Traitement du psoriasis par méthotrexate à l’ère des biothérapies : étude chez 21 patients tunisiens

Introduction. Nous présentons ici les résultats en terme d’efficacité et de tolérance du méthotrexate administré chez 21 patients tunisiens atteints de psoriasis sévère. Méthode. Il s’agit d’une étude rétrospective menée, de janvier 2002 à décembre 2009, au service de dermatologie de l’Hôpital Charles Nicolle de Tunis. Nous avons recensé 21 patients atteints de psoriasis sévère et mis sous méthotrexate. Résultats. La moyenne d’âge des patients était de 53 ans avec un sex-ratio de 6. La durée moyenne d’évolution du psoriasis était de 10 ans (un mois - 60 ans). Il s’agissait d’un psoriasis en plaques dans 18 cas (85,8 %) [surface cutanée moyenne atteinte de 63 %], d’un psoriasis érythrodermique dans 2 cas (9,5 %) et d’un psoriasis arthropathique dans 1 cas (4,7 %). Le méthotrexate a été administré per os à une dose initiale de 5 à 7,5 mg/semaine. La dose maximale hebdomadaire était de 7,5 mg à 12,5 mg. La rémission était totale dans 62 % des cas et partielle dans 28,5 % des cas. Des effets indésirables hématologiques et hépatiques ont été observés chez 2 patients (9,5 %). La période de rémission après l’arrêt du méthotrexate était en moyenne de 14 mois (3 mois-3 ans). Une récidive à type de psoriasis sévère a été observée chez 7 patients. Conclusion. Notre étude montre une bonne réponse clinique du psoriasis sévère au méthotrexate et ce en terme de taux et de durée de rémission, malgré des doses hebdomadaires plus faibles que celles classiquement utilisées dans la littérature

CHRONIC LINEAR ULCERATIONS OF THE INGUINO-CRURAL AND BUTTOCKS FOLDS

Vulvo-perineal Crohn's disease is a rare condition either when it is isolated or associated with digestive manifestations. In the former condition named metastatic Crohn's disease, it may constitute a diagnostic challenge and may be confused especially with other infectious or inflammatory disorders. We report a case of vulvo-perineal Crohn's disease in a 46-year-old woman. A 46-year-old woman was diagnosed with a vulvo-perineal Crohn's disease without digestive involvement. There was a chronic edema of the vulva with linear ulcerations on the inguino-crural regions and the buttocks fold, of 3 years. Treatment with metronidazole (1 g/day for 6 months) led to almost complete healing of the ulcerations with a sustained result. Physicians must be aware of the diverse manifestations and confusing presentations of vulvo-perineal Crohn's disease

Effects of heat exposure on Akt/S6K1 signaling and expression of genes related to protein and energy metabolism in chicken (Gallus gallus) pectoralis major muscle.

In order to improve understanding of the heat-induced changes in muscle growth, we determined the expression of genes related to protein and energy metabolism in the pectoralis major muscle of chickens. We also explored the protein kinase B (PKB also called Akt)/p70 S6 kinase (S6K1)/S6 pathway that mediates anabolic signals thereby regulating metabolism and hypertrophic/atrophic balance. Four-week-old chickens were exposed to 32 or 22 degrees C for 1 week. Chickens from both groups were then fasted for 16 h or left fed, and submitted to an oral administration of glucose-arginine to induce an anabolic response (30-min treatment) or left untreated. High ambient temperature and the associated decrease in feed intake modified the expression of certain energy-related genes (e.g. -40% for PGC-1alpha) and protein metabolism (e.g. about +80% for atrogin-1), but the expression of several muscle metabolism-related genes considered here was unchanged. The capacity for muscle protein synthesis, i.e. RNA/protein ratio, was reduced in warm conditions (approximately -20%). Slightly lower activation of S6 induced by glucose-arginine treatment was found at 32 degrees C compared to 22 degrees C, which might indicate somewhat lower efficiency of mRNA translation. Analysis of glucose/insulin balance suggested changes in glucose metabolism under heat exposure. However, this remains to be characterized

Degradation of Reactive Yellow 18 Using Ionizing Radiation Based Advanced Oxidation Processes: Cytotoxicity, Mutagenicity and By-Product Distribution

The degradation of Reactive Yellow 18 (RY-18), induced by gamma radiation in aqueous medium, was carried out as a function of gamma radiation dose (5–20 kGy) and concentration of hydrogen peroxide, the initial dye concentration and pH of the solution were optimized for the maximum degradation efficiency. Gamma radiations alone and in combination with H2O2 were used to degrade the RY-18. A degradation rate of 99% was achieved using an absorbed dose of 20 kGy, 0.6 mL H2O2 in acidic pH. Variations in the functional groups of untreated and treated RY-18 were determined by FTIR analysis. The LCMS technique was used to determine the intermediates formed during the degradation process. The cytotoxicity and mutagenicity of RY-18 were studied by hemolytic and Ames tests, respectively. There were significant reductions in cytotoxicity and mutagenicity in response to gamma radiation treatment. Cytotoxicity was reduced from 15.1% to 7.6% after treatment with a 20 kGy absorbed dose of gamma radiations with 0.6 mL H2O2. Mutagenicity was reduced by 81.3% and 82.3% against the bacterial strains TA98 and TA100 after treatment with a 20 kGy absorbed dose with 0.6 mL H2O2. The advanced oxidation process efficiency was evaluated using the byproduct formations, which were low-molecular-weight organic acid units, which through further oxidation were converted into carbon dioxide and water end products. Based on RY-18 degradation, cytotoxicity and mutagenicity reduction, the gamma radiation in combination with H2O2 has potential for the removal of dye from the effluents

Degradation of Reactive Yellow 18 Using Ionizing Radiation Based Advanced Oxidation Processes: Cytotoxicity, Mutagenicity and By-Product Distribution

The degradation of Reactive Yellow 18 (RY-18), induced by gamma radiation in aqueous medium, was carried out as a function of gamma radiation dose (5–20 kGy) and concentration of hydrogen peroxide, the initial dye concentration and pH of the solution were optimized for the maximum degradation efficiency. Gamma radiations alone and in combination with H2O2 were used to degrade the RY-18. A degradation rate of 99% was achieved using an absorbed dose of 20 kGy, 0.6 mL H2O2 in acidic pH. Variations in the functional groups of untreated and treated RY-18 were determined by FTIR analysis. The LCMS technique was used to determine the intermediates formed during the degradation process. The cytotoxicity and mutagenicity of RY-18 were studied by hemolytic and Ames tests, respectively. There were significant reductions in cytotoxicity and mutagenicity in response to gamma radiation treatment. Cytotoxicity was reduced from 15.1% to 7.6% after treatment with a 20 kGy absorbed dose of gamma radiations with 0.6 mL H2O2. Mutagenicity was reduced by 81.3% and 82.3% against the bacterial strains TA98 and TA100 after treatment with a 20 kGy absorbed dose with 0.6 mL H2O2. The advanced oxidation process efficiency was evaluated using the byproduct formations, which were low-molecular-weight organic acid units, which through further oxidation were converted into carbon dioxide and water end products. Based on RY-18 degradation, cytotoxicity and mutagenicity reduction, the gamma radiation in combination with H2O2 has potential for the removal of dye from the effluents

Traitement du psoriasis par méthotrexate à l’ère des biothérapies : étude chez 21 patients tunisiens

Introduction. Nous présentons ici les résultats en terme d’efficacité et de tolérance du méthotrexate administré chez 21 patients tunisiens atteints de psoriasis sévère. Méthode. Il s’agit d’une étude rétrospective menée, de janvier 2002 à décembre 2009, au service de dermatologie de l’Hôpital Charles Nicolle de Tunis. Nous avons recensé 21 patients atteints de psoriasis sévère et mis sous méthotrexate. Résultats. La moyenne d’âge des patients était de 53 ans avec un sex-ratio de 6. La durée moyenne d’évolution du psoriasis était de 10 ans (un mois - 60 ans). Il s’agissait d’un psoriasis en plaques dans 18 cas (85,8 %) [surface cutanée moyenne atteinte de 63 %], d’un psoriasis érythrodermique dans 2 cas (9,5 %) et d’un psoriasis arthropathique dans 1 cas (4,7 %). Le méthotrexate a été administré per os à une dose initiale de 5 à 7,5 mg/semaine. La dose maximale hebdomadaire était de 7,5 mg à 12,5 mg. La rémission était totale dans 62 % des cas et partielle dans 28,5 % des cas. Des effets indésirables hématologiques et hépatiques ont été observés chez 2 patients (9,5 %). La période de rémission après l’arrêt du méthotrexate était en moyenne de 14 mois (3 mois-3 ans). Une récidive à type de psoriasis sévère a été observée chez 7 patients. Conclusion. Notre étude montre une bonne réponse clinique du psoriasis sévère au méthotrexate et ce en terme de taux et de durée de rémission, malgré des doses hebdomadaires plus faibles que celles classiquement utilisées dans la littérature