Seven imported histoplasmosis cases due to Histoplasma capsulatum var. capsulatum: From few weeks to more than three decades asymptomatic period.

Histoplasma capsulatum is a nonendemic fungus in Europe. Epidemiological, clinical biological features and follow-up of seven imported cases in France were reported. These cases underlined the difficulties of such diagnosis in nonendemic areas due to greatly variable asymptomatic period, and lack of specific clinical signs. Thus, anamnesis should be carefully analysed; mucocutaneous signs and immunosuppression should be systematically investigated. Biological diagnosis requires multiple sites sampling and long-term conservation of culture medium.

Validity of the Nike+ device during walking and running.

We determined the validity of the Nike+ device for estimating speed, distance, and energy expenditure (EE) during walking and running. Twenty trained individuals performed a maximal oxygen uptake test and underwent anthropometric and body composition testing. Each participant was outfitted with a Nike+ sensor inserted into the shoe and an Apple iPod nano. They performed eight 6-min stages on the treadmill, including level walking at 55, 82, and 107 m x min(-1), inclined walking (82 m x min(-1)) at 5 and 10% grades, and level running at 134, 161, and 188 m x min(-1). Speed was measured using a tachometer and EE was measured by indirect calorimetry. Results showed that the Nike+ device overestimated the speed of level walking at 55 m x min(-1) by 20%, underestimated the speed of level walking at 107 m x min(-1) by 12%, but closely estimated the speed of level walking at 82 m x min(-1), and level running at all speeds (p<0.05). Similar results were found for distance. The Nike+ device overestimated the EE of level walking by 18-37%, but closely estimated the EE of level running (p<0.05). In conclusion the Nike+ in-shoe device provided reasonable estimates of speed and distance during level running at the three speeds tested in this study. However, it overestimated EE during level walking and it did not detect the increased cost of inclined locomotion.

Sludge accumulation in an anaerobic pond and viability of helminth eggs: a case study in Burkina Faso.

Accumulation rates and pathogen concentrations in primary stabilization pond sludges in developing countries are important parameters for adequate sludge management and the safeguarding of public health with sludge reuse in agriculture. An anaerobic pond has been investigated for sludge accumulation rates and helminth egg viability after four years of operation in Burkina Faso. The rate of sludge accumulation was measured at 0.037 m(3)/capita-year or 2.26 kg dry weight/capita-year. An equation describing vertical distribution of total solids in the accumulated sludge was found to be adequately represented by a regression equation. Influent helminth egg concentrations were reduced on average by 90% in the anaerobic pond effluent. Ascaris lumbricoides and Ancylostoma sp. were the most common eggs present in the sludge after four years of operation. The average concentration of helminth eggs in pond sludge was 536 eggs/g TS, and the percentages of viability ranged from 10.8% (47 viable eggs/g TS) to 57.2 (1,772 viable eggs/g TS, with an average rate of 36% (336 viable eggs/g TS). From a sludge depth and section study, egg viability was found to be randomly distributed in the sludge layer.

[Hookworm discovered in a patient presenting with severe iron-deficiency anemia]. / Ankylostomose révélée par une anémie ferriprive particulièrement sévère.

The purpose of this report is to describe a case involving severe anemia in a patient from New Caledonia. Endoscopic discovery of adult hematophagic hookworms in mainland France is novel because it is exceptional. However, this case also reminds us that hookworm disease is extremely widespread in the world. It often goes unrecognized causing progressive, insidious anemia that can be severe though long-term tolerance is good.

Pediatric angiostrongyliasis.

Angiostrongyliasis, the leading cause worldwide of eosinophilic meningitis, is an emergent disease due to Angiostrongylus cantonensis larvae, transmitted accidentally to humans. Contamination of children usually occurs by direct contact with an infected mollusk. Eosinophilic meningoencephalitis is the major clinical feature of this parasitic infection in humans. It is usually benign for adults, but more severe for children. Clinical symptoms usually combine fever, meningitis, and neurological signs (somnolence, moaning, hypotonia, convulsions, and increased intracranial pressure). Presumptive diagnosis of human angiostrongyliasis is based on epidemiologic characteristics, clinical symptoms, medical history, and laboratory findings, in particular, hypereosinophilia in blood and cerebrospinal fluid. Treatment is based on corticosteroids associated with anthelmintics. This work reviews the diagnosis and treatment of this life-threatening (especially in children) parasitic disease and the need for preventive action.

A history of scanning electron microscopy developments: towards "wet-STEM" imaging.

A recently developed imaging mode called "wet-STEM" and new developments in environmental scanning electron microscopy (ESEM) allows the observation of nano-objects suspended in a liquid phase, with a few manometers resolution and a good signal to noise ratio. The idea behind this technique is simply to perform STEM-in-SEM, that is SEM in transmission mode, in an environmental SEM. The purpose of the present contribution is to highlight the main advances that contributed to development of the wet-STEM technique. Although simple in principle, the wet-STEM imaging mode would have been limited before high brightness electron sources became available, and needed some progresses and improvements in ESEM. This new technique extends the scope of SEM as a high-resolution microscope, relatively cheap and widely available imaging tool, for a wider variety of samples.

Wet STEM: a new development in environmental SEM for imaging nano-objects included in a liquid phase.

Environmental scanning electron microscopy (ESEM) enables wet samples to be observed without potentially damaging sample preparation through the use of partial water vapour pressure in the microscope specimen chamber. However, in the case of latices in colloidal state or microorganisms, samples are not only wet, but made of objects totally submerged in a liquid phase. In this case, under classical ESEM imaging conditions only the top surface of the liquid is imaged, with poor contrast, and possible drifting of objects. The present paper describes experiments using a powerful new Scanning Transmission Electron Microscopy (STEM) imaging system, that allows transmission observations of wet samples in an ESEM. A special device, designed to observe all sorts of objects submerged in a liquid under annular dark-field imaging conditions, is described. Specific features of the device enable to avoid drifting of floating objects which occurs in the case of a large amount of water, thus allowing slow-scan high-definition imaging of particles with a diameter down to few tens of nm. The large potential applications of this new technique are then illustrated, including the imaging of different nano-objects in water. The particular case of grafted latex particles is discussed, showing that it is possible to observe details on their surface when submerged in water. All the examples demonstrate that images acquired in wet STEM mode show particularly good resolution and contrast, without adding enhancing contrast objects, and without staining.

[Videophone assistance and home hospitalization: the ViSaDom program]. / Téléassistance en hospitalisation b domicile: le programme ViSaDom.

OBJECTIVE: The purpose of this project was to study the clinical feasibility of videophone-based communication between patients in their homes, and the care teams who work in the Home Hospitalization department (HH). METHODS: This pilot study of videophone users compared them with a group of control patients also in HH. They came from either the adult, maternity or pediatric departments. Patients who met the inclusion criteria and consented to participate in the study were randomly assigned to one of two groups: those who had a videophone installed in their homes (telemedicine group), and those who received the standard HH care (control group). Sixteen patients in the telemedicine group were matched with 16 from the control group, according to age, Karnofsky Index score, and the reason for HH admission. RESULTS: The mean videophone call lasted six minutes, and patients averaged 23 calls each over the study period (0.7 calls per patient per working day). The videophone enabled better follow-up of wounds: for example, the nurse could transmit photos from the patient's home for real-time coordination. It was also useful for following patients suffering from pain, for technical nursing care, and for educating patients and their caregivers. Anxiety (measured with the Hospital Anxiety and Depression Scale) diminished during the study period for the telemedicine patients, compared with the control group (p=0.048). Within the telemedicine group, all patients and their families were very satisfied or satisfied with their care and with the communication (15/15), although the staff's level of satisfaction was slightly lower (14/16); there were no significant differences between groups. CONCLUSION: The ViSaDom program indicates that videophone communication is feasible and acceptable and could be a useful tool for improving the quality, efficiency and effectiveness of care.

[Principle of the useful field of view and normative data]. / Principes de réalisation du champ visuel attentionnel et élaboration de normes.

PURPOSE: The useful field of view is a test which takes into account the influence of patient attention during the evaluation of the visual field. This study aims to generate normative data for an adaptation of the useful field of view (UFOV) test. These normative data are essential to judge, in a clinical setting, whether patients' performance is normal or not across demographically similar peers, in order to advise whether or not to resume driving after a brain injury (traumatic brain injury, stroke or cerebral tumour). PATIENTS AND METHODS: This study examined demographic influences on an UFOV adaptation in a sample of 52 control participants (17 males and 35 females, aged 19 to 69) with no prior ophthalmologic or neurologic history. This adaptation used three visual attention tasks. In a simple task (ST), the participant had to detect, as fast as (s)he could, a single target in a visual display; in a double task (DT,) (s)he had to detect both a central and a lateral target in a double task with visual distractions present on the screen. The number of missed targets and the time needed to detect them are measured. RESULTS: Time to detect target was found to differ by gender and by age. Men and young people (from 19 to 29 years) are faster at detecting central and lateral targets. However, no demographic influence was observed on the number of missed targets. CONCLUSIONS: A normative table for this French UFOV adaptation is provided. This will allow clinicians to compare patient performance with similar peers and may help in identifying persons who would benefit from training on a driving simulator or having a road test with a driving-school.

Bone marrow involvement by disseminated toxoplasmosis in acquired immunodeficiency syndrome: the value of bone marrow trephine biopsy and immunohistochemistry for the diagnosis.

A bone marrow biopsy was performed on four patients with acquired immune deficiency syndrome (AIDS) for a long-running course fever of unknown origin associated with a recent pancytopenia. In the four cases, striking histological similarities, such as interstitial edema, foci of necrosis and only few scattered or clustered histiocytes, were found. Near or in the foci of necrosis, free forms, and pseudocysts of Toxoplasma gondii were observed not only in the cytoplasm of macrophages and of some granulocytes, but also within megakaryocytes. No sign of other parasitic, bacterial, or fungus infection has been found. The diagnosis was confirmed by immunohistochemistry in the four cases and ultrastructural examination in one case. This case study stresses the importance of bone marrow histological changes for the diagnosis of severe toxoplasmosis in AIDS patients and particularly the localization of T gondii within the cytoplasm of megakaryocytes.

Neotropical echinococcosis in Suriname: Echinococcus oligarthrus in the orbit and Echinococcus vogeli in the abdomen.

This paper reports two cases of neotropical echinococcosis caused by Echinococcus oligarthrus and E. vogeli, neither of which has been reported from Suriname. Case 1, a six-year-old boy, presented a 15 x 25 mm retro-ocular cystic tumor (observed by ultrasound, computed tomography scan, and magnetic resonance imaging) causing exophthalmia, chemosis, palpebral ptosis, and blindness of the left eye. Of two tentative diagnoses, Echinococcus cyst or dermoid tumor, the former was shown to be correct at surgery when a clear liquid and detached protoscoleces were aspirated. Rostellar hooks of the protoscolex were characteristic of E. oligarthrus. Case 2, a 41-year-old man, had polycystic masses excised from the liver and abdomen. A presurgery diagnosis of E. vogeli infection was made due to calcifications seen in the lesions, positive serology, residence of the patient in the tropical forest, and later by the size and shape of rostellar hooks. The presence of these two parasites in one of the former Guianas is not surprising; both species are endemic in tropical forest in Central and South America wherever people have not exterminated wild canids, especially the bush dog, (Speothos venaticus), and felids (wild cats of several species), along with pacas, agoutis, and other rodents that serve as intermediate host of these two cestodes. Eighty-six cases of polycystic echinococcosis are known in people from 11 countries from Nicaragua to Argentina: 32 due to E. vogeli, three to E. oligarthrus, and 51 for which determination of the species was not possible because the hooks of the protoscolex were not found or described. Research to elucidate aspects of transmission of E. vogeli and E. oligarthrus is of practical importance for defining measures for preventing the severe and frequently fatal illnesses caused by these two cestodes.

[Toxocariasis and functional intestinal disorders. Presentation of 4 cases]. / Toxocarose et troubles fonctionnels intestinaux. Présentation de 4 cas.

We report 4 cases of adults patients, suffering from irritable bowel syndrome, which had been attributed late to toxocariasis and for whom the treatment led to recovery. Hypereosinophilia was present only in 3 cases. These cases show that toxocariasis is not limited anymore to its two classical expressions: visceral larva migrans and ocular toxocariasis. So it is useful to think of it to confirm and treat it in the case of patients suffering from irritable bowel syndrome. This enables shorter diagnosis delay (14 months in average for our patients) and this is essential for therapeutic efficiency.

Quantitative methods for evaluating optical and frictional properties of cationic polymers.

This paper presents three quantitative methods to examine gloss, opacity, and friction of cationic polymers. The adsorption of cationic polymers onto hair and skin can be regarded as a thin film coating. Therefore, optical and frictional properties of polymer films are of significant relevance to the applications of cationic polymers in hair care products. Such properties reflect the desirable hair condition attributes consumers seek in shampoo and conditioner products. Using these test methods, polyquaternium-10 and cationic guar samples of varying molecular weight and cationic substitution were compared. The effect of an anionic surfactant, sodium dodecyl sulfate (SDS), on polymer film properties was also investigated. Neat guar hydroxypropyl trimonium chloride imparts less friction than polyquaternium-10 but dulls the substrate employed in this study. The optical data show that polyquaternium-10 provides greater film clarity and gloss than cationic guars. In the presence of SDS, polyquaternium-10 also displays similar or lower friction than cationic guar. The comparative optical and frictional results are in good agreement with the visual assessment of the cationic polymer films. These results clearly demonstrate that polyquaternium-10 exhibits superior film properties in the forms of both neat polymer and polymer/surfactant complex. In addition, microscopic techniques such as scanning electron microscopy (SEM) and atomic force microscopy (AFM) provide powerful explanations for the differences noted between the two popular classes of cationic polymers. The test methods described in this paper can be utilized to differentiate the upper performance potential of cationic polymers. These objective and standardized test methods derived from the coatings industry are not affected by the variability of hair or the formulation complexity of end products. They can be useful tools in the product development process in quickly screening the relative performance of different polymers.

[Allergic granulomatous nodule of the conjunctiva disclosing onchocerciasis]. / Nodule granulomateux allergique de la conjonctive révélateur d'une onchocercose.

A new case of conjunctival allergic nodule is reported in a Guinean man. This lesion was first described by Ashton and Cook in 1979. Histologically, this nodule consists of amorphous eosinophilic material surrounded by epithelioid and giant cells arranged in a pallisade; some eosinophils are often found in the inflammatory reaction. This lesion usually resolves spontaneously. In documented cases, nematodes and particularly filaria such as Mansonella perstans are usually isolated. Our observation is the first documented case with Onchocerca volvulus. Microfilariae were detected by examination of normal saline containing the biopsy specimen. The new major antifilarial treatment ivermectin was associated.

[Severe keratomycosis. Diagnosis and treatment]. / Kératomycoses sévères. Diagnostic et traitement.

We reported three consecutive cases of severe fungal keratitis initially undiagnosed by corneal scrapping. Corneal biopsy showed fungal elements of Paecilomyces lilacinus, Fusarium solani, Scedosporium apiospermum. Most cases of fungal keratitis could be treated successfully if adequate antifungal therapy were started early. Early and accurate diagnosis is of major importance. The results of our cases confirm the superiority of corneal biopsy over corneal scrapping. Corneal biopsy is a procedure of choice in suspected cases of keratomycosis in which corneal scrapings fail.

[Dirofilariasis in France: a case in Languedoc in an HIV-seropositive patient]. / La dirofilariose en France: un cas languedocien chez un sujet sérologiquement positif pour le VIH.

Dirofilaria repens is an endemic canine parasite in the Mediterranean area. Human infestation is rare. We observed a case in an HIV-positive patient who presented an ocular filaria which was successfully removed under local anesthesia. In man, filariae may be expulsed without a parasite cycle or complete a growth cycle, depending on the individual's immunological status. The disease has been known in southern France for several centuries, mainly in lagoons near the Mediterranean seaside. A review of the literature however shows that observation of clinical cases is rare, only 46 cases having been reported to date. Outcome is favorable.

[Heterophyiasis and diarrhea after travel: a case report of a child returning from a trip to Egypt]. / Hétérophyose et diarrhée chez le voyageur: a propos d'un cas observé chez un enfant au retour d'un séjour en Egypte.

The most frequently reported parasite-related diarrheal diseases in tropical travellers are amibiaisis, giardiasis, and certain types of nematoodiasis. Intestinal distomiasis is uncommon because the parasite is strictly limited to certain areas of the world. However observation is possible as is demonstrated by this case report involving a 3-year-old child who presented diarrhea two weeks after returning from a six-week stay Egypt. Heterophyes heterophyes eggs were identified. This small fluke has only exceptionally been reported in France where no indigenous case has ever been described. The present report provides an opportunity to review the clinical symptoms and epidemiology of this rare distomiasis, found only in south-east Asia and Egypt. Comparison of egg morphology allowed diagnosis of hysterophiasis by differentiation from smaller fluke species (Clonorchis and Opistorchis). The authors of this report emphasize that this is a rare but possible cause of diarrhea in travellers.

[The association of cryptosporidiosis and isosporosis in a patient with acquired immunodeficiency syndrome (AIDS)]. / Association d'une cryptosporidiose et d'une isosporose chez un sujet atteint du syndrome d'immunodépression acquise (SIDA).

We describe one case of AIDS patient who have excreted simultaneously oocysts of Isospora belli and Cryptosporidium species for ten months. These parasites were noticed with qualitative and quantitative changes. Different treatments were successless about these parasites. This double infestation in tropical AIDS patients appear to have a conspicuously frequency.

[Pulmonary bilharziasis caused by Schistosoma mansoni with impairment of general state]. / Bilharziose pulmonaire à Schistosoma mansoni avec altération de l'état général.

The authors report on one case of pulmonary bilharziosis at Schistosoma mansoni observed in a West-Indian female showing an impairing of her general condition with fever and dyspnea. Diagnosis was brought out by a pulmonary biopsy, after thoracotomy. Treatment by praziquantel was remarkably efficient. Scarcity of symptomatic cases and paucity of pulmonary radiological pictures are opposite of the frequency of pathological lesions in this parenchyma. The authors discuss the physiopathology of pulmonary bilharziosis in both their invading phase and state phase, as well as their frequency. They come to the conclusion that both parasitological examination of stools and biopsy of mucous membrane of rectum are simple, reliable and harmless implements of diagnosis.