The Phantom Urine: An Unexpected Finding during a Routine Cesarean Section.

We present here an atypical finding during an elective repeat cesarean section. Despite urine flow through an indwelling bladder catheter, bladder remains distended during the whole procedure. Unexpected anatomical variations and malformations can make routine surgery challenging. Urinary tract anomalies should be suspected in cases of unexpected difficult bladder catheterization

Lausannevirus Seroprevalence among Asymptomatic Young Adults.

Objectives: The giant Lausannevirus was recently identified as a parasite of amoeba that replicates rapidly in these professional phagocytes. This study aimed at assessing Lausannevirus seroprevalence among asymptomatic young men in Switzerland and hopefully identifying possible sources of contact with this giant virus. Methods: The presence of anti-Lausannevirus antibodies was assessed in sera from 517 asymptomatic volunteers who filled a detailed questionnaire. The coreactivity between Lausannevirus and amoeba-resisting bacteria was assessed. Results: Lausannevirus prevalence ranged from 1.74 to 2.51%. Sporadic condom use or multiple sexual partners, although frequent (53.97 and 60.35%, respectively), were not associated with anti-Lausannevirus antibodies. On the contrary, frequent outdoor sport practice as well as milk consumption were significantly associated with positive Lausannevirus serologies (p = 0.0066 and 0.028, respectively). Coreactivity analyses revealed an association between Criblamydia sequanensis (an amoeba-resisting bacterium present in water environments) and Lausannevirus seropositivity (p = 0.001). Conclusions: Lausannevirus seroprevalence is low in asymptomatic Swiss men. However, the association between virus seropositivity and frequent sport practice suggests that this member of the Megavirales may be transmitted by aerosols and/or exposure to specific outdoor environments. Milk intake was also associated with seropositivity. Whether the coreactivity observed for C. sequanensis and Lausannevirus reflects a common mode of acquisition or some unexpected cross-reactivity remains to be determined. © 2013 S. Karger AG, Basel

Influence de divers facteurs écologiques sur la bioaccumulation d'éléments métalliques (Cd, Cu, Pb, Zn) chez de jeunes palourdes (Ruditapes philippinarum) au cours du prégrossissement en nourricerie

La bioaccumulation des métaux chez les mollusques peut être une conséquence de la désorption des éléments métalliques fixés sur les particules inertes ou vivantes en suspension dans l'eau qui leur servent de nourriture. Les meilleures expériences réalisées jusqu'ici semblent indiquer que les matières en suspension ont un rôle mineur dans la contamination des mollusques. Mais quelles que soient les précautions prises, les expériences ne simulent jamais parfaitement les phénomènes naturels. Aussi, nous avons choisi de reprendre cette question à l'aide d'une expérience en grand volume où le nombre de paramètres contrôlés est restreint mais où les organismes sont dans des conditions aussi proches que possible de la réalité.Au cours d'un prégrossissement expérimental, les jeunes palourdes reçoivent des quantités variables contrôlées de nourriture phytoplanctonique. La fourniture d'une nourriture plus abondante a pour conséquence d'augmenter les quantités de cuivre et de zinc et au contraire de diminuer celles de plomb contenues dans chaque individu. Elle entraîne également une diminution des concentrations en cadmium et plomb traduisant une « dilution biologique » de ces métaux. L'augmentation de la densité de la population expérimentale a un effet négatif sur les quantités de cuivre et de zinc contenues dans les individus. A âge identique, les individus les plus grands présentent des concentrations plus faibles en cuivre et zinc et plus élevées en cadmium et plomb.L'utilisation des eaux marines souterraines présente deux avantages: une production algale intense à un coût économique négligeable et la possibilité par échange thermique de réchauffer en hiver les eaux marines naturelles et ainsi de maintenir une croissance des mollusques toute l'année. L'emploi des eaux de forage n'entraîne aucun effet néfaste dans les phénomènes de bioaccumulation des métaux, du moins pour ceux étudiés ici : cadmium, cuivre, plomb et zinc.Metal bioaccumulation in bivalves may occur as a consequence of the ingestion of inert or living particles with fixed trace elements. The best experiments like those carried out by BORCHARDT (1983, 1985) concerning Cd in mussels have shown that the role suspended matter plays in the contamination of molluscs is insignificant. But, however reliable the experimental methodologies, laboratory conditions never reproduce perfectly natural phenomena. We planned therefore to restudy the problem by using a largescale experiment where the procedure was characterized by a restricted number of controlled parameters and the organisms as close as possible to the real conditions.During an experimental nursing of young carpet shells, we assessed the influence of various controlled quantifies of phytoplankton and of experimental population density on the transfer of metal from their environment to molluscs.Carpet-shell brood (Ruditapes philippinarum) was distributed in several cylindrical containers the bottom of which consisted in a sieve. Food and seawater were renewed continuously by means of an ascending current (BAUD et BACHER, 1990). Nursing assays were carried out during summer over a period of 74 days. Eight groups of carpet shells were constituted according to food supplies (0, lx, 2x and 4x of Skeletonema costatum grown upon underground seawater plus natural phytoplankton) and population density (25 000 or 50 000 individuals per experimental container). Young molluscs were fed according to a cycle of 3 h-feeding periods and 2 h-periods with no food alternately. The average concentrations of algal cells in mollusc breeding seawater were 17.5, 35 and 70.103 cells/L. This seawater was renewed at a flow rate of 3 m3/h.At the end of the nursing period, molluscs exposed to different experimental conditions were separated by using sieves of different mesh-size (6, 8 and 10 mm). Young carpet shells were purged for 36 h in order to limit the overvaluation of bioaccumulated metal levels due to ingested matter (AMIARD-TRIQUET et al., 1984; KENNEDY, 1986). In each experimental and size-related categories, 90 individuals were sampled and divided into 3 groups of 30 specimens.In these groups, soft tissues were separated from the shells and oven-dried at 80 °C for 48 h. The dry samples were powdered and three aliquot parts of about 100 mg each were digested with 1 ml of concentrated nitric acid (HNO3, Suprapur) at 95 °C for 1 h. Then the trace element analyses were performed in this solution diluted with deionized water by dame (Zn) or by flameless (Cd, Cu, Pb) atomic absorption spectrophotometry using the Zeeman effect (AMIARD et al., 1987).The influence of both food supplies and experimental population density on the dry weight of soil tissues of young carpet shells, their metal concentration and body burdens were examined by means of multi-linear regression analysis.Increasing body burdens of Cu (4) and Zn (5) and decreasing body burden of Pb (3), corresponded to more abundant food supplies. The increase of phytoplankton supplies induced a decrease of Cd (6) and Pb (7) concentrations as a consequence of a « biological dilution » of these metals. Increasing density induced a depletion of Cu (4) and Zn (5) body burdens. Among individuals of the same age, the biggest ones exhibited the lowest concentrations of Cu and Zn (8 and 9) and the highest concentrations of Cd and Pb (6 and 7).Increased food supplies induce a biological dilution of Cd and Pb in young carpet-shells. These results are in agreement with previous data concerning Cd, Cu, Pb and Zn in different species (MACKAY et al., 1975; BOYDEN, 1971; PHELPS et al., 1985; BERTHET, 1986). Thus front a sanitary point of view, the use of ground seawater for algal culture is not a risk since metal concentrations in molluscs are not enhanced

Cigarette smoking during pregnancy and adverse perinatal outcomes: a cross-sectional study over 10 years.

It has been shown that active exposure to tobacco is associated with adverse pregnancy outcomes including, but not limited to, intrauterine fetal death, reduced fetal weight, and higher risk of preterm birth. We want to investigate these effects in a high-income country. This cross-sectional study examined 20,843 pregnant women who delivered over 10 years at the Maternity Hospital of the Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, Switzerland. The objective was to evaluate a dose-response relationship between daily cigarette use during pregnancy and possible adverse perinatal outcomes. The social and clinical characteristics as well as obstetric and neonatal outcomes were compared between the smoking and the non-smoking groups. Adjusted odds ratios (aOR) and trend analyses (p <sub>trend</sub> ) were calculated. Nineteen thousand five hundred fifty-four pregnant women met the inclusion criteria and 2,714 (13.9%) of them were smokers. Even after adjusting for confounding factors, smoking during pregnancy was associated with preterm birth, birthweight < 2500 g, intrauterine growth restriction, neonatal respiratory and gastrointestinal diseases, transfer to the neonatal intensive care unit, and neonatal intensive care unit admissions > 7 days. Intrauterine death and neonatal infection were associated with heavy smoking (≥ 20 cigarettes/day). Smoking appeared to be a protective factor for pre-eclampsia and umbilical cord arterial pH below 7.1. A significant trend (p <sub>trend</sub> < 0.05) was identified for preterm birth, intrauterine growth restriction, birthweight < 2500 g, umbilical cord arterial pH below 7.1, transfers to our neonatal intensive care unit, and neonatal intensive care unit admissions more than 7 days. Cigarette smoking is associated with several adverse perinatal outcomes of pregnancy with a dose-dependent effect

Evaluation of a Multiplex Real-Time PCR Assay for Detecting Chlamydia trachomatis in Vaginal Samples.

Chlamydia trachomatis is an important cause of sexually transmitted infections (STI) in Western countries. It is often asymptomatic, and thus, left untreated, and can have severe negative consequences, such as tubal infertility or adverse pregnancy outcomes. Other sexually transmitted microorganisms, such as Neisseria gonorrhoeae and Trichomonas vaginalis, as well as normal residents of the vaginal flora, such as genital mycoplasmas, also negatively impact human sexual and reproductive health. We evaluated the reliability of the Seegene Allplex STI Essential Assay for C. trachomatis detection using the real-time qPCR routinely used in our diagnostic laboratories as the gold standard. The Seegene assay displayed a sensitivity of 97.8% and a specificity of 98.9%. As this assay can also detect six other urogenital pathogens, we applied it to 404 samples from women who attended Lausanne University Maternity Hospital and obtained the following prevalence rates: 2.5% for C. trachomatis, 3.5% for Mycoplasma hominis, 6.3% for Ureaplasma urealyticum, and 27.7% for Ureaplasma parvum. Two samples were positive for Trichomonas vaginalis, and one sample was positive for Mycoplasma genitalium. Bacterial vaginosis was present in 4.5% of the cases and was strongly associated with M. hominis. Finally, we confirmed the association between C. trachomatis infection and pre-term birth (p = 0.03) but could not detect any association of this condition with other urogenital pathogens (Mycoplasma/Ureaplasma). In conclusion, given its high sensitivity and specificity for C. trachomatis DNA detection as well as its multiplex format, which simultaneously provides results for six other urogenital pathogens, the Seegene Allplex™ STI Essential Assay represents an appealing diagnostic tool in modern microbiology laboratories

Orbital contribution to the magnetic properties of nanowires: Is the orbital polarization ansatz justified?

We show that considerable orbital magnetic moments and magneto-crystalline anisotropy energies are obtained for a Fe monatomic wire described in a tight-binding method with intra-atomic electronic interactions treated in a full Hartree Fock (HF) decoupling scheme. Even-though the use of the orbital polarization ansatz with simplified Hamiltonians leads to fairly good results when the spin magnetization is saturated this is not the case of unsaturated systems. We conclude that the full HF scheme is necessary to investigate low dimensional systems

Seroprevalence of Coxiella burnetii and Brucella abortus among pregnant women.

Coxiella burnetii and Brucella abortus are two intracellular bacteria implicated in zoonotic miscarriage. In the present study, C. burnetii and B. abortus seroprevalence was compared among women from London with and without miscarriage. Coxiella burnetii seroprevalence was high (4.6%, 95% CI 2.8-7.1) despite the rare apparent exposure of this urban population. Only two patients exhibited anti-B. abortus antibodies. As a result of the risk of chronic Q fever with endocarditis and/or hepatitis, the mode of Coxiella burnetii infection in this population merits further investigation

Utility of an Algorithm to Increase the Accuracy of Medication History in an Obstetrical Setting.

BACKGROUND: In an obstetrical setting, inaccurate medication histories at hospital admission may result in failure to identify potentially harmful treatments for patients and/or their fetus(es). METHODS: This prospective study was conducted to assess average concordance rates between (1) a medication list obtained with a one-page structured medication history algorithm developed for the obstetrical setting and (2) the medication list reported in medical records and obtained by open-ended questions based on standard procedures. Both lists were converted into concordance rate using a best possible medication history approach as the reference (information obtained by patients, prescribers and community pharmacists' interviews). RESULTS: The algorithm-based method obtained a higher average concordance rate than the standard method, with respectively 90.2% [CI95% 85.8-94.3] versus 24.6% [CI95%15.3-34.4] concordance rates (p<0.01). CONCLUSION: Our algorithm-based method strongly enhanced the accuracy of the medication history in our obstetric population, without using substantial resources. Its implementation is an effective first step to the medication reconciliation process, which has been recognized as a very important component of patients' drug safety