Search

Platelets are currently acknowledged as cells of innate immunity and inflammation and play a complex role in sepsis. We examined whether different types of LPS have different effects on the release of soluble signaling/effective molecules from platelets. We used platelet-rich plasma from healthy volunteers and LPS from two strains of gram-negative bacteria with disparate LPS structures. We combined LPS-stimulated platelet supernatants with reporter cells and measured the PBMC cytokine secretion profiles. Upon stimulation of platelets with both Escherichia coli O111 and Salmonella minnesota LPS, the platelet LPS::TLR4 interaction activated pathways to trigger the production of a large number of molecules. The different platelet supernatants caused differential PBMC secretion of IL-6, TNFα, and IL-8. Our data demonstrate that platelets have the capacity to sense external signals differentially through a single type of pathogen recognition receptor and adjust the innate immune response appropriately for pathogens exhibiting different types of 'danger' signals.

Meprobamate poisoning are serious and sometimes fatal. Faced with a potential stop of marketing, we conducted a multicenter retrospective study to assess the severity criteria presented by patients admitted to the ICU for severe meprobamate poisoning, whether with alone form or in combination with aceprometazine. One hundred fourty-six patients have been enrolled between January 2005 and June 2011: 38 had a single meprobamate poisoning, 104 to meprobamate and aceprometazine and 4 to both forms. At admission, 88% of patients exhibited coma (Glasgow ≤ 7) and half of them a systolic blood pressure ≤90 mmHg. Mortality rate was 3%. Our results did not find any significant between-group difference, either in regard of clinical or biological severity criteria. These data argue for a cessation of marketing of all meprobamate-based specialities. Language: fr

We investigated the effects of either intravenous (IV) or intrabronchial (IB) treatment with transforming growth factor beta1 (TGF-beta1) during bacterial pneumonia in rats. Immediately following IB Escherichia coli inoculation (T0), animals (n=270) were randomized to receive a single treatment with human recombinant TGF-beta1 either via IV or IB, or via both IV and IB routes, or to receive placebo (human serum albumin, HSA) only. Blood and lung analysis was done at 6 and 168 h after E. coli inoculation. Other animals (n=40) were administered IV TGF-beta1 or HSA at T0 and 6, 12 and 24 h after E. coli inoculation to investigate the effects of multiple treatments also on survival rates alone. All animals received ceftriaxone daily. Route of administration did not influence TGF-beta1 (p=ns for the effect of TGF-beta1 comparing IV vs IB routes) and we averaged over this variable in analysis. The relative risk of death (mean +/- sem) was not altered by either single treatments administered at T0 (-0.18 +/- 0.25, p=0.47) or multiple treatments (0.40 +/- 0.50, p=0.66) of TGF-beta1. Single treatment with TGF-beta1 first decreased and then increased vascular leukocytes at 6 and 168 h, respectively, but increased alveolar leukocytes at both time points (p=0.02 comparing the differing effects of TGF-beta1 on vascular and alveolar leukocytes at 6 and 168 h). Although TGF-beta1 decreased blood and lung bacteria counts at 6 and 168 h, it also increased serum tumor necrosis factor levels and lung injury scores at these time points (p

Resume La serotherapie anti-infectieuse avait ete progressivement abandonnee ces dernieres annees, avecl'apparition d'antibiotiques efficaces mais aussi en raison de sa mauvaise tolerance et de sa faible efficacite, en dehors d'indications limitees, essentiellement en prevention. Le developpement d'anticorps monoclonaux humanises, l'apparition de bacteries multiresistantes, l'absence d'agents anti-infectieux efficaces notamment dans certaines infections virales, la mortalite toujours elevee du choc septique et de l'infection, malgre les antibiotiques les plus modernes, chez les immunodeprimes, de plus en plus severes et nombreux, ont fait reconsiderer l'interet des immunoglobulines aussi bien en preventif qu'en curatif, en monotherapie et/ou en association avec les antimicrobiens, dans certains infections.

Resume Introduction L’actinomycose est une infection bacterienne subaigue ou chronique qui atteint le sujet aussi bien immunocompetent qu’immunodeprime. Les lesions cervico-faciales et thoraco-abdominales sont les plus frequentes. Les localisations cerebrales sont exceptionnelles mais de pronostic severe. Observation Une femme de 56 ans, immunocompetente, etait hospitalisee pour un tableau infectieux non documente avec troubles du comportement et desorientation temporo-spatiale. Une aggravation progressive des signes neurologiques conduisait au coma avec necessite de ventilation mecanique. La neuro-imagerie montrait des abces cerebraux multiples dont la biopsie stereotaxique neurochirurgicale permettait le diagnostic anatomo-pathologique d’actinomycose. Un traitement adapte par bi-antibiotherapie et sans exerese chirurgicale permettait une evolution clinique favorable. Commentaires En l’absence de documentation microbiologique, l’examen histologique permet le diagnostic d’actinomycose cerebrale. Une double antibiotherapie adaptee peut permettre la guerison sans sequelle, meme en presence d’abces cerebraux multiples.

Inferior vena cava thrombosis is a major complication after filter placement. The thrombus can propagate through the filter leading to a high risk of pulmonary embolism. We report such a case in a patient with a Gunther filter, successfully treated with urokinase, and we discuss the efficacy and the safety of thrombolytic therapy in such situations.

Effectiveness of a single dose of APD Bisphosphonate in acute hypercalcaemia: Eighteen patients remaining hypercalcaemic (corrected calcaemia > 3 mMoles/l) after IV rehydratation received a dose of APD of 60 (Ca 3,5 MG/l). Normocalcaemia was achieved in every case, before Day 3 in 16 cases/18. This result was obtained, in patients with solid tumors with (6 pts) or without (4 pts) bone metastases, with myeloma (3 pts) and even with primary hyperparathyroidism (5 pts). Tolerance was excellent.