Erosive toe-web intertrigo: Clinical features and management.

BACKGROUND: Toe-web (TW) intertrigo is a common disease of fungal or bacterial origin. Gram-negative bacterial (GNB) TW intertrigo consists of weeping, erosive, painful lesions that may be recurrent, leading to functional disability. Eczema is often associated with this condition. The management of intertrigo is poorly codified. OBJECTIVE: To evaluate the efficacy and safety of a standardized treatment plan using topical steroids in relation to the course and the frequency of recurrence of GNB-TW intertrigo. METHODS: We conducted a prospective open interventional multicentre study from June 2020 to June 2021. Standardised treatment using TCS together with follow-up via phone calls were performed over a 6-month period. In addition, a retrospective historical monocentric study was performed for patients with suspected TW-GNB intertrigo treated without standardized management. The primary endpoint was disease duration. We performed a Wilcoxon test to compare the median duration of GNB-TW intertrigo in both series. RESULTS: We included 13 patients in the prospective cohort and 14 in the retrospective cohort. In both cohorts, most patients were male with a median age of 59 years. The most frequent signs were fissures and exudates. Eczema was often associated (51.8%). Identified risk factors were psoriasis, local humidity, fungal intertrigo, vascular disease (arterial or venous insufficiency), and a history of multiple local treatments prior to diagnosis. Pseudomonas aeruginosa was the predominant pathogen (48.1%). Median durations of TW-GNB intertrigo were 56 days and 61 days. There was no significant difference in the median duration of the disease between the prospective and the retrospective cohorts (respectively61 days and 56 days; p > 0.58). Relapses were more frequent in the retrospective cohort (respectively 7.7% and 21.4%). CONCLUSION: GNB-TW intertrigo is a difficult-to-treat disease often associated with eczema. While topical corticosteroids (TCS) seem to be an effective and well-tolerated treatment they do not appear to reduce disease duration compared to other treatments.

Giant rectified voltages from magnetization dynamics of an atomically sharp domain wall.

Magnetization dynamics is of great interest in the aim of using spins in nanoscale information technology, which ultimately should reach the atomic size. In the present work, we explore magnetization and spin dynamics in atomic ferromagnetic contacts both experimentally and theoretically. We demonstrate that domain walls induce a giant rectification effect as the DC voltages measured across the contacts are greatly enhanced by the presence of a domain wall. This effect is understood using multiscale dynamic simulations showing that the atomic sized walls oscillate, both in position and size, when submitted to the radio-frequency excitation. This leads to an increase by three orders of magnitude due to the large atomic scale spin excursion at resonance in the presence of an atomic sized domain wall. Beside the interesting amplified rectification, this could also be used as a unique tool to measure dynamical properties at the atomic scale.

Realization of a micrometre-scale spin-wave interferometer.

The recent development of spin dynamics opens perspectives for various applications based on spin waves, including logic devices. The first important step in the realization of spin-wave-based logics is the manipulation of spin-wave interference. Here, we present the experimental realization of a micrometre-scale spin-wave interferometer consisting of two parallel spin-wave waveguides. The spin waves propagate through the waveguides and the superposition or interference of the electrical signals corresponding to the spin waves is measured. A direct current flowing through a metal wire underneath one of the spin-wave waveguides affects the propagation properties of the corresponding spin wave. The signal of constructive or destructive interference depends on the magnitude and direction of the applied direct current. Thus, the present work demonstrates a unique manipulation of spin-wave interference.

Large RF susceptibility of transverse domain walls.

Changes in domain wall resistance under radio-frequency (RF) irradiation are experimentally studied for transverse walls. An original experimental technique is applied to the measurement in a permalloy nano-stripe with a notch, where the walls are found to provide a largely enhanced resistive response as compared to saturated domains. Their susceptibility is found to be an order of magnitude larger than that of the domains in a frequency range between 5 and 20 GHz. We argue that the RF fields induce an internal distortion of the magnetization profile that depends on the shape of the domain wall.

[Vaginal dryness]. / La sécheresse vaginale.

Vaginal dryness is one of the "little problems" that are too often, ignored. The disorder essentially manifests at the time of menopause, but can occur at other times, such as with oral contraception, following vaginal infection, after treatment for infection, etc. Screening for the disorder should become routine. Management should have precise objectives: cure of the infection and restablishment of the vaginal flora in order to reconstitute a natural balance. Treatment can be adapted for each patient to obtain effective and lasting results.

Antiphospholipid and antiprotein syndromes in non-thrombotic, non-autoimmune women with unexplained recurrent primary early foetal loss. The Nîmes Obstetricians and Haematologists Study--NOHA.

Various antiphospholipid and/or antiprotein antibodies have been suspected to be associated with recurrent early foetal loss in absence of any habitual aetiology. We conducted a hospital-based case control study on women with no antecedent of thromboembolic or autoimmune disease. We studied 3 groups of 518 women: patients with unexplained primary recurrent early foetal loss, patients with explained episodes and mothers with no previous obstetrical accident. Matching the 3 groups was carried out on the basis of age, number or pregnancies and time elapsed since the end of the last pregnancy. Significant biological markers were then prospectively tested. The various antibodies were shown to be dependent on parity and on the presence of previous foetal loss: cut-off values were thus calculated using data obtained from the group of explained accidents, and adjusted for parity. Only anti-phosphatidylethanolamine IgM [odds ratio: 6.0, 95% confidence interval (2.3-15.7), p = 0.0003], anti-beta2-glycoprotein I IgG [4.4, (1.6-11.7), p = 0.0035] anti-annexin V IgG antibodies [3.2 (1.2-8.1), p = 0.015] and lupus anticoagulant [3.0, (1.3-6.8), p = 0.009], were found to be independent retrospective risk factors for unexplained early foetal loss. These four markers were subsequently found to be, during the following pregnancy, associated with a significant risk of foetal loss despite a low-dose aspirin treatment. In non-thrombotic, non-auto-immune women with unexplained primary recurrent early foetal loss, subgroups of patients with positive anti-phosphatidylethanolamine IgM antibodies, or positive anti-beta2-glycoprotein-I IgG antibodies, or positive anti-annexin V IgG antibodies or lupus anticoagulant must be particularised. This should allow therapeutic trials to be carried in well-defined patients.

Pallister-Killian syndrome [i(12p)]: first pre-natal diagnosis using cordocentesis in the second trimester confirmed by in situ hybridization.

Pallister Killian syndrome (PKS) is the most frequent form of partial autosomal tetrasomy 12p in humans. Sufferers have a mosaic of isochromosome 12p [i(12p)]. We report the first pre-natal diagnosis on fetal blood cells after cordocentesis during the second trimester. The extra chromosome was first diagnosed by in situ hybridization. Fluorescence in situ hybridization (FISH) was used to count the interphase and/or metaphase cells containing the isochromosome. A review of the literature identified 27 other reports of PKS diagnosed pre-natally. We showed that the most consistent pre-natal ultrasound findings include hypertelorism, broad neck, shorts limbs, abnormal hands or feet, diaphragmatic hernia and hydramnios. Recognition of this congenital malformation pattern pre-natally may allow utilization of FISH.

Assessment for Subclinical Kidney Damage in Workers Exposed to Low Concentrations of Hydrocarbons.

It has been suggested the risk of hydrocarbon-induced chronic nephropathy is negligible at low exposure levels. The first purpose of the study was to test this hypothesis by selecting a population slightly exposed to hydrocarbons. Moreover, as hypertension might be associated with an increased excretion of nephrotoxic mercapturates, the association between blood pressure and urinary concentration of S-phenylmercapturic acid (S-PMA) was also examined. Lifetime exposure assessment, main tests of subclinical kidney damage, and statistical approach were taken from a previous study that had included primarily moderately or heavily exposed workers and had found hydrocarbon-induced nephrotoxic effects. No nephrotoxic effect of exposure could be ascertained in the present study. S-PMA concentration was not increased in hypertensive workers. Thus, the risk of hydrocarbon-induced chronic nephropathy might be extremely low in workers slightly exposed to hydrocarbons. The negative results of some studies might be due to the low lifetime hydrocarbon exposures of the study populations.

Amniocentesis before 15 weeks' gestation: technical aspects and obstetric risks.

In a prospective case-control study, early amniocenteses (EAC, n = 242) at between 12 and 14 weeks gestation, were compared with standard amniocenteses (SAC, n = 242) performed at between 15 and 24 weeks gestation. The medical records of these 484 cases were reviewed for indications, success rate, color and volume of amniotic fluid, gestational age, number of needle insertions, location of the placenta, culture failure rate, obstetric complications and therapeutic abortion rate. There were no significant differences between the two groups in success rate, in culture success rate or in the outcome of the pregnancies. The volume of the sample taken was smaller in the EAC patients (P < 0.001), and therapeutic abortions were performed significantly earlier (P < 0.02.) Results show that EAC is feasible from 11 weeks' gestation, and can be performed for the usual indications as an alternative to chorionic villus sampling. In the near future, cytogenetic techniques will enable results to be obtained in less than a week.

[Placental chorioangioma. Two cases and review of the literature]. / Chorio-angiome placentaire. A propos de 2 cas et revue de la littérature.

Two cases of placental chorioangiomas were discovered, one echographically after in utero death at mid-term pregnancy and the second during the neonatal period associated with acute hydramniosis and a single umbilical artery. At 8 months, the new-born was in good health after persistent cholestasis at birth. A review of the literature of the macroscopic, histologic, echographic characteristics and the foetal-maternal complications of chorioangiomas revealed few cases of in utero death, especially so early in term.

Identification of human papillomavirus antigen in a bladder tumor.

Human papillomavirus (HPV) antigen was found in one of six noninfiltrating (grade II) carcinomas of the bladder. The antigen was located in the nuclei of the superficial cells. This virus-bearing tumor occurred in a patient with no known risk factors. The presence of HPV in low-grade urinary lesions seems to be frequent and may reflect the early stages of carcinogenesis; in fact, HPV infections may cause papillomas and carcinomas of the urothelial mucosae as well as the genital mucosae.

Sonographic detection of fluid in the cul-de-sac in children--a normal finding?

Fluid in the cul-de-sac was found in 6.7% of ultrasound examinations of the abdomen and pelvis in children aged one day to 20 years. The amount was graded as minimal (+), moderate (++), or abundant ( ). Excluding teenage girls and those clinical situations in which free intraperitoneal fluid was expected (48 children) or could be explained by clinical circumstances (71 children), there remained a group of 65 children in whom no explanation of the usually minimal amount of fluid in the cul-de-sac could be found. A small amount of such fluid is a normal finding in 1.5% to 2% of children of both genders. Follow-up examinations in 16 patients found to have minimal incidental fluid in the pelvis showed repeat findings only in two; in the others no free fluid was demonstrated. A moderate amount of incidental free fluid was not associated with any morbidity: two of seven having a follow-up examination were normal. A large amount of free pelvic fluid, even when found incidentally, should not be considered as normal.

[Uterus didelphys with a blind hemi-vagina and homolateral renal agenesis]. / Utérus didelphe avec hémi-vagin borgne et agénésie rénale homolatérale.

The authors report a case of bicervical bicornuate uterus with a blind hemi-vagina associated with homolateral renal agenesis. A review of the embryology and the various etiopathogenic theories for this rare anomaly are presented and the therapeutic principles are discussed.

Sonographic measurements of the normal bladder wall in children.

The thickness of the bladder wall was measured sonographically in 410 children (1 day to 19 years old) and in 10 adults. None had complaints related to the urinary tract. The bladder wall thickness varied mostly with the state of bladder filling and only minimally with age and gender. The normal bladder wall had a mean thickness of 2.76 mm when the bladder is almost empty and 1.55 mm when it is distended. There is a linear relationship between bladder fullness and bladder wall thickness; the upper limits are 3 and 5 mm for a full or empty bladder respectively.