Purpura of the face and neck: an atypical clinical presentation revealing a hepatosplenic T cell lymphoma

BACKGROUND: Hepatosplenic T cell lymphoma (HSTL) is a rare but very aggressive peripheral T cell lymphoma whose initial silent clinical presentation unfortunately delays the diagnosis and worsens the prognosis of patient survival. Efforts should be aimed at early recognition and treatment. METHODS: We describe a case of a 62-year-old woman who presented at our clinic with a non-palpable purpuric eruption of the face. Investigations revealed thrombocytopenia with hepatosplenomegaly, which showed rapid progression together with accentuation of the purpura. Two months later, a bone marrow biopsy revealed the diagnosis of a HSTL. RESULTS: The patient received six cycles of CHOP chemotherapy (vincristine, cyclophosphamide, doxorubicin, methylprednisolone) followed by a well-tolerated autologous bone marrow graft. Normalization of the platelet count resulted in regression of the purpuric rash. CONCLUSION: To our knowledge, this is the first report of a facial thrombocytopenic purpura as the inaugural symptom of HSTL. It emphasizes the privileged position of the dermatologist for early recognition of potentially lethal HSTL.

L'expérience des grands brûlés de la face : épreuves sociales et travail de reconnaissance

L'épreuve « factuelle » et physique de la brûlure grave des grands brûlés de la face fait l'objet d'une analyse sociologique systématique : alors qu'un accident peut, en quelques secondes, provoquer une véritable rupture biographique, l'acceptation du nouveau statut et la « reconstruction » d'un rapport à soi et aux autres prend beaucoup de temps. Les modalités de cette reconstruction et les tentatives pour retrouver une impossible « apparence normale » dans la vie publique sont ici analysées. Tout en étant attentive aux modalités de l'interaction, la présente étude relève d'une démarche sociologique compréhensive menée à partir d'observations et d'entretiens conduits avec ces personnes, amenant dans le giron de la sociologie une expérience éprouvanteencore peu connue, celle des grands brûlés de la face. Le registre discursif adossé à cette dernière vient compléter certaines représentations véhiculées par les médias, les fictions et qui influent sur la perception et la visibilité de ceux-ci. A l'aune du concept d'épreuve issu de la « sociologie pragmatique », le parcours du grand brûlé peut être examiné en prêtant une attention particulière au moment initial du parcours post¬brûlure : l'accident. La mise en récit de cette première épreuve est révélatrice des tentatives pour le grand brûlé de maintenir un lien entre un avant et un après l'accident. S'ensuit un continuum d'épreuves intervenant dès le moment où les grands brûlés se présentent physiquement face à autrui dans l'espace public suscitant des réactions de gêne et de malaise. Dans le prolongement des travaux d'Erving Goffman, on peut les concevoir comme des motifs d'« inconfort interactionnel ». Cette mise en évidence de l'inconfort interactionnel montre la nécessité de ne pas se limiter à une sociologie de la brûlure grave qui s'attarderait seulement sur les ajustements des interactions. A partir des travaux d'Axel Honneth sur la reconnaissance, il est possible de lire cette gestion des situations d'interaction dans une autre optique, celle qui, pour le grand brûlé, consiste à se préserver du mépris. Ce travail met l'accent sur des habiletés interactionnelles, des compétences qui fonctionnent comme des ressorts et permettent au grand brûlé de gérer des situations susceptibles de conduire au mépris. En s'appuyant sur des situations d'interaction racontées, deux formes de lutte individuelle, de quête de reconnaissance, peuvent être dégagées : d'une part, la « lutte contre » la trop grande visibilité et contre la prégnance de certains préjugés et, d'autre part, la « lutte pour » faire connaître des aspects invisibles ou moins visibles de la brûlure grave. - This thesis analyzes the "factual" and physical ordeal of a severe burn as experienced by victims of severe facial burns. In a few seconds, an accident provokes a biographical rupture and persons involved need time to integrate their new status. This thesis concentrates on the "reconstruction" modes of the relationship with oneself and with others, and on attempts to find an impossible "normal appearance" in public life. While being attentive to the modalities of interaction, the study uses comprehensive sociology based on observations and interviews. This thesis brings into sociology litde known views of those suffering severe facial burns. These views supplement certain media representations that influence perceptions and visibility of the people involved. Applying the concept of test, a key concept of pragmatic sociology, the progression of a severely burned person can be described by focusing on the initial moment: the accident. The recounting of this first challenge reveals the severely burned person's efforts to link the "before" and "after" the accident. A continuum of challenges follows. These tests occur when the severely burned person physically faces others in a public space and when visible discomfort and embarrassment show, reactions which we consider, following Erving Goffman's works, as situations of "interactional discomfort." Emphasis on interactional discomfort shows the necessity of expanding the sociology of severe burns to more than just adjustments to interactions. Based on Axel Honneth's works, we can read the management of interactions from another point of view, in which the severely burned person tries to avoid contempt. This work emphasizes interactional aptitudes, skills that act like rebounding springs, and allow the severely burned person to manage situations that might lead to contempt. Starting with descriptions of interactions, we have determined two forms of individual struggle that appear to be a search for recognition: on one hand, the "struggle against" too much visibility and against the strength of certain prejudices, and, on the other hand, a "struggle for" making known rtain invisible or less visible aspects of a severe burn.

Inexperienced sonographers can successfully visualize and assess a three-dimensional image of the fetal face using a standardized ultrasound protocol.

Introduction: A standardized three-dimensional ultrasonographic (3DUS) protocol is described that allows fetal face reconstruction. Ability to identify cleft lip with 3DUS using this protocol was assessed by operators with minimal 3DUS experience. Material and Methods: 260 stored volumes of fetal face were analyzed using a standardized protocol by operators with different levels of competence in 3DUS. The outcomes studied were: (1) the performance of post-processing 3D face volumes for the detection of facial clefts; (2) the ability of a resident with minimal 3DUS experience to reconstruct the acquired facial volumes, and (3) the time needed to reconstruct each plane to allow proper diagnosis of a cleft. Results: The three orthogonal planes of the fetal face (axial, sagittal and coronal) were adequately reconstructed with similar performance when acquired by a maternal-fetal medicine specialist or by residents with minimal experience (72 vs. 76%, p = 0.629). The learning curve for manipulation of 3DUS volumes of the fetal face corresponds to 30 cases and is independent of the operator's level of experience. Discussion: The learning curve for the standardized protocol we describe is short, even for inexperienced sonographers. This technique might decrease the length of anatomy ultrasounds and improve the ability to visualize fetal face anomalies.

Face Short-Term Memory-Related Electroencephalographic Patterns can Differentiate Multi- versus Single-Domain Amnestic Mild Cognitive Impairment.

Amnestic mild cognitive impairment (aMCI) is characterized by memory deficits alone (single-domain, sd-aMCI) or associated with other cognitive disabilities (multi-domain, md-aMCI). The present study assessed the patterns of electroencephalographic (EEG) activity during the encoding and retrieval phases of short-term memory in these two aMCI subtypes, to identify potential functional differences according to the neuropsychological profile. Continuous EEG was recorded in 43 aMCI patients, whose 16 sd-aMCI and 27 md-aMCI, and 36 age-matched controls (EC) during delayed match-to-sample tasks for face and letter stimuli. At encoding, attended stimuli elicited parietal alpha (8-12 Hz) power decrease (desynchronization), whereas distracting stimuli were associated with alpha power increase (synchronization) over right central sites. No difference was observed in parietal alpha desynchronization among the three groups. For attended faces, the alpha synchronization underlying suppression of distracting letters was reduced in both aMCI subgroups, but more severely in md-aMCI cases that differed significantly from EC. At retrieval, the early N250r recognition effect was significantly reduced for faces in md-aMCI as compared to both sd-aMCI and EC. The results suggest a differential alteration of working memory cerebral processes for faces in the two aMCI subtypes, face covert recognition processes being specifically altered in md-aMCI.

Visualizing key authenticity: turning your face into your public key

La informació biomètrica s'ha convertit en una tecnologia complementària a la criptografia que permet administrar còmodament les dades criptogràfiques. Són útils dues necessitats importants: en primer lloc, posar aquestes dades sempre a mà i, a més, fent fàcilment identificable el seu legítim propietari. En aquest article es proposa un sistema que integra la signatura biomètrica de reconeixement facial amb un esquema de signatura basat en la identitat, de manera que la cara de l'usuari esdevé la seva clau pública i la ID del sistema. D'aquesta manera, altres usuaris poden verificar els missatges utilitzant fotos del remitent, proporcionant un intercanvi raonable entre la seguretat del sistema i la usabilitat, així com una manera molt més senzilla d'autenticar claus públiques i processos de distribució.

Preferred Spatial Frequencies for Human Face Processing Are Associated with Optimal Class Discrimination in the Machine

Psychophysical studies suggest that humans preferentially use a narrow band of low spatial frequencies for face recognition. Here we asked whether artificial face recognition systems have an improved recognition performance at the same spatial frequencies as humans. To this end, we estimated recognition performance over a large database of face images by computing three discriminability measures: Fisher Linear Discriminant Analysis, Non-Parametric Discriminant Analysis, and Mutual Information. In order to address frequency dependence, discriminabilities were measured as a function of (filtered) image size. All three measures revealed a maximum at the same image sizes, where the spatial frequency content corresponds to the psychophysical found frequencies. Our results therefore support the notion that the critical band of spatial frequencies for face recognition in humans and machines follows from inherent properties of face images, and that the use of these frequencies is associated with optimal face recognition performance.

Beyond the net generation debate: A comparison of digital learners in face-to-face and virtual universities

In the last decade, an important debate has arisen about the characteristics of today"s students due to their intensive experience as users of ICT. The main belief is that frequent use of technologies in everyday life implies that competent users are able to transfer their digital skills to learning activities. However, empirical studies developed in different countries reveal similar results suggesting that the"digital native" label does not provide evidence of a better use of technology to support learning. The debate has to go beyond the characteristics of the new generation and focus on the implications of being a learner in a digitalised world. This paper is based on the hypothesis that the use of technology to support learning is not related to whether a student belongs to the Net Generation, but that it is mainly influenced by the teaching model. The study compares behaviour and preferences towards ICT use in two groups of university students: face-to-face students and online students. A questionnaire was applied to a sample of students from five universities with different characteristics (one offers online education and four offer face-to-face education with LMS teaching support). Findings suggest that although access to and use of ICT is widespread, the influence of teaching methodology is very decisive. For academic purposes, students seem to respond to the requirements of their courses, programmes, and universities. There is a clear relationship between students" perception of usefulness regarding certain ICT resources and their teachers" suggested uses of technologies. The most highly rated technologies correspond with those proposed by teachers. The study shows that the educational model (face-to-face or online) has a stronger influence on students" perception of usefulness regarding ICT support for learning than the fact of being a digital native.