Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn\u27s disease

Perineal hernia is a rare complication of pelvic surgeries that can occur in patients with perianal Crohn\u27s disease (pCD) as a long-term outcome of surgeries for complex fistula treatment. We present a case of a symptomatic pCD male patient with multiple perianal surgeries who presents with anal pain, diarrhea, and discharge. Magnetic resonance imaging showed a perineal hernia in the ischioanal fossa violating the convergence of the left external sphincter complex. The hernia was treated with an open primary hernia repair via the perineal approach. It recurred after 3 months, and the patient underwent secondary hernia repair with gracilis muscle interposition and mesh placement. Unfortunately, this was complicated by superficial skin dehiscence and mesh extrusion, but the flap remained viable and the hernia repair was intact. Incidence, symptoms, risk factors, imaging findings, and management of perineal hernias are reviewed

Prediction of Associations between microRNAs and Gene Expression in Glioma Biology

Despite progress in the determination of miR interactions, their regulatory role in cancer is only beginning to be unraveled. Utilizing gene expression data from 27 glioblastoma samples we found that the mere knowledge of physical interactions between specific mRNAs and miRs can be used to determine associated regulatory interactions, allowing us to identify 626 associated interactions, involving 128 miRs that putatively modulate the expression of 246 mRNAs. Experimentally determining the expression of miRs, we found an over-representation of over(under)-expressed miRs with various predicted mRNA target sequences. Such significantly associated miRs that putatively bind over-expressed genes strongly tend to have binding sites nearby the 3′UTR of the corresponding mRNAs, suggesting that the presence of the miRs near the translation stop site may be a factor in their regulatory ability. Our analysis predicted a significant association between miR-128 and the protein kinase WEE1, which we subsequently validated experimentally by showing that the over-expression of the naturally under-expressed miR-128 in glioma cells resulted in the inhibition of WEE1 in glioblastoma cells

MACVIA Clinical Decision Algorithm in Allergic Rhinitis in adolescents and adults

International audienceThe selection of pharmacotherapy for patients with allergic rhinitis depends on several factors, including age, prominent symptoms, symptom severity, control of allergic rhinitis, patient preferences and cost. Allergen exposure and resulting symptoms vary and treatment adjustment is required. Clinical decision support systems (CDSS) may be beneficial for the assessment of disease control. Clinical decision support systems should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine the treatment and its step-up or step-down strategy depending on AR control. MACVIA-LR (Fighting chronic diseases for active and healthy ageing) one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (MASK: MACVIA-ARIA Sentinel networK). A clinical decision support system is currently being developed to optimize allergic rhinitis control. An algorithm developed by consensus is presented in this paper. This algorithm should be confirmed by appropriate trials