Prevalence and Effect of Genetic Risk of Thromboembolic Disease in Inflammatory Bowel Disease

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Modulation of Immune Cell Subsets by Hepatitis C Virus and Antiviral Therapy in Early Virological Response HCV Genotype 4-Infected Patients with Compensated Liver Disease

BackgroundResolution of chronic hepatitis C virus (HCV) infection requires a complicated interaction between immune cell subsets. The effect of antiviral therapy on immune cell subsets remains to be defined. This study aimed to investigate the absolute count of certain immune cell subsets during therapy with pegylated interferon-α and ribavirin (PegIFN/RBV).Materials and MethodsSixty HCV genotype 4-infected patients with compensated liver disease were treated with PegIFN/RBV therapy for 52 weeks. Efficacy was measured by studying the early virological response (EVR) at post-therapy week 12. Absolute counts of mature T cells, T helper cells, T cytotoxic cells, activated T cells, natural killer cells, natural killer/T (NKT) cells, B cells, and T regulatory cells (Treg), and the ratio of T helper to T cytotoxic cells were longitudinally analyzed by flow cytometry throughout the treatment and follow-up course.ResultsOf the 60 genotype 4-infected subjects, 39 (65%) had EVR and 21 (35%) were non-EVR patients. In the first part of this study, there were significantly lower mean absolute count values of mature T, T cytotoxic, B, and NKT cells. Also, we detected statistically significantly lower mean values for the percentages of T cytotoxic, NKT, Treg, and activated T cells of HCV-infected patients at baseline values when compared with healthy subjects. After the initiation of PegIFN/RBV therapy, frequencies of T helper cells, activated T cells, Treg cells, B cells, and T helper:T cytotoxic ratio were found to be significantly lower in EVR patients than in non-EVR patients (p < 0.05). In contrast, frequencies of T cytotoxic and NKT cells were significantly increased in EVR patients when compared to non-EVR patients (p < 0.05).ConclusionThese results suggest a pattern of higher levels of T cytotoxic and NKT cells, and lower levels of T helper, activated T, Treg, and B cell populations in patients who respond favorably to PegIFN/RBV therapy.     

A standardized protocol to achieve normoglycaemia during labour and delivery in women with type 1 diabetes

AIM: To evaluate a standardized protocol for maintaining near-normoglycaemia during labour and delivery in women with type 1 diabetes. METHODS: Over a nine-year period (1997-2005), 229 pregnancies in 174 women with type 1 diabetes were delivered at one centre. The same regimen was used for the induction of labour (group 1) and in women admitted in spontaneous labour (group 2): 10% dextrose (80ml/h) intravenous was given along with short-acting insulin, starting at 1IU/h intravenous via an infusion pump. Capillary blood glucose (CBG) was determined hourly, and the insulin infusion rate was modified accordingly. RESULTS: Labour was induced in 85 cases (37%) and spontaneous in 23 cases (10%), and an elective C-section was performed in 121 cases (53%). Maternal glycaemia during labour was 6.1+/-1.6 (range: 3.9-9.2)mmol/l in group 1, and 6.9+/-2.0 (range: 4.7-12.0)mmol/l in group 2. Maternal glycaemia at delivery was 5.8+/-1.5 (range: 3.4-9.4) and 6.3+/-1.9 (range: 4.1-11.4)mmol/l in groups 1 and 2, respectively. Women who underwent an elective C-section were not included in the standardized protocol and had higher glycaemia at delivery 7.1+/-2.0 (range: 2.7-13.5)mmol/l. Neonatal hypoglycaemia occurred in 30 infants (13%), and was only associated with preterm delivery. CONCLUSION: Using a standardized simple protocol during labour, maternal glycaemia was maintained within a near-normal range in 80-85% of cases.     

A rare case of penile epidermoid carcinoma

Penile neoplasms are rare. The main goal of our case report is to demonstrate the important role of imaging in local and regional cancer extension assessment, to guide the treatment plan. We report a case of penile epidermoid carcinoma in a 54 year old uncircumcised man, with a history of chronic smoking, presenting with a mass in the base of the penis.     

Retroperitoneal desmoid tumor in a patient with familial adenomatous polyposis: A case report

Desmoid tumors are benign fibroblastic neoplasms, with locally invasive features and a tendency of recurrence. They are considered an aggressive non-metastatic fibromatosis. The retroperitoneal location is extremely rare. Their exact mechanism of occurrence is still controversial, but could be related to a genetic predisposition, hormonal factors or traumatic factors, including surgery. This entity faces management difficulties due to its rarity, the variable circumstances of its discovery, and the non-specific clinical manifestations. Their sensitivity to chemotherapy and radiotherapy is limited and surgery remains the only curative treatment in symptomatic cases, however observational waiting could consist the most appropriate management in selected asymptomatic patients, moreover it could avoid unnecessary morbidity from surgery or radiotherapy, which makes the management of this condition a multidisciplinary decision and should be adapted to fit the patients individually. We report a case of a retroperitoneal desmoid tumor in a 31-year-old woman with a history of familial adenomatous polyposis, through which we will discuss this extremely rare neoplastic entity.     

Reversible splenial lesion syndrome (RESLES): Two patients as study cases

Reversible splenial injury syndrome (RESLES) is a rare clinicoradiological entity that defines a reversible lesion in the splenium of the callosum in magnetic resonance imaging.RESLES may be of infectious iatrogenic or metabolic origin. We report 2 cases of drug induced RESLES in our training.The presence of an isolated lesion of the corpus callosum in a context of polymedication by psychotropic drugs and the regression in less than 4 weeks suggests a toxic origin, in particular medicinal.The pathophysiology of these reversibles lesions of the splenium of callosum is not very clear, most often it is a phenomenon of vasogenic edema that is evoked, the clinical symptoms are very varied and nonspecific, and the prognosis is generally good in the absence of underlying disorder.