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We quantified S1-specific IgG, neutralizing antibody titers, specific IFNγ secreting T cells and functionality of specific CD4+ and CD8+ T cells in 130 young adults (median age 44.0 years) and 106 older residents living in a long-term care facility (86.5 years) after 2 doses of BNT162b2. Three months after the first injection, humoral and cellular memory responses were dramatically impaired in the 54 COVID-19-naive older compared to the 121 COVID-19-naive younger adults. Notably, older participants’ neutralizing antibodies, detected in 76.5% (versus 100% in young adults,P< 0.0001), were ten times lower than the younger’s antibody titers (P< 0.0001). Antibody and T cell responses were greater among the 52 COVID-19-recovered than among the 54 COVID-19-naive older adults (P< 0.0001). Our study shows that 2 doses of BNT162b2 does not guarantee long-term protection against SARS-CoV-2 in the older. An additional dose should be considered to boost their specific memory response.

Many countries with a high perinatal level have started a policy of vaccination of pregnant women against pertussis. To date, France has not chosen this policy. The objective was to review knowledge on pertussis mortality in infants. Compare the strategies available to protect the infant before his first vaccination, scheduled for two months of age. We proceeded to a litterature analysis, from January 1998 to 2021. Search by the following keywords used ; "Whooping cough, vaccination, pregnancy, strategy, cocooning", on the scientific basis of "Pubmed", as well as French and foreign vaccination recommendations. Currently 90% of whooping cough deaths are concerning infants under six months of age and this mortality represents 2% of mortality in the first year of life. Vaccination at birth is not effective. The cocooning strategy, which consists of vaccinating those around the child, is expensive and difficult to implement. A systematic vaccination policy for pregnant women is effective and reasonably expensive when compared to the cocooning strategy. In England, it was recently accompanied by a 78% reduction in confirmed cases of pertussis in infants under six months of age. In conclusion, compared to cocooning strategy, pertussis vaccination of pregnant women appears more effective and cost-effective, and this with each pregnancy.

Introduction Sur l’annee 2019, notre service de Maladies infectieuses a du faire face a plusieurs epidemies de bacteries hautement resistantes aux antibiotiques emergentes (BHRe). Nous avons pris en charge 36 patients porteurs de BHRe anales avec 19 cas identifies de transmissions croisees. Le service a du adapter son activite : interruption temporaire des admissions et mise en place d’une strategie de « cohorting » sur certaines periodes correspondant aux « pics epidemiques ». Au vu de l’impact pluridimensionnel de ces evenements indesirables et de leur recurrence sur l’annee, nous avons realise une revue de morbi-mortalite afin d’en determiner les causes et consequences et ameliorer nos pratiques. Un des axes d’amelioration decide a ete la realisation, d’un depistage systematique du portage anal de BHRe a l’entree avec mise en place des precautions complementaires (PC) specifiques BHRe en complement des autres mesures d’hygiene existantes au sein de notre institution : suivi des patients connus porteurs de BHRe, depistage anal en presence de facteurs de risque de BHRe, strategie de prevalence et « contact-tracing » autour d’un cas « positif ». Materiels et methodes Il s’agit d’une etude observationnelle, monocentrique, retrospective et descriptive. Cette etude a ete realisee de 1 janvier 2020 au 31 decembre 2020 au sein du service Maladies infectieuses. Lors de chaque entree, un depistage par ecouvillon anal d’un portage de BHRe a ete realise avec mise en place des PC specifiques BHRe jusqu’a l’obtention des resultats bacteriologiques. Une affiche de signalement « BHRe entree » a ete creee, en reference a « l’entree », contrairement a celles destinees aux patients « contacts » et « positifs ». La tracabilite du prelevement d’entree etait realisee sur un support partage par les membres de l’equipe paramedicale. L’infirmier (iere) en charge du patient devait recuperer les resultats bacteriologiques pour adapter les precautions d’hygiene au statut infectieux du patient. Resultats Au total, 772 patients ont ete hospitalises sur l’ensemble de l’annee 2020 dans notre service. 548 sur 772 (71 %) patients ont beneficie d’un ecouvillon anal de depistage BHRe d’entree systematique. Sur l’ensemble de ces patients, 20/548 (4 %) etaient porteurs d’une BHRe. Dix-sept sur 20 (85 %) etaient connus porteurs des l’entree, 2 sur 20 ont ete decouverts au decours d’une prevalence (10 %). Un patient sur 20 (5 %) presentait un resultat positif dans le cadre du depistage systematique d’entree. La strategie de depistage systematique a l’entree a permis de depister 0,2 % de portage anal de BHRe (1/529). Conclusion Le depistage systematique du portage anal de BHRe a l’entree ne permet pas de rattraper le diagnostic de portage anal et d’en prevenir la transmission croisee.

Chlamydia trachomatis (CT) is the most common sexually transmitted bacterial infection worldwide. It is asymptomatic in most cases and mainly affects young women, with potential long term sequelae (pelvic inflammatory disease, tubal infertility, obstetric complications). The impact on male fertility is controversial. Screening methods as well as antibiotics use have recently been reassessed due to resistance phenomena and the negative effect on the urogenital microbiota. Positive CT serology may be indicative of tuboperitoneal pathology, which may not be noticed on hysterosalpingography. New research on single-nucleotide polymorphisms (SNPs) aims to establish a patient profile at higher risk of infectious tubal damage due to CT. CT seropositivity is also associated with decreased spontaneous pregnancy rates and is a predictive factor for obstetrical complications.

Postpartum endometritis accounts for 2% of postpartum infections in developed countries. In France, 2.3% of deaths are attributed to puerperal infections. The most important risk factor is cesarean delivery, especially if it is done after the start of labor. Bacteria of the vaginal microbiota are associated with postpartum endometritis. Symptoms are abdomino-pelvic pain, hyperthermia and abnormal lochia. The diagnosis is confirmed by uterine mobilization pain. The first-line antibiotic therapy is amoxicillin-clavulanic acid 3 to 6 grams per day depending on the weight, intravenously or orally. In case of impossibility to use penicillins (anaphylaxis for example), the combination of clindamycin 600mg×4/d plus gentamicin 5mg/kg×1/d may be use, it must be a specialized decision in case of maternal breastfeeding. The treatment is continued until obtaining 48hours of apyrexia and the disappearance of pelvic pain. In case of persistence of fever and/or pelvic pain after 72hours of antibiotic therapy, pelvic imaging should be performed for placental retention, septic thrombophlebitis, deep abscess or any other surgical complication and eliminate differential diagnoses. It is important to highlight the difficulties of interpreting endo-uterine images in ultrasound. Hypocoagulant heparin therapy should be started in case of septic thrombophlebitis for 6 weeks, or longer if there are complications such as embolism or thrombotic risk factors. Regarding prevention, during a caesarean section, a vaginal swab with iodinated polividone or chlorhexidine is recommended before caesarean if possible, and extraction of the placenta must be spontaneous.

To provide up-to-date guidelines on management of pelvic inflammatory disease (PID).An initial search of the Cochrane database, PubMed, and Embase was performed using keywords related to PID to identify reports in any language published between January 1990 and January 2012, with an update in 2018. All identified reports published in French and English relevant to the areas of focus were included. A level of evidence based on the quality of the data available was applied for each area of focus and used for the guidelines.PID must be suspected when spontaneous pelvic pain is associated with induced adnexal or uterine pain (grade B). Pelvic ultrasonography is necessary to exclude tubo-ovarian abscess (TOA) (grade C). Microbiological diagnosis requires endocervical and TOA sampling for molecular and bacteriological analysis (grade B). First-line treatment for uncomplicated PID combines ceftriaxone 1g, once, by intra-muscular (IM) or intra-venous (IV) route, doxycycline 100mg×2/d, and metronidazole 500mg×2/d oral (PO) for 10 days (grade A). First-line treatment for complicated PID combines IV ceftriaxone 1 to 2g/d until clinical improvement, doxycycline 100mg×2/d, IV or PO, and metronidazole 500mg×3/d, IV or PO for 14days (grade B). Drainage of TOA is indicated if the collection measures more than 3cm (grade B). Follow-up is required in women with sexually transmitted infections (STI) (grade C). The use of condoms is recommended (grade B). Vaginal sampling for microbiological diagnosis is recommended 3 to 6months after PID (grade C), before the insertion of an intra-uterine device (grade B), before elective termination of pregnancy or hysterosalpingography. Targeted antibiotics on identified bacteria are better than systematic antibioprophylaxis in those conditions.Current management of PID requires easily reproducible investigations and antibiotics adapted to STI and vaginal microbiota.

Resume La prevention des chutes chez la personne âgee est un veritable enjeu de sante publique. La demographie bretonne presente des particularites en faveur d’actions vers les plus de 60 ans et les secteurs prioritaires sont les cantons bretons ayant la plus forte demographie de personnes âgees. Selon l’Institut national de prevention et d’education pour la sante (INPES), les programmes de prevention des chutes ont fait la preuve de leur efficacite en termes de reduction du risque de chutes, du nombre d’hospitalisations et de limitation de la perte d’autonomie fonctionnelle. Les interventions de prevention des chutes les plus efficaces combinent plusieurs strategies d’action, ciblent plusieurs facteurs de risque et impliquent plusieurs intervenants, tant du secteur sanitaire que du secteur medicosocial. Ainsi, l’association « Kine Ouest Prevention », regroupant des kinesitherapeutes bretons, a mis en place depuis 1999 des actions « Equilibr’Age », dans le cadre d’un programme regional « Bretagne Equilibre » pilote par la Carsat Bretagne. Plusieurs actions d’evaluation ont ete realisees et temoignent des benefices apportes. Les perspectives prevoient de poursuivre et de renforcer ces actions, mais surtout d’apporter une validation scientifique par la creation d’un Comite scientifique Bretagne Equilibre.

Bacillus cereus is a ubiquitous telluric organism. B. cereus endocarditis is a rare condition seen mostly in prosthetic heart valves and among intravenous drug users. We report a new case of a patient without risk factors and with a good clinical outcome not requiring valve replacement.In October 2014, a 50-year-old woman was referred to the dermatology department of Lille University Hospital for lower-limb wounds developing 6 months earlier. She presented fever without clinical signs of infection, except for the lower-limbs wounds. Blood cultures revealed the presence of B. cereus. Transesophageal echocardiography was performed and revealed two foci of aortic valve vegetation with a diameter of 5mm. After bacterial sensitivity testing, rifampicin and levofloxacin treatment was given for six weeks, with complete remission. A skin graft was performed and good improvement was seen.Nineteen cases of B. cereus endocarditis have been described previously, only one of which was without risk factors. We described a case of complete remission after a 6-week course of antibiotics. Our case demonstrates that BC should not be considered as a blood culture contamination, and that treatment may be complex due to antibiotic resistance.

Resume Le trouble de personnalite limite (TPL) represente 10 % de l’activite psychiatrique ambulatoire. Le risque de suicide est important, ainsi que l’alteration du fonctionnement psychosocial. L’objectif de notre revue de litterature est de determiner l’efficacite des psychotherapies adaptees aux sujets presentant un TPL sur la sphere affective, comportementale, le fonctionnement interpersonnel et global ainsi que sur la personnalite. Pour cela, nous avons realise une revue de litterature de 1990 a 2008 sur Medline recoupant les mots clefs, « borderline personality disorder » et « psychotherapy » avec les limites « randomised control trial » ou « meta analysis ». Nous avons retenu 39 resumes, dont 17 (44 %) ont ete selectionnes, apres application des criteres d’exclusion (methode non controlee, etude centree sur un psychotrope, etude ne correspondant pas a notre objectif). Les psychotherapies apparaissent efficaces dans la prise en charge de plusieurs aspects touchant au TPL. La therapie comportementale et dialectique possede le plus haut niveau de preuve, notamment concernant son action sur les comportements autoagressifs. La therapie basee sur la mentalisation possede le plus large spectre d’action. La therapie cognitive manualisee et la formation d’inspiration systemique a la prediction emotionnelle et a la resolution de probleme offrent la faisabilite la plus importante. En l’etat actuel, il existe des differences d’indication probable en fonction des symptomes cibles et des ressources sanitaires disponibles.

Resume Objectif Evaluer la qualite des prescriptions de fluoroquinolones, d’aminosides et de l’amoxicilline-acide clavulanique au sein des secteurs de medecine. Methodes Recueil un jour donne des prescriptions antibiotiques ciblees sur ces molecules. Comparaison aux recommandations locales et aux manuels de references. Evaluation des antibiotherapies sur le choix de la molecule, les conditions d’administration (posologies, voies et rythmes d’administration, durees de traitement), la reevaluation des traitements a 48–72 heures, l’adaptation posologique des aminosides selon les dosages seriques. Resultats Soixante-trois patients ont ete inclus et 67 antibiotiques « cibles » prescrits. La prevalence des patients sous antibiotiques etait de 24,4 %, celle sous antibiotiques « cibles » de 14,6. Le choix de la molecule etait conforme pour 67 % des prescriptions. Les posologies administrees etaient adequates dans 94 % des cas et les rythmes d’administration dans 97 % des cas. Le relais per os des que possible a ete realise pour la moitie des patients. Les durees de traitement ont ete respectees pour 94 % des prescriptions. La reevaluation des antibiotherapies a 48–72 heures a ete realisee dans 66 % des cas. L’adaptation posologique des aminosides, quand elle etait necessaire, a ete realisee une fois sur trois. Pour l’ensemble des criteres de qualite mesures, le niveau de conformite globale des prescriptions etait de 44 %. Conclusion Differentes actions pourraient ameliorer la qualite de l’antibiotherapie : diffusion large de protocoles, reevaluation systematique des traitements a 48–72 heures, formation des jeunes prescripteurs, renforcement du role des correspondants medicaux en antibiotherapie et des infectiologues, evaluation periodique de l’antibiotherapie.

During their post-meiotic maturation, male germ cells undergo an extensive reorganization of their genome, during which histones become globally hyperacetylated, are then removed and progressively replaced by transition proteins and finally by protamines. The latter are known to tightly associate with DNA in the mature sperm cell. Although this is a highly conserved and fundamental biological process, which is a necessary prerequisite for the transmission of the male genome to the next generation, its molecular basis remains mostly unknown. We have identified several key factors involved in this process, and their detailed functional study has enabled us to propose the first model describing molecular mechanisms involved in post-meiotic male genome reprogramming. One of them, Bromodomain Testis Specific (BRDT), has been the focus of particular attention since it possesses the unique ability to specifically induce a dramatic compaction of acetylated chromatin. Interestingly, a mutation was found homozygous in infertile men which, according to our structural and functional studies, disrupts the function of the protein. A combination of molecular structural and genetic approaches has led to a comprehensive understanding of new major actors involved in the male genome reprogramming and transmission.

Several studies evidenced a pathogenic interaction between P. aeruginosa and C. albicans. P. aeruginosa is one of the most frequent microorganisms responsible for ventilator-associated pneumonia (VAP) and C. albicans usually colonize tracheo-bronchial tract of patients undergoing mechanical ventilation in the intensive care unit. In vitro, P. aeruginosa exploits filamentous fungi resulting in fungal killing and limitation of C. albicans growth in the host. Biofilm also play an important role as a persistent source of infectious material for recurrent episodes of VAP. Indeed, Candida spp and P. aeruginosa are the most common pathogens retrieved from endotracheal tube biofilm and tracheal secretions in patients with VAP. Finally, it has been demonstrated that previous tracheo-bronchial C. albicans colonization enhanced the incidence of P. aeruginosa pneumonia in a murine model. A recent study performed in patients requiring intubation and mechanical ventilation identified Candida spp tracheo-bronchial colonization as a risk factor for P. aeruginosa VAP. In addition, a retrospective study suggested that antifungal treatment might reduce P. aeruginosa VAP or tracheo-bronchial colonization in intubated patients with Candida spp tracheo-bronchial colonization. These interactions have major environmental and medical consequences. Experimental studies providing a better understanding of the mechanisms of interaction and clinical studies evaluating the necessity of a antifungal treatment might improve the management of these opportunistic infections.

Resume Si l'adolescence des enfants issus d'adoptions internationales se deroule le plus souvent bien, les remaniements identificatoires et objectaux, caracteristiques de cette periode, connaissent dans ce contexte quelques specificites. En effet, les interrogations relatives aux origines et a la filiation se posent avec d'autant plus d'acuite que l'enfant a ete soustrait tardivement a son milieu culturel d'origine. Les assises narcissiques et identitaires des parents adoptifs sont, elles aussi dans ce contexte, mises a rude epreuve. Il semble que plus les parents adoptifs sont parvenus a depasser leurs propres conflits, et ont acquis une certaine stabilite dans leur identite d'adoptant, moins ces adolescents ont de difficultes a traverser cette periode.

E-mail Address : sophie.rousseaux@ujf-grenoble.fr; International audience; Patients with severe spermatogenesis impairment can now successfully father a child thanks to the use of intracytoplasmic sperm injection (ICSI). In oligozoospermic patients, many studies have reported significantly higher sperm aneuploidy rates and therefore an increased risk of transmitting a chromosomal abnormality via the injection of abnormal spermatozoa. However, the frequency of aneuploidy is highly variable between patients. The aim of the present work was to identify clinical and biological factors, which, together with non-obstructive oligozoospermia, could be predictive of elevated sperm aneuploidies. The sperm aneuploidy rates for chromosomes X, Y, 13, 18 and 21 were assessed in 31 infertile men with well-characterized spermatogenesis impairment, and in a population of control men with proven fertility. The frequency of sperm aneuploidy was compared between several patient subgroups according to their clinical and biological factors. Nearly half of the oligozoospermic males (15/31) had a significantly increased disomy rate for at least one of the five chromosomes compared with that observed in the control population (mean disomy rates + 1.96 standard deviation). Factors significantly associated with higher numbers of aneuploid sperm were cigarette smoking, an elevated follicle-stimulating hormone level, a sperm concentration less than 1 M/mL, and a severe teratozoospermia. Hence, several factors predictive of an increased risk of sperm aneuploidy rates were identified in ICSI male candidates with a non-obstructive oligozoospermia.

Resume Puberte et maladie chronique ont en commun de provoquer de profonds remaniements physiques et psychiques qui, loin d'evoluer dans un mouvement coherent apparaissent souvent comme deux processus concurrents l'un de l'autre, le risque etant que le second (la maladie) occulte le premier (le processus de sexuation). Cette question de la concurrence entre corps pubere et corps malade fait l'objet de la reflexion clinique et psychopathologique qui suit.

Electrochromatography (EC) on a porous monolithic stationary phase prepared within the channels of a microsystem is an attractive alternative for on-chip separation. It combines the separation mechanisms of electrophoresis and liquid chromatography. Moreover, the porous polymer monolithic materials have become popular as stationary phase due to the ease and rapidity of fabrication via free radical photopolymerization. Here, we describe a hexyl acrylate (HA)-based porous monolith which is simultaneously in situ synthesized and anchored to the inner walls of the channel of a cyclic olefin copolymer (COC) device in only 2 min. The baseline separation of a mixture of neurotransmitters including six amino acids and two catecholamines is realized.

Dissolved methane and high resolution bathymetry surveys were conducted over the Rock Garden region of Ritchie Ridge, along the Hikurangi margin, eastern New Zealand. Multibeam bathymetry reveals two prominent, northeast trending ridges, parallel to subduction along the margin, that are steep sided and extensively slumped. Elevated concentrations of methane (up to 10 nM, 10× background) within the water column are associated with a slump structure at the southern end of Eastern Rock Garden. The anomalous methane concentrations were detected by a methane sensor (METS) attached to a conductivity‐temperature‐depth‐optical backscatter device (CTDO) and are associated with elevated light scattering and flare‐shaped backscatter signals revealed by the ship's echo sounder. Increased particulate matter in the water column, possibly related to the seepage and/or higher rates of erosion near slump structures, is considered to be the cause of the increased light scattering, rather than bubbles in the water ...

The purpose of this review was to analyze the literature concerning community-acquired pneumonia (CAP) and acute exacerbations of chronic obstructive pulmonary disease (AECOPD) published in the last five years. CAP and AECOPD are frequent diseases that are to this day still associated with high morbidity and mortality rates. Patient management, especially the choice of the management environment, outpatient or intensive care, depends on the knowledge and recognition of predictors of complications, mortality risk factors, and severity signs to the extent that predictive algorithms have been established. However, research and publications concerning discharge criteria and follow-up of CAP and AECOPD patients is more sparse.

In addition to genetic information, the spermatozoon carries another type of information, named epigenetic, which is not associated with variations of the DNA sequence. In somatic cells, it is now generally admitted that epigenetic information is not only regulated by DNA methylation but also involves modifications of the genome structure, or epigenome. During male germ cell maturation, the epigenome is globally re-organized, since most histones, which are associated to DNA in somatic cells, are removed and replaced by sperm specific nuclear proteins, the protamines, responsible for the tight compaction of the sperm DNA. However, a small proportion of histones, and probably other proteins, are retained within the sperm nucleus, and the structure of the sperm genome is actually heterogeneous. This heterogeneity of the sperm epigenome could support an epigenetic information, transmitted to the embryo, which could be crucial for its development. Although it is nowadays possible to appreciate the global structure of the sperm genome, the precise constitution of the sperm epigenome remains unknown. In particular, very recent data suggest that specific regions of the genome could be associated with particular proteins and define specific structures. This structural partitioning of the sperm genome could convey important epigenetic information, crucial for the embryo development.

Auriferous quartz pebble conglomerates (QPC) formed during Tertiary sedimentary recycling in the Waimumu district, Southland, New Zealand. These sediments contain fine-grained gold of detrital origin with abundant surface textures and gold-forms associated with authigenic gold remobilisation. Most authigenic gold contains no detectable silver and occurs as overgrowths on detrital Au–Ag and Au–Ag–Hg alloys that contain up to 13 wt.% Ag, and 9 wt.% Hg. Fine-grained Au–Ag and Au–Ag–Hg alloys are compositionally heterogeneous, exhibiting both well-defined silver-depleted and silver-enriched rims. Rare coarse Au–Ag alloy is intergrown with quartz and is homogenous. Discrete grains of authigenic, porous, sheet-like gold occur in carbonaceous mudstone within a QPC sequence. Some QPC contain abundant sulphide minerals. Some of these sulphides (pyrite and arsenopyrite) are of long-distance detrital origin, presumably from the Otago Schist, whereas the bulk of the sulphide suite is marcasite of variably transported diagenetic origin, derived from the erosion of QPC and underlying Tertiary sediments. There has also been authigenic deposition of sulphide minerals in the QPC themselves. These diagenetic sulphides include framboidal and anhedral marcasite, and framboidal and euhedral pyrite. Sulphur isotope data for the sulphide minerals range from − 45‰ to + 18‰ (relative to VCDT). Sulphur isotope data for euhedral detrital pyrite and arsenopyrite range from − 9‰ to − 1‰ and are most likely derived from the Otago Schist to the north. Both framboidal and anhedral marcasite have lower values ( Both the gold and diagenetic sulphides from the Belle-Brook QPC are compositionally similar to gold and sulphides from Archaean QPC. Porous, sheet-like authigenic gold is morphologically similar to gold associated with carbonaceous material in the Witwatersrand. In addition, Southland marcasite textures resemble the rounded and banded pyrite in Witwatersrand QPC placers. There is abundant evidence from these Tertiary QPC in southern New Zealand for sedimentary transport of sulphide minerals and post-depositional sulphide mineralisation in the surficial environment despite an oxygen-rich atmosphere. These young deposits thus provide an example of authigenic gold and sulphide textures formed during diagenesis in unmetamorphosed placers. Many of these textures are similar to those commonly ascribed to metamorphic processes in Archaean auriferous QPC.

Resume Les proteines du surfactant A et D (SP-A et SP-D) sont deux collectines pulmonaires. Elles se lient a divers pathogenes bacteriens, viraux ou fongiques et possedent plusieurs recepteurs membranaires sur les pneumocytes et les macrophages alveolaires. Elles favorisent la clairance bacterienne pulmonaire en exercant un chimiotactisme pour les macrophages alveolaires et les polynucleaires neutrophiles ainsi qu'en favorisant la phagocytose par activation directe des cellules phagocytaire et opsonisation des pathogenes. Par ailleurs, elles modifient la production de radicaux libres et la secretion de cytokines en fonction de l'etat d'activation de la cellule. In vivo, les souris deficientes en SP-A infectees par Pseudomonas aeruginosa ont une clairance bacterienne pulmonaire diminuee et une reponse inflammatoire locale augmentee. En revanche, les souris deficientes en SP-D presentent de profondes anomalies des macrophages alveolaires et un stress oxydatif important en dehors de toute infection. Les patients atteints de mucoviscidose sont frequemment colonises par P. aeruginosa . Ces sujets, de meme que les patients souffrant de pneumonies aigues sans maladie pulmonaire chronique, presentent une diminution importante des taux de SP-A et SPD dans le liquide de lavage bronchoalveolaire. P. aeruginosa secretent plusieurs proteases dont deux d'entre elles, l'elastase et la protease IV, degradent SP-A et de SP-D, entrainant une inhibition de leur fonction immunitaire. Des etudes complementaires sont necessaires afin de determiner si le deficit en SP-A et SP-D est un facteur favorisant ou une consequence de l'infection.

The setting of male-specific epigenetic information is a complex process, which involves a major global re-organisation, as well as localized changes of the nucleus structure during the pre-meiotic, meiotic and post-meiotic stages of the male germ cell differentiation. Although it has long been known that DNA methylation in targeted regions of the genome is associated with male-specific genomic imprinting, or that most core histones are hyperacetylated and then replaced by sperm-specific proteins during the post-meiotic condensation of the nucleus, many questions remain unanswered. How these changes interact, how they affect the epigenetic information and how the paternal epigenetic marks contribute to the future genome are indeed major issues remaining to be explored.

Introduction Les experts francais et europeens proposent des « signes cliniques d’alerte » qui doivent faire evoquer un deficit immunitaire primitif chez l’enfant et chez l’adulte. Parmi les evenements infectieux, un depistage de deficit immunitaire primitif est preconise chez les adultes ayant presente au moins 2 infections bacteriennes graves. De telles infections etant exceptionnelles chez l’adulte jeune, nous avons voulu evaluer l’interet d’un tel depistage apres une premiere infection invasive a germe encapsule, en l’absence de tout autre facteur predisposant. Patients et methodes Les patients eligibles ont ete identifies au sein de 3 centres hospitaliers grâce aux bases de donnees du programme de medicalisation des systemes d’information et des laboratoires de bacteriologie. Les patients etaient inclus s’ils etaient âges de 18 et 40 ans et avaient ete hospitalises entre 2010 et 2012 pour une infection invasive a germe encapsule (pneumocoque, streptocoque A, Haemophilus influenzae, meningocoque et gonocoque) Les criteres d’exclusion etaient les comorbidites ou causes d’infection generales (cancer, diabete, insuffisance renale ou hepatique, immunosuppresseurs, VIH, asplenie, deficit immunitaire primitif deja connu) ou locales (tabagisme, infection virale sous-jacente, pathologie pulmonaire chronique pour les infections pulmonaires ; breche meningee en cas de meningite non meningococcique ; porte d’entree buccale, dentaire ou cutanee pour les infections a streptocoque du groupe A). Les donnees cliniques et biologiques disponibles etaient recueillies dans les dossiers medicaux, ainsi que les antecedents infectieux personnels et familiaux, les resultats du bilan de premiere intention eventuellement realise (NFS, immunoglobulines (Ig) A, G et M, CH50 et fractions C3 et C4 du complement), et le diagnostic du DIP nouvellement identifie. En cas de bilan de premiere intention incomplet, les patients etaient recontactes au moment de l’etude via leur medecin traitant, et une consultation specialisee proposee dans les cas les plus suspects (bilan de premiere intention anormal, antecedents infectieux personnels ou familiaux comparables). Resultats Sur les 3 centres participants, 84 patients presentaient une infection invasive a germe encapsule entre 18 et 40 ans. Parmi eux, 46 patients etaient exclus du fait d’une cause generale et/ou locale. Les 38 patients inclus presentaient un âge moyen de 24,9 ± 7,7 ans et un sex-ratio H/F a 0,9. Dans 37 cas (97 %), il s’agissait d’un premier episode d’infection invasive. Les infections etaient des meningites chez 25 patients (66 % ; meningocoque n = 22, pneumocoque n = 2, Haemophilus n = 1), des pneumonies bacteriemiques a pneumocoque chez 9 patients (24 %), et des arthrites septiques chez 2 patients (5,3 % ; streptocoque A n = 1, gonocoque n = 1). Une bacteriemie sans porte d’entree etait documentee chez 2 patients (5,3 % ; streptocoque A n = 1, meningocoque n = 1). Au total, 8 patients (21 %) avaient un deficit immunitaire primitif. Trois patients avaient un deficit immunitaire commun variable, revele par une pneumonie bacteriemique (n = 2) ou une meningite a meningocoque (n = 1). Une patiente presentait un deficit en sous-classes IgG2 et IgA diagnostique apres une bacteriemie a streptocoque A. Quatre patients avaient un deficit en complement diagnostique apres une meningite a meningocoque (C6, C7, C8) ou une arthrite a gonocoque (C7). Conclusions Notre etude suggere une prevalence importante des deficits immunitaires primitifs chez les jeunes adultes ayant presente une premiere infection invasive a germe encapsule, en l’absence de tout autre facteur predisposant. Dans cette population tres ciblee, un depistage des deficits immunitaires primitifs des le premier evenement infectieux grave pourrait etre propose systematiquement.

The structure of metallic foams is described mainly in terms density distribution and porosity characteristics. Because of the lengthy, difficult preparation and image analysis of such specimens, the architecture of the metallic network has not been the subject of many investigations. This article thus describes the methods of preparation and automatic image analysis which can be used for cellular structures and discusses the results obtained with reference to a number of chosen examples. The methods of image analysis used to separate the metallic structure into cell edges and nodes are demonstrated on Alporas and metal foams which were manufactured using the powder compacting process (PCP).

The deformation behaviour of different types of closed cell aluminium foam (Alulight, Alporas) was studied. Compression tests indicate that inhomogeneities in the density distribution might be the ...

During their post-meiotic maturation, male germ cells undergo an extensive reorganization of their genome, during which histones become globally hyperacetylated, are then removed and progressively replaced by transition proteins and finally by protamines. The latter are known to tightly associate with DNA in the mature sperm cell. Although this is a highly conserved and fundamental biological process, which is a necessary prerequisite for the transmission of the male genome to the next generation, its molecular basis remains mostly unknown. We have identified several key factors involved in this process, and their detailed functional study has enabled us to propose the first model describing molecular mechanisms involved in post-meiotic male genome reprogramming. One of them, Bromodomain Testis Specific (BRDT), has been the focus of particular attention since it possesses the unique ability to specifically induce a dramatic compaction of acetylated chromatin. Interestingly, a mutation was found homozygous in infertile men which, according to our structural and functional studies, disrupts the function of the protein. A combination of molecular structural and genetic approaches has led to a comprehensive understanding of new major actors involved in the male genome reprogramming and transmission.

Borderline personality disorder (BPD) accounts for 10% of outpatient psychiatric practice. The risk of suicide attempts is high and the psychosocial impairment significant. Different theoretical streams have suggested psychotherapeutical approaches for BPD.to examine the efficacy of psychotherapy for BPD patients on affective symptoms, behavioural outcomes, interpersonal and social functioning, as well as BPD criteria.We reviewed the medical literature from 1990 to 2008 on Medline by combining the following keywords "borderline personality disorder" and "psychotherapy" (inclusion criteria). We restricted the analysis to "randomised control trial" or "meta analysis".Of the 39 abstracts that came out from the search, we selected 17 (44%) after applying the exclusion criteria. According to our review, different types of psychotherapies have shown some efficacy on reducing affective symptoms and BPD criteria, as well as improving behavioural outcomes and psychosocial functioning. Dialectical behavioural therapy presents the best-documented efficacy, notably on reducing self-mutilating and suicidal behaviours (five randomized controlled trials [RCT]). Mentalization based treatment seems to be efficient on the four types of outcomes, but has been the object of only one RCT. Finally, some evidence suggests that Manual Assisted Cognitive Treatment and Systems Training for Emotional Predictability and Problem Solving are the most cost-effective and easiest to be implemented.According to our review, some evidence supports an efficiency of psychotherapies in the management of several features of BPD. It is likely that, depending on the target symptoms, one type of therapy might be more efficient than another. The acceptability of these long-term treatments is however unknown.

A fronte di un'intensa e profonda attività di ricerca, in ambito petrologico, vulcanologico, geochimico e geodinamico, in relazione all'evoluzione e alle caratteristiche del vulcanismo nell'area mediterranea, poco sforzo è stato speso per un'adeguata comprensione dei processi idrotermali che interessano aree estremamente complesse, dal punto di vista geologico, come quella del mar Tirreno meridionale. In quest'area insistono sistemi di bacini di retroarco e sistemi di roll back in corrispondenza di noti seamounts (Marsili, Palinuro, Vavilov), nonché attività magmatica tipica di arco di isole (in corrispondenza del gruppo delle Eolie) con magmatismo assai diverso in evoluzione verso un sistema calcalino alto in potassio. Al fine di individuare potenziali flussi idrotermali in suddetta zona, è stata instaurata una collaborazione tra i ricercatori del nostro Istituto ( IAMC-CNR di Napoli), e dell'Osservatorio Vesuviano (INGV) di Napoli, con il gruppo di ricercatori del NOAA di Seattle e del GNS neozelandese, considerati leader nel campo delle ricerche di plumes idrotermali in aree geodinamicamente attive del pianeta (Arco delle Marianne, Arco Egeo, area di Tonga, etc.). È stata, quindi, pianificata una campagna oceanografica focalizzata su un survey sistematico delle attività idrotermali potenzialmente presenti nell'area meridionale del mar Tirreno.

BACKGROUND: Cytogenetically detectable aberrations of the Y chromosome, such as isodicentrics, rings or translocations are sometimes associated with male non-obstructive infertility. This report presents a detailed analysis of the clinical, cytogenetic and molecular data in three patients with a re-arranged Y chromosome. METHODS: Patients A and B were azoospermic, whereas patient C was cryptozoospermic. All had a somatic mosaic karyotype including a population of 45,X cells and a cell line with a re-arranged Y chromosome. A molecular and FISH analysis of their re-arranged Y was undertaken, which specifically focussed on the presence of the AZFa, b and c regions. RESULTS: The AZFa region was present in all the three patients. The AZFb and AZFc regions were absent in patients A and B, whereas, in patient C, the distal part of AZFb and the whole AZFc region were deleted. Moreover, in this patient, the AZF FISH analysis revealed a mosaicism for the size of the AZF deletion within the re-arranged Y, suggesting a progressive enlargement of the deletion during cell mitotic divisions. CONCLUSIONS: This investigation allowed not only a more precise description of the abnormal Y, but also shed light on how this re-arrangement could be involved in the infertility phenotype.

The effect of three stabilized peracetic acid (PAA) preparations (Bioxal M), with or without surfactants, on an Escherichia coli biofilm model was studied. The biofilm was prepared in glass tubes, and was evaluated indirectly using spectrophotometry. The ability of the products to fix or remove the biofilm was determined by their detergent activity (DA). None of the preparations tested fixed the biofilm. The effect of Bioxal M-1 on the biofilm was equivalent to the control (sterile water). Bioxal M-2 and Bioxal M-3 displayed slightly positive DAs. Non-ionic surfactant improved the DA of the products. Regardless of disinfectant activity, PAA agents display different DAs depending on their formulation. This criterion could be used to select the weakest biofilm-fixing agents. Users should therefore be concerned about the efficiency of the cleaning stage of medical devices. When choosing PAA products, non-fixing ability should be considered in addition to antimicrobial activity.

In many species, including humans, chromatin remodelling during spermiogenesis is initiated with a marked increase in histone acetylation in elongating spermatids. We have investigated whether this process is disturbed when spermatogenesis is defective or in human testicular tumours. For this purpose, the presence of highly acetylated histone H4 was detected on testicular sections from men with a severe impairment of spermatogenesis of several origins, as well as in different types of testicular tumours. In most tubules devoid of germinal cells (including SCO, Sertoli cell only syndromes) or lacking spermatocytes and spermatids, the Sertoli cells' nuclei showed a global increase in histone H4 acetylation. A similar observation was made in the peritumoral seminiferous tubules of testicular tumour tissues, whenever they were lacking germinal cells, with carcinoma in situ (CIS) cells being hypoacetylated. The global hyperacetylation of elongating spermatids during spermatogenesis could be part of an intercellular signalling pathway involving Sertoli cells and germinal cells, which could be disturbed in cases of severe spermatogenesis impairment, as well as in tubes surrounding germ cells in testicular tumours.

International audience; Chromatin remodelling in the fertilised mouse egg is intimately linked to protein synthesis and degradation, to protamine by histone replacement and to specific histone modifications. The involvement of histone deacetylases (HDACs) in the beginning of development is poorly understood. HDACs are essential for cell proliferation and in the control of gene expression in a wide variety of mammalian systems. Here we focus on mHDAC6, a recently identified class II histone deacetylase, and we analyse its expression and localisation in oocytes and pronuclear zygotes. By indirect immunofluorescence we show that mHDAC6 is detected in the cytoplasm of germinal vesicle (GV) stage oocytes and 1-cell embryos. Ectopic expression of this enzyme after injection into germinal vesicles and pronuclei alters the nuclear structure and causes premature compaction of the chromatin. Our data suggest that the effect of condensation is linked to the ubiquitin-binding activity of mHDAC6, rather than to its function as a deacetylase.

An in vitro angiogenesis system was designed for screening angiogenic agonists and antagonists. In order to obtain large quantities of cells and reproducibility, human endothelial cells with extended life spans were developed by retroviral transfection. The resulting cells grown in a serum-free medium containing endothelial cell growth supplement (ECGS) have a telomerase activity, extended life spans of at least 21 passages, and an endothelial cell phenotype (diI-acetylated-LDL upake, factor VIII-related antigen, VEGFR-1 and R-2, and tissue-type plasminogen activator (tPA)) that resembled that of unaltered primary endothelial cells. Exceptions were (i) a higher expression of tPA, and (ii) a non-significant growth response to FGF-2 or VEGF stimulation. Within three-dimensional fibrin gels, specific cell clones rapidly formed tubular structures in a more reproducible manner than those observed with low-passage primary cells. Tube formation by primary endothelial cells and those with extended life spans was dependent upon FGF-2 and ECGS, respectively. Both cell types produced FGF-2 and VEGF cytokines. Increasing doses of suramin significantly decreased the size of microvessels formed by both cell lines. These functional results indicate that a vascular matrix system containing human cells with extended life spans can be successfully utilized as an in vitro assay for antiangiogenic compounds.

Here we report a detailed analysis of waves of histone acetylation that occurs throughout spermatogenesis in mouse. Our data showed that spermatogonia and preleptotene spermatocytes contained acetylated core histones H2A, H2B and H4, whereas no acetylated histones were observed throughout meiosis in leptotene or pachytene spermatocytes. Histones remained unacetylated in most round spermatids. Acetylated forms of H2A and H2B, H3 and H4 reappeared in step 9 to 11 elongating spermatids, and disappeared later in condensing spermatids. The spatial distribution pattern of acetylated H4 within the spermatids nuclei, analyzed in 3D by immunofluorescence combined with confocal microscopy, showed a spatial sequence of events tightly associated with chromatin condensation. In order to gain an insight into mechanisms controlling histone hyperacetylation during spermiogenesis, we treated spermatogenic cells with a histone deacetylase inhibitor, trichostatin A (TSA), which showed a spectacular increase of histone acetylation in round spermatids. This observation suggests that deacetylases are responsible for maintaining a deacetylated state of histones in these cells. TSA treatment could not induce histone acetylation in condensing spermatids, suggesting that acetylated core histones are replaced by transition proteins without being previously deacetylated. Moreover, our data showed a dramatic decrease in histone deacetylases in condensing spermatids. Therefore, the regulation of histone deacetylase activity/concentration appears to play a major role in controling histone hyperacetylation and probably histone replacement during spermiogenesis.