Síndrome Paraneoplásico: Dermatomiositis secundaria a carcinoma de vesícula biliar: Reporte de un caso / Paraneoplastic Syndrome. Dermatomyositis secondary to gallbladder carcinoma: A case report

RESUMEN La dermatomiositis paraneoplásica, y en particular vinculada a carcinoma de vesícula biliar es una entidad infrecuente, con menos de diez casos reportados a nivel mundial. Presentamos un paciente de 74 años con manifestaciones clínicas y dermatológicas asociadas a dermatomiositis, lo que impulsó a realizar estudios más específicos, los cuales permitieron diagnosticar finalmente un carcinoma de vesícula biliar. Haremos un repaso de esta patología en relación con el caso presentado, destacando la importancia del examen dermatológico completo como primer eslabón en el diagnóstico de neoplasias de órganos internos.

ABSTRACT Paraneoplastic dermatomyositis, particularly associated with gallbladder carcinoma, is an infrequent entity, with less than 10 cases reported worldwide. We present a 74-year-old patient with clinical and dermatological manifestations associated with dermatomyositis, which prompted more specific studies, to finally find gallbladder carcinoma. We will review this pathology in relation to the case presented, highlighting the importance of the complete dermatological examination as the first link in the diagnosis of neoplasms of internal organs.

3D printing of lignin: Challenges, opportunities and roads onward.

As the second most abundant biopolymer on earth, and as a resource recently becoming more available in separated and purified form on an industrial scale due to the development of new isolation technologies, lignin has a key role to play in transitioning our material industry towards sustainability. Additive manufacturing (AM), the most efficient-material processing technology to date, has likewise made great strides to promote sustainable industrial solutions to our needs in engineered products. Bringing lignin research to AM has prompted the emergence of the nascent "lignin 3D printing" field. This review presents the recent state of art of this promising field and highlights its challenges and opportunities. Following a review of the industrial availability, molecular attributes, and associated properties of technical lignins, we review R&D efforts at implementing lignin systems in extrusion-based and stereolithography (SLA) printing technologies. Doing so underlines the adage of lignin research that "all lignins are not created equal," and stresses the opportunity nested in this chemical diversity created mostly by differences in isolation conditions to molecularly select and tune the attributes of technical lignin systems towards desirable properties, be it by modification or polymer blending. Considering the AM design process in its entirety, we finally propose onward routes to bring the full potential to this emerging field. We hope that this review can help promote the unique value and overdue industrial role of lignin in sustainable engineered materials and products.

Inefficacy of Kinesio-Taping(®) on early postoperative pain after ACL reconstruction: Prospective comparative study.

INTRODUCTION: Kinesio-Taping(®) (K-Tape) is used in sports traumatology with the aim of reducing pain and improving blood and lymph circulation. The main objective of the present study was to assess the efficacy of K-Tape on early postoperative pain after anterior cruciate ligament (ACL) reconstruction. The study hypothesis was that K-Tape significantly decreases pain. METHOD: A prospective non-randomized comparative study was conducted in 2013-2014 and included all patients who underwent primary ACL reconstruction by hamstring graft. Analgesia was standardized. Two groups, "K-Tape" and "controls", were formed according to the days on which the study physiotherapist was present. The K-Tape compression/decompression assembly was applied immediately postoperatively and maintained for 3days. Patients filled out online questionnaires. The main assessment criterion was mean postoperative pain (D0-D3) on a 0-to-10 scale. Secondary criteria were analgesia intake on the three WHO levels, awakening during the night of D0 due to pain, signs of postoperative discomfort, and patient satisfaction. RESULTS: Sixty patients (30 per group) were included, 57 of whom could be assessed: 28 K-Tape, 29 controls; 44 male, 13 female; mean age, 30.9±8.9 years. At inclusion, the two groups were comparable. There was no significant difference in mean (D0-D3) knee pain intensity: 3.8±2.2 for K-Tape, and 3.9±2 for controls (P=0.93). Analysis of variance (ANOVA) found no significant intergroup difference in evolution of pain (P=0.34). There were no other significant differences on the other assessment criteria. CONCLUSION: K-Tape showed no efficacy on early postoperative pain following ACL reconstruction. LEVEL OF EVIDENCE: III; prospective non-randomized comparative study.

Metastable patterning of plasma nanocomposite films by incorporating cellulose nanowhiskers.

A new method is presented for developing patterned, thin nanocomposite films by introducing cellulose nanowhiskers during the pulsed plasma polymerization of maleic anhydride. Metastable film structures develop as a combination of dewetting and buckling phenomena. By controlling the maleic anhydride monomer to cellulose nanowhisker weight ratio, the whiskers can be incorporated into a homogeneously covering patterned polymer film. Excess nanowhiskers are required to prevent complete dewetting and deposit dimensionally stable films. The formation of anchoring points is assumed to stabilize the film through a "pinning" effect to the substrate. The latter control the in-plane film stresses, similar to the effects of surface inhomogeneities such as artificial scratches. The different morphologies are evaluated by optical microscopy, AFM, contact angle measurements, and ellipsometry. Further analysis by infrared spectroscopy and XPS suggests esterification between the maleic anhydride and cellulose moieties.

Active immunization against murine TNFalpha peptides in mice: generation of endogenous antibodies cross-reacting with the native cytokine and in vivo protection.

New lines of treatment targeting cytokines have been successfully developed recently and are now widely used in therapy. They are based on passive administration of cytokine inhibitors either soluble receptors or mAbs and the major example is TNFalpha in rheumatoid arthritis (RA). Since a few years, our group has developed a novel alternative approach targeting cytokines by using active immunization against biologically inactive but immunogenic cytokine derivatives. In the present work, we present a new aspect of this research, based on immunization against specific cytokine peptides chosen by molecular modelling. We could elicit a significant humoral response against four TNFalpha peptides by active immunization, and show that the Abs generated cross-reacted with the native cytokine with good titers as determined by ELISA. Interestingly, during coimmunization experiments with couples of peptides, one showed a clear immunodominant effect over the other. Overall, we could not show the neutralization of TNFalpha biological activity in vitro by the immunized sera, but it seems that it is not a prerequisite to observe clinical efficacy. Indeed, using the LPS/galactosamine-induced shock, we could demonstrate that one of the four peptides tested conferred a clinical protection. These results validate the feasibility and efficacy of active immunization against cytokine peptides, and confirm that active immunization against cytokines could represent in the future an alternative to passive immunization in many diseases.

[2 years' evaluation of vision screening at nursery schools in Bordeaux]. / Bilan de deux années de dépistage visuel dans les écoles maternelles de la ville de Bordeaux.

The role of the primary care agents is fundamental to the early detection of amblyopia though careful assessment of visual acuity. We find our personal experience of a check up realized in Bordeaux infant schools. 15% of children under the age of 6 years had a visual anomaly.