Central vein sign differentiates Multiple Sclerosis from central nervous system inflammatory vasculopathies.

In multiple sclerosis (MS), magnetic resonance imaging (MRI) is a sensitive tool for detecting white matter lesions, but its diagnostic specificity is still suboptimal; ambiguous cases are frequent in clinical practice. Detection of perivenular lesions in the brain (the "central vein sign") improves the pathological specificity of MS diagnosis, but comprehensive evaluation of this MRI biomarker in MS-mimicking inflammatory and/or autoimmune diseases, such as central nervous system (CNS) inflammatory vasculopathies, is lacking. In a multicenter study, we assessed the frequency of perivenular lesions in MS versus systemic autoimmune diseases with CNS involvement and primary angiitis of the CNS (PACNS). In 31 patients with inflammatory CNS vasculopathies and 52 with relapsing-remitting MS, 3-dimensional T2*-weighted and T2-fluid-attenuated inversion recovery images were obtained during a single MRI acquisition after gadolinium injection. For each lesion, the central vein sign was evaluated according to consensus guidelines. For each patient, lesion count, volume, and brain location, as well as fulfillment of dissemination in space MRI criteria, were assessed. MS showed higher frequency of perivenular lesions (median = 88%) than did inflammatory CNS vasculopathies (14%), without overlap between groups or differences between 3T and 1.5T MRI. Among inflammatory vasculopathies, Behçet disease showed the highest median frequency of perivenular lesions (34%), followed by PACNS (14%), antiphospholipid syndromes (12%), Sjögren syndrome (11%), and systemic lupus erythematosus (0%). When a threshold of 50% perivenular lesions was applied, central vein sign discriminated MS from inflammatory vasculopathies with a diagnostic accuracy of 100%. The central vein sign differentiates inflammatory CNS vasculopathies from MS at standard clinical magnetic field strengths. Ann Neurol 2018;83:283-294

De la sensibilité à l'action hémorragipare des endotoxines

Doctorat en sciences médicalesinfo:eu-repo/semantics/nonPublishe

Intérêt du suivi des bruits respiratoires trachéaux dans le diagnostic de dysrythmies respiratoires nocturnes.

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Les études de sommeil chez l'adulte: Intérêt dans la bronchopathie et dans le syndrome d'apnée du sommeil

info:eu-repo/semantics/publishe

Management of otitis media with effusion in children

Otitis media with effusion in children: B-ENT Guidelines. OME is highly prevalent among young children, with peak prevalences at around two and five years of age. Although serious complications are rare, the burden of OM is large with impaired quality of life and high direct and indirect socio-economic costs. To date, medical treatment of OME is not recommended because of the limited scientific evidence that this treatment is effective in the long term. Surgical candidacy for OME depends largely on hearing status, associated symptoms, the child's developmental risk and the anticipated chance of spontaneous resolution of the effusion. Ultimately, the recommendation for surgery must be individualized

Sensory recovery after microsurgical repair of digital nerves.

The authors study 65 cases of repair of digital nerve lesions performed in 60 patients. They evaluate the quality of sensory recovery by clinical (Dellon and Weber Tests) and electrophysiological tests (velocity, amplitude and duration of the Compound Sensory Action Potential). The results show a complete recovery in 26%, a recovery of discrimination sensitivity in 73.8% and a recovery of protective sensation in 96.9% of the cases. Age and severity of the associated trauma are the most important factors influencing the quality of the sensory recovery.info:eu-repo/semantics/publishe

Apport de la polysomnographie à la mise au point des malades atteints d'une bronchopneumopathie chronique obstructive (BPCO).

SCOPUS: ar.jinfo:eu-repo/semantics/publishe