Safety and immunogenicity of a trivalent, inactivated, mammalian cell culture-derived influenza vaccine in healthy adults, seniors, and children.

We performed randomized, double-blind, controlled trials to assess the safety and immunogenicity of an inactivated, Madin Darby Canine Kidney (MDCK)-derived cell line produced influenza vaccine in healthy adults (19-50 years), children (3-12 years) and the elderly (> or =65 years). We studied three lots of cell culture-derived vaccine and one lot of licensed egg-derived vaccine in healthy adults (n=462), two lots of cell culture-derived vaccine and one lot of egg-derived vaccine in seniors (n=269), and one lot of each vaccine in children (n=209). Adverse events were collected during the first 3 days post-immunization; serum was collected before and 1 month after immunization. Rates of local and systemic adverse reactions were similar with both vaccines. An injection site adverse event rated at least moderate severity was reported by 21.9% of children who received the egg-derived vaccine and 25.0% of those who received the cell culture-derived vaccine. In healthy adults the proportions were 12.1 and 15.3%, respectively and 6.7 and 6.3%, respectively in seniors. Systemic events of at least moderate severity were 12.4 and 12.5% in children, 19.8 and 13.6% in healthy adults, and 14.1 and 9.7% in seniors; none of these differences were statistically significant. The antibody response against all three viruses was similar between the two vaccines. From 83 to 100% of children, healthy adults and seniors achieved hemagglutination inhibition titers in excess of 40 post-immunization. We conclude that the cell culture-derived vaccine was safe and immunogenic in children, healthy adults and seniors.     

AIDS-associated Kaposi's sarcoma: 22 cases

BACKGROUND: Kaposi's sarcoma is the most common acquired immune deficiency syndrome (AIDS)-associated malignancy. Our aim was to analyse the epidemiological, clinical, therapeutic findings in AIDS patients with Kaposi's sarcoma. METHODS: This was a retrospective chart review of AIDS patients with Kaposi's sarcoma diagnosed between 1991 and 2005. Epidemiological data, the stage of human immunodeficiency virus's (HIV) infection, clinical characteristics of Kaposi's sarcoma, treatment rendered and outcome were collected. The search of HHV8 was not done. RESULTS: Twenty two patients were included. They were 17 men and 5 females (sex-ratio=3.4/ 1) with a mean age of 33.6 years at the diagnosis of HIV infection. The Kaposi's sarcoma appeared after a period varying between 0 and 10 years. The Kaposi's sarcoma uncovered the infection in 5 cases. There were 6 homosexual men. The mean rate of CD4 was 216 21/mm3 at the diagnosis of Kaposi's sarcoma. All patients had skin lesions. Mucocutaneous lesions were isolated in 12 cases and associated with visceral involvement in 10 cases; lung (10 cases), gastrointestinal tract (5 cases), lymphadenopathy (5 cases), liver (4 cases), spleen (2 cases). Antiretroviral therapy was prescribed for 13 patients. Six patients received chemotherapy and 3 others radiotherapy. Outcome was favourable in 4 cases with a partial improvement of the skin lesions in 3 cases and a complete regression in 1 case. Twelve patients died. CONCLUSION: AIDS associated Kaposi's sarcoma is a severe condition because of visceral localisations and the field of immunodeficiency. It requires a precocious diagnosis and collaboration. The identification of HHV8 in the aetiopathogenic mechanism of Kaposi's sarcoma can lead to the development new therapeutic approaches.     

Multifocal tuberculosis revealed by multiple cutaneous gummas in the immunocompetent

Cutaneous tuberculosis is rare. Its occurrence in multifocal tuberculosis (MT) is uncommon and happens frequently in the context of immunosuppression. We report the case of MT with multiple cutaneous gummas and bone and lung involvement that occurred in an apparently immunocompetent patient.     

Association of Fas/Apol gene promoter （-670 A/G） polymorphism in Tunisian patients with IBD

AIM： To detect a possible association between the polymorphism of the （-670 A/G） Fas/Apol gene promoter and susceptibility to Crohn＇s disease （CD） and ulcerative colitis （UC） in the Tunisian population. METHODS： The （-670 A/G） Fas polymorphism was analyzed in 105 patients with CD, 59 patients with UC, and 100 controls using the polymerase chain reaction restriction fragment length polymorphism method. RESULTS： Significantly lower frequencies of the Fas -670 A allele and A/A homozygous individuals were observed in CD and UC patients when compared with controls. Analysis of （-670 A/G） Fas polymorphism with respect to sex in CD and UC showed a significant difference in A/A genotypes between female patients and controls （P corrected = 0.004 ＂in CD patients＂ and P corrected = 0.02 ＂in UC patients＂, respectively）. Analysis also showed a statistically significant association between genotype AA of the （-670 A/G） polymorphism and the ileum localization of the lesions （P corrected = 0.048） and between genotype GG and the colon localization （P corrected = 0.009）. The analysis of IBD patients according to clinical behavior revealed no difference. CONCLUSION： Fas-670 polymorphism was associated with the development of CD and UC in the Tunisian population.     

Idiopathic snapping scapula in a Moroccan patient: A rare cause of shoulder pain

Introduction

The jumped shoulder blade or “snapping scapula” is a rare cause of shoulder pain that entails cracking of the scapula in connection with multiple causes. In 30% of cases no etiology is found.