Nail disorders to be kept in mind.

Recognizing and diagnosing the most common nail diseases is essential, to be able to guide patients and provide appropriate treatment. However, uncommon nail disorders should not be neglected, in order to avoid inadequate treatment and above all to ensure that no severe underlying disorder, with severe prognosis, is overlooked.

Examination of the nails: Main signs.

Understanding the anatomy of the nail apparatus is a prerequisite for diagnosing and managing various nail disorders. The latter may be associated with systemic pathologies, or accompany infectious, inflammatory, tumoral, toxic or traumatic dermatoses. Before attempting to identify the cause, a rigorous clinical examination should be conducted to screen for elementary lesions that may affect general nail shape, nail surface, subungual attachments, periungual soft tissue or nail color. All of these guide differential diagnosis.

Surgery for benign nail tumor.

The vast majority of tumors in the nail apparatus have a different clinical presentation and course from their equivalents on the skin. Some, such as onychomatricoma and onychopapilloma, are unique to the nail and others, such as superficial acral fibromyxoma, have a tropism for the nail apparatus. As a rule, benign lesions respect the general architecture of the nail apparatus, whereas malignant tumors are destructive. Treatment is always surgical and good knowledge of the anatomy and the procedures is mandatory in order not to induce postoperative nail dystrophy.

[Which contribution of wastewater treatment plants in the fight against antimicrobial resistance?] / La filière d'assainissement, quel rôle dans la lutte contre l'antibiorésistance ?

Due to the massive use of antibiotics, antimicrobial resistance (AMR) continues to spread, endangering global disease control and environmental quality. The sources of bacteria or antimicrobial resistance genes are linked to human activities: urban, hospital and industrial discharges, livestock farms). The role of sanitation systems-sewerage, wastewater treatment and sludge treatment (WWTP)-in the problem of AMR has not yet been clearly established by the scientific community. The data available to date show that they eliminate part of the bacteria, genes and antibiotics, although this is not their primary vocation. WWTPs thus play an important filtering role to limit dissemination in the environment. On the other hand, some authors warn against their potential involvement in the selection of new resistant germs, given the conditions conducive to the exchange of genetic material between microbial strains of various types and exposed to selective agents. Today, knowledge of the mechanisms involved in the selection of antibiotic resistance and the fate of bacteria and resistance genes within sanitation systems remains limited. Research is needed to better characterize the contribution of wastewater systems and the performance of wastewater, recycled water, stormwater and sludge treatment processes.

Du fait de l'utilisation massive des antibiotiques, l'antibiorésistance (ABR) ne cesse de se répandre, mettant en danger le contrôle des maladies dans le monde et la qualité de l'environnement. Les sources d'émissions de bactéries ou de gènes de résistance aux antimicrobiens sont liées aux activités humaines : rejets urbains, hospitaliers, industriels, élevages. Le rôle que jouent les systèmes d'assainissement ­ réseau, filières de traitement des eaux usées (STEU) et traitement des boues ­ dans la problématique de l'ABR n'a pas encore été clairement établi par la communauté scientifique. Les données disponibles à ce jour montrent que les STEU éliminent une partie des bactéries, gènes et antibiotiques, bien que ce ne soit pas leur vocation première. Elles jouent ainsi un rôle de filtre important pour limiter la dissémination dans l'environnement. Mais à l'inverse, certains auteurs mettent en garde contre leur implication potentielle dans la sélection de nouveaux germes résistants, compte tenu des conditions propices aux échanges de matériel génétique entre souches microbiennes de natures diverses et exposées à des agents sélectifs. Aujourd'hui, les connaissances sur les mécanismes impliqués dans la sélection de l'ABR et le devenir des bactéries et gènes de résistance au sein des systèmes d'assainissement restent limitées. Des travaux de recherche sont nécessaires pour mieux caractériser leur contribution et évaluer les performances des procédés de traitement des eaux usées, recyclées, pluviales et des boues.

Analysis of endocrine activity in drinking water, surface water and treated wastewater from six countries.

The aquatic environment can contain numerous micropollutants and there are concerns about endocrine activity in environmental waters and the potential impacts on human and ecosystem health. In this study a complementary chemical analysis and in vitro bioassay approach was applied to evaluate endocrine activity in treated wastewater, surface water and drinking water samples from six countries (Germany, Australia, France, South Africa, the Netherlands and Spain). The bioassay test battery included assays indicative of seven endocrine pathways, while 58 different chemicals, including pesticides, pharmaceuticals and industrial compounds, were analysed by targeted chemical analysis. Endocrine activity was below the limit of quantification for most water samples, with only two of six treated wastewater samples and two of six surface water samples exhibiting estrogenic, glucocorticoid, progestagenic and/or anti-mineralocorticoid activity above the limit of quantification. Based on available effect-based trigger values (EBT) for estrogenic and glucocorticoid activity, some of the wastewater and surface water samples were found to exceed the EBT, suggesting these environmental waters may pose a potential risk to ecosystem health. In contrast, the lack of bioassay activity and low detected chemical concentrations in the drinking water samples do not suggest a risk to human endocrine health, with all samples below the relevant EBTs.

Virus-like particles as virus substitutes to design artificial virus-recognition nanomaterials.

Functional recognition imprints of virus-like particles, at the surface of silica particles, were generated following a strategy based on protein-templated polycondensation of organosilanes.

Removal of MS2, Qß and GA bacteriophages during drinking water treatment at pilot scale.

The removal of MS2, Qß and GA, F-specific RNA bacteriophages, potential surrogates for pathogenic waterborne viruses, was investigated during a conventional drinking water treatment at pilot scale by using river water, artificially and independently spiked with these bacteriophages. The objective of this work is to develop a standard system for assessing the effectiveness of drinking water plants with respect to the removal of MS2, Qß and GA bacteriophages by a conventional pre-treatment process (coagulation-flocculation-settling-sand filtration) followed or not by an ultrafiltration (UF) membrane (complete treatment process). The specific performances of three UF membranes alone were assessed by using (i) pre-treated water and (ii) 0.1 mM sterile phosphate buffer solution (PBS), spiked with bacteriophages. These UF membranes tested in this work were designed for drinking water treatment market and were also selected for research purpose. The hypothesis serving as base for this study was that the interfacial properties for these three bacteriophages, in terms of electrostatic charge and the degree of hydrophobicity, could induce variations in the removal performances achieved by drinking water treatments. The comparison of the results showed a similar behaviour for both MS2 and Qß surrogates whereas it was particularly atypical for the GA surrogate. The infectious character of MS2 and Qß bacteriophages was mostly removed after clarification followed by sand filtration processes (more than a 4.8-log reduction) while genomic copies were removed at more than a 4.0-log after the complete treatment process. On the contrary, GA bacteriophage was only slightly removed by clarification followed by sand filtration, with less than 1.7-log and 1.2-log reduction, respectively. After the complete treatment process achieved, GA bacteriophage was removed with less than 2.2-log and 1.6-log reduction, respectively. The effectiveness of the three UF membranes tested in terms of bacteriophages removal showed significant differences, especially for GA bacteriophage. These results could provide recommendations for drinking water suppliers in terms of selection criteria for membranes. MS2 bacteriophage is widely used as a surrogate for pathogenic waterborne viruses in Europe and the United States. In this study, the choice of MS2 bacteriophage as the best surrogate to be used for assessment of the effectiveness of drinking water treatment in removal of pathogenic waterborne viruses in worst conditions is clearly challenged. It was shown that GA bacteriophage is potentially a better surrogate as a worst case than MS2. Considering GA bacteriophage as the best surrogate in this study, a chlorine disinfection step could guaranteed a complete removal of this model and ensure the safety character of drinking water plants.