Portage d'un environnement Unix sur le noyau Gothic

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Modulation of microtubule assembly by the HIV-1 Tat protein is strongly dependent on zinc binding to Tat

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Myocardial extracellular volume by T1 mapping: a new marker of arrhythmia in mitral valve prolapse.

We aimed to evaluate the relationship between mitral annular disjunction (MAD) severity and myocardial interstitial fibrosis at the left ventricular (LV) base in patients with mitral valve prolapse (MVP), and to assess the association between severity of interstitial fibrosis and the occurrence of ventricular arrhythmic events. In MVP, MAD has been associated with myocardial replacement fibrosis and arrhythmia, but the importance of interstitial fibrosis remains unknown. In this retrospective study, 30 patients with MVP and MAD (MVP-MAD) underwent cardiovascular magnetic resonance (CMR) with assessment of MAD length, late gadolinium enhancement (LGE), and basal segments myocardial extracellular volume (ECVsyn). The control group included 14 patients with mitral regurgitation (MR) but no MAD (MR-NoMAD) and 10 patients with normal CMR (NoMR-NoMAD). Fifteen MVP-MAD patients underwent 24 h-Holter monitoring. LGE was observed in 47% of MVP-MAD patients and was absent in all controls. ECVsyn was higher in MVP-MAD (30 ± 3% vs 24 ± 3% MR-NoMAD, p < 0.001 and vs 24 ± 2% NoMR-NoMAD, p < 0.001), even in MVP-MAD patients without LGE (29 ± 3% vs 24 ± 3%, p < 0.001 and vs 24 ± 2%, p < 0.001, respectively). MAD length correlated with ECVsyn (rho = 0.61, p < 0.001), but not with LGE extent. Four patients had history of out-of-hospital cardiac arrest; LGE and ECVsyn were equally performant to identify those high-risk patients, area under the receiver operating characteristic (ROC) curve 0.81 vs 0.83, p = 0.84). Among patients with Holter, 87% had complex ventricular arrhythmia. ECVsyn was above the cut-off value in all while only 53% had LGE. Increase in ECVsyn, a marker of interstitial fibrosis, occurs in MVP-MAD even in the absence of LGE, and was correlated with MAD length and increased risk of out-of-hospital cardiac arrest. ECV should be includedin the CMR examination of MVP patients in an effort to better assess fibrous remodelling as it may provide additional value beyond the assessment of LGE in the arrhythmic risk stratification

Transfusion Related Acute Lung Injury (TRALI) Caused by Red Blood Cell Transfusion Involving Residual Plasma Anti-HLA Antibodies: A report on two Cases and General Considerations

TRALI is considered a serious hazard among immune complications of blood transfusion and its occurrence is admitted to be globally underestimated. Each type of blood product is likely to cause TRALI. We report here on two consecutive observations of TRALI caused by red blood cell concentrates, in which anti-HLA class I and class II antibodies resulting from post-gravitational allo-immunization were evidenced in donors. HLA class I and II antigenic community between recipients and donors' husbands were found and strong reacting IgG antibodies directed at several of those common antigens were detected in the donors' serum. Both donors had more than 3 pregnancies, raising the issue of blood donor selection or of plasma reduction for cellular products

Better care for babies: the added value of a modified reverse syphilis testing algorithm for the treatment of congenital syphilis in a maternity Hospital in Central African Republic.

BACKGROUND: In high syphilis prevalence settings, the syphilis testing and treatment strategy for mothers and newborns must be tailored to balance the risk of over treatment against the risk of missing infants at high-risk for congenital syphilis. Adding a non-treponemal test (Rapid Plasma Reagin - RPR) to a routine rapid treponemal test (SD Bioline Syphilis 3.0) for women giving birth can help distinguish between neonates at high and low-risk for congenital syphilis to tailor their treatment. Treatment for neonates born to RPR-reactive mothers (high-risk) is 10?days of intravenous penicillin, while one dose of intramuscular penicillin is sufficient for those born to RPR non-reactive mothers (low-risk). This strategy was adopted in March 2017 in a Médecins Sans Frontières supported hospital in Bangui, Central African Republic. This study examined the operational consequences of this algorithm on the treatment of newborns. METHODS: The study was a retrospective cohort study. Routine programmatic data were analysed. Descriptive statistical analysis was done. Total antibiotic days, hospitalization days and estimated costs were compared to scenarios without RPR testing and another where syphilis treatment was the sole reason for hospitalization. RESULTS: Of 202 babies born to SD Bioline positive mothers 89 (44%) and 111(55%) were RPR-reactive and non-reactive respectively (2 were unrecorded) of whom 80% and 88% of the neonates received appropriate antibiotic treatment respectively. Neonates born to RPR non-reactive mothers were 80% less likely to have sepsis [Relative risk (RR)?=?0.20; 95% Confidence interval (CI)?=?0.04-0.92] and 9% more likely to be discharged [RR?=?1.09; 95% CI?=?1.00-1.18] compared to those of RPR-reactive mothers. There was a 52%, and 49% reduction in antibiotic and hospitalization days respectively compared to a scenario with SD-Bioline testing only. Total hospitalization costs were also 52% lower compared to a scenario without RPR testing. CONCLUSIONS: This testing strategy can help identify infants at high and low risk for congenital syphilis and treat them accordingly at substantial cost savings. It is especially appropriate for settings with high syphilis endemicity, limited resources and overcrowded maternities. The babies additionally benefit from lower risks of exposure to unnecessary antibiotics and nosocomial infections

Progress in paleoclimate modeling

International audienceThis paper briefly surveys areas of paleoclimate modeling notable for recent progress. New ideas, including hypotheses giving a pivotal role to sea ice, have revitalized the low-order models used to simulate the time evolution of glacial cycles through the Pleistocene, a prohibitive length of time for comprehensive general circulation models (GCMs). In a recent breakthrough, however, GCMs have succeeded in simulating the onset of glaciations. This occurs at times (most recently, 115 kyr B.P.) when high northern latitudes are cold enough to maintain a snow cover and tropical latitudes are warm, enhancing the moisture source. More generally, the improvement in models has allowed simulations of key periods such as the Last Glacial Maximum and the mid-Holocene that compare more favorably and in more detail with paleoproxy data. These models now simulate ENSO cycles, and some of them have been shown to reproduce the reduction of ENSO activity observed in the early to middle Holocene. Modeling studies have demonstrated that the reduction is a response to the altered orbital configuration at that time. An urgent challenge for paleoclimate modeling is to explain and to simulate the abrupt changes observed during glacial epochs (i.e., Dansgaard-Oescher cycles, Heinrich events, and the Younger Dryas). Efforts have begun to simulate the last millennium. Over this time the forcing due to orbital variations is less important than the radiance changes due to volcanic eruptions and variations in solar output. Simulations of these natural variations test the models relied on for future climate change projections. They provide better estimates of the internal and naturally forced variability at centennial time scales, elucidating how unusual the recent global temperature trends are

Reemergence of Syphilis in Martinique, 2001–2008

Syphilis reemerged in Martinique in 2004 and initially affected 3 HIV-infected patients. By March 2008, syphilis was diagnosed for 37 men and 18 women. As of October 31, 2009, this outbreak had not yet been brought under control. It initially affected mainly men who had sex with men before it spread to heterosexual persons, minority group members, and crack cocaine users

Disentangling Immediate Adaptive Introgression from Selection on Standing Introgressed Variation in Humans.

Recent studies have reported evidence suggesting that portions of contemporary human genomes introgressed from archaic hominin populations went to high frequencies due to positive selection. However, no study to date has specifically addressed the postintrogression population dynamics of these putative cases of adaptive introgression. Here, for the first time, we specifically define cases of immediate adaptive introgression (iAI) in which archaic haplotypes rose to high frequencies in humans as a result of a selective sweep that occurred shortly after the introgression event. We define these cases as distinct from instances of selection on standing introgressed variation (SI), in which an introgressed haplotype initially segregated neutrally and subsequently underwent positive selection. Using a geographically diverse data set, we report novel cases of selection on introgressed variation in living humans and shortlist among these cases those whose selective sweeps are more consistent with having been the product of iAI rather than SI. Many of these novel inferred iAI haplotypes have potential biological relevance, including three that contain immune-related genes in West Siberians, South Asians, and West Eurasians. Overall, our results suggest that iAI may not represent the full picture of positive selection on archaically introgressed haplotypes in humans and that more work needs to be done to analyze the role of SI in the archaic introgression landscape of living humans