Swimming pool deck as environmental reservoir of Fusarium

While investigations on fungal contamination of swimming pools usually focus on dermatophytes, data on other potentially pathogenic molds are scarce. Here, we report the investigation of fungal colonization of the deck surrounding a hospital physical therapy swimming pool. Five series of samples from 8 sites were collected over one year from the pool surroundings. Concomitantly, 58 patients using the swimming pool were examined and samples obtained from those with suspected onychomycosis. All surface samples were positive for fungi, with Fusarium the most frequently recovered from 22 of 27 samples of sites surrounding the pool. Among the outpatients evaluated, two presented with a mixed onychomycosis from which Fusarium and Trichophyton rubrum were isolated. The questions of possible acquisition from the swimming pool area must be considered in both cases as the ungual lesions had developed within the previous three months. This warrants further studies to better understand the epidemiology of potentially pathogenic molds in areas surrounding pools in order to adopt appropriate measures to avoid contamination. This is of particular importance within medical institutions, considering the potential role of Fusarium onychomycosis as a starting point for disseminated infections in immunocompromised patient

From exploitation to empowerment: the case of Latin-American migrant women employed as hotel maids in Spain

48 p.Cet article aborde la question de l’exploitation des migrantes latino-américaines, femmes de chambres d’hôtels en Espagne. Il a pour objectif de démontrer les conditions d’aliénation et d’exploitation que subissent les travailleuses dans un secteur hôtelier externalisé et précaire, qui constitue une niche d’emploi particulièrement importante pour les migrantes latino-américaines. Il porte également sur les processus développés par et pour les travailleuses de ce secteur, afin de dépasser l’exploitation et d’ouvrir la voie vers l’empowerment, individuel et collectif.Este artículo trata de la explotación de las migrantes latinoamericanas en España que trabajan de camareras de pisos en los hoteles. Tiene el objetivo de analizar las condiciones de alienación y de explotación de las cuales las trabajadoras son víctimas, en un sector hostelero externalizado y precario, que constituye un nicho de empleo importante para las migrantes latinoamericanas. Además, el artículo se centra en los medios desarrollados por y para las trabajadoras de este sector, con el objetivo de ir más allá de la explotación y abrir el camino hacia el empoderamiento, tanto individual como colectivo.This article tackles the issue of the exploitation of Latin-American migrant women living in Spain and working as maid in the hotels. It will pay a special attention to the conditions of alienation and exploitation endured by women workers in an outsourced and precarious hotel industry, which constitutes an important employment niche for Latin American migrant women. It also focuses on the resources developed by and for women workers in this sector, to go beyond exploitation and open the way to individual and collective empowerment

Development of a duplex real-time PCR for the detection of Rickettsia spp. and typhus group rickettsia in clinical samples.

Molecular diagnosis using real-time polymerase chain reaction (PCR) may allow earlier diagnosis of rickettsiosis. We developed a duplex real-time PCR that amplifies (1) DNA of any rickettsial species and (2) DNA of both typhus group rickettsia, that is, Rickettsia prowazekii and Rickettsia typhi. Primers and probes were selected to amplify a segment of the 16S rRNA gene of Rickettsia spp. for the pan-rickettsial PCR and the citrate synthase gene (gltA) for the typhus group rickettsia PCR. Analytical sensitivity was 10 copies of control plasmid DNA per reaction. No cross-amplification was observed when testing human DNA and 22 pathogens or skin commensals. Real-time PCR was applied to 16 clinical samples. Rickettsial DNA was detected in the skin biopsies of three patients. In one patient with severe murine typhus, the typhus group PCR was positive in a skin biopsy from a petechial lesion and seroconversion was later documented. The two other patients with negative typhus group PCR suffered from Mediterranean and African spotted fever, respectively; in both cases, skin biopsy was performed on the eschar. Our duplex real-time PCR showed a good analytical sensitivity and specificity, allowing early diagnosis of rickettsiosis among three patients, and recognition of typhus in one of them

Mineralization of organic pollutants by anodic oxidation using reactive electrochemical membrane synthesized from carbothermal reduction of TiO2

Reactive Electrochemical Membrane (REM) prepared from carbothermal reduction of TiO2 is used for the mineralization of biorefractory pollutants during filtration operation. The mixture of Ti4O7 and Ti5O9 Magnéli phases ensures the high reactivity of the membrane for organic compound oxidation through •OH mediated oxidation and direct electron transfer. In cross-flow filtration mode, convection-enhanced mass transport of pollutants can be achieved from the high membrane permeability (3300 LMH bar-1). Mineralization efficiency of oxalic acid, paracetamol and phenol was assessed as regards to current density, transmembrane pressure and feed concentration. Unprecedented high removal rates of total organic carbon and mineralization current efficiency were achieved after a single passage through the REM, e.g. 47 g m-2 h-1 - 72% and 6.7 g m-2 h-1 - 47% for oxalic acid and paracetamol, respectively, at 15 mA cm-2. However, two mechanisms have to be considered for optimization of the process. When the TOC flux is too high with respect to the current density, aromatic compounds polymerize in the REM layer where only direct electron transfer occurs. This phenomenon decreases the oxidation efficiency and/or increases REM fouling. Besides, O2 bubbles sweeping at high permeate flux promotes O2 gas generation, with adverse effect on oxidation efficiency

Tuberculous Cutaneous Ulcers Associated with Miliary Tuberculosis in an Elderly Woman

Skin localizations in disseminated tuberculosis may present a clinical resistant evolution. An 81-year-old woman, treated by long-term steroids and methotrexate for rheumatoid polyarthritis, developed a disseminated tuberculosis in chest, bones and skin. While pulmonary symptoms quickly improved under conventional tuberculostatic drugs, skin ulcers showed positive cultures for 5 months and healed after 12 months of treatment

A new interface element connecting 3D finite elements with non-coincident nodes to simulate delamination in composite laminates

Composite failure phenomena remain complex and lead to over‐size structures in many industries, involving long and costly experimental campaigns. Numerical approaches are a good alternative to decrease sizing costs. The Discrete Ply Model developed in Institut Clément Ader over these last ten years shows good results in simulation of impact and compression after impact of composite laminates, ply drop‐offs, open hole tensile tests… But the present approach leads to certain limitations for complex stacking sequences and induces unwanted characteristic lengths between consecutive plies. A user element for delamination calculation is developed that allows to define an interface corresponding to the overlapping zone between the two volume elements of upper and lower plies, whereas this overlapping zone is not directly defined by nodes of the mesh (volume elements have non‐coincident nodes). The present paper details the new interface element implementation, its validation from DCB and ENF test simulations, and then its improvement is discussed

Long-term HIV infection and antiretroviral therapy are associated with bone microstructure alterations in premenopausal women

Summary: We evaluated the influence of long-term HIV infection and its treatment on distal tibia and radius microstructure. Premenopausal eumenorrheic HIV-positive women displayed trabecular and cortical microstructure alterations, which could contribute to increased bone fragility in those patients. Introduction: Bone fragility is an emerging issue in HIV-infected patients. Dual-energy X-ray absorptiometry (DXA) quantified areal bone mineral density (BMD) predicts fracture risk, but a significant proportion of fracture risk results from microstructural alterations. Methods: We studied the influence of long-term HIV infection on bone microstructure as evaluated by high-resolution peripheral quantitative computed tomography (HR-pQCT) in 22 HIV-positive (+ve) premenopausal eumenorrheic women and 44 age- and body mass index (BMI)-matched HIV-negative (−ve) controls. All subjects completed questionnaires regarding calcium/protein intakes and physical activity, and underwent DXA and HR-pQCT examinations for BMD and peripheral skeleton microstructure, respectively. A risk factor analysis of tibia trabecular density using linear mixed models was conducted. Results: In HIV+ve women on successful antiretroviral therapy (undetectable HIV-RNA, median CD4 cell count, 626), infection duration was 16.5 ± 3.5 (mean ± SD) years; median BMI was 22 (IQR, 21-26) kg/m2. More HIV+ve women were smokers (82 versus 50%, p = 0.013). Compared to controls, HIV+ve women had lower lumbar spine (spine T-score −0.70 vs −0.03, p = 0.014), but similar proximal femur BMD. At distal tibia, HIV+ve women had a 14.1% lower trabecular density and a 13.2% reduction in trabecular number compared to HIV−ve women (p = 0.013 and 0.029, respectively). HR-pQCT differences in distal radius were significant for cortical density (−3.0%; p = 0.029). Conclusions: Compared with HIV−ve subjects, premenopausal HIV+ve treated women had trabecular and cortical bone alterations. Adjusted analysis revealed that HIV status was the only determinant of between group tibia trabecular density differences. The latter could contribute to increased bone fragility in HIV+ve patient

Noninfectious Wound Complications in Clean Surgery: Epidemiology, Risk Factors, and Association with Antibiotic Use

Background: Noninfectious wound complications are frequent and often are confused with and treated as infection. Methods: We assessed the epidemiology, impact, risk factors, and associations with antibiotic use of noninfectious wound complications in clean orthopedic and trauma surgery. We report a single-center, prospective, observational study in an orthopedic department. Results: Among 1,073 adult patients, 630 (59%) revealed clinically relevant postoperative noninfectious wound complications, leading to a significant prolongation of hospital stay (14 vs. 12days; Wilcoxon rank-sum test; p<0.02) compared with patients without complications. The most frequent and severe complications were discharge with dehiscence (n=437; 41%) and hematoma (n=379; 35%). Forty-seven patients (47/630; 7%) underwent reoperation for dehiscence (n=39) or hematoma (n=8). These patients made up 4.3% of the entire study population (47/1,073). In multivariate analysis, an ASA score ≥2 points, age≥60years, surgery duration for ≥90min, implant-related surgery, and poor compliance toward nurses' recommendations were pronounced risk factors for these complications, whereas antibiotic-related parameters had no influence. Staple use was significantly associated with wound discharge but not with hematoma. Conclusions: Wound complications, such as dehiscence with discharge or hematoma after clean orthopedic and trauma surgery, are frequent with an overall incidence of 60%. Although they lead to few surgical reinterventions, they prolong hospital stay by 2days. Few clinical parameters show association with wound complications. Among them, improvements of patient compliance and avoidance of staples use for skin closure are the most promising actions to decrease complication ris

Simulation d'impact à moyenne vitesse et de compression ou cisaillement après impact sur grandes plaques composites stratifiées

International audienceComposites are known to be vulnerable to out-of-plane loading such as impact. To design composite structures without performing long and costly experimental campaigns several numerical approaches have been developed. The model developed in Institut Clément Ader over the last year enables representation of main failures appearing in a composite laminate subjected to low velocity/low energy impact. The work presented here deals with the validation of this model to account for damages in composite laminates under medium velocity impact.Les matériaux composites sont connus pour être vulnérables aux sollicitations hors plan comme les impacts. Pour s'abstenir de réaliser des campagnes expérimentales couteuses, de nombreux outils de simulations numériques sont développés. Le modèle développé à l'Institut Clément Ader depuis une dizaine d'années permet de représenter les principaux endommagements présents dans un stratifié composite lors d'un impact à faible vitesse/faible énergie. Le travail présenté ici a pour but de valider le bon fonctionnement du modèle pour des impacts à moyenne vitesse

The "Buruli Score": development of a multivariable prediction model for diagnosis of Mycobacterium ulcerans infection in individuals with ulcerative skin lesions, Akonolinga, Cameroon

Background Access to laboratory diagnosis can be a challenge for individuals suspected of Buruli Ulcer (BU). Our objective was to develop a clinical score to assist clinicians working in resource- limited settings for BU diagnosis. Methododology/Principal Findings Between 2011 and 2013, individuals presenting at Akonolinga District Hospital, Cameroon, were enrolled consecutively. Clinical data were collected prospectively. Based on a latent class model using laboratory test results (ZN, PCR, culture), patients were categorized into high, or low BU likelihood. Variables associated with a high BU likelihood in a multivariate logistic model were included in the Buruli score. Score cut-offs were chosen based on calculated predictive values. Of 325 patients with an ulcerative lesion, 51 (15.7%) had a high BU likelihood. The variables identified for the Buruli score were: characteristic smell (+3 points), yellow color (+2), female gender (+2), undermining (+1), green color (+1), lesion hyposensitivity (+1), pain at rest (-1), size >5cm (-1), locoregional adenopathy (-2), age above 20 up to 40 years (-3), or above 40 (-5). This score had AUC of 0.86 (95% CI 0.82-0.89), indicating good discrimination between infected and non-infected individuals. The cut-off to reasonably exclude BU was set at scores = 4 (PPV 69.0%; 95% CI 49.2-84.7). Patients with intermediate BU probability needed to be tested by PCR. Conclusions/Significance We developed a decisional algorithm based on a clinical score assessing BU probability. The Buruli score still requires further validation before it can be recommended for wide use