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1) Le virus de la peste bovine est susceptible d'infecter les carnivores et provoque chez eux une maladie cliniquement inapparente, mais génératrice d'anticorps neutralisants. Le virus de la maladie de Carré (souche furet) provoque chez les bovins une infection inapparente, décelable seulement par les techniques sérologiques. Les souches avianisées possèdent un pouvoir infectant irrégulier. 2) L'infection par le virus de la peste bovine confère aux carnivores une résistance solide à la maladie de Carré, immunité vraie, solide et durable (au moins 11 mois et demi). Réciproquement, l'infection par le virus de Carré confère aux bovins une immunité solide contre la peste bovine. 3) Les sérums contre la peste bovine neutralisent le virus de Carré in ovo et in vivo à des dilutions analogues à celles des sérums homologues. Les sérums contre la maladie de Carré neutralisent faiblement et irrégulièrement contre le virus bovipestique. 4) Le lapin semble indifférent au virus de Carré, qui n'engendre chez lui ni l'immunité ni la formation d'anticorps neutralisants. 5) La structure antigénique du virus bovipestique semble plus complexe que celle du virus de Carré, qui représenterait une forme dégradée de celui-ci.

A 22-year-old patient underwent fine needle aspiration of a nodule at the outer center of the right lobe of the thyroid, and it was reported to be Bethesda system category IV, Hurthle cell follicular neoplasia. The patient, who persented to Onsekiz Mart University Research and Application Hospital, underwent surgery. During right total thyroidectomy, an almost totally infarcted nodule and papillary structures around these infarcted areas were detected. Herein, we report on diagnostic challenges faced in confirming whether the infarcted nodule was a case of reactive papillary changes or an underdiagnosed papillary carcinoma and how the challenges were overcome using immunohistochemistry analysis and molecular genetic testing. In addition, we examined the case along with a literature review because an accompanying synchronous brain stem astrocytoma was detected in the patient after thyroidectomy.

Abstract Purpose: To investigate the effects of pycnogenol on peritoneal adhesions and additionally to investigate the immunohistochemical effects of free oxygen radicals and reactive lymph nodes detected in the adhesive tissue that was sampled surrounding the cecum on intra-abdominal adhesions. Methods: Twenty-seven Wistar Albino rats were divided into three groups. In group 1 (sham), laparotomy was performed and stitched up. In group 2 (control), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered 2 cc of saline. In group 3 (experimental), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered a sterile Pycnogenol derivative. The rats in all groups were re-laparotomized on postoperative day 7; samples were obtained from the peritoneal tissue surrounding the cecum, and the rats were sacrificed. Results: In group 3, there was a statistically significant difference in terms of inflammation, lymph node size, and free oxygen radicals; these parameters tended to increase. In terms of fibrosis evaluated using H&E and MT, there was no significant difference between groups 2 and 3. Conclusions: No positive outcomes indicating that pycnogenol reduces intra-abdominal adhesions were obtained. However, it caused severe inflammation in the tissue. Moreover, a significant increase in lymph node size was detected secondary to inflammation. Additionally, in immunohistochemical analyses conducted to detect oxidative stress, pycnogenol increased the production of free oxygen radicals in the tissue.

This is part 2 of 6 of the dossier What do we talk about when we talk about queer death?, edited by M. Petricola. The contributions collected in this article sit at the crossroads between thanatology, gender studies, and LGBT+ studies and tackle questions such as: how can queer death studies problematise heteronormative/cisnormative constructions of dying, death, and mourning? How can queer death studies approach the post-mortem manipulation of transgender identities? How can this discipline change the current cultural perception of the link between queerness and suicide? The present article includes the following contributions: – Alasuutari, V., Queering the heteronormative and cisnormative lifeworld of death; – Whitestone S., Queering as identity preservation: transgender identity after death; – Goret Hansen L., When i talk about queer death, I talk about trans-necropolitics and suicide prevention; – Jaworski K., Notes towards rethinking the agency of queer youth suicide; – Doletskaya O., Queer death and victimhood in Russia: ‘westernised queer activism’; – Zubillaga-Pow J., Lesbian Liebestod: sapphic suicide in chinese society.

INTRODUCTION[|]The aim of this study was to compare the effects of breast-conserving surgery (BCS) and subcutaneous mastectomy with implant reconstruction (SMIR) in terms of postoperative psychosocial effects, sexuality, and quality of life.[¤]METHODS[|]Demographic data and clinical breast cancer parameters of patients who underwent BCS (n=48) or SMIR (n=27) between January 2012 and December 2016 were reviewed retrospectively. The data were collected via face-to-face interview using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the breast cancer-specific submodule, EORTC QLQ-BR23.[¤]RESULTS[|]In this study group, 23 (48%) patients who underwent BCS and 25 (92.6%) patients who underwent SMIR were premenopausal (p0.05). Fatigue scores on the QLQ-C30 were greater for SMIR patients, as well as arm symptoms in the QLQ-BR23 side effects scale (p

In a prospective, nationwide study in France of Escherichia coli responsible for pneumonia in patients receiving mechanical ventilation, we determined E. coli antimicrobial susceptibility, phylotype, O-type, and virulence factor gene content. We compared 260 isolates with those of 2 published collections containing commensal and bacteremia isolates. The preponderant phylogenetic group was B2 (59.6%), and the predominant sequence type complex (STc) was STc73. STc127 and STc141 were overrepresented and STc95 underrepresented in pneumonia isolates compared with bacteremia isolates. Pneumonia isolates carried higher proportions of virulence genes sfa/foc, papGIII, hlyC, cnf1, and iroN compared with bacteremia isolates. Virulence factor gene content and antimicrobial drug resistance were higher in pneumonia than in commensal isolates. Genomic and phylogenetic characteristics of E. coli pneumonia isolates from critically ill patients indicate that they belong to the extraintestinal pathogenic E. coli pathovar but have distinguishable lung-specific traits.

Abstract Background The change from non-molecular to nucleic acid amplification tests (NAATs) is known to increase the detection of Clostridium difficile infection (CDI); however, the impact on stool rejection policies in clinical laboratories is unclear. The current guidelines have reinforced the importance of respecting strict conditions for performing tests on stool samples for CDI diagnosis. The purpose of this study was to estimate whether the implementation of molecular tests has resulted in changes in stool rejection policies between clinical laboratories that introduced NAATs and those that did not. Results A survey was conducted to evaluate the change in the number of stool samples rejected and the rejection criteria among 12 hospital laboratories in southwestern France before and after the switch from non-molecular tests to NAATs using retrospective data from June 1 till September 30, 2013 and the same period 2014. Four laboratories introduced NAATs as a second or third step in the process. A total of 1378 and 1297 stools samples were collected in 2013 and 2014, respectively. The mean number of rejected stool samples significantly increased (p

In the context of climate change, the reduction of greenhouse gas emissions is a global concern. Recent publications estimate that 30–40% of total anthropogenic greenhouse gases are directly emitted by urban areas. This paper focuses on CO2, which is the main anthropogenic greenhouse gas, and presents an implementation of CO2 flux modelling in urban areas within the urban canopy model Town Energy Balance (TEB). Highly weather-dependent contributors to CO2 fluxes (buildings and vegetation) are explicitly modelled by TEB using the Building Energy Model (BEM) for buildings and Interactions between Soil, Biosphere and Atmosphere (ISBA) for urban vegetation. This approach allows the impacts of the urban microclimate on CO2 fluxes to be simulated. Non-weather-dependent contributors (traffic and human respiration) are simulated using simpler approaches. A sensitivity study applied to the centre of Toulouse, France, highlights the relevance of detailed input data related to traffic, building use and human behaviour to simulate accurate CO2 fluxes. The results show that traffic (48.5%) and buildings (42%) are the main contributors to the annual mean CO2 flux. A comparison of the model results with independent eddy-covariance flux data shows good agreement with a root mean square error of 15.3 μmol m−2 s−1 and demonstrates that the model is able to reproduce seasonally averaged daily cycles of CO2 fluxes. In future studies, this model can be used to quantify the impacts on CO2 fluxes of different urban development scenarios such as urban expansion, changes in urban form, changes in practices related to the heating of buildings or urban greening strategies. Keywords: CO2fluxes, Eddy covariance, Cities, Urban canopy layer model, Model evaluation

We report 2 cases of pulmonary Bordetella hinzii infection in immunodeficient patients. One of these rare cases demonstrated the potential transmission of the bacteria from an avian reservoir through occupational exposure and its persistence in humans. We establish bacteriologic management of these infections and suggest therapeutic options if needed.

Chorioangioma, or hemangioma of the placenta, is the most frequent non-trophoblastic tumor of the placenta consisting of blood vessels and stroma. A great proportion of these tumors are small and well delineated within the placental parenchyma and have no or minimal adverse impact on the fetus. Unfortunately, large tumor size is linked to serious complications such as fetal anemia, hydrops and intrauterine death. This is probably because of arteriovenous shunts leading to progressive heart failure of the fetus. With the increasing rates of antenatal screenings with ultrasonography, prenatal diagnosis of these tumors is widely achieved. Here we report a case of giant placental chorioangioma diagnosed in the second trimester of pregnancy. The size of the tumor minimally increased during follow-up and at term, uncomplicated labor was achieved. Macroscopic and histologic examination confirmed the diagnosis. [Med-Science 2016; 5(4.000): 1037-9]

Clostridium difficile causes antibiotic-associated diarrhoea and pseudomembranous colitis. The main virulence factors of C. difficile are the toxins A (TcdA) and B (TcdB). A third toxin, called binary toxin (CDT), can be detected in 17% to 23% of strains, but its role in human disease has not been clearly defined. We report six independent cases of patients with diarrhoea suspected of having C. difficile infection due to strains from toxinotype XI/PCR ribotype 033 or 033-like, an unusual toxinotype/PCR ribotype positive for CDT but negative for TcdA and TcdB. Four patients were considered truly infected by clinicians and were specifically treated with oral metronidazole. One of the cases was identified during a prevalence study of A−B−CDT+ strains. In this study, we screened a French collection of 220 nontoxigenic strains and found only one (0.5%) toxinotype XI/PCR ribotype 033 or 033-like strain. The description of such strains raises the question of the role of binary toxin as a virulence factor and could have implications for laboratory diagnostics that currently rarely include testing for binary toxin.

Le dosage des IgG totales sur sérum est un examen courant de biologie médicale. Plus spécialisé, le dosage des sous- classes d'IgG sur sérum trouve sa place en deuxième ligne lors d'un bilan de déficit immunitaire ou pour la maladie associée aux IgG4 (MAG4). Dans le liquide céphalorachidien, leur évaluation permet la distinction entre un transsudat et une synthèse intrathécale. Concernant les sous-classes d'IgG dans le LCR, les laboratoires de biologie médicale commencent à recevoir des demandes, afin de mettre en évidence la présence d'IgG4. Dans le LCR elles seraient liées à la pachyméningite hypertrophique associée à la MAG4 mais, en l'absence d'étude clinique de grande envergure, leur dosage ne semble être pertinent que lorsque la biopsie tissulaire est impossible. La technique de dosage validée sur sérum est quantitative en milieu liquide (néphélémétrie/turbidimétrie). L'utilisation de ces techniques sur LCR doit être validée par chaque laboratoire, en l'absence de validation des kits sur LCR. Cette revue actualisée de la littérature revient sur les différentes indications des dosages d'IgG et des sous-classes d'IgG sur sérum, sur l'intérêt du dosage des sous- classes d'IgG sur le LCR et les techniques associées. Serum total IgG measurement is a common lab act in medical biology. More specialized, serum IgG subclasses measurement plays a key role in IgG4-Re- lated Disease but is also useful for second-line diagnosis in humoral immune deficiencies. In the cerebrospinal fluid (CSF), an index is used as an indicator of the relative amount of CSF IgG compared to serum. Any increase in the index reflects IgG production in the central nervous system. Regarding IgG subclasses in the CSF, medical laboratories are now getting demands, actually to find out if there is any IgG4 subclass. These IgG4 in CSF could be associated with IgG4-related hypertrophic pachymeningitis but without appropriate studies corroborating this, their measurement should be done only when tissue biopsy cannot be performed. Quantitative measurement on serum is validated with nephelometry and turbidimetry assays. Each laboratory has to validate the assays on CSF before giving results. In this mini review, we present the indications of total IgG and IgG subclasses on serum as well as the benefit of IgG subclasses in CSF and the techniques available in a medical laboratory. [ABSTRACT FROM AUTHOR]

The production of aboveground soft tissue represents an important share of total net primary production in tropical rain forests. Here we draw from a large number of published and unpublished datasets (n=81 sites) to assess the determinants of litterfall variation across South American tropical forests. We show that across old-growth tropical rainforests, litterfall averages 8.61±1.91 Mg ha−1 yr−1 (mean ± standard deviation, in dry mass units). Secondary forests have a lower annual litterfall than old-growth tropical forests with a mean of 8.01±3.41 Mg ha−1 yr−1. Annual litterfall shows no significant variation with total annual rainfall, either globally or within forest types. It does not vary consistently with soil type, except in the poorest soils (white sand soils), where litterfall is significantly lower than in other soil types (5.42±1.91 Mg ha−1 yr−1). We also study the determinants of litterfall seasonality, and find that it does not depend on annual rainfall or on soil type. However, litterfall seasonality is significantly positively correlated with rainfall seasonality. Finally, we assess how much carbon is stored in reproductive organs relative to photosynthetic organs. Mean leaf fall is 5.74±1.83 Mg ha−1 yr−1 (71% of total litterfall). Mean allocation into reproductive organs is 0.69±0.40 Mg ha−1 yr−1 (9% of total litterfall). The investment into reproductive organs divided by leaf litterfall increases with soil fertility, suggesting that on poor soils, the allocation to photosynthetic organs is prioritized over that to reproduction. Finally, we discuss the ecological and biogeochemical implications of these results.

La biologie est un outil incontournable dans le diagnostic et la prise en charge des patients allergiques. L'apprentissage à l'interprétation d'un bilan biologique est essentiel pour le praticien. En raison de la diversité des cursus, les jeunes allergologues n'ont pas tous la même formation. À la demande du Conseil Scientifique de la Société française d'allergologie (SFA), le Groupe de Travail Biologie de l'Allergie a réalisé une enquête auprès des jeunes allergologues afin d'évaluer leur niveau de formation en biologie de l'allergie et de connaître leurs attentes en termes de formation continue. Au total, 162 allergologues ont été contactés et 36 ont répondu. Les répondants étaient majoritairement des femmes (78 %), allergologues exclusifs (83 %) et 69 % étaient issus du DES d'Allergologie. La moitié estimait avoir eu une formation suffisante en biologie de l'allergie et 50 % ont effectué un stage dans un laboratoire de biologie médicale. Soixante-trois pour cent se considéraient comme compétents pour l'interprétation des bilans. Pour leur formation continue, ils utilisaient les sites internet des sociétés savantes, les revues scientifiques et des webinaires qu'ils jugeaient satisfaisants. Aucune personne n'avait recours à un système d'évaluation des compétences. Plus de 95 % des répondants sont en faveur d'une mise à disposition de documents synthétiques de référence et tous les consulteraient s'ils étaient accessibles en ligne sur le site de la SFA. En conclusion, la formation des jeunes allergologues sur la biologie de l'allergie a besoin d'être complétée et harmonisée, sur le plan théorique et pratique. Plusieurs outils pédagogiques sont plébiscités pour le maintien des compétences. Blood tests are an essential tool for the diagnosis and management of allergy. Learning how to interpret test results is therefore essential for the physician. Due to the diversity of their education, young allergists do not all have the same training. At the request of the French Society of Allergology (SFA) Scientific Committee, the In vitro Diagnosis Working Group carried out a survey for young allergists in order to evaluate their level of initial training in allergy in vitro diagnosis and to know their expectations in terms of continuing medical education. A total of 162 allergists were consulted and 36 responded. Half of them considered that they had sufficient training in allergy in vitro diagnosis and 50% considered themselves competent in the interpretation of tests. For their continuing medical education, they use the websites of learned societies (SFA, EEACI), scientific journals and webinars and consider them satisfactory or very satisfactory. More than 95% of them are in favour of the online availability of summary sheets or reference documents in in vitro diagnosis, and all of them would consult these tools if they were accessible on the SFA website. In conclusion, the training of young allergists in allergy blood tests needs to be completed and standardised, both theoretically and practically. Several educational tools are available and popular to achieve this and help them to keep valuable skills up to date. [ABSTRACT FROM AUTHOR]

Recently, the worldwide propagation of clonal CTX-M-15-producing Escherichia coli isolates, namely ST131 and O25b:H4, has been reported. Like the majority of extra-intestinal pathogenic E. coli isolates, the pandemic clone ST131 belongs to phylogenetic group B2, and has recently been shown to be highly virulent in a mouse model, even though it lacks several genes encoding key virulence factors (Pap, Cnf1 and HlyA). Using two animal models, Caenorhabditis elegans and zebrafish embryos, we assessed the virulence of three E. coli ST131 strains (2 CTX-M-15- producing urine and 1 non-ESBL-producing faecal isolate), comparing them with five non-ST131 B2 and a group A uropathogenic E. coli (UPEC). In C. elegans, the three ST131 strains showed intermediate virulence between the non virulent group A isolate and the virulent non-ST131 B2 strains. In zebrafish, the CTX-M-15-producing ST131 UPEC isolates were also less virulent than the non-ST131 B2 strains, suggesting that the production of CTX-M-15 is not correlated with enhanced virulence. Amongst the non-ST131 B2 group isolates, variation in pathogenic potential in zebrafish embryos was observed ranging from intermediate to highly virulent. Interestingly, the ST131 strains were equally persistent in surviving embryos as the non-ST131-group B2 strains, suggesting similar mechanisms may account for development of persistent infection. Optical maps of the genome of the ST131 strains were compared with those of 24 reference E. coli strains. Although small differences were seen within the ST131 strains, the tree built on the optical maps showed that these strains belonged to a specific cluster (86% similarity) with only 45% similarity with the other group B2 strains and 25% with strains of group A and D. Thus, the ST131 clone has a genetic composition that differs from other group B2 strains, and appears to be less virulent than previously suspected.

O Grupo Shell começou a utilizar a técnica de cenários em seu processo de planejamento no final dos anos 60. Isto foi feito depois de constatar que a velocidade de mudanças no meio ambiente tinha chegado a tal ponto que não permitiria mais o uso de projeções lineares baseadas em comportamentos históricos. Era necessário desenvolver uma técnica que permitisse vislumbrar as tendências de mudanças de comportamento do meio ambiente antes de ser surpreendido por elas. A crescente complexidade da relação entre todas as variáveis que influenciam o meio ambiente e a rapidez com que as mudanças acontecem fazem com que o futuro seja muito mais imprevisível hoje do que há 100 anos atrás. Possivelmente os estrategistas daquela época achavam o mesmo do período anterior, uma vez que a velocidade de mudança parece estar em constante aceleração. Desta forma, planejamento torna-se um processo de aprendizado e cenários um importante instrumento deste processo.

O Grupo Shell começou a utilizar a técnica de cenários em seu processo de planejamento no final dos anos 60. Isto foi feito depois de constatar que a velocidade de mudanças no meio ambiente tinha chegado a tal ponto que não permitiria mais o uso de projeções lineares baseadas em comportamentos históricos. Era necessário desenvolver uma técnica que permitisse vislumbrar as tendências de mudanças de comportamento do meio ambiente antes de ser surpreendido por elas. A crescente complexidade da relação entre todas as variáveis que influenciam o meio ambiente e a rapidez com que as mudanças acontecem fazem com que o futuro seja muito mais imprevisível hoje do que há 100 anos atrás. Possivelmente os estrategistas daquela época achavam o mesmo do período anterior, uma vez que a velocidade de mudança parece estar em constante aceleração. Desta forma, planejamento torna-se um processo de aprendizado e cenários um importante instrumento deste processo.

Abstract The recently developed rapid immunochromatographic tests (ICT) have the potential to provide a quick and easy diagnosis of Campylobacter enteritis in comparison to culture. In a previous study we found them sensitive but lacking in specificity. The aim of the present study was to focus on the problem of specificity and determine the positive predictive value (PPV) of a positive result of the ImmunoCard Stat! Campy (Meridian Bioscience, Cincinnati, OH, USA). For this purpose, the stools positive by ICT were cultured according to 3 different protocols: Karmali agar, Preston enrichment broth subcultured on Karmali agar, and a filtration method on a blood agar without antibiotics, all incubated for 7 days at 37°C. Out of 609 stools from adults and children with community acquired enteritis, the reference methods detected 25 positive cases (4.1%) (culture: 19, specific PCR and ELISA both positive: 6) and the ICT: 31 including the 25 true positives. The PPV was 80.6%. We conclude that ICT is a good method to screen Campylobacter positive stools but because of its lack of specificity the positive stools must be tested by another method.

BACKGROUND: Arterial puncture is often painful for patients. The aim of this study was to compare use of local anesthesia as a eutectic mixture of 2 local anesthetics, lidocaine and prilocaine, versus placebo. METHODS: We conducted a double-blind, randomized controlled trial. Subjects were eligible if arterial puncture was indicated. The primary outcome was an experienced pain > 2 on a numerical pain rating scale. As having had a previous experience of arterial puncture was expected to be predictive of the current response, we planned 3 comparisons between use of local anesthesia and placebo: in the whole sample, among subjects with a painful previous experience, and among subjects with a painless previous experience. Multiple testing was analyzed using the Bonferroni correction for the primary outcome. The secondary outcome was the numerical pain rating scale score itself. All analyses were performed on an intention-to-treat basis. RESULTS: A total of 136 subjects were included in this study. The primary outcome occurred in 20.9% in the active arm versus 37.7% in the placebo arm in the whole sample (relative risk 0.55; 95% CI when adjusting for multiple testing ranged was 0.28-1.09, P = .10; 95% CI without adjustment was 0.32-0.97, P = .038). No significant heterogeneity in the study treatment effect was found when considering previous painful or painless arterial puncture (P = .70). The numerical pain rating scale score was 1.55 6 2.03 in active group versus 2.09 « 2.15 in the placebo group (P = .13). CONCLUSIONS: We found that application of a eutectic mixture reduced the number of painful arterial punctures by 50% compared with placebo. However, this result was not statistically significant. (ClinicalTrials.gov registration NCT01964248.) [ABSTRACT FROM AUTHOR]

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Les dosages d'IgG et de leurs sous-classes sont des examens courants de biologie médicale. Les IgG sériques totales trouvent leur place en première intention dans les diagnostics des déficits immunitaires primitifs ; mais aussi dans leur suivi et celui des traitements par immunoglobulines polyvalentes. Pour les sous-classes d'IgG sériques, elles sont recommandées en deuxième ligne ou pour la maladie associée aux IgG4. Dans le liquide céphalorachidien, l'intérêt porte aujourd'hui sur les IgG qui permettent la distinction entre un transsudat et une synthèse intrathécale. La technique de dosage est quantitative en milieu liquide (néphélémétrie/turbidimétrie). Parmi les difficultés rencontrées, nous retrouvons l'absence de standard international pour les réactifs des sous-classes d'IgG, les discordances entre le dosage des IgG totales et celui des sous-classes dosées individuellement et la mauvaise évaluation des concentrations des IgG4. Dans cette revue actualisée de la littérature nous revenons sur ces difficultés mais aussi sur les améliorations proposées par les fournisseurs. Nous apportons également quelques pistes sur d'autres améliorations encore possibles pour pallier les difficultés qui persistent. Total IgG and IgG subclasses measurements are common lab acts in medical biology. The main indications are primary immunodeficiency's diagnosis and follow-up treatment with multivalent immunoglobulins. IgG subclass measurement plays a key role in IgG4-Related Disease but is also useful for second-line diagnosis in humoral immune deficiencies. In the cerebrospinal fluid, an index is used as an indicator of the relative amount of CSF IgG compared to serum. Any increase in the index is a reflection of IgG production in the central nervous system. There is no reference material allowing standardization of IgG subclass assays, discrepancies between total IgG and sum of IgG subclasses are quite frequent and IgG4 seem to be underestimated and lead to cross reactivity. In this review, we show that the manufacturers along the difficulties encountered during lab routine have made some improvements. In addition, we are making some suggestions for further improvements that can be done to reduce the difficulties that remain. [ABSTRACT FROM AUTHOR]

Les réactions d'hypersensibilité retardée (HSR) sont définies comme celles qui surviennent plus de six heures après une exposition aux allergènes et font intervenir l'immunité à médiation cellulaire. La peau est l'organe le plus souvent atteint dans les HSR aux produits naturels ou de synthèse ainsi qu'aux médicaments. La plupart des éruptions cutanées sont bénignes et spontanément résolutives, mais certaines sont graves, entraînant un risque élevé de morbidité et de mortalité. Elles doivent être reconnues tôt et gérées rapidement. La démarche diagnostique repose sur une anamnèse exhaustive, des tests in vivo tels que l'intradermoréaction retardée, le patch-test ou le test de provocation orale et des tests biologiques in vitro explorant l'activité de lymphocytes T spécifiques. Les performances de ces tests varient selon les manifestations cliniques. Les avancées concernant l'immunopathogenèse ont permis d'identifier des allèles HLA associés aux manifestations cliniques et ainsi de déterminer des facteurs de prédisposition. Cet article décrit les caractéristiques et la place actuelle de ces tests selon les phénotypes d'HSR. Delayed hypersensitivity reactions (DHR) are defined as reactions that occur more than 6 hours after exposure to small reactive molecules or drugs. The skin is the most often affected organ. Potentially life-threatening severe cutaneous adverse reactions (SCAR) are associated with a high risk of morbidity and mortality. They should be recognized and managed early by clinicians. The diagnostic workup is based on a precise anamnesis, a history of past events, in vivo tests such as delayed intradermal testing, patch-test or oral challenge and in vitro biological tests exploring the specific lymphocyte activity. Advances in understanding the delayed T cell–mediated reactions lead to identification of predisposing of HLA alleles. We describe the performance of these tests regarding the HSR phenotypes. [ABSTRACT FROM AUTHOR]

BACKGROUND: In a previous study of subjects suspected of having ventilator-associated pneumonia, a rapid susceptibility testing approach by using ETEST (BioMérieux) strips directly applied to bronchoalveolar lavage samples provided valuable information at hour 24. The primary objective of this study was to assess a new direct specimen testing by using an even more-rapid E-test approach (at hour 10), which could promote an early de-escalation of the antimicrobial therapy. METHODS: Twenty-eight subjects with ventilator-associated pneumonia admitted to a medical ICU were prospectively included. In parallel with standard routine methods, E-test strips were directly applied onto agar plates seeded with bronchoalveolar lavage samples and were analyzed after 10 h of incubation. E-test results were used to identify potential drug choices by simulating clinical decision making if the microscopy results had been available at the point of care. These choices were analyzed for concordance with the narrowest adequate antimicrobial therapy according to the Minimum Inhibitory Concentrations (MICs) provided by the reference method (ie, the laboratory routine diagnostic). RESULTS: At hour 10, direct specimen testing was readable in 18 of 28 bronchoalveolar lavage samples (64%). Total agreement between the 10-h direct specimen testing approach and the laboratory routine diagnostic approach was 90%, with a sensitivity of 83% and a specificity of 95%, with 8% major errors and 3% very major errors. The concordance between the 2 tests was very good (kappa = 0.79). If the 10-h E-test results were taken into account, then an early de-escalation strategy would have been possible in 10 of 18 cases (55%) at hour 10. CONCLUSIONS: This rapid susceptibility testing approach provided early (10 h) and valuable information that could lead to an early adjustment of empirical antimicrobial treatment in a ventilator-associated pneumonia setting. [ABSTRACT FROM AUTHOR]

Le réseau AllergoBioNet est constitué de biologistes hospitaliers spécialistes des analyses contribuant au diagnostic et au suivi des maladies allergiques. Initialement constitué d'une dizaine de membres, il comporte actuellement soixante-dix-neuf biologistes français exerçant dans 29 CHU et 15 CH, ainsi qu'un biologiste belge. Parmi ces laboratoires, 10 ont été labellisés « laboratoires de biologie médicale de référence » (LBMR) du fait de leur expertise des explorations biologiques des maladies allergiques, des autres causes d'hypersensibilité, des pathologies mastocytaires et du complément. Les objectifs principaux des biologistes du réseau sont de tester et mettre en oeuvre des techniques robustes et fiables accréditées par le COFRAC, d'être un outil de formation médicale continue pour maintenir et actualiser les connaissances et compétences et de promouvoir des projets de recherche dont les résultats sont présentés dans les congrès nationaux et internationaux et sous forme d'articles publiés dans des revues spécialisées. Cet article est un appel auprès des biologistes hospitaliers à s'impliquer dans le domaine de l'allergologie via le réseau AllergoBioNet, mais aussi auprès des allergologues qui peuvent solliciter la collaboration de ces biologistes spécialisés pour répondre à leurs questions pratiques (conditions pré-analytiques, conservation des échantillons), de discuter des qualités analytiques des méthodes utilisées pour comprendre leurs limites techniques, de savoir où adresser le patient nécessitant une analyse très spécialisée et d'échanger autour de l'interprétation des résultats. Ce partenariat permet d'enrichir mutuellement les savoirs et les pratiques dans le but d'optimiser la prise en charge des patients. AllergoBioNet is a French association of clinical laboratory specialists of allergic and mast-cell-related diseases and their differential diagnoses. Its 79 members are working in clinical laboratories in 29 Universitary Hospitals and 15 General Hospitals in France and another one in Belgium. Ten of these laboratories have recently been certified as « laboratoires de biologie médicale de référence » (Reference Clinical Laboratories, LBMR) to valorize the expertise in hypersensitivity, mast-cell and complement laboratory investigations. The first mission of these laboratory professionals is to ensure that results are accurate and reliable. Thus, they deal with all the process of continuous quality improvement and are able to minimize errors of the sample's workflow (pre-analytic, analytic and post-analytic phases). Since years, they are certified by the French Organization for Quality (COFRAC). Moreover, they evaluate newer diagnostic tests, ensure continuous medical formation to actualize competences and knowledge, participate in research protocols and publish in national and international specialized reviews. The aims of this article are (1) to encourage all medical laboratory specialists working in the field of allergic diseases (diagnosis, monitoring patients and responses to therapy) to join the AllergoBioNet network; (2) to encourage physicians to collaborate with these laboratory professionals, so that they could answer to practical questions (ie: pre-analytical needs and conservation samples), receive updates for state-of-the-art laboratory methods and devices, refer patients needing highly specialized analyses and ensure interdisciplinary interpretation of clinical and laboratory results. This partnership should improve mutual competences and contribute to patient care. [ABSTRACT FROM AUTHOR]

La biologie est un outil incontournable dans le diagnostic et la prise en charge des patients allergiques. Pour compléter l'enquête auprès des jeunes allergologues publiée en 2022, le Groupe de travail biologie de l'Allergie (GTBA) en partenariat avec l'ANAFORCAL a réalisé une nouvelle enquête auprès des allergologues seniors afin d'évaluer leur formation en biologie de l'allergie et de connaître leurs attentes en termes d'information et formation continue. Au total, 1092 allergologues ont été contactés (avec des doublons entre les deux listes) et 219 ont répondu. Les allergologues s'estiment être bien formés. Plus de 70 % estiment avoir de bonnes connaissances sur le sujet et 94 % se forment régulièrement sur le sujet, en congrès tout d'abord, par la lecture d'articles scientifiques puis en réunions de formation locales. Sur cet échantillon, 69,4 % ont lu les recommandations sur la biologie de l'allergie publiées en 2021. Parmi ceux qui l'ont lu, 90 % en sont satisfaits. Cependant sur cet échantillon, 89 % n'ont jamais fait de stage dans un laboratoire d'immunoallergologie pendant leurs études. Cette enquête rapporte que 95 % des répondants veulent plus de formation et information, à propos des nouveaux allergènes moléculaires, puis de l'exploration des angiœdèmes bradykiniques, des puces à allergènes, à propos de la tryptase et enfin pour le suivi de l'immunothérapie allergénique (ITA). Ces thématiques sont souhaitées en formation DPC en ligne, au congrès francophone d'allergologie (CFA), ou sous forme de fiches sur le site de la Société française d'allergologie (SFA). Biology is an essential tool in the diagnosis and management of allergic patients. To complete the survey of young allergists published in 2022, the Allergy Biology Working Group (GTBA) in partnership with ANAFORCAL has carried out a new survey of senior allergists to assess their training in allergy biology and to know their expectations in terms of information and continuing education. A total of 1095 allergists were contacted (with duplicates between the two lists) and 219 responded. Allergists consider themselves to be well trained. More than 70% believe they have a good knowledge of the subject and 94% receive regular training on the subject, first at congresses, by reading scientific articles and then at local training meetings. Of this sample, 69.4% have read the recommendations on the biology of allergy published in 2021. Of those who have read it, 90% are satisfied with it. However, of this sample, 89% had never done an internship in an immuno-allergology laboratory during their studies. This survey reports that 95% of respondents want more training and information, about new Activé par Editorial Manager® and ProduXion Manager® about Aries Systems Corporation molecular allergens, then the exploration of bradykine angioedema, allergen chips, about tryptase and finally for the follow-up of immunotherapy allergen (ITA). These themes are desired in online CPD training, at the French-speaking congress of allergology (CFA), or in the form of sheets on the site of the French Society of Allergology (SFA). [ABSTRACT FROM AUTHOR]

La vérification d'une méthode de dosage selon la norme NF/EN/ISO 15189 requiert l'analyse des performances de la technique (répétabilité, fidélité intermédiaire, exactitude et incertitude de mesure) avant toute utilisation en routine. Les coefficients de variation (CV) des résultats de précision intra-essai et inter-essais obtenus doivent être comparés à ceux des pairs et à ceux qui pratiquent ces mêmes dosages quelle que soit la technique. En l'absence de publications nationales ou internationales pour les IgE spécifiques et la tryptase, le réseau des biologistes des centres hospitaliers AllergoBioNet a analysé les résultats fournis par 24 centres pour proposer des limites acceptables des critères de performance pour le dosage des IgE totales et spécifiques et de la tryptase. Checking a dosing method according to NF/EN/ISO 15189 standard requires analysis of the performance of the technique (repeatability, intermediate fidelity, accuracy and measurement uncertainty) before routine use and follow-up annually. The coefficients of variation (CV) of the intra-assay and inter-assays accuracy results obtained must be compared with those of peers and those who perform the same determination regardless of the technique. In the absence of national or international guidelines for monitoring the performance of specific IgE and tryptase assay, the French network of hospital laboratories AllergoBioNet analysed the results provided by 24 centers and propose recommendations for total IgE, specific IgE and tryptase assays. [ABSTRACT FROM AUTHOR]