Diversity and enzymatic profiles of indigenous yeasts isolated from three types of palm wines produced in Côte d'Ivoire.

AIMS: To investigate the genotypic diversity and enzymatic activity of yeast flora isolated from spontaneous fermenting saps of various palm trees (Borassus aethiopum, Raphia hookeri, Elaeis guineensis) tapped for palm wines. METHODS AND RESULTS: PCR-restriction fragment length polymorphism of ITS-5.8S rDNA combined to 26S rRNA gene and/or the partial ACT1 gene sequencing were applied for yeast characterization, and their enzymatic profiles assessed by using API ZYM kits. Thirteen genera and 23 species were identified, with the highest diversity (14 species) in raffia wine. Saccharomyces cerevisiae was dominant and common to all palm wines. Some potentially pathogenic yeasts were also isolated. The majority of tested strains displayed high amylo-peptidase, phosphatase, ß-glucosidase and α-glucosidase activities and esterase activity. CONCLUSIONS: Diverse yeast species colonized palm wines, among which some were related to a specific type of wine and the majority of them have the ability to digest starch, sugar, protein or lipid. SIGNIFICANCE AND IMPACT OF THE STUDY: This study is a first step in understanding the significance of indigenous yeast flora of palm wines from Côte d'Ivoire. This knowledge is important as a tool for establishing new indigenous yeast collection; which could be used for the product quality improvement and as enzyme sources for biotechnological purposes.

Transcriptomic Signature of the CD24hi CD38hi Transitional B Cells Associated With an Immunoregulatory Phenotype in Renal Transplant Recipients.

The role of B cells after transplant regarding allograft rejection or tolerance has become a topic of major interest. Recently, in renal transplant recipients, a B cell signature characterized by the overexpression of CD19+ CD38hi CD24hi transitional B cells has been observed in operationally tolerant patients and in belatacept-treated patients with significantly lower incidence of donor-specific antibodies. The phenotypic and functional characterization of these transitional B cells is far from exhaustive. We present the first transcriptomic and phenotypic analysis associated with this cell phenotype. Three populations were studied and compared: (i) transitional CD24hi CD38hi , (ii) CD24+ CD38- , and (iii) CD24int CD38int B cells. Transcriptome bioinformatic analysis revealed a particular signature for the CD24hi CD38hi population. Phenotypic analysis showed that CD24hi CD38hi transitional B cells also expressed CD9, CD10, CD1b and inducible T cell costimulator ligand (ICOS-L) markers. In addition, we found enrichment of IL-10+ cells among CD24hi CD38hi cells expressing ICOS-L and CD1b, the latter showing regulatory properties. Renal transplant recipients treated with belatacept exhibited significant expression of CD1b. Our results show that transitional CD24hi CD38hi B cells exhibit a distinct and specific profile, and this could be helpful for understanding of immune-regulatory mechanisms and immune monitoring in the field of organ transplant and autoimmune disease.

Th-17 Alloimmune Responses in Renal Allograft Biopsies From Recipients of Kidney Transplants Using Extended Criteria Donors During Acute T Cell-Mediated Rejection.

Although renal transplantation using expanded criteria donors has become a common practice, immune responses related to immunosenescence in those kidney allografts have not been studied yet in humans. We performed a retrospective molecular analysis of the T cell immune response in 43 kidney biopsies from patients with acute T cell-mediated rejection including 25 from recipients engrafted with a kidney from expanded criteria donor and 18 from recipients grafted with optimal kidney allograft. The clinical, transplant and acute T cell-mediated rejection characteristics of both groups were similar at baseline. The expression of RORγt, Il-17 and T-bet mRNA was significantly higher in the elderly than in the optimal group (p = 0.02, p = 0.036, and p = 0.01, respectively). Foxp3 mRNA levels were significantly higher in elderly patients experiencing successful acute T cell-mediated rejection reversal (p = 0.03). The presence of IL-17 mRNA was strongly associated with nonsuccessful reversal in elderly patients (p = 0.008). Patients with mRNA IL17 expression detection and low mRNA Foxp3 expression experienced significantly more treatment failure (87.5%) than patients with no mRNA IL17 expression and/or high mRNA Foxp3 expression (26.7%; p = 0.017). Our study suggests that the Th17 pathway is involved in pathogenesis and prognosis of acute T cell-mediated rejection in recipients of expanded criteria allograft.

[Adolescents' knowledge and behavior on sexuality, infectious transmitted diseases, and human papillomavirus vaccination: results of a survey in a French high school]. / Connaissances et comportements des adolescents en matière de sexualité, infections sexuellement transmissibles et vaccination contre le papillomavirus humain : résultats d'une enquête transversale dans un lycée.

UNLABELLED: Teenager sexuality is a public health issue. In teenagers attending a high school, we assessed their knowledge and behavior on sexuality, infectious transmitted diseases, human papilloma virus (HPV) vaccination, and cervical cancer. Then in girls, we estimated the anti-HPV vaccination coverage and focused on factors associated with poor knowledge of these topics. METHODS: This was a knowledge, attitudes, and practices cross-sectional study conducted at the beginning of the 2010-2011 school year in the Saint-Cyr military high school, using an anonymous self-administered questionnaire. RESULTS: Among 669 adolescents (M/F sex-ratio, 2.3; mean age, 17 years [IC 95%, 15-20]), 40% had already had sex and 92% had used contraception. Boys and girls had a poor level of knowledge on infectious transmitted diseases. Regarding knowledge on HPV and cervical cancer, a better level was significantly associated with female gender (P=10(-4)). In multivariate analysis, male gender, age under 18 years, lack of dialogue with parents on these subjects, low socioeconomic status of parents, and absence of health education were significantly associated with poor knowledge on these topics. CONCLUSION: These data should help healthcare providers better target access and content of sexual health education training.

Determination of ketamine and norketamine in plasma by micro-liquid chromatography-mass spectrometry.

A sensitive method of determination of ketamine and norketamine by micro-liquid chromatography/mass spectrometry was developed as part of a clinical trial in a pediatric population. Compounds were extracted from 100 microl plasma samples using solid-phase extraction on Oasis MCX cartridges. Separation was achieved on a C18 micro-column with a mobile phase composed of formic acid 0.1% and acetonitrile (90/10, v/v). Detection of ketamine, norketamine and their internal standard norketamine D4 was performed using selected ion monitoring at m/z 238.2, 224.2 and 228.2, respectively. Under these conditions, no loss of signal due to matrix effect was found and time of analysis did not exceed 10 min. Extracted calibration curves were linear from 5 to 500 ng/ml for each analyte, with correlation coefficients over 0.999. Intra- and inter-day validation studies showed mean recoveries between 98.1 and 101.7% and a relative standard deviation below 1.9%. Extraction recoveries ranged from 84.8 to 89.8% for both ketamine and norketamine. Limit of quantification was 4 ng/ml for each analyte.

A controlled trial of corticosteroid injections into facet joints for chronic low back pain.

BACKGROUND: Chronic low back pain is a common problem with many treatments, few of which have been rigorously evaluated. This randomized, placebo-controlled trial was designed to evaluate the efficacy of injections of corticosteroid into facet joints to treat chronic low back pain. METHODS: Patients with chronic low back pain who reported immediate relief of their pain after injections of local anesthetic into the facet joints between the fourth and fifth lumbar vertebrae and the fifth lumbar and first sacral vertebrae were randomly assigned to receive under fluoroscopic guidance injections of either methylprednisolone acetate (20 mg; n = 49) or isotonic saline (n = 48) in the same facet joints. Ninety-five patients were followed for six months and their condition assessed with scales of pain severity, back mobility, and limitation of function. RESULTS: After one month, none of the outcome measures evaluating pain, functional status, and back flexion differed clinically or statistically between the two study groups. Forty-two percent of the patients who received methylprednisolone and 33 percent of those who received placebo reported marked or very marked improvement (95 percent confidence interval for the difference, -11 to 28 percentage points; P = 0.53). The results were similar after three months. At the six-month evaluation, the patients treated with methylprednisolone reported more improvement, less pain on the visual-analogue scale, and less physical disability. The differences were reduced, however, when concurrent interventions were taken into account. Moreover, only 11 patients (22 percent) in the methylprednisolone group and 5 (10 percent) in the placebo group had sustained improvement from the first month to the sixth month (95 percent confidence interval for the difference, -2 to 26; P = 0.19). CONCLUSIONS: We conclude that injecting methylprednisolone acetate into the facet joints is of little value in the treatment of patients with chronic low back pain.

[Not Available]. / L'arthrite rhumatoide: approche thérapeutique.

Rheumatoid arthritis is the most common chronic inflammatory joint disease. To overcome joint inflammation and eventually induce disease remission, the physician must often use drugs that are more and more toxic. Indications, method of administration, and common adverse effects of non-steroidal anti-inflammatory drugs, local steroid injections, second-line agents, and steroids are reviewed. The author briefly discusses a new therapeutic concept and emphasizes the importance of patient education and early referral to an interdisciplinary rehabilitation team.

Cardiac surgery in septuagenarians: is there a difference in mortality and morbidity?

Open heart surgery is being performed with increased frequency in elderly patients. Results vary considerably probably as the profile of the surgical population changes. A comparison was established by means of univariate analysis between two consecutive series of 100 patients undergoing bypass grafting or valvular replacement. Group A patients were 70 years of age or older; group B patients were less than 65 years of age. Various clinical, operative, and postoperative parameters were monitored. A significant difference was found between the two groups. Elderly patients tended to be white, female, with poor left ventricular and renal function, had carotid or peripheral vascular disease, and new onset of symptoms. Fewer patients had single-vessel disease and received internal mammary artery grafts. Operative mortality rate was higher in group A subjects and postoperative neurologic complications were also more frequent in this group. Factors influencing operative mortality were the association between vascular disease, presence of left main coronary artery disease, and urgency of the procedure. The mortality rate was 17.2% in 29 patients with associated vascular disease and 4.8% (3/63) in those without vascular disease (p = 0.048). Operative mortality was 4.1% without left main coronary artery disease, 15% with left main coronary artery disease (p = 0.083), and 4% in 84 patients having elective operations versus 31.2% in patients having 16 emergency procedures (p = 0.001). Short-term follow-up revealed a higher late mortality rate in elderly subjects and suggested an increased incidence of early pulmonary embolus. Nevertheless, elective cardiac surgery may be safely performed in septuagenarians with an expected operative mortality rate under 5%.

Coronary artery bypass grafting with saphenous vein.

Occlusion rate of the saphenous vein is around 12-20% during the 1st year and 2-4% annually for the next 4 or 5 years. Subsequently, this rate doubles, so that at 10 years, approximately 50% of grafts become occluded due to the occurrence of graft atherosclerosis. A similar percentage of patent grafts show atherosclerotic changes at the end of the 1st decade. Sequential vein grafts probably suffer the same fate although late follow-up is lacking. Reoperation is estimated to be 30% at 10 years, as judged by angiographic criteria. The operative risk of reoperation is at least double that of primary operation; symptomatic relief appears to be of shorter duration. Recent technical changes to better preserve medial and endothelial function and to pharmacologically inhibit platelet function may lead to longer duration of the venous conduit.

Factors influencing early and late survival in patients with combined mitral valve replacement and myocardial revascularization and in those with isolated replacement.

During a 5 1/2-year period, 251 patients underwent mitral valve replacement (MVR) at our institution: 76 had combined MVR and coronary artery bypass grafting (CABG), and 175 without major coronary artery disease (CAD) had isolated MVR. In-hospital mortality for MVR + CABG was 13.2% (10/76); it was 8.6% (6/70) when patients with preoperative mechanical support were excluded, 7.9% (5/63) for elective operations, and 8.2% (5/61) for nonischemic mitral disease. Overall, in-hospital mortality for isolated MVR was 6.3% (11/175); it was 4.4% (7/161) excluding patients requiring mechanical support and 3.1% (5/157) for elective operations. Of a host of clinical characteristics in patients with MVR +CABG, few were found to influence in-hospital mortality: age greater than 60 years, degree of incapacitation (New York Heart Association Functional Class IV), previous history of myocardial infarction or congestive heart failure, cardiac enlargement (cardiothoracic index greater than 50%), and ischemic mitral disease (33.3% in-hospital mortality; p less than 0.05). Of the invasive variables, only one influenced in-hospital mortality: wall motion score greater than 10 (31.6% in-hospital mortality; p less than 0.01). Of the operative variables studied, the number of grafts (3 or more: 33.3% in-hospital mortality; p less than 0.05), the need for mechanical support (47.4% in-hospital mortality; p less than 0.0001), and emergency operation (38.5% in-hospital mortality; p less than 0.005) had a significant effect on mortality. The type of mitral lesion, the type of prosthesis, the extent of CAD or the completeness of revascularization, the presence of pulmonary hypertension, and atrial fibrillation appeared to have no influence.(ABSTRACT TRUNCATED AT 250 WORDS)

Immunoregulation of lung fibroblast growth: alteration in asbestos-induced pulmonary fibrosis.

Initial studies on mononuclear cell-fibroblast interactions have shown that stimulated human lymphocytes produced a fibroblast growth inhibitory factor and that asbestos, a fibrogenic dust, interferes with this process in vitro. To investigate the role of these interactions in pathologies characterized by pulmonary fibrosis, we used a rat model of asbestos-induced fibrosis. Rats received a single intratracheal instillation of either saline or 10 mg of chrysotile asbestos fibres. Three months after treatment, peripheral blood mononuclear leucocytes (PBML) supernatant fractions were prepared and their effects on lung fibroblast growth measured. As for human PBML, rat PBML stimulated with Concanavalin A (Con A) produced 24 h after initiation of the cultures a soluble factor which inhibits lung fibroblast DNA synthesis and growth in a dose-dependent fashion. By contrast, Con A-stimulated PBML from rats exposed to asbestos failed to produce significant levels of fibroblast growth inhibitory activity. No significant change of total PBML number or in the proportion of circulating mononuclear cell populations was observed. Furthermore, upon stimulation with lipopolysaccharide (LPS), monocytes from asbestotic animals retained their capacity to produce interleukin (IL-1), a mediator required for lymphokine production. Our study demonstrates that suppression of FGIF production by circulating PBML occurs in animals with lung fibrosis and suggests that mechanisms other than impairment of IL-1 production may be responsible for the suppressive effect of asbestos on the production of such fibroblast regulatory lymphokine.