Introduction of nonnative cultured fish is one of the most important threats to native salmonid populations. In brown trout, more than a century of stocking practices has led to a large hybridization ...between initially geographically isolated lineages, threatening native populations and thereby intraspecific diversity. In the French region of Haute-Savoie, managers and scientists implemented together three management strategies (genetic refuge, direct translocation of wild spawners and stocking with native fry) on 19 test sites for more than 15 years, in the aim to recover pure or nearly pure native populations. Here we propose an assessment of the different management strategies based on a synthetic analysis of the evolution of the introgression rate. While none of the implemented strategies completely achieves the initial objective to restore pure native populations, they differ in their efficiency: introgression rates tend to decrease quickly when direct translocation of native spawners of stocking with native fry strategies are used. The genetic refuge strategy shows slower and more heterogeneous changes of introgression rates. In general, pure nonnative fish are efficiently removed but at the cost of an increased presence of hybrids. Our results imply that intraspecific dynamics react quickly to management practices and that these changes are probably fueled by evolutionary feedbacks that are not yet well understood.
Summary
Background
Some prognostic markers of venous leg ulcer (VLU) healing have been evaluated, mostly in retrospective studies.
Objectives
To identify which clinical characteristics, among those ...known as possible prognostic factors of VLU healing, and which VLU‐associated sociodemographic and psychological factors, are associated with complete healing at week 24 (W24).
Methods
A prospective, multicentre, cohort study was conducted in 22 French dermatology departments between September 2003 and December 2007. The end point was comparison between healed and nonhealed VLUs at W24, for patient clinical and biological characteristics; psychological, cognitive and social assessments; affected leg inclusion characteristics; venous insufficiency treatment and percentage of initial wound area reduction during follow‐up.
Results
In total, 104 VLUs in 104 patients were included; 94 were analysed. The mean VLU area and duration were 36·8 ± 55·5 cm2 and 24·8 ± 45·7 months, respectively. At W24, 41/94 VLUs were healed. Univariate analysis significantly associated complete healing with superficial venous surgery (P = 0·001), adherence to compression therapy at W4 (P = 0·03) and W24 (P = 0·01), ankle‐joint ankylosis (P = 0·01) and mean percentage of VLU area reduction at W4 (P = 0·04). Multivariate analysis retained superficial venous surgery during follow‐up odds ratio (OR) 8·4, 95% confidence interval (CI) 1·9–48·2 and percentage reduction of the VLU area at W4 (OR 1·6, 95% CI 1·0–2·14) as being independently associated with healing.
Conclusions
These results indicate that complete healing of long‐standing, large VLUs is independently associated with ablation of the incompetent superficial vein and percentage of wound area reduction after the first 4 weeks of treatment.
What's already known about this topic?
Despite advances in venous leg ulcer (VLU) management, the time to ulcer healing generally remains long.
Some prognostic markers of healing have been evaluated, mostly in retrospective studies.
What does this study add?
In this prospective, multicentre, cohort study, complete healing of long‐standing, large VLUs at 6 months was independently associated with ablation of the incompetent superficial vein and percentage of wound area reduction after the first 4 weeks of treatment.
We report two cases of cutaneous granuloma induced by anti-TNF-alpha therapy: a 47-year-old man suffering from psoriatic arthritis treated with infliximab and a 56-year-old woman treated with ...adalimumab for polyarticular juvenile rheumatoid arthritis. The biospies confirmed the diagnosis of a 'sarcoidosis-like' reaction. No systemic involvement was observed. Such cases of noninfectious granulomatous diseases occurring during anti-TNF-alpha therapy are becoming increasingly frequent.
This randomized, double-blind, placebo-controlled study assessed the safety, tolerability and plasma kinetic behaviour of single oral doses of 94% pure crystalline bulk epigallocatechin gallate ...(EGCG) under fasting conditions in 60 healthy male volunteers. In each group of 10 subjects, eight received oral EGCG in single doses of 50 mg, 100 mg, 200 mg, 400 mg, 800 mg or 1600 mg, and two received placebo. Blood samples were taken at intervals until 26 h later. The area under the concentration-time curve from 0 h to infinity (AUC(0–∞)), the maximum plasma concentration (C
max) of EGCG, the time taken to reach the maximum concentration (T
max), and the terminal elimination half-life (t
1/2z) of EGCG were determined. Safety and tolerability were assessed. In each dosage group, the kinetic profile revealed rapid absorption with a one-peak plasma concentration versus time course, followed by a multiphasic decrease consisting of a distribution phase and an elimination phase. The mean AUC(0– ∞) of total EGCG varied between 442 and 10368 ng·h/ml. The according mean C
max values ranged from 130 to 3392 ng/ml and were observed after 1.3–2.2 h. The mean t
1/2z values were seen between 1.9 and 4.6 h. Single oral doses of EGCG up to 1600 mg were safe and very well tolerated.
Background
Elderly patients with diffuse large B‐cell lymphoma (DLBCL) have an inferior prognosis, due in part to advanced age and pre‐existing comorbidities, with reduced tolerability and ...deliverability of standard R‐CHOP chemotherapy.
Aims
To examine the deliverability, toxicity and efficacy of R‐CHOP and the prevalence of the germinal and non‐germinal phenotype DLBCL in an elderly Australian cohort.
Methods
This retrospective analysis included patients ≥75 years diagnosed with DLBCL. Comprehensive chemotherapy and toxicity data were collected for patients treated with R‐CHOP. Baseline demographics and chemotherapy characteristics were compared with progression‐free (PFS) and overall survival (OS). Immunohistochemical staining identified the prevalence of the non‐germinal centre (non‐GCB) phenotype.
Results
Of the 111 patients, 92 (83%) commenced R‐CHOP with 26/92 (28%) receiving ≤4 cycles. Median average relative dose (ARD) was 0.80 (0.07–1.17). Median average relative dose intensity (ARDI) was 0.89 (0.33–1.18). Serious adverse events occurred in 77% of patients with ≥Gd3 adverse events in 74%. Overall response rate was 85%. Two‐year PFS was 63% and OS 74%. ARD and performance status ≥2 were significant prognostic factors for PFS and OS but not ARDI. Non‐GCB‐phenotype was identified in 44/72 (61%) of patients with immunohistochemical data.
Conclusion
Despite high response rates and respectable survival estimates, the absence of standard therapy in 17% of patients, and dose reductions and serious toxicity of R‐CHOP in this Australian cohort highlights the need for the development of less toxic yet efficacious treatments for very elderly patients with DLBCL. The high prevalence of the non‐GCB phenotype highlights the potential value of targeted biological therapy for this demographic.
This study examined stocking with three early life stages of brown trout, Salmo trutta L., in the context of rehabilitating a native lineage. Experimental sections in five streams were stocked ...successively with three stages (I: unfed fry at the end of the reabsorption phase, II: fed fry measuring 2-3 cm and III: fed fry measuring 4-5 cm) derived from a hatchery stock bred from wild spawners. The three stages were distinguished by single or multiple fluoromarking of the otoliths with alizarin redS. The index of relative stocking efficiency was greater for stage II than for stage I in all sections and equivalent or greater than that for stage III. Stage II achieved significantly larger mean length and weight in autumn than stage III stockings.
Febrile ulceronecrotic Mucha-Habermann disease (FUMHD) is a rare subtype of pityriasis lichenoides et varioliformis acuta, characterized by an acute onset of ulceronecrotic papules, rapidly ...coalescing into large ulcers with necrotic crusts, associated with high fever and severe systemic symptoms. We report a case of a 65-year-old woman with a resistant form of FUMHD successfully treated with a tumor necrosis factor-α (TNFα) inhibitor (infliximab). After 1 year of treatment, because of the recurrence of lesions and -occurrence of severe sepsis, we decided to change the therapeutic procedure by introducing intravenous immunoglobulin witch induced a spectacular improvement. Only few cases of FUMHD treated with intravenous immunoglobulin have been reported to date. In our case, we describe the first utilization of TNFα inhibitors in the treatment of FUMHD: TNFα inhibitors may be useful, particularly in resistant cases. Further reports are required to confirm this potential therapeutic option.
A multidisciplinary study was made of brown trout Salmo trutta in the Borne River, a typical fast‐flowing mountain stream in the Northern French Alps, in the geographical range of the Mediterranean ...lineages (ML). Information on (1) the proportion of stocked fluoro‐marked fish in the angling harvest, (2) the introgression of introduced DNA microsatellite alleles into the native gene pool and (3) the demography of the population in situ in autumn revealed two contrasting populations separated by a physical barrier to upstream migration. A native S. trutta population (c. 10 000 adults) lives downstream of the barrier and is characterized by a large frequency of ML alleles (82–97%) and high densities (43–55 fish 100 m−2). This population is maintained predominantly by natural recruitment of juveniles (51–82%). In contrast, the upstream population is characterized by a large frequency of Atlantic lineage (AL) alleles (78–100%) and low densities (1–2 fish 100 m−2) and appears to be maintained by restocking (90–100%). The origins of these sharply contrasting populations appear to reflect isolation by an impassable barrier, catastrophic flooding, a downstream gradient in water quality, stocking and fishing pressure. The native downstream population has been resilient to large sudden floods and to intensive stockings of domesticated AL fish. The results of this study justify a shift in management towards conservation and rehabilitation of the native population.
Crohn's disease is a chronic inflammatory intestinal pathology which can be associated to different extra-digestive manifestations. We reported a case of recurrent genital lymphedema leading to ...Crohn's disease diagnosis.
A 49-year-old man was referred for increased penis and scrotal volume, associated with recurrent febrile flare during the 10 previous years. Clinically, we noted an inflammatory penis and scrotum lymphedema. Clinical urological examination, and biological, bacteriological, computer-tomography examinations were negative. Metastatic Crohn's disease was diagnosed in association with concomitant severe terminal ileitis. Treatment with corticosteroids and azathioprine resulted in significant decrease of inflammatory genital lymphedema.
Genital inflammatory lymphedema occurs during inflammatory, infectious, and tumor diseases. Some cases of metastatic genital lymphedema related to Crohn's disease are described, most often in children. Inflammatory genital lymphedema associated with gastrointestinal symptoms may suggest Crohn's disease.
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