When Inequality is Equitable: Validity, Propriety and Third Party Allocations

The author summarizes theories of equity and distributive justice that predict actors use legitimate distribution rules to act to maintain or to restore equity. He elaborates those ideas, distinguishing legitimacy based on validity (socially supported) from propriety (acceptance by the focal actor). Experimental research showed strong effects of both types of legitimacy on behavior, with validity having slightly stronger effects.This research was supported by a grant from the National Science Foundation (SOC #7817^3<»), Morris Zelditch, Jr.» Principal Investigator. Computations were supported by a grant from the Office of the Dean of Graduate Studies and Research at Stanford University

Autoimmune hepatitis in a patient with thymectomy: the benefit of histology and MUM-1 immunostaining.

A 61 years-old female patient, with a history of myaesthenia gravis since 1992, for which she underwent a thymectomy and is treated by pyridostigmine 60 mg once daily, was referred to our outpatient clinic by her general practioner for symptoms of nausea, lack of appetite and pyrosis. Abdominal clinical examination and upper gastrointestinal tract endoscopy were normal. Routine biological testing showed an important liver enzyme perturbation, with a typical hepatocellular injury pattern: aspartate aminotransferase level (AST) at 1449 U/L, alanine aminotransferase level (ALT) at 1856 U/L, alkaline phosphatase level (ALP) at 211 U/L, gamma-glutamyl transpeptidase level (GGT) at 211 U/L, lactate dehydrogenase level (LDH) at 796 UI/L, total bilirubinemia was 5.85 mg/dL, direct bilirubinemia was 5.18 and ferritinemia was above 2000 ng/ml. Peripheral blood cells showed 2670 leucocytes/µL (with 46.3% of neutrophils and 25.7% of lymphocytes). Abdominal ultrasound was normal. [...

Efficacité et tolérance des capsaïcinoïdes topiques dans le traitement de la douleur neuropathique. Une revue systématique et méta-analyse des essais cliniques randomisés

Introduction : La douleur neuropathique est fréquente, et sa prise en charge peut être difficile en cas d’inefficacité des traitements et de survenue d’effets secondaires. Une alternative aux traitements systémiques est l’application topique de capsaïcinoïdes. L’objectif du travail est d’évaluer l’efficacité d’un traitement topique à base de capsaïcinoïdes dans le traitement de la douleur neuropathique. Méthodes : En accord avec les recommandations PRISMA, une recherche systématique des essais cliniques publiés entre le 1er janvier 1990 et le 31 août 2014, en langue anglaise et française, a été réalisée dans PubMed/Central et la Cochrane Database. Les indications, les modalités de traitement et les résultats thérapeutiques ont été collectés. Des analyses qualitative et quantitative (méta-analyses) des données ont été réalisées. Résultats : Dix-sept études ont été incluses à partir de 153 études identifiées. Les données rassemblées permettent de conclure à l’efficacité de la capsaïcine pour traiter les douleurs neuropathiques postherpétiques et la polyneuropathie sensorielle distale associée au VIH. Les indications pourraient être élargies, mais les données sont insuffisantes pour tirer des conclusions. Conclusion : La capsaïcine topique est efficace pour les douleurs neuropathiques postherpétiques et dans la neuropathie associée au VIH. Des recherches complémentaires sont nécessaires dans d’autres indications, ainsi que pour évaluer l’éventuelle place d’autres capsaïcinoïdes[Efficacy and tolerance of topical capsaicinoids in the treatment of neuropathic pain. a systematic review and meta-analysis of randomized controlled trials] Introduction: Neuropathic pain is frequent and its management can be difficult in case of unsuccessful treatment and side effects. An alternative to systemic treatments is the topical use of capsaicinoids. The goal of this work is to evaluate the efficacy of the topical use of capsaicinoids to treat neuropathic pain. Method: In agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic research of clinical trials published between 1/1/1990 and 31/08/2014, in English and French, was performed in PubMed/Central and the Cochrane Database. The indications, modalities of treatment and therapeutic results were registered. Qualitative and quantitative (meta-) analyses of the data were performed. Results: Seventeen studies were included, from 153 identified works. The extracted data permitted us to conclude that capsaicin is efficient in treating post-herpetic neuropathic pain as distal HIV-associated polyneuropathy. The data are insufficient to conclude whether the indications may be broadened. Conclusion: Topical capsaicin is effective in treating postherpetic and HIV-associated neuropathic pain. Further studies are needed to evaluate other indications and the potential place of other capsaicinoid

Echtyma gangrenosum caused by coinfection with group A Streptococcus and Staphylococcus aureus :an emerging etiology? Case reports and literature review

Ecthyma gangrenosum (EG) is a potentially lethal skin infection, most commonly due to Pseudomonas aeruginosa with bacteremic dissemination and affecting mostly immunocompromised patients. We present two cases of EG in two men in Belgium recently admitted to our hospital, caused by a suspected coinfection by group A Streptococcus and Staphylococcus aureus, with a cutaneous dissemination, in which multiple impetigo lesions were the portal of entry. The first patient had no risk factors nor immunodeficiency, but the second was a homeless man with drug and alcohol abuse and advanced HIV infection. Early management of the condition is crucial, with initial broad spectrum antibiotherapy, rapidly narrowed down to the germs identified and skin lesion debridement if necessary. Any immunocompromising condition must be ruled out in any patient suffering from EG.info:eu-repo/semantics/publishe

Determinants of Renal Micro-Perfusion as Assessed with Contrast-Enhanced Ultrasound in Healthy Males and Females

(1) Background: The renal microcirculation is essential to maintain the renal function, but its determinants in humans have been poorly studied. Contrast-enhanced ultrasound (CEUS) allows the non-invasive quantification of the cortical micro-perfusion at the bedside using the perfusion index (PI). The aims of this study were to assess whether differences exist in PI between healthy males and females and to identify clinical determinants associated with cortical micro-perfusion. (2) Methods: Healthy, normotensive volunteers (eGFR > 60 mL/min/1.73 m2, no albuminuria) underwent CEUS under standardized conditions with the destruction–reperfusion (DR) technique. The mean PI of four DR sequences was reported as the primary outcome measure (3) Results: A total of 115 subjects (77 females and 38 males) completed the study; the mean ± SD age was, respectively, 37.1 ± 12.2 and 37.1 ± 12.7 years in females and males, and the mean eGFR was 105.9 ± 15.1 and 91.0 ± 17.4 mL/min/1.73 m2. The PI (median) was higher in females than in males, i.e., 2705 (IQR 1641–3777) vs. 1965 (IQR 1294–3346) arbitrary units (a.u), p = 0.02). A correlation analysis showed positive associations between PI and eGFR, female sex, heart rate, plasma renin activity (PRA) and plasma aldosterone concentrations (PAC), negative associations with potassium, bicarbonate and systolic blood pressure, and no associations with age, body mass index and renal resistive index (RRI). In a multivariate linear regression analysis, only PRA remained significantly associated with PI. (4) Conclusions: Although the PI was higher among females, this association was no longer significant after adjustment for covariates. There was no difference in females tested during the follicular or the luteal phases. In conclusion, the PI was only weakly influenced by classic clinical variables, but was positively associated with PRA, suggesting that the renin–angiotensin system plays a role in the regulation of the cortical micro-perfusion in humans. Identifying which other factors contribute to the large variations in micro-perfusion across individuals needs further study