Septic Shock Sera Containing Circulating Histones Induce Dendritic Cell–Regulated Necrosis in Fatal Septic Shock Patients

Objectives: Innate immune system alterations, including dendritic cell loss, have been reproducibly observed in patients with septic shock and correlated to adverse outcomes or nosocomial infections. The goal of this study is to better understand the mechanisms behind this observation in order to better assess septic shock pathogenesis.Design: Prospective, controlled experimental study. Setting: Research laboratory at an academic medical center. Subjects: The study enrolled 71 patients, 49 with septic shock and 22 with cardiogenic shock. Seventeen healthy controls served as reference. In vitro monocyte-derived dendritic cells were generated from healthy volunteers. Interventions: Sera were assessed for their ability to promote in vitro dendritic cell death through flow cytometry detection in each group of patients. The percentage of apoptotic or necrotic dendritic cells was evaluated by annexin-V and propidium iodide staining. Measurements and Main Results: We observed that only patients with septic shock and not patients with pure cardiogenic shock were characterized by a rapid and profound loss of circulating dendritic cells. In vitro analysis revealed that sera from patients with septic shock induced higher dendritic cell death compared to normal sera or cardiogenic shock (p < 0.005). Sera from surviving patients induced dendritic cell death through a caspase-dependent apoptotic pathway, whereas sera from nonsurviving patients induced dendritic cell-regulated necrosis. Dendritic cell necrosis was not due to necroptosis but was dependent of the presence of circulating histone. The toxicity of histones toward dendritic cell could be prevented by recombinant human activated protein C. Finally, we observed a direct correlation between the levels of circulating histones in patients and the ability of the sera to promote dendritic cell-regulated necrosis. Conclusions: The study demonstrates a differential mechanism of dendritic cell death in patients with septic shock that is dependent on the severity of the disease

Challenging History: Past Reconstruction in Colum McCann's Songdogs

The present paper analyses the way in which Colum McCann's novel Songdogs (1995) constitutes an attempt at reconstructing and reconciling oneself with the past, a theme that a number of contemporary critics perceive as characteristic of the Irish literary experience. It will be argued that via the novel's non-linear, fragmented narrative structure, on the one hand, and its frequent use of static images reminiscent of photography on the other, McCann engages the concept of memory and translates its founding functional principles into a personal literary technique. The task of recovering significance from distinct media - be it still images or the novel's texture - will be construed as operating on two levels. The novel's mixed plot lines constructed out of apparently unrelated clusters of images and the reader's efforts at organising them into larger meaningful compositions will be understood as parallel to the protagonist's attempts at forging all the stories embedded in Songdogs into a master narrative of his family's history.El presente ensayo analiza la manera en la que la novela de Colum McCann Songdogs (1995) constituye una tentativa de reconstruir y reconciliarse con el pasado, un tema considerado por un gran número de críticos contemporáneos como característico de la experiencia literaria irlandesa. Se propondrá que la estructura no-lineal de la narrativa por un lado y su uso frecuente de imágenes estáticas reminiscentes de la fotografía por el otro le permiten a McCann adentrarse en el concepto de la memoria y traducir sus principios funcionales en una técnica literaria personal. La tarea de recuperar significados de distintos medios - sean imágenes fijas o la textura de la novela - se observará en dos niveles distintos. Los varios argumentos, construidos a partir de grupos de imágenes aparentemente independientes, y los esfuerzos por parte del lector para organizarlos en unidades significativas más grandes serán paralelos a los intentos del protagonista de aunar todas las historias incluidas en Songdogs en una narración completa de su historia familiar

Douleurs lombo-pelviennes liées à la grossesse (efficacité du traitement en médecine manuelle et ostéopathique dans le service de gynécologie-obstétrique du Centre hospitalo-universitaire de Nice)

NICE-BU Médecine Odontologie (060882102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Santé et précarité (évolution de l'activité du centre d'Albret, consultation medico-sociale du CHU de Bordeaux, entre 1995 et 2006)

BORDEAUX2-BU Santé (330632101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Intoxication par le Lithium (à propos de 39 cas)

BORDEAUX2-BU Santé (330632101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Landau parameters and collective modes in nuclear matter with relativistic non-linear models

The Landau parameters have been calculated in relativistic non-linear models, on the one hand, from the second derivative of the total energy density with respect to the quasinucleon distribution, on the other, from the longitudinal dielectric function in relativistic RPA with and without the Pauli blocking terms in the polarization operators. The link between the Landau parameters and the collective modes in nuclear matter was shown