Teigne favique du dindon due à un nouveau dermatophyte

Resumé Une epizootie de teigne favique (crête blanche) a été observée chez des dindons provenant d'un élevage près de Toulouse. Les lésions étaient localisées à la région glabre de la tête et du cou. L'examen histopathologique montre un épiderme infiltré par les polynucléaires, couvert de nombreuses microspores et envahi en profondeur par des filaments mycéliens qui pénètrent dans le derme et dans les cones pileux sans attaquer la tige plumale. La maladie expérimentale a été reproduite chez la poule (crête blanche), chez le cobaye et le lapin (lésions érythémato-squameuses et croûteuses) mais non chez la souris. Le dermatophyte isolé, décrit sous le nom deTrichophyton gallopavum n. sp. est une espèce inter-intermédiaire entreT. gallinae etT. quinckeanum.     

Aspergilosis pulmonar en un paciente crítico no inmunodeprimido

BackgroundIn non-immunocompromised patients admitted to intensive care departments or units (ICU), it is difficult to establish a definitive diagnosis of pulmonary aspergillosis because the signs and symptoms of this infectious disease are non-specific, and serological techniques are not very specific as well. For this reason, a diagnosis of possible pulmonary aspergillosis is initially established, and the starting of the treatment is controversial.Case reportAn immunocompetent subject had a work-related accident after a fall, which resulted in multiple injuries (head, thorax, lower extremities). The patient required mechanical ventilation since admission. On the second week of ICU admission, he showed a clinical presentation of respiratory infection with fever, purulent secretions, bilateral pulmonary infiltrates and repeated isolation of Mucor and Aspergillus fumigatus in bronchial secretions and pharyngeal swabs. The patient was treated with amphotericin B lipid complex and voriconazole with an excellent clinical and radiological outcome.ConclusionsCombined treatment of antifungal agents, in this case amphotericin B lipid complex and voriconazole, is a therapeutic possibility to be considered in patients who failed to respond to initial antifungal monotherapy.     

Ascite chyleuse à Mycobacterium tuberculosis : un cas clinique

Chylous ascites is a rare manifestation of tuberculosis. We report the case of a 63-year-old man admitted with ascites and bilateral lower limb edema developed two years previously, with progressive increase. He had a history of microbiologically confirmed and properly treated pleuropulmonary tuberculosis, 20 years before. Although Mycobacterium tuberculosis could not be detected in the ascitic fluid, chest, abdominal and pelvic computed tomography showed findings very suggestive of tuberculosis sequelae. A lymphoscintigraphy was performed and also supported our diagnostic hypothesis of chylous ascites and lymphedema due to tuberculosis sequelae associated or not with active infection. The intention was to further investigate if any form of active tuberculosis was present due to reactivation of the infection. Unfortunately, the patient died before these assessments could be completed.     

ClearPEM,un TEP dédié au sein

Conventional breast imaging (mammography, ultrasound, MRI) relies on the analysis of anatomical characteristics. Whole-body positron emission tomography (PET) allows for the acquisition of a metabolic image, yet is limited by its poor spatial resolution. The Crystal Clear Collaboration developed a PET dedicated for breast imaging, the ClearPEM, in order to offer a high-resolution nuclear imaging technique. The patient is installed in the prone position on the exam bed, with two detector plates rotating around to breast to acquire a 3-dimensional image. Two prototypes were built and installed in hospitals. We summarize the technical solutions necessary for the development of this system and present a summary of its performances as well as an outlook on preclinical and clinical tests.     

sHER-2 : un nouveau marqueur ?

The extracellular domain of the HER-2 (ERBB2) oncoprotein (p105^HER-2, ECD HER-2) is shed in the serum and can be detected by immunoassay. The currently approved cutoff for an elevated HER-2 ECD is greater than 15 ng/mL. HER-2 ECD is attractive as a potentially useful serum biomarker. In metastatic breast cancer, serum assay of HER-2 ECD is recommended to assess HER-2 status when unknown in primary tumor or metastatic biopsy is not feasible. In that case, it has been recommended to consider a 50 ng/mL serum HER-2 ECD cutoff as criteria to select patients for HER-2 targeted therapy. It might offer additional prognostic or predictive value compared with HER-2 tumor tissue testing. In addition, it can be measured serially and might be able to monitor treatment response, predict relapse or provide a real-time assessment of HER-2 status at metastatic disease.     

Chocolate: (un)healthy source of polyphenols?

There is recent epidemiological evidence that chocolate consumption may improve vascular health. Furthermore, several small-scale human intervention studies indicate that habitual chocolate intake enhances the production of vasodilative nitric oxide and may lower blood pressure. It is hypothesized that potential beneficial effects of chocolate on vascular health are at least partly mediated by cocoa polyphenols including procyanidins. Based on cell culture studies, molecular targets of chocolate polyphenols are endothelial nitric oxide synthetase as well as arginase. However, human bioavailability studies suggest that the plasma concentrations of cocoa polyphenols are manifold lower than those concentrations used in cultured cells in vitro. The experimental evidence for beneficial vascular effects of chocolate in human interventions studies is yet not fully convincing. Some human intervention studies on chocolate and its polyphenols lack a stringent study design. They are sometimes underpowered and not always placebo controlled. Dietary chocolate intake in many of these human studies was up to 100 g per day. Since chocolate is a rich source of sugar and saturated fat, it is questionable whether chocolate could be recommended as part of a nutrition strategy to promote vascular health.