THE BACTERIOLOGY OF TRICHOMYCOSIS AXILLARIS

SUMMARY. A method is described for the isolation and culture of the causative organisms of trichomycosis axillaris. Hairs from 7 cases, 6 of the yellow variety and one of the red, have been examined. Three species of Corvnebacteria were isolated from each of the 6 cases and 2 were isolated from the seventh. The species from the cases with the red granules were similar to those isolated from those with the yellow granules. It was concluded from these results that it was unjustifiable to refer to the causative agent of this disease as a single agent such as C. tenuis.     

Outcomes of Pregnancy in Patients with Preexisting Postural Tachycardia Syndrome

Background: Postural orthostatic tachycardia syndrome (POTS) occurs more commonly in women than in men and often affects women of childbearing age. Many of these women wish to have children, yet there are little reported data on the outcomes of pregnancy in patients with POTS. To date there has been one report of two patients with POTS who successfully completed pregnancy. We report the outcomes of 22 women with preexisting POTS who became pregnant.
Objective: To assess the outcome of pregnancy in patients with preexisting POTS.
Methods and Results: Twenty-two patients, age 30 ± 7 years, with POTS became pregnant. Migraine was the common comorbidity found in 40% of patients. Medications used were β- blockers (18%), midiodrine (31%), selective serotonin reuptake inhibitors (31%), fludrocortisone (13%), combination (40%), and none (18%). During pregnancy, symptoms of POTS remained unchanged in three (13%), improved in 12 (55%), and worsened in seven (31%) patients. One patient who had recurrent episodes of syncope without aura was found to have complete heart block and received a cardiac pacemaker. All patients completed pregnancy successfully. There were no stillbirths. One patient developed hyperemesis. Eighteen patients had vaginal delivery and four patients delivered by cesarian section. No other complications of pregnancy were encountered. Congenital abnormalities were encountered in the form of one atrial septal defect, one ventricular septal defect, and one Down's syndrome. Postpartum symptoms of POTS remained stable in 15 (69%) patients and worsened in seven (31%) patients.
Conclusion: Based on our observation, patients with POTS can safely complete pregnancy if they desire to do so. POTS should not be considered a contraindication to pregnancy per se.     

The coexistence of chronic leukemia and pregnancy

The co-existence of pregnancy in 4 patients with chronic myelogenous leukemiahas been reported. One patient was known to have had chronic myelogenous leukemia 3 years prior to her pregnancy. The diagnosis of leukemia was made duringthe course of pregnancy in the remaining 3 patients; 1 in the first trimester, theother 2 in the third trimester. No specific therapy was required in any of the patients during pregnancy. Their children at birth showed no stigmata of leukemia.

Current literature on the subject has been reviewed. The consensus is that pregnancy does not influence the prognosis of chronic myelogenous leukemia. Duringthe period of gestation, the symptoms can be controlled by administration of asolution of potassium arsenite (Fowler’s solution) and irradiation therapy over longbones, spleen and mediastinum without exposing the fetus.

     

An Anatomic‐Based Approach for the Placement of Implantable Loop Recorders

Introduction: Placement of the Reveal implantable loop recorder (ILR; Medtronic Inc., Minneapolis, MN, USA) has previously involved preoperative cutaneous mapping to determine the optimal location. We describe an anatomic‐based approach to ILR placement that does not require cutaneous mapping. Method: A total of 63 patients (40 women, 23 men, mean age 38 ± 15 years) were included in the study. Each underwent implantation of a Reveal ILR in the left upper chest area midway between the supraclavicular notch and the left breast area. Thirty‐two patients received a Medtronic Reveal DX ILR and 31 received Reveal XT device. Results: In all 62 patients, adequate electrocardiographic tracings were obtained at implant without the need for preoperative cutaneous mapping, and all were followed for a period of 10 ± 4 months afterwards. The mean P wave amplitude was 0.12 ± 0.20 mV at implant and at follow‐up (6–14 months postimplant); the amplitude was 0.11 ± 0.19 mV. The peak‐to‐peak QRS amplitude was 0.48 ± 0.15 mV at implant and 0.44 ± 0.16 mV at a follow‐up of 6–14 months. The P waves were not detected in two patients at follow‐up. In one patient, decreased amplitude of QRS complex resulted in the autoactivation of the device and in one other patient noise was inappropriately oversensed and recorded. Conclusion: A simple anatomic approach can be used for reveal ILR placement. (PACE 2010; 33:1149–1152)