[The importance of education in the management of chronic kidney disease patient]. / Prise en charge du patient insuffisant rénal: intérêt d'une approche educative complémentaire au suivi médical.

Chronic kidney disease (CKD) is complex to manage, especially when a substitutive treatment has to be implemented. Strict medical follow-up is mandatory but not sufficient to provide optimal care to the CKD patients. Educational intervention gives more skills to the patients to cope with this chronic disease. In this approach, physicians and nurses help patients to have a greater acceptance of their illness and make their treatment their own. Therapeutic education is part of this patient-centred approach. Peer counselling is also used in our program as well as an educative journal.

[Hemolytic uremic syndrome following gemcitabine treatment]. / Syndrome hémolytique et urémique suite a un traitement de gemcitabine.

Hemolytic uremic syndrome (HUS) in children is classically associated with diarrheas related to the production of a shiga-toxin. HUS occurs among oncologic patients, in relation with the cancer itself, or as a complication of the cytostatic treatment. The physician should be familiar with the triad of HUS (microangiopathic hemolytic anemia, thrombocytopenia and renal failure) and search actively for this pathology in oncologic patient. The treatment is essentially empirical. It includes plasma exchanges, control of blood pressure, hydro-electrolytic balance control with dialysis, if necessary. Blood transfusion should be avoided. Potential mortal complications associated with HUS can be prevented by a rapid diagnosis and a prompt initiation of adequate therapy.

Accurate and high resolution in situ hybridization analysis of gene expression in secondary stem tissues.

Accurate in situ hybridization analysis in secondary stem tissues of plants has been hindered by specific characteristics of these tissues. First, secondary cell walls non-specifically bind probes used for in situ hybridization thus preventing gene expression analysis in the lignified regions of the stem, such as the xylem. Second, the mRNA in the cambial meristem and its recent derivatives are prone to inadequate fixation when conventional techniques are used. Here we describe an in situ hybridization technique which uses fast freezing and freeze substitution to cryoimmobilize the mRNA followed by embedding in a methacrylate resin for high-resolution analysis of gene expression. By using a transgenic poplar line harbouring rolC:uidA, rolC:iaaM, the gene expression pattern could be compared with histochemical GUS staining. This in situ hybridization technique results in superior preservation of cellular contents, retention of mRNA in all cell types in the poplar stem, a significant reduction of non-specific binding to secondary cell walls and a resolution not previously possible in secondary tissues. This technique will be particularly valuable for the expression analysis of genes involved in xylogenesis and wood formation.