Exophiala dermatitidis Revealing Cystic Fibrosis in Adult Patients with Chronic Pulmonary Disease

Cystic fibrosis (CF) is a genetic inherited disease due to mutations in the gene cystic fibrosis transmembrane conductance regulator (CFTR). Because of the huge diversity of CFTR mutations, the CF phenotypes are highly heterogeneous, varying from typical to mild form of CF, also called atypical CF. These atypical features are more frequently diagnosed at adolescence or adulthood, and among clinical signs and symptoms leading to suspect a mild form of CF, colonization or infection of the respiratory tract due to well-known CF pathogens should be a warning signal. Exophiala dermatitidis is a melanized dimorphic fungus commonly detected in respiratory specimens from CF patients, but only very rarely from respiratory specimens from non-CF patients. We described here two cases of chronic colonization of the airways by E. dermatitidis, with recurrent pneumonia and hemoptysis in one patient, which led clinicians to diagnose mild forms of CF in these elderly patients who were 68- and 87-year-old. These cases of late CF diagnosis suggest that airway colonization or respiratory infections due to E. dermatitidis in patients with bronchiectasis should led to search for a mild form of CF, regardless of the age and associated symptoms. On a broader level, in patients with chronic respiratory disease and recurrent pulmonary infections, an allergic bronchopulmonary mycosis or an airway colonization by CF-related fungi like E. dermatitidis or some Aspergillus, Scedosporium or Rasamsonia species, should be considered as potential markers of atypical CF and should led clinicians to conduct investigations for CF diagnosis

Sustainable machining approach for CAD/CAM/CNC systems based on a dynamic environmental assessment

International audienceSustainability assessment is becoming an unquestionable issue for manufacturing companies that are urged by governments and customers to provide environment-friendly products. Machining, as one of the major manufacturing operations, has high potential factors regarding the environmental impacts of production system. Nevertheless, environmental assessments are mainly done post-product design and post-machining processes design. Integrating environmental assessment in the machining processes design could lead to significant improvements in sustainable manufacturing field. Major difficulties to perform such an assessment are the availability of the machining data and the lack of calculation rules to express them in terms of environmental impacts. This article presents a new approach based on the STandard for the Exchange of Product model data—compliant Numerical Control to integrate the machining environmental assessment in the earlier design phases. It proposes to establish cognitive links between the machining data included in STandard for the Exchange of Product model data—compliant Numerical Control and environmental indicators. The approach is implemented on a demonstrator and validated by a use case