprehensive public health response, motivating changes to national masking recommendations, and raising questions about infection and transmission among vaccinated individuals. To characterize the outbreak and the viral population underlying it, we combined genomic and epidemiological data from 467 individuals, including 40% of known outbreak-associated cases. The Delta variant accounted for 99% of sequenced outbreak-associated cases. Phylogenetic analysis suggests over 40 sources of Delta in the dataset, with one responsible for a single cluster containing 83% of outbreak-associated genomes. This cluster was likely not the result of extensive spread at a single site, but rather transmission from a common source across multiple settings over a short time. Genomic and epidemiological data combined provide strong support for 25 transmission events from, including many between, fully vaccinated individuals; genomic data alone provides evidence for an additional 64. Together, genomic epidemiology provides a high-resolution picture of the Provincetown outbreak, revealing multiple cases of transmission of Delta from fully vaccinated individuals. However, despite its magnitude, the outbreak was restricted in its onward impact in MA and the US, likely due to high vaccination rates and a robust public health response.
Catégories: Actus Santé

Airborne transmission of SARS-CoV-2 over distances greater than two metres: a rapid systematic review

Objective To evaluate the potential for long-distance (over two metres) airborne transmission of SARS-CoV-2 in indoor community settings and investigate factors which may impact this transmission. Design Systematic review and narrative synthesis. Data source MEDLINE, Embase, medRxiv, Arxiv and WHO COVID-19 Research Database for studies published from 27 July 2020 to 21 April 2021; existing relevant rapid systematic reviews for studies published between 1 January to 27 July 2020. Eligibility criteria for study selection Observational studies that included a thorough epidemiological assessment of routes of transmission and which reported on the likelihood of airborne transmission of SARS-CoV-2 at a distance greater than two metres in indoor community settings. Data extraction and synthesis Data extraction was completed by one reviewer and independently checked by a second reviewer. Primary outcomes were COVID-19 infections via airborne transmission over distances greater than two metres and any factors that may have modified transmission risk. Included studies were rated using a quality criteria checklist (QCC) for primary research and certainty of key outcomes was determined using GRADE. Narrative synthesis was themed by setting. Results Of the 3,780 articles screened for inclusion, 15 publications reporting on 13 epidemiological investigations were included (three high, six medium and four low quality). Airborne transmission at distances greater than two metres was likely to have occurred for some or all transmission events in 12 studies and was unclear in one study (GRADE: very low certainty). In all studies, one or more factors plausibly increased the likelihood of long-distance airborne transmission occurring, particularly insufficient air replacement (GRADE: very low certainty), recirculating air flow (GRADE: very low certainty) and singing (GRADE: very low certainty). In nine studies, the primary cases were reported as being asymptomatic, presymptomatic or around symptom onset at the time of transmission. Conclusion This rapid systematic review found evidence of long-distance airborne transmission of SARS-CoV-2 in indoor community settings and identified factors that likely contributed to this transmission in all included studies. These results strengthen the need for adequate mitigation measures in indoor community settings, particularly adequate ventilation with fresh air, and caution required with the use of recirculating air flow systems. Systematic review registration PROSPERO CRD42021236762
Catégories: Actus Santé

Mutations on non-structural proteins of SARS-CoV-2 are possibly responsible for adverse clinical outcomes in a real-life practice

Among a single COVID-19 cluster population from the end of March through April 2021 in Asahikawa, we experienced the cases in which patients manifested severe clinical symptoms compared to patients who were infected before that. A hundred three patients (age range: 65 to 89 years old) enrolled in this study were divided into two groups, group A: the patients infected from November 2020 to March 2021, and group B: the patients in this cluster population. The mortality rates were 6.1% in group A and 16.2% in group B (OR: 2.97, 95%CI: 0.65-15.38). For the severity of disease, the patients in group B reached to the clinical state which requires higher oxygen flow rate more quickly (mild; p=0.892, moderate; p=0.117, severe; p=0.029). Whole viral genome sequences revealed five non-synonymous mutations by comparison of the isolates with each group. Of these, four were on NSPs including nsp3, 6 and 15, and one was on S protein located near the C-terminus, suggesting that mutations on NSPs could be responsible for adverse clinical outcomes in COVID-19 patients.
Catégories: Actus Santé

Modeling brings additional insights into the kinetics of SARS-CoV-2 neutralizing antibody

Following the paper by Seow et al. published in Nature Microbiology, we reanalyzed the publicly available data using dynamical models of humoral response. The main conclusion is that, from available data, we can demonstrate that the decline of neutralizing antibodies (as measured with ID50) is biphasic, which is compatible with two types of antibody secreting cells (short lived and long lived). We found that lower bound of half life of the long-lived antibody secreting cells is 450 days. Moreover, our model predicts that the neutralizing antibody response could be more durable than suggested (up to 129 days for individuals with no requirement of supplemental oxygen and up to 175 days for others). A result which adds insight on the longevity of immune response.
Catégories: Actus Santé

SARS-CoV-2 variants associated with vaccine breakthrough in the Delaware Valley through summer 2021

The severe acute respiratory coronavirus-2 (SARS-CoV-2) is the cause of the global outbreak of COVID-19. Evidence suggests that the virus is evolving to allow efficient spread through the human population, including vaccinated individuals. Here we report a study of viral variants from surveillance of the Delaware Valley, including the city of Philadelphia, and variants infecting vaccinated subjects. We sequenced and analyzed complete viral genomes from 2621 surveillance samples from March 2020 to September 2021 and compared them to genome sequences from 159 vaccine breakthroughs. In the early spring of 2020, all detected variants were of the B.1 and closely related lineages. A mixture of lineages followed, notably including B.1.243 followed by B.1.1.7 (alpha), with other lineages present at lower levels. Later isolations were dominated by B.1.617.2 (delta) and other delta lineages; delta was the exclusive variant present by the last time sampled. To investigate whether any variants appeared preferentially in vaccine breakthroughs, we devised a model based on Bayesian autoregressive moving average logistic multinomial regression to allow rigorous comparison. This revealed that B.1.617.2 (delta) showed three-fold enrichment in vaccine breakthrough cases (odds ratio of 3; 95% credible interval 0.89-11). Viral point substitutions could also be associated with vaccine breakthroughs, notably the N501Y substitution found in the alpha, beta and gamma variants (odds ratio 2.04; 95% credible interval of 1.25-3.18). This study thus provides a detailed picture of viral evolution in the Delaware Valley and a geographically matched analysis of vaccine breakthroughs; it also introduces a rigorous statistical approach to interrogating enrichment of viral variants.
Catégories: Actus Santé

SARS-CoV-2 variant transmission in a community-health population (Mexico City, Mexico)

The SARS-CoV-2 variant, B.1.1.519, arose in North and Central America, circulating primarily in Mexico. We demonstrate that this variant peaked during the second wave of COVID-19 in Mexico City in the spring of 2021. This variant is likely more infectious, attributed to mutation in the RBD of the spike protein T478K also seen in the alpha variant (B.1.1.7). However the time dynamics of the spread of this variant drastically changed upon the introduction of delta (B.1.617.2) to the country in which we observe a shift from 0% in May 2021 to 55% delta in the span of one month. Since the delta variant has dominantly spread across the globe, we investigated the increasing frequency of the Mexico variant , B.1.1.519, in the public community within Mexico City. Once present, the delta variant was 78% of the Mexico City catchment in July 2021, a time which marked the commencement of Mexicos third wave. Our data supports the growing concern that the delta variant is closely associated with the massive infection spread of the VOC in Central and South America. While the T478K mutation, also seen in the alpha variant, has evidence for increased transmissibility, these data suggest that the delta variant shows overall increased fitness seeing as it outcompeted the B.1.1519 this Mexico community.
Catégories: Actus Santé

Longitudinal and comparative analysis of humoral response upon COVID-19 vaccination

The emergence of COVID-19 has led to a worldwide challenge for the rapid development of vaccines. Several types of safe and effective vaccines have been available in a time frame never seen before. Comparative studies to know the extent of protection and the immune response elicited by the different vaccines are of outstanding utility. Here, as a correlate for protection, we perform a comparative study of the humoral response to three vaccines, ChAdOx1 (Oxford-AstraZeneca), mRNA-1273 (Moderna), and BNT162b2 (Pfizer-BioNTech) by applying a flow cytometry-based highly sensitive method that we had previously developed. We have found that mRNA vaccines (mRNA-1273 and BNT162b2) induce a stronger humoral response that lasts for at least 6 months after vaccination. We also show that only one dose of BNT162b2 is enough to achieve the maximum response in seropositive pre-vaccination donors.
Catégories: Actus Santé

Immune Responses in Fully Vaccinated Individuals Following Breakthrough Infection with the SARS-CoV-2 Delta Variant in Provincetown, Massachusetts

Background A cluster of over a thousand infections with the SARS-CoV-2 delta variant was identified in a predominantly fully vaccinated population in Provincetown, Massachusetts in July 2021. Immune responses in breakthrough infections with the SARS-CoV-2 delta variant remain to be defined. Methods Humoral and cellular immune responses were assessed in 35 vaccinated individuals who were tested for SARS-CoV-2 in the Massachusetts Department of Public Health outbreak investigation. Results Vaccinated individuals who tested positive for SARS-CoV-2 demonstrated substantially higher antibody responses than vaccinated individuals who tested negative for SARS-CoV-2, including 28-fold higher binding antibody titers and 34-fold higher neutralizing antibody titers against the SARS-CoV-2 delta variant. Vaccinated individuals who tested positive also showed 4.4-fold higher Spike-specific CD8+ T cell responses against the SARS-CoV-2 delta variant than vaccinated individuals who tested negative. Conclusions Fully vaccinated individuals developed robust anamnestic antibody and T cell responses following infection with the SARS-CoV-2 delta variant. These data suggest important immunologic benefits of vaccination in the context of breakthrough infections.
Catégories: Actus Santé

One-dose ChAdOx1 nCoV-19 Vaccine Effectiveness Against Symptomatic COVID-19 in a vulnerable community in Rio de Janeiro, Brazil: test-negative design study

We conducted a test-negative study design at the community "Complexo da Mar&eacute", the largest group of favelas in Rio de Janeiro, Brazil, when Gamma and Delta were the predominant variants circulating. We estimated 42.4% (95% CI, 24.6, 56.0) protection against symptomatic COVID-19 after 21 days of one dose of ChAdOx1.
Catégories: Actus Santé

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