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Bacteria of the genus Gordonia are rarely involved in human infections. We report here the case of a 30-year-old man from Guinea Buissau with mycetoma of the foot. 16S DNA sequencing after surgical biopsy identified Gordonia westfalica. To our knowledge, this is the first report of human infection caused by G. westfalica.

We studied how the electronic, superconducting, and magnetic properties of $\mathrm{YB}{\mathrm{a}}_{2}\mathrm{C}{\mathrm{u}}_{3}{\mathrm{O}}_{7}/\mathrm{N}{\mathrm{d}}_{1\ensuremath{-}x}{(\mathrm{C}{\mathrm{a}}_{1\ensuremath{-}y}\mathrm{S}{\mathrm{r}}_{y})}_{x}\mathrm{Mn}{\mathrm{O}}_{3}$ multilayers depend on the tolerance factor and the hole doping of the manganite. In particular, we investigated the granular superconducting state and the related magnetic-field-driven insulator-to-superconductor transition that was previously discovered in corresponding multilayers with $\mathrm{P}{\mathrm{r}}_{0.5}\mathrm{L}{\mathrm{a}}_{0.2}\mathrm{C}{\mathrm{a}}_{0.3}\mathrm{Mn}{\mathrm{O}}_{3}$ [B. P. P. Mallett et al., Phys. Rev. B 94, 180503(R) (2016)]. We found that this granular superconducting state occurs only when the manganite layer is in a charge/orbital ordered and CE-type antiferromagnetic state (Mn-CO/OO). The coupling mechanism underlying this intriguing proximity effect seems to involve the domain boundaries of the Mn-CO/OO and/or the charge disordered regions of the manganite layer that become more numerous as the hole doping is reduced below $x=0.5$.

Thermoelectric power generation technology aims to convert thermal energy into electricity. Micromodule design optimization depends directly on the thermal environment. For low thermal energy input, optimized thermoelectric devices require 100 μm to 500 μm element thickness. These dimensions currently present a challenge for standard mass-production manufacturing techniques. In this paper, a unique printing technology for micromodule fabrication is presented. This technology is compared with a traditional bulk thermoelectric manufacturing process to highlight the advantages of the printing process to obtain scalable thermoelectric devices. Initial thermoelectric materials have been integrated in inks and then deposited by a spray technology onto a polymer substrate. A complete micromodule for application on nonplanar surfaces is also presented.

In major applications, optimal power will be achieved when thermoelectric films are at least 100 μm thick. In this paper we demonstrate that screen-printing is an ideal method to deposit around 100 μm of (Bi,Sb)2(Te,Se)3-based films on a rigid or flexible substrate with high Seebeck coefficient value (90 μV K−1 to 160 μV K−1) using a low-temperature process. Conductive films have been obtained after laser annealing and led to acceptable thermoelectric performance with a power factor of 0.06 μW K−2 cm−1. While these initial material properties are not at the level of bulk materials, the complete manufacturing process is cost-effective, compatible with large surfaces, and affords a mass-production technique.

Resume Introduction La superposition des epidemies de rotavirus et de VRS provoque un afflux brutal en hiver de malades dans les services de pediatrie, situation propice aux infections nosocomiales chez les enfants les plus jeunes. Objectif L'objectif de cette etude est de mesurer l'incidence des infections nosocomiales a rotavirus chez les enfants de moins de deux ans en periode hivernale. Methodes Nous avons mene dans un service de pediatrie generale a Paris une etude de cohorte historique pendant quatre hivers successifs. Une recherche systematique de rotavirus etait effectuee a l'admission chez les enfants de moins de deux ans. Tout enfant ayant une diarrhee nosocomiale apparue apres 48 heures d'hospitalisation avec virologie des selles initiale negative, avait une nouvelle recherche de rotavirus. Resultats Les infections nosocomiales a rotavirus ont dans notre etude une incidence globale sur les periodes etudiees de 13,9 % avec une variation allant de 15,9 a 12,7 % chez les enfants de moins de deux ans, alors que le portage asymptomatique de rotavirus a l'admission est de l'ordre de 3 %. Le risque d'infection nosocomiale augmente avec la duree d'hospitalisation et concerne principalement les tres jeunes enfants. Conclusion L'incidence d'infections nosocomiales a rotavirus est importante (13,9 %) malgre les mesures d'isolement et de prevention systematique. Elles sont favorisees par l'afflux brutal de tres jeunes patients aux urgences et dans les services de pediatrie du fait de la superposition des epidemies de bronchiolites a VRS et de gastro-enterites a rotavirus dans la region parisienne.

For medium temperature applications, magnesium silicide stannide and manganese silicide (HMS) are considered as the most promising thermoelectric materials. The scale-up of these materials was performed by gas phase atomization for powder production, followed by Spark Plasma Sintering process in a pre-industrial scale technological platform for thermoelectrics “PAMIRE” (Grenoble, France). Kilograms batches of thermoelectric powder were processed, leading to the production of a large quantity of homogenous 60 mm diameter silicide pellets.

Resume La variete des tableaux cliniques observes chez l'enfant contamine par un adulte tuberculeux rend difficile l'application de regles simples. Les indications du scanner chez le jeune enfant et les risques de l'abstention therapeutique avec surveillance restent discutes. Patients Une serie de 69 enfants issus de 50 familles differentes et vivant en contact etroit avec un adulte tuberculeux avere est rapportee. Une tomodensitometrie (TDM) thoracique a ete pratiquee systematiquement chez 51 enfants. Resultats L'IDR est souvent prise en defaut : 3 enfants sur 17 avec atteinte tuberculeuse radiologique avaient une IDR negative malgre le BCG. Les resultats de la TDM compares a ceux de la radiographie standard pour la recherche d'adenopathies etaient differents uniquement chez des enfants de moins de 5 ans. Cinquante-huit enfants ont recu le traitement habituel de tuberculose latente ou patente, ou une chimioprophylaxie : aucun de ces patients n'avait de tuberculose evolutive 2 a 4 ans plus tard. Chez 11 enfants examines initialement en dehors du service, une surveillance sans traitement immediat avait ete decidee. Quatre d'entre eux avaient, 6 a 18 mois plus tard, une tuberculose patente et 5 d'entre eux une tuberculose latente (6/9 avaient plus de 3 ans). Conclusion Cette serie montre que le risque de tuberculose est majeur en cas de contage familial, et que l'abstention therapeutique avec surveillance en cas de bilan negatif n'est possible que si les familles et les medecins pratiquent la surveillance conseillee, ce qui n'est pas toujours le cas. Par ailleurs, la TDM systematique pour rechercher des adenopathies n'est utile que chez l'enfant de moins de 5 ans.

A 54-year-old patient received medical consultation for an acrokeratosis paraneoplastica in association with antidiuretic syndrome that revealed a small cell epidermoid and anaplastic bronchial cancer. Treatment of the neoplasm by polychemotherapy with Adriblastine, Carboplastine and Vepeside rapidly cured the acrokeratosis. Similarly, the syndrome of inappropriate antidiuretic hormone secretion was also completely controlled by hydrous restriction and treatment with demeclocyeline. Our observation illustrates quite well the paraneoplastic aspect of acrokeratosis whose association with antidiuretic syndrome has been rarely reported.

Resume Le malaise designe tout evenement inhabituel survenu chez un patient et comportant un caractere de gravite. En periode neonatale, nous distinguons deux populations : les exprematures et les enfants nes a terme. Chez l'expremature parvenu a proximite du terme, il faut evoquer la persistance d'apnees et l'hyperreflectivite vagale dont les traitements, ou l'existence meme, sont parfois controverses. La troisieme cause courante de malaise est le reflux gastro-œsophagien, elle est commune au nouveau-ne a terme. Chez celui-ci, les malaises semblent presenter les memes etiologies que celles rapportees chez le nourrisson de tout âge ; certaines particularites sont neanmoins suggerees par une etude personnelle. Enfin, il faut garder en memoire le lien eventuel entre malaise et mort subite, et poursuivre la surveillance des enfants ayant presente un malaise en periode neonatale.

Resume Le dosage de l’interferon alpha (IFN-α) comme temoin d’infection virale est utile dans certaines situations cliniques. Sa validite n’est pas reconnue chez le tres jeune nourrisson. Objectif. – Determiner s’il existe une difference dans la detection d’IFN-α produit lors d’infections virales entre les enfants de moins et de plus de six mois. Methode. – Trois infections virales du nourrisson etaient choisies : la meningite a enterovirus, l’infection a virus respiratoire syncitial et la gastroenterite a rotavirus. Retrospectivement, 233 enfants ayant presente une de ces infections et ayant eu un dosage d’IFN-α etaient recenses sur trois ans. Une analyse comparative de la production qualitative et quantitative d’IFN-α etait faite entre les groupes des moins de six mois ( n = 105) et des plus de six mois ( n = 128). Un groupe de patients finalement non infectes mais ayant eu un dosage d’IFN-α etait pris comme controle ( n = 15). Resultats. – Une production d’IFN-α etait detectee aussi frequemment chez les moins de six mois (81,9 % des cas) que chez les plus âges (80,3 % des cas), quelle que soit l’infection virale en cause ( p = 0,3–0,63). Les valeurs quantitatives d’IFN-α produit n’etaient pas significativement differentes entre les deux groupes et etaient meme significativement plus elevees chez les moins de six mois admis pour une meningite a enterovirus. Aucune production d’IFN-α n’etait observee chez les controles. Conclusion. – La detection d’IFN-α lors d’infections virales chez le tres jeune nourrisson est aussi sensible que chez l’enfant plus âge. Elle peut etre utile dans des situations diagnostiques incertaines.

Resume En periode d’epidemies grippales les enfants sans risque morbide particulier ont des hospitalisations plus frequentes, en particulier pour des causes respiratoires. Mais il s’agit la de donnees epidemiologiques car le virus grippal est rarement recherche. Nous avons etudie de facon prospective la frequence des infections grippales survenant au moment ou quelque temps avant une pneumonie communautaire. Population et methodes. – Tous les enfants d’un a 15 ans hospitalises pour pneumonie communautaire entre avril 2000 et 2002 ont eu une recherche de virus grippal par immunofluorescence et culture, et une serologie. La cinetique des anticorps par fixation du complement (brievete du pic) permet de conclure a une infection grippale recente si le taux est superieur ou egal a 1/64. Un groupe temoin d’enfants examines en consultation pendant l’hiver 2001–2002 a ete constitue. Resultats. – Parmi 33 enfants anterieurement sains (âge moyen 4,9 ans), huit avaient une pneumonie a pneumocoques, dix une pneumonie a mycoplasmes, un a chlamydia et huit n’avaient pas d’etiologie retrouvee. Les six autres avaient une pneumonie aigue virale due au VRS dans deux cas, a un adenovirus dans un cas et au virus Influenza A dans trois cas (12 %). Treize des 33 enfants (39,4 %) avaient des IgG superieurs ou egaux a 1/64 en fixation du complement contre le virus grippal, indiquant une grippe dans les semaines precedentes (5/8 pour les pneumonies a pneumocoques et 5/10 pour les pneumonies a mycoplasmes) : 9/13 de ces infections recentes a virus influenza n’avaient pas eu de traduction clinique evidente. Dans le groupe controle (enfants asthmatiques du meme âge) 1/30 (3 %) avait des anticorps superieurs ou egaux a 1/64 (p Conclusion. – Dans cette etude, la grippe est directement en cause dans 12 % des pneumonies communautaires conduisant a l’hospitalisation de l’enfant de plus d’un an. Dans 39,4 % des cas, l’infection grippale a precede l’episode aigu de quelques semaines, favorisant une infection a pneumocoques, a mycoplasmes ou a d’autres agents pathogenes.

Resume Le traitement conventionnel des enfants atteints de fievre typhoide ou de salmonellose severe repose sur les β-lactamines et en particulier la ceftriaxone. En raison de leur faible pouvoir de penetration intracellulaire, les β-lactamines, meme actives in vitro, sont quelquefois en situation d’echec clinique. La solution est, dans ces circonstances, d’utiliser les fluoroquinolones, qui elles ont une excellente penetration intracellulaire. L’objectif de cette etude est d’evaluer dans une etude retrospective l’efficacite et les eventuels accidents secondaires de la ciprofloxacine orale chez les patients avec une salmonellose severe en echec clinique de traitement par la ceftriaxone. Patients. – De 1995 a 2000, 215 patients avec une infection aigue a salmonelle ont ete identifies par le laboratoire de bacteriologie d’un hopital parisien (âge : 1 mois a 15 ans). Cent treize de ces enfants ont du etre hospitalises en raison de leur etat clinique. Trois ont ete exclus de l’etude. Aucune des 110 souches restantes (dont 4 S. typhi , 51 S. typhimurium et 25 S. enteritidis ) n’etaient resistantes a la ceftriaxone ou la ciprofloxacine, mais 41 souches soit 37,3 % produisaient une β-lactamase. Douze patients ont eu une guerison rapide sans traitement antibiotique et 98 (âge moyen 3,9 ans) ont ete traites (ceftriaxone chez 91 patients, amoxicilline chez 7) en raison d’un syndrome dysenterique (43 %), d’un choc (15 %), ou d’une fievre persistante avec diarrhee severe. Resultats. – Chez 72 enfants, la ceftriaxone (ou l’amoxicilline chez 5) a entraine une guerison rapide, avec disparition de la fievre (en 1,5 j en moyenne) et de la diarrhee (2,2 j en moyenne). Trois semaines apres la guerison clinique, un portage asymptomatique de salmonelles a ete observe chez 22/38 patients, soit 58 %. Chez les 26 autres patients, la ceftriaxone etait cliniquement inefficace malgre sa bonne activite in vitro, et les enfants ont recu un traitement par ciprofloxacine orale (20 mg kg –1 j –1 , 5 j) apres 2 a 7 j de fievre prolongee et de diarrhee severe. La guerison clinique des la mise sous ciprofloxacine a ete obtenue en moins de 48 h. Les souches retrouvees chez ces 26 patients incluaient 4 S. typhi et 15 S. typhimurium ( p p Conclusion. – Dans les salmonelloses severes, l’echec clinique de la ceftriaxone n’est pas rare, particulierement au cours des infections a S. typhi ou a S. typhimurium produisant une β-lactamase, et un traitement par la ciprofloxacine orale permet une guerison rapide.

Introduction Les epidemies de bacteries hautement resistantes (BHR) – enterocoque resistant aux glycopeptides (ERG) – representent actuellement un probleme en France. En nephrologie et compte tenu du profil polypathologique des patients, les unites d’hemodialyse peuvent representer des niches a ces BHR. La dissemination de l’ERV dans le service et aux autres patients peut se faire, dans ce cas la, tres rapidement. Les consequences sont importantes avec un impact majeur financier, humain et organisationnel. Observation Situation clinique et epidemiologique : en mars 2015, le service s’est trouve face a une faible epidemie d’ERV. Un premier cas a ete detecte et declare positif chez un patient hospitalise et hemodialyse. Tous les patients contacts ont ete depistes et cette compagne de depistage a mis en evidence 6 autres cas. Au total 7 patients ont ete depistes positifs a ERG (cohorte epidemique VANB) avec 5 patients traites par hemodialyse et 2 par dialyse peritoneale. Du fait du risque eleve de dissemination de cette BHR, un depistage systematique de tous les patients du service a ete realise et mettant en evidence un patient porteur d’ERV van A (la souche epidemique est van B). Discussion La lutte contre l’epidemie d’ERG a ete tres couteuse. Elle a pu etre maitrisee grâce a la vigilance et aux differentes actions mises en place rapidement : recommandations standards, renforcement des mesures d’hygiene, compagnes regulieres de sensibilisation et de formation, arret des admissions, isolement des patients porteurs et contacts avec des locaux, des seances et du personnels dedies (cohorting). Cette maitrise a ete obtenue au prix de contraintes humaines, financieres et organisationnelles indispensables : baisse importante de l’activite, surcout majeur, reorganisation du service augmentation importante des activites du laboratoire de bacteriologie. Le retentissement sur la prise en charge et l’impact social sont egalement a signaler : infection-impact sur la prise en charge. Conclusion L’epidemie de BH a ERG est un evenement grave avec des consequences financieres, humaines et organisationnelles majeures. Les equipes doivent etre sensibilisees a ce probleme et s’organiser en mettant une politique de prevention, de depistage et d’isolement (politique d’alerte et demarche positive).

An automated system for mycobacteria culture, BACTEC 9000 MB, was compared with Lowenstein Jensen culture. On a total of 4,484 pulmonary and extrapulmonary human clinical samples, 126 (2.8%) were positive for mycobacteria on Lowenstein Jensen (LJ) medium; 105 (2.34%) were identified as Mycobacterium tuberculosis and 39 (1.10%) as non tuberculosis mycobacteria. The mean time of detection of Mycobacterium tuberculosis on the 131 positive samples was reduced to approximately ten days with BACTEC 9000 MB compared to the LJ (17.6 versus 27.38 days). Through the results of this comparative study, we confirmed that BACTEC 9000 MB is a more efficient system than LJ for culture detection of all mycobacteria from various sites samples.

The incidence of rotavirus and RSV outbreaks during winter seasons leads to overcrowding of pediatric units in the Paris area, and increases the risk of viral nosocomial infections in hospitalized young infants.The aim of this study was to measure the incidence of rotavirus nosocomial infections in children less than 2 years of age during 4 consecutive winters.All infants admitted in the pediatric unit during the winter were prospectively screened for rotavirus with a stools exam. All children with negative stools examination on admission but developing diarrhea after 2 days of hospitalization underwent a new screening test for rotavirus in stools.During the 4 consecutive winters, the global incidence of nosocomial rotavirus infection was 13.9% (12.7 to 15.9%). Asymptomatic carriage of rotavirus was detected in 3% of admitted infants. The risk of nosocomial rotavirus infection increases with young age and the length of hospital stay.The incidence of nosocomial rotavirus infections was high in this unit. It is related to overcrowding due to coincidence of diarrhea and bronchiolitis outbreaks in the Paris area and to the young age of hospitalized patients.

The heterogeneity of clinical presentations of children in contact with a tuberculous adult do not allow simple guidelines for treatment and exams. Indications of thoracic computed tomography (CT) in young children and the risk of a follow-up without antituberculous treatment are always discussed.Sixty-nine children, belonging to 50 families, living in close contact with an adult treated for tuberculosis were explored during 7 years in a General Pediatric Unit. A CT was performed in 51 patients.Mantoux test was negative in 3/17 children with typical tuberculous disease on X-ray. When results of CT were compared with those of standard thoracic X-ray, a difference for the diagnosis of mediastinal adenopathies was found only in children younger than 5 years. Fifty-eight patients were given usual treatment of latent or patent tuberculosis if indicated, or a chemoprophylaxis. All of them had normal clinical and X-ray exam 2 to 4 years later. Eleven children, initially checked in an other unit, were given no treatment, but a follow-up was set up. However, after 6 to 24 months, 4/11 had a patent tuberculosis and 5/11 a latent tuberculosis, 6/9 being aged more than 3 years.This study shows that risk of tuberculosis after familial contamination is high, and that the choice of absence of treatment with following re-evaluation, is sometimes questionable because families or doctors do not perform the prescribed follow-up. To perform systematically a thoracic CT, searching for mediastinal adenopathies, is useful only before the age of 5 years.

On a first anatomical series of 52 hearts of trisomic 21 fetuses, published in June 2002, we described a new minor cardiac anomaly, belonging to the atrioventricular septal defect, with a linear insertion of the atrioventricular valves without defect. We want to confirm these data, on a larger series of 213 new hearts of trisomic 21 fetuses by adding a complementary section to the standard examination; 100% of controls have shown a normal insertion with an offsetting of the atrioventricular valves. On 113 out of these 213 hearts of trisomic 21 fetuses, with a so called "normal" heart at the standard examination showing no defect, the complementary section has shown that only 37.2% of these hearts have a normal insertion, whereas 62.83% show a linear insertion, without offsetting and without any septal defect. This linear insertion has been observed in all the different types of atrioventricular septal defect as a good hallmark for trisomy 21; but, since then, they have always been described associated with a septal defect, atrial or ventricular. Our hypothesis is that the linear insertion of the atrioventricular valves without defect is the minor form of the atrioventricular septal defect spectrum, taking place between the prior described partial types of atrioventricular septal defect, in which there is always a defect (ostium primum type atrial septal defect or inflow type ventricular septal defect), and the real normal heart. A precise description of the level of the complementary section and of the anatomic peculiarities of the linear insertion of the atrioventricular valves without defect would help its screening in fetal ultrasonography.

IFN-alpha detection is useful in some clinical circumstances, but its use has never been validated in young infants with viral infections.The authors wanted to determine it there was any difference in the assessment of IFN-alpha production between infants under or over six months of age.A series of 233 children with identified common viral infections who had been assessed for IFN-alpha production was retrospectively analyzed. The viral infections were enteroviral meningitis (n =103), respiratory syncytial virus infections (n =60), and rotavirus gastroenteritis (n =70). Data collected from the group of infants under six months of age (n =105) was compared to that of the older children (n =128). Qualitative and quantitative values of interferon-alpha were determined for each group.Interferon-alpha was detected in very young infants (81.9% of cases) as often as in the older age group (80.3% of cases), for any of the three viral infections (P =0.3-0.63). The mean level of interferon-alpha production detected was not lower in the youngest group, and even higher in the group under six months of age with enteroviral meningitis.Interferon-alpha detection in very young infants is efficient and may be useful to differentiate between viral and bacterial infection particularly when the etiological diagnosis appears uncertain.

Children without chronic or serious medical conditions are at increased risk for hospitalization during influenza seasons, mainly with respiratory tract infections. But influenza virus infections frequently remain undiagnosed, even in hospitalized patients. We prospectively studied the rate of concomitant and preceding influenza infections in children hospitalized with a community acquired pneumonia (CAP).All 1-15-year-old children with CAP requiring hospitalization between 1st April 2000 and 2002 had nasopharyngeal aspirate for viruses, immunofluorescence and serologies for respiratory pathogens. The peak of influenza IgG measured by complement fixation (CF) is transient, and a titer of 1/64 or more indicates an acute influenza infection in the preceding weeks. Children with chronic disease were excluded and a control group of patients from outpatient clinic was measured.Among 33 previously healthy children (age 4.9 years, range 1.2-14 years), 8 had a pneumococcal pneumonia, 10 a pneumonia caused by Mycoplasma pneumoniae (MP), 1 by Chlamydia pneumonia, and 8 of unknown origin. In six patients immunofluorescence was positive: Respiratory Syncitial Virus, 2, Adenovirus, 1 and Influenza A, 3 (including a patient with concomitant MP infection). Thirteen of the 33 children (39.4%) had evidence of a recent influenza A infection with CF abor = 1/64: with pneumococcal pneumonia, 5/10 with MP pneumonia, 3/8 with unknown origin pneumonia, 9/13 of these previous influenza infections being clinically inapparent. Only 1/30 children of control group (3.3%) had CF abor = 1/64.In this study, influenza infection is the direct cause of CAP of children in 12% of cases. In other children with CAP, 39.4% of patients had an influenza infection in the preceding weeks which leads to secondary infection caused by Streptococcus pneumoniae or by MP or other pathogens.

Children with enteric fever or severe salmonella infections are usually treated with beta-lactam antibiotics, particularly ceftriaxone. Due to their poor penetration into cells, beta-lactam antibiotics, even if active in vitro, are sometimes clinically ineffective because they cannot reach the intracellular sites of Salmonella multiplication.To evaluate in a retrospective study usefulness, efficacy and safety of oral ciprofloxacin in patients with severe salmonellosis and clinical failure of ceftriaxone or beta-lactam antibiotics.From July 1, 1995 to 2000, the bacteriology laboratory of a French pediatric hospital had identified 215 patients aged between 1 month and 15 years with positive blood or stools for Salmonella sp, 113 of them requiring hospitalization due to their clinical symptoms. Three were excluded for sickle-cell disease or poor nutritional status. None of the 110 strains (including 4 S. typhi, 51 S. typhimurium, 25 S. enteritidis, 6 S. hadar and 5 S. heidelberg) isolated was resistant to ceftriaxone or ciprofloxacin. Forty-one of the 110 strains (37.3%) produced a beta-lactamase. Twelve patients had a rapid recovery without antibiotic treatment, and 98 (mean age 3.9 years) were given antibiotics (ceftriaxone in 91 and amoxicillin in 7) for dysentery (43%), shock (15%) or persistent high fever and severe diarrhea (42%).In 72 children (mean age = 3.6 years) ceftriaxone treatment (amoxicillin in 5) for 5 or 7 days was rapidly effective: apyrexia was obtained in 1.5 day after the start of treatment and the number of stools per day was 4 or less in 2.2 days. Two to 3 weeks after clinical recovery, asymptomatic carriage was present in 22/38 patients. In the 26 other patients ceftriaxone (amoxicillin in 2) treatment was clinically ineffective, despite good in vitro activity, and was switch for oral ciprofloxacin (20 mg kg(-1) d(-1), 5 days) after 2 to 7 days of lasted fever and/or severe diarrhea. Clinical improvement with ciprofloxacin was obtained in less than 48 h. The strains involved in these 26 patients included the 4 S. typhi and 15 S. typhimurium (P0.05), 13/15 (P0.01) producing beta-lactamase. Asymptomatic carriage was found in 5/22 patients (P0.05) after recovery. None of the patient treated with ciprofloxacin had side effect.In severe salmonellosis, the clinical failure of treatment with ceftriaxone is not rare, particularly in S. typhimurium producing beta-lactamase infection and short treatment with oral ciprofloxacin is safe and allows to obtain a rapid recovery.

An automated system for mycobacteria culture, BACTEC 9000 MB, was compared with Lowenstein Jensen culture. On a total of 4,484 pulmonary and extrapulmonary human clinical samples, 126 (2.8%) were positive for mycobacteria on Lowenstein Jensen (LJ) medium; 105 (2.34%) were identified as Mycobacterium tuberculosis and 39 (1.10%) as non tuberculosis mycobacteria. The mean time of detection of Mycobacterium tuberculosis on the 131 positive samples was reduced to approximately ten days with BACTEC 9000 MB compared to the LJ (17.6 versus 27.38 days). Through the results of this comparative study, we confirmed that BACTEC 9000 MB is a more efficient system than LJ for culture detection of all mycobacteria from various sites samples.

Six bitches free of canine herpesvirus 1 (CHV-1) were vaccinated against the virus; a first injection was given 10 days after the presumed date of mating and a second six weeks later. Six similar bitches were left unvaccinated as controls, and all the pups were challenged oronasally with a virulent strain of CHV-1 at three days of age. All the vaccinated bitches seroconverted and had high antibody titres when the puppies were challenged, but the control bitches remained seronegative. In the control group, 62 per cent (18 of 29) of the pups died of CHV-1-induced disease; most of them showed typical clinical signs and macroscopic lesions, and CHV-1 infection was confirmed by the isolation of the virus or by PCR. None of the puppies in the vaccinated group died of CHV-1 infection. The efficacy of the vaccine was confirmed in CHV-1-positive breeding units. The rate of pregnancy tended to be higher in vaccinated bitches and the mortality of pups before weaning was significantly reduced in the litters born to vaccinated bitches.

Feline calicivirus (FCV) is a major oral and respiratory pathogen of cats, able to induce subclinical infection as well as acute disease. It is also characterized by a high degree of antigenic variation. This work sought to address the question of the existence of distinct biotypes of FCV. Eight French, 6 British and 9 American FCV isolates, responsible for acute oral/respiratory disease or chronic gingivitis/stomatitis, were compared for their pathogenicity, antigenic profiles and serological relationships. Antigenic profiles were assessed by an indirect immunofluorescence assay with a large panel of characterized monoclonal antibodies. Cross-neutralisation assays were performed with specific cat antisera collected at 30 days p.i., then analysed by calculation of antigenic bilateral relatedness and dominance. Whatever their pathogenic origin, all the isolates induced an acute upper-respiratory tract infection in oronasally infected SPF kittens. Their antigenic profiles were different and did not correlate with their geographical or pathological origin. Cross-neutralisation studies and calculation of the mean bilateral relatedness allowed us to distinguish chronic original isolates from acute original ones. This study did not confirm the existence of FCV biotypes but showed that the chronic carrier state is related to the emergence of antigenically distant viruses.

Summary Between 1988 and 1991,644 serum samples were collected from 480 grizzly bears (Ursus arctos horribilis) and 40 black bears (Ursus americanus) from Alaska, United States of America, and were tested for selected canine viral infections and zoonoses. Antibody prevalence in grizzly bears was 0% for parvovirus, 8.3% (40/480) for distemper, 14% (68/480) for infectious hepatitis, 16.5% (79/480) for brucellosis, 19% (93/480) for tularaemia and 47% (225/478) for trichinellosis. In black bears, prevalence ranged from 0% for distemper and parvovirus to 27.5% for trichinellosis and 32% for tularaemia. Antibody prevalence for brucellosis (2.5%) and tularaemia (32%) were identical for grizzly bears and black bears from the geographical area of interior Alaska. Links between differences in prevalence and the origin of the grizzly bears were observed. Antibodies to canine distemper virus and infectious hepatitis virus were mainly detected in grizzly bears from Kodiak Island and the Alaskan Peninsula. Brucellosis antibodies were prevalent in grizzly bears from western and northern Alaska, whereas tularaemia antibodies were detected in grizzly bears from interior Alaska and the Arctic. There was a strong gradient for antibodies to Trichinella spp. from southern to northern Alaska. For most diseases, antibody prevalence increased with age. However, for several infections, no antibodies were detected in grizzly bears aged from 0 to 2 years, in contrast to the presence of those infections in black bears. Grizzly bears served as excellent sentinels for surveillance of zoonotic infections in wildlife in Alaska.

Eighty-three patients scheduled for outpatient surgery were enrolled in this double-blind, randomized trial designed to compare the safety and efficacy of single and multiple doses of flurbiprofen 50 mg. and acetaminophen 300 mg. plus codeine phosphate 30 mg. During the multiple dose segment, statistically significant differences were observed during the first 24 hour postoperative period regarding relief of pain and pain intensity. Flurbiprofen provided greater relief of pain than the acetaminophen with codeine phosphate combination. This study supports the use of flurbiprofen as a suitable alternative to acetaminophen plus codeine phosphate in the treatment of postoperative pain following foot surgery.

Feline immunodeficiency virus (FIV), the causative agent of feline AIDS, induces a disease syndrome in cats characterized by a decreased lymphocyte-proliferative response to mitogens at all stages of infection and selective depletion of CD4 lymphocyte subsets. In this work, we report that peripheral blood lymphocytes isolated from FIV-infected cats undergo a spontaneous death, in vitro, according to a programmed cell death (PCD) or apoptosis. This phenomenon has also been seen in peripheral blood lymphocytes from HIV-infected humans and SIV-infected macaques. Four different techniques were used to document PCD in FIV-infected cats. DNA gel electrophoresis has shown a DNA fragmentation pattern with DNA fragments displaying sizes corresponding to multiples of oligonucleosomes DNA length unit (180 bp). Transmission electron microscopy revealed condensation of both nuclear chromatin and cytoplasm. An increase in the percentage of fragmented DNA was demonstrated by Burton's technique. In addition, flow cytometric analysis detected a cell population with condensed chromatin. The spontaneous PCD in FIV-infected cats could not be inhibited by RNA synthesis inhibitors or protein synthesis inhibitors. Our results could have implications for understanding the pathogenesis of FIV-infection and establishing specific strategies against apoptosis in cats and humans.

Determine the risk factors in blood donors with anti hepatitis C antibodies (anti-HCV ab) possible liver involvement and evaluation of their infectious potential by a search for viral RNA in blood.Between July 1990 and October 1991, 19,632 blood donors were screened for hepatitis C. Antibodies to HCV were detected in 74 donors (2nd generation ELISA, Abbott). We evaluated the risk factors, determined ALAT levels and looked for circulating RNA virus by amplification of the non-coding region of the viral genome (RTPCR) in 68 of these 74 donors screened. A control was chosen arbitrarily from 103 donors with high ALAT levels, but with no antibodies to HCV nor detectable circulating viral DNA.The prevalence of anti-HCV ab in blood donors in 0.37%. No risk factor was found in 29 donors (43%). Parenteral exposure (former i.v. drug addiction and history of transfusions) was found to be the mode of transmission of hepatitis C in 23 donors (34%). History of NANB jaundice (non-post transfusion) was reported in 1 donor (1%). The remaining 15 donors (22%) were found to have minor risk factors - either isolated or in combination (exposure, tatoos, multiple sexual partners). Former i.v. drug addiction (p = 0.0000006) as well as a history of transfusions (p = 0.0071) are significantly more frequent in the group of donors with antibodies to HCV. None of the 35 sexual partners of the tested donors proved to be positive. 21 donors (30%) had high ALAT (+2 SD). Viral RNA was detected in blood of 26 donors (38%). The proportion of cases with positive viral RNA was 61% if only those donors with high ALAT levels were taken into consideration (13 positive of 21).Risk factors were found in 39 donors (57%) with antibodies to HCV. History of parenteral exposure was found to be significantly more frequent than in the control group (p = 0.0000054). Sexual transmission within couples was not demonstrated in the population tested. A positive PCR test is a probable indicator of a continuous viral replication and reflects a possible chronic hepatic involvement as well as a potential infectivity. This test is positive in at least 38% of donors with antibodies to HCV and in more than 60% of those who, in addition, have high ALAT levels.

We theoretically investigate the thermoelectric properties of sintered SiGe alloys, compare them with new and previous experimental measurements, and evaluate their potential for further improvement. The theoretical approach is validated by extensive comparison of predicted bulk mobility, thermopower, and thermal conductivity, for varying Ge and doping concentrations, in the 300–1000K temperature range. The effect of grain boundaries is then included for Si0.8Ge0.2 sintered nanopowders and used to predict optimized values of the thermoelectric figure of merit at different grain sizes. Our calculations suggest that further optimization of current state of the art n-type (p-type) material would be feasible, possibly leading to ∼5% (4%) ZT enhancement at 1000 K and 16% (6%) at room temperature. Even larger enhancements should be possible if the phonon scattering probability of the grain boundaries could be increased beyond its present value.

The authors report on three cases of severe P. falciparum malaria successfully treated by iv quinine and exchange transfusion. Serum concentrations of Tumor Necrosis Factor (TNF) were determined before and during treatment. After an initial decrease, serum levels of TNF remained markedly elevated during the first 48 hours despite exchange transfusion. Though exchange transfusion accelerates the elimination of parasites from the blood, it seems to have no immediate effects on reducing serum levels of cytokines such as TNF.

Introduction La coloscopie, examen couramment pratique dans nos services, comporte un risque de complications potentiellement graves. La loi du 4 mars 2002 donne obligation au medecin de fournir une information sur les benefices et les risques de ce type d’examen et le recueil du consentement eclaire doit etre formalise. Le but de ce travail a ete d’evaluer la qualite de l’information delivree et egalement la comprehension de celle-ci par le patient. Patients et Methodes Durant une periode de 3 mois, d’avril a juin 2008, une participation au protocole dit « info colo » a ete proposee a tout patient adulte ayant une coloscopie programmee avec une preparation intestinale realisee au domicile. Ces patients avaient l’information habituellement delivree dans le service avec lors de la consultation du gastroenterologue une information orale et ecrite sur les risques de l’examen. L’information ecrite est un document propre au service, inspire de celui de la SFED, detaillant le principe de la coloscopie (insertion d’un endoscope par l’anus pour realiser une exploration visuelle du colon), la desinfection des endoscopes entre chaque patient et les risque de perforation et d’hemorragie. Quelques semaines apres la consultation initiale, dans le meme temps que la consultation d’anesthesie prealable, le patient recevait une information par les infirmiers d’endoscopie sur la preparation intestinale et le regime sans residu. A la sortie du patient de l’hopital de jour ou de semaine, le compte rendu de la coloscopie etait remis au patient et il etait propose selon les cas un rendez-vous de consultation. Dans les 24 a 48 h apres le retour au domicile, le patient etait interroge au telephone par une personne independante du service (MS) sur la qualite de l’information, la notion de risque et le vecu de l’examen. Resultats 45 patients (16 hommes, 29 femmes, âge moyen 55,1 ± 13,8 ans) ont ete inclus. II s’agissait de la premiere coloscopie chez 20 patients (44,4 %). La totalite des patients declarait avoir recu une information ecrite sur les risques de l’examen. Un patient (4,5 %) disait ne pas avoir ete informe du principe de l’examen. L’information sur la preparation colique avant la coloscopie etait bien assimilee par 100 % des patients. 18 patients (40 %) declaraient ne pas avoir ete informes des modalites de desinfection des endoscopes entre chaque patient. Seuls 33 patients (73,3 %) etaient capables de citer le type de complications pouvant etre observees. La qualite de l’accueil et la recommandation d’effectuer l’examen dans les memes conditions pour eux meme ou leur entourage etaient exprimes par la totalite des patients. En revanche, seuls 21 patients (47 %) disaient avoir recu leur compte rendu d’endoscopie a la sortie du service. Conclusion L’information du patient sur la coloscopie est relativement standardisee dans le service. Cette etude montre que malgre cette information, les messages sur les risques de l’examen ne sont pas bien assimiles par certains patients. Des progres restent a faire sur la delivrance de l’information a la sortie des patients.

In 1987, a 50-year-old patient presented with isolated thrombocytopenia (27,000/mm3) which proved to be refractory to steroid medication and high i.v. doses of immunoglobulin. Two years later he developed macrocytic anemia. Chromosomal analysis confirmed the diagnosis of myelodysplastic syndrome (MDS), refractory anemia type with blast excess. Cytogenetically, three cellular populations were observed: one normal (75% of metaphases) and two abnormal, clone A (2%) 46,XY, del(5q), del(11q), and clone B (23%) 46,XY, del(5q), del(11q) plus 2 other anomalies. Evolution was characterized by worsening of the bicytopenia with marked hypoplasia of the megakaryocytic and erythroid series while the percentage of blasts remained stable. Concerning the chromosomal markers, the normal population disappeared and clone A became predominant (clone A 97%, clone B 3%). This case shows that isolated thrombocytopenia can be the sole initial manifestation of MDS. We discuss the possibility that "refractory thrombocytopenia" constitutes a diagnostic category like refractory anemia or refractory anemia with ring sideroblasts. The proliferative advantage of clone A or the disadvantage of clone B may be due to the occurrence of new, cytogenetically non-detectable mutations.

On an anatomical series of 52 hearts of trisomic 21 fetuses published in June 2002, we described a new minor cardiac anomaly belonging to the atrioventricular septal defect spectrum. It consists in a linear insertion of the atrioventricular valves (LIAVV) without defect instead of the normal offsetting. We wanted to confirm these data on a prospective series of 243 hearts of trisomic 21 fetuses compared to 100 normal hearts of normal fetuses. We added a complementary section, apex to the inferior pulmonary veins, to the standard examination. 100% of controls showed a normal offsetting of the atrioventricular valves. At the standard examination 127 out of 243 hearts of trisomic 21 fetuses (52%) showed a so called ‘‘normal’’ heart. Out of these 127 hearts, the complementary section showed a linear insertion, without offsetting and without any septal defect in 64%. Finally, only 19% of the 243 hearts of trisomic 21 were really normal with had a normal offsetting. This linear insertion, already observed in all the different types of atrioventricular septal defects(AVSD) is considered as a good hallmark for trisomy 21; but, since then, it has always been described associated with a defect. Our results confirm that the LIAVV without defect is a minor form of the AVSD spectrum, taking place between the prior described partial types of AVSD, which always have a defect, and the very normal heart. These findings induced a prospective echographic study comparing the echographic findings to the anatomical data in order to improve the scan screening of the trisomy 21.

Many diabetes-related amputa tions are the result of plantar calluses that become ulcerated, infected, and gangrenous. One hundred diabetic volunteers with plantar calluses were studied for 18 months in Salt Lake City. The patients' calluses were measured monthly. To provide a base line for comparison, the patients wore regular shoes for a minimum of three months, after which they switched to run ning shoes. The study found that the wearing of running shoes reduced the size of the patients' calluses significantly, leading to the conclusion that running shoes may contribute to a reduc tion in foot problems of persons with diabetes.

Diabetic patients show a thrombotic tendency with an increase of platelet functions (for a review see reference 1). Prostaglandins and thromboxanes are produced during platelet activation and some of those are potent pro-aggregatory molecules (2, 3). Recently, some investigators have found that diabetic platelet-rich plasmas produce more prostaglandin E-like material than normal platelets when they are aggregated (4). Otherwise, platelets obtained from diabetic subjects are less sensitive to the antiaggregatory effects of imidazole, a thromboxane synthesis inhibitor (5).

In the early 1980s a new, although still empirical therapy was proposed for women undergoing recurrent spontaneous abortions of unknown origin, where an immunologic cause is suspected. The treatment consists in immunization of the women with human lymphocytes. We report here on our own first experience with this modality and discuss the results in light of the different immunologic tests which were performed before and after immunization with paternal lymphocytes. 11/13 treated women belong to the group with abortions of alloimmune origin, 6/11 patients were delivered of a normal baby in the 40th week of gestation (median), one patient is pregnant in the 36th week of gestation, 2 had abortions again and two women are not yet pregnant. Further investigations suggest that 2/13 women had abortions of autoimmune origin; one of these women had a normal baby in the 33rd week of gestation and the other is pregnant in the 18th week.