[Update on cutaneous dirofilariasis]. / La dirofilariose cutanée.

Dirofilariasis is a worldwide zoonotic infection that rarely affects humans and is caused by filarial nematodes of the genus Diroflaria transmitted by mosquitoes. Cutaneous dirofilariasis, due to D. repens, presents as inflammatory lesions that develop into subcutaneous nodules. These clinical symptoms may be consistent with Wells' cellulitis. Diagnosis of dirofilariasis involves demonstration of the presence of the nematode during skin biopsy and identification of the worm through macroscopic, histological and PCR analysis. Surgical resection of the nodule remains the gold standard treatment. The number of cases of human cutaneous dirofilariasis has increased in the recent years and the disease must not be misdiagnosed.

Scabietic vasculitis: Report of 2 cases.

BACKGROUND: The infectious causes of cutaneous vasculitis are well known and include streptococcal infections among others. Cases resulting from parasitic infection are less frequent. Scabies, which is currently on the increase, has only been reported in a few isolated cases. Herein, we report two noteworthy cases of profuse scabies complicated by cutaneous vasculitis. PATIENTS AND METHODS: Case 1: a 90-year-old woman, residing in a nursing home, was admitted to our dermatology department complaining of pruritus, present for one month, predominantly on the inside of the thighs and on the buttocks, associated with purpuric lesions on the lower limbs. A skin biopsy revealed leukocytoclastic vasculitis. A diagnosis of scabies was based on severe pruritus and hypereosinophilia and was confirmed by microscopic examination of the parasitology sample and the skin biopsy sample. Despite thorough investigation, no other cause of vasculitis could be found. Complete regression of the skin lesions was achieved with scabies treatment only, without any specific treatment for the vasculitis. Case 2: a 74-year-old man, living in a nursing home, was hospitalized for purpuric papules on the lower limbs, present for one month. Physical examination revealed linear patterns in the interdigital spaces associated with scabies evident on dermoscopic examination. The skin biopsy revealed signs of vasculitis. As in our first case, no aetiology of vasculitis was found and a favorable outcome was achieved by means of scabies treatment alone with no specific treatment for vasculitis. DISCUSSION: Both of our patients presented scabies and vasculitis. In view of the absence of other causes of vasculitis and of the complete regression of lesions due to vasculitis without recurrence achieved with the scabies treatment alone, a diagnosis was made of scabietic vasculitis, probably as a result of cutaneous hypersensitivity reaction to humeral mediators.

Cutaneous and pulmonary dirofilariasis due to Dirofilaria repens.

Dirofilariasis is a worldwide zoonotic infection that accidentally affects humans. It is caused by filarial nematodes of the genus Dirofilaria, which are transmitted by mosquitoes. Cutaneous dirofilariasis appears as inflammatory lesions that could be consistent with Wells' cellulitis. We present a remarkable case of human infection with Dirofilaria repens, causing both subcutaneous and pulmonary nodules.

Comparison of reproductive performance in lactating dairy cows bred by natural service or timed artificial insemination.

The objective of this study was to compare reproductive performance of lactating dairy cows bred by natural service (NS) or timed AI (TAI). One thousand fifty-five cows were blocked by parity and enrolled to receive either NS or TAI. Cows in both groups were presynchronized with 2 injections of PGF(2alpha) given at 42 and 56 d postpartum. Fourteen days after the last PGF(2alpha) injection, cows in the TAI group were enrolled in an Ovsynch protocol (d 0 GnRH; 7 d later, PGF(2alpha); 56 h after PGF(2alpha) injection, second dose of GnRH; and 16 h after second GnRH cows were TAI). Cows in the TAI group were resynchronized with an intravaginal insert containing progesterone inserted 18 d after TAI and removed 7 d later when GnRH was given. Cows were examined by ultrasonography on d 32 after TAI; nonpregnant cows received PGF(2alpha) and GnRH 56 h later followed by TAI 16 h after the GnRH injection. Nonpregnant cows in TAI group were reinseminated up to 5 times using the same scheme. Cows in the NS group were exposed to bulls 14 d after the second PGF(2alpha) injection, and ultrasonography was performed 42 d after exposure to bulls to determine pregnancy status. Nonpregnant cows in the NS group were reexamined by transrectal palpation combined with ultrasound every 28 d until diagnosed pregnant or 223 d postpartum, whichever occurred first. Cows diagnosed pregnant in TAI or NS were reconfirmed 28 d later to determine pregnancy loss. All bulls underwent an evaluation of breeding soundness and were rested for 14 d after 14 d of cow exposure. Health disorders were evaluated up to 70 d postpartum, and body condition score was evaluated at d 70 postpartum. Blood was collected on d 56 and 65 postpartum and analyzed for progesterone to determine cyclicity. The proportion of pregnant cows in the first 21 d of breeding did not differ between groups. The overall 21-d cycle pregnancy rate (PR), which included a total of 8 and 5 service opportunities for NS and TAI, respectively, was not different between groups (25.7 and 25.0% for NS and TAI, respectively). The daily rate of pregnancy was 15% greater for NS than TAI because cows in NS had a greater PR, which resulted in fewer median days open (111 vs. 116 d). Proportion of pregnant cows at 223 d postpartum was greater in the NS than TAI group (84.2 vs. 74.8%, respectively). Cyclicity did not affect reproductive performance. Cows with body condition score >/=2.75 had greater proportion of pregnant cows in the first 21 d of breeding and daily PR in the first 223 d postpartum Primiparous cows had greater proportion of pregnant cows and daily PR than multiparous cows at 223 d postpartum. In conclusion, the greater proportion of pregnant cows in the NS group was attributed to more opportunities for breeding than in the TAI group.

Does mandibular third molar have an impact on dental mandibular anterior crowding? A literature review.

Mandibular dental anterior crowding is a common multi-factorial phenomenon. The involvement of the lower third molar remains unclear. These pending questions led us to conduct a literature review to evaluate the impact of the lower third molar on mandibular dental anterior crowding. Twelve articles were selected, published from 1974 to 2014. Four studies were prospective. Sample size ranged from 30 to 9044. The average age was 20.56 years old. Seven studies considered patient with orthodontic treatment. The studies compared two to four groups. Studying tools were radiographs, casts and clinical examinations. Little's irregularity index, TSALD and Ganss ratio were used. In total, 83% of articles (n=10/12) did not find any significant relationship between lower third molar and mandibular dental anterior crowding. However, methods and designs of these studies being questionable, a definite conclusion on the impact of mandibular third molar on mandibular dental anterior crowding cannot be set.

Impact of antithrombotic treatment in orbital haematoma.

INTRODUCTION: Orbital haematomas threaten the visual prognosis, but no treatment guidelines have been proposed. Antithrombotics could affect their prognosis and treatment. This study aimed to evaluate the effect of antithrombotics in the management of orbital haematomas and to suggest a standardised protocol. MATERIAL AND METHODS: We conducted a retrospective study by sending a standardised questionnaire to 20 French maxillofacial surgery university departments to collect all the cases of orbital haematoma. RESULTS: Twenty-five cases from 10 centres were collected, including five patients treated with anticoagulant and one patient treated with dual antiplatelet. Antithrombotics increased the risk of amaurosis and ocular disorders significantly. Surgery was performed for 66.7% of patients treated with antithrombotic and for 89.5% of other patients. Surgical delay was longer in patients treated with antithrombotic. Surgical drainage was used in most of the cases, whereas canthotomy with inferior cantholysis was the least-used technique. CONCLUSION: Antithrombotics appear to worsen the functional prognosis of orbital haematomas. A surgical management of orbital haematoma in patients treated with antithrombotics is not contraindicated. Surgical delay must be shortened as much as possible. A lateral canthotomy with inferior cantholysis seems to be an appropriate solution.

Rectal temperature, calving-related factors, and the incidence of puerperal metritis in postpartum dairy cows.

The objectives of this study were as follows: 1) to evaluate the association among abnormal calving, parity, and season on the incidence of puerperal metritis (PM) and clinical endometritis (CE) during d 3 to 13 and 20 to 30 postpartum, respectively; 2) to describe the rectal temperature (RT) of cows with PM before diagnosis; and 3) to document associations among PM, CE, and reproductive performance in lactating dairy cows. This study followed a prospective observational study design. Cows were classified as having an abnormal calving status (AC), i.e., cows calving with dystocia, twins, retained fetal membranes, or some combination of these conditions, and having a normal calving status (NC). Daily RT was recorded from d 3 to 13 postpartum for all cows, and health examinations were performed on cows that appeared not well. A total of 450 calvings were evaluated. Cows with an AC had greater odds of PM than cows with NC [adjusted odds ratio (AOR) = 4.8; 95% confidence interval (CI) = 2.9 to 8.0). A season by parity interaction showed that primiparous cows that calved during the warm season had lower AOR of PM than during the cool season (0.24; 95% CI = 0.09 to 0.62), whereas multiparous cows did not have seasonal effects on PM (1.43; 95% CI = 0.65 to 3.18). Cows with AC have greater AOR for CE than cows with NC (2.8; 95% CI = 1.7 to 4.9), and greater AOR of CE were detected in cows diagnosed with PM than in cows without PM (2.2; 95% CI = 1.1 to 3.9). Rectal temperature in cows with PM increased significantly 24 h before diagnosis of PM, reaching 39.2 +/- 0.05 degrees C on the day of diagnosis. In cows with PM and fever at diagnosis, the RT began to increase from 72 to 48 h before the diagnosis of PM and continued to increase to 39.7 +/- 0.09 degrees C on d 0 (day of diagnosis). Nonetheless, cows with PM without fever at diagnosis had no daily increases in RT before diagnosis of PM. Still, the RT on d 0 was different from cows without PM. Cows without PM had a stable RT (38.6 +/- 0.01 degrees C). There were no detected differences in first-service conception risk or cumulative pregnancy risk by 150 d postpartum between cows with or without PM. Still, a season effect on first-service conception AOR (warm vs. cool = 0.98; 95% CI = 0.18 to 0.72) and accumulated pregnancy AOR by 150 d postpartum was detected (warm vs. cool = 0.18; 95% CI = 0.10 to 0.33).

[Rituximab-induced acute thrombocytopenia in a patient with chronic lymphocytic leukemia]. / Un cas de thrombopénie aiguë au rituximab dans la leucémie lymphoïde chronique.

INTRODUCTION: Rituximab is a chimeric anti-CD20 monoclonal antibody generally well tolerated. However, a severe but rare rituximab-related immune-toxic syndrome, associating fever, chills and thrombocytopenia can occur shortly after the infusion. CASE REPORT: We report a case of severe acute rituximab-induced thrombocytopenia with favorable outcome in a patient with chronic lymphocytic leukemia and discuss the possible underlying mechanisms. CONCLUSION: Despite the potential initial severity of rituximab-induced thrombocytopenia in CLL, chemotherapy should not be discontinued; tolerance might increase as the hematologic disorder is controlled.