First described in HIV-infected patients who recently initiated highly active antiretroviral therapy, the immune reconstitution inflammatory syndrome (IRIS) is best characterized as a collection of ...inflammatory disorders triggered by rapid resolution of immunosuppression. Treatment of IRIS is a clinical challenge due to the variety of clinical presentations and the presence of multiple pathogens capable of causing the syndrome. Hepatosplenic candidiasis, an uncommon form of invasive Candida species infection, was recently suggested to belong to the spectrum of fungus-related IRIS. We report 2 cases of probable hepatosplenic candidiasis according to the guidelines of the European Organization for Research and Treatment of Cancer and the Mycosis Study Group, occurring in pediatric patients with acute leukemia during rapid neutrophil recovery after cytotoxic chemotherapy. In both cases, abdominal computed tomography scan revealed multiple hepatic micronodules, and liver biopsy showed nonspecific granulomatous lesions. Hepatosplenic candidiasis symptoms (fever, nausea and vomiting, abdominal pain) resolved within 2 days after adjunction of corticosteroid therapy to antifungal treatment. Inflammatory markers and related radiologic abnormalities decreased or disappeared within 1 month. Recovery of neutrophil count in a context of hepatosplenic candidiasis may result in a heightened inflammatory response. Corticosteroid therapy in this setting is associated with prompt resolution of the symptoms.
: Selection for targeted therapies in melanoma is currently based on the search for mutations in selected genes. We aimed at evaluating the interest of signalling and chemosensitivity studies in ...addition to genotyping for assessing the best suitable treatment in an individual patient. We extracted genomic DNA and melanoma cells from tumor tissue of a skin metastasis of a 17‐year‐old woman with stage IV melanoma progressing despite three successive lines of treatment. Despite the absence of mutation in BRAF, NRAS cKIT, the MAPK pathway was activated and a significant response to sorafenib, a mitogen‐activated protein kinase (MAPK)/RAF inhibitor, was found in signalling and chemosensitivity assays. A treatment combining sorafenib and dacarbazine produced a partial response for 9 months, with marked necrosis in some lesions. Chemosensitivity assays and signalling pathway studies could be of great value in addition to genotyping for assessing the most appropriate treatment in melanoma.
: Progressive liver injury is a concern in HIV-infected children exposed to long-term antiretroviral drugs and to the cytopathic effect of HIV. Yet liver biopsy is usually considered too invasive to ...be repeated in these patients. The aims of this study are to evaluate the feasibility of noninvasive hepatic investigations in HIV-1-infected children, assess the prevalence of signs of liver affection, and analyse the influence of the HIV disease severity and the exposure to antiretroviral therapy.
: A cross-sectional study conducted in 26 HIV-1 vertically infected children ages 8 to 18 years old. Liver function was assessed with standard serum biochemical markers, FibroTest, ActiTest, SteatoTest, Forns index, aspartate aminotransferase to platelet ratio index, ultrasound, and Fibroscan.
: Nineteen (>60%) children had signs of liver affection on at least 1 of the test results: 13 (50%) had elevated liver enzymes, 15 (63%), 8 (33%), 5 (21%), and 5 (21%) had abnormal FibroTest, ActiTest, Forns index, and aspartate aminotransferase to platelet ratio index results, respectively. Four children (17%) had mild liver steatosis on ultrasound. Fibroscan measures were significantly higher in patients than in age-matched healthy children. Patients with elevated Fibroscan measures also had significantly higher FibroTest results. Age, HIV stage N in the Centers for Disease Control and Prevention classification and exposure duration to nucleoside reverse transcriptase inhibitor and non-nucleoside reverse transcriptase inhibitor drugs were the main risk factors for hepatotoxicity.
: More than half of our population of HIV-infected children had biological and/or radiological signs of liver affection. Regular follow-up of liver function is necessary in these patients, which is now possible with noninvasive procedures.
Abstract
Accurate knowledge of the functional response of predators to prey density is essential for understanding food web dynamics, to parameterize mechanistic models of animal responses to ...environmental change, and for designing appropriate conservation measures. Greater flamingos (
P
hoenicopterus roseus
), a flagship species of
M
editerranean wetlands, primarily feed on
A
rtemias
(
A
rtemia spp
.) in commercial salt pans, an industry which may collapse for economic reasons. Flamingos also feed on alternative prey such as
C
hironomid larvae (e.g.,
C
hironomid spp
.) and rice seeds (
O
ryza sativa
). However, the profitability of these food items for flamingos remains unknown. We determined the functional responses of flamingos feeding on
A
rtemias,
C
hironomids, or rice. Experiments were conducted on 11 captive flamingos. For each food item, we offered different ranges of food densities, up to 13 times natural abundance. Video footage allowed estimating intake rates. Contrary to theoretical predictions for filter feeders, intake rates did not increase linearly with increasing food density (type I). Intake rates rather increased asymptotically with increasing food density (type II) or followed a sigmoid shape (type III). Hence, flamingos were not able to ingest food in direct proportion to their abundance, possibly because of unique bill structure resulting in limited filtering capabilities. Overall, flamingos foraged more efficiently on
A
rtemias
. When feeding on
C
hironomids, birds had lower instantaneous rates of food discovery and required more time to extract food from the sediment and ingest it, than when filtering
A
rtemias
from the water column. However, feeding on rice was energetically more profitable for flamingos than feeding on
A
rtemias
or
C
hironomids, explaining their attraction for rice fields. Crucially, we found that food densities required for flamingos to reach asymptotic intake rates are rarely met under natural conditions. This allows us to predict an immediate negative effect of any decrease in prey density upon flamingo foraging performance.
Relapses of lymphoblastic leukaemia traditionally involve the central nervous system and testes in boys. Involvement of the female pelvic organs is frequently found at autopsy; however, involvement ...of the cervical uterus is rare and even less commonly symptomatic. A 13-cm uterine mass was discovered in a 15-year-old adolescent with a history of lymphoblastic leukaemia during childhood. Pelvic MRI was the best tool to assess the size, characteristics and invasive nature of this lesion of the uterine cervix. To our knowledge, this is a unique case in that we describe the MRI appearance of a relapsing lymphoblastic leukaemic mass both before and after treatment.
Nous présentons un cas d’histiocytose langerhansienne chez un enfant de trois ans ayant une atteinte osseuse multifocale crânienne et fémorale, qui sont des localisations très fréquentes dans les ...histiocytoses. La scintigraphie osseuse est utile à la fois au bilan d’extension initial et au suivi associée aux autres techniques d’imagerie.
We present one case of bone-Langerhans’ cell histiocytosis in a three-year-old male child presenting osseous lesions in the skull and the femur, which are very frequent localisations in histiocytosis. Bone scintigraphy is useful for both initial staging and follow-up associated with other imaging modalities.
Since the initial report of X-linked agammaglobulinemia by Bruton, numerous autosomal primary immune deficiencies affecting early B-cell differentiation have been described in humans. The ...identification of these autosomal mutations has been facilitated by phenotype comparison with knockout mice. In mice, defects in B-cell development have been observed after disruption of genes encoding transcription factors, the interleukin-7 pathways as well as structural or signaling components of the pre-B-cell receptor. In general, the phenotypes of primary immune deficiencies in humans correlate with those observed in mutant mice, validating the use of the mouse model approach. In addition, we report a follow-up analysis of an autosomal primary deficiency in a young female patient born from consanguinous parents and characterized by the absence of pre-B and B-cell compartments. The patient's gene defect was identified as a cytosine insertion at the beginning of the CH1 exon of the Ig(mu) gene, resulting in a stop codon at position 48 and the absence of Ig(mu) chain expression. The precise phenotype of this patient is compared to other autosomal primary immunodeficiencies affecting humans and mice.
La négociation semble bien être devenue le modèle dominant de régulation des rapports sociaux. Le phénomène juridique n'est pas épargné : pas une de ses branches qui ne témoigne de l'irrésistible ...ascension du droit négocié. On négocie la loi, tant en amont qu'en aval de son adoption : on négocie le règlement des conflits tant au tribunal qu'en dehors des prétoires. S'il convient donc de prendre l'exacte mesure du phénomène et des transformations qu'il imprime dans l'ordre juridique tout entier, faut-il pour autant céder au mythe du « tout conventionnel » ? Adoptant une méthode critique et interdisciplinaire, le présent ouvrage multiplie les raisons de résister à cette dérive. Au plan sociologique, il souligne la permanence des rapports de force derrière les figures de l'accord et du compromis ; au plan éthique, il rappelle l'impossibilité de nouer le lien social à partir d'un point de vue exclusivement solipsiste ; au plan juridique, il montre combien règle et accord se déterminent réciproquement. De sorte qu'en définitive, c'est un nouvel objet de recherche qui s'est fait valoir – et qui donne son titre à l'ouvrage : l'entrelacement dialectique du droit négocié et du droit imposé. Par ailleurs, la négociation elle-même apparaît dédoublée, oscillant sans cesse entre un pôle idéal (la « délibération ») marqué par la bonne foi et la rationalité procédurale, et un pôle cynique (le « marchandage ») caractérisé par la défiance et le calcul d'intérêt. C'est au carrefour de cette double dialectique de l'autonomie et de l'hétéronomie, de la délibération et du marchandage que ce livre place le droit négocié, éclairé ici par la théorie du droit, les sciences sociales et la doctrine juridique.
Les femmes et le droit Andrini, Simona; Beauthier, Régine; Belleau, Marie-Claire ...
1999
Book
Odprti dostop
Le présent ouvrage réunit les contributions qui ont été présentées lors du colloque organisé le 27 octobre 1997 par le Centre de sociologie politique du droit des Facultés universitaires Saint-Louis. ...L'objectif est de dévoiler la position qu'occupent les femmes dans le droit, aussi bien dans l'élaboration des règles juridiques que dans leur application, dans les textes que dans les représentations de ceux qui les forgent ou les appliquent. Dans ce cadre, le droit est appréhendé comme un instituteur et un révélateur privilégiés de la réalité et de la représentation de la place des femmes dans la société et des rapports de genre qui s'y développent. Issues de disciplines différentes (science politique, droit, histoire, sociologie) et portant sur des branches ou des domaines différents du droit (droit civil, droit social, droit du travail, magistrature), les investigations proposées sur les relations entre les femmes et le droit s'inscrivent à la fois dans une perspective de sociologie politique et dans une démarche féministe. Quoique multiples, ces regards se croisent néanmoins sur un même objet : le travail, le divorce, la carrière de magistrat, la sécurité sociale. Le lecteur bénéficiera ainsi d'un éclairage comparatif, dans le temps ou dans l'espace.
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