Chronic Q fever. Ninety-two cases from France, including 27 cases without endocarditis

OBJECTIVE: Chronic Q fever is seldom recognized; before 1989, only 234 cases had been reported in the literature. The 92 cases of chronic Q fever collected at the French National Reference Center for Rickettsioses from 1982 through 1990 represent the largest series ever reported. PATIENTS: The patients included in the study were diagnosed between July 31, 1982, and August 1, 1990, at the French National Reference Center for Rickettsioses as having chronic Q fever by the following criteria: presence of antibody against Coxiella burnetii phase I antigen at a titer greater than or equal to 800 for IgG and 50 for IgA by the indirect immunofluorescence test. Epidemiologic, clinical, laboratory, and treatment data were collected from 39 different collaborative hospitals throughout France. MAIN OUTCOME MEASURE: For each serologically selected patient, a computerized questionnaire was utilized to record 188 different items of demographic, epidemiologic, clinical, laboratory, and therapeutic data, which were analyzed. RESULTS: Chronic Q fever occurs more frequently in city dwellers than in rural inhabitants, and exposure to domestic ruminants and raw milk is an important feature. Immunocompromising conditions (20.2%) and underlying heart disease (88.4%) or vascular disease are the most important risk factors to consider in potential cases of chronic Q fever. The mortality in these patients with endocarditis was high (23.5%). The clinical spectrum of 84 patients included 57 cases of endocarditis, three cases of vascular prosthesis infection, three cases of aneurysmal infection, three cases of osteoarthritis, four cases with lung localizations, nine asymptomatic cases, three cases of hepatitis, and two cases with cutaneous forms of the disease. CONCLUSIONS: In patients with unexplained fever, negative blood cultures, and a history of underlying vascular or cardiac disease, Q fever should be considered.     

Loss of substance of the lateral region of the face

The cardiovascular effects of a partially purified extract of fish oil, enriched in the n-3 series fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), were studied in stroke-prone spontaneously hypertensive rats (SHR-SP) fed with high- and low-sodium diets during 5 weeks. Addition of salt to the low-salt control diet at a level commonly found in human food items (6% NaCl of the dry weight of the diet) produced a remarkable rise in blood pressure, an increase in left ventricular weight-to-body weight ratio (LVH-index) and an increase in kidney weight-to-body weight ratio (RH-index). Fish oil (20% of the dry weight of the diet) did not significantly influence the blood pressure or LVH-index or RH-index during the low-salt control diet. However, fish oil completely prevented the remarkable rise in blood pressure and clearly antagonized the rise of both LVH- and RH-indices, induced by the high-salt diet. The fish oil supplementation increased the levels of the polyunsaturated fatty acids of the n-3 series and decreased those of the n-6 series in plasma and kidney, irrespective of the salt content of the diet. Fish oil lowered serum thromboxane B2 concentration by approximately 75%. During the high-salt diet, fish oil markedly decreased water intake and urine volume, and increased urinary sodium concentration by about 60%. Our findings show that, in addition to an antihypertensive effect, fish oil also decreases LVH and RH. These effects appear to be due to an improved ability to excrete sodium and could be explained by the observed changes in the fatty acid composition and metabolism.     

TCAD and SPICE modeling help solve ESD protection issues in analog CMOS technology

The number of circuit design iterations due to electrostatic discharge (ESD) failures increases with the complexity of VLSI technologies and their shrinking. In this paper, we show how TCAD and ESD SPICE modeling can be used to solve ESD protection issues in an analog CMOS technology.     

Characterization of edible oils,butters and margarines by Fourier transform infrared spectroscopy with attenuated total reflectance

The combination of attenuated total reflectance (ATR) and mid-infrared spectroscopy (MIRS) with statistical multidimensional techniques made it possible to extract relevant information from MIR spectra of lipid-rich food products. Wavenumber assignments for typical functional groups in fatty acids were made for standard fatty acids: Absorption bands around 1745 cm⁻¹, 2853 cm⁻¹, 2954 cm⁻¹, 3005 cm⁻¹, 966 cm⁻¹, 3450 cm⁻¹ and 1640 cm⁻¹ are due to absorption of the carbonyl group, C−H stretch, =CH double bonds of lipids and O−H of lipids, respectively. In lipid-rich food products, some bands are modified. Water strongly absorbs in the region of 3600–3000 cm⁻¹ and at 1650 cm⁻¹ in butters and margarines, allowing one to rapidly differentiate the foods as function of their water content. Principal component analysis was used to emphasize the differences between spectra and to rapidly classify 27 commercial samples of oils, butters and margarines. As the MIR spectra contain information about carbonyl groups and double bonds, the foods were classified with ATR-MIR, in agreement with their degree of esterification and their degree of unsaturation as determined from gas-liquid chromatography analysis. However, it was difficult to differentiate the studied food products in terms of their average chainlength.     

In situ regeneration of the Ni-based catalytic reformer of a 5 kW PEMFC system

The paper reports the results of on-site regeneration catalytic bed of the natural gas reformer in a 5 kW PEM fuel cell system. The Ni catalyst previously poisoned by sulphur from the available natural gas, could be re-activated by injection of pure water steam, following the method developed for industrial reformers using the same metal catalyst: this method was shown to be perfectly efficient, provided no natural gas was fed during the operation. Results of the tests conducted are presented and discussed in relation to published data on S-sorption on Ni surfaces.     

SFG and DFG investigation of Au(111), Au(210), polycrystalline Au,Au–Cu and Au–Ag–Cu electrodes in contact with aqueous solutions containing KCN and 4-cyanopyridine

We report on potential-dependent in situ SFG and DFG spectroscopy carried out at Au(111), Au(210), polycrystalline Au, Au–Cu and Au–Ag–Cu electrodes in contact with aqueous solutions containing CN⁻ and 4-cyanopyridine (4CP). Spectroelectrochemical work was complemented by cyclic voltammetry. The chief stress has been placed on systematising and quantifying the interaction between 4CP and CN⁻ and the attending effects on the vibrational and electronic structures of the interface. The voltammetric behaviour of the investigated electrodes, modified by the addition of 4CP to the CN⁻ electrolyte, denote changes in the CN⁻ adsorption characteristics and effects of the adsorbed CN⁻ layer on the electrodic reactivity of 4CP. The differences among the investigated electrodes can be explained in terms of their respective degrees of atomic packing or with alloying effects on the stability of adsorbed CN⁻. The potential-dependent spectra have been analysed quantitatively with a model for the second order non linear susceptibility accounting for vibrational and electronic effects. The spectral changes induced by addition of 4CP denote interaction of the aromatic with the electrode through the CN⁻ monolayer. The non-resonant contribution yields information on the effects of 4CP on the fine structure of the bound electron density of states.     

Silicon single electron transistors with SOI and MOSFET structures: the role of access resistances

Coulomb blockade has been widely reported in silicon and metallic structures without intentional tunnel barriers. In particular, a simple constriction in silicon-on-insulator (SOI) allows to build a three-terminal silicon single-electron transistor (SET) operating at moderate temperature. The key parameters are the access resistances confining the electrons and the size of the gate-channel overlap, which sets the Coulomb energy. Thin films of doped silicon with sheet resistance of a few tens of h/e/sup 2/ are well suited for fabricating optimized access resistances. Low doped extensions with typical resistivity 1000 /spl Omega//spl mu/m (at 300 K) are also good candidates. We illustrate this MOS-SET principle in SOI constriction and standard MOSFET of similar size. Although relying on different concepts, the ultimate MOSFET and MOS-SET are shown to be technologically close, differing mostly by the ratio between the channel resistance over the access resistance. Because this ratio is decreasing as the gate length shrinks, single electron effects should become more and more important at high temperature in the subthreshold regime of standard field effect transistor devices.     

Optically Tunable Nonlinearities in Polymers Based on Photoisomerizable Metal‐Based Coordination Complexes

The bottom‐up design of polymer films exhibiting quadratic nonlinear optical properties that can be tuned optically and chemically is described. The polymer matrices are doped with metal‐containing chromophores built around a Zn^II core and photoisomerizable ligands with two different geometries. These molecules possess specifically designed photophysical and nonlinear optical properties to be used towards all‐optical poling, an interference process between one‐ and two‐photon excitations that locally induces macroscopic second‐order effects in polymer films. It is shown that grafting the molecules onto the polymer chains improves the stability of the macroscopic photoinduced nonlinearity in the films.     

Estimating the costs of occupational injury in the United States

This article estimates workplace injury costs in the U.S. These costs have been studied in less detail than most injury costs. Our methods, which mostly use regularly published data, produce order-of-magnitude estimates. Overall, workplace injuries cost the U.S. an estimated $140 billion annually. This estimate includes $17 billion in medical and emergency services, $60 billion in lost productivity, $5 billion in insurance costs, and $62 billion in lost quality of life. One sixth of the societal costs result from the 3% of workplace injuries in motor vehicle crashes. Motor vehicle costs per injury are almost 6 times the workplace injury average.     

Effect of nadroparin, a low-molecular-weight heparin, on clinical and angiographic restenosis after coronary balloon angioplasty: the FACT study. Fraxiparine Angioplastie Coronaire Transluminale

BACKGROUND: Experimental studies suggest that the antiproliferative effect of heparin after arterial injury is maximized by pretreatment. No previous studies of restenosis have used a pretreatment strategy. We designed this study to determine whether treatment with nadroparin, a low-molecular-weight heparin, started 3 days before the procedure and continued for 3 months, affected angiographic restenosis or clinical outcome after coronary angioplasty. METHODS AND RESULTS: In a prospective multicenter, double-blind, randomized trial, elective coronary angioplasty was performed on 354 patients who were treated with daily subcutaneous nadroparin (0.6 mL of 10,250 anti-Xa IU/mL) or placebo injections started 3 days before angioplasty and continued for 3 months. Angiography was performed just before and immediately after angioplasty and at follow-up. The primary study end point was angiographic restenosis, assessed by quantitative coronary angiography 3 months after balloon angioplasty. Clinical follow-up was continued up to 6 months. Clinical and procedural variables and the occurrence of periprocedural complications did not differ between groups. At angiographic follow-up, the mean minimal lumen diameter and the mean residual stenosis in the nadroparin group (1.37+/-0.66 mm, 51.9+/-21.0%) did not differ from the corresponding values in the control group (1.48+/-0.59 mm, 48.8+/-18.9%). Combined major cardiac-related clinical events (death, myocardial infarction, target lesion revascularization) did not differ between groups (30.3% versus 29.6%). CONCLUSIONS: Pretreatment with the low-molecular-weight heparin nadroparin continued for 3 months after balloon angioplasty had no beneficial effect on angiographic restenosis or on adverse clinical outcomes.