Les poux : diagnostic,nuisance et rôle vectoriel

The three specific human ectoparasites are described. Pediculus capitis is the most widespread in France. The capitis pediculosis is a minor nuisance but a medical and economic problem mainly due to the inefficiency and the hight cost of the treatment and due to the absence of a public health politic specific to this subject. Pediculus corporis is the one species able to transmit pathogenic agents as Rickettsia prowasekii, the agent of exanthematic typhus. Pthirius pubis, rare, is the agent of a minor sexually transmitted disease, but it indicates the existence of sexual relations at risk. Pruritus and contagious circumstances help to remind to the diagnosis which is confirmed only when the parasites or their nits are found : P. capitis on the scalp, P. corporis in the clothes or in bedding and P. pubis mainly on the pubis hair.     

Stratégies de prévention des infections à CMV chez les sujets immunodéprimés

Cytomegalovirus (CMV) infection in immunosuppressed patients is associated with mortality if treatment is not prescribed.Strategies for the prevention of CMV disease is very important to establish. The choice of a strategy depends on epidemiologic factors (CMV-positivity of the patient or of the donor if transplantation), on the type of immunosuppression (allogeneic bone marrow transplantation, solid organ transplantation, HIV infected patients, long-term corticosteroid therapy). Several strategies for prevention can be proposed : prophylaxis for all patients, prophylaxis only for patients at high-risk, preemptive therapy when antigenemia or PCR (leucocytes or plasma) are positive, secondary prophylaxis. A treatment is proposed, except for CMV-negative patient, and CMV-negative donor if transplantation. It can be intravenous and/or oral ganciclovir, intravenous acyclovir or oral valaciclovir. Valganciclovir is an oral prodrug of ganciclovir that can be used in HIV patients with CMV disease. The strategy employed must have the better efficacy but quality of life and cost-effectivness have to be considered. Clinical evaluation is useful to determine the more adapted strategy.     

Mise en place et fonctionnement de l'hémovigilance en France : Les lois,les décrets,les arrêtés,les notes et les directives

A national system of surveillance and alert, from blood collection to the follow-up of the recipients called haemovigilance, is now operational in French. Three tools : traceability from donors to recipients, reports of transfusion adverse events, and rigorous management of information related to the transfusion process.     

Dispositifs médicaux de diagnostic in vitro : Le point sur la réglementation actuelle et future

The French regulation for IVD-MD is changing as a result of the new European directive. Vigilance was planned in the previous regulation as it is in the European regulation. Its putting into service is being studied but won't be easy.