Allergie à l’hemisuccinate de methylprednisolone chez une patiente atteinte d’une dysfonction des cordes vocales à l’effort

International audienceVocal cord dysfunction, defined as involuntary folding of the vocal cords during inhalation resulting in sudden inspiratory dyspnoea, is rare. Diagnosis is difficult due to more frequent potential differential diagnoses, including asthma. Hypersensitivity to systemic glucocorticosteroids is another rare disease. Herein we report the case of a 19-year old girl, initially consulting for asthma, who presented several episodes of brutal inspiratory dyspnoea followed by generalized urticaria during sports activities. The allergy, respiratory and ear/nose/throat work-up made us suspect a vocal cord dysfunction associated with an immediate IgE-mediated allergy to méthylprednisolone hemisuccinate (with tolerance to prednisolone and méthylprednisolone). Treatment consisted of speech therapy, contraindication to sports, and withdrawal of méthylprednisolone hemisuccinate. No relapses occurred during follow-up

An international expert consensus statement focusing on pre and post hair transplantation care

Aim To achieve international expert consensus and give recommendations on best practices in hair transplantation surgery, focusing on pre- and post-transplantation care. Methods A modified Delphi method was used to reach consensus. An international scientific committee developed an 81-statement questionnaire. A panel of 38 experts in hair transplantation from 17 countries across 4 continents assessed the questionnaire. Results Two consensus rounds were carried out, with 59 out of 81 statements (73%) reaching consensus. Expert recommendations emphasize the correct selection of candidates for hair transplantation and the need for patients to have received adequate medical treatment for alopecia before transplant. Comorbidities should be assessed and considered while planning surgery, and an individualized plan for perioperative care should be drawn up before transplant. Certain medications associated with increased risk of bleeding should be withdrawn before surgery. Specific recommendations for post-transplantation care are given. After transplantation, patients should gradually resume their normal haircare regimen. Close follow-up should be carried out during the first year after transplant. Conclusions This study presents numerous consensus-based recommendations on general aspects of hair transplantation, including candidate selection, medical therapy prior to transplantation, anesthesia, and resuming haircare after transplantation

Prenatal BACs-on-Beads (TM): the prospective experience of five prenatal diagnosis laboratories

Objective We previously reported on the validation of Prenatal BACs-on-Beads (TM) on retrospectively selected and prospective prenatal samples. This bead-based multiplex assay detects chromosome 13, 18, 21 and X/Y aneuploidies and the nine most frequent microdeletion syndromes. We demonstrated that Prenatal BACs-on-Beads (TM) is a new-generation, prenatal screening tool. Here, we describe the experience of five European prenatal diagnosis laboratories concerning the ongoing use of Prenatal BACs-on-Beads (TM). Methods Some 1653 samples were analyzed. All results were confirmed by conventional karyotyping or another appropriate technique. All indications for invasive prenatal diagnosis were included. Amniotic fluid and chorionic villus samples were analyzed in equivalent proportions. Results The failure rate was 3.3% and the overall abnormality detection rate was similar to 1/10. Eighty-five percent of the detected abnormalities were common aneuploidies. Eleven microdeletions and duplications were identified, thus giving an overall yield for microdeletion and microduplication detection of 1/145. Compared with QF-PCR, Prenatal BACs-on-Beads (TM) provides an additional detection rate of similar to 1/250 for low-risk pregnancies. The false positive and negative rates were both <1%. Conclusion When associated with conventional karyotyping, the Prenatal BACs-on-Beads (TM) assay combines a short turnaround time (typical of rapid aneuploidy detection tests) with valuable detection of the most frequent microdeletion syndromes that cannot be detected in cytogenetic analyses. (C) 2012 John Wiley & Sons, Ltd