Antiretroviral activity of 5-azacytidine during treatment of a HTLV-1 positive myelodysplastic syndrome with autoimmune manifestations

Myelodysplastic syndromes (MDS) are often accompanied by autoimmune phenomena. The underlying mechanisms for these associations remain uncertain, although T cell activation seems to be important. Human T-lymphotropic virus (HTLV-1) has been detected in patients with myelodysplastic syndromes, mostly in regions of the world which are endemic for the virus, and where association of HTLV-1 with rheumatological manifestation is not rare. We present here the case of a 58 year old man who presented with cytopenias, leukocytoclastic vasculitis of the skin and glomerulopathy, and was diagnosed as MDS (refractory anemia with excess blasts - RAEB 1). The patient also tested positive for HTLV-1 by PCR. After 8 monthly cycles of 5-azacytidine he achieved a complete hematologic remission. Following treatment, a second PCR for HTLV-1 was carried out and found to be negative. This is the first report in the literature of a HTLV-1-positive MDS with severe autoimmune manifestations, which was treated with the hypomethylating factor 5-azacitidine, achieving cytogenetic remission with concomitant resolution of the autoimmune manifestations, as well as HTLV-1-PCR negativity. HTLV-1-PCR negativity may be due to either immune mediated clearance of the virus, or a potential antiretroviral effect of 5-azacytidine. 5-azacytidine is known for its antiretroviral effects, although there is no proof of its activity against HTLV-1 infection in vivo

Sullivan au solstice. Les Saisons Sullivan, de Françoise Sullivan et Marion Landry avec une postface de Louise Déry. Galerie de l’UQAM, 91 p.

The influence of monomeric and micellar concentrations of the cationic monomeric, dodecyltrimethylammonium bromide (DTAB), and the corresponding dimeric, bis(N, N-dimethyl-N-dodecyl) ethylene-1,2-diammonium dibromide (12-2-12), surfactants on the formation and transformation of amorphous calcium phosphate (ACP) was investigated. The combination of microscopy (AFM and TEM) and light scattering techniques (size and zeta potential measurements) enabled, for the first time, the simultaneous monitoring of the effect that additives exert on different length scales during CaP formation in solution - from prenucleation clusters and ACP particles to the crystalline phase. Depending on their aggregation state (monomers or micelles) and the geometry of the aggregate (spherical or elongated micelles), DTAB and 12-2-12 have exhibited different effects on the rate of ACP transformation, as well as on the morphology of the amorphous and crystalline phases. It was shown that the effect of surfactants on the precipitation process observed on the microscale could be a result of different pathways on the nanoscale. The obtained results may have implications for the understanding of the general mechanism of inorganic-organic interactions underlying the biomineralization processes, as well as for materials science

Fluctuating hearing loss in the only hearing ear: cochlear implantation in the contralateral deaf side

Objective To investigate the hearing performance of adult patients presenting unilateral deafness with contralateral fluctuating hearing loss who received a cochlear implant on the deaf side. Study Design Case series with chart review. Setting University tertiary referral center. Subjects and Methods Preoperatively and at 6 and 12 months postoperatively, 23 patients underwent pure tone audiometry and speech audiometry with disyllabic and monosyllabic words in a quiet environment and sentences in quiet and noisy (signal-to-noise ratio +10 dB SPL) environments under best-aided conditions. The Abbreviated Profile of Hearing Aid Benefit (APHAB) inventory was evaluated preoperatively and at 6 and 12 months postoperatively. Results No difference was found between pre- and postoperative tests for disyllabic and monosyllabic words. For sentences in quiet and noisy environments, a difference between pre- and postoperative performance was present at 1 year ( P = .002 and P = .02, respectively). In a noisy environment, a difference was present at 6 and 12 months postoperatively as compared with the preoperative value (mean ± SD: 6 months: 42% ± 7.1% vs 61% ± 6.5%, P = .016). A significant improvement in the APHAB score was found at 6 and 12 months postimplantation (Friedman's 2-way analysis of variance by ranks, P < .001). The number of years of hearing deprivation of the deaf ear was not correlated with performance. Conclusion When incapacitating fluctuating hearing loss occurs in patients presenting a contralateral deaf ear, a cochlear implant is indicated in the latter ear, significantly improving performance in noisy conditions and allowing a better quality of communication to be achieved