Activity of Different Antistaphylococcal Therapies, Alone or Combined, in a Rat Model of Methicillin-Resistant Staphylococcus epidermidis Osteitis without Implant.

We developed a rat model of methicillin-resistant Staphylococcus epidermidis (MRSE) osteitis without implant to compare the efficacy of vancomycin, linezolid, daptomycin, ceftaroline, and rifampin either alone or in association with rifampin. A clinical strain of MRSE was inoculated into the proximal tibia. Following a 1-week infection period, rats received either no treatment or 3, 7, or 14 days of human-equivalent antibiotic regimen. Quantitative bone cultures were performed throughout the 14-day period. The mean ± SD quantity of staphylococci in the bone after a 1-week infection period was 4.5 ± 1.0 log10 CFU/g bone, with this bacterial load remaining stable after 3 weeks of infection (4.9 ± 1.4 log10 CFU/g bone). Vancomycin monotherapy was the most slowly bactericidal treatment, whereas ceftaroline monotherapy was the most rapidly bactericidal treatment. The addition of rifampin significantly increased the bacterial reduction for vancomycin, linezolid, and daptomycin. All tibias were sterilized after 2 weeks of treatment except for animals receiving vancomycin or daptomycin alone (66.6% and 50% of sterilization, respectively). These results show that ceftaroline and linezolid alone remain good options in the treatment of MRSE osteitis without implant. The combination with rifampin increases the antibiotic effect of vancomycin and daptomycin lines.

Efficacy of Bacteriophages in a Staphylococcus aureus Nondiabetic or Diabetic Foot Infection Murine Model.

This study investigated the in vivo efficacy of three bacteriophages combined compared with linezolid in two mouse models (nondiabetic and diabetic) of Staphylococcus aureus foot infection. In both models, a single injection of bacteriophages in the hindpaw showed significant antibacterial efficacy. Linezolid was as effective as bacteriophages in nondiabetic animals but ineffective in diabetic animals. These findings further support preclinical and clinical studies for the development of phage therapy.

[Kimura's disease of the hard palate]. / Localisation palatine d'une maladie de Kimura.

INTRODUCTION: Kimura's disease is an inflammatory and autoimmune disease that is endemic in Middle East and Asian countries but remains rare in Europe. It usually presents as subcutaneous nodules combined with cervical lymphadenopathies in the cervicofacial region. The oral mucosa localization is extremely rare. We report for the first time a case of hard palate localization. OBSERVATION: A 61-year-old male patient from Martinique consulted for a recent median, extensive and poorly defined black area localized on the hard palate. It was painless and did not cause any discomfort. We performed a biopsy to rule out a melanoma. The pathology report led to diagnosing Kimura's disease. The biological parameters, especially the renal status, were normal. A simple medical supervision was prescribed. DISCUSSION: This was the first time Kimura's disease was observed as a pigmented area located on the hard palate. The diagnosis of melanoma first had to be ruled out. The histological and immunohistological parameters are mandatory to make a diagnosis.

[I. Induced abortions and spontaneous abortions. Psychopathological aspects apropos of a preliminary sample of 411 requests for pregnancy interruption]. / I.--Avortements provoqués et avortements spontanés. Aspects psychopathologiques à propos d'un premier échantillon de 411 demandes d'interruption de grossesse

Since 1975 (17th January), abortion is free and legal in France. The authors analyse 411 first cases of women requiring for an abortion (seen over a period of 11 weeks). Most of them are young women, single, many begin their sexual life. Unwanted pregnancy indicates absence of contraception by ignorance, refusal or ambivalence (never used = 184 cases). 105 women used archaic and inefficient contraceptive means. Modern contraceptive means was used by 154 women but ill applied, ill tolerated and/or discarded (pill = 103 cases, I.U.D. = 14, diaphragme = 2, condoms = 35). Unwanted pregnancy and abortion signify failure of contraception. We compare psychologic and psychopathologic features of women requiring repeated induced abortion with those of women suffering of repeated spontaneous abortion and infertility. These women have frequently (same) problems of feminine identity, bad maternal imago, absence of father, unhappy, and conflictive childhood, immature sexuality and personnality. Contradiction between conscious and unconscious wishes create the two opposite situations and intrapsychic conflicts (spontaneous abortion = conscious willing of pregnancy + unconscious rejection of unbearable pregnancy; induced abortion = strong but unconscious wish of pregancy + conscious and volontary rejection of maternity). Psychotherapy should improve sexual and affective life and in both cases. The authors compare infanticide and abortion behaviors, contraceptive means, and psychological problems of doctors who are asked abortion.

[A religious sect, its mental ill patients, its physician and its psychiatrists]. / Une secte religieuse, ses malades mentaux, son médecin et ses psychiatres

A religious Sect (Jéhovah witness), its mental patients, its doctor and its psychiatrists. The authors study religious sects, specially Jéhovoah witness. Such 15 mentally ill patients among this group have been treated at the psychiatric clinic. The fact that they are members of a community, sharing the same religious faith, and having in common severe rules of life, is considered as having a pathogenic or beneficial effect. One of them, physician, explain their opinion of mental illness : they believe in biological factors and discard any psychotherapeutic mean.

[Doctors and their resistance to abortion].

PIP: Complex motivations for abortion not perceived by some doctors, the scale and reality of abortion in medical practice, unconscious fantasies experienced by some abortionists, and the reactions of general practitioners, psychiatrists, and gynecologists to abortion are discussed. Most women are in a state of acute stress when they request abortion, psychological suffering based on normal ambivalence or sometimes on personality problems. Some doctors are incapable of accepting pluralism, of separating morality from psychology, and do not realize the numbers of abortions being performed. Some analysts have found voyerism, exhibitionism, aggression, oedipal conflicts and manicheanism inherent in the act of abortion by a male operator. General practitioners, usually the 1st to be approached, see a panicked woman ready to agree to anything in order to convince the doctor to grant her an abortion; they often respond by treating her as a symptom. Psychiatrists may range from very analytical to perfunctory in signing the required form. They are faced with the paradox that only healthy women can handle an abortion, but only in neurotic women are abortions justified. Gynecologists have problems because abortion patients rarely return for other care, forcing them to perform abortion procedures only. Some develop depression, hypersexuality, or even become opposed to abortions.^ieng