"Mycobacterium massilipolynesiensis" sp. nov., a rapidly-growing mycobacterium of medical interest related to Mycobacterium phlei.

In French Polynesia, respiratory tract clinical isolate M26, displayed unusual phenotype and contradictory phylogenetic affiliations, suggesting a hitherto unidentified rapidly-growing Mycobacterium species. The phenotype of strain M26 was further characterized and its genome sequenced. Strain M26 genome consists in a 5,732,017-bp circular chromosome with a G + C% of 67.54%, comprising 5,500 protein-coding genes and 52 RNA genes (including two copies of the 16 S rRNA gene). One region coding for a putative prophage was also predicted. An intriguing characteristic of strain M26's genome is the large number of genes encoding polyketide synthases and nonribosomal peptide synthases. Phylogenomic analysis showed that strain M26's genome is closest to the Mycobacterium phlei genome with a 76.6% average nucleotide identity. Comparative genomics of 33 Mycobacterium genomes yielded 361 genes unique to M26 strain which functional annotation revealed 84.21% of unknown function and 3.88% encoding lipid transport and metabolism; while 48.87% of genes absent in M26 strain have unknown function, 9.5% are implicated in transcription and 19% are implicated in transport and metabolism. Strain M26's unique phenotypic and genomic characteristics indicate it is representative of a new species named "Mycobacterium massilipolynesiensis". Looking for mycobacteria in remote areas allows for the discovery of new Mycobacterium species.

[Severe pulmonary tuberculosis in the ICU, diagnosis and treatment]. / Diagnostic et traitement d'une pneumonie tuberculeuse grave en réanimation.

INTRODUCTION: Pulmonary tuberculosis can rarely lead to acute respiratory distress syndrome and anti-tuberculous therapy initiation depends on this difficult diagnosis in ICU. CASE REPORT: A 50-year-old man presented a septic shock and acute respiratory distress syndrome with bilateral infiltrates mainly in the upper lobes on chest radiography. Diagnosis of pulmonary tuberculosis was made 10days after admission on examination of cavitary and diffuse infiltrates on a second CT scan, in addition to presence of acid-fast bacilli on smear examination of bronchial aspirates. Amikacin, with four first-line anti-tuberculous drugs, was started in the case of a resistant strain and seriousness of the illness. After 14weeks, he left on rifampicin and isoniazid treatment. CONCLUSIONS: There are no specific recommendations concerning pulmonary tuberculosis in ICU but a delay in initiation of anti-tuberculous therapy is a factor of poor prognosis. Using a second-line anti-tuberculous drug, like amikacin or/and fluoroquinolones, within initial treatment may accelerate improvement of sepsis and immediately treat resistant strains, when genomic methods for detection of resistance are not available in routine.

[Change in the mental contents in the paradoxical stage and in stage 2 under the effects of a benzodiazepine, flunitrazepam]. / Modification des contenus mentaux en stade paradoxal et en stade 2 sous l'effet d'une benzodiazépine le flunitrazépam.

In some insomniacs under flunitrazepam treatment is noted on one hand a global increase of dream memories, and on the other hand an increase of dreams with unpleasant or anxious contents. The present investigation is intended first to test the hypothesis of a possible increase of mental contents in sleep outside the paradoxical phases, to account for the increase of dream memories without concomitant increase of paradoxical stage. Second it intends to investigate if the increase of unpleasant dreams may be found in the normal subject in laboratory.

Analysis of dream contents by scaled and rated measurements.

The study was undertaken in order to test a dream-rating scale and to propose some modifications, especially for use in laboratory situations where the effect of a given experimental factor is to be assessed on mental activity in sleep. Dreams collected from normal subjects under EEG monitoring were analysed in detail in order to establish definitions for each rating point of each dimension of the rating scale. The scoring of a second set of dreams by two judges using this scale resulted in an inter-rater agreement significantly above the level of chance agreement.

Benzodiazepine-induced modifications of dream content: the effect of flunitrazepam.

The purpose of this study was to investigate the effect of flunitrazepam, a benzodiazepine with strong hypnotic properties, on dream content. Eight normal subjects were studied in laboratory by the awakening technique, and the dream contents were rated by two judges according to nine scaled dimensions: unreality, participation of the dreamer, pleasantness, unpleasantness, verbal aggresivity, physical aggressivity, sexuality, sensoriality and time of reference in the dreamer's life. By comparison with placebo condition, flunitrazepam induced more unpleasantness, more verbal aggressivity, more physical aggressivity, and more sexuality in dreams. This increase of emotionally loaded contents can be related to a disinhibitory effect of this drug, and the possible involvement of dopaminergic or serotoninergic systems is discussed.

[E.E.G. appearances in hyperphenylalaninaemia (author's transl)]. / Aspects évoluties de l'E.E.G. dans les hyperphénylalaninémies.

Since 1973 the authors have studied the EEG appearances in hyperphenylalaninaemia : 82 children were studied, comprising : 68 children with phenylketonuria, 33 of whom had been treated within the first 3 months of life, whilst 35 had only started therapy after 9 months; 14 patients with hyperphenylalaninaemia. The morphological appearances seen commonly were compared with those described in the literature: the abnormalities and maturational changes were observed, including background rhythm changes, characteristic appearance of high amplitude, sharp spindles and percentages of generalised fast rhythms. Incidence of re-evaluation tests was also studied. Serial changes represented the most important aspect of this study, correlations being possible between the tracings and the child's development. The effects of correct dietary management, nonadherence to treatment, and the changes occurring on stopping treatment were also assessed. An assessment of the value of the EEG in following these cases could thus be made.