Abnormal T-cell phenotype in episodic angioedema with hypereosinophilia (Gleich's syndrome): frequency, clinical implication and prognosis

BACKGROUND: Episodic Angioedema with eosinophilia (EAE, Gleich\u27s syndrome) is a rare disorder consisting of recurrent episodes of angioedema, hypereosinophilia and frequent elevated serum Immunoglobin M. METHODS: We conducted a retrospective multicenter nationwide study regarding the clinical spectrum and therapeutic management of patients with EAE in France. RESULTS: Thirty patients were included with a median age at diagnosis of 41 years [5-84]. The median duration of each crisis was 5.5 days [1-90] with swelling affecting mainly the face and the upper limbs. Total serum IgM levels were increased in 20 patients (67%). Abnormal T-cell immunophenotypes were detected in 12 patients (40%) among which 5 (17%) showed evidence of clonal TCR γ gene rearrangement. Median follow-up duration was 53 months [31-99]. The presence of an abnormal T-cell population was the sole factor associated with a shorter time to flare (hazard ratio 4.15 [CI 95% 1.18-14.66; p=0.02). At last follow-up, 3 patients (10%) were able to withdraw all treatments and 11 (37%) were in clinical and biological remission with less than 10 mg of daily prednisone. CONCLUSION: EAE is a heterogeneous condition that encompasses several disease forms. Although patients usually respond well to glucocorticoids, those with evidence of abnormal T-cell phenotype have a shorter time to flare

Efficacy and Safety of Lacosamide in Painful Diabetic Neuropathy

OBJECTIVE: To evaluate efficacy and safety of lacosamide compared with placebo in painful diabetic polyneuropathy. RESEARCH DESIGN AND METHODS: Diabetic patients with at least moderate neuropathic pain were randomized to placebo or lacosamide 400 (in a slow or standard titration) or 600 mg/day over 6-week titration and 12-week maintenance periods. Primary efficacy criterion was intra-individual change in average daily Numeric Pain Rating Scale score from baseline to the last 4 weeks. RESULTS: For the primary end point, pain reduction was numerically but not statistically greater with lacosamide compared with placebo (400 mg/day, P = 0.12; 600 mg/day, P = 0.18). Both doses were significantly more effective compared with placebo over the titration (P = 0.03, P = 0.006), maintenance (P = 0.01, P = 0.005), and entire treatment periods (P = 0.03, P = 0.02). Safety profiles between titration schemes were similar. CONCLUSIONS: Lacosamide reduced neuropathic pain and was well tolerated in diabetic patients, but the primary efficacy criterion was not met, possibly due to an increased placebo response over the last 4 weeks.status: publishe

Auxiliary Armed Forces and Innovations in Security Governance in Mozambique’s Civil War

Who rules during the civil war? This article argues that the concept of armed group governance must be expanded to include auxiliary armed forces linked to rebels or the government. Comparing the organization of rebel and government auxiliaries, the article demonstrates that security governance during war is never static, but evolves over time. Evidence from the civil war in Mozambique (1976–1992) shows that the auxiliary’s origin shapes its initial level of autonomy. Second, auxiliary contribution to battlefield success of one side may induce innovations adopted by auxiliaries on the other. Both have distinct consequences for the nature of governance.The Institutions of Politics; Design, Workings, and implications ( do not use, ended 1-1-2020

Numerical simulation of steady-state mixed convection sodium flow experiments

International audienceIn the framework of the validation of the TrioCFD code for mixed convection and steady-state sodium flows, four experiments obtained using the SUPERCAVNA experimental equipment and involving Richardson numbers ranging from 0.13 to 4.21 are simulated. The TrioCFD numerical tool uses a RANS approach with a $k-\epsilon$ turbulence model including a buoyancy term and the computed results are in very good agreement with the experiments

La vie des sections : II. - Section de jeunes

Lejamble C., Dangel Jacqueline, Guézennec , Geffray Catherine, Perrin Michel, Gelot Huguette, Zussy Bernard. La vie des sections : II. - Section de jeunes. In: Bulletin de l'Association Guillaume Budé, n°3, octobre 1984. pp. 244-259

La vie des sections : II. - Section de jeunes

Lejamble C., Dangel Jacqueline, Guézennec , Geffray Catherine, Perrin Michel, Gelot Huguette, Zussy Bernard. La vie des sections : II. - Section de jeunes. In: Bulletin de l'Association Guillaume Budé, n°3, octobre 1984. pp. 244-259

TALL-3D open and blind benchmark on natural circulation instability

International audienceDesign and safety analysis of the currently developed pool type liquid metal cooled fast nuclear reactors is currently impaired by limited operational experience for such systems and insufficient confidence in the predictive capabilities of the applied modelling. Understanding of pool-reactor thermal-hydraulics is crucial for assessment of reactor performance and passive safety systems reliability. Credibility of the analysis tools can be established in the process of code validation, which includes open and blind benchmarks against integral experiments.TALL-3D is a lead-bismuth eutectic (LBE) loop built to provide experimental data for validation of standalone and coupled system thermal-hydraulics (STH) and computational fluid dynamics (CFD) codes. This paper summarizes the results of the open and blind benchmark exercise, performed using experimental data on natural circulation instability in liquid metal flows from the TALL-3D facility.An approach for selection of experimental data for benchmark and tests for model input calibration is presented. A list of parameters, initial and boundary conditions are defined based on modelling limitations and sources of experimental uncertainty. A set of requirements and assessment criteria for the blind calculations were specified. Results of simulations are compared to experimental data. Implications of the benchmark test results for the codes validity and lessons learned are reported