Non-Infectious Complications in B-Lymphopenic Common Variable Immunodeficiency.

BACKGROUND AND OBJECTIVE: Common variable immunodeficiency (CVID) is considered the most symptomatic type of inborn errors of immunity in humans. Along with infectious complications, which have numerous consequences, non-infectious complications are also a major challenge among CVID patients. METHODS: All registered CVID patients in the national database were included in this retrospective cohort study. Patients were divided into two groups based on the presence of B-cell lymphopenia. Demographic characteristics, laboratory findings, non-infectious organ involvements, autoimmunity, and lymphoproliferative diseases were evaluated. RESULTS: Among 387 enrolled patients, 66.4% were diagnosed with non-infectious complications; however, 33.6% had only infectious presentations. Enteropathy, autoimmunity, and lymphoproliferative disorders were reported in 35.1%, 24.3%, and 21.4% of patients, respectively. Some complications, including autoimmunity and hepatosplenomegaly, were reported to be significantly higher among patients with B-cell lymphopenia. Among organ involvement, dermatologic, endocrine and musculoskeletal systems were predominantly affected in CVID patients with B-cell lymphopenia. Among autoimmune manifestations, the frequency of rheumatologic, hematologic, and gastrointestinal autoimmunity was reported to be higher compared to other types of autoimmunity independent from the B cell-lymphopenia. Furthermore, hematological cancers, particularly lymphoma, were slightly introduced as the most common type of malignancy. Meanwhile, the mortality rate was 24.5%, and respiratory failure and malignancies were reported as the most common cause of death in our patients without significant differences between the two groups. CONCLUSION: Considering that some of the non-infectious complications might be associated with B-cell lymphopenia, therefore, regular patient monitoring and follow-up along with proper medications (besides immunoglobulins replacement therapy) are highly recommended to prevent further sequels and increase the patients' quality of life.

Focusing on functional knee parameter determination to develop a better clinical gait analysis protocol.

BACKGROUND: Attempts to improve protocol standards of marker-based clinical gait analysis (CGA) have been one of the main focuses of research to enhance robustness and reliability outcomes since the 1990s. Determining joint centres and axes constitutes an important aspect of those protocols. Although the hip joint is more prominent in such studies, knee joint center (KJC) and axis (KJA) directly affect all outcomes. RESEARCH QUESTION: What recommendations arise from the study of the scientific literature for determining knee joint parameters (KJP) for protocols of CGA? METHODS: A systematic, electronic search was conducted on November 2018 using three databases with the keyword combination ("functional approach" OR "functional method" OR "functional calibration") AND ("hip joint" OR "knee joint" OR "ankle joint") and analyzed by four reviewers. Given the existence of a recent review about the hip joint and the lack of material about the ankle joint, only papers about the knee joint were kept. The references cited in the selected papers were also screened in the final round of the search for these publications. The quality of the selected papers was assessed and aspects regarding accuracy, repeatability, and feasibility were thoroughly considered to allow for a comparison between studies. Technical aspects, such as marker set choice, KJP determination techniques, demographics, and functional movements, were also included. RESULTS: Thirty-one papers were included and on average received a rating of about 75 % according to the quality scale used. The results showed that functional methods are superior or equivalent to predictive methods to estimate the KJA, while a regression method was slightly better for KJC prediction. SIGNIFICANCE: Calibration methods should be applied to CGA whenever feasibility is reached. No study to date has focused on evaluating the in vivo RoM required to obtain reliable and repeatable results and future work should aim in this direction.

[An exceptional association of tuberculosis: clavicular and metacarpal]. / Une association exceptionnelle de tuberculose: claviculaire et métacarpienne.

We report an exceptional association of metacarpal and clavicular tuberculosis in a two-year-old child with SAFA2 sickle cell disease. We emphasize the role of imaging (X-ray and CT scan) in this work. The definitive diagnosis is confirmed by the pathological examination of biopsy samples. This location should be known in endemic tuberculosis areas.

Arthroscanner du genou : à propos de 68 cas colligés à l'hôpital militaire d'Abidjan (HMA)

But: Decrire les donnees epidemiologiques; cliniques et scanographiques des lesions du genou observees a l'arthroscanner dans le service de radiologie de l'Hopital Militaire d'Abidjan Materiel et Methode: Nous avons mene une etude retrospective de novembre 2008 a juillet 2010; soit une periode de 20 mois concernant 68 patients.Resultats: Au plan clinique le genou droit etait le plus lese 54% des cas ; la notion de traumatisme a ete retrouvee dans 60% des cas ; les symptomes cliniques n'etaient pas toujours enonces par les cliniciens. Au plan scanographique les lesions meniscales ont ete retrouvees chez 51% des cas ; les lesions ligamentaires chez 48% des cas; avec 29% d'atteinte du LCA; les lesions cartilagineuses chez 25% et 59% de nos patients etaient au stade d'arthrose.Conclusion: L'arthroscanner a permis de faire le bilan lesionnel cartilagineux; meniscal et meme ligamentaire. Toutefois; l'IRM reste l'examen de reference pour l'etude des derangements intra articulaires du genou du fait de son innocuite et de sa resolution en contraste; mais elle reste encore inaccessible dans la plus part des pays d'Afrique noire

DETECTION OF LACTOBACILLI IN MONTHLY MAIL-IN STOOL SAMPLES FROM 3-18 MONTHS OLD INFANTS AT GENETIC RISK FOR TYPE 1 DIABETES.

The feasibility to detect lactobacilli in mail-in infant stools collected monthly from 3-18 months old children was investigated. The aim was to determine total lactobacilli and Lactobacillus plantarum (L. plantarum) content (ng/g feces) in 50 infants each from Colorado (648 samples), Finland (624 samples) and Sweden (685 samples) who participated in the TEDDY (The Environmental Determinants of Diabetes in the Young) study. Total lactobacilli content varied markedly between 5 and 16,800 ng/g feces in the three clinical sites within and between individuals especially in infants. L.plantarum also varied markedly intra- and inter-individually from <0.5 - 736 ng/g feces. A higher variability of total lactobacilli was found before 10 months of age than after in the three different clinical sites. Sweden had the lowest total lactobacilli content compared to Colorado and Finland while the L.plantarum content was higher in Sweden. Mail-in stool samples from infants should prove useful in analyzing probiotics in childhood.

Modelling the interaction of ankle-foot orthosis and foot by finite element methods to design an optimized sole in steppage gait.

In this study, based on kinematics data in steppage gait, a finite element model of human gait with ankle-foot orthosis (AFO) has been proposed to optimize the role of AFO through minimizing stress in the patients' sole. The required kinetics data for the model were captured through a force plate and then analysed by 3D-DOCTOR and ANSYS software. In the proposed three-dimensional finite element model the transmitted tension in soft tissue and bones during gait was calculated. By changing the thickness and materials of different layers of sole in AFO the tension variations have been assessed. Unlike previous studies, the effect of orthosis on tension generated in bones and muscles has been dynamically and continuously modelled and the contact between AFO and sole has been considered in this model. By using the optimized sole the stress distribution has been changed by +50.38% in the forefoot, +15% in the midfoot and -37.79% in the hindfoot. The tension reduction in the sole can improve the effect of AFO during abnormal gait. It is possible to design each orthosis sole based on the kinetics data of each patient.