Concomitant behavior of arsenic and selenium from the karst infillings materials of the fractured carbonate Dogger Aquifer (Hydrogeological Experimental Site, Poitiers, France).

Petrographic and mineralogical analyses combined with sequential extractions and leaching experiments as a function of pH were performed on black clayey sediments fulfilling karsts in the Hydrogeological Experimental Site (HES) of Poitiers (France) to investigate the behavior of arsenic and selenium in a fractured limestone aquifer. Sequential extractions showed that arsenic is mainly associated with pyrite (about 35%) and secondary iron oxyhydroxides (around 13%), along with a substantial exchangeable fraction (about 13%). The soluble fraction and the fraction associated to organic matter are âˆ¼2% and ∼5%, respectively. The distribution of selenium is mainly pyritic (around 39%) or associated with organic matter (about 18%). Its association to secondary iron oxyhydroxides minerals is low (around 2%), whereas its soluble fraction is around 5%. SEM analyses revealed the presence of arsenic "hot spots" into euhedral pyrite crystals surrounded by a halo of iron oxyhydroxides resulting from their alteration, and both are enriched with arsenic. Selenium has a similar pyritic origin but after alteration, it is predominantly associated with organic matter. Despite different distributions, the leaching experiment as a function of pH showed that the mobilization of arsenic and selenium overlapped below pH 2 and above pH 8. The main differences were observed between pH 2 and 8 with a plateau at 5% of released selenium, whereas the amount of mobilized arsenic continuously decreased. The pH-dependence of both elements is attributed to the partial dissolution of pyrite in acidic conditions combined with desorption processes at higher pH values.

[Widespread of clinical practice guidelines, concerning urinary incontinence in women]. / Diffusion des recommandations pour la pratique clinique concernant l'incontinence urinaire de la femme.

OBJECTIVE: Recommendations for good clinical practice concerning the treatment of urinary incontinence in women are available from the HAS (Haute Autorité de santé or French National Authority for Health), the Collège national des gynécologues obstétriciens français (French national college of gynaecologists and obstetricians) and Association française des urologues (French association of urologists). We wanted to conduct the first investigation of these recommendations to primary care physicians (GPs) and gynaecologists in the cities located in the same area of health. METHODS: A questionnaire was sent to GPs and gynaecologists (French administrative divisions 78 and 92), with questions on the recommendations, as well as the methods of dissemination of these recommendations. Response rate: 22%. RESULTS: A total of 72 questionnaires were usable from 51 (71%) GPs and 21 (29%) gynaecologists. Of these, 76% of gynecologists and 47% of GPs were aware of recommendations from the HAS for clinical practice for urinary incontinence in women (P=0.04). Only 56% of doctors prescribed a urinalysis (dipstick or bacteriological urinalysis) and evaluated the residual urine in women seeking care for symptoms of urinary incontinence. Training for one or two days was the most desirable/popular method of dissemination of the recommendations (30 out of 72 doctors), followed by journals such as Prescrire, then the mailing and forms provided by the HAS, especially when combined with office visits from a representative of the HAS. CONCLUSION: This study provided an interesting perspective on the knowledge, dissemination and application of recommendations for good clinical practice concerning urinary incontinence in women.

Case report: Early prosthetic treatment in children with ectodermal dysplasia.

BACKGROUND: Ectodermal dysplasia affects at least two ectoderm-derived structures such as hair, nails, skin, sweat glands and teeth. The dentition in hypohidrotic ectodermal dysplasia (XHED) is altered with many phenotypes ranging from oligodontia to anodontia. No consensus exists on the ideal age for beginning of prosthetic rehabilitation. CASE REPORT: A 2-year-old male patient with severe oligodontia in the primary dentition was referred for examination, evaluation and treatment. The child exhibited classical XLHED features with sparse hair, absence of eyelashes and eyebrows, severe hypohidrosis associated with heat intolerance and skin dryness. Radiographic examination revealed only intra-osseous maxillary primary canines. He presented an apparent prognathism of partially functional cause, retrusion of the maxillary and lateral deviation of the mandible. TREATMENT: The rehabilitation protocol was similar to an edentulous adult but extra care was taken to avoid discomfort to this very young patient. For example, alginate was used for the impressions for its neutral taste, ease of use, and quick setting speed. An hour was given for the child to adapt to the maxillary prosthesis and then the mandibular one was fitted. Denture adhesive was used to maximize retention. The child succeeded in eating some dry biscuits and drinking some water, demonstrating the exceptional potential for adaptation children usually present with at this very young age. FOLLOW-UP: Three months later, the prognathic tendency had vanished and he could eat hard food. Periodic recall visits were scheduled and at six months and normalization of oral functions was almost complete. Three years later, a new set of prostheses was made very easily as the child knew the protocol and was used to dentures wearing. CONCLUSIONS: Prosthetic rehabilitation must be done at the earliest age possible in order to maintain and correct the oral functions and prevent growth anomalies. It makes the subsequent treatment steps easier. Early rehabilitation and follow-up seems to be one of the keys to a successful treatment that help these children overcome their handicap and integrate them into society.