This analysis excluded the 2009–10 season because monovalent vaccine was not available to the local population when the pandemic wave arrived in October–November

2009, and influenza was absent from the study population in the subsequent winter months. Influenza vaccination status was determined by a real-time, internet-based vaccination registry used by all public and private vaccination providers serving the population (http://www.recin.org). A validation study of PD0325901 the registry during the 2006–07 and 2007–08 influenza seasons demonstrated that the registry captured 95% of all influenza vaccinations that were received by study participants [19]. A similar high level of capture was demonstrated in a validation study during the 2011–12 season (unpublished data). Adults were classified as vaccinated if they had received influenza vaccine ≥14 days before the onset of illness. Dates of hospital admission and discharge diagnoses were identified from the electronic medical record for a 14 day period after onset of influenza illness. To adjust for use of antiviral drugs, we extracted dates of antiviral prescriptions for all participants. The main outcome was an acute care hospital admission occurring within 14 days of

influenza symptom onset. Although most hospital admissions occurred after an outpatient enrollment, some participants were initially enrolled and swabbed after admission to the hospital. Covariates included age, MK 2206 Rutecarpine gender, antiviral prescription, specific high risk

medical conditions, year, and influenza type/subtype [A/H3N2, A/H1N1, pandemic H1N1 (A/H1N1pdm09), B]. Study participants were classified as having a high risk medical condition if they had at least one visit during a recent 12 month period with an ICD-9 CM diagnosis code of interest. High risk conditions were classified into the following groups: cancer, cardiovascular disease, diabetes, pulmonary, and other. Antiviral prescription was defined as a prescription of oseltamivir, zanamivir, amantadine, or rimantadine within 14 days of symptom onset for persons not hospitalized and between symptom onset and hospital admission for persons who were hospitalized. We restricted the analysis of hospital admissions to enrolled adults aged ≥20 years because influenza-related hospitalization was less common in children, and potential confounding factors are likely to be different for adults and children. Studies of influenza vaccination and hospital admission are particularly susceptible to confounding, since persons who are vaccinated may be more likely to have pre-existing chronic medical conditions or other risk factors for hospital admission. To minimize confounding by indication for vaccination, we used a propensity score regression adjustment [20] and [21].

Helium was the carrier gas at a flow rate of 1 ml/min. Diluted samples (1/100 in hexane, v/v) of 1 μl were injected manually. The identification of the components was based on the comparison of their mass spectra with spectra libraries, as well as by comparison of the retention times. All experiments were carried out in triplicate and mean ± SD values are presented. Data were analysed by one way Analysis of Variance (ANOVA) followed by the Duncan’s Multiple Range Test. The acceptance of traditional medicine as an Anti-diabetic Compound Library cost alternative form for health care and the development of microbial resistance to the

available antibiotics have led many authors to investigate the antimicrobial activity of medicinal plants.36 The present work highlights the

composition of essential oil isolated from T. decandra and its effect on antioxidant and inhibition of bacterial and fungal growth. The composition of the oil of T. decandra is presented in Table 1. Twenty-three components were identified using gas chromatography, representing 99.98% of the oil. The oil yield from the plant was 4% v/w. The major components of T. decandra oil were Eicosane (18.81%), Tetracosane (16.17%), Hexadecane (14.84%), Dotriacontane (8.17%), Nonacosane (7.13%), Tetrapentacosane (5.61%), Henelcosane (4.34%), 2,4-Di-tert-butylphenol (2.92%), Bis (2-ethyl hexyl) phthalate (2.74%) and Phytol Epigenetics Compound Library (2.19%) while 4,6-Dimethyldodecane, 3,7-Dimethyldecane, 3,4,5,6-Tetramethyloctane, 3-Ethyl-3-methylheptane, 3,8-Dimethylundecane were found in minor concentrations. GC spectrum of essential oil not obtained from T. decandra ( Fig. 1). Disc diffusion assay was performed with the essential oil, in order to identify the antimicrobial activity. The essential oil of T. decandra

has shown higher range of Diameter of Inhibition Zone (DIZ) from 19 ± 0.01 to 24 ± 0.05 mm at a concentration level of 1 mg/ml. Chloramphenicol and Nystatin have shown DIZ ranging from 18 ± 0.05 to 23.6 ± 0.02 mm at a concentration of 30 μg/disc. All DIZ corresponding to test organisms are tabulated in Table 2. The results of minimal inhibitory concentration are given in Table 3. E. faecalis and S. typhi (MIC: 625) are most sensitive to essential oil with an MIC value of 625 μg/ml. MIC values for Chloramphenicol and Nystatin ranged from 3.13 to 50 μg/ml. Total phenolic contents of essential oil were 72.4 ± 1.26 mg/g weight of essential oil. The control and test samples were compared for the determination of percentage of inhibition of DPPH. The essential oil and butylated hydroxyl anisole have shown 70.64 ± 0.05 and 85.32 ± 0.24 respectively. The essential oil of Sesuvium portulacastrum exhibited notable antibacterial activity against all the bacterial species in the range of 5.3–14.5 mm. 37 Essential oil has been isolated and analysed for chemical composition S. portulacastrum. As observed in the present study the oil is a complex mixture of 12 compounds, representing more than 99.

It is therefore possible that trauma-relevant nightmares are peculiar in that they do not occur during REM sleep. This is in keeping with study subject reports that even with PTSD nightmare reduction, normal dreaming

was preserved or even restored following the prazosin treatment arm. Another double-blind placebo-controlled crossover study of civialians addressed whether daytime-only prazosin treatment reduced PTSD symptoms during a trauma-relevant stress paradigm that simultaneously measured PFC-related executive function (Taylor et al., 2006). The Stroop Color-Word Interference Test (Golden, 1976), has been used for decades to assess cognitive function, and shown to involve PFC activity in humans (Milham et al., 2003). The E-Stroop is a modification developed to study the cognitive effects of increased emotional arousal in PTSD Epigenetics activator in a controlled laboratory setting (McNally et al., 1990). In brief, it is a timed task that requires the participant to read a list of trauma-relevant words and name the color of ink that

each word is printed in. The experimental trauma-related Protein Tyrosine Kinase inhibitor word list consisted of five words chosen by each participant from their personal narrative of their etiologic trauma event (e.g., “fire” and “9/11” for a World Trade Center occupant who survived the September 11, 2001, terrorist attack). Time to completion, errors of omission and commission, as well as subjective distress were all recorded. At doses averaging 3.2 ± 1.3 mg, prazosin simultaneously reduced subjective stress and improved cognitive performance over the placebo condition, suggesting that alpha 1 adrenergic

blockade improved PFC function in PTSD individuals under duress (Taylor et al., 2006). Together, these clinical trials support the role of alpha-1 adrenergic blockade in reducing PTSD symptoms. These studies showed a reduction in daytime symptoms of PTSD, even when only dosed at night. Several studies report a reduction of the hyperarousal category of PTSD symptoms as measured by the CAPS. It is interesting that most of the symptoms in this category Idoxuridine are those associated with PFC deficits including irritability, aggression, recklessness, and impaired concentration. In the trauma-relevant stress paradigm study, prazosin’s simultaneous reduction of both subjective stress and objective measures of cognitive function further support preclinical findings that alpha-1 receptor stimulation impairs PFC function, and that blockade of these receptors can restore function. A recent case report cites high doses of prazosin, up to 30 or 40 mg, as efficacious and well-tolerated in the treatment of daytime PTSD symptoms, (Koola et al., 2014) underscoring the need for further studies on the use of higher doses of prazosin to treat daytime PTSD symptoms.

8 ± 14.4 months). Among the rotavirus infected children, 58.5% were in the age group of 7–12 months, while 14.5% belonged to ≤6 months. Analysis of the clinical severity scores indicated very severe, severe,

moderate and mild disease in 2.8%, 56.5%, 38.7% and 2.3% of the patients suffering for rotavirus gastroenteritis. As against this, 5%, 47%, 38.3% and 7.7% of the patients tested negative for rotavirus experienced very severe, severe, moderate selleck compound and mild disease, respectively. In general, children with rotavirus diarrhea had significantly less mild and more severe disease than those with rotavirus-negative diarrhea (P < 0.05). Rotavirus infected children had more episodes of vomiting than did uninfected children (P < 0.05). The multiplex PCR conducted for genotyping of rotavirus strains showed amplification of VP7 and VP4 genes in 197 (81.7%) and 190 (78.8%) strains respectively and identified genotypes of both genes in 178 (73.8%) strains (Table 2). 32 (13.2%) strains remained untypeable for both genes. We detected infections with mixed rotavirus strains in 18 (10.1%) of the 178 specimens. Among the strains typed for both VP7 and VP4 genes, G1P[8] strains attained the highest score (31.4%). This was followed by G2P[4] (20.2%); G9P[8] (11.8%); G9P[4]

(10.1%); G12P[6] (6.1%); G12P[8] (3.3%); G2P[8] (2.8%); G2P[6] (2.2%); G3P[8] (0.5%); G4P[4] (0.5%) and G1P[4] (0.5%) rotavirus strains. G1P[8] strains continued to remain prevalent in all the years of study except Venetoclax the year 2009 in

which G9P[8] strains (15.2%) were predominant. G9P[8] strains remained second highest in the year 2010 and only declined markedly in circulation in 2011–2012. We found higher circulation of G9P[4] strains, an unusual combination of G and P types in 2010–2012 as compared to 2009. Mixed infections were highest (27.1%) in the year 2009 and declined drastically in the following years (Table 3). Two rotavirus vaccines, Rotarix™ and RotaTeq® have been licensed in ∼90 to 100 countries to use against rotavirus diarrhea. Both vaccines are recommended by the World Health Organization (WHO) in childhood immunization programs conducted globally [9]. Studies report difference in the efficacies of these vaccines against severe rotavirus diarrhea in high and middle income (85–98%) and low income (39–72%) countries [10]. In countries like India, where the vaccine efficacy data is yet to be acquired, monitoring of rotavirus disease and strains is essential to assess the impact of rotavirus vaccines and circulating rotavirus strains on each other. The data obtained in this direction in the present study reaffirm earlier reports (2005–2009) of the characteristics of rotavirus infections, large rotavirus disease burden and strain diversity among children in Pune, western India [3] and [4]. Our data showed that rotavirus positivity continued to remain significant in each year of the study period (2009–2012) and concurred with recent study reports from India [11].

We wish to thank Dr Kathy Stiller and Dr Kylie Hill for their insightful comments on the protocol for this

systematic review. “
“Treatment of sputum retention and the associated chronic infection in the airways of people with cystic fibrosis involves several therapeutic approaches. Antibiotics are administered to suppress infection (Southern et al 2004, Ryan et al 2003, Smyth and Walters 2003), manual physiotherapy techniques and other physical interventions are used to clear infected mucus from the airways (van der Schans et al 2000), and various mucoactive medications are used to click here improve the properties of the mucus to facilitate its clearance (Jones and Wallis 2010, Wark and McDonald 2009). One of these mucoactive medications is recombinant human deoxyribonuclease, or dornase alpha (Pulmozyme®). It reduces the viscosity of sputum in people with cystic fibrosis by cleaving strands of the deoxyribonucleic acid (DNA) released by neutrophils (Lieberman 1968). This makes the sputum flow more easily (Shak et al 1990). Regular use of dornase alpha improves lung function and quality of life, and reduces the number and severity of respiratory exacerbations (Hubbard et al 1992, Ramsey et al 1993, Fuchs et al 1994). Although dornase alpha has been used widely in the management of cystic fibrosis for more than 15 years, the optimal timing of administration with respect to physical airway

clearance techniques is still unclear. During its clinical development, trials Metalloexopeptidase allowed dornase alpha to be administered either before or after selleck products physical airway clearance techniques. Only recently have trials started to address this potentially important aspect of its administration. Fitzgerald and colleagues (2005) compared administration of dornase alpha 30 min before and 30 min after physical airway clearance techniques in children and adolescents with cystic fibrosis. They found that the two timing regimens had similar effects on measures

of lung function, quality of life, and peak exercise capacity. In a similar study, van der Giessen and colleagues (2007) also found that the regimens had non-significant differences in most measures of lung function. However, as their primary outcome, they included an additional measure: maximal expiratory flow at 25% of the forced vital capacity (FVC). This outcome was significantly better when dornase alpha was administered before physical airway clearance techniques. Wilson and colleagues (2007) performed a similar study in adults and children with cystic fibrosis and found no significant differences for most outcomes. However, in those outcomes that did differ (ie, forced expiratory flow rate between 25% What is already known on this topic: The timing of dornase alpha in relation to physiotherapy techniques may alter the effect of these two interventions on airway clearance. However, this has not been examined in adults with cystic fibrosis.

7 hr (SD 3.3), a difference of 1.9 hr (95% CI 0 to 3.8). While this difference in observation period between the stroke survivors and healthy controls may be partially explained by a general slowness of movement which would result in a longer time to get dressed and undressed, it is probably mainly the result of spending a longer time in bed. When the data were adjusted, our finding that ambulatory stroke survivors spend the same relative amount of time physically active as age-matched healthy controls also concurs click here with the only previous study to measure duration of physical activity (Sakamoto et al 2008). Interestingly,

in both studies there was little difference between groups in the relative amount of time spent walking – the main difference was

the shorter time spent standing by people with stroke. In terms of frequency, our finding that ambulatory stroke survivors carry out fewer activity counts than age-matched healthy controls concurs with previous studies (Manns et al 2009, Hale et al 2008, Sakamoto et al 2008). It is difficult to compare the activity counts from different studies directly because different activity monitors are used and the definition of an activity count differs between studies. However, we can examine the frequency carried out by the stroke survivors as a proportion of that carried BTK signaling inhibitor out by healthy controls across studies to get an overall estimate of the deficit in physical activity in ambulatory stroke survivors. Our stroke survivors carried out 52% of the activity counts of our age-matched controls. This is similar to Sakamoto et al (2008, 56%), Manns et al (2009, 50%) and Hale et al (2008, 51%). Importantly, the ambulatory ability of stroke survivors of across

studies was similar, with average walking speed ranging 0.72–0.80 m/s. Therefore, the stroke survivors walked at about 60–67% of healthy elderly walking speed (1.2 m/s, Bohannon 1997), and were physically active at 50–56% of the frequency of age-matched controls. That is, the deficit in the frequency of physical activity can be largely explained by the slowness of movement by the stroke survivors. This is not surprising since speed is a function of frequency and duration. Comparing the raw and adjusted data provides some interesting insights into the nature of the differences in physical activity between people after stroke and healthy controls. The raw data indicate that people after stroke spend less time on their feet and have fewer activity counts. However, when adjusted to a fixed observation period, the differences in time on feet disappear but the differences in activity counts remain. This suggests that the reduction in physical activity observed after stroke is because of slowness of movement (ie, fewer counts in an equivalent time period) rather than a diminished amount of time spent being active.

This organic phase added drop by drop (2 ml/min) in external aqueous phase containing surfactant PVA in a fixed concentration (0.5% w/v) at 13,500 rpm (Omni GLH homogenizer). This suspension was then processed in high pressure homogenizer (Gea Niro Soavi, Italy) for eight cycles. A subsequently

organic solvent from external aqueous phase was removed under reduced pressure. The formed REPA-EC polymeric nanoparticles were recovered by centrifugation (R243A, Remi) at 18,000 rpm Selleckchem trans-isomer for 20 min followed by washing thrice with distilled water and washed nanoparticles were subjected to freeze drying (Scanvac, Denmark). The viscosity of internal phase was measured by Brookfield rotational digital viscometer DVLV II at 25 °C. The obtained REPA-EC NPs were dispersed in distilled water by sonication and vortex mixing for 30 s and the particle size (Z-average mean) and zeta potential were determined by using Nano series Malvern Instruments, UK. The percentage yields of dried nanoparticles were calculated by using Eq. (1) equation(1) Percentageyield=MassofnanoparticlesrecoveredMassofpolymers,drugandformulationexcipients×100

Accurately weighed freeze dried nanoparticles were dissolved in dichloromethane. Then REPA was extracted in 50 ml phosphate buffer (pH 7.4) solution. After the evaporation of DCM and removal of precipitated polymer by filtration, the amount of drug in phosphate buffer was measured using Ultraviolet selleck compound spectroscopy (U2900, Hitachi, Japan) at 275.5 nm. Encapsulation

efficiency (%) and drug content (%, w/w) were represented by Eqs. (2) and (3) respectively. equation(2) Encapsulationefficiency(EE%)=MassofdruginnanoparticlesMassofdrugusedinformulations×100 equation(3) Drugcontent(%,ww)=MassofdruginnanoparticlesMassofnanoparticlesrecovered×100 The shape and surface characteristics of nanoparticles were investigated and photographed using Field Emission-Scanning Electron Microscopy (FE-SEM) (S4800, Hitachi, Japan). Appropriate samples were mounted on stub, using double sided adhesive carbon tapes. Samples were gold coated and observed for morphology, at acceleration voltage of 1.0 kV. The samples (REPA, EC and nanoparticles) were homogeneously mixed with potassium bromide and infrared spectrums were recorded in region of 4000-400 cm−1 by using infrared spectrophotometer (IR-8400, mafosfamide Shimadzu Co. Ltd., Singapore). X-ray diffraction of samples was carried out using Model-D8 Advance, Bruker AXS GmbH, Germany diffractometer. A Cu Kα source operation (40 kV, 40 mA) was employed. The diffraction pattern were recorded over a 2θ angular range of 3–50° with a step size of 0.02° in 2θ and a 1 s counting per step at room temperature. Accurately weighed samples were suspended in 100 ml phosphate buffer saline (pH 7.4). The solution was stirred at 50 rpm with temperature adjusted to 37 ± 1 °C. At programmed time intervals 5 ml samples were reserved and centrifuged at 20,000 rpm for 30 min.

During the 6-month follow-up, at least one SAE was reported by 2.8% (35/1272) of the QIV GSK2656157 cell line group, and 1.4% (3/213) and 3.2% (7/218) of the TIV-Vic and TIV-Yam groups, respectively (Supplementary Table 1). None of the SAEs were considered

to be vaccine related. This Phase III, randomized, double-blind study of healthy adults aged ≥18 years showed that QIV was immunologically superior versus TIV for the alternate-lineage B strain, and was non-inferior for the influenza strains shared in the QIV and TIVs. HI antibody responses were also shown to be consistent between three lots of QIV, thus demonstrating manufacturing consistency of the candidate vaccine. Our results show that in people aged ≥18 years, QIV offers improved immunogenicity against the additional B strain without affecting antibody responses to existing strains compared with conventional TIVs; therefore, our study supports a switch

from conventional TIV to QIV with the aim of improving protection against influenza B disease. The immunogenicity and safety findings reported for this QIV which was manufactured in Canada are Quisinostat mw consistent with a previous report of an inactivated QIV produced by the same company using a different process at facilities in Germany [16]. The results add to the growing evidence in both children and adults which shows that live attenuated and inactivated QIVs provide similar immune responses against shared vaccine strains versus TIV with added protection against the additional B strain [12], [13], below [14], [15], [16] and [17]. We showed that each of the vaccines elicited strong

HI antibody responses against the A/H1N1 and A/H3N2 vaccine strains, and against B/Brisbane/60/2008 (Victoria) and/or against B/Florida/4/2006 (Yamagata). SCRs and SPRs against each vaccine strain were considered to be high, and immune responses were slightly stronger against influenza A than influenza B strains with QIV and both TIVs. The persistence of antibody responses was assessed six months after vaccination in a sub-cohort of subjects, and whereas immune responses decreased at 6 months in each vaccine group relative to those measured at day 21 after vaccination, they remain notably increased above baseline levels. In the QIV group, antibody persistence at 6 months appeared to be more robust against the influenza B strains with SPRs of 94.9% and 99.6% against B/Victoria and B/Yamagata, respectively, compared with SPRs of 66.5% and 64.6% against A/H1N1 and A/H3N2, respectively. Antibody levels were decreased against the influenza A strains at 6 months post-vaccination, and the clinical significance of this is uncertain. Descriptive analyses were also performed to further assess the immunogenicity of QIV according to age. The median age was 50.0 years (18–91 years) overall, with an equal distribution of subjects aged 18–64 years versus ≥65 years in each group.

This work has in part been presented at the 47th Interscience Conference on Antimicrobials and Anti-infective Chemotherapy (ICAAC), September 2007, in Chicago. IL. This work also forms the medical thesis of Barbara Rath, MD, at the Medical Faculty, University of Basel, Switzerland. The authors kindly thank

Jane Gidudu, MD, MPH in the Brighton Secretariat at the US Centers for Disease Control, Atlanta, USA, as well as the Brighton Collaboration Steering Committee, in particular Brigitte Keller-Stanislawski, MD, Paul-Ehrlich Institute, Langen, Germany, for their comments. We also kindly acknowledge the support through the University-Children’s LBH589 datasheet Hospital (UKBB) and by Prof. Urs Beat Schaad. The study was funded by a UKBB Matching Funds Grant. “
“Co-aggregation, an early event of biofilm formation, is characterized as an intra- or inter-species interaction of oral bacteria during Ibrutinib solubility dmso the development of oral plaques which function as a mixed-culture biofilm

for the growth of a spatially organized and metabolically integrated microbial community [1] and [2]. Biofilms form when planktonic cells adhere to surfaces, proliferate, and co-aggregate with other bacteria. During proliferation and co-aggregation, bacteria use amino acids including cysteine and methionine as nutrients and convert them into volatile sulfur compounds (VSCs) [3] and [4]. Once plaques were formed, they increase the risk of developing various dental diseases such as caries and periodontitis [5]. Thus, the process of bacterial co-aggregation presents a valuable early target for therapy aimed at suppressing the progress of oral bacterial infections and preventing halitosis and periodontal diseases. The Gram-negative anaerobe Fusobacterium nucleatum (F. nucleatum) is an oral bacteria that exists as a part of the normal oral microbiome [6]. However, it also

has pathogenic potential and is implicated in periodontal diseases as well as halitosis [6] and [7]. Additionally, F. nucleatum is thought to act as a “microbial bridge” as it can co-aggregate with early and late colonizers of dental plaque [8]. Evidence also shows that F. nucleatum can enter the bloodstream Ribonucleotide reductase and cause endocarditis [9], urinary tract infection [10] or preterm birth [11]. Although systemic diseases in association with microbial species in oral biofilm have been reported [12] and [13], there are difficulties in establishing a causal role for oral bacteria in systemic conditions. The major outer membrane protein of F. nucleatum, FomA, has been shown to function as a non-specific porin in lipid bilayer membranes [14], and to function as a porin in vivo when recombinantly expressed in Escherichia coli (E. coli) [15].

Syndrome Eisenmenger Inclut tous les défets intra et extracardiaques Venetoclax order qui se manifestent au départ par un shunt systémique-pulmonaire et qui progressent entraînant une élévation des résistances vasculaires pulmonaires (RVP) et l’inversion du shunt (pulmonaire-systémique) ou un shunt bidirectionnel ; les patients ont dans la plupart des cas une cyanose, une polyglobulie et une atteinte multi-organe. Shunts gauches – droits • Corrigeables Incluent les défets modérés à larges : les RVP sont augmentées de façon légère à modérée, le shunt systémique-pulmonaire est toujours prévalent et la cyanose est absente Hypertension artérielle

pulmonaire associée à une découverte fortuite de cardiopathie congénitale Élévation importante des RVP dans un contexte de défets cardiaques minimes, qui n’explique pas ce niveau très important des RVP ; le tableau clinique est similaire à l’HTAP idiopathique. La fermeture de ces défets est contre-indiquée. Hypertension artérielle pulmonaire post-opératoire La cardiopathie congénitale a été corrigée chirurgicalement, mais l’HTAP soit persiste dans le post-opératoire immédiat soit va réapparaitre des mois ou des années après la chirurgie.

Le phénotype clinique est souvent grave. Depuis 2008, l’HTAP associée à une schistosomiase fait partie du groupe Autophagy inhibitor 1 des HTP. La schistosomiase touche 200 millions de personnes au niveau mondial, dont 10 % vont développer la forme hépatosplénique [27] and [28]. Parmi les patients avec atteinte hépatosplénique, 5 % vont avoir une HTAP qui devient below par conséquence la forme d’HTAP la plus courante au monde [27] and [28]. Le mécanisme est multifactoriel, impliquant l’hypertension porto-pulmonaire, l’inflammation locale due aux œufs de schistosoma et l’obstruction mécanique par les œufs. Le résultat se traduit par des modifications histologiques artérielles pulmonaires à type de lésions plexiformes, similaires à ceux de l’HTAPi [27]. La mortalité de l’HTAP associée à la schistosomiase peut atteindre 15 % à 3 ans, mais les traitements

spécifiques de l’HTAP semblent améliorer le pronostic [28]. La maladie veino-oclusive (MVO) et l’hémangiomatose capillaire pulmonaire (HCP) sont des pathologies rares et graves. Sur le plan histologique, la MVO et l’HCP sont caractérisées, en proportions différentes, par une prolifération intimale au niveau des veines septales associée à une dilatation et une prolifération des capillaires pulmonaires [29]. Comme la preuve anatomopathologique est difficile à obtenir chez les patients avec une HTP, une approche non invasive incluant la tomodensitométrie thoracique, la fonction respiratoire, les paramètres gazométriques et le lavage broncho-alvéolaire est fiable dans la pratique courante pour affirmer le diagnostic [29] (tableau II).