Apraxia occurs frequently in patients with dementia. Buccofacial apraxia (BFA) characteristics have been less investigated than limb or speech apraxia. An association between BFA and oropharyngeal dysphagia (OD) in old patients with dementia has not yet been explored. We aimed to assess the prevalence of BFA in patients with dementia and evaluate the relationship between BFA, OD, and dementia. We have prospectively included 117 outpatients with dementia referred to a geriatric consultation. Oropharyngeal dysphagia was diagnosed using the volume viscosity swallowing test (V-VST). Buccofacial apraxia was evaluated by miming 7 meaningless gestures. A complementary geriatric assessment of 6-domains completed the evaluation. Buccofacial apraxia was present in 54 (48.6%) patients. Proxies reported OD more frequently in the group of patients with BFA compared to the group without (P = .04). Prevalence of OD assessed with the V-VST was similar between patients with and without apraxia (P = .9). Patients with BFA had a significant lower Mini-Mental State Examination suggesting a more severe cognitive decline (18.1 ± 4.5 vs 15.8 ± 5, P = .01), a lower activities of daily living relative to disabilities (5 ± 0.8 vs 4.3 ± 1.3, P = .001), and had a lower gait speed that indicated frailty (P = .03).In conclusion, our results indicate a relationship between BFA and severity of dementia, disability, and frailty with no significant association between BFA and OD.

Alongside the well-characterized enterohemorrhagicEscherichia coli(EHEC) O157:H7, serogroup O157 comprises sorbitol-fermenting typical and atypical enteropathogenicE. coli(EPEC/aEPEC) strains that carry the intimin-encoding geneeaebut not Shiga toxin-encoding genes (stx). Since little is known about these pathogens, we characterized 30 clinical isolates from patients with hemolytic uremic syndrome (HUS) or uncomplicated diarrhea with respect to their flagellin gene (fliC) type and multilocus sequence type (MLST). Moreover, we applied whole-genome sequencing (WGS) to determine the phylogenetic relationship with othereae-positive EHEC serotypes and the composition of therfbO157 region.fliCtyping resulted in fivefliCtypes (H7, H16, H34, H39, and H45). Isolates of eachfliCtype shared a unique ST. In comparison to the 42 HUS-associatedE. coli(HUSEC) strains, only thestx-negative isolates withfliCH7 shared their ST with EHEC O157:H7/H⁻strains. With the exception of one O157:H⁻_fliCH16isolate, HUS was exclusively associated withfliCH7. WGS corroborated the separation of thefliCH7 isolates, which were closely related to the EHEC O157:H7/H⁻isolates, and the diverse group of isolates exhibiting differentfliCtypes, indicating independent evolution of the different serotypes. This was also supported by the heterogeneity within therfbO157 region that exhibited extensive recombinations. The genotypic subtypes and distribution of clinical symptoms suggested that thestx-negative O157 strains withfliCH7 were originally EHEC strains that loststx. The remaining isolates form a distinct and diverse group of atypical EPEC isolates that do not possess the full spectrum of virulence genes, underlining the importance of identifying the H antigen for clinical risk assessment.

During the Great War of 1914 to 1918, spectacular progress was made in the field of facial reconstruction. The sheer number and severity of facial lesions inflicted during the fighting obliged French and German surgeons to take a close interest in the treatment of patients wounded in such a manner. As head surgeon of the fifth division “blessés de la face” at the hospital of Val-de-Grace, Hippolyte Morestin was responsible for one of the largest surgical departments specializing in facial surgery and reconstruction during the war. During his time of service, he developed various surgical techniques such as autoplasties using cartilaginous and adipose grafts to reconstruct tissue defects. This study focuses primarily on the adipose graft techniques and their aesthetic outcome used by Morestin during and in the aftermath of World War I. This is a historical descriptive study. Our research is based on documents available at the museum and archives of the Val-de-Grace Army Health Service (hospital activity reports, pre- and postoperative patient photographs, newspaper clippings, documented accounts of ward nurses, wax anatomy models). Thirty-four clinical cases published by Hippolyte Morestin dealing with facial reconstruction during the World War I were studied. Fat was mainly used to fill craniofacial substance losses after carrying out often complex reconstructions. The surgical technique is well documented and subdivided into 3 succeeding procedures. Most of the time, the grafts were of autologous origin but sometimes heterologous samples were used. Although the primary objective was to increase volume, an improved quality of skin healing and better skin flexibility were observed. The fat thus allowed the filling of substance losses, and its positive effects on scarring were noticed even before the regenerative properties of the stem cells present in body fat were discovered. Hippolyte Morestin can be named one of the pioneers of facial reconstruction. A retroperspective analysis of his work with adipose grafts proves interesting because even though not being the first to apply this technique, he contributed, by means of experimentation and reproduction to proving it an innovative and useful method in facial reconstruction. It was not until the 1990s that adipose grafts were again applied under the name of lipostructure. Nowadays, they are commonly used in cosmetic and restorative surgery.

Introduction: Hippocrates, a Greek physician during the fifth century BC., is often considered the father of medicine. The Corpus Hippocraticum comprising of 58 volumes was attributed to him alone for a long time. Nowadays, it is considered that several authors contributed to its creation between 450 and 150 BC., so over a period of 300 years. The objective of our study was to develop a nosological classification of all passages treating head and neck diseases. Material and methods: We read and analyzed all volumes of the Corpus Hippocraticum in French translation and extracted all passages dealing with oto–rhino–laryngological and maxillo-facial conditions (n = 65). We classified all pathologies into five distinctive nosological groups: traumatic, infectious, malformation, cancerous and inflammatory Results: Traumatic diseases represented 36.9% (n = 24), infectious 52.3% (n= 34), malformation 0% (n = 0), cancerous 11.5% (n = 1) and inflammatory 9.3% (n= 6). These results represent the living conditions of this era, during which diseases were mostly of infectious or traumatic nature (wars, physical labor and recreational sporting activity, living together on close quarters, etc.). Conclusion: The meticulously detailed observations of the corpus give us a precious insight into the early perception of diseases, their progression and early attempts of treatment.

Human papillomavirus-mediated recurrent respiratory papillomatosis (RRP) is a premalignant neoplasia of the upper airway characterized by significant dysphonia and respiratory obstruction. Immune checkpoint blockade has emerged as a potential alternative to repeated surgical interventions in RRP. Here, we investigated the intralesional T-cell composition and expression of the immune checkpoints programmed death-ligand 1 (PD-L1) and cytotoxic T-lymphocyte antigen 4 (CTLA-4) in RRP. We analyzed tissue samples from 30 patients treated at a tertiary care center between 2009 and 2021, including paired samples from individual patients collected at different time points. Immunohistochemical staining was performed for CD4, CD8, CTLA-4, FoxP3, and PD-L1 and correlated with disease severity and previous adjuvant therapies. Overall disease burden and intervention-free survival were not associated with the abundance of CD4⁺, CD8⁺, or FoxP3⁺ T cells, nor with immune checkpoint expression. However, patients with aggressive disease exhibited a higher intralesional FoxP3/CD4 T-cell ratio. Prior intralesional cidofovir treatment was associated with reduced CD4⁺ T-cell infiltration. These findings suggest that a locally immunosuppressive microenvironment, reflected by an elevated FoxP3/CD4 ratio, contributes to disease severity in RRP. Consistent CTLA-4 expression across all evaluated samples supports further investigation of anti-CTLA-4 therapy, either alone or in combination with other checkpoint inhibitors.