Cellulitis Revealing a Cryptococcosis-Related Immune Reconstitution Inflammatory Syndrome in a Renal Allograft Recipient

Immune reconstitution inflammatory syndrome (IRIS) has rarely been described in the course of disseminated cryptococcosis in solid organ transplant recipients. We report here the case of a renal transplant recipient who developed severe cellulitis in the context of Cryptococcus neoformans-associated IRIS while undergoing reduction of his immunosuppressive therapy. IRIS appeared concomitantly with a dramatic increase of blood CD4+ T cells (94-460/mm(3)) and required the administration of a short-term steroid therapy to resolve.     

Bioinformatics: The philosophical and ethical issues at stake in a new modality of research practices

This article deals with the integration of ethical reflection into the research practices of the project at the Lille Nord-Pas-de-Calais genopole: “Multifactorial genetic pathologies and therapeutic innovations”. The general hypothesis of this text is that changes in research practices in biology (mainly through the use of bioinformatics) imply changes in medical practices, which require critical reflection. This hypothesis could be broken down into three sub-hypotheses: (1) Research in biology is undergoing a complete transformation; (2) Research in biology is a cultural practice, which cannot be reduced to a simple cognitive action; (3) Research in biology is a techno-scientific practice. As for the method, the aim of our research at the Medical Ethics Centre is to elucidate the philosophical and ethical range of biomedical practices. This work entails a double task for reflection. On the one hand, from the revelation of ethical tensions present in these practices, we have to think about what is at stake in these practices, and more broadly in society. On the other hand, we have to analyse the conditions enabling the actors to assume the significance of ethical reflection in their practices. The method set up to undertake this double task could be qualified as “narrative hermeneutics”, as its aim is to attempt to interpret the stakes in practices from proximity with these practices and from what their actors have to say about them. The text then goes on to analyse more specifically the emergence and place of bioinformatics in present-day biomedical research.     

Differentiated rabbit prostatic stromal cells in primary culture display functional alpha1A-adrenoceptors

AIMS: BPH is characterized by uncontrolled proliferation and increased contractility of prostatic smooth muscle cells. The activation of alpha1-adrenoceptors (alpha1-AR) seems involved in the latter event, but the lack of in vitro models expressing these receptors has hampered a more specific characterization of their role. In order to do so, we attempted to develop a new model of rabbit cultured prostatic stromal cells (PSC) in a non-proliferative and differentiated state. METHODS: The expression of cytoskeletal and stromal markers was confirmed by immunohistochemistry on primary cultured PSC. Alpha1-AR subtype expression was assessed by RT-PCR, while receptor coupling to the ERK1/ERK2 and calcium pathways was studied by Western Blot and Fura-2 calcium imaging, respectively. RESULTS: Cells grown under non-proliferative conditions displayed a differentiated phenotype, with expression of contractile cytoskeletal and stromal proteins. Furthermore, the alpha1A-AR was shown to activate ERK1/ERK2 as well as calcium signaling. CONCLUSION: These results emphasize the interest of this model for the characterization of PSC adrenergic regulation, in particular through the little-known alpha1A-AR.     

Antimicrobial activities of the methanol extract and compounds from the twigs of Dorstenia mannii (Moraceae)

Background

Ribosome-inactivating proteins (RIP) have been studied in the search for toxins that could be used as immunotoxins for cancer treatment. Pulchellin, a type 2 RIP, is suggested to induce immune responses that have a role in controlling cancer.

Methods

The percentage of dendritic cells and CD4⁺ and CD8⁺ T cells in the spleen (flow cytometry), cytokines?? release by PECs and splenocytes (ELISA) and nitric oxide production by PECs (Griess assay) were determined from tumor-bearing mice injected intratumorally with 0.1?ml of pulchellin at 0.75???g/kg of body weight. Statistical analysis was performed by one-way ANOVA with Tukey??s post hoc test.

Results

Pulchellin-treated mice showed significant immune system activation, characterized by increased release of IFN-?? and Th2 cytokines (IL-4 and IL-10), while IL-6 and TGF-?? levels were decreased. There was also an increase in macrophage??s activation, as denoted by the higher percentage of macrophages expressing adhesion and costimulatory molecules (CD54 and CD80, respectively).

Conclusions

Our results suggest that pulchellin is promising as an adjuvant in breast cancer treatment.     

Face rehabilitation for post-burn deformities

Severe post-burn sequelae of the face can result from deep initial burns or inappropriate (initial or secondary) treatment. They still remain a surgical challenge, leading to both aesthetic and functional diseases. The acute treatment is preventive, and usually consists in early split thickness skin grafts from the scalp, while full thickness skin grafts and local flaps are employed for the sequels. Our surgical treatment consists in scar replacement using expanded supraclavicular skin. Depending on the location of the scars and depending on available skin, surgical procedure can use expanded full thickness skin graft or expanded advancement flaps. Some “aesthetic” procedures like lipofilling, rhinoplasty or botulinum toxin can be performed in order to improve the final aspect. Good aesthetic and functional results are usually obtained if fundamental rules are respected: preservation of aesthetic units of the face, good management of skin availability. In any case, whatever techniques are employed, numerous surgical procedures and months of rehabilitation are necessary to achieve good cosmetic and functional results.     

Uso de fármacos inmunomoduladores en una consulta de uveítis

ObjectiveThe treatment of noninfectious uveitis includes steroids and immunomodulatory drugs, the use of which has increased in the last few years, and the options have been enriched with the development of new treatments. However, clear therapeutic guidelines and protocols have not been developed. The purpose is to analyze the response to the drugs used and the characteristics of the patients treated at a multidisciplinary uveitis clinic.Material and methodsObservational and retrospective study of the patients attended to from January 2012 to December 2015. Infectious, posttraumatic and postoperative uveitis, as well as masquerade syndrome, were excluded.ResultsTwo hundred six patients were included. Overall, 58.80% had uveitis without association of systemic disease, mostly idiopathic uveitis, and 35.65% had uveitis with systemic involvement, mainly related to spondyloarthritis. Uveitis without systemic association and anterior uveitis achieved disease control with local treatment more frequently than others (p = .002 and p < .001, respectively). In all, 49.76% of the patients required systemic treatment. Among those treated with immunomodulators, 53.26% needed a second drug and 31.52% needed a third drug. Women required immunomodulators more often than men (P = .042). Methotrexate was the most widely used immunomodulator. Posterior uveitis responded less favorably to the second immunomodulator than anterior uveitis (p = .006).ConclusionsAlmost half of the patients needed an immunomodulatory drug and some of them required successive drug changes. Intermediate uveitis was the most treatment-refractory uveitis.