Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study.

BACKGROUND: Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach. OBJECTIVE: To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach. METHODS: Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed. RESULTS: Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers. CONCLUSIONS: In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.

[What is the current state of the artificial pancreas in diabetes care?] / Wo steht das künstliche Pankreas in der Diabetestherapie?

The artificial pancreas (also referred to as closed-loop system) brings us one step closer to the decade-long dream of automated insulin delivery. The closed-loop system directs subcutaneous insulin delivery corresponding to the glucose concentration using a control algorithm. Evidence shows that closed-loop systems substantially improve glucose control and quality of life; however, fully automated closed-loop systems have not yet been accomplished. Active input from patients is required for mealtime insulin dosing and corrections. This article provides an overview on the current state of development of the artificial pancreas in the treatment of diabetes.

Gene transcript accumulation and in situ mRNA hybridization of two putative glutamate dehydrogenase genes in etiolated Glycine max seedlings.

Glutamate dehydrogenase (EC 1.4.1.2) is a multimeric enzyme that catalyzes the reversible amination of α-ketoglutarate to form glutamate. We characterized cDNA clones of two Glycine max sequences, GmGDH1 and GmGDH2, that code for putative α- and ß-subunits, respectively, of the NADH dependent enzyme. Temporal and spatial gene transcript accumulation studies using semiquantitative RT-PCR and in situ hybridization have shown an overlapping gene transcript accumulation pattern with differences in relative gene transcript accumulation in the organs examined. Detection of NADH-dependent glutamate dehydrogenase activity in situ using a histochemical method showed concordance with the spatial gene transcript accumulation patterns. Our findings suggest that although the two gene transcripts are co-localized in roots of etiolated soybean seedlings, the ratio of the two subunits of the active holoenzyme may vary among tissues.

[Esophageal foreign body revealed by respiratory distress]. / Détresse respiratoire révélant un corps étranger œsophagien méconnu.

Ingestion of a foreign body is usually accidental in children. Respiratory symptoms, often favored by the persistence of the foreign body in the esophagus, can be revealing, but rarely respiratory distress as a method telling. We report a case of unrecognized esophageal foreign body revealed by respiratory distress.

Evolution of a fatal septic arthritis caused by a Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus strain.

We report the observation of a septic arthritis of the knee complicated within first 36 hours by multiorgan failure including acute respiratory distress syndrome (ARDS), heart failure, acute renal failure and disseminated intravascular coagulation (DIC). A diagnosis of staphylococcal arthritis was suspected confirmed by direct examination, and culture showed a Staphylococcus aureus sensitive to methicillin. The sample sent to the National Reference Centre for Staphylococci (Lyon, France) for genetic analysis confirmed the isolate positive for the PVL gene expression. The fulminating evolution of a septic S. aureus arthritis in an otherwise healthy man should probably evoke the possibility of LPV strain. Anti-PLV antibiotics with anti-staphylococcal activity, such as clindamycin and linezolid should be started without waiting for typing of the S. aureus strain.

Facteurs predictifs de gravite des cellulites cervico-faciales diffuses d'origine dentaire : a propos de 78 cas

Introduction : La cellulite cervico-faciale est une dermohypodermite qui prend origine au niveau de la graisse hypodermique a partir d'effraction d'un foyer dentaire. Sa gravite reside d'une part dans sa forme diffuse avec risque d'obstruction des voies aeriennes et de mediastinite et d'autre part dans sa forme necrosante avec risque de fasciite necrosante et de gangrene gazeuse. en l'absence de prise en charge multidisciplinaire et urgente; l'evolution de ces formes grave se fera vers le sepsis; le choc septique et le Syndrome de defaillance multi viscerales. L'objectif est de retrouver des facteurs predictifs d'extension allant de l'atteinte des voies aeriennes superieures a l'infiltration mediastinale; ainsi que des facteurs predictifs du type de cellulite (phlegmoneuse ou necrotique). Patients et methode : etude retrospective faite sur une periode de 7ans qui a permis d'exploiter 78 dossiers de cellulites cervico-faciales diffuses (CCFD) colligees au service d'OrL et chirurgie maxillo-faciale du CHU de rabat; l'atteinte des voies aeriennes(VaS) l'atteinte mediastinale et le type de cellulite ont ete retenu sur la tomodensitometrie. afin de degager les elements predictifs de gravite statistiquement significatifs; l'evaluation a porte sur l'analyse des elements epidemiologiques; cliniques; par acliniques et evolutifs en comparant respectivement les groupes de CCFD avec et sans atteinte des voies aeriennes(VaS); avec et sans atteinte mediastinales; et en cas de formes necrosantes versus cellulites phlegmoneuses. L'analyse statistique a ete faite par le logiciel spss version 13.01 et les comparaisons ont ete realisees en utilisant les tests khi 2 et le test exact de Fisher pour les variables qualitatives; le test student et anOVa pour les variables quantitatives. Resultats : Cette serie comporte 44 hommes et 34 femmes; L'age moyen est 32 ans. Les facteurs favorisants significatifs sont; Le mauvais etat buccodentaire et l'ethylotabagisme; alors que les aInS et Le diabete ne sont pas significatifs. Le diagnostic est clinique; et la tomodensitometrie permet l'etude de l'extension; le type; et de suivre l'evolution sous traitement. Les signes cliniques significatifs sont; l'alteration de l'etat general; le sepsis; la dyspnee; et les crepitations sous cutanees. Tous les malades ont ete hospitalises; dont 15 en reanimation; avec signification statistique pour le sepsis; l'atteinte mediastinale; et la cellulite necrosante ou gangreneuse. Le drainage chirurgical (44;9) avec signification pour mediastinites. L'evolution etait favorable chez 75 patients ;3 deces par choc septique Conclusion : Cette etude a montree comme decrit dans la litterature que la CCFD predomine chez le sujet jeune de sexe masculin; que la mauvaise hygiene bucco-dentaire intervient dans la genese de la cellulite phlegmoneuse avec infiltration des VaS et que l'ethylotabagisme a un effet dans les formes graves cervico-mediastinales et necrosantes .la clinique a permit le diagnostic mais elle a sous estimee l'atteinte des VaS et mediastinale et c'est la tomodensitometrie qui permit de preciser l'extension et le type de cellulite. L'antibiotherapie etait comparable a la litterature; le drainage chirurgical des CCFD a ete realise sous anesthesie generale avec intubation classique ou sous fibroscope; La tracheotomie n'est pas recommandee en premiere intention que lorsqu'elle etait inevitable. Le recours a la chirurgie en urgence etait pour les memes imperatifs que la litterature dans les formes necrotiques; dans l'atteinte mediastinale; et en cas de sepsis

Cloning and characterization of Lotus japonicus formate dehydrogenase: a possible correlation with hypoxia.

Formate dehydrogenases (FDHs, EC 1.2.1.2) comprise a group of enzymes found in both prokaryotes and eukaryotes that catalyse the oxidation of formate to CO(2). FDH1 from the model legume Lotus japonicus (LjFDH1) was cloned and expressed in E. coli BL21(DE3) as soluble active protein. The enzyme was purified using affinity chromatography on Cibacron blue 3GA-Sepharose. The enzymatic properties of the recombinant enzyme were investigated and the kinetic parameters (K(m), k(cat)) for a number of substrates were determined. Molecular modelling studies were also employed to create a model of LjFDH1, based on the known structure of the Pseudomonas sp. 101 enzyme. The molecular model was used to help interpret biochemical data concerning substrate specificity and catalytic mechanism of the enzyme. The temporal expression pattern of LjFDH1 gene was studied by real-time RT-PCR in various plant organs and during the development of nitrogen-fixing nodules. Furthermore, the spatial transcript accumulation during nodule development and in young seedpods was determined by in situ RNA-RNA hybridization. These results considered together indicate a possible role of formate oxidation by LjFDH1 in plant tissues characterized by relative hypoxia.

Lotus japonicus contains two distinct ENOD40 genes that are expressed in symbiotic, nonsymbiotic, and embryonic tissues.

ENOD40, an early nodulin gene, has been postulated to play a significant role in legume root nodule ontogenesis. We have isolated two distinct ENOD40 genes from Lotus japonicus. The transcribed regions of the two ENOD40 genes share 65% homology, while the two promoters showed no significant homology. Both transcripts encode a putative dodecapeptide similar to that identified in other legumes forming determinate nodules. Both ENOD40 genes are coordinately expressed following inoculation of roots with Mesorhizobium loti or treatment with purified Nod factors. In the former case, mRNA accumulation could be detected up to 10 days following inoculation while in the latter case the accumulation was transient. High levels of both ENOD40 gene transcripts were found in nonsymbiotic tissues such as stems, fully developed flowers, green seed pods, and hypocotyls. A relatively lower level of both transcripts was observed in leaves, roots, and cotyledons. In situ hybridization studies revealed that, in mature nodules, transcripts of both ENOD40 genes accumulate in the nodule vascular system; additionally, in young seed pods strong signal is observed in the ovule, particularly in the phloem and epithelium, as well as in globular stage embryos.

[Anorectal tuberculosis disclosed by hemorrhoidal thrombosis]. / Tuberculose ano-rectale révelée par une thrombose hemorroïdaire.

The authors report on a case of anorectal tuberculosis. Revealed by an hemorroïdal thrombosis with febrile symptoma and purulent discharge, its macroscopic aspect was the one of anal mucous membrane ulceration, irregular with elevated border. The diagnosis was confirmed by anatomopathologic exam. The course was favourable under specific treatment. Etiologic investigation did not show any other localisation. Then, present aspects of anorectal tuberculosis are discussed, as well as possible relationships with hemorroïdal disease and its complications, particularly the fissural ones.

[Thrombosis of the superior vena cava in Behcet's disease. Apropos of a case associated with chylothorax]. / Les thromboses de la veine cave supérieure au cours de la maladie de Behcet. A propos d'un cas associé à un chylothorax.

The authors report a case of superior vena cava thrombosis associated to a chylothorax during Behcet's disease. This thrombosis was revealed during an evolutive phase by dyspnea and a superior vena cava syndrome. Its course was favourable under a medical treatment associating: pleural drainage, parenteral feeding, corticotherapy and heparin therapy. Then the authors review the bibliography and recall the frequency, pathogenesis, clinic and treatment of this unusual complication of the Touraine's aphthosis. Such a complication appears paradoxically to present a favourable course.