Utilidad del diltiazem tópico al 2% en la condrodermatitis nodular del hélix: descripción de 2 casos / Usefulness of 2% Topical Diltiazem in Chondrodermatitis Nodularis Helicis: A Report of 2 Cases

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New insight into the ternary complexes of uranyl carbonate in seawater.

Uranium is naturally present in seawater at trace levels and may in some cases be present at higher concentrations, due to anthropogenic nuclear activities. Understanding uranium speciation in seawater is thus essential for predicting and controlling its behavior in this specific environmental compartment and consequently, its possible impact on living organisms. The carbonato calcic complex Ca2UO2(CO3)3 was previously identified as the main uranium species in natural seawater, together with CaUO2(CO3)32-. In this work, we further investigate the role of the alkaline earth cation in the structure of the ternary uranyl-carbonate complexes. For this purpose, artificial seawater, free of Mg2+ and Ca2+, using Sr2+ as a spectroscopic probe was prepared. Combining TRLIF and EXAFS spectroscopy, together with DFT and theoretical thermodynamic calculations, evidence for the presence of Sr alkaline earth counter ion in the complex structure can be asserted. Furthermore, data suggest that when Ca2+ is replaced by Sr2+, SrUO2(CO3)32- is the main complex in solution and it occurs with the presence of at least one monodentate carbonate in the uranyl coordination sphere.

Simultaneous passenger lymphocyte syndrome and multiple alloimmunization against donor's blood group antigens after liver transplantation.

BACKGROUND: If 'passenger lymphocyte syndrome' (PLS) is a well-recognized complication in ABO-mismatched solid organ transplantation, the coexistence of this reaction with recipient's alloimmunization against multiple antigens expressed on the residual red blood cells in the graft is less common and unpredictable. METHODS: The receiver of an ABO minor-mismatch liver graft from a cadaveric donor developed haemolytic anaemia within 2 weeks after transplantation. The organ donor was of blood group O D+C+c+E+e+ K+k+ Le(a+b-) and the recipient, A1 D-C-c+E-e+ K-k+ Le(a-b-). The donor and recipient were both tested for irregular antibodies. Elution was performed on the recipient's red blood cells (RBCs). RESULTS: None of the recipient and donor had irregular alloantibodies at the time of transplantation. On day 10, anti-A antibodies were detected in the recipient's serum and eluted from his RBCs. At the same time, the patient developed multiple alloantibodies: anti-D, anti-C, anti-E, anti-K and anti-Le(a) against the donor's erythrocyte antigens. CONCLUSION: Although serological analysis and haemolytic parameters confirmed the diagnosis of PLS which required transfusion support, no sign of graft damage due to recipient's immune reaction was detected. This case illustrates the required follow-up of the recipient after transplantation.

[A KEL*02mod allele responsible for an apparent maternity exclusion]. / Un allèle KEL*02mod responsable d'une exclusion apparente de maternité

The patient's rare KEL:1,-2 phenotype was highlighted in course of a routine preoperative erythrocyte typing. Unexpectedly, her two daughters presented a KEL:-1,2 phenotype what appeared first as an apparent maternity exclusion. Flow cytometry, genotyping and adsorption-elution analyses were then performed for those three patients. KEL genotyping showed that the patient's genotype was KEL*01/KEL*02 whereas that of her daughters was KEL*02/KEL*02. By using polyclonal anti-KEL2 reagent, weak amount of KEL2 was identified on the patient's erythrocytes, a result which was confirmed by both flow cytometry and adsorption-elution assays, suggesting that patient's phenotype was in fact KEL:1,2w. These results are in favour of a weak expressed KEL*02 allele (KEL*2mod) transmission coding for a KEL2 antigen detected in some technical conditions only. Those results allowed to explain the apparent maternity exclusion based on initial KEL phenotype. This study also seems to confirm the presence of a compensatory mechanism of the KELmod allele deficient expression in heterozygote patients. A KEL phenotype retrospective study of 80,000 subjects showed a local KEL:1,-2 frequency four times lower than that described in literature. Moreover, a significant number of those individuals would in reality be KEL:1,2w, what still would decrease the real frequency of the KEL:1,2 subjects.

[Hemoptysis in a young man smoking cannabis]. / Inhalation de cannabis frelaté, responsable d'une hémoptysie.

The respiratory toxicity of cannabis is well known today. Along with the classic cannabis 'joint', there are other ways of consuming it, which should be known. Smoking cannabis that has been cut with micro-particles of silicon dioxide may cause hemoptysis. We will describe here the case of a young 16-year-old man who was in the hospital because of hemoptic expectoration. The etiologic investigation was negative, in particular a thoracic scan and a bronchial fiberscope. Questioning the patient afterwards allowed us to discover the inhalation of cannabis 2 h before the hemoptysis, cannabis mixed with micro-particles of silicon dioxide. Stopping inhalation stopped the symptoms. Pediatricians should be familiarized with such practices. Silicon dioxide particles cause ENT problems or bronchial ones (coughing, spitting, hemoptysis, wheezing). Over the long term, the risk of silicosis cannot be excluded, although a longer and more complete exposure is necessary.

High production of poly(3-hydroxybutyrate) from a wild Bacillus megaterium Bolivian strain.

AIM: Taking into account that a novel strain of Bacillus megaterium was isolated from Uyuni salt lake (Bolivia) in a previous work, the objectives of this new study were to determine the maximal Poly-3-hydroxybutyrate production potential of B. megaterium strain uyuni S29 in an industrial conventional media, the possibility that the strain accumulates different types of polyhydroxyalkanoates, the cellular morphology during the biosynthesis process and the characterization of the produced biopolymers. METHODS AND RESULTS: The micro-organism was first tested in a 3-L bioreactor obtaining a high specific growth rate of 1·64 h(-1). A second fed-batch experiment was carried out in shaking flasks, reaching up to 70% PHB of cell dry mass. The biosynthesized polymers were extracted by two different extraction procedures and characterized. The results showed that all of them were PHB with thermal properties different to the conventional PHB. The micrographs taken by TEM show the different cell morphology during the fermentation process. CONCLUSIONS: In this previous study, the strain not only grew properly in the industrial conditions proposed without spore formation, but also produced and accumulated a large content of PHB, never reached before for its genus. Therefore, if the culture conditions can be optimized, the biopolymer production could be increased. SIGNIFICANCE AND IMPACT OF THE STUDY: The impact of the study has related to the area of the biomaterials and their production. The study provides new data related to the high production of PHB from the wild novel strain B. megaterium uyuni S29, the highest polymer accumulation for the genus Bacillus without spores formation.

[Clinical case of the month. Mild hemolytic disease of the newborn due to an anti-Wr(a) antibody]. / Maladie hémolytique néonatale modérê due à un anticorps anti-Wr(a).

A Caucasian woman, with a A+ CCD.ee K neg erythrocyte phenotype and no history of blood transfusion, delivered a first child who developed mild anemia. The direct antiglobulin test performed on the newborn red blood cells belonging to the A+ CCD.ee K neg group, was strongly positive for IgG. During the pregnancy and after the delivery, the woman had a negative irregular antibody screening test, using standard red blood cells. However, at birth, using a collection of thawed red blood cells with rare phenotypes (private antigens), the lab showed an antibody anti-Wr(a) in the maternal serum. The activity of the maternal antibody, with a titer of 16, was completely inhibited by dithiothreitol, indicating the nature IgM of the circulating antibody. The presence of the antigen Wr(a) on the surface of the newborn and its biological father red blood cells was confirmed. The concentration of IgG anti-Wr(a) on baby erythrocytes was demonstrated by the presence of the antibody anti-Wr(a) in the eluate. This case illustrates the difficulties to detect antibodies against private antigens on baby erythrocytes, responsible of hemolytic diseases of newborn. Indeed, standard red blood cell panels used for irregular antibodies screening test do not express generally those private antigens.

[Understanding questions: a specific difficulty in children with pragmatic communication and language disorders]. / La comprensión de preguntas: una dificultad especifica en niños con trastornos pragmáticos de la comunicación y el lenguaje.

INTRODUCTION: The question-answer schema is the basis for communicative interaction and is therefore a fundamental aim of the work carried out with children with severe communication and language impairment. DEVELOPMENT: Answering questions requires basic skills that enable the listener to identify intonation and facial expression, as well as skills in interpreting intentions and in understanding linguistic content. Some questions can rest on contextual-social keys and others may be based on lexical or structural keys. Some questions, however, call for a more complex understanding, such as 'what' and 'who' questions. Here, we propose an analysis of the skills involved in understanding questions and the consequences on intervention strategies. CONCLUSIONS: Intervention in understanding questions should combine different approaches (cognitive, social, linguistic) depending on the type of question, the specific difficulties the child has and the context.

[The effect of leukocyte-reduction on the transfusion reactions to red blood cells concentrates]. / Effet de la déleucocytation des concentrés érythrocytaires sur les réactions transfusionnelles.

SUBJECT: In order to assess the impact of leukocyte reduction, all transfusion reactions reported at Liege Teaching Hospital's Blood Bank 2 years before and after the implementation of universal leukocyte reduction of red blood cells concentrates which started-up on 1 January 2005 were evaluated. STUDY DESIGN AND METHODS: A retrospective analysis of transfusion reactions from 1 January 2003 to 31st December 2006 was undertaken. Data were collected from computerized reports, which were entered as soon as a transfusion reaction was reported. Symptoms were classified in different reaction's categories. Blood cultures, antibody screening and direct antiglobulin test were performed. Differences between the two time periods, before (2003-2004) and after (2005-2006) universal leukoreduction were determined by the Chi-square test and significance was defined as a p value less than 0.05. RESULTS: During period before the implementation of systematic leukoreduction, 68.7% of red blood cells transfused were leukoreduced. A total of 365 transfusion reactions in 91,996 red blood cells units transfused (0.4%) were reported, of which 266 were classified as febrile non-hemolytic transfusion reactions (72.9%), followed by allergic reactions (7.1%) and miscellaneous reactions (3.8%). When comparing the two-time periods, the rate of all transfusion reactions in general significantly decreased from 0.49 to 0.31% (p<0.001). Therefore, universal leukocyte reduction significantly reduced the rates of febrile non-hemolytic transfusion reactions (0.35% versus 0.24%; p=0.002) and allergic reactions (0.05% versus 0.01%; p<0.001). CONCLUSION: Universal leukocyte reduction significantly reduced the rate of transfusion reactions.

[Plasma calcium in haemodialysis patients: total calcium or ionized calcium? Should we systematically provide a value of total corrected calcium on our protocols?]. / Calcium chez les patients hémodialysés : calcémie totale ou calcium ionisé ? Le laboratoire doit-il systématiquement fournir au clinicien une valeur de calcémie totale corrigée obtenue par calcul ?

Ionized calcium is the only physiologically active form of calcium. Because of the variation of albumin, pH and haemoconcentration observed during haemodialysis session in patients with chronic renal failure, measure of total calcium does not reflect the real variation of ionized calcium. However, many formulae to correct total calcium by albumin have been proposed but none of them has been validated in dialysis patients. At present time, computing progress permit laboratory to systematically provide a value of corrected total calcium on protocols but is it really indicated? Our results showed that any of those formulae allows obtaining a value of total calcium that possesses a significant critical difference in relation to total calcium. Thus, correction formulae must be abandoned in aid of ionized calcium in haemodialysis patients.

Leishmaniasis cutánea esporotricoide / Sporotrichoid cutaneous leishmaniasis

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Diagnostic evaluation of clinically normal subjects with chronic hyperCKemia.

The authors analyzed muscle biopsy specimens of 104 patients with creatine kinase activity greater than 500 UI/L (normal 10 to 170 UI/L) without signs of muscle weakness. They achieved a definite or probable diagnosis in 55% of cases. The most frequently identified diseases were glycogen storage diseases, muscular dystrophies, and inflammatory myopathies. The probability of making a diagnosis was higher in children and when creatine kinase level was greater than 2,000 UI/L.

[Ghosal haematodiaphyseal dysplasia: a new case]. / Un nouveau cas de dysplasie hématodiaphysaire de Ghosal.

Ghosal-type hematodiaphyseal dysplasia has been first described in 1986, as a steroid-dependent anemia with endosteal broadening of the long bone's diaphyses and metaphaphyses, which makes a distinction with the periosteal reaction in Camuratti-Engelmann's disease and with Caffey's disease. Extreme pallor is first noticed and leads to search for palpable thick long bones that are not always clinically obvious. The transmission of this rare entity seems to be autosomal recessive, with a common racial background from the Middle East and the Indian subcontinent. Anemia is considerably improved by steroids, which allow to avoid blood cells transfusions, but a minimum maintenance dose is necessary to keep the hemoglobin at a normal level probably during the whole life, involving iatrogen complications. The mechanism of anemia and the genetic cause of the disease are yet unknown.

[Speech therapy intervention in comprehension disorders]. / Intervención logopédica en los trastornos de comprensión.

INTRODUCTION: Most of the studies conducted on the subject of language pathologies have focused on the expressive aspect, but there is now generalised agreement on considering that most language disorders stem essentially from problems in the processes allowing input of verbal information provided by the environment. DEVELOPMENT: We analyse the processes that take place in a child's mind when faced with verbal production and the communicative intentions of others, in an attempt to understand the nature of their difficulties. CONCLUSIONS: The comprehension of oral language brings into play a series of extremely complex processes that combine different domains of higher mental functioning. Speech therapy intervention must ensure it analyses the true extent of the verbal comprehension of each child and attempt to achieve a representation of the levels of alteration involved in the faulty understanding.

Intervención logopédica en los trastornos de comprensión / Speech therapy intervention in comprehesion disorders

Introduction. Most of the studies conducted on the subject of language pathologies have focused on the expressive aspect, but there is now generalised agreement on considering that most language disorders stem essentially from problems in the processes allowing input of verbal information provided by the environment. Development. We analyse the processes that take place in a child’s mind when faced with verbal production and the communicative intentions of others, in an attempt to understand the nature of their difficulties. Conclusions. The comprehension of oral language brings into play a series of extremely complex processes that combine different domains of higher mental functioning. Speech therapy intervention must ensure it analyses the true extent of the verbal comprehension of each child and attempt to achieve a representation of the levels of alteration involved in the faulty understanding (AU)

Introducción. La mayor parte de los trabajos relacionados con la patología del lenguaje se ha centrado en la vertiente expresiva, pero actualmente existe consenso en considerar que la mayor parte de los trastornos de lenguaje derivan esencialmente de dificultades en los procesos de ‘entrada’ del input verbal proporcionado por el entorno. Desarrollo. Se analizan los procesos que ocurren en la mente de un niño cuando se enfrenta a la producción verbal y a las intenciones comunicativas de los demás, con el fin de intentar comprender la naturaleza de sus dificultades. Conclusiones. La comprensión del lenguaje oral pone en marcha procesos muy complejos que combinan distintos dominios de las funciones mentales superiores. La intervención logopédica debe preocuparse en analizar el alcance real de la comprensión verbal de cada niño e intentar llegar a una representación de los niveles de alteración implicados en los fallos de comprensión (AU)

Potential of biopartitioning micellar chromatography as an in vitro technique for predicting drug penetration across the blood-brain barrier.

The blood-brain barrier (BBB) is considered to be the main barrier to drug transport into the central nervous system (CNS). The BBB restricts the passive diffusion of many drugs from blood to brain. The ease with which any particular drug diffuses across the BBB is determined largely by the molecular features of drugs, and it is therefore possible to predict the BBB permeability of a drug from its molecular structure. Biopartitioning micellar chromatography (BMC), a mode of micellar liquid chromatography that uses micellar mobile phases of Brij35 in adequate experimental conditions, can be useful in mimicking the drug partitioning process into biological systems. Retention in BMC depends on the hydrophobicity, electronic and steric properties of drugs. In this paper, the usefulness of BMC for predicting the BBB penetration ability of drugs expressed as the brain/blood distribution coefficient (BB) is demonstrated. A multiple linear regression (MLR) model that relates the BB distribution coefficients data with BMC retention data and total molar charge is proposed. The model is obtained using 44 heterogeneous drugs including, neutral, anionic, and cationic compounds. A comparison with other reported methodologies to predict the BBB permeability is also presented.