Succès du traitement par paclitaxel d’une rechute viscérale d’un sarcome de Kaposi après transplantation rénale

We report the observation of a patient who presented with post-transplant Kaposi's sarcoma after a delay of eight months with a dual cutaneous and palatal localisation. The reduction in immunosuppressive treatment and the introduction of Rapamune® allowed good clinical progress initially with regression of the skin lesions. He subsequently presented later a skin relapse with visceral localisation. Chemotherapy was conducted based on weekly paclitaxel infusions allowing partial remission and maintenance of renal graft function with good clinical tolerance.     

Systemic treatment of patients with gastrointestinal stromal tumor: Current status and future opportunities

Imatinib mesylate is considered the standard first-line systemic treatment for patients with advanced gastrointestinal stromal tumor (GIST). Results from recent research have expanded the knowledge of tyrosine kinase inhibitors in management of GIST. In the setting of unresectable and metastatic GIST, long-term follow-up of the B2222 study showed that imatinib 400 and 600 mg/d produced objective responses in 68% of patients and clinical benefit in 84%; it also extended median survival from 19 months in historical controls to 57 months. The MetaGIST analysis in two large phase 3 trials consisting of more than 1600 patients with metastatic and/or unresectable GIST showed that imatinib 800 mg/d compared with the standard 400-mg/d dose conferred a progression-free survival advantage in patients with KIT exon 9 mutations but not in other subpopulations. The higher starting dose does not significantly improve overall survival. The BFR14 trial demonstrated that interrupting imatinib is associated with a high risk of rapid disease progression. For patients with imatinib-intolerant or imatinib-resistant GIST, sunitinib or a variety of investigational agents, including the next-generation kinase inhibitor nilotinib, may be viable options for achieving disease control. In the setting of primary localized GIST, function- sparing surgical resection is the standard treatment approach, but some patients may be at substantial risk of disease recurrence and metastasis depending on tumor size, mitotic count, and possibly other factors. Initial results from ACOSOG Z9001 indicate that adjuvant imatinib for 1 year prolongs recurrence-free survival following surgical resection of larger (at least 3 cm) KIT-expressing GIST. Other ongoing studies are further exploring the role of imatinib in both adjuvant and neoadjuvant therapy. Recent updates to clinical practice guidelines and recommendations now incorporate some of these new findings.     

Mechanisms of vascular dysfunction in the interleukin-10–deficient murine model of preeclampsia indicate nitric oxide dysregulation

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Wing shape of dengue vectors from around the world.

Wing shape is increasingly utilized in species identification and characterization. For dengue vectors Aedes aegypti and Aedes albopictus, it could be used as a complement for ensuring accurate diagnostic of damaged specimens. However, the impact of world migration on wing shape is unknown. Has the spread of these invasive species increased shape variation to the extent of producing interspecific overlapping? To answer this question, the geometric patterns of wing venation in Ae. aegypti and Ae. albopictus were compared between natural populations from the Pacific Islands, North and South America and South East Asia. The geometry of 178 female and 174 male wings were described at 13 anatomical landmarks, and processed according to Procrustes superposition, partial warps and subsequent multivariate analyzes. The variation of shape did not produce significant interspecific overlapping. Regardless of geographic origin, Ae. aegypti was recognized as Ae. aegypti and Ae. albopictus as Ae. albopictus. Some significant geographic differentiation was observed in Colombia for Ae. aegypti and in Thailand for Ae. albopictus. Globally, the morphology of these mosquitoes, for both size and shape, appeared well preserved. Strong canalizing mechanisms could account for the observed patterns of relatively uniform morphology, which could also be attributed to sporadic, recurrent mixing of populations, thwarting phenotypic drift.     

Short-term decreased post transplant lymphoproliferative disorder risk after kidney transplantation using two novel regimens

BackgroundBelatacept is employed alongside calcineurin inhibitor (CNI) therapy to prevent graft rejection in kidney transplant patients who are Epstein-Barr virus (EBV) seropositive. Preliminary data suggested that rates of post-transplant lymphoproliferative disorder (PTLD) were higher in individuals treated with belatacept compared to CNI therapy alone.MethodsThe records of 354 adults who underwent kidney only transplantation from January 2015 through September 2021 at one medical center were evaluated. Patients underwent treatment with either low-doses of mycophenolate, tacrolimus and sirolimus (B⁰, n = 235) or low-doses of mycophenolate, tacrolimus and belatacept (B¹, n = 119). All recipients underwent induction with antithymocyte globulin and a rapid glucocorticosteroid taper. Relevant donor and recipient information were analyzed and endpoints of PTLD were assessed.ResultsThere were no cases of PTLD in either cohort within the study period. Recipients in the belatacept cohort experienced lower estimated glomerular filtration rates at 12 months (B⁰: 67.48 vs. B¹: 59.10, p = 0.0014). Graft failure at 12 (B⁰: 1.28% vs. B¹: 0.84%, p = 1.0) and 24 months (B⁰:2.55% vs. B¹: 0.84%, p = 0.431) were similar. There was no difference in rejection rates at 12 (B⁰: 1.27% vs. B¹: 2.52%, p = 0.408) or 24 months (B⁰: 2.12% vs. B¹: 2.52%, p = 1.000). Both groups had similar rates of malignancy, mortality and CMV/BK viremia.ConclusionNon-belatacept (MMF, tacrolimus and sirolimus) and belatacept-based (MMF, tacrolimus and belatacept) regimens do not appear to pose any increased risk of early onset PTLD. Both cohorts benefited from low rates of rejection, malignancy, mortality and graft failure. Recipients will continue to be monitored as PTLD can manifest as a long-term complication.     

Amniotic fluid peptides predict postnatal kidney survival in developmental kidney disease

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Do children with ASD have difficulty handwriting under time pressure?

BackgroundChildren with autism spectrum disorder (ASD) often experience significant handwriting impairment, however the influence of time pressure on overall performance is unclear. The aim of the current study was to characterise the handwriting profile of children with ASD across both non-speeded and speeded conditions, with particular focus given to spacing difficulties and handwriting errors. A further aim was to explore the relationships between handwriting and both intellectual and motor skills under different task conditions.MethodBoys with ASD (n = 23) and matched controls (n = 20) aged 8–12 years completed a modified version of the speed subtest of the Handwriting Performance Test, which allowed for both an ecologically valid and relatively simple motoric task. Participants wrote a simple phrase (cat and dog) five times in each condition.ResultsNo significant group differences were identified for handwriting errors or spacing between words in either condition, however the ASD group demonstrated greater variability relative to controls, particularly in the speeded condition. Significant negative associations were identified between motor proficiency and handwriting errors in the non-speeded condition.ConclusionsWhile motor processes are shown to have a significant role in overall handwriting proficiency, it appears that motor ability may influence the handwriting process to different degrees, depending on the nature of the task employed. A lack of group differences with respect to handwriting errors and spacing between words may suggest that children with ASD have the ability to compensate for underlying motor impairment when completing a well-practiced writing task.