Bull Acad Natl Med
· 2021 Oct · PMID 34248144
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The COVID-19 pandemic required a rapid adaptation of health care organization. The objective was to ensure the care of patients avoiding contamination at the time of delivery and for the nursing staff. The establishment...The COVID-19 pandemic required a rapid adaptation of health care organization. The objective was to ensure the care of patients avoiding contamination at the time of delivery and for the nursing staff. The establishment of parent-child essential links beyond the pandemic was also taken into account. The reorganization of care first relied upon the constitution of a multidisciplinary operational team which allowed for efficient responsiveness. Then, the activities were refocused on the epidemic situation with the deprogramming of non-urgent activities and the articulation with the ambulatory network. A reorganization of the schedules and a specific training in dressing were carried out. The supply of surgical masks, disinfectant gels and wipes has been provided. A triage of admissions was set up with a special circuit and dedicated staff. A specific delivery room and operating theater equipped with strictly essential materials have been associated with a specific neonatal resuscitation station. In neonatology, two sectors where positive pressure has been suspended have been dedicated to families at risk. Wearing a mask and washing hands with disinfection with hydroalcoholic gel was required for all patients. The children were left at their mothers' bedside in a private room. An incentive for breastfeeding was made. Early discharge from 48 hours was systematically organized with relay by midwife at home. In conclusion, this adaptation of the organization of care has made it possible to respond satisfactorily to the specific situation of this pandemic.
Bull Acad Natl Med
· 2021 Oct · PMID 34248143
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Full text
With the COVID-19 pandemic, barrier measures also concerned the world of work. In particular, teleworking was encouraged over a long period in France and then generalized in April 2021, promoting social isolation. The an...With the COVID-19 pandemic, barrier measures also concerned the world of work. In particular, teleworking was encouraged over a long period in France and then generalized in April 2021, promoting social isolation. The anxious climate linked to the pandemic and the precipitous nature of this decision induced a new psychosocial risk factor. The psychological manifestations linked to stress: anxiety, depressive disorders and others justify without delay a global action plan with systematic support measures by local management, systematic screening for possible maladjustment by the occupational health services and support people in difficulty. For this purpose and in these circumstances, self-questionnaires, directed questionnaires and video interviews appear to be the most suitable means. The chosen and part-time teleworking making it possible to reconcile family and professional life will remain a solution at certain times of life, but full-time teleworking cannot constitute an univocal and lasting solution.
Bull Acad Natl Med
· 2021 Aug · PMID 34108733
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Coronaviruses are RNA viruses classified into Alphacoronavirus, Betacoronavirus, Gammacoronavirus and Deltacoronavirus. Their name comes from their conformation with the observation of spicules forming a sort of crown. C...Coronaviruses are RNA viruses classified into Alphacoronavirus, Betacoronavirus, Gammacoronavirus and Deltacoronavirus. Their name comes from their conformation with the observation of spicules forming a sort of crown. Coronaviruses seem to come from bats, and more particularly Alphacoronaviruses and Betacoronaviruses (the genus where zoonoses are observed), while birds are the source of Gammacoronaviruses and Deltacoronaviruses. The first coronavirus identified was that of avian infectious bronchitis in 1931 in the United States, while the first coronaviruses were described in humans only in the 1960s. This is why coronaviruses were mainly known in the veterinary community. Most Alphacoronaviruses are species specific. They can be responsible for serious diseases such as the cat coronavirus, responsible for feline infectious peritonitis, transmissible gastroenteritis (GET) in piglets and porcine epidemic diarrhea (PED), porcine respiratory coronavirus (PRCV). Finally, a deltacoronavirus can be found in both pigs (PD CoV UKU15) and birds.
Migus A, Ardaillou R, Berche P
… +6 more, Boitard C, Clément B, Couvreur P, Debré P, Netter P, au nom d’un groupe de travail bi-académique de l’Académie nationale de pharmacie et de l’Académie nationale de médecine
Bull Acad Natl Med
· 2021 Aug · PMID 34092797
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The COVID-19 pandemic occurred in the context of a dramatic decline in support for biological and health research in France. An analysis of resources allocated to this sector shows that the credits in 2020 correspond to...The COVID-19 pandemic occurred in the context of a dramatic decline in support for biological and health research in France. An analysis of resources allocated to this sector shows that the credits in 2020 correspond to only 17.2 % of the total credits allocated to research, the lowest ratio inat least 15 years. Another weakness in the system of support for hospital research is the way funds from the health insurance system are allocated. To bring it into line with international best practices, the task of allocating these funds should be entrusted to a "Hospital Research Orientation Council", which should also be involved in the implementation of national research programming. Another article deals with the organization of research. Recommendations are also made to improve the functioning of the research system at the local level, particularly in university hospitals, and at the national level.
Bull Acad Natl Med
· 2021 Aug · PMID 34092795
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Coronavirus disease in veterinary medicine has been known since 1931 and is the cause of one of the most damaging diseases in poultry farming: avian infectious bronchitis (BIA). The characteristics most useful for the st...Coronavirus disease in veterinary medicine has been known since 1931 and is the cause of one of the most damaging diseases in poultry farming: avian infectious bronchitis (BIA). The characteristics most useful for the study of epidemiology are presented, in particular the very strong mutagenicity and the seasonality of infections with this virus. The control programs are based on numerous biosecurity measures applied as much to prevent viruses from spreading from sources of infection: biocontainment measures, as to measures to prevent contamination of uninjured herds: bioexclusion measures The control of avian coronaviruses is based mainly on vaccinations and because of the very strong mutagenic power of the virus, a race is regularly underway, to succeed in matching the different viruses frequently appearing in farms and vaccine viruses. This also obliges us to adapt each time and region by region the pool of vaccines used and the vaccination programs used.
Bull Acad Natl Med
· 2021 Aug · PMID 34092794
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The city of Wuhan, capital of Hubei, was the starting point of the Covid-19 epidemic and its doctors were led to develop novel strategies that have benefited the global fight in the country. But whatever strategies we ho...The city of Wuhan, capital of Hubei, was the starting point of the Covid-19 epidemic and its doctors were led to develop novel strategies that have benefited the global fight in the country. But whatever strategies we hold up, the basic golden rule for controlling the pandemic has been early detection, reporting, isolation and treatment. The modalities of the battle were: swift action to block transmission with a vigorous, multifaceted response; resource allocation (a nationwide command system); Fangcang shelter hospitals; Broad community engagement: -provision of support via a volunteer network; People embraced behavioral change: -wearing masks and social distancing; Widespread testing: technical innovation; Science and technology curb the pandemic with research and digital technology; Free diagnosis and treatment for COVID-19. The success of our experience has provided valuable information to the international community in the fight against the pandemic.
Bull Acad Natl Med
· 2021 Aug · PMID 34075253
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From the beginning of this century, three coronaviruses (CoVs) have caused severe human respiratory diseases, including severe respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and corona virus disease...From the beginning of this century, three coronaviruses (CoVs) have caused severe human respiratory diseases, including severe respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and corona virus disease 2019 (COVID-19), which outbroke in 2002-2003, 2012 and 2019-2020, respectively. These viruses are three different species belonging to family, genus. Discovery of closely-related CoVs in bats indicates that bats are natural reservoirs of these viruses. How and when the bat CoVs cross-species barriers to infect humans are largely understudied. This article provides an overview of the distribution, genetic evolution and interspecies transmission of bat coronaviruses in China, particularly focusing on bat SARS-related CoVs (SARSr-CoVs). Our studies showed that SARS-related CoVs are highly prevalent in horseshoe bats and some of them use the same receptor as SARS-CoV and SARS-CoV-2 and have wide cell tissue tropism. However, these bat viruses seem to be low pathogenic in human ACE2 transgenic mice compared with the SARS-CoV-2. These results imply that these bat CoVs have potential interspecies transmission to other animals and humans. Our work highlights the necessity of preparedness for future emerging infectious diseases caused by these CoVs.