The Schnitzler syndrome

The Schnitzler syndrome is a rare and underdiagnosed entity which is considered today as being a paradigm of an acquired/late onset auto-inflammatory disease. It associates a chronic urticarial skin rash, corresponding from the clinico-pathological viewpoint to a neutrophilic urticarial dermatosis, a monoclonal IgM component and at least 2 of the following signs: fever, joint and/or bone pain, enlarged lymph nodes, spleen and/or liver, increased ESR, increased neutrophil count, abnormal bone imaging findings. It is a chronic disease with only one known case of spontaneous remission. Except of the severe alteration of quality of life related mainly to the rash, fever and pain, complications include severe inflammatory anemia and AA amyloidosis. About 20% of patients will develop a lymphoproliferative disorder, mainly Waldenström disease and lymphoma, a percentage close to other patients with IgM MGUS. It was exceedingly difficult to treat patients with this syndrome until the IL-1 receptor antagonist anakinra became available. Anakinra allows a complete control of all signs within hours after the first injection, but patients need continuous treatment with daily injections

Keep off the grass?:Cannabis, cognition and addiction

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this record.In an increasing number of states and countries, cannabis now stands poised to join alcohol and tobacco as a legal drug. Quantifying the relative adverse and beneficial effects of cannabis and its constituent cannabinoids should therefore be prioritized. Whereas newspaper headlines have focused on links between cannabis and psychosis, less attention has been paid to the much more common problem of cannabis addiction. Certain cognitive changes have also been attributed to cannabis use, although their causality and longevity are fiercely debated. Identifying why some individuals are more vulnerable than others to the adverse effects of cannabis is now of paramount importance to public health. Here, we review the current state of knowledge about such vulnerability factors, the variations in types of cannabis, and the relationship between these and cognition and addiction.This work was supported by grants from the US National Institutes of Health to L.H.P. (AA020404, AA006420, AA022249 and AA017447) and by grants from the UK Medical Research Council to H.V.C. and C.J.A.M. (G0800268; MR/K015524/1)

A Fast Method of Virtual Stent Graft Deployment for Computer Assisted EVAR

International audienceIn this paper we introduce a new method simulating stent graft deployment for assisting endovascular repair of abdominal aortic aneurysms. The method relies on intraoperative images coupled with mechanical models. A multi-step algorithm has been developed to increase the reliability of simulations. The first step predicts the position of the stent graft within the aorta. The second step is an axisymmetric geometric reconstruction of each individual stent. The third step minimizes the rotation of each stent around its main axis. Finally, the last step virtually deploys each stent within a deployment box extracted from the preoperative CT scan. A proof of concept is performed on a patient. The accuracy is compatible with the clinical threshold of 3 mm: the average distance between target and simulated stents is 1.73 ± 0.37 mm. Fenestrations of the stent-graft are reconstructed with a maximum error of less than 2.5 mm, which is enables a secure catheterization of secondary arteries. In summary, the method is able to assist EVAR practitioners by providing all necessary information for a fast and accurate stent graft positioning, combining intraoperative data and a mechanical model in a very low cost framework