More rapid blood interferon α2 decline in fatal versus surviving COVID-19 patients

BackgroundThe clinical outcome of COVID-19 pneumonia is highly variable. Few biological predictive factors have been identified. Genetic and immunological studies suggest that type 1 interferons (IFN) are essential to control SARS-CoV-2 infection.ObjectiveTo study the link between change in blood IFN-α2 level and plasma SARS-Cov2 viral load over time and subsequent death in patients with severe and critical COVID-19.MethodsOne hundred and forty patients from the CORIMUNO-19 cohort hospitalized with severe or critical COVID-19 pneumonia, all requiring oxygen or ventilation, were prospectively studied. Blood IFN-α2 was evaluated using the Single Molecule Array technology. Anti-IFN-α2 auto-Abs were determined with a reporter luciferase activity. Plasma SARS-Cov2 viral load was measured using droplet digital PCR targeting the Nucleocapsid gene of the SARS-CoV-2 positive-strand RNA genome.ResultsAlthough the percentage of plasmacytoid dendritic cells was low, the blood IFN-α2 level was higher in patients than in healthy controls and was correlated to SARS-CoV-2 plasma viral load at entry. Neutralizing anti-IFN-α2 auto-antibodies were detected in 5% of patients, associated with a lower baseline level of blood IFN-α2. A longitudinal analysis found that a more rapid decline of blood IFN-α2 was observed in fatal versus surviving patients: mortality HR=3.15 (95% CI 1.14–8.66) in rapid versus slow decliners. Likewise, a high level of plasma SARS-CoV-2 RNA was associated with death risk in patients with severe COVID-19.ConclusionThese findings could suggest an interest in evaluating type 1 IFN treatment in patients with severe COVID-19 and type 1 IFN decline, eventually combined with anti-inflammatory drugs.Clinical trial registrationhttps://clinicaltrials.gov, identifiers NCT04324073, NCT04331808, NCT04341584

Kasside kliiniliste endokriinsete juhtumide analüüs, keskenduses diabeedile ja hüpertüroidismile

Final Thesis Curriculum in Veterinary MedicineThe aim of this paper is to determine whether there are any differences in signalment, diagnostics and treatment for the two main feline endocrinopathies: diabetes mellitus (DM) and hyperthyroidism (HT) in 2 different clinics. 1 is located in Normandy, France, and 1 is in Tartumaa, Estonia. This is a retrospective case study comprising of 46 cases; 14 cases of DM (7 in each clinic) and 32 cases of HT (4 in France and 28 in Estonia). While studying the patients’ files, the date of diagnosis for each endocrinopathy was determined and the following parameters were selected: age, breed, gender, diagnostic and treatment methods. Weight and whether or not diabetic remission was achieved was also assessed in DM cases; laboratory test results were analyzed for HT cases. Exactly 30% of these cases are DM cases. Male neutered Domestic Shorthair cats of 10-11 years of age are the typical patient, here. Moreover, the average patient was 4.8kg at the time of diagnosis. Polydipsia (PD) and/or polyuria (PU) was observed by owners in 71.4% of cases, followed by lethargy (in 50% of cases). The main observation here is the same rate of remission despite using 2 different types of insulin: lente insulin in France and glargine insulin in Estonia. As for HT, which represents 70% of our cases, the patient is on average 13.7 years and comes in for weight loss, vomiting and inappetence. All patients are treated medically with methimazole. As regards signalment, the cases of this study generally support the statements found in literature. The main difference in DM were remission rates according to the insulin used. In HT, dynamic function tests and treatment plans other than medical seem to exist only in theory, i.e. in literature.Selle töö eesmärk on analüüsida kahe erineva kliiniku baasil (Prantsusmaal Normandias ja Eestis Tartumaal) erinevusi kahe peamise kasside endokrinopaatia: suhkurtõve (DM) ja hüpertüreoidismi (HT) haigustunnustes, diagnostikas ja ravis.. See on retrospektiivne juhtumiuuring, mis hõlmab 46 haigusjuhtu: 14 DM juhtu (igas kliinikus 7) ja HT 32 juhtu (4 Prantsusmaal ja 28 Eestis). Patsientide haiguslugude uurimisel määrati iga endokrinopaatia diagnoosimise kuupäev ja koguti järgmised parameetrid: vanus, tõug, sugu, diagnostika- ja ravimeetodid. DM juhtudel hinnati ka kehakaalu ja seda, kas saavutati diabeetiline remissioon või mitte; analüüsiti HT juhtude laboratoorsete analüüside tulemusi. Täpselt 30% neist juhtudest on DM juhtumid. Tüüpilised patsiendid olid 10–11-aastased isased steriliseeritud lühikarvalised kodukassid. Keskmine patsient kaalus haiguse diagnoosimise hetkel 4,8 kg. Polüdipsiat (PD) ja/või polüuuriat (PU) täheldasid omanikud 71,4% juhtudest, millele järgnes letargia (50% juhtudest). Peamine tähelepanek DM juures on sama remissiooni määr vaatamata 2 erinevat tüüpi insuliini kasutamisele: lente insuliin Prantsusmaal ja glargiininsuliin Eestis. HT haigusjuhud moodustasid 70% kõigist käsitletud juhtudest. Keskmine patsient oli 13,7-aastane, kellel täheldati kaalulangust, oksendamist ja isutust. Kõiki patsiente raviti meditkamentoosselt metimasooliga. Käsitletud juhtude haigustunnuste spetsiifika toetab üldiselt kirjanduses leiduvaid väiteid. Peamine erinevus oli DM remissioonimäärades vastavalt kasutatud insuliinile. HT puhul selgus, et praktikas ei kasutata kirjanduses soovitatud funktsionaalseid teste ja spetsiifilisi raviplaane. Piirdutakse valdavalt medikamentoosse raviga

Diagnosis of genital herpes simplex virus infection in the clinical laboratory.

International audienceSince the type of herpes simplex virus (HSV) infection affects prognosis and subsequent counseling, type-specific testing to distinguish HSV-1 from HSV-2 is always recommended. Although PCR has been the diagnostic standard method for HSV infections of the central nervous system, until now viral culture has been the test of choice for HSV genital infection. However, HSV PCR, with its consistently and substantially higher rate of HSV detection, could replace viral culture as the gold standard for the diagnosis of genital herpes in people with active mucocutaneous lesions, regardless of anatomic location or viral type. Alternatively, antigen detection-an immunofluorescence test or enzyme immunoassay from samples from symptomatic patients--could be employed, but HSV type determination is of importance. Type-specific serology based on glycoprotein G should be used for detecting asymptomatic individuals but widespread screening for HSV antibodies is not recommended. In conclusion, rapid and accurate laboratory diagnosis of HSV is now become a necessity, given the difficulty in making the clinical diagnosis of HSV, the growing worldwide prevalence of genital herpes and the availability of effective antiviral therapy

Compatibilité du pantoprazole injectable lors d’administration en Y

Résumé Peu de données sont publiées concernant la compatibilité du pantoprazole intraveineux et d’autres médicaments ¹˒²˒³. Le présent travail dresse donc une liste des compatibilités du pantoprazole lorsqu’il est mélangé en Y avec divers autres médicaments. Nous avons noté une incompatibilité physique du pantoprazole avec une grande quantité d’autres médicaments, dont toutes les céphalosporines et tous les aminosides testés. Certains autres médicaments sont toutefois physiquement compatibles avec le pantoprazole lors d’une administration en Y. Le peu de données publiées corrobore nos résultats dans certains cas¹˒². Abstract Few data have been published regarding the compatibility of intravenous pantoprazole with other drugs. This paper presents pantoprazole compatibilities when mixed with a number of medications in Y-site administration. We have noted physical incompatibility of pantoprazole with many medicatons, such as cephalosporins and aminosides. However, certain medications are compatible with pantoprazole in Y-site administration. The few existing publications corroborate our findings

Les cancers des voies aérodigestives supérieures associés aux papillomavirus

Les carcinomes des voies aérodigestives sont le plus souvent secondaires à une intoxication alcoolo-tabagique. Cependant, il a été démontré que les papillomavirus oncogènes humains (HPV) ont un rôle de plus en plus important dans la genèse de ces cancers. Les carcinomes HPV+ sont le plus souvent observés chez des sujets plus jeunes que ceux porteurs de carcinomes secondaires à une intoxication alcoolo-tabagique. Ils sont principalement localisés au niveau de l’oropharynx et, en particulier, au niveau de l’amygdale. Le virus HPV est détecté dans les cancers de l’oropharynx avec une fréquence variant de 40 à 90 % suivant l’origine géographique des patients. Ces carcinomes HPV+ sont de meilleur pronostic et leur radio- ou chimiosensibilité est meilleure. Pour l’instant, aucune modification de traitement n’est recommandée, mais plusieurs essais thérapeutiques sont en cours. La vaccination préventive des garçons devient une véritable question de santé publique, ce d’autant qu’elle est déjà en place dans certains pays. D’autre part, une meilleure compréhension du microenvironnement tumoral de ces cancers permettra, à terme, de proposer une vaccination thérapeutique

An unusual human papillomavirus type 82 detection in laryngeal sqamous cell carcinoma: case report and review of literature

International audienc

COVID-19–Related Collapsing Glomerulopathy in a Kidney Transplant Recipient

International audienceWe report a case of a kidney transplant recipient who presented with acute kidney injury and nephrotic-range proteinuria in a context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Kidney biopsy revealed collapsing glomerulopathy. Droplet-based digital polymerase chain reaction did not detect the presence of SARS-CoV-2 RNA in the biopsy fragment, and the virus was barely detectable in plasma at the time of the biopsy. SARS-CoV-2 RNAemia peaked several days later, followed by a seroconversion despite the absence of circulating CD19-positive lymphocytes at admission due to rituximab-based treatment of antibody-mediated rejection 3 months earlier. Genotyping for the 2 risk alleles of the apolipoprotein L1 (APOL1) gene revealed that the donor carried the low-risk G0/G2 genotype. This case illustrates that coronavirus disease 2019 infection may promote a collapsing glomerulopathy in kidney allografts with a low-risk APOL1 genotype in the absence of detectable SARS-CoV-2 RNA in the kidney and that podocyte injury may precede SARS-CoV-2 RNAemia

Étude de la prévalence du papillomavirus (HPV) dans les cancers des voies aéro-digestives sur une cohorte unicentrique française de 372 patients

International audienceIntroduction: French data about HPV role in head and neck carcinomas are sparse, although French patients are mostly heavy smokers. In this series of oropharyngeal et non-oropharyngeal tumors, we aimed to determine what were the clinicopathological features associated with HPV and evaluate survival of patients according to HPV status.Methods: Three hundred and seventy-two cases of head and neck squamous cell carcinomas were reviewed and clinicopathological data were detailed. For each case, we performed a HPV PCR and an immunostaining against p16 protein (paraffin embedded tissues).Results: The series contained 90% of heavy smokers and 36% of tumors were located in oropharynx. HPV DNA was detected in 46% of oropharyngeal carcinomas and 16% of non-oropharyngeal carcinomas. Genotype 16 was the most frequently detected (84%). Clinicopathological features significantly associated with HPV DNA were: oropharyngeal location; absence of tobacco smoking; nodal involvement; poorly-differentiated non-keratinizing histology; positive p16 immunostaining. HPV infection was significantly associated with a longer survival for oropharyngeal carcinomas. It was not the case for non-oropharyngeal carcinomas.Conclusion: In this French series with lot of heavy smokers, under half of carcinomas are HPV induced. Clinicopathological features and survival data associated with HPV infection are the same as those classically described in literature