Severe and prolonged hypophosphatemia after intravenous iron administration in a malnourished patient.

Malnutrition may result in a phosphate-deficient state owing to a chronically insufficient phosphate intake. Concomitant iron deficiency is common and often supplemented by the intravenous route. It is not widely recognized that some parenteral iron formulations can induce hypophosphatemia. Herein we report a case of a severe and symptomatic hypophosphatemia (0.18 mM, normal range 0.8-1.4 mM) associated with an inappropriately reduced tubular reabsorption of phosphate (33%, norm >95%) in a malnourished patient with anorexia/bulimia who received 2 × 500 mg iron carboxymaltose (FCM) intravenously. Despite intravenous and oral phosphate supplements, it required 2 months to achieve a normal serum phosphate level. Our case demonstrates that in a chronically malnourished and phosphate-deficient state intravenous FCM could potentially be dangerous. If this form of iron application cannot be avoided, phosphate supplementation before and after iron infusion as well as close monitoring of phosphate levels are needed.

[2011 findings from literature on general internal ambulatory medicine]. / Acquisitions thérapeutiques en médecine ambulatoire en 2011.

In 2011 several articles seemed significant for the practice of general medicine. Diagnosis of hypertension needs several measurements and may need 24-hour ambulatory blood pressure monitoring. Glycosylated hemoglobin is a reliable tool to diagnose diabetes mellitus. The ABCD2 score with neurological imaging help the triage of transient ischemic attacks. Pulmonary embolism can be treated as outpatient for low risk patients. Gluten-free diet may be tried in irritable bowel syndrome. Nitrofurantoin is a reasonable alternative for simple urinary tract infection in women, but antibiotics are not needed after drainage of an uncomplicated skin abscess. Subclinical thyroid dysfunction is a risk factor of osteoporosis in older men. Sequential use of MMSE and ACE scores is a promising approach to assess medical decision-making capacity.

Flock management and histomoniasis in free-range turkeys in France: description and search for potential risk factors.

The relationship between flock management and histomoniasis, a re-emergent infection in poultry, was investigated by statistical techniques used in veterinary epidemiology to deal with various problems including: multicollinearity, confounding, interaction or sample size. Associations between the variables describing flock management were examined by multivariate descriptive analysis to reduce the number of independent variables, prior to investigating associations with the disease. No homogenous groups of farms were found in the 44 free-range turkey flocks sampled in France. Histomonas meleagridis was identified in 26/38 flocks and histomoniasis was confirmed in 19 flocks. Cleanliness of the building, wet litter and diarrhoea were linked with H. meleagridis and severity of histomoniasis. Sharing outdoor fields simultaneously with chickens was related to serious macroscopic lesions determined by post-mortem examinations. Contrary to general belief, acidification of drinking water with organic acid had consistent association with the presence of H. meleagridis in turkey caeca. These results confirm previous findings and provide several new hypotheses on the effects of hygiene and water management on H. meleagridis and histomoniasis.

[Sanitary inspection of poultry]. / Inspection sanitaire des volailles.

The purpose of this technical notice is to provide public health agents with guidelines for sanitary inspection of poultry. Focusing on zoonosis-related hazards, this step-by-step notice presents the symptoms and lesions that must be checked for to approve or to reject poultry for human consumption.

[Meat inspection. 2.--Bovine]. / Inspection sanitaire des animaux de boucherie. 2.--Bovins.

The purpose of this second technical notice is to provide public health agents with guidelines for inspection of bovine meat. Focusing on hazards related to zoonotic agents, this notice successively presents the symptoms and lesions that must be checked for before approving or rejecting meat for human consumption.

[Meat inspection. 1. - sheep and goats]. / Inspection sanitaire des animaux de boucherie 1- petits ruminants.

The purpose of this initial technical notice is to provide public health agents with guidelines for inspection of mutton and goat meat. Focusing on hazards related to zoonotic agents, this notice successively presents the symptoms and lesions that must be checked for to determine to approve or reject meat for human consumption.

[Meat inspection. 3.--Swine]. / Inspection sanitaire des animaux de boucherie 3--porcins.

The purpose of this third technical notice is to provide public health agents with guidelines for inspection of swine meat. Focusing on hazards related to zoonotic agents, this notice presents a step-by-step description of sanitary inspection procedures necessary to approve or reject swine meat for human consumption.

[Cerebral infarction of arterial origin and haematological causation: the Lausanne experience and a review of the literature]. / Infarctus cérébraux artériels d'origine hématologique: expérience lausannoise et revue de la littérature.

INTRODUCTION: Hematological diseases are seldom found as the etiology of ischemic strokes, but are frequently investigated by expensive laboratory tests after a first cerebral vascular event. METHODS: In the Lausanne Stroke Registry, we retrospectively reviewed the cases of patients hospitalized between 1979 and 2001 for a first ischemic arterial stroke which was attributed to a hematological etiology. Of 4697 patients, 22 (0.47 per cent) had a stroke due to one of the following hematological pathology: polycythemia vera (4), secondary polycythemia (4), essential thrombocytemia (2), secondary thrombocytosis (4), multiple myeloma (1), CIVD (1), protein S deficiency (1), antiphospholipid antibody syndrome (4), moderate homocysteinemia (1). A literature review was undertaken for each hemopathy. CONCLUSION: In light of the results of these data, we concluded that a complete blood count provides sufficient hematological screening for the majority of patients hospitalized for an arterial stroke. The antiphospholipid antibody syndrome is a rare cause of cerebral infarction, which needs to be investigated in young patients, in cases of multiple or recurring stroke or in the presence of a typical history. Inherited thrombophilias are not a significant risk factor for arterial cerebral infarction and their investigation is only warranted for a sub-group of young patients with a cryptogenic stroke, in which group the prevalence is slightly increased. Moderate homocysteinemia must be considered as a cerebrovascular risk factor of minor importance, but potentially treatable by a substitution of vitamin B12, B6 and folates. The efficacy of this substitution in the prevention of cardiovascular events needs yet to be demonstrated.

Optimal growth temperature of O157 and non-O157 Escherichia coli strains.

AIMS: There are several biological characteristics that differ between Escherichia coli O157:H7, a dangerous food-borne pathogen, and the other serotypes of E. coli. METHODS AND RESULTS: The optimal growth temperatures (T(opt)) were determined for 32 E. coli strains, whether each strain belonged to the O157 serotype or not. The mean values of T(opt) for the O157 and non-O157 groups were 40.2 and 41.2 degrees C, respectively. SIGNIFICANCE AND IMPACT OF THE STUDY: This difference is statistically significant (P=0.0002) but has no biological implication.

Development of an ELISA for pantothenic acid (vitamin B5) for application in the nutrition and biological fields.

Immunological assays appear to be the only alternative to the microbiological method for analysis of pantothenic acid in foods and blood. In order to evaluate the influence of the linker on the immunogenicity of the hapten, we have tried to raise antisera against pantothenic acid in rabbits using different conjugates. The hapten was coupled to a carrier protein (BSA or thyroglobulin) using adipoyl dichloride (adipoyl conjugate) or bromoacetyl bromide (acetyl conjugate). Only the acetyl conjugate has induced the production of a specific antibody. With this antibody, an assay on microplate using the ELISA inhibition technique was developed to measure pantothenic acid. The use of pantothenic acid coupled to thyroglobulin with adipoyl dichloride as the capture antigen has improved the sensitivity of the ELISA. This assay was applied to food products and blood.

Automated image analysis of in vitro decondensation of human spermatozoa nuclei. III. Variable decondensation with and without incubation in the seminal fluid.

The effect of seminal fluid upon human spermatozoa was analyzed using in vitro chromatin decondensation and automated image analysis. A number of specimen portions processed after incubation in seminal fluid showed different total mean areas as compared to the corresponding portions processed immediately. Comparison of the results obtained with and without delay showed that the incubation in seminal fluid promoted decondensation in some cases, but retarded it in others. Thus, the seminal fluid stabilized the chromatin condensation in some spermatozoa, but not all. The stabilization may be due to the influence of prostatic zinc.