Lausanne, Switzerland
Lausanne, Switzerland

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Giulieri S.,University of Lausanne | Morisod B.,University of Lausanne | Edney T.,University of Lausanne | Odman M.,University of Lausanne | And 10 more authors.
Clinical Infectious Diseases | Year: 2011

We report a Mycobacterium haemophilum outbreak after permanent make-up of the eyebrows performed by the same freelance artist. Twelve patients presented an eyebrow lesion and cervical lymphadenitis. All were treated with antibiotics. Surgery was required in 10 cases. M. haemophilum DNA was identified in the make-up ink. © 2011 by the Infectious Diseases Society of America.


Idrizi A.,Service of Nephrology | Barbullushi M.,Service of Nephrology | Gjata M.,Service of Internal Medicine | Koroshi A.,Service of Nephrology | And 3 more authors.
Central European Journal of Medicine | Year: 2011

We aim to define the prevalence of nephrolithiasis, the impact of anatomic and metabolic factors to stone formation and prognosis of patients with autosomal dominant polycystic kidney disease in Albania. We included 200 patients with autosomal dominant polycystic kidney from 2002 to 2009. The patients underwent X-ray, renal ultrasonography. We performed the metabolic evaluation of blood and urine. Survival times were calculated as the time to dialysis, transplantation, or death. Kaplan-Meier product-limit survival curves were constructed. Log rank test was used to compare the survival curves. Nephrolithiasis was present in 116 of our patients with autosomal dominant polycystic kidney disease (58%), with a mean age 46.4±5.7 years. Sixty five patients with kidney stones (56%) were women. The stones were composed primarily of urate (47%) and calcium oxalate (39%), and other compounds 14%. In 40% of patients the presence of stones was associated with a history of urinary tract infections and flank pain. In our study the prevalence of nephrolithiasis is 58%, higher than it reported in literature. Except anatomic and metabolic factors, there are other contributor factors to stone formation in our patients such socioeconomic status of patients, geographic zones and dietary habits. © Versita Sp. z o.o.


PubMed | Service of Internal Medicine, Scientific Institute of Public Health, Ghent University, Instituut Tropische Geneeskunde and 4 more.
Type: | Journal: BMC infectious diseases | Year: 2015

The Belgian HIV epidemic is largely concentrated among men who have sex with men and Sub-Saharan Africans. We studied the continuum of HIV care of those diagnosed with HIV living in Belgium and its associated factors.Data on new HIV diagnoses 2007-2010 and HIV-infected patients in care in 2010-2011 were analysed. Proportions were estimated for each sequential stage of the continuum of HIV care and factors associated with attrition at each stage were studied.Of all HIV diagnosed patients living in Belgium in 2011, an estimated 98.2% were linked to HIV care, 90.8% were retained in care, 83.3% received antiretroviral therapy and 69.5% had an undetectable viral load (<50 copies/ml). After adjustment for sex, age at diagnosis, nationality and mode of transmission, we found lower entry into care in non-Belgians and after preoperative HIV diagnoses; lower retention in non-Belgians and injecting drug users; higher retention in men who have sex with men and among those on ART. Younger patients had lower antiretroviral therapy uptake and less viral suppression; those with longer time from diagnosis had higher ART uptake and more viral suppression; Sub-Saharan Africans on ART had slightly less viral suppression.The continuum of HIV care in Belgium presents low attrition rates over all stages. The undiagnosed HIV-infected population, although not precisely estimated, but probably close to 20% based on available survey and surveillance results, could be the weakest stage of the continuum of HIV care. Its identification is a priority along with improving the HIV care continuum of migrants.


de Rham C.,University of Geneva | Hadaya K.,University of Geneva | Bandelier C.,Service of Internal Medicine | Ferrari-Lacraz S.,University of Geneva | Villard J.,University of Geneva
Transplant Immunology | Year: 2014

Human cytomegalovirus (CMV) infection may be a serious complication related to immunosuppression after solid organ transplantation. Due to their cytotoxicity, T-cells and natural killer (NK) cells target and clear the virus from CMV-infected cells. Although immunosuppressive drugs suppress T-cell proliferation and activation, they do not affect NK cells that are crucial for controlling the infection. The regulation of NK cells depends on a wide range of activating and inhibitory receptors such as the family of killer-cell immunoglobulin-like receptors (KIRs). Several human genetic studies have demonstrated the association of KIR genes with the clearance of infections. Since the respective activities of the different KIR proteins expressed by NK cells during CMV infection have not been extensively studied, we analyzed the expression of KIRs in a cohort of 22 CMV-IgG+ renal transplant patients at the time of CMV reactivation, after antiviral therapy and 6months later. Our data revealed a marked expression of KIR3DL1 during the acute phase of the reactivation. We set up an in vitro model in which NK cells, derived either from healthy donors or from transplanted patients, target allogeneic fibroblasts, CMV-infected or uninfected. Our results demonstrate a significant correlation between the lysis of CMV-infected fibroblasts and the expression of KIR3DL1. Blocking experiments with antibodies to MHC-I, to NKG2D and to NKG2C confirmed the importance of KIR3DL1. Consequently, our results suggest that KIR proteins and especially KIR3DL1 could play an important role during CMV-infection or CMV reactivation in immunosuppressed patients. © 2014 Elsevier B.V.


Pfenniger A.,University of Geneva | van der Laan S.W.,University Utrecht | van der Laan S.W.,Interuniversity Cardiology Institute of the Netherlands | Foglia B.,University of Geneva | And 7 more authors.
Atherosclerosis | Year: 2012

Objective: Cx40 is a gap junction protein important for cell-cell communication in the endothelium. Polymorphisms in the promoter region of the human Cx40 gene, -44G>A and +71A>G, were shown to reduce Cx40 transcription by half. As mice with an endothelial-specific deletion of Cx40 are more susceptible to atherosclerosis, this study was designed to discover a correlation between these polymorphisms and atherosclerosis in European populations. Methods and results: 803 patients referred to the Geneva University Hospitals for elective coronary angiography were divided according to the number of significantly stenosed vessels (from 0 to 3) and were genotyped for the Cx40 polymorphisms. Genotype distribution in the control group was -44GG/+71AA = 59.8%, -44AG/+71AG = 35.1% and -44AA/+71GG = 5.2%. Surprisingly, this distribution was similar in the CAD group, with -44GG/+71AA = 58.5%, -44AG/+71AG = 37.6% and -44AA/+71GG = 3.8% (p= 0.67). Moreover, no significant association between histological carotid plaque composition of culprit lesions and Cx40 polymorphisms could be detected in 583 Dutch patients of the Athero-Express study. Conclusions: Despite a clear antiatherogenic role of Cx40 in mice, our study could not detect an association of Cx40 promoter polymorphisms and CAD in human. Moreover, a correlation with atherosclerotic plaque stability or hypertension could not be demonstrated either. Connexin polymorphisms affecting channel function may be of greater importance for cardiovascular disease than polymorphisms affecting the expression level of the protein. © 2012 Elsevier Ireland Ltd.


Hadaya K.,University of Geneva | Avila Y.,University of Geneva | Valloton L.,CHUV | Valloton L.,Transplantation Center | And 8 more authors.
Clinical Immunology | Year: 2010

Polyclonal rabbit anti-thymocyte globulin (rATG) is widely used in solid organ transplantation (SOT) as induction therapy or to treat corticosteroid-resistant rejection. In vivo, the effect of rATG on natural killer (NK) cells has not been studied. These cells are of particular relevance after SOT because classical immunosuppressive drugs do not inhibit or even can activate NK cells. A cohort of 20 recipients at low immunological risk, that had been receiving rATG as induction therapy, was analyzed for receptor repertoire, cytotoxicity and capacity of NK cells to secrete IFN-γ before kidney transplantation and at different time points thereafter. NK cells expressed fewer killer-cell immunoglobulin-like receptors (KIR), fewer activating receptors NKG2D, but more inhibitory receptor NKG2A compatible with an immature phenotype in the first 6. months post transplantation. Both cytotoxicity of NK cells and the secretion of IFN-γ were preserved over time after transplantation. © 2010 Elsevier Inc.


PubMed | Service of Internal Medicine and University of Geneva
Type: Journal Article | Journal: Transplant immunology | Year: 2014

Human cytomegalovirus (CMV) infection may be a serious complication related to immunosuppression after solid organ transplantation. Due to their cytotoxicity, T-cells and natural killer (NK) cells target and clear the virus from CMV-infected cells. Although immunosuppressive drugs suppress T-cell proliferation and activation, they do not affect NK cells that are crucial for controlling the infection. The regulation of NK cells depends on a wide range of activating and inhibitory receptors such as the family of killer-cell immunoglobulin-like receptors (KIRs). Several human genetic studies have demonstrated the association of KIR genes with the clearance of infections. Since the respective activities of the different KIR proteins expressed by NK cells during CMV infection have not been extensively studied, we analyzed the expression of KIRs in a cohort of 22 CMV-IgG(+) renal transplant patients at the time of CMV reactivation, after antiviral therapy and 6 months later. Our data revealed a marked expression of KIR3DL1 during the acute phase of the reactivation. We set up an in vitro model in which NK cells, derived either from healthy donors or from transplanted patients, target allogeneic fibroblasts, CMV-infected or uninfected. Our results demonstrate a significant correlation between the lysis of CMV-infected fibroblasts and the expression of KIR3DL1. Blocking experiments with antibodies to MHC-I, to NKG2D and to NKG2C confirmed the importance of KIR3DL1. Consequently, our results suggest that KIR proteins and especially KIR3DL1 could play an important role during CMV-infection or CMV reactivation in immunosuppressed patients.


Idrizi A.,Service of Nephrology | Barbullushi M.,Service of Nephrology | Beqiri A.,Service of Surgery | Hoxha L.,Service of Gastrohepatology | And 6 more authors.
Central European Journal of Medicine | Year: 2013

Introduction: Liver involvement is the most frequent extrarenal manifestation in autosomal dominant polycystic kidney disease (ADPKD). We studied the impact of liver cysts on renal function in our patients with ADPKD. Methods: a retrospective observational from January 2002 to January 2009 e divided 138 patients with ADPKD into two groups: one group of 68 patients without liver cysts and another group of 70 patients with liver cysts. Renal function was considered to be impaired when the creatinine clearance was less than 60 ml/min. Differences were considered significant at the P<0.05 level. Results: The liver cysts were more frequent in female patients. No renal failure survival difference was found between patients in both groups (P=0.05). Female patients with liver cysts and three or more pregnancies had a worse survival rate than female patients with liver cysts with fewer than three or no pregnancies (P<0.01). Conclusion: Our study showed that there was no renal failure survival difference between patients with liver cysts compared with those without liver cysts. Female patients with liver cysts and three or more pregnancies had a greater risk of developing end stage renal disease when compared with patients with liver cysts and fewer than three or no pregnancies. © 2013 Versita Warsaw and Springer-Verlag Berlin Heidelberg.

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