Affective experiences during COVID-19 pandemic lockdown and posttraumatic growth: A 1-year longitudinal study in France

BACKGROUND

The COVID-19 crisis has resulted in major restrictions on daily life that are undeniably detrimental to individual wellbeing. Nevertheless, there may be positive psychological changes over the longer term, particularly in the form of posttraumatic growth (PTG).

METHODS

A total of 1075 individuals representative of the French population took part in an online survey during the first lockdown (T1: March to May 2020) and 1 year later (T2). Their affective experiences at T1 were analyzed, together with the development of PTG at T2.

RESULTS

Three affective profiles were identified at T1: one associated with feelings of loneliness and depressive symptoms (Loneliness cluster), one with positive feelings (Happiness cluster), and one with rather negative feelings of anger and fear, but also a feeling of happiness (Negative-moderate cluster). PTG was generally low at T2, with the Negative-moderate cluster achieving the highest score.

LIMITATIONS

This study was based on an online survey, and an exploratory cluster analysis was conducted. Complementary studies should be conducted to determine the predictive value of our findings.

CONCLUSIONS

Within the space of 1 year following the first lockdown due to COVID-19, people living in France, especially those who had experienced a mixture of feelings during lockdown, appeared to develop some form of PTG. Nevertheless, PTG was rather weak overall.

L’enfer c’est les autres : de la simple présence d’autrui aux stéréotypes sociaux (effets sur les performances cognitives)

Les activités mentales et processus neurobiologiques sous-jacents sont ancrés dans des contextes et des fonctionnements sociaux dont l’influence fait désormais l’objet de nombreux travaux expérimentaux en référence à la « cognition sociale » et aux « neurosciences cognitives, sociales et affectives ». Précisément, les travaux présentés dans notre communication contribuent à élucider comment certaines composantes élémentaires de la vie en société (simple présence des autres, évaluations de soi et comparaisons sociales interpersonnelles, stéréotypes sociaux) agissent sur les performances cognitives (attention, raisonnement, mémoire) à tous les âges de la vie. Nous rappellerons d’abord les effets attentionnels liés, chez l’homme et chez le primate non humain, à la présence des congénères [1–3] et leurs conséquences pratiques pour l’utilisation des tests neuropsychologiques impliquant en particulier les fonctions exécutives. Nous verrons ensuite comment des facteurs psychosociaux plus intégrés, comme certains stéréotypes sociaux en rapport avec le genre ou avec le vieillissement, influencent les performances des personnes stigmatisées (visées par ces stéréotypes), avec pour conséquence le maintien artificiel de certaines différences entre les deux sexes s’agissant notamment des compétences visuo-spatiales, ou entre personnes jeunes et âgées s’agissant de la mémoire et des capacités d’inhibition cognitive [4,5].

Asymmetric bi-layer PFSA membranes as model systems for the study of water management in the PEMFC

New bi-layer PFSA membranes made of Nafion® NRE212 and Aquivion™ E79-05s with different equivalent weights are prepared with the aim of managing water repartition in the PEMFC.

[Interpersonal sensorimotor coordination dynamics in schizophrenic patients: introducing a new experimental paradigm]

Compared to healthy individuals, schizophrenic patients suffer from sensorimotor disorders including problems when tracking moving targets and perceiving biological motion. Recent advances in embodied cognition and social coordination dynamics have emphasized the important role played by bodily information exchange (e.g. facial expressions, posture, and movements) in the way people interact with and mutually influence each other. These experimental studies on healthy participants provide data on sensorimotor performances of a patient that are recorded at high temporal and spatial resolutions. They should therefore be considered in studies on schizophrenic patients. These functional, quantitive and dynamic aspects of sensorimotor coordination abilities, may offer promising perspectives and could lead to a better understanding of sensorimotor disorders in schizophrenia. The purpose of this article is to introduce a new experimental paradigm in schizophrenia inspired by the field of coordination dynamics, a theoretical and experimental approach born more than 30 years ago that has recently expanded to interpersonal interactions, the so-called social coordination dynamics. In our study, we hypothesize that the sensorimotor deficits associated with schizophrenia in social interaction may be, at least partially, due to a failure to properly pick up information about the movements of other people. We therefore designed a study where healthy individuals and schizophrenic patients were asked to intentionally track the oscillations of visual targets of various social relevance using hand movements. Four different rhythmic visual stimuli varying in degree of biological relevance (form and motion) are used: [1] an oscillating dot; [2] a computer generated hand moving up and down continuously driven by a sine function; [3] pre-recorded oscillatory movements of a real hand; and [4] the hand of a real individual (behind a curtain that occluded vision of the rest of the body). Two distinct dependent variables are computed to quantify the coordination between the movements of the participants and the visual stimuli: the relative phase and the power spectrum overlap between their own movements. In this preliminary study, analyses of kinematic data revealed that schizophrenic patients had trouble synchronizing to (the more) "biological" target unlike control healthy individuals. These results suggest that patients with schizophrenia may suffer from sensorimotor coordination disabilities with socially relevant visual stimuli. The novel paradigm we introduce in research on schizophrenia should allow for a better understanding of the troubles these patients encounter when interacting with other people thanks to an approach rooted and building on social coordination dynamics as well as motor and social cognition.

Mass treatment of trachoma with azithromycin 1.5% eye drops in the Republic of Cameroon: feasibility, tolerance and effectiveness

Aims

An epidemiological study carried out in 2006 indicated a high prevalence of blinding trachoma in the Kolofata Health District, Far North Region, Republic of Cameroon. As a result, the national blindness control programme of Cameroon instituted a trachoma elimination programme using the SAFE strategy.

Methods

A campaign to treat the entire district population with azithromycin 1.5% eye drops was undertaken in February 2008. To measure the effectiveness of treatment on the prevalence of active trachoma, two epidemiological studies were conducted on a representative sample of children aged between 1 and 10 years. The first study was performed just prior to the treatment campaign and the second study was performed 1 year later.

Results

The prevalence of active forms of trachoma (trachomatous inflammation—follicular (TF) + TF/trachomatous inflammation—intense (TI)) dropped from 31.5 (95% CI 26.4 to 37.5)% before treatment to 6.3 (95% CI 4.1 to 9.6)% 1 year after treatment—a reduction of nearly 80%. There were no reports of serious or systemic side effects. Tolerance was excellent and no treatment was interrupted.

Conclusion

Mass treatment with azithromycin 1.5% eye drops is feasible, well tolerated and effective.

Improved surgical mesh integration into the rat abdominal wall with arginine administration

Prosthetic meshes are used as the standard of care in abdominal wall hernia repair. However, hernia recurrences and side effects remain unsolved problems. The demand by health care providers for increasingly efficient and cost-effective surgery encourages the development of newer strategies to improve devices and outcomes. Here, we evaluated whether l-arginine administration was able to ameliorate long-term polypropylene prostheses incorporation into the abdominal wall of Sprague-Dawley rats. Meshes were placed on-lay and continuous l-arginine was administered. In vivo biocompatibility was studied at 7, 25 and 30 days post-implantation. Effectively, l-arginine administration in combination with mesh triggered subtle changes in ECM composition that impinged on critical biochemical and structural features. Lastly, tensile strength augmented and stiffness decreased over the control condition. This could help to restructure the mechanical load transfer from the implant to the brittle surrounding tissues, i.e., impact load and fatigue load associated with mechanical tensions could be distributed between the mesh and the restored tissue in a more balanced manner, and ultimately help to reduce the incidence of loosening, recurrences, and local wound complications. Since the newly formed tissue is more mechanically stable, this approach could eventually be introduced to human hernia repair.

Burned breast reconstructive surgery with Integra dermal regeneration template

Reconstruction of the burned breast poses several clinical challenges, since scarring can adversely affect the development, contour and positioning of the breast as well as the cosmetic appearance of the skin surface. Conventional management entails contracture release and thick split-thickness skin grafting. We investigated an alternative approach employing dermal regeneration template (Integra) for breast reconstruction in 12 consecutive patients who had suffered anterior chest wall burns in childhood. Integra is a bilayer material consisting of a collagen and chondroitin-6-sulfate dermal regeneration template and a temporary silicone epidermal layer. Portions of the scar contracture preventing the breast from assuming the desired shape and position were excised. Unmeshed Integra sheets were applied to the wound bed immediately following excision. Sufficient vascularization of the forming neodermis occurred within 28 days on average to enable removal of the silicone layer and placement of unmeshed 0.005in. epidermal autografts. Upon histological examination one month postoperatively, naturally-formed collagen fibres were observed in the dermal regeneration template. By one year, host collagen had typically completely replaced the Integra matrix, and elastic fibres were evident throughout the neodermis. Durable improvements in breast contour and shape were attained in all patients, and clinically-relevant recontracture of the graft site did not occur within the follow-up period. A statistically significant improvement of 6.0 (95% CI, 5.0-6.5) in Vancouver Scar Scale score was demonstrated at one year. A very high level of satisfaction in the outcome of reconstruction was expressed by 92% of the patients. Grafting with Integra provides an effective and well-tolerated alter-native to thick split-thickness grafting for breast reconstruction. Chief advantages are the availability of a biocompatible material in unlimited quantity that can be tailored to the particular wound site and the avoidance of a deep donor site wound with attendant potential for infection, scarring and permanent pigment changes.

Ocular involvement in a case of systemic indeterminate cell histiocytosis: a case report

PURPOSE

To describe ocular involvement in a case of systemic indeterminate cell histiocytosis, a rare disease characterized by the proliferation of indistinct histiocytes. These histiocytes resemble Langerhans cells but lack Birbeck granules. The disease usually occurs in adults, with no predisposition for either sex. The clinical features include multiple asymptomatic nodules and cutaneous papules. There are no previous reported cases in the literature regarding ocular indeterminate cell histiocytosis and its treatment.

METHODS

A patient with skin papules and hyperpigmentation associated with systemic involvement and corneal infiltration was diagnosed with systemic indeterminate cell histiocytosis after a skin biopsy. Immunohistochemical examination showed specific surface proteins of indeterminate cells, and electron microscopy showed Langerhans-like cells without typical Birbeck granules. Progressive and severe photophobia and corneal thickening made bilateral corneal transplant necessary.

RESULTS

Visual acuity remained stable because of the use of systemic immunosuppressors, which decrease the recurrence of infiltration after a corneal transplant.

CONCLUSION

Indeterminate cell histiocytosis is a rare disease and there is no previous description of ocular involvement. Infiltrating lesions must be treated with corneal transplant and systemic cyclosporin if they decrease visual acuity.

Churg-Strauss syndrome: outcome and long-term follow-up of 32 patients

OBJECTIVES

To study the clinical spectrum and evolution of Churg-Strauss syndrome in order to assess the clinicopathological features of the disease, the response to treatment and the long-term outcome.

METHODS

Thirty-two patients with proven allergic and granulomatous angiitis (Churg-Strauss syndrome) and followed up at a single institution were evaluated. They were recruited between 1977 and 1999 from internal medicine departments. Data were obtained retrospectively from medical files in 15 cases and prospectively, using a standardized form, for the remaining patients.

RESULTS

All patients had asthma and hypereosinophilia. The lungs, skin and peripheral nervous system were the organs most frequently involved. Antineutrophil cytoplasmic antibodies with antimyeloperoxidase specificity (MPO-ANCA) were detected in 77.8% of tested patients but they were not useful for monitoring disease activity. Extravascular granulomas were rarely seen in tissue biopsies. Forty per cent of the patients were treated with steroids alone. Immunosuppressive agents were added to the treatment when severe neurological, cardiac or gastrointestinal involvement was present. The outcome and long-term survival were good. Clinical relapse was rare after the first year of therapy. Dysaesthesiae of the distal limbs, neurophatic pain and cardiac failure were the most frequent sequelae.

CONCLUSIONS

Churg-Strauss syndrome is a rare disorder characterized by hypereosinophilia and systemic vasculitis occurring in patients with asthma and allergic rhinitis. Vasculitis commonly affects the lungs, skin and peripheral nervous system. Outcome and long-term survival is usually good with steroids alone or in combination with immunosuppressive agents. The syndrome has a low mortality rate compared with other systemic vasculitides.

Early imaging of integration response to polypropylene mesh in abdominal wall by environmental scanning electron microscopy: comparison of two placement techniques and correlation with tensiometric studies

The repair of incisional hernias has taken advantage of the strength provided by prosthetic mesh grafts, but the best position for inserting the materials has not been conclusively established. Environmental scanning electron microscopy (ESEM) provides imaging of biologic samples with minimal manipulation. We used ESEM for early imaging of the integration response to polypropylene meshes placed in two anatomic positions in the abdominal wall and correlated results with tensiometric studies. Two macroporous polypropylene prostheses were implanted in a rat model--one on the abdominal aponeurotic layer and one on the peritoneal surface--without creating a wall defect. Studies were performed over implantation intervals of 7, 15, and 30 days in strips obtained from the polypropylene fiber-receptor repair tissue interface. Microscopic appearance, tensile strength, percent elongation, and stiffness were evaluated. Meshes implanted on the abdominal aponeurotic layer showed better early tissue incorporation (higher collagen deposition, capillary density, cell accumulation) and increased tensile strength, reflecting tighter anchorage to the abdominal wall. The percent elongation increased from day 7 to day 30 after implantation, mainly in the deep stratum. The ESEM images correlated well with biomechanical results, indicating the potential of this technique as a powerful, effective tool for use in wound-healing studies.

Ameloblastic fibrosarcoma: report of a case. Immunohistochemical study and review of the literature

Ameloblastic fibrosarcoma is a rare malignant odontogenic tumour characterized by a benign epithelial component within a malignant fibrous stroma. Its behaviour is relatively benign, with absence of metastatic disease, and the prognosis is reported to be good. It is a paradoxical neoplasm with "sarcomatous" morphological and immunohistochemical patterns but with a favourable clinical course. We report a new case of this tumour in a mandibular ramus of a 31-years-old male patient, that was surgically excised and treated with adjuvant chemotherapy and radiotherapy. Five years later the patient is free of disease. The growth potential of ameloblastic fibrosarcoma is evaluated and compared with a related lesion, the ameloblastic fibroma. The sarcomatous mesenchymal component of ameloblastic fibrosarcoma is positive to Ki67, PCNA and p53, in front of the negativity of ameloblastic fibroma.

Malignant tumors of the minor salivary glands. Retrospective study on 59 cases

Minor salivary glands cancer account for 2-4% of head and neck cancer, 10% of all oral cavity cancer and 15-23% of all salivary glands cancer (1). There is a remarkable variation in clinical presentation, behavior and histology of those neoplasms. The incidence of malignancy is around 52-60% (2-4) Several classifications of salivary gland tumors have been presented, but for the present study we have utilized the WHO classification of 1992 (5). We present the results of a review of our experience with those malignancies, considering prognostic factors as histopathology, tumor grade, clinical staging, age and sex, primary location, regional and distant metastasis.

Early effects of exogenous arginine after the implantation of prosthetic material into the rat abdominal wall

We have investigated the effects of high arginine (Arg) levels (7.5 mg/100 g body weight per hour) on the early integration of biocompatible mesh grafts into the rat abdominal wall. Studies were performed over implantation intervals of 6, 12, 24 or 48 hours (n=12, each). Arginine and related compounds were quantified in plasma, wound fluids and multiple tissues. Plasma nitric oxide (NO) production was studied. Strips were taken from the polypropylene fiber-host tissue interfaces (PTIs) for optical microscopic analysis and for immunohistochemical analysis using rat-specific antibodies against type I and type III collagens. Exogenous Arg was metabolized at the peripheral tissues but reliably reached the wound space. High amounts of Arg and ornithine (Orn) were detected in the specimens considered. No changes on citrulline (Ctr) or NO concentrations were observed, overall suggesting that, during the period studied, the arginase pathway predominated. The acute scarring response differed significantly in the two placements considered. The P-SS interface evidenced more extensive new tissue growth than the P-DS interface. Forty-eight hours after mesh implantation cellular infiltration, fibroblast proliferation, and mesh-surrounding angiogenesis were higher in the arginine-treated rats. Type III collagen staining was related to arginine treatment, being higher (++) in the study group. In conclusion, and independently of the site of mesh placement, supplemental Arg seemed to favorably affect early local collagen deposition. This could be potentially helpful to ameliorate the integration of biomaterials into the tissues and, consequently, to allow for the design of more selective therapeutic strategies to prevent hernia recurrence rates.

[The Institute of Tropical Ophthalmology of Africa]

The Tropical Ophthalmology Institute of Africa (TOIA) is an integral part of the OCCGE. Located in Bamako since 1953, the TOIA is operated jointly by the member states of the OCCGE, the French Cooperation Ministry, and the WHO for which it serves as a center for the prevention of blindness. In addition to providing eye care for the people of western Africa, the TOIA promotes clinical, epidemiologic, and surgical research and carries out health surveys in function of the needs of the member states of the OCCGE. The major purpose of the TOIA is to training doctors and ophthalmologic nurses as well as for cataract operators and eyeglasses technicians. At the center of a network dedicated to the fight against blindness, the range of action of the TOIA now reaches beyond the borders of the eight states in the OCCGE.

[Ocular cysticercosis]

Ocular cysticercosis results from development of Taenia solium larvae, Cysticercus cellulosae, in the eye. This condition is observed all over the world but is particularly common in developing countries. The eye, like nervous system and muscle tissue, is a prime location for parasitic development because of its rich vascularization. Intraorbital cysticercosis accounts for 75 to 85% of cases and if untreated leads to blindness. Intravitreal involvement is the most common followed by subretinal involvement. Involvement of other structures such as the camera aqueosa, iris, and crystalline lens is rare. Diagnosis of intraocular cysticercosis is straightforward when cysticerci are visible. Immunologic testing of aqueous humor using ELISA, western-blot, or immunodetection of circulating antigens can be useful diagnostic techniques in patients with opacification of the eye. Involvement of the orbit, palpebra, conjunctiva, and lacrimal glands is observed in 20 to 25% of cases. Diagnosis of adnexal involvement is facilitated by ultrasonography and CT-scan. Drug therapy for ocular manifestations of cysticercosis is ineffective and hastens progression of the disease by exacerbating the inflammatory response. Surgical treatment is the only alternative. Significant progress has been made thanks to new microsurgical vitreal and retinal procedures but these techniques are often unavailable in developing countries. The severity of ocular cysticercosis and poor management facilities in developing countries underlines the need for prevention by sanitary measures and health education.

Social presence effects in the Stroop task: further evidence for an attentional view of social facilitation

In contrast with R. B. Zajonc's (1965) classic view about social facilitation-inhibition (SFI) effects, it was found that the presence of relatively unpredictable audiences and forced social comparison with a slightly superior coactor both facilitated performance in the Stroop task while inhibiting automatic verbal processing. Not only do these findings reveal that social presence can help inhibit the emission of dominant responses, providing further support for an attentional view of SFI effects, but they also demonstrate the power of social situations over what has been thought to be invariant automatic processing. As such, they are inconsistent with the view reiterated in more than 500 articles on Stroop interference over the past 60 years and suggest that more attention should be paid to the situations in which cognition takes place.

Social presence effects in the Stroop task: further evidence for an attentional view of social facilitation

In contrast with R. B. Zajonc's (1965) classic view about social facilitation-inhibition (SFI) effects, it was found that the presence of relatively unpredictable audiences and forced social comparison with a slightly superior coactor both facilitated performance in the Stroop task while inhibiting automatic verbal processing. Not only do these findings reveal that social presence can help inhibit the emission of dominant responses, providing further support for an attentional view of SFI effects, but they also demonstrate the power of social situations over what has been thought to be invariant automatic processing. As such, they are inconsistent with the view reiterated in more than 500 articles on Stroop interference over the past 60 years and suggest that more attention should be paid to the situations in which cognition takes place.

Image analysis of dermal collagen changes during skin aging

OBJECTIVE

To determine progressive quantitative, directional and textural changes in dermal collagen as a function of age and sex and to estimate their evolutive trend with appropriate regression models.

STUDY DESIGN

Ninety-six samples of abdominal skin from autopsy cases were analyzed. The ages ranged from 3.5 months to 86 years. Picro-Sirius-stained slides were examined by polarizing microscopy, and spatial density, directional features and texture of collagen were measured by computerized image analysis. Nonlinear regression models were built to estimate evolutive changes with respect to age. The relationship between spatial orientation of collagen bundles and age was best modeled by linear regression.

RESULTS

The evolutive patterns of dermal thickness and spatial density of collagen bundles correspond to a second-order polynomial model with a progressive increase from childhood to middle age and a relatively sharp decrease after the seventh decade. The evolution of textural pattern of dermal collagen, defined by gradient analysis, depicts a sort of inverted U. Its complexity is maximum in the first year of life, decreases until the period 25-50 years and increases progressively after the sixth decade. The horizontal orientation of collagen bundles with intermingled fascicles oriented in other directions, shown by young individuals, is progressively simplified with aging. In elderly subjects, collagen bundles have a horizontal orientation. No significant sex-related differences were found.

CONCLUSION

Dermal collagen changes related to aging are apparently independent of sex, at least in abdominal skin, and show characteristic curvilinear evolutive trends defined by decreased dermal thickness in the elderly, decrease in the spatial density of collagen bundles and increase in textural heterogeneity of the dermis. Progressive simplification in the orientation of collagen bundles leading to a predominant horizontal disposition followed a linear trend. These changes could contribute to providing a substantial morphologic basis to age-associated biomechanical alterations in the skin.

[Training at the African Institute of Tropical Ophthalmology in Bamako]

The African Institute of Tropical Ophthalmology (AITO) is an OCCCMED institute, founded in Bamako in 1953. The OCCCMED itself is based at Bobo Dioulasso (Burkina Faso). AITO is a WHO collaborating center for the prevention of blindness. Training is one of the main activities of the institute, along with eye care, research and assessment. The prevalence of blindness in sub-Saharan countries is about 1.2%, with blindness mostly caused by cataracts, trachoma, glaucoma and onchocercosis. The demand for eye care is high but there are currently too few trained personnel to satisfy that demand. Therefore, AITO's role in training eye-care professionals is particularly important. The institute trains ophthalmologists, specialist nurses, eye surgeons (who remove cataracts) and spectacle manufacturers. Training is carried out within the framework of the community and apprenticeship in the workplace. The student must attain specific targets, listed in a "competency passport" issued at the start of training. Clinical and surgical ophthalmology and general eye care are taught. Training costs and grants are mostly paid by the Lions Club International Sight First Program or by the French Overseas Development Ministry. Since 1991, AITO has trained to graduation: 18 ophthalmologists; 24 eye surgeons; 83 specialist nurses; 16 spectacle manufacturers.

[Future of ophthalmology nurses and physicians trained at the African Institute of Tropical Ophthalmology]

Six ophthalmologists and 24 specialist ophthalmology nurses from French-speaking African countries graduate from AITO each year. Their training focuses on the skills they will need to participate in the national programs to combat blindness. All the ophthalmologists (10) and specialist ophthalmology nurses (42) from Mali, Niger, Burkina Faso and Senegal, who graduated from AITO within the last ten years were interviewed. Eight of the ten ophthalmologists and all of the specialist nurses are currently working in national programs to combat blindness. The specialist nurses knew more about public eye health issues than about optics. The training given is appropriate for ophthalmology professionals working in these countries. The chief demand of both ophthalmologists and specialist nurses was that they should have continuous training and supervision.

[Activities of the African Institute of Tropical Ophthalmology, 1990-1997]

The African Institute of Tropical Ophthalmology (AITO) was founded in Bamako in 1953. It is part of a regional structure, The Organization for Cooperation and Coordination in the Control of Major Endemic Diseases (OCCCMED). AITO is a WHO collaborating center for the prevention of blindness and has four aims: the provision of eye care, training (ophthalmologists, cataract surgeons, specialist nurses, spectacle manufacturers), research (epidemiology, clinical and surgical) and assessment of public eye care as a function of the needs of the member states of OCCCMED. The European Regional Program for the Prevention of Blindness and an International Sight First Program Center are located at AITO. AITO is at the heart of a network dedicated to fighting blindness, and its activities extend beyond the borders of the OCCCMED.

[Synthesis of the blindness situation in the countries of the Organization for Cooperation and Coordination in the Control of Major Endemic Diseases]

The major causes of blindness in the OCCCMED states are cataracts, trachoma, glaucoma and oncocercosis. The prevalence of blindness is about 1.2% and there are about 880,000 blind individuals and 2,500,000 people with impaired vision. Cataracts were the cause of blindness in 440,000 people and the cause of visual impairment in 1,320,000 individuals. About 1,500,000 people were found to have oncocercosis, and about 24,000 were blind. The true rate of trachoma is unknown. Thirteen thousand cataracts are surgically removed in the region each year, the CSR (cataract surgery rate) being 210. In the last few years, national programs have been set up to combat blindness and equipment and training have been established. With a ratio of 1 ophthalmologist per 523,000 people, the WHO's objectives are becoming attainable.

Health education and antibiotic therapy in trachoma control

The objective of this study was to confirm whether the combination of a health education programme with a mass treatment campaign was able to improve the effectiveness of trachoma control. An open controlled clinical trial with a 2 x 2 factorial design was carried out. Four villages, matched for size and epidemiological, economic and social conditions, were included in the study. The first village received mass treatment with 1% oxytetracycline eye drops combined with a specific health education programme. The second village received only a health education programme. The third village received only mass treatment and the fourth village did not receive any intervention during the study (control village). 1810 subjects were enrolled of whom 76% were successfully followed for 6 months. The incidence of new cases ranged between 1.6% and 14.2%. In this study the combination of a health education programme with mass treatment failed to increase the cure rate. There was even a negative interaction (P = 0.03). The best results were obtained in the village where antibiotic treatment was used alone, both in terms of cure rate (82%) and reduction of C trachomatis transmission. These results suggest that the addition of a health education programme does not systematically improve the performances of a mass treatment campaign. The efficacy of this combination depends essentially on the capacity of the community to modify its hygiene behaviour.

Reactive arthritis with a severe lesion of the cervical spine

Reactive arthritis, or Reiter's disease, characteristically affects the joints of the lower limbs in an asymmetrical pattern. Usually it does not affect the cervical spine, and atlantoaxial subluxations are the exception. This paper describes the case of an HLA-B27-positive female patient with a sexually acquired reactive arthritis where a non-reducible atlantoaxial subluxation was present. The patient was followed from age 27 to 41. By the age of 38, an anterior decompression of the cervico-medullary junction was performed by a transoral approach; in a second stage, the patient underwent an occipito-cervical posterior fusion. The pathological study revealed a non-specific and chronic inflammatory infiltrate.

Recurrent paroxysmal headache associated with facial ecchymosis

The case of a 58-year-old man with chronic paroxysmal headache and facial ecchymosis is described. The headache was pulsating, of short duration, without nausea or vomiting, and occasionally associated with flashing lights. Ecchymoses were mainly located in the middle forehead region and their appearance was associated with a reduction in intensity of the headache. Blood coagulation tests were within normal limits, and a skin biopsy of the ecchymotic lesion ruled out an underlying vasculitis. These attacks were difficult to include in any particular type of headache, although some aspects were similar to migraine headache. The possible mechanism of hemorrhages is discussed.

Angiolymphoid hyperplasia with eosinophilia affecting the oral mucosa: report of a case and a review of the literature

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon disorder of unknown aetiology. Clinically, it is characterized by cutaneous papules or nodules on the head and neck, and extracutaneous involvement is rare. We report a 30-year-old woman who had an asymptomatic submucosal nodule on the upper lip, which histopathologically showed features of ALHE, and review the previously described 15 cases of oral ALHE.

Sjögren's syndrome: histologic and immunohistochemical study

Labial salivary gland tissues from 20 patients with primary Sjögren's syndrome (group 1), 26 with the secondary type of the disease (group 2), 16 patients with the incomplete form of the disease and 10 normal controls were examined for the presence of lymphocyte infiltrates, epithelial damages and plasma cell aggregates. Activated T lymphocytes of the helper phenotype predominated in groups 1 and 2. Aberrant epithelial expression of HLA class II molecules was found in the same group of patients, while IgG- and IgM- containing plasma cells were detected.

[Management of postoperative endophthalmitis epidemics in tropical areas. Report of 24 cases seen at the Tropical Ophthalmology Institute of Africa]

An epidemic of postoperative endophthalmitis occurred at the Tropical Ophthalmology Institute of Africa in September 1994. Due to the seriousness of this outbreak, a survey was undertaken to diagnose cases, trace the origin of contamination within the facilities and staff, and screen for the organism in patients with or without endophthalmitis. A total of 24 cases of endophthalmitis following 118 procedures involving the eyeball were found. There was no significant correlation between the occurrence of endophthalmitis and sex, age, type of surgery, surgeon, surgical assistant, operating room staff, postoperative complications, operating room, care providers, or type of hospitalisation. There was a significant correlation between the occurrence of endophthalmitis and the presence of secretions on the first bandage. Staphylococcus aureus was identified in 16 cases and in one patient hospitalized for an ulcer of the cornea. Staphylococcus aureus contamination was found in two fluids used for eye washing. We conclude that the probable cause of this epidemic was nosocomial infection and emphasize the importance of maintaining basic sterility measures despite the need to minimize costs in developing countries.

Epidermal growth factor excretion in burned rats

Evidence for epidermal growth factor (EGF) involvement in the physiological response to burns was sought from urinary levels of EGF, urea and creatinine in male rats using a standardized thermal skin injury model (25 per cent body surface) and treated with fluid resuscitation. Postmortem, the skin lesions were studied by microscopy to guarantee the absence of inflammatory complications. Statistically significant differences were observed in body weight, urea and creatinine excretion when compared to the basal values. When EGF excretion results were evaluated as raw data (expressed as ng/mg of creatinine or ng/day) compared to basal levels, no statistically significant differences were observed. However, when the results were expressed as percentage increases with respect to the basal values, a statistically significant increase was found over the first 7 days postinjury (P = 0.029).