Adrenal insufficiency after glucocorticoid withdrawal in children with rheumatic diseases

?Glucocorticoids (GCs) are often used for the treatment of rheumatic disorders. However, doses are prescribed, which may suppress the hypothalamic-pituitary-adrenal (HPA) axis. After GC withdrawal, recovery of the HPA axis may be delayed putting the patient at risk for adrenal insufficiency. We assessed adrenal function and factors influencing adrenal responsiveness after termination of GC therapy in paediatric patients with rheumatic diseases.

Immune response to influenza vaccination in children treated with methotrexate or/and tumor necrosis factor-alpha inhibitors

In children treated with immunosuppressive medication such as methotrexate and tumor necrosis factor-alpha (TNF-α) inhibitors, additional immunizations are recommended because of increased susceptibility to infections. However, it is unclear if adequate antibody response to vaccinations can be established in children receiving methotrexate and/or TNF-α inhibitors. In a prospective open label study, we assessed seroprotection and seroconversion following influenza vaccination during 2 seasons (6 strains) in 36 children with autoimmune disease treated either with methotrexate (n=18), TNF-α inhibitors (n=10) or both (n=8) and a control group of 16 immunocompetent children. Influenza antibody titers were determined by hemagglutinin inhibition assay, before and 4-8 weeks after vaccination. Post-vaccination seroprotection (defined as a titer ≥1:40) did not significantly differ between immunosuppressed and immunocompetent subjects. Seroconversion, defined as the change from a nonprotective (< 1:40) to a protective titer (≥1:40) with at least a 4-fold titer increase, was less likely to occur in immunosuppressed patients, although no significant difference from the control group was established. Safety evaluation of vaccination showed no serious adverse events. Children receiving methotrexate and/or TNF-α inhibitors can be safely and effectively immunized against influenza, with a seroprotection after vaccination comparable to immunocompetent children.

Motifs slaves dans les lettres autrichiennes du XIXe siècle: tentative de compréhension et de synthèse dans le cas de Marie von Ebner-Eschenbach

Marie von Ebner-Eschenbach (1830-1916) was born and grew up in Moravia. Despite the fact that her very first language was Czech, all her literary work was written in German ; despite of her Czech origins from her fatherside, all the references to be found in her work concerning the social and national development of the Czech society of that time express, if not animosity, at least a total lack of understanding. Everthing happens as if the author just wanted to confirm and uphold the official views of the Austrian Monarchy. In this article, I’d like to show, mainly on the example of the novel Božena (1876), that a more careful reading which would take into account not only the textual statements of the writer, but as well the composition of the plot and the various behaviors of the Czech and German protagonists, could allow to bring nuances to Ebner-Eschenbach’s position towards the Czech – namely to see that she was perfectly aware and respectful of the cultural diversity and complexity of the Czech lands and that she felt a deep compassion for the claims of the minorities asking for the transformation of the Habsburg Empire into a Federation of free nations.

Poetik des Unbehagens. Unlust als 'point de départ' in Romanen Marie NDiayes

Die Romane der französischen Autorin Marie NDiaye (geb. 1967) sind durchzogen von Zuständen des Unwohlseins: NDiayes Protagonistinnen werden auf diffuse Weise sozial ausgegrenzt oder massiv bedrängt, verlieren die Kontrolle über ihren Körper oder geraten in schwindelerregende Zweifel über den Realitätsgehalt ihrer Sinneswahrnehmungen und Erinnerungen. Anhand der Romane "En famille" (1990), "Autoportrait en vert" (2005) und "Mon cœur à l’étroit" (2007) zeigt der Aufsatz, dass diese Momente des Unbehagens nicht nur die Suchbewegungen und Erkenntnisprozesse der Romanfiguren auslösen, sondern auch die kreative Spannung bilden, die den Vorgang der literarischen inventio in Gang setzt. Theoretische Modelle einer Psychologie, in der Unlust als Antrieb fungiert, finden sich bei Leibniz, Locke und Freud; Elemente einer Narratologie der Unlust, mit der sich die quête-Struktur von NDiayes Romanen beschreiben lässt, bietet die strukturalistische Märchentheorie Wladimir Propps und seiner Nachfolger.