Influence of environmental temperature on the occurrence of non-necrotizing cellulitis of the leg SIR, Non-necrotizing cellulitis of the leg is a common cutaneous bacterial infection whose risk factors include venous insufficiency, lymphoedema and toe-web intertrigo. The role of environmental temperature remains controversial. 1 To study the relationship between environmental temperature and the frequency of non-necrotizing cellulitis of the leg, we reviewed all patients hospitalized with nonnecrotizing cellulitis of the leg in a university hospital in a temperate region of France during a 4-year period, and correlated findings with the local environmental temperature during the same period.Patients included in this study were consecutive patients referred for non-necrotizing cellulitis of the leg from January 1995 to December 1998 in the Departments of Dermatology, Internal Medicine and Infectious Diseases of the Rouen University Hospital. The diagnosis of cellulitis of the leg was retrospectively identified using the database of the Medical Information System. The mean and maximum temperatures of each the 8 days prior to the date of hospital admission were obtained from the local meteorological unit for each case. Correlations between the mean and maximum daily temperature of each day from day ) 8 to the admission day (lag 0-8 days) and the daily number of patients hospitalized for cellulitis of the leg were studied using a nonparametric Poisson regression model to adjust for time trends and days of the week (generalized additive model). 2 Eight hundred and ninety-eight patients with cellulitis of the leg [342 men (38%) and 556 women (62%)] were
For the accurate design of some types of mechanisms, it is necessary to combine multibody dynamics computer simulations with finite element structural analysis. These types of mechanisms are the multibody mechanisms in which the body (frame) stiffness of some of the bodies have the same magnitude as some of their elastic elements. With this in mind, the traditional go-kart chassis design process is reviewed. The traditional approach to evaluate the structural properties of its frame consists of an iterative process in which FEM techniques are applied considering constant load cases. These load cases are defined according to the maximum stresses to which it will be subjected during its operation (circulation in a race circuit). However, as it will be proven in this work, the load case will depend on the design of the frame itself. Due to the stiffness of the frame, for the same driving conditions (vehicle trajectory and speed) the structural load condition varies significantly. A design methodology is proposed for this type of system that combines multibody simulation and finite elements.
The risk of suffering opportunistics infections in the immunoincompetent patient is a fact perfectly established. An uncommon situation constitutes the bronchopaties, pathologies with a high prevalence among the general population that they require habitually, among other, steroid treatment. The immunosupression confers to the clinical evolution of the infections, as a consequence of the inadequate response to the physical stress, due to the inhibition of the hypothalamus-hypophysis axis being able to in particularly serious cases, to develop the denominated macrophage activation syndrome, a serious and uncommon syndrome that darkens the clinical prognosis in these patients. In presence of a feverish syndrome of uncertain origin in a patient in immunosuppressor treatment, although it is to low dose, it is necessary to carry out a exhaustive differential diagnosis, should consider, among them, the infection for Leishmania, a parasitosis whose incidence is increasing notably in the last years in the immunosuppressed population. We present the clinical case of a 63 year-old patient, immunoincompetent as a consequence of secondary chronic steroid therapy to asthmatic bronchopaty that experiences an uncommon form of visceral leishmaniasis in our area, consistent in multiorganic failure in the context of the development of a macrophage activation syndrome.
Q fever is an uncommon zoonotic rickettsial disease with no exanthem or specific cutaneous lesions. Only nonspecific cutaneous involvement has been reported to date. A 69-year-old Spanish woman with chronic myelogenous leukaemia developed fever and two subcutaneous nodules. The patient complained of extreme pain. Biopsy revealed a granulomatous lobular panniculitis with a characteristic 'fibrin ring' or 'doughnut' appearance: fibrin and inflammatory cells arranged around a central clear space. Changes of membranous lipodystrophy were also found. Q fever serological studies were positive. Our patient had panniculitis with singular histopathological features. These histopathological changes have been described in liver and bone marrow of patients with Q fever. To the best of our knowledge, this cutaneous involvement due to Q fever has not previously been described in the literature.
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