[Atypical alveolar echinococcosis with systemic involvement in a patient treated with dupilumab]. / Une échinococcose alvéolaire atypique d'évolution systémique chez une patiente traitée par dupilumab.

INTRODUCTION: Alveolar echinococcosis is an endemic parasitic disease prevalent in certain cold regions of the Northern Hemisphere, including Eastern France, Switzerland, Germany, Canada, and the United States. Widely underdiagnosed, it is associated with infection by Echinococcus multilocularis, a small tapeworm belonging to the cestode class, capable of causing multi-systemic involvement, particularly in elderly or immunocompromised patients. CASE REPORT: We present the case of an 82-year-old patient, immunocompromised due to prolonged corticosteroid therapy and treatment with dupilumab. She was referred to our department for a diagnostic assessment of atypical hepatic and pulmonary lesions, initially suspected of tuberculosis or an IgG4-related disease. The hypothesis of alveolar echinococcosis caused by E. multilocularis was eventually considered based on a set of arguments, further confirmed by molecular diagnosis. We discuss the role of dupilumab in the systemic evolution and atypical presentation of the disease, through the induction of a specific immunosuppression. CONCLUSION: Alveolar echinococcosis should be systematically considered in case of systemic disease with prominent hepatic and pulmonary involvement, especially in immunocompromised patients.

[Acute generalized pustular bacterid followed by Sweet's syndrome and erythema nodosum]. / Pustulose aiguë généralisée post-streptococcique suivie d'un syndrome de Sweet et d'un érythème noueux.

INTRODUCTION: Streptococcal infections can cause various skin manifestations related to the direct action of the offending organism itself or to a reactional mechanism. Reactional manifestations are less well known and understood, and they include generalized acute pustulosis belonging to the spectrum of neutrophilic dermatoses. We report a case of generalized acute pustulosis followed by Sweet syndrome and erythema nodosum occurring after a streptococcal infection. PATIENTS AND METHODS: A 60-year-old woman was consulting for a diffuse pustular rash after a throat infection, with high levels of anti-streptolysin (337 U/L) and anti-streptodornase (2560 U/L). The biopsy showed folliculitis and a neutrophilic infiltrator of the dermis, and bacteriological and mycological cultures were sterile. The patient then developed papules evoking Sweet syndrome followed by nodules typical of erythema nodosum after 20 days. A favourable outcome was achieved under colchicine. DISCUSSION: Generalized acute pustulosis is a form of neutrophilic dermatosis whose mechanisms, area predilection and treatment are poorly known. The clinical presentation of this patient was initially typical and the secondary progression to lesions like those in Sweet syndrome is consistent with the pathophysiological continuity and overlap of these entities.

A Probabilistic Model to Study Spatial Variations of Primary Productivity in River Impoundments.

A stochastic approach to model the spatial variability of primary productivity in a river impoundment is presented in which data from LANDSAT-TM images of reference data from the field were used as basic inputs to the model. Primary productivity is predicted here by a set of variables (chlorophyll, temperature, and turbidity) combined by means of multivated probabilistic model wherein probability distribution functions were assigned to each variable. Linear regression analysis was used to relate the field reference data to the image data used as input to the model. The model was applied using maps of the variables obtained from the digital imagery. The results was a map of primary productivity probabilities converted to absolute values utilizing the cumulative function for field measurements of primary productivity. The field data were collected over °1.5 yr at 16-d intervals at 12 sample sites. The overall r2 between the model results using field-measured variables and the measured primary productivity carbon values was 0.85 with an RMS (root mean square) error of 16 mg°m-3 °h-1 , where the carbon values ranged from 4 to 300 mg. m-3. h-1 . To test the methodology for the generation of primary productivity maps from LANDSAT imagery, two maps of primary productivity for Kentucky Lake were generated from data collected in August and December 1988. The model output was, in turn, compared to primary production carbon measurements from the reservoir. The r2 s were 0.89 and 0.76 with RMS errors in these carbon values of 10 and 18 mg°m-3 °h-1 . No specific assumptions about Kentucky Lake were required for this approach, so the methodology is applicable to other lakes or reservoirs in similar trophic states.

[Correlations between pregnancy pathology, study of the placenta, antenatal echography and examination of the product of conception in a series of 175 congenital malformations]. / Corrélations entre la pathologie gravidique, l'étude du placenta, l'échographie anténatale et l'examen du produit de conception dans une série de 175 malformations congénitales.

In order to verify the hypothesis that during pregnancy in a woman without peculiar history, signs could be discovered when the fetus is malformed we have reviewed the files of 175 women who had a malformed child and of 300 controls. All of these women had at least one clinical examination and one ultrasonographic examination during pregnancy. Two clinical symptoms were more often discovered in the mother of the malformed fetus (p less than 0.001): decrease of fetal movements and small for date fetus. The placenta is never abnormal in the mother with normal fetus. Placenta is abnormal in 31% of the mother with malformed fetus but the abnormalities are not specific. Ultrasonographic examinations allowed more often the discovery of a malformation when hydramnios (p less than 0.001) or fetal hypotrophy (p less than 0.01) or an anomaly of the morphology of the fetus is discovered. Accuracy of prenatal diagnostic is considered for the different categories of congenital malformations.

Response of bacteria isolated from a pristine prairie stream to concentration and source of soluble organic carbon.

Responses of native aquatic bacteria to source and concentration of dissolved organic carbon was observed by using gradient plates. Dissolved organic carbon of prairie (grasses) or gallery forest (bur oak) origin was used as the carbon source in these observations. Bacteria isolated from sediments in the grassland reaches of a prairie stream showed growth only on grass leachates. Bacteria isolated from the gallery forest reaches of the same stream were able to grow on plates made from either source of leachate. The differing quality, quantity, and rate of supply of these dissolved organic carbon sources should select for variation in the bacterial assemblages.

[Treatment of menopausal hot flushes with a nonhormonal medication, veralipride]. / Le traitement des bouffées de chaleur de la ménopause par un médicament non hormonal, le véralipride.

The value of veralipride in menopausal disorders is no longer questionable and has been documented by a number of studies. The purpose of this paper is to study the clinical effectiveness and to look for the biological consequences of three months therapy with veralipride. To achieve this, a thorough biological study (hematology, glucids, lipids, hepatic and renal function) was done in 21 patients with a menopausal syndrome before and after taking veralipride for three months. Clinical effectiveness was excellent with 80% satisfactory results. No signs of intolerance or adverse side-effects were seen. We recorded no significant changes in biological parameters. No disturbances of renal or hepatic function were detected, either in individual assessments or in the overall statistical analysis of the study group. Because it is well tolerated, effective, and devoid of adverse metabolic side-effects, we conclude that veralipride is the best non-hormonal treatment for menopausal disorders presently available.

[Study of fetal respiration by ultrasound. Correlation with gestational age and diagnosis of fetal distress]. / Etude de la respiration foetale par les ultra-sons. Corrélation avec l'âge gestationnel et diagnostic de la souffrance foetale.

The authors, following the work of Boddy and Robinson, studied the value of recording fetal breathing activity in the antenatal diagnosis of fetal distress. Fetal respiratory movements are detected with unidimensional echography, thanks to an electronic grille which is able to isolate a thoracic echo which is then reproduced on a rapid recorder after amplification. In normal pregnancies there is a highly significant correlation between fetal respiratory activity and the length of amenorrhoea. In a series of twelve cases with fetal distress that were recorded during labour and were defined after delivery by an Apgar score of less than or equal to 6 and an umbilical arterial pH less than or equal to 7.17, prenatal recordings showed a pathological reduction in fetal breathing movement in 9 cases. In this series only 5 cardiotocograms were shown to be abnormal.