M Duong

Centre Hospitalier Universitaire de Dijon, Dijon, Bourgogne, France

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Publications (76)271.9 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction Les consultations informelles en infectiologie (CII) constituent un travail non négligeable pour les praticiens. Cette étude vise à objectiver rétrospectivement cette activité en la quantifiant et en établissant ses caractéristiques. Méthodes Les données ont été recueillies à partir des demandes faxées, d’octobre 2009 à mai 2012. Mille neuf cent soixante-douze avis ont été inclus. Après analyse de la demande, un entretien téléphonique avec le demandeur permettait d’apporter des précisions puis, l’avis était transmis par fax. Résultats Les patients avaient en moyenne 64 ± 21 ans. Vingt-neuf pour cent des requêtes émanaient des services de chirurgie et 71 % de médecine. La cardiologie (10 %), l’hépato-gastro-entérologie (10 %) et la chirurgie cardiovasculaire (9,69 %) étaient les plus représentées. Les pathologies principales étaient urogénitales (19 %), ostéoarticulaires (14 %) et cardiovasculaires (11 %). Quarante-neuf pour cent étaient qualifiées de nosocomiales et 25,3 % étaient des bactériémies. Les demandes concernaient dans 95,6 % une question thérapeutique et diagnostique dans 16,2 % des cas. Les recommandations de l’infectiologue étaient thérapeutiques dans 96,5 % des cas et diagnostiques dans 43,7 %. Une modification du traitement était suggérée dans 38,5 % des cas. Vingt-deux pour cent des consultations avaient nécessité un avis supplémentaire. Conclusion Ce travail démontre, par les importantes modifications de traitements antibiotiques, le nombre de demandes qui augmente et la complexité des cas, la nécessité d’avis en infectiologie dans notre établissement. Le système « en deux étapes » par fax mis en place semble acceptable pour tenter de limiter les biais liés au mode informel par rapport à celui du téléphone, modalité la plus usitée dans d’autres établissements.
    Médecine et Maladies Infectieuses 03/2014; · 0.75 Impact Factor
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    ABSTRACT: It is not clearly known how frequently the recommendations given to travelers are followed, and what factors could encourage compliance with these recommended measures. Adults consulting at a Medical Department for International Travelers (International Travelers' Medical Services, ITMS) in October and November 2010 were asked to answer a questionnaire before their journey. They were also contacted for a post-travel telephone interview to determine whether they had followed the recommendations regarding vaccinations and malaria prevention, and the reasons for poor or noncompliance with these recommendations. A total of 353 travelers were included, with post-travel data available for 321 of them. Complete compliance with all the recommendations (vaccinations and malaria chemoprophylaxis) was observed in 186/321 (57.9%) of the travelers. Only 55.6% (233/419) of the prescribed vaccinations were given, with huge variability according to the type of vaccine. Only 57.3% (184/321) of the patients used a mosquito net. Among the 287 prescriptions for antimalarial drugs, 219 (76.3%) were taken correctly, 37 (12.9%) were taken incorrectly (noncompliance with the duration and/or dosage), and 31 (10.8%) were not taken at all. Traveling to areas of mass tourism (Kenya/Senegal), consulting their general practitioner (GP), and being retired were significantly and independently associated with better overall compliance in univariate and multivariate analyses. Compliance could be improved by focusing on factors associated with poor compliance to improve the advice given to less compliant travelers, by providing clear information tailored to each traveler, with a focus on key messages, and by improving coordination between ITMS and GPs.
    Journal of Travel Medicine 03/2013; 20(2):78-82. · 1.68 Impact Factor
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    ABSTRACT: Disseminated non-tuberculosis mycobacterial infections are associated with a defect of the cellular immune response. They have been mainly reported in AIDS patients. Cases related to the presence of anti-interferon-γ autoantibodies are rare. We report a non HIV-infected 45-year-old Thai woman, with a past medical history of Graves' disease. She presented with recurrent disseminated and severe non-tuberculous mycobacterial infections that were related to the production of anti-interferon-γ autoantibody. The diagnosis was suspected in the presence of a negative interferon-γ release assay (IGRA) including with the positive control, and evidenced by the identification of specific antibodies. Anti-interferon-γ autoantibody production is a rare cause of non tuberculous mycobacterial infection. Such a mechanism should be suspected in non HIV-infected patients and especially in those having an Asiatic ethnicity or an associated immune disorder. A negative IGRA (including with the positive control) is a reliable diagnostic tool and should be completed with the identification of specific autoantibodies.
    La Revue de Médecine Interne 02/2012; 33(2):103-6. · 0.90 Impact Factor
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    ABSTRACT: We report three consecutive cases of tularemia occurring in Burgundy, France, a region previously considered not endemic for tularemia. The patients presented with varied and unspecific clinical manifestations. The epidemiological circumstances, especially the mode of contamination, were not particularly suggestive of tularemia. Serological diagnosis was delayed in two cases because of the lack of significant antibody titers at the time of admission. In contrast, a diagnosis could readily be obtained in all three cases by detection of Francisella tularensis DNA from clinical samples using PCR-based methods. These cases highlight the increased incidence and geographical spread of tularemia in France, and the usefulness of real-time PCR technology for the early diagnostic confirmation of tularemia.
    International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 12/2011; 15(12):e882-3. · 2.17 Impact Factor
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    ABSTRACT: The aim of the study was to identify the most useful clinical criteria to measure effectiveness and adherence to antiretroviral treatment in a rural area of Cameroon. All patients under antiretroviral therapy followed for at least 3 months at the Tokombéré UPEC hospital were eligible. Therapeutic failure was defined according to clinical criteria including weight, Karnofsky's index, or occurrence of WHO stage IV conditions. The criteria for drug adherence were based on patient statement (drugs taken over the last 4 days) and pharmacy-controlled drug delivery. Patient sociodemographic characteristics were collected via a questionnaire. Fifty-six patients were included, most of whom were at AIDS stage on treatment initiation. The mean duration of antiretroviral therapy was 1 year. 21, 10, and 19% of patients were in therapeutic failure according to "weight", "Karnofsky's index", and "WHO stage IV", respectively. Non-adherence was reported in 5% of patients according to the declarative method and 20% according to pharmacy controlled drug delivery. Weight modification during treatment was significantly correlated with the evolution of Karnofsky's index (p=0.03). A significant correlation between therapeutic failure and non-observance was only found when using the weight criterion and the declarative method (p=0.004). The effectiveness and adherence to antiretroviral therapy can be evaluated by simple clinical criteria. Using these criteria can be recommended in rural areas until access to biological follow-up becomes available in developing countries.
    Médecine et Maladies Infectieuses 04/2011; 41(4):176-80. · 0.75 Impact Factor
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    ABSTRACT: Objectives The study's objective was to evaluate with a standardized questionnaire the knowledge of healthcare workers (HCWs) regarding occupational vaccinations and their vaccination coverage.
    Médecine et Maladies Infectieuses 03/2011; 41(3):135-139. · 0.75 Impact Factor
  • European journal of dermatology: EJD 01/2011; 21(1):128-9. · 1.95 Impact Factor
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    ABSTRACT: The study's objective was to evaluate with a standardized questionnaire the knowledge of healthcare workers (HCWs) regarding occupational vaccinations and their vaccination coverage. This cross-sectional survey was conducted in the department of infectious diseases of a 1796 bed-teaching hospital in Dijon, France. Fifty-seven (93%) out of 61 HCPs completed the questionnaire. Vaccination against HVB was the most frequently mentioned vaccination (79%), followed by BCG (66%), and combine vaccine against diphtheria, tetanus, and polio (DTP) (66 %). Influenza was the most often quoted among recommended vaccinations (70%), followed by measles (61%), pertussis (39%), and varicella (14%). The number of correct answers was significantly correlated with age of participants, being a physician, and having had courses on vaccination. Almost all HCPs were up to date for mandatory vaccinations. In 2009 to 2010, vaccination rates against seasonal flu and H1N1 flu reached 88%. Only 52% of HCPs knew about their pertussis immunization and only a third of those born before 1980 had been tested for measles. HCPs knowledge of mandatory vaccinations is adequate but more limited for recommended vaccinations. Information on influenza vaccination has significantly improved its perception among HCPs resulting in a better adhesion to vaccination.
    Médecine et Maladies Infectieuses 12/2010; 41(3):135-9. · 0.75 Impact Factor
  • Médecine et Maladies Infectieuses 11/2010; 40(11):654-6. · 0.75 Impact Factor
  • Médecine et Maladies Infectieuses. 11/2010; 40(11):654–656.
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    ABSTRACT: Syphilitic ocular involvement is thought to be rare in HIV infected patients. During a 5-year study in 509 HIV-positive patients, syphilis was diagnosed in 3.9%, and the eye was involved in one-fifth of these. The high risk for sequelae emphasizes the need for prevention and for early diagnosis.
    Sexually transmitted diseases 01/2010; 37(1):41-3. · 2.58 Impact Factor
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    ABSTRACT: Because high serum low-density lipoprotein (LDL) and total cholesterol concentrations before treatment have been found to be significant positive prognostic factors for a sustained virological response to HCV therapy in monoinfected patients, the aim of this study was to assess this relationship in HIV-HCV-coinfected patients. Pretreatment fasting lipid parameters (in particular total cholesterol, LDL, high-density lipoprotein [HDL], apolipoprotein B [apoB] and triglycerides [TG]) were assessed in 315 patients from the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) HC02-Ribavic therapeutic trial. There was a significant correlation between pretreatment lipid parameters and steatosis (total cholesterol r=-0.23, P<0.0001; LDL r=-0.23, P<0.0001; HDL r=-0.28, P<0.0001; and TG r=0.18, P=0.002), but not with fibrosis. None of these lipid parameters were significant predictors of a sustained virological response to HCV therapy, even after adjustment for the type of interferon treatment and for the main known prognostic factors for a response to HCV therapy. The possible effect of lipid metabolism on virological response is outweighed by other prognostic factors that affect response to HCV therapy in the ANRS HC02-Ribavic study.
    Antiviral therapy 01/2010; 15(5):797-800. · 3.07 Impact Factor
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    ABSTRACT: The authors wanted to identify the factors associated with prescription or non-prescription of antibiotics by general practitioners (GPs), for three frequent infectious diseases: tonsillitis, acute bronchitis (AB) and exacerbations of chronic bronchitis (ECB). A cross-sectional study included 574 patients followed by 58 randomly selected GPs in Eastern France. Data on physicians, patients (clinical, social and environmental) and antibiotic treatment (type, motivations) was collected during the consultation via a standardized questionnaire. Official recommendations for tonsillitis, AB and ECB were known by GPs in 100, 96 and 91% of the cases, respectively. An antibiotic was administered in 61% of tonsillitis cases, 64% of AB and 84% of ECB. The correlation between prescribing or not antibiotics and official recommendations was variable (tonsillitis: 81.3%, ECB 89.6%, AB: 36.5%). Clinical criteria were the main factors influencing antibiotic prescription. A rapid antigen detection test for streptococcus A was performed in 65% of tonsillitis cases (positive in 55%) increased conformity with recommendations to 93.7%. A second consultation, poor tolerance and patient demand were also significantly associated with a higher rate of antibiotic prescription. Recommendations were known, but semiologic definitions and nosologic limits varied from one physician to another. Recommendations must be based on routine medical practice surveys to include factors influencing prescription, even if non significant. Paraclinical tests help in therapeutic decision making and in the non-prescription of antibiotics but such tests need to be more commonly used.
    Médecine et Maladies Infectieuses 07/2009; 39(9):714-21. · 0.75 Impact Factor
  • The American journal of medicine 05/2009; 122(4):e5-6. · 5.30 Impact Factor
  • Revue De Medecine Interne - REV MED INTERNE. 01/2009; 30.
  • Journal of Antimicrobial Chemotherapy 01/2009; 63:380-388. · 5.34 Impact Factor
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    ABSTRACT: The combination of one non-nucleoside reverse transcriptase inhibitor (NNRTI) with two nucleoside reverse transcriptase inhibitors is a validated first-line antiretroviral (ARV) therapy. The once-daily combination of lamivudine, tenofovirDF and nevirapine has not been evaluated in a clinical trial. Randomized, open-label, multicentre, non-inferiority trial comparing lamivudine, tenofovirDF and nevirapine once daily (Group 2) with zidovudine/lamivudine and nevirapine twice daily (Group 1), in naive HIV-1-infected patients with a CD4 count <350/mm(3). We planned to enroll 250 patients. As of May 2006, 71 patients had been enrolled (35 in Group 1 and 36 in Group 2) and an unplanned interim analysis was done. The groups were comparable at baseline: median CD4 count was 195 and 191/mm(3) and median plasma viral load was 4.9 log(10) and 5.01 log(10), respectively, in Groups 1 and 2. Eight early non-responses (22.2%) were observed, all in Group 2, while two later viral rebounds occurred. Resistance genotypes for the nine Group 2 failing patients showed the mutations M184V/I (n = 3), K65R (n = 6), one or more NNRTI resistance mutations in all cases. At baseline, the nine Group 2 patients who failed had higher median plasma viral load (5.4 log(10)) and lower median CD4 count (110/mm(3)) than the other Group 2 patients (4.7 log(10), P = 0.002 and 223/mm(3), P = 0.004). Nevirapine trough concentrations were not different between the two groups, nor between patients with full viral suppression or those who failed in Group 2. Due to slow recruitment, and those results, the steering committee decided to stop the trial at 12 months. In ARV-naive HIV-1-infected patients, the once-daily lamivudine, tenofovirDF and nevirapine regimen resulted in a high rate of early virological failures. The reasons for the failures remain unclear.
    Journal of Antimicrobial Chemotherapy 12/2008; 63(2):380-8. · 5.34 Impact Factor
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    ABSTRACT: The world-wide AIDS epidemic is reflected in Western Europe in an increasing number of HIV-infected persons who originate from Africa. We describe the characteristics and response to antiretroviral therapy (ART) of HIV-infected patients born in Africa and living in France. Analysis of data from the (Anti PROtéase COhorte APROCO) cohort study of HIV-infected patients initiating ART was carried out. Included in the study were 90 patients born in sub-Saharan Africa, 53 in North Africa and 771 in metropolitan France. At baseline, there was a higher proportion of women and of the heterosexual transmission route of infection among patients born in sub-Saharan Africa, a higher proportion of injecting drug users among patients born in North Africa and a higher frequency of unemployment and of unstable housing conditions among patients born in both sub-Saharan and North Africa as compared with patients born in France. The median CD4 cell count was lower in patients born in both sub-Saharan and North Africa (sub-Saharan Africa: 197 cells/microL; North Africa: 222 cells/microL) than in patients born in France (307 cells/microL). Median HIV-1 viral loads were similar. After a median follow-up time of 36 months (2506 patient-years), the Kaplan-Meier estimations of probability of survival without new AIDS-defining events were not different. After 36 months of ART, in multivariate analysis, median CD4 cell count, CD4/CD8 ratio and viral load were not statistically different according to birthplace, but the median CD4 percentage was lower in patients born in both sub-Saharan and North Africa. The adherence profiles were similar. Although clinical response and adherence to ART did not appear to differ in patients according to their birthplace, the reasons for the more advanced HIV infection observed at ART initiation among patients born in Africa should be further investigated.
    HIV Medicine 05/2007; 8(3):164-70. · 3.16 Impact Factor
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    ABSTRACT: Inhibition of DNA polymerase gamma by nucleoside reverse transcriptase inhibitors (NRTIs) can cause mitochondrial dysfunction and cellular toxicity. Hyperlactataemia, which is a consequence of a shift in the metabolism of pyruvate, is an indicator of nucleoside-related mitochondrial toxicity. We evaluated exercise and oxidative capacities as well as circulatory and ventilatory responses to exercise in 24 HIV-infected patients on NRTIs presenting hyperlactataemia [mean (+/-standard deviation) fasted lactate=3.5+/-1.1 mmol/L]; 27 NRTI-treated patients with normal baseline lactate concentrations were used as controls (mean fasted lactate=1.6+/-0.3 mmol/L). In the patients with hyperlactataemia, the average peak work capacity (1.7+/-0.6 W/kg) and peak oxygen consumption (VO(2)) (21+/-4 mL/kg/min) were significantly lower (P<0.01) than in control subjects (work, 2.1+/-0.4 W/kg; VO(2), 25+/-4 mL/kg/min). The capacity to increase oxygen extraction during exercise was significantly diminished in the hyperlactataemia group, as shown by a low peak systemic arteriovenous oxygen difference (a-vO(2)) difference compared with controls (11+/-3 vs 14+/-3 mL/dL; P=0.008), and as indicated by a linear correlation between VO(2) and systemic a-vO(2) difference (r(2)=0.76). During exercise, the increases in cardiac output relative to VO(2) (mean Delta cardiac output (Q)/DeltaVO(2)=8+/-3.6) and ventilation (mean Delta ventilation (VE)/DeltaVO(2)=48.6+/-13.2) were significantly higher in hyperlactataemia patients compared with controls (mean cardiac output Delta(Q)/DeltaVO(2)=6+/-2; mean DeltaVE/DeltaVO(2)=42+/-12.7; P=0.03). The degree of exercise limitation in patients with nucleoside-related mitochondrial toxicity correlates directly with the severity of impaired muscle oxidative phosphorylation, as indicated by the capacity for muscle oxygen extraction. Exaggerated circulatory and ventilatory responses to exercise are direct consequences of the level of impaired muscle oxidative phosphorylation.
    HIV Medicine 03/2007; 8(2):105-11. · 3.16 Impact Factor
  • Revue De Medecine Interne - REV MED INTERNE. 01/2007; 28:85-86.

Publication Stats

880 Citations
271.90 Total Impact Points

Institutions

  • 1999–2014
    • Centre Hospitalier Universitaire de Dijon
      • • Department of Infectious Diseases
      • • Department of Anatomy and Pathological Cytology
      Dijon, Bourgogne, France
  • 2000–2007
    • Hôpital Universitaire Necker
      Lutetia Parisorum, Île-de-France, France
  • 2005
    • University of Burgundy
      Dijon, Bourgogne, France
  • 1999–2001
    • Centre hospitalier de l'Université de Montréal (CHUM)
      Montréal, Quebec, Canada
  • 1998
    • Centre d'enseignement et de recherche en foresterie de Sainte-Foy
      Québec, Quebec, Canada