Monogenic diabetes in adults: A multi-ancestry study reveals strong disparities in diagnosis rates and clinical presentation.

AIM: Identification of monogenic diabetes (MgD) conveys benefits for patients' care. Algorithms for selecting the patients to be genetically tested have been established in EuroCaucasians, but not in non-EuroCaucasian individuals. We assessed the diagnosis rate, the phenotype of MgD, and the relevance of selection criteria, according to ancestry in patients referred for a suspected MgD. METHODS: Seven genes (GCK, HNF1A, HNF4A, HNF1B, ABCC8, KCNJ11, INS) were analyzed in 1975 adult probands (42% non-EuroCaucasians), selected on the absence of diabetes autoantibodies and ≥2 of the following criteria: age ≤40 years and body mass index <30 kg/m2 at diagnosis, and a family history of diabetes in ≥2 generations. RESULTS: Pathogenic/likely pathogenic variants were identified in 6.2% of non-EuroCaucasian and 23.6% of EuroCaucasian patients (OR 0.21, [0.16-0.29]). Diagnosis rate was low in all non-EuroCaucasian subgroups (4.1-11.8%). Common causes of MgD (GCK, HNF1A, HNF4A), but not rare causes, were less frequent in non-EuroCaucasians than in EuroCaucasians (4.1%, vs. 21.1%, OR 0.16 [0.11-0.23]). Using ethnicity-specific body mass index cutoffs increased the diagnosis rate in several non-EuroCaucasian subgroups. CONCLUSION: The diagnosis rate of MgD is low in non-EuroCaucasian patients, but may be improved by tailoring selection criteria according to patients'ancestry.

Fatal outcome after reactivation of inherited chromosomally integrated HHV-6A (iciHHV-6A) transmitted through liver transplantation.

HHV-6A and HHV-6B are found as inherited and chromosomally integrated forms (iciHHV-6A and -6B) into all germinal and somatic cells and vertically transmitted in a Mendelian manner in about 1% of the population. They were occasionally shown to be horizontally transmitted through hematopoietic stem cell transplantation. Here, we present a clinical case of horizontal transmission of iciHHV-6A from donor to recipient through liver transplantation. Molecular analysis performed on three viral genes (7.2 kb) in the recipient and donor samples supports transmission of iciHHV-6A from the graft. Transmission was followed by reactivation, with high viral loads in several compartments. The infection was uncontrollable, leading to severe disease and death, despite antiviral treatments and the absence of resistance mutations. This case highlights the fact that physicians should be aware of the possible horizontal transmission of iciHHV-6 and its consequences in case of reactivation in immunocompromised patients.

Unravelling redox processes of Li7MnN4 upon electrochemical Li extraction-insertion using operando XAS.

A large data set of XAS (X-ray Absorption Spectroscopy) Manganese K-edge spectra has been collected operando and studied upon the electrochemical oxidation of the promising Li-ion battery anode material Li7MnN4. Using chemometric tools such as PCA (Principal Component Analysis) and MCR-ALS (Multivariate Curve resolution - Alternating Least Squares), three independent environment spectra were insulated. Based on the faradaic yield and well-chosen comparison of absorption spectrum energies within the frame of the coordination charge model, these environments were ascribed to unusual oxidation states allowed by nitride chemistry at a low potential (∼1.2 V vs. Li+/Li), i.e. Mn5+ (3d2), Mn6+ (3d1) and Mn7+ (3d0). Also, their relative amounts are discussed with regard to the long-range structural variation which can be simply described by two successive biphasic domains followed by a solid-solution behaviour. Gathering this long-range and local structure information provides a complete picture of the redox mechanisms occurring in Li7MnN4.

Diagnosis of community-acquired acute respiratory illness: From conventional microbiological methods to molecular detection (multiplex).

Investigations of the etiologic agents of community-acquired acute respiratory illness may lead to better treatment decisions and patient outcomes. In a routine care setting, we assessed the diagnostic performance of a multiplex PCR assay with respect to conventional microbiological methods, in a continuous series of adult cases of community-acquired acute respiratory illness. We enrolled 279 adult patients hospitalised for community-acquired acute respiratory illness at Tours University Hospital during the winter of 2011-2012. Respiratory samples (mostly nasopharyngeal aspirates) were studied prospectively by indirect immunofluorescence assay and multiplex PCR, that enable detection of 8 viruses and 21 respiratory pathogens respectively. In total, 255 of the 279 (91.4%) samples had interpretable results by both methods. At least one respiratory pathogen was detected by multiplex PCR in 171 specimens (65%). Overall, 130 (76%) of the 171 positive samples were positive for only one respiratory pathogen, 37 (22%) samples were positive for two pathogens and four (2%) were positive for three pathogens. With indirect immunofluorescence assay, a respiratory virus was detected in 27 of the 255 (11%) specimens. Indirect immunofluorescence assay detected some of the influenza virus A (15/51, 29%) infections identified by multiplex PCR and some (7/15, 47%) human metapneumovirus and (5/12, 42%) respiratory syncytial virus infections, but it did not detect all the adenovirus infections. Thus, access to multiplex molecular assays improves the diagnostic spectrum and accuracy over conventional methods, increasing the frequency of identification of the respiratory pathogens involved in community-acquired acute respiratory illness.

Life-threatening Escherichia coli cellulitis in patients with haematological malignancies.

Cellulitis due to Escherichia coli is rare and usually secondary to a cutaneous portal of entry. Skin and soft tissue infections (SSTI) secondary to E. coli bacteraemia have been reported exclusively in immunodeficient patients. Here, we report two cases of serious cellulitis secondary to E. coli bacteraemia in patients with haematological malignancies. Both isolated strains belonged to phylogenetic group B2 and harboured some of the main virulence factor genes commonly found in extra-intestinal pathogenic E. coli (ExPEC), including neuC, iro and fimH. Cellulitis due to E. coli seems to be linked to the immunocompromised status of patients rather than to a highly virulent clone. Nevertheless, some of the virulence factors appear to be important because both isolates belong to phylogenetic group B2. This aetiology should be considered in SSTI in patients with haematological malignancies.

Carboplatin and oxaliplatin decomposition in chloride medium, monitored by XAS.

The stability of carboplatin and oxaliplatin aqueous solutions has been studied under different chloride ions concentration and pH conditions. For both compounds, we demonstrate the chloration of the platinum first coordination shell.

Short stereoselective route to gamma-CF3 allylic alcohols: rearrangements with creation of quaternary CF3-substituted carbons

A concise preparation of tetrasubstituted hindered functionalized CF3-olefins 2-7 from corresponding enol ether 3 is described. Geometrically pure gamma-CF3, gamma-alkyl allylic alcohols thus prepared could undergo Claisen-type rearrangements and provide, in good yields, carboxylic esters and amides containing a beta- quaternary CF3-substituted carbon.

[Reading and speaking]. / Lecture et parole.

Reading is an activity that refers to the universe of language and speech and because of this, it cannot be grasped without the existence of a speaking subject. Children must get their share of fairy tales and stories in order to live in the warmth of words and light of literature.

The kinetics of intestinal calcium absorption in the rat: an analytical and model building study.

The experimental data obtained from in vivo single pass perfusion of duodenal, jejunal, and ileal intestinal segments of 33- and 50-day-old rats have been used to test a series of models for calcium absorption. Each model was checked for the statistical validity and goodness-of-fit with the experimental data. The model adopted for the duodenum and jejunum had two major components, one saturable and the other nonsaturable, and a minor secretory component. This model was not applicable to ileal calcium absorption. Here the secretory component appeared to be much more important, and the absorption parameters varied in such a manner as to suggest that this intestinal segment was capable of short term autoregulation of dietary calcium absorption.

Effect of beta adrenergic agonists and beta blocking agents on hemopoiesis in human bone marrow.

The effect of propranolol (non specific blocking agent), acebutolol (beta 1 blocking agent), butoxamine (beta 2 blocking agent) and several beta adrenergic agonists was studied on 3H-thymidine (3H-TdR) incorporation and granulo-monocyte colony formation in agar by human bone marrow. Only butoxamine and propranolol decreased 3H-TdR incorporation by total normal bone marrow cells at concentrations above 10(-6) M for butoxamine and 10(-5) M for propranolol. Autoradiography showed that inhibition of 3H-TdR incorporation by butoxamine was slightly more pronounced on neutrophil precursors than on red cell precursors (neutrophil series LI..53 and erythroblasts .67 compared to control bone marrow cells at 10(-5) M concentration). The development of granulo-monocyte colonies in agar culture was delayed by preincubation with butoxamine at concentrations above 5 X 10(-6) M. Hydroxyurea suicide showed that this was due to a decrease in the number of CFU-C in S phase. beta 2 blocking agents are able to decrease the number of normal hematopoietic cells entering S phase. This effect is seen on both neutrophil and erythroblastic precursors and on granulo-monocyte progenitors. It could be used as a means of protecting bone marrow cells during cancer intensive chemotherapy.

[The binding of iron to normal human erythrocyte membranes and its intracellular penetration as a function of different glucides]. / Etude de la fixation du fer sur la membrane de l'hématie humaine normale et de sa pénétration intracellulaire en fonction de différents glucides

In vivo intestinal absorption of iron in rat is greatly enhanced by Lactose and D-Xylose. Both sugars are also able to increase the amount of iron bound to the red cell membrane in the animal. Similar effects have been noted when using human normal red cells. Lactose of D-Xylose are able to convert into an active transport curve the linear diffusion curve which is noted when iron is used without any ligand. It is possible to quantify the effect of both sugars on the flux of iron towards the red cell membrane.