Integrated analysis of randomized controlled trials evaluating bortezomib + lenalidomide + dexamethasone or bortezomib + thalidomide + dexamethasone induction in transplant-eligible newly diagnosed multiple myeloma.

Objective: Providing the most efficacious frontline treatment for newly diagnosed multiple myeloma (NDMM) is critical for patient outcomes. No direct comparisons have been made between bortezomib + lenalidomide + dexamethasone (VRD) and bortezomib + thalidomide + dexamethasone (VTD) induction regimens in transplant-eligible NDMM.

Methods: An integrated analysis was performed using patient data from four trials meeting prespecified eligibility criteria: two using VRD (PETHEMA GEM2012 and IFM 2009) and two using VTD (PETHEMA GEM2005 and IFM 2013-04).

Incidence, management and outcome of respiratory syncytial virus infection in adult lung transplant recipients: a 9-year retrospective multicentre study.

Objectives: To analyse functional outcome parameters according to antimicrobial treatments after respiratory syncytial virus (RSV)-confirmed infection in adult lung transplant recipients.

Methods: A 9-year retrospective multicentre cohort study (2011-19) included adult lung transplant recipients with RSV-confirmed infection. The first endpoint determined new allograft dysfunction (acute graft rejection and chronic lung allograft dysfunction (CLAD)) 3 months after infection.

[Which are the significance of low level of glycated hemoglobin A1c?].

Glycated hemoglobin A1c (HbA1c) reflects the mean blood glucose over the lifespan of red blood cells and has become a valuable tool both for diagnosis and monitoring of diabetes. Nevertheless, some factors may under-estimate the HbA1c value, compromising its application. The aim of this retrospective study was to evaluate the incidence rate of HbA1c lower than 4% and to identify some clinical and biological factors that can potentially reduce the HbA1c level.

Lenalidomide, Bortezomib, and Dexamethasone with Transplantation for Myeloma.

Background: High-dose chemotherapy plus autologous stem-cell transplantation has been the standard treatment for newly diagnosed multiple myeloma in adults up to 65 years of age. However, promising data on the use of combination therapy with lenalidomide, bortezomib, and dexamethasone (RVD) in this population have raised questions about the role and timing of transplantation.

Methods: We randomly assigned 700 patients with multiple myeloma to receive induction therapy with three cycles of RVD and then consolidation therapy with either five additional cycles of RVD (350 patients) or high-dose melphalan plus stem-cell transplantation followed by two additional cycles of RVD (350 patients).

Pulmonary fibrosis in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis: a series of 49 patients and review of the literature.

Pulmonary fibrosis (PF) is an uncommon manifestation observed in patients with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV), particularly microscopic polyangiitis (MPA). While patients with PF associated with AAV seem to have a worse prognosis, these patients have been described only in case reports or small retrospective case series. In this retrospective multicenter study, we report the main features and long-term outcomes of patients with PF associated with AAV, fulfilling the American College of Rheumatology criteria and/or Chapel Hill definitions.

A novel mutation 3090 G>A of the mitochondrial 16S ribosomal RNA associated with myopathy.

We describe a young woman who presented with a progressive myopathy since the age of 9. Spectrophotometric analysis of the respiratory chain in muscle tissue revealed combined and profound complex I, III, II+III, and IV deficiency ranging from 60% to 95% associated with morphological and histochemical abnormalities of the muscle. An exhaustive screening of mitochondrial transfer and ribosomal RNAs showed a novel G>A substitution at nucleotide position 3090 which was detected only in urine sediment and muscle of the patient and was not found in her mother's blood cells and urine sample.

[Pulmonary mucormycosis in a multiple-trauma patient].

Mucormycosis are opportunist infections occurring usually among predisposed patients. We report a case of an 18-year-old male with a severe thoracic trauma who developed an Absidia infection on his contused pulmonary parenchyma, without presenting the usual risk factors (diabetes mellitus, immunodeficiency). The early diagnosis using bronchoscopy has probably improved the outcome by allowing a faster treatment.

A novel mutation in the mitochondrial tRNA Asn gene associated with a lethal disease.

We describe a lethal mitochondrial disease in a 10-month-old child who presented with encephalomyopathy. Histochemical and electron microscopy examinations of skeletal muscle biopsy revealed abnormal mitochondria associated with a combined deficiency of complexes I and IV. After excluding mitochondrial DNA deletions and depletion, direct sequencing was used to screen for mutation in all transfer RNA (tRNA) genes.

[Opioid tolerance: what if it was just a question of receptor internalization?].

Despite side effects which appear upon chronic administration of opioid agonists, these drugs remain widely used and effective for pain relief. Among these side effects, tolerance is the major factor limiting the effectiveness of these drugs. Desensitization, defined by a decrease of opioid receptor transduction, would be a crucial step in the development of tolerance.

Differential sorting of human delta-opioid receptors after internalization by peptide and alkaloid agonists.

Desensitization and internalization of G protein-coupled receptors observed after agonist activation are considered two important regulatory processes of receptor transduction. Endogenous human delta-opioid receptors (hDOR) are differentially regulated in terms of desensitization by peptide ([d-Pen2,5]enkephalin (DPDPE) and Deltorphin I) and alkaloid (etorphine) agonists in the neuroblastoma cell line SK-N-BE (Allouche, S., Roussel, M.

[Late revealing of congenital diaphragmatic hernia: diagnostic difficulties].

Two patients, aged four and six months, with congenital diaphragmatic hernias, and who presented outside of the neonatal period, are reported. Clinical presentation was a progressive respiratory failure, and radiographic findings showed a consolidation of the left lung, associated with a pneumothorax in one and an ascites in the other. One had previous normal chest X-rays.

Desmin phosphorylation abnormalities in cytoplasmic body and desmin-related myopathies.

Cytoplasmic body myopathy (CBM) and desmin-related myopathy (DRM) are both characterized by an abnormal accumulation of desmin. To determine whether these abnormalities involve similar or different forms of desmin, we performed desmin two-dimensional electrophoresis: our results showed an increase in the two acidic isoforms in CBM muscles as compared with an increase in the number of acidic isovariants in DRM samples. A process of hyperphosphorylation involved in these acidic forms was confirmed by alkaline phosphatase application onto the muscle samples in both pathological conditions.

Pharmacological approaches to the prevention of restenosis after coronary angioplasty.

Restenosis in the months following a successful percutaneous transluminal coronary angioplasty (PTCA) remains the main limitation to this technique for myocardial revascularisation. Despite intensive investigation in this area, no pharmacological therapy has yet been found to be useful in preventing restenosis after conventional balloon angioplasty. The occurrence of restenosis, which is now known to be caused by both vessel remodelling and neointimal hyperplasia, might be reduced in the future by a combined mechanical and pharmacological approach.

Perindopril plus nifedipine versus perindopril plus hydrochlorothiazide in mild to severe hypertension: a double-blind multicentre study. The Multicentre Study Group on Treatment Association with Perindopril.

Thiazide diuretics are considered as the choice drug to combine with ACE inhibitors for the treatment of hypertension. However, there is much evidence showing that the combination of ACE inhibitors with a calcium channel blocker is effective and safe. We compared the safety and efficacy of perindopril 8 mg once daily plus nifedipine SR 10 mg twice daily with perindopril 8 mg once daily plus hydrochlorothiazide (HCTZ) 12.

Chronic Lymphocytic Leukemia in Younger Adults: Preliminary Results of a Study Based on 454 Patients-IWCLL/Working Group.

Whether all younger adult patients with chronic lymphocytic leukemia (CLL) should be offered intensive and/or experimental treatments is currently undecided. In order to investigate the natural history and prognosis of CLL in younger adults, information on 454 B-CLL patients less than 50 yrs old, from 13 different International groups was collected and analyzed. The male/female proportion is 1.

[Gonadal function in primary apparent male osteoporosis. 12 cases].

The testicular endocrine function was studied in 12 patients aged from 33 to 76 years (mean: 56.3 +/- 11.5 years) presenting with an apparently primary vertebral osteoporosis and in 14 age-matched controls (mean: 52.

[Peripheral neuropathy in severe mixed cryoglobulinemia syndrome].

A syndrome of polyneuropathy and cryoglobinemia is reported in a 76-year-old woman. Nerve biopsy showed severe demyelination and vascular involvement was demonstrated in a muscle biopsy. Peripheral neuropathy is discussed in the context of the Gougerot-Sjögren syndrome, associated with cryoglobins in the blood.