Cutaneous Larva Migrans.

BACKGROUND: Cutaneous larva migrans (CLM) is a helminthic infection found in tropical areas. It is commonly seen in patients in contact with soil contaminated by cat and dog hookworm larvae. CLM manifests as an erythematous, serpiginous, and pruritic cutaneous eruption. We present a case of a 27-year-old female with a serpiginous lesion on the plantar surface of the right foot. METHODS AND RESULTS: The patient was prescribed Albendazole at 400 mg twice a day for three days. After treatment, the lesion and pruritus have decreased in severity. CONCLUSIONS: Hookworm-related CLM is diagnosed clinically based on the typical clinical presentation. Clinicians need to be aware of the possibility of hookworm-related CLM with a history of travel to tropical areas, especially walking barefoot.

Management of a recurrent stroke due to a carotid web.

Carotid web is a rare intraluminal parietal protrusion in the carotid artery. This vascular anomaly mostly occurs at the bifurcation causing turbulent flow, and is responsible of thrombi formation associated with embolic ischemic events. We report the case of a 35-year-old woman, with no medical history, who presented a recurrent middle cerebral artery (MCA) occlusion within twelve hours caused by a carotid bulb web. Although considered as a rare entity, carotid web is associated with the risk of recurrent strokes in the MCA territory and especially in the absence of the typically recognized risk factors. The key imaging is the CT angiography that shows the web, the cerebral artery occlusion, and the outcome appreciation. Therapeutic strategy associates antithrombotic treatment and operative management with stenting of the carotid web or endarterectomy.

A New Case of Association of Megaloblastic Anemia and Pancytopenia of Infants.

BACKGROUND: Vitamin B12, or cobalamin deficiency, an infrequent clinical entity in pediatric age, is found almost solely in breastfed infants whose mothers are purely vegetarian, non-supplemented or with pernicious anemia. Megaloblastic anemia in infants presents with generalized weakness or irritability. METHODS: Diagnosis is usually centered on complete blood count, vitamin dosing, and peripheral smear, which may show macrocytes, hypersegmented neutrophils, reticulocytopenia and a raised mean corpuscular volume (MCV ˃ 100 fL). Pancytopenia has also been noted. RESULTS: We report an exclusive breastfed nine-month-old female child who presented with irritability, developmental delay, and difficulties in introducing new foods. Her initial blood count revealed pancytopenia. Vitamin B12 levels were found to be reduced. Maternal levels of Vitamin B12 were also found to be borderline low. The child was treated as per protocols, and improvement was evidenced with the return of hematological parameters to the regular and gradual advancement of milestones. CONCLUSIONS: We aim to underscore the importance of megaloblastic anemia as an important and rare cause of anemia in infancy.

Oral behaviours and wake-time masseter activity in patients with masticatory muscle pain.

BACKGROUND: Little is known about wake-time masseter activity of patients with masticatory muscle pain in real-life settings. OBJECTIVES: The aims of this study were (1) to assess wake-time masseter activity of women with masticatory muscle pain (MMP) and compare it with that of pain-free women; and (2) to investigate the association between objectively measured masseter contractions and self-reported oral behaviours. METHODS: Adult women (N = 27) diagnosed with MMP were age-matched with pain-free women (N = 26). The electromyographic (EMG) activity of the masseter muscle when awake was recorded unilaterally for two consecutive days. The number of contraction episodes and relative contraction time (%) were calculated using cut-off thresholds of 3%, 5% and 10% of maximum voluntary contraction (MVC). Self-reported daytime oral activity was assessed using the Oral Behaviours Checklist (OBC, items 3-21). Data were analysed using univariate tests and mixed-model analyses. RESULTS: The number of contraction episodes was similar between groups for all detection thresholds, but the relative contraction time at the lower detection thresholds (i.e. 3% MVC and 5% MVC) was significantly longer (1.5-fold) in the MMP than in the pain-free group. The OBC scores were significantly higher in the women with MMP than in controls, but no positive association could be found between EMG variables and OBC scores. CONCLUSION: Women with MMP engage in low-level masseter muscle contractions, which last longer than those of pain-free controls. There was no relationship between self-reported oral behaviours and masseter activity when awake. These findings support the notion that prolonged low-level clenching when awake may play a role in the pathophysiology of MMP.

Factors influencing patient's perception of long-term treatment with low-molecular-weight heparins for cancer-associated thrombosis: an updated analysis of TROPIQUE, a prospective observational study.

PURPOSE: Our objective was to compare patient's expectations to their experience and to identify factors predictive of patient's perception of long-term LMWH for the treatment of cancer-associated thrombosis (CAT). METHODS: Results from the validated Perception Anticoagulant Treatment Questionnaires (PACTQ) completed before inclusion (PACTQ1 for expectations) and at the end (PACTQ2 for convenience and satisfaction) of the 6-month TROPIQUE study were studied with principal component analysis. Possible predictive factors of improved perception of LMWH treatment were analyzed with the Kruskall-Wallis test. RESULTS: Among 409 included patients treated with LMWH, 269 PACT-Q1 and 139 PACT-Q2 were evaluable for treatment perception. Patients had high expectations (A1-A7 score of 26.7 ± 3.5, max = 35). Treatment cost (A7 = 1.90 ± 1.31) and concern about a mistake in anticoagulation (A5 = 1.93 ± 1.12) had little importance while LMWH treatment was considered easy to use (A4 = 4.20 ± 0.93). Six-month treatment with LMWH was associated with a high rate of convenience (B1-B11, C1-C2 = 55.1 ± 8.38, max = 65) and a high satisfaction score (D1-D7 = 25.1 ± 4.32, max = 35). Patients' confidence in treatment and perception of possible LMWH side effects were moderate while perception of autonomy and independence significantly improved at the end of the study compared to inclusion. PACT-Q2 satisfaction score was low in patients who experienced bleeding (PACT-Q2 24.1 ± 3.3 vs. 25.1 ± 4.3). LMWH twice daily tended to be found less convenient compared than once daily (53.3 ± 7.2 vs. 55.0 ± 8.3). CONCLUSION: CAT patients had a good perception of the 6-month LMWH treatment when comparing expectations and experience. Using a quantitative scale validated in the general population for VTE and subcutaneous injection and including a large number of patients, bleeding complications and LMWH twice daily were associated with a nonsignificant trend towards a worsen perception.

[Retroperitoneal leiomyoma: a case report]. / Léiomyome rétro-péritonéal: à propos d'un cas.

Retroperitoneal leiomyoma is a rare benign tumor of the retroperitoneum. We report a clinical case of a 43-year-old patient, who suffered from back pain and weight loss. Imaging revealed a retroperitoneal mass, then the patient had a total excision of the tumor. Histological examination of the surgical specimen concluded to retroperitoneal leiomyoma. The evolution was good without recurrence after 12 months.

A review of the metrics for One Health benefits.

One Health as a concept has been with us for many years, yet it is only recently that it is actively being discussed as a way of mitigating risks in society. Initiatives in the use of this concept require methods to monitor the benefits gained from an holistic approach to health, yet there is an absence of adequate frameworks to measure One Health benefits. This paper explores the problem with a review of the available literature and an examination of methods used. It concludes that most published work on One Health describes how this concept is valuable without trying to estimate the size of benefit or type of value. A framework for measuring the advantages of a One Health approach is needed and, through the process of an international workshop and the development of a One Health business case, the authors are working towards its development.

[History of pelvic prolapse]. / L'histoire de prolapsus pelviens.

The history of pelvic prolapse back to the era of the pharaohs, about 1500 years before Christ. Hippocrates practiced succussion. Grenades, pieces of soaked linen were used as pessaries.Over the centuries, the eolution in understanding of this female pathology led to different treatment modalities, some of which we can currently seem strange.

Neck and shoulder muscle activity of orthodontists in natural environments.

Work related musculoskeletal disorders (WMSDs) are common among dentists and possibly caused by prolonged static load. The aim of this study was to assess the contraction pattern of neck and shoulder muscles of orthodontists in natural environments. Electromyographic (EMG) activity of right sternocleidomastoid and trapezius muscles were recorded by means of portable recorders in eight orthodontists during working conditions, and both active and resting non-working conditions. Recordings were analysed in terms of contraction episode (CE) count, amplitude, and duration. The sternocleidomastoid and trapezius muscles contracted about 40-70times per hour in the natural environment. Their EMG activity pattern mainly consisted of short-lasting, low-amplitude CEs. The counts and amplitude of sternocleidomastoid CEs did not differ across vocational and non-vocational conditions. The number and amplitude of trapezius CEs were slightly but significantly higher during the vocational condition. There were highly significant (p<0.001) differences in duration of CEs across conditions, with two to threefold increase in the average duration of trapezius muscle contractions found in the vocational setting. During orthodontic work, operators commonly hold muscular contractions for significantly longer periods than are encountered in non-vocational settings. This behaviour may be associated causally with the increases seen in WMSDs through proposed pathophysiological mechanisms occurring at the motor unit level. Our findings may also be valid for other occupations characterised by seated static postures with precision hand and wrist movements.

[A case report of an acute myocardial infarction with simultaneous occlusion of circumflex and right coronary artery]. / Infarctus du myocarde secondaire à l'occlusion aiguë simultanée des portions proximales de la circonflexe et de la coronaire droite: à propos d'un cas.

Acute myocardial infarction due to simultaneous occlusion of two major coronary arteries is a rare phenomenon. We report a case of a 53-year-old man with many cardiovascular risk factors, who presented to the emergency with an acute coronary syndrome with ST segment elevation in anterior and inferior leads, complicated by atrioventricular block and cardiogenic shock. The coronary angiogram showed proximal occlusion of left circumflex artery and right coronary artery. Both arteries were treated successfully with thrombectomy followed by coronary stent implantation. Some similar cases have been reported, but the exact physiopathological mechanism is unknown. There is no clear strategy established for the therapeutic coverage, however, percutaneous revascularisation seems to be actually appropriated treatment.

[Sympathetic response in primary hypertension]. / Les réponses sympathiques dans l'hypertension artérielle essentielle.

UNLABELLED: High blood pressure (BP) is a major cause of cardiovascular disease and primary hypertension is a frequent pathological condition. Sympathetic hyperactivity may be involved in primary hypertension. The purpose of this study was mainly to evaluate sympathetic activity when performing cardiovascular autonomic profile examination in patients with primary hypertension in comparison with normotensive subjects. PATIENTS AND METHODS: This prospective study included one group of hypertensive patients (n=120, mean age 54 years) compared with a control group (n=120, mean age 52 years) of normotensive subjects. Autonomic tests included deep-breathing (DB), hand-grip (HG) and echostress test (ES). Comparison tests between the two groups, similar in age, were expressed as mean+/-SE and made using the t Student test, p<0.05 was considered significant. RESULTS: Alpha-adrenergic sympathetic response using ES method produced a BP response of 20,0%+/-9,8 in hypertensive patients group and 15,2%+/-8,6 in the control group (p<0.001). Alpha-adrenergic sympathetic response using three minutes HG test was of 16,7%+/-7,5 in hypertensive patients group and 13,3%+/-6,5 in the control group (p<0.001). Vagal stimulation in hypertensive group after DB showed that electrocardiographic: ECG (EKG) waves R (RR) interval variation was of 30,2%+/-8,1 meanwhile in the control group this RR variation was of 46,1%+/-21,1 p<0.001, and the one of HG of 15 seconds was 17,6%+/-10,2 versus 32,5%+/-12,7 p<0.001. CONCLUSION: Hypertensive patients had a significantly higher sympathetic response to central and peripheral stimulations and a significantly lower parasympathetic response when compared to normotensive controls.

Antiproliferative effect of polyphenols and sterols of virgin argan oil on human prostate cancer cell lines.

BACKGROUND: The aim of our study has to evaluate the antiproliferative effect of polyphenols and sterols extracted from the virgin argan oil on three human prostatic cell lines (DU145, LNCaP, and PC3). METHODS: Cytotoxicity, anti-proliferative effects and nuclear morphological changes of cells were analyzed after treatment with sterols and polyphenols. The results were compared to 2-methoxyestradiol (2ME(2)) as positive control. RESULTS: Polyphenols and sterols of virgin argan oil and 2ME(2) exhibited a dose-response cytotoxic effect and antiproliferative action on the three tested cell lines. The antiproliferative effect of polyphenols was similar for the DU145 and LNCaP cell lines; the GI(50) (defined as the concentration inhibiting growth by 50% in comparison with the control) was respectively 73 and 70microg/ml. The antiproliferative effect of sterols was 46 and 60microg/ml as GI(50) for the DU145 and LNCaP cell lines. For the PC3 cell line, the best antiproliferative effect was obtained by argan sterols with GI(50)=43microg/ml. On the other hand, the nuclear morphology analyses have shown an increased proportion of pro-apoptotic of nuclei in LNCaP cell treated with IC(50) of polyphenols or sterols compared to control cells. Our results show for the first time the antiproliferative and pro-apoptotic effects of polyphenols and sterols extracted from virgin argan oil and confirm the antiproliferative and pro-apoptotic effects of 2ME(2) on prostate cancer cell lines. CONCLUSION: These data suggest that argan oil may be interesting in the development of new strategies for prostate cancer prevention.

Tocopherols and saponins derived from Argania spinosa exert, an antiproliferative effect on human prostate cancer.

The aim of our study is to evaluate the antiproliferative effect of tocopherols obtained from alimentary virgin argan oil extracted from the endemic argan tree of Morocco and of saponins extracted from argan press cake on three human prostatic cell lines (DU145, LNCaP, and PC3). The results were compared to 2-methoxyestradiol as antiproliferative drug candidates. Cytotoxicity and antiproliferative effects were investigated after cells' treatment with tocopherols and saponins compared to 2-Methoxyoestradiol as the positive control. Tocopherols and saponins extracted from argan tree and 2-methoxyestradiol exhibit a dose-response cytotoxic effect and an antiproliferative action on the tested cell lines. The best antiproliferative effect of tocopherols is obtained with DU145 and LNCaP cell lines (28 microg/ml and 32 microg/ml, respectively, as GI50). The saponins fraction displayed the best antiproliferative effect on the PC3 cell line with 18 microg/ml as GI50. Our results confirm the antiproliferative effect of 2-methoxyestradiol and show for the first time the antiproliferative effect of tocopherols and saponins extracted from the argan tree on hormone-dependent and hormone-independent prostate cancer cell lines. These data suggest that argan oil is of potential interest in developing new strategies for prostate cancer prevention.

[Functional properties of a new line of immortalized human endothelial cells]. / Propriétés fonctionnelles d'une nouvelle lignée de cellules endothéliales humaines immortalisées.

An immortalized human endothelial cell line was obtained by transfecting umbilical vein endothelial cells in primary culture with plasmid pMK16 containing SV40 replicated origin defective gene. The essential functional properties demonstrated in these immortalized human endothelial cells also retaining the classical phenotypical characteristics of endothelial cells in primary culture are: (1) endothelin-1 secretion; (2) capacity to convert big endothelin-1 into endothelin-1; (3) the capacity to secrete IL1 beta and IL6 interleukins both spontaneously and after lipopolysaccharide (LPS) stimulation; (4) arginine transfer from the extracellular to the intracellular medium. Such stable cell line could facilitate studies of regulation of endothelin-1 production; (5) No-synthase activity; (6) binding and metabolisation of acetylated low-density lipoproteins.

Bactericidal activity of beta-lactams and amikacin against Haemophilus influenzae: effect on endotoxin release.

Ampicillin or cefotaxime, alone or in combination with amikacin, were tested at levels achievable in CSF for bactericidal activity against eight clinical isolates of Haemophilus influenzae serotype b. Endotoxin release was determined by the limulus amoebocyte lysate test and by macrophage tumour necrosis factor production for each beta-lactam antibiotic, alone and in combination with amikacin. Accelerated killing was observed when amikacin was added to ampicillin or cefotaxime; however, the additional antibiotic-induced bacterial lysis observed after the addition of amikacin to beta-lactam antibiotics was not associated with an increase in endotoxin release.

Kinetics of gentamicin in cochlear hair cells after chronic treatment.

Presence of gentamicin (GM) in cochlear hair cells was detected by immunohistochemistry in guinea pigs (GPs) cochlea 1, 9 and 41 days after a 6-day treatment with GM at 60 mg/kg/day (s.c.). The number of GPs in each group was respectively 7, 12 and 6. Twelve other non-treated GPs served as controls. Cochlear function was measured, just before sacrifice, by VIIIth nerve compound action potential (CAP) audiograms. Functional and immunohistological evaluations were performed by two independent naïve observers respectively. Functional changes were minimal: only one out of the 25 treated GPs, from the 41-day group, showed significant threshold elevations on high frequencies. Meanwhile GM labelling was observed in most outer hair cells (OHCs) from the three rows of all the treated GPs, with radial and longitudinal gradients, and found similar in the 3 groups. These results 1) confirm that GM is significantly present in OHCs before the development of ototoxicity and 2) indicate that GM accumulates and is maintained inside the OHCs for very long periods of time, i.e. that its clearance from the hair cells, if any, would be very slow.