Faut-il encore craindre la tuberculose au XXIème siècle ?

info:eu-repo/semantics/nonPublished

The bigger the better? or what we know and what we still need to learn about anthracycline dose per course, dose density and cumulative dose in the treatment of breast cancer.

Clinical Trial

Molecular dissociation of FHA-induced IL-10 and IL-12 secretion by human dendritic cells.

info:eu-repo/semantics/nonPublished

Role of the IL-10/IL-12 balance in the primary cellular immune response of infants to pertussis vaccines

info:eu-repo/semantics/nonPublished

Effects of different molecular forms of FHA on IL-10 and IL-12 secretions by human dendritic cells.

info:eu-repo/semantics/nonPublished

LPS-binding protein and IL-6 Mark paradoxical tuberculosis immune reconstitution inflammatory syndrome in HIV patients

Background: Tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) remains a poorly understood complication in HIV-TB co-infected patients initiating antiretroviral therapy (ART). The role of the innate immune system in TB-IRIS is becoming increasingly apparent, however the potential involvement in TB-IRIS of a leaky gut and proteins that interfere with TLR stimulation by binding PAMPs has not been investigated before. Here we aimed to investigate the innate nature of the cytokine response in TB-IRIS and to identify novel potential biomarkers. Methods: From a large prospective cohort of HIV-TB co-infected patients receiving TB treatment, we compared 40 patients who developed TB-IRIS during the first month of ART with 40 patients matched for age, sex and baseline CD4 count who did not. We analyzed plasma levels of lipopolysaccharide (LPS)-binding protein (LBP), LPS, sCD14, endotoxin-core antibody, intestinal fatty acid-binding protein (I-FABP) and 18 pro-and anti-inflammatory cytokines before and during ART. Results: We observed lower baseline levels of IL-6 (p = 0.041), GCSF (p = 0.036) and LBP (p = 0.016) in TB-IRIS patients. At IRIS event, we detected higher levels of LBP, IL-1RA, IL-4, IL-6, IL-7, IL-8, G-CSF (p ≤ 0.032) and lower I-FABP levels (p = 0.013) compared to HIV-TB co-infected controls. Only IL-6 showed an independent effect in multivariate models containing significant cytokines from pre-ART (p = 0.039) and during TB-IRIS (p = 0.034). Conclusion: We report pre-ART IL-6 and LBP levels as well as IL-6, LBP and I-FABP levels during IRIS-event as potential biomarkers in TB-IRIS. Our results show no evidence of the possible contribution of a leaky gut to TB-IRIS and indicate that IL-6 holds a distinct role in the disturbed innate cytokine profile before and during TB-IRIS. Future clinical studies should investigate the importance and clinical relevance of these markers for the diagnosis and treatment of TB-IRIS. Copyright: © 2013 Goovaerts et al.

IL-12RB1 deficiency and disseminated Mycobacterium tilburgii disease.

Mycobacterium tilburgii rarely causes disseminated disease. We describe a case of M. tilburgii infection in an otherwise healthy 33-year-old woman, who was found to carry bi-allelic mutations of the gene encoding the β1 chain of the IL-12 receptor.

Revisiting human IL-12Rβ1 deficiency: A survey of 141 patients from 30 countries

Interleukin-12 receptor β1 (IL-12Rβ1) deficiency is the most common form of Mendelian susceptibility to mycobacterial disease (MSMD). We undertook an international survey of 141 patients from 102 kindreds in 30 countries. Among 102 probands, the first infection occurred at a mean age of 2.4 years. In 78 patients, this infection was caused by Bacille Calmette-Guérin (BCG; n = 65), environmental mycobacteria (EM; also known as atypical or nontuberculous mycobacteria) (n = 9) or Mycobacterium tuberculosis (n = 4). Twenty-two of the remaining 24 probands initially presented with nontyphoidal, extraintestinal salmonellosis. Twenty of the 29 genetically affected sibs displayed clinical signs (69%); however 8 remained asymptomatic (27%). Nine nongenotyped sibs with symptoms died. Recurrent BCG infection was diagnosed in 15 cases, recurrent EM in 3 cases, recurrent salmonellosis in 22 patients. Ninety of the 132 symptomatic patients had infections with a single microorganism. Multiple infections were diagnosed in 40 cases, with combined mycobacteriosis and salmonellosis in 36 individuals. BCG disease strongly protected against subsequent EM disease (p = 0.00008). Various other infectious diseases occurred, albeit each rarely, yet candidiasis was reported in 33 of the patients (23%). Ninety-nine patients (70%) survived, with a mean age at last follow-up visit of 12.7 years ± 9.8 years (range, 0.5-46.4 yr). IL-12Rβ1 deficiency is characterized by childhood-onset mycobacteriosis and salmonellosis, rare recurrences of mycobacterial disease, and more frequent recurrence of salmonellosis. The condition has higher clinical penetrance, broader susceptibility to infections, and less favorable outcome than previously thought. © 2010 Lippincott Williams & Wilkins.

Association of fever and severe clinical course in bronchiolitis

Little attention has been given to the relation between fever and the severity of bronchiolitis. Therefore, the relation between fever and the clinical course of 90 infants (59 boys, 31 girls) hospitalised during one season with bronchiolitis was studied prospectively. Fever (defined as a single recording > 38.0°C or two successive recording > 37.8°C) was present in 28 infants. These infants were older (mean age, 5.3 v 4.0 months), had a longer mean hospital stay (4.2 v2.7 days), and a more severe clinical course (71.0%v 29.0%) than those infants without fever. Radiological abnormalities (collapse/consolidation) were found in 60.7% of the febrile group compared with 14.8% of the afebrile infants. These results suggest that monitoring of body temperature is important in bronchiolitis and that fever is likely to be associated with a more severe clinical course and radiological abnormalities.

[Book review] Chance encounters: a first course in data analysis and inference

Book review of: Chance Encounters: A First Course in Data Analysis and Inference by Christopher J. Wild and George A.F. Seber 2000, John Wiley & Sons Inc. Hard-bound, xviii + 612 pp ISBN 0-471-32936-3

A survey of teaching and assessment methods employed in UK higher education programmes for HCI course

A survey of teaching and assessment methods employed in UK Higher Education programmes for Human-Computer Interaction (HCI) courses was conducted in April 2003. The findings from this survey are presented, and conclusions drawn.

Web-based course support systems: an essential tool for supporting flexible learning environment

In Higher Education web-based course support systems are essential for supporting flexible learning environments. They provide tools to enable the interaction between student and tutor to reinforce transfer of theory to understanding particularly in an academic environment, therefore this paper will examine issues associated with the use of curriculum and learning resources within Web-based course support systems and the effectiveness of the resulting flexible learning environments This paper is a general discussion about flexible learning and in this case how it was applied to one of the courses at undergraduate level one. The first section will introduce what is flexible learning and the importance of flexible learning in Higher Education followed by the description of the course and why the flexible learning concepts is important in such a course and finally, how the flexibility was useful for this particular instance.

Structured reflection breaks embedded in an online course – effects on learning experience, time on task and performance

The purpose of this article is to gain an insight into the effects of practicing short, frequent,and structured reflection breaks interspersed with the learning material in a computer-based course. To that end, the study sets up a standardized control trial with two groups of secondary school pupils. The study shows that while performance is not affected by these embedded “reflection rituals,” they significantly impact time on task and perceived learning. The study also suggests that the exposure to such built-in opportunities for reflection modifies the engagement with the content and fosters the claimed readiness for application of a similar reflective approach to learning in other occasions.

A Competence-Based Course Authoring Concept for Learning Platforms with Legacy Assignment Tools

This paper is concerned with several of the most important aspects of Competence-Based Learning (CBL): course authoring, assignments, and categorization of learning content. The latter is part of the so-called Bologna Process (BP) and can effectively be supported by integrating knowledge resources like, e.g., standardized skill and competence taxonomies into the target implementation approach, aiming at making effective use of an open integration architecture while fostering the interoperability of hybrid knowledge-based e-learning solutions. Modern scenarios ask for interoperable software solutions to seamlessly integrate existing e-learning infrastructures and legacy tools with innovative technologies while being cognitively efficient to handle. In this way, prospective users are enabled to use them without learning overheads. At the same time, methods of Learning Design (LD) in combination with CBL are getting more and more important for production and maintenance of easy to facilitate solutions. We present our approach of developing a competence-based course-authoring and assignment support software. It is bridging the gaps between contemporary Learning Management Systems (LMS) and established legacy learning infrastructures by embedding existing resources via Learning Tools Interoperability (LTI). Furthermore, the underlying conceptual architecture for this integration approach will be explained. In addition, a competence management structure based on knowledge technologies supporting standardized skill and competence taxonomies will be introduced. The overall goal is to develop a software solution which will not only flawlessly merge into a legacy platform and several other learning environments, but also remain intuitively usable. As a proof of concept, the so-called platform independent conceptual architecture model will be validated by a concrete use case scenario.