Early tolerability of Comirnaty vaccine in patients with chronic neurological diseases

International audiencePatients with chronic neurological diseases may have predisposing risk factors for severe COVID-19 and should be considered as priority candidates for SARS-CoV-2 vaccination. Nevertheless, the safety of RNA vaccine was evaluated in healthy volunteers or in patients with stable chronic medical conditions excluding patients with chronic neurological diseases. We report here the early tolerability of Comirnaty vaccine in 36 patients with chronic neurological diseases and demonstrate good early tolerability, better than found in healthy people in phase 3 trials

Binocular control of saccades in idiopathic Parkinson's disease

We focused on the saccade disconjugate control of idiopathic Parkinson's disease (IPD) patients. In IPD saccade accuracy was differently impaired in the two eyes, namely, the disconjugate component was larger than in controls, more for the remembered than for the reflexive task

Localization accuracy of AC-PC line and functional pallidal target using BRW stereotactic implementation system and axial CT scanning : an experimental study

BACKGROUND: Ventriculography is still considered an unavoidable step for functional target localization, even though this method is invasive and requires stereotactic rooms, orthogonal frames, and parallax-free X-ray equipment. In this experimental study, the authors investigated the feasibility of performing stereotactic lesions using a conventional, widely employed frame, such as the Brown-Roberts-Wells (BRW) apparatus, and computerized axial tomography (CAT) imaging. METHODS: Five ex vivo models consisting of cadaveric brains enclose in a plastic shell were fixed in a BRW frame. A simple BRW implementation was used to ensure more symmetrical placement of the basal ring. Two-millimeter plastic balls were inserted at the level of the anterior (AC) and posterior commissures (PC) and at the target in the pallidus. Their final position was measured on the anatomical specimens and compared with Schaltenbrand Atlas maps. RESULTS: The error in estimating the length of the intercommissural line ranged from 0.5 mm to 2.0 mm, with a maximum backward angulation of four degrees in predicting the AC-PC plane. Upon dissection, in four out of five cases, the balls were found within the area of the pallidus defined by Laitinen for posteroventral pallidotomy. CONCLUSIONS: The authors conclude that anatomical identification of the AC-PC line and the pallidus target, using the BRW stereotactic system and CAT axial images alone offers sufficient accuracy. They suggest that functional neurosurgery for movement disorders could be safely and successfully carried out without ventriculography if neurophysiological monitoring is also employed

Cerebral venous thrombosis at high altitude: A systematic review

Background and objective High altitude may be a factor associated with cerebral venous thrombosis (CVT). As our knowledge of CVT at high altitude is limited, it was decided to pool such information from the available case studies to determine whether high altitude can predispose to CVT. Methods A systematic review of the literature was performed for cases reporting CVT at high altitude. Searches of the PubMed database (up to July 2016) were performed for publications, using \u2018cerebral venous thrombosis\u2019 and \u2018high altitude\u2019 as keywords. Cross-referencing was also done to complete the search. Results Ultimately, 13 articles were included in our systematic review. The population consisted of 17 patients, predominately male (14/17), with a mean age of 32 (range: 19\u201347) years. Altitude range was 3000\u20138200\ua0m. Nine patients stayed at high altitude for\ua0>\ua02 weeks; the duration of high altitude stay was unknown for the remainder. A hypercoagulable state was found in nine patients: secondary polycythemia in five; protein C deficiency in one; protein S deficiency in one; and factor V Leiden mutations in two. No comorbidities were found in any of these patients. Conclusion Long-term stays at high altitude in association with a hypercoagulable state\ua0\u2013\ua0in particular, congenital or acquired thrombophilia\ua0\u2013\ua0appears to predispose to CVT. The association of CVT with a single exposure to high altitude seems low, but the risk cannot as yet be specifically estimated

Intracranial metastasis of testicular seminoma in an HIV-positive. Case report and review

We present what appears to be the first case of an intracranial metastasis from testicular seminoma in an HIV-positive patient. The computed tomography and magnetic resonance imaging appearance of the lesion mimicked meningioma or lymphoma. A significant increase in the risk of testicular seminoma has been reported in AIDS patients. Whenever there is lymph-node involvement upon diagnosis of testicular seminoma, intracranial metastases may appear. After surgical removal of an intracranial metastasis from testicular seminoma, radiotherapy should be considered. Chemotherapy is to be included in the treatment of intracranial metastases from testicular seminoma with systemic involvement

Intracranial metastasis of testicular seminoma in an HIV-positive. Case report and review

Abstract We present what appears to be the first case of an intracranial metastasis from testicular seminoma in an HIV-positive patient. The computed tomography and magnetic resonance imaging appearance of the lesion mimicked meningioma or lymphoma. A significant increase in the risk of testicular seminoma has been reported in AIDS patients. Whenever there is lymph-node involvement upon diagnosis of testicular seminoma, intracranial metastases may appear. After surgical removal of an intracranial metastasis from testicular seminoma, radiotherapy should be considered. Chemotherapy is to be included in the treatment of intracranial metastases from testicular seminoma with systemic involvemen

Microscopic versus endoscopic transsphenoidal surgery for pituitary adenoma: Analysis of surgical safety in 221 consecutive patients

Transsphenoidal route is now considered the gold standard for the removal of pituitary adenoma. Up to date, no clear superiority in terms of efficacy has been demonstrated between transsphenoidal microscopic and endoscopic approaches. Surgical safety may be a relevant argument in favor or against the choice of one of the two surgical approaches. In our experience, the microscope and the endoscope are both safe instruments for the resection of pituitary adenomas. Because of the lack of prospective randomized controlled trials, the choice of one of the two instruments should depend on surgeon-specific preferences and hospital assets. This article is protected by copyright. All rights reserved

Gene Expression Profile Analysis of Human Mesenchymal Stem Cells from Herniated and Degenerated Intervertebral Discs Reveals Different Expression of Osteopontin

Gene expression analysis provides an effective methodology to identify clinically relevant genes implicated in intervertebral disc (IVD) pathology. The analysis of gene profile in mesenchymal stem cells (MSCs) from human herniated IVD (H-IVD) and degenerated IVD (D-IVD) has not yet been investigated. We present in this study a characterization of MSCs isolated from clinically categorized H-IVD and D-IVD disc samples. H-IVD-MSCs and D-IVD-MSCs showed multipotent mesenchymal differentiation ability, expressing positivity for adipogenic, osteogenic, and chondrogenic markers with an immunophenotypical profile representative of MSCs. FACS analyses revealed a higher expression of CD44 in D-IVD-MSCs compared to H-IVD-MSCs. Gene expression profile revealed that most genes under investigation displayed large variations and were not significantly different in the two types of analyzed IVD-MSCs. Conversely, the gene expression of osteopontin (OPN), a protein involved in bone matrix mineralization and extracellular matrix destruction, was found markedly increased (more than 400-fold) in D-IVD-MSCs compared to H-IVD-MSCs. Moreover, the OPN protein expression was detectable only in D-IVD-MSCs, and its levels were directly related with D-IVD severity. These findings suggest that an abnormal expression of OPN in D-IVD-MSCs occurs and plays a pivotal role in the pathophysiological process of human disc degeneration. We speculate that the regulation of the OPN pathway might be a therapeutic target to counteract disc degeneration