Efficacious treatment of non-dermatophyte mould onychomycosis with topical amphotericin B.

BACKGROUND: Dermatophytes are the main cause of onychomycosis, but various non-dermatophyte moulds (NDMs) are often the infectious agents in abnormal nails. In particular, Fusarium spp. and other NDMs are mostly insensitive to standard onychomycosis treatment with topical agents as well as with oral terbinafine and itraconazole.¦OBJECTIVE: The aim of this work is to report the efficacy of a topical amphotericin B solution on NDM onychomycosis in a series of 8 patients resistant to multiple conventional topical and systemic treatments.¦METHODS: Treatment consisted in the application of an optimized amphotericin B solution once daily to the affected nails and surrounding tissue. No mechanical debridement or medications were allowed except for trimming excessively long nails or in some cases occasionally applying urea-based cream to soften thickened nail plates.¦RESULTS: Onychomycosis was clinically cured in all patients after a 12-month treatment. Mycological cure was obtained in all but 1 patient.¦CONCLUSIONS: Topical amphotericin B is an efficacious, safe, cheap and easy-to-apply treatment which should be considered as first-line therapy for NDM onychomycosis.

« Histoyre des quatre filz Amon ».

Commençant par : « Or dit le conte que du temps du roy Alixandre ne fut ouye une hystoire pareille de ceste qui si apres s'ensuit, commeil advint des quatre filz Amon,... » et finissant par : «... vostre grande vaillance, ne vostre grant hardement, ne vostre bonté, car il ne vous eust mye occis... » . Incomplet à la fin.

Frequency and determinants of using pharmacological enhancement in the clinical practice of in-hospital stroke rehabilitation.

Background: Pharmacological enhancement in stroke rehabilitation (PESR) is promising. Data about its use in clinical practice are missing. Methods: In a prospective, explorative study of four rehabilitation centers, we systematically observed the frequency and determinants of using PESR in consecutive patients. PESR was defined as using agents potentially enhancing post-stroke recovery exclusively to aid rehabilitation without an established indication. Results: 257 (55.4%) of 464 patients had agents potentially enhancing recovery. Selective serotonin reuptake inhibitors (SSRI) (n = 125, 26.9%), levodopa (n = 114, 24.6%), serotonin-noradrenaline reuptake inhibitors (SNRI) (n = 52, 11.2%), and acetylcholinesterase inhibitors (n = 48, 10.3%) were used most often. SSRI in 102/125 patients and SNRI in 46/52 patients were mostly used for accompanying depressive symptoms. 159 (34.3%) patients had PESR (without an otherwise established indication). In PESR patients, levodopa (n = 102, 64.1%) was used most commonly. PESR was primarily used for aphasia (36.5%) and paresis (25.2%). PESR patients did not differ from non-PESR patients in age, gender and stroke type. However, the utilization rates of PESR differed significantly across centers (2, 4, 38 and 55%). Conclusion: SSRI and SNRI were predominately used for accompanying depression, while levodopa was nearly exclusively used to aid stroke rehabilitation in the absence of an otherwise established indication. The differences in utilization rates for PESR between centers suggest therapeutic uncertainty and indicate the need for additional studies.

Gastrostomies, PEG, sondes et boutons: pour ne plus les confondre et savoir les gérer!

On confond trop souvent le mode de confection des gastrostomies avec le nom de l'équipement du conduit. Ainsi combien de fois avons-nous été appelés pour avis sur une « PEG » qui en fait était une gastrostomie équipée d'un bouton. Le but de ce travail est de clarifier les problèmes de techniques de gastrostomies chez l'enfant, les équipements à disposition et d'évoquer les problèmes qui s'y rapportent.

Psychometrics of the Dyadic Coping Inventory in three language groups

This article introduces the Dyadic Coping Inventory (DCI; Bodenmann, 2008) and aims (1) to investigate the reliability and aspects of the validity of the Italian and French versions of the DCI, and (2) to replicate its factor structure and reliabilities using a new Swiss German sample. Based on 216 German-, 378 Italian-, and 198 French-speaking participants, the factor structure of the original German inventory was able to be replicated by using principal components analysis in all three groups after excluding two items in the Italian and French versions. The latter were shown to be as reliable as the German version with the exception of the low reliabilities of negative dyadic coping in the French group. Confirmatory factor analyses provided additional support for delegated dyadic coping and evaluation of dyadic coping. Intercorrelations among scales were similar across all three languages groups with a few exceptions. Previous findings could be replicated in all three groups, showing that aspects of dyadic coping were more strongly related to marital quality than to dyadic communication. The use of the dyadic coping scales in the actor-partner interdependence model, the common fate model, and the mutual influence model is discussed.

Ex vivo Pulsatile Perfusion of Human Saphenous Veins Induces Intimal Hyperplasia and Increased Levels of the Plasminogen Activator Inhibitor 1.

Vessel wall trauma induces vascular remodeling processes including the development of intimal hyperplasia (IH). To assess the development of IH in human veins, we have used an ex vivo vein support system (EVVSS) allowing the perfusion of freshly isolated segments of saphenous veins in the presence of a pulsatile flow which reproduced arterial conditions regarding shear stress, flow rate and pressure during a period of 7 and 14 days. Compared to the corresponding freshly harvested human veins, histomorphometric analysis showed a significant increase in the intimal thickness which was already maximal after 7 days of perfusion. Expression of the endothelial marker CD31 demonstrated the presence of endothelium up to 14 days of perfusion. In our EVVSS model, the activity as well as the mRNA and protein expression levels of plasminogen activator inhibitor 1, the inhibitor of urokinase-type plasminogen activator (uPA) and tissue-type plasminogen activator (tPA), were increased after 7 days of perfusion, whereas the expression levels of tPA and uPA were not altered. No major change was observed between 7 and 14 days of perfusion. These data show that our newly developed EVVSS is a valuable setting to study ex vivo remodeling of human veins submitted to a pulsatile flow.

Brevia de fide catholica (f. 1-52v). Acta paparum (f. 53-139v).

F. 1-52v. Recueil de textes de piété, en italien sauf le premier. « Confiteor Deo omnipotenti Patri et Filio et Spiritui sancto (...) martiribus tuis Grisanto et Darie, confessoribus tuis Prospero et Venerio atque beato Francisco... - ... eternam amen » (1). — [Rubrique :] « Quisti son li X comandam. de la leze ». « Primo non adorare altro che uno solo dio et per questo commandamento se veta le idole... - ... non e » (1v-3v). — [Rubrique :] « Quisti son li XII articoli de la fede ». « Credo in Dio padre omnipotente creatore del celo et de la terra. 1. S. Petro. Et in Yesu... - ... alli boni. 11. S. Thadeo. 12. S. Mathia » (3v). — [Rubrique :] « Quisti son li septe peccati mortali. Lo primo Elatio ». « Superbia cio e reputare de havere bene per propria virtu et non da Dio... - ... tante fiade pecca mortalmente » (3v-10). — [Rubriques :] « Quisti son li dexe comandamenti soto brevita » (...) « Quisti sono li septe sacramenti » (...) « Que son le VII opere de la misericordia temporale » (...) « Queste son le spirituale » (...) « Questi son li setti peccati mortali » (...) « Circha de sopra in li dexe comandamenti. Quista sun li V sentimenti de lo corpo » (...) « Quisti sono li septi doni del Spirito sancto che sono contra li VII peccati mortali » (...) « Queste sono le III virtu theologie » (...) « Quatuor sono le cardinale » (...) « Queste son le conditione de la confessione » (...) « Quisti son li casi de la papa sive papali » (...) « Casus exclusi » (...) « Quisti sun li cassi de lo episcopo sive episcopali » (...) (10-12). — [NICOLAUS DE AUXIMO, O. F. M. (Nicolò da Osimo), Compendio de salute], cf. Umberto Picciafuoco, Fr. Nicolò da Osimo: vita, opera, spiritualità, 1980 ; « Per dare breve introductione delle cose necessarie ad la salute ad ciaschuno simplice lo quale desidera de salvarse, me sono studiato de redirre le dicte cose sotto breve compendio, retracto de uno libro dicto Quadriga spirituale... - ... molto cose secondo li doctori » (12-52v).F. 53-139v. Actes pontificaux et varia. EUGENIUS IV papa, Bulla [ad Jacobum de Primadiciis de Bononia, O. F. M. (Giacomo Primadizzi) ?], de communione pascali, [07/07/1446], cf. Archivum Franciscanum Historicum, 21, 1928, p. 270 n. 1, 282-283 « Eugenius papa IIIIus. Dilecte fili salutem et apostolicam benedictionem. Fidedigna relatione percepimus in civitate Licii non parvam... - ... VIII kal. julii 1446, po. no. anno XVI° » (éd. ibid., p. 282-283, avec une date corrigée) (53-54). — [PAULUS II papa], Bulla, 14/04/1469 « I ». [Rubrique :] « Bulla que quotannis in cena Domini publicari per summum pontificem consuevit ». « Dilecti filii salutem et apostolicam benedictionem. Consueverunt predecessores nostri romani pontifices annis singulis in die cene Domini sedentes...-... die XIIII° aprilis 1469 p. n. anno quinto. L. Dathus » (55-56). — PAULUS II papa, Bulla, 30/03/1469 « 2. Bulla. Paulus (...). Consueverunt sancte memorie romani pontifices predecessoris [sic] nostri ad retinendam puritatem... - ... tertio kal. aprilis, p. n. anno quinto. De curia. Signata A. Ingherannus, L. Dathus » (56v-64). — PAULUS II papa, Bulla, 06/06/1469 « 3. Paulus (...). Decet romanum pontificem sic in suis fore gratiis liberalem quod in ecclesiarum... - ... octavo id. junii, p. n. anno quinto. De curia, B. Lunensis » (64v-67). — PAULUS II papa, Bulla, 02/07/1469 « Paulus papa II. 4. [Rubrique :] Presidenti monasteriorum Sancte Justine de Padua ». « Dilecte fili salutem et apostolicam benedictionem. Bullam presentibus alligatam constitutionis et decreti nostri circa annexa et juncta beneficia... - ... die IIa julii M° CCCC LXVIIII p. n. anno quinto. L. Dathus » (67v-68). — PAULUS II papa, Bulla, de casibus reservatis, [03/03/1470] cf. Cesare Censi, Manoscritti francescani della Biblioteca Nazionale di Napoli, 2 vol., 1971 (Spicilegium bonaventurianum, VII-VIII), t. I, p. 222, qui renvoie au ms. Napoli, Biblioteca Nazionale, V H 33 (n° 125 a de la liste de Cenci) ; incomplet de la fin « 5. [Rubrique :] Bulla pro casibus reservatis ». « Paulus (...). Etsi dominici gregis saluti semper intenti singulis cum humilitate poscentibus ea benigne... - ... omnipotentis Dei et beatorum » [Petri et Pauli...] (68v-70). — PAULUS II papa, Bulla, 23/11/1464 « 6. [Rubrique :] Contra symoniacos ». « Paulus (...). Cum detestabile scelus simoniace pravitates tam divinorum quam sacrorum canonum... - ... nono kal. decembres, p. n. anno primo » (70v-72). — PAULUS II papa, Bulla, [01/03/1468], cf. C. Censi, op. cit., ms. Napoli, Bibl. Naz., I H 43 et V H 33 (n° 50 ap et 125 d) « 7. [Rubrique :] Bulla prohibens ne bona ecclesiarum et Dei alienari possint ultra triennium ». « Paulus (...). Ambitiose perversorum cupiditati illorum precipue qui divinis et humanis legibus affectata... - ... M° CCCC LXVII kalendis martii p. n. anno quarto » (72v-74). — PAULUS II papa, Bulla, 31/01/1468 « 8. [Rubrique :] De celebratione dierum festorum in terris ecclesie ». « Paulus (...). Perniciosa consuetudo aut verius corruptela que in gravem divine majestatis ac sanctorum... - ... M° CCCC LXVII pridie kal. febr. anno p. n. IIII° » (74v-76v). — Exemplum de Raymundo cardinale nepote Honorii pape et beata Maria virgine et Annunciatione ejus. [Rubrique :] « Pro jejunio domine nostre ». « Honorius summus pontifex habuit ex sorore nepotem Raymundum nomine tituli sanctorum Johannis et Pauli cardinalem libidini ita deditum... - ... regna migravit » (77-79). — PAULUS II papa, Bulla, de jubilaeo, 19/04/1470 « 10 ( ?). [Rubrique :] De publicatione anni jubilei redacti ad M CCCC LXXV ». « Paulus (...). Ineffabilis providentia summi patris qui pro redemptione humani generis ejusque reconcilianda natura... - ... tertiodecimo kalendas maii p. n. anno sexto » (79-85). — PAULUS II papa, Breve, ad episcopum Cumanensem, 22/04/1471 « Breve pontificis ad episcopum Cumanensem. Paulus II. Venerabilis frater (...). Expositum fuit nobis nonnullos istius civitatis Cumane ejusque diocesis existere qui contra libertatem... - ... XXII aprilis 1471 p. n. anno septimo » (86-86v). — PAULUS II papa, Breve, ad episcopum Cumanensem, 07/06/1471 « Suprascriptum breve non habuit locum sed reformatum fuit in formam infrascriptam : Paulus II. Ven. (...). Expositum nobis fuit pro parte dilecti filii nobilis viri Galeaz Marie ducis Mediolani nonnullos istius civitatis Cumane... - ... 7° junii 1471 p. n. anno 7° » (86v-87v). — PAULUS II papa, Breve, [ad Galeazzum Mariam Sforza ducem Mediolanensem], 31/05/1471 « Dilecte fili (...). Diligenter exposuit nobis dilectus filius Augustinus de Rubeis eques et doctor Parmensis consiliarius et orator ad nos tuus... - ... ultimo maii 1471, p. n. anno septimo » (87v-88v). — NICODEMUS [TRANCHEDINI], Littera ad Galeazzum Mariam Sforza ducem Mediolanensem, 13/05/1471, cf. Paola Sverzelatti, « Per la biografia di Nicodemo Tranchedini [1413-1481] di Pontremoli, ambasciatore sforzesco », Aevum, 1998, LXII, 485-557 [4° Z 4794] « Littere Nicodemi ad illustrissimum d. ducem. El papa me ha dicto questa sera che heri sera deputo et immediate hebbe ad se li inferri... - ... Johachinus et Franciscus de Padua advocati consistoriales ». « Suprascriptis videnda commissa fuit bulla pontificis » (89-89v). — AUGUSTINUS DE RUBEIS (Agostino de’Rossi) et NICODEMUS [TRANCHEDINI], Littera ad Galeazzum Mariam Sforza ducem Mediolanensem, 25/05/1471 « Littere d. Augustini et Nicodemi ad principem. Illustrissimo (...). Questi xi sonno mo stati piu volte insieme et col papa anchora et heri se fece el consistorio... - ... XXV maii 1471. Augustinus et Nicodemus » (89v-91). — Iidem ad eumdem, 27/05/1471 « Eorundem. Illustrissimo (...). Credace la vestra signoria per cosa se havesse ad agitar. qua postquam questo nostro sancto patre fu facto papa... - ... XXVII maii 1471 » (91-94v). — [EUGENIUS IV papa, Gratiae concessae Francisco de Platea de Bononia, O. F. M., 01/1440], cf. Cesare Censi, Manoscritti francescani della Biblioteca Nazionale di Napoli, 2 vol., 1971 (Spicilegium bonaventurianum, VII-VIII), t. II, p. 1060, qui renvoie à deux exemplaires du texte, mss. Napoli, Biblioteca Nazionale, cod. VII G 50 et VII G 66 [n° 371 et 383 de la liste de Cenci] « Copia. Ego frater Franciscus de Bononia frater venerabilis viri fratris Jacobi de Primidiciis de Bononia Florentiam accessi... - ... M CCCC XL die III et die decima januarii » (95-98v). — PAULUS II papa, Breve ( ?), ad Julium Cesari de Varano domicellum, incomplet de la fin « Paulus episcopus (...) dilecto filio nobili viro Julio Cesari de Varano domicello civitatis nostre Camerini et pro nobis (...) gubernatori (...). Inter cura multiplices quibus assidue permimur illa precipue sollicitat mentem nostram... - ... merito commendari » (100-106v). — NICOLAUS V papa, Breve ( ?), ad Franciscum Sforza, 24/07/1447 « Nicolaus (...) dilecto filio nobili viro Francisco Sfortie vicecomiti, comiti et marchioni (...). Sedes apostolica pia mater recurrentibus ad eam cum humilitate filiis post excessum libenter... - ... nono kal. augusti, p. n. anno primo. Pe. de Noxeto » (107-111v). — FRANCISCUS PHILELPHUS ( ?), [De Sacerdotio Christi (extractum et translatum e graeco Souda), versio italica], cf. Giovanni Mercati, Ultimi contributi alla storia degli Umanistici, 1939, I, p. 74-76 (4° Z 1722 (90)) « Tractatello traducto per messere Francescho Philelpho singularissimo poetha de greco in latino per luy trovato presso autentici et antiqui autori, reducto in volgare ad contemplatione d’alcuni devoti cortesani del illustrissimo signiore duca di Milano, ad confirmatione de la fede nostra et confusione de Judei. Regnando Justiniano imperatore clementissimo fo uno homo principe de Judei chiamato Theodosio... - ... teneva occulto » (112-118v). — « Electi beneficii et superni doni data ad quella anima che oldira la sancta messa integramente monifestati per li sancti doctori... - ... ligno de la vita » (118v-119). — MARTINUS V papa, Bulla, de excommunicatione hereticorum, [28/03/1426 ?], incomplète de la fin ; cf. C. Censi, op. cit., I, p. 501-502 (n° 304 f) « 1. Excommunicationes plures contente in processu qui fit annuatim in curia in cena Domini. Martinus (...). Excommunicamus et anathematizamus ex parte omnipotentis Dei Patris et Filii et Spiritus sancti auctoritate Petri... - ... incursurum. Datum Rome etc » (120-122v). — « Item excommunicamus et anathematizamus omnes illos qui per se vel per alium vel alios directe vel indirecte... - ... cautione prestitis » (122v-123v). — PAULUS II papa, Bulla, 11/04/1471 « 2. Paulus (...). Consueverunt sancte memorie romani pontifices predecessores nostri ad retinendam puritatem... - ... tertio idus aprilis, p. n. anno VII° » (124-130v). — SIXTUS IV papa, Bulla, de excommunicatione hereticorum, 26/03/1472 « 2. Sixtus (...). Excommunicamus et anathematizamus ex parte omnipotentis Dei Patris et Filii et Spiritus sancti auctoritate quoque beatorum... - ... septimo kal. aprilis etc. anno primo » (131-134v). — SIXTUS IV papa, Breve ( ?), ad Ferdinandum I regem Sicilie, 01/03/1472 « 4. Sixtus (...) carissimo in Christo filio Ferdinando regi Sicilie illustri (...). Dum eximie fidelitatis devotionis atque prudentie tue ceterasque tibi a Domino traditas virtutes...-... kalendis martiis [sic] p. n. anno primo. M. Milinus » (135-139v).

Passer d'un modèle de fonctionnement associatif à un modèle institutionnel: une analyse des transformations de l'organisation du travail

Le monde de l'action humanitaire a connu des développements importants durant les dernières décennies. Sur les terrains d'interventions, les crises et les conflits se sont fortement complexifiés, nécessitant la participation de spécialistes de nombreux domaines. Par ailleurs, les volumes financiers générés par les campagnes de dons et mis à disposition par les bailleurs de fonds ont considérablement augmenté. En corollaire de cette croissance financière, les exigences de contrôle et de traçabilité des fonds se sont renforcées. En lien avec ces éléments, le nombre de salariés dans les grandes organisations non gouvernementales a augmenté de manière exponentielle. Une littérature spécifique sur les modalités d'évaluation des performances, le management et le « leadership » des organisations dites du « tiers secteur » a d'ailleurs vu le jour, comme l'illustre la naissance, en 1990, de la revue « Nonprofit Management and Leadership ». Les pays bénéficiaires de l'aide ont également développé des exigences spécifiques envers les projets mis en oeuvre par les ONG. Par des phénomènes de « socialisation des standards occidentaux », ces derniers attendent des acteurs internationaux un certain niveau de qualité des programmes.Pour s'adapter à ces évolutions et répondre aux exigences d'efficacité auxquelles elles sont soumises, les organisations d'aide ont dû se transformer. Les grandes organisations ont ainsi connu durant les dernières décennies un mouvement de professionnalisation de leur structure, les conduisant à se rapprocher d'un modèle de fonctionnement que nous nommerons ici « institutionnel », à savoir formalisé et organisé. Nous employons ici le terme de professionnalisation dans l'appréciation qu'en font les acteurs du milieu humanitaire, à savoir en ce qu'il désigne « les restructurations internes auxquelles leurs organisations font face depuis la fin des années 1980 ». Différents indicateurs de cette professionnalisation au sein des ONG peuvent être identifiés, notamment une plus forte division du travail, le développement de statuts spécifiques, la salarisation croissante des métiers de l'humanitaire ou encore le recours aux fonds publics.Une conséquence également de cette évolution est l'entrée de nouveaux métiers sur la scène humanitaire. À côté des professions traditionnellement à l'origine des ONG (médecins, ingénieurs, juristes, etc.), la complexification et la diversification des tâches a rendu nécessaire de faire appel à des compétences professionnelles spécifiques dans des domaines tels que la communication, l'informatique ou la finance, pour ne citer que quelques exemples. Des connaissances et des pratiques spécifiques en matière de management des ONG se sont développées depuis la fin des années 1990. Le métier de logisticien est apparu, lequel est enseigné dans des structures spécialisées (par exemple par l'association Bioforce en France). Des formations académiques spécialisées dans le domaine de l'humanitaire et de la coopération ont également vu le jour, avec le but affiché de former des professionnels spécialistes de l'humanitaire. On peut par exemple citer le PIAH en Suisse (Programme interdisciniplinaire en action humanitaire, 2011), ou encore les formations dispensées par le CIHC aux États-Unis. [auteur]

The four- vs. alternative six-factor structure of the French WISC-IV: Comparison using confirmatory factor analyses

Exploratory and confirmatory factor analyses reported in the French technical manual of the WISC-IV provides evidence supporting a structure with four indices: Verbal Comprehension (VCI), Perceptual Reasoning (PRI), Working Memory (WMI), and Processing Speed (PSI). Although the WISC-IV is more attuned to contemporary theory, it is still not in total accordance with the dominant theory: the Cattell-Horn-Carroll (CHC) theory of cognitive ability. This study was designed to determine whether the French WISC-IV is better described with the four-factor solution or whether an alternative model based on the CHC theory is more appropriate. The intercorrelations matrix reported in the French technical manual was submitted to confirmatory factor analysis. A comparison of competing models suggests that a model based on the CHC theory fits the data better than the current WISC-IV structure. It appears that the French WISC-IV in fact measures six factors: crystallized intelligence (Gc), fluid intelligence (Gf), short-term memory (Gsm), processing speed (Gs), quantitative knowledge (Gq), and visual processing (Gv). We recommend that clinicians interpret the subtests of the French WISC-IV in relation to this CHC model in addition to the four indices.

Construct validity and internal reliability of a French version of FACES III in adolescents and adults

Family cohesion and adaptability, as operationalised in the Family Adaptability and Cohesion Scales III (FACES III), are two hypothesised dimensions of family functioning. We tested the properties of a French version of FACES III in school-children (mean age: 13 years; S.D:0.85) recruited from the general population and their parents. Separate confirmatory factor analyses were performed for adolescents and adults. The results of both analyses were compatible with a two-factor structure similar to that proposed by the authors of the original instrument. However, orthogonality between the two factors was only supported in the adult data. Internal reliability estimates were 0.78 and 0.68 in adolescents and 0.82 and 0.65 in adults, for cohesion and adaptability respectively.

The influence of drinking pattern, at individual and aggregate levels, on alcohol-related negative consequences.

AIM: To determine the extent drinking patterns (at the individual and country level) are associated with alcohol-related consequences over and above the total alcohol the person consumes. METHODS: Hierarchical linear models were estimated based on general population surveys conducted in 18 countries participating in the GENACIS project. RESULTS: In general, the positive association between drinking pattern scores and alcohol-related consequences was found at both the individual and country levels, independent of volume of drinking. In addition, a significant interaction effect indicated that the more detrimental the country's drinking pattern, the less steep the association between the volume of drinking and its consequences. CONCLUSION: Drinking patterns have an independent impact on consequences over and above the relationship between volume and consequences.

Placental immaturity, endocardial fibroelastosis and fetal hypoxia.

We describe a term newborn who, after a normal gestational course, presented at birth with absent cardiac activity and no spontaneous breathing. Death occurred within 30 h. Autopsy revealed placental villous immaturity, multiple acute hypoxic lesions, but also chronic hypoxic lesions like endocardial fibroelastosis. This striking association of endocardial fibroelastosis and placental villous immaturity is reviewed and correlated with 2 other cases of placental villous immaturity that led to in utero death at 39 and 41 weeks of gestation. Placental villous immaturity must be suspected and looked for by both pediatricians and obstetricians in every case of stillbirth or perinatal asphyxia of unclear origin. In order to minimize the risk of recurrence in further pregnancies, elective cesarean section may be considered.