Autoimmune thrombotic thrombocytopenic purpura associated with disseminated sarcoidosis: A case report.

Sarcoidosis is an inflammatory disease known to be associated with multiple autoimmune disorders. There is a restricted number of descriptions of the association between sarcoidosis and autoimmune thrombotic thrombocytopenic purpura (aTTP). We present the case of a 63-year-old woman admitted to the hospital to investigate a possible sarcoidosis who had hemolytic anemia and thrombocytopenia, with low ADAMTS13 activity and anti-ADAMTS13 antibodies, leading to a diagnosis of aTTP. Sarcoidosis was later confirmed and the two conditions evolved separately after 6 months, questioning the link between them. Clinicians should be aware of this rare cause of thrombocytopenia in patients with sarcoidosis, as aTTP is a life-threatening condition.

Occipital artery biopsy: Surgical technique.

Giant cell arteritis is a systemic inflammatory disorder that primarily affects medium- and large-size arteries. Usually, the temporal artery is involved. In rare cases, the patient experiences symptoms elsewhere, such as in the occipital region. In such cases, biopsy of the occipital artery can be considered. Few studies are available on how to perform such a biopsy. In this case report, we describe the procedure in detail, with a focus on the important anatomic structures. We wish to offer other surgeons a quick reference in the case of a request for a biopsy of the occipital artery.

Fusarium infections: Epidemiological aspects over 10 years in a university hospital in France.

BACKGROUND: Fusarium is an environmental mold that causes deep or superficial mycosis in immunocompromised or immunocompetent patients respectively. METHODS: This epidemiological study evaluated the frequency of Fusarium infections in our university hospital center in France over a decade from 2007 to 2016 and its representativeness in the main clinical infections. RESULTS: A total of 715 Fusarium sp. were isolated from various sampling sites. Fusarium was detected in 0.47% of blood cultures, 31.1% of ophthalmic samples, and 8.48% of nail samples. The frequency of Fusarium infections was stable over this decade. CONCLUSIONS: The main Fusarium species complexes recorded in this study were Fusarium oxysporum species complex and Fusarium solani species complex, indicating the importance of Fusarium as a fungal agent that should be considered in clinical practice. A focus on invasive fusarioses shows that they all occur in hematology patients.

Molecular identification of Fusarium species complexes: Which gene and which database to choose in clinical practice?

Identification of Fusarium at the level of the species complex is difficult with phenotypic methods, so it is necessary to use molecular sequencing methods. This study presents, for 33 isolates distributed among the four major species complexes, the performance of five identification schemes involving ITS (internal transcribed spacer), EF1α (translation elongation factor 1 alpha), RPB1 (largest subunit of RNA polymerase) and RPB2 (second largest subunit of RNA polymerase) genes and two databases: GenBank and Fusarium MLST (MultiLocus Sequence Typing). In our practice, the identification of the fungus from a culture is performed with EF1α and from a primary sample with ITS, using in both cases the specific database Fusarium MLST.

Synthesis and Antibacterial Evaluation of Bis-thiazolium, Bis-imidazolium, and Bis-triazolium Derivatives.

Given the worldwide spread of bacterial drug resistance, there is an urgent need to develop new compounds that exhibit potent antibacterial activity and that are unimpaired by this phenomenon. Quaternary ammonium compounds have been used for many years as disinfectants, but recent advances have shown that polycationic derivatives exhibit much stronger activity and are less prone to bacterial resistance than commonly used monocationic compounds. In this sense, we prepared three series of new bis-cationic compounds: bis-thiazoliums, bis-imidazoliums, and bis-1,2,4-triazoliums. If some compounds of the first series showed fair antibacterial activity, most of those belonging to the two other series were highly potent, with minimum inhibitory concentrations close to 1 µg mL-1 . Some of them also exhibited low toxicity toward eukaryotic MRC-5 lung fibroblasts, and we showed that this toxicity is clearly correlated with clogP. Finally, four selected compounds were found to exhibit a clear bactericidal effect.

Mechanism of triglyceride lowering in mice expressing human apolipoprotein A5.

Overexpression of human APOA5 in mice results in dramatically decreased plasma triglyceride levels. In this study we explored the mechanism underlying this hypotriglyceridemic effect. Initially we found that triglyceride turnover was faster in hAPOA5 transgenic mice compared to controls, and this strongly correlated with increased LPL activity in postheparin plasma. Furthermore, we show that in vitro recombinant apoAV interacts physically with lipoprotein lipase and significantly increased its activity. We show that both apoB and apoCIII are decreased in hAPOA5 transgenic mice indicating a decrease in VLDL number. To further investigate the mechanism of hAPOA5 in a hyperlipidemic background, we inter-crossed hAPOA5 and hAPOC3 transgenic mice. We found a marked decrease in VLDL triglyceride and cholesterol, as well as apolipoprotein B and CIII levels. These data indicated that apoAV induces a decrease in VLDL size by activating lipolysis and an increase of VLDL clearance. In a postprandial state, the normal triglyceride response found in wild-type mice was significantly reduced in hAPOA5 transgenics. In addition, we demonstrated that in response to this fat load in hAPOA5xhAPOC3 mice, apoAV, but not apoCIII, was redistributed from primarily HDL to VLDL. This shift of apoAV in VLDL appears to limit the increase of triglyceride by activating the lipoprotein lipase.