Photographic art and dealing with death

Recently, we were faced with a request from a student photographer who wanted to take pictures of bodies donated to our institute and used for dissection courses for medical students or for scientific purposes. Students are expressly forbidden to take pictures in the dissection hall; however, we allowed this student photographer to do her diploma work in our institute. The reason why she was proposing such a topic was that her brother died young and her parents donated his body to science. To overcome this loss of a loved one, she wanted to know what happens to the donated bodies. She followed the procedure of embalming and different dissections that took place during the summer semester and she took pictures throughout. The outcome of this work was a very nice photographic document, called 'dissection', a book with many pictures but no figure legends. The image document shows the different steps in the preparation and preservation of bodies and the work of an anatomist in the dissection hall. As we impose rules on our students, we had also to give directives in the use of the photographs taken, especially for a photographer who will use the most prominent pictures for exhibitions, i.e. that the pictures do not show names or are used for publication on the internet, or show identification numbers of cadavers, or give indication ofn the institution and are relatively anonymous. This story tells how one can deal with death and at the same time advance one's personal career. The author represents the Swiss Anatomical Society SGAHE and is supported by the Swiss Academy of Science, ScNat.

Association of mutations in the NALP3/CIAS1/PYPAF1 gene with a broad phenotype including recurrent fever, cold sensitivity, sensorineural deafness, and AA amyloidosis.

OBJECTIVE: Familial cold urticaria (FCU) and Muckle-Wells syndrome (MWS) are dominantly inherited autoinflammatory disorders that cause rashes, fever, arthralgia, and in some subjects, AA amyloidosis, and have been mapped to chromosome 1q44. Sensorineural deafness in MWS, and provocation of symptoms by cold in FCU, are distinctive features. This study was undertaken to characterize the genetic basis of FCU, MWS, and an overlapping disorder in French Canadian, British, and Indian families, respectively. METHODS: Mutations in the candidate gene NALP3, which has also been named CIAS1 and PYPAF1, were sought in the study families, in a British/Spanish patient with apparent sporadic MWS, and in matched population controls. Identified variants were sought in 50 European subjects with uncharacterized, apparently sporadic periodic fever syndromes, 48 subjects with rheumatoid arthritis (RA), and 19 subjects with juvenile idiopathic arthritis (JIA). RESULTS: Point mutations, encoding putative protein variants R262W and L307P, were present in all affected members of the Indian and French Canadian families, respectively, but not in controls. The R262W variant was also present in the subject with sporadic MWS. The V200M variant was present in all affected members of the British family with MWS, in 2 of the 50 subjects with uncharacterized periodic fevers, and in 1 of 130 Caucasian and 2 of 48 Indian healthy controls. No mutations were identified among the subjects with RA or JIA. CONCLUSION: These findings confirm that mutations in the NALP3/CIAS1/PYPAF1 gene are associated with FCU and MWS, and that disease severity and clinical features may differ substantially within and between families. Analysis of this gene will improve classification of patients with inherited or apparently sporadic periodic fever syndromes.

Prolonged antiretroviral therapy initiated at seroconversion is associated with a polyfunctional HIV-1-specific T-cell profile comparable to that of long-term non-progressors (LTNPs)

Background: Early initiation of antiretroviral therapy (ART) may dramatically curtail cumulative immunological damage allowing maximal levels of immune preservation/reconstitution and induce an immunovirological status similar to that of HIV-1 LTNPs with low viral reservoirs and polyfunctional HIV-1 specific T cell responses.Methods: We performed a cross-sectional study of an HIV-1 seroconverter cohort on long-term ART (LTTS) and compared it to one of LTNPs. Inclusion criteria for 20 LTTS were: (a) ?4 years ART; (b) long-term aviremia and (c) absence of treatment failure and for 15 LTNPs: (a) ?7 years of documented HIV-1 infection; (b) <1000 HIV-1 RNA copies/mL and ?500 CD4+ T-cells/mm3 in >90% of measurements; (d) absence of AIDS-defining conditions; (e) ART-naı¨ve except for temporary ART for prevention of MTCT. In both cohorts, we analysed residual viral replication and reservoirs in peripheral blood, as measured by cellassociated HIV-1 RNA and DNA in PBMCs, respectively and used polychromatic flow cytometry to analyse HIV-1-specific CD4+ and CD8+ T-cell functional profile in terms of cytokine production using IFN-c, IL-2, TNF-a production.Results: Cell-associated DNA [47.7 (4.8-583.2) in LTTS and 19.7 (0.5-295.5) in LTNPS, p=0.10], and RNA [3.9 (0-36) and 5.8 (0-10.3), respectively] were shown to be similarly low in both cohorts. We identified 103 CD8 T cell epitope-specific responses, all subjects responding to ?1 epitope. Mean responding number of responding epitopes per patient was 2 and 4 in LTTS and LTNPS, respectively. Mean% of cytokine-secreting CD8 T cells was 0.37% and 0.50% (p=0.06), of these 43% and 39% (p=0.12) were secreting simultaneously IFN-c, IL-2 and TNF-a. Respective values for CD4 T cells were 0.28% and 0.33% (p=0.28) of which 33% and 30% (0.32) were secreting these 3 cytokines simultaneously.Conclusions: Long-term aviremia after very early ART initiation is associated with low levels of reservoirs saturation ad residual replication. Although less broad CD8 T cell responses were found in LTTS, HIV-1 specific CD4 and CD8 T cell responses showed similar magnitude and functional profile in the 2 cohorts. Our results indicate that prolonged ART initiated at the time of HIV-1 seroconversion is associated with immuno-virological features which resemble those of LTNPs. (BHIVA Research Award Winner 2008: Anna Garcia-Diaz.)

Socioeconomic status, structural and functional measures of social support, and mortality: The British Whitehall II Cohort Study, 1985-2009.

The authors examined the associations of social support with socioeconomic status (SES) and with mortality, as well as how SES differences in social support might account for SES differences in mortality. Analyses were based on 9,333 participants from the British Whitehall II Study cohort, a longitudinal cohort established in 1985 among London-based civil servants who were 35-55 years of age at baseline. SES was assessed using participant's employment grades at baseline. Social support was assessed 3 times in the 24.4-year period during which participants were monitored for death. In men, marital status, and to a lesser extent network score (but not low perceived support or high negative aspects of close relationships), predicted both all-cause and cardiovascular mortality. Measures of social support were not associated with cancer mortality. Men in the lowest SES category had an increased risk of death compared with those in the highest category (for all-cause mortality, hazard ratio = 1.59, 95% confidence interval: 1.21, 2.08; for cardiovascular mortality, hazard ratio = 2.48, 95% confidence interval: 1.55, 3.92). Network score and marital status combined explained 27% (95% confidence interval: 14, 43) and 29% (95% confidence interval: 17, 52) of the associations between SES and all-cause and cardiovascular mortality, respectively. In women, there was no consistent association between social support indicators and mortality. The present study suggests that in men, social isolation is not only an important risk factor for mortality but is also likely to contribute to differences in mortality by SES.

Art. "Gütergemeinschaft"

(Résumé de l'ouvrage) Die RGG4 bietet in 15 665 Artikeln und Teilartikeln einen fundierten Überblick über Religion und Religionen, wie sie gelebt und gedacht wurden und werden. Sie bietet den neuesten Forschungsstand, dargestellt von 3 972 ausgewiesenen Kennern der jeweiligen Materie aus 74 Ländern. Die RGG4 führt die Tradition der ersten drei Auflagen fort: Aus der Mitte des evangelischen Glaubens ist weit mehr als die Theologie im Blick, nach deren Kriterien wird aber gewichtet.Die RGG4 erschließt die Themen in Form von biographischen Artikeln, Länder-, Orts-, Begriffs- und Ereignisartikeln sowie Artikeln über Gruppierungen und Institutionen. Knappe Definitionsartikel und Querverweise erleichtern die schnelle Information. Ausführliche Reihenartikel behandeln Stichworte wie "Abendmahl" oder "Christentum" aus vielerlei Perspektiven. Die RGG4 ist durch die Artikelvielfalt und die detailgenaue Darstellung ein Nachschlagewerk; zugleich ist sie eine Lehr- und Repetitionsbibliothek. Sie bringt mit einem ausgesucht lesbaren Schriftbild ein Maximum an Information auf einer Seite. Die acht Bände der RGG4 decken jeweils ganze Buchstaben ab. Der das Werk abschließende Registerband ermöglicht den Zugang zu dem in der RGG4 enthaltenen Wissen nach noch spezielleren Fragestellungen wie beispielsweise Namen und Stichworten, die keinen Haupteintrag haben. Selbstverständlich ist die RGG4 auf alterungsbeständigem Papier gedruckt, solide fadengeheftet und in Buckramleinen gebunden. Die RGG4 erhielt von der Stiftung Buchkunst die Auszeichnung "Eines der schönsten Bücher 1998. Vorbildlich gestaltet in Satz, Druck, Bild und Einband."

Art. "Hellenisten"

(Résumé de l'ouvrage) Die RGG4 bietet in 15 665 Artikeln und Teilartikeln einen fundierten Überblick über Religion und Religionen, wie sie gelebt und gedacht wurden und werden. Sie bietet den neuesten Forschungsstand, dargestellt von 3 972 ausgewiesenen Kennern der jeweiligen Materie aus 74 Ländern. Die RGG4 führt die Tradition der ersten drei Auflagen fort: Aus der Mitte des evangelischen Glaubens ist weit mehr als die Theologie im Blick, nach deren Kriterien wird aber gewichtet.Die RGG4 erschließt die Themen in Form von biographischen Artikeln, Länder-, Orts-, Begriffs- und Ereignisartikeln sowie Artikeln über Gruppierungen und Institutionen. Knappe Definitionsartikel und Querverweise erleichtern die schnelle Information. Ausführliche Reihenartikel behandeln Stichworte wie "Abendmahl" oder "Christentum" aus vielerlei Perspektiven. Die RGG4 ist durch die Artikelvielfalt und die detailgenaue Darstellung ein Nachschlagewerk; zugleich ist sie eine Lehr- und Repetitionsbibliothek. Sie bringt mit einem ausgesucht lesbaren Schriftbild ein Maximum an Information auf einer Seite. Die acht Bände der RGG4 decken jeweils ganze Buchstaben ab. Der das Werk abschließende Registerband ermöglicht den Zugang zu dem in der RGG4 enthaltenen Wissen nach noch spezielleren Fragestellungen wie beispielsweise Namen und Stichworten, die keinen Haupteintrag haben. Selbstverständlich ist die RGG4 auf alterungsbeständigem Papier gedruckt, solide fadengeheftet und in Buckramleinen gebunden. Die RGG4 erhielt von der Stiftung Buchkunst die Auszeichnung "Eines der schönsten Bücher 1998. Vorbildlich gestaltet in Satz, Druck, Bild und Einband."

Maintien des capacités des myopathes ou l'art de prescrire l'exercice physique [How to maintain the motor capacities in neuromuscular disorders or the art to prescribe physical exercises].

Optimum management of non-acquired neuromuscular disorders requires a multidisciplinary approach in order to prevent secondary complications related to the progression of the disease and to maintain the patient's independency in daily activities. For treatments, the physiotherapists and occupational therapists must have precise and measurable goals to quantify muscle strength and functions in conjunction with a specialist in neurorehabilitation. Examples of simple motor scores or scales are given in order to transmit precise information to the GP and the multidisciplinary team, and type of orthosis and physiotherapy programmes are given as pieces of advice to assume the follow-up of patients.