[Polyneuropathies in vitamin B1 deficiency in Reunion and Mayotte islands in 70 patients of Maori and Comorian descent] : Polyneuropathies par hypovitaminose B1 aux îles de la Réunion et de Mayotte : à propos de 70 cas d'origine mahoraise et comorienne.

International audienceBeriberi is an uncommon disorder related to thiamine deficiency. It is mainly found in underdeveloped countries among populations with poorly diversified diet, consisting largely of milled white cereals, a poor source of thiamine. In industrialized countries, thiamine deficiency with cardiac failure is more frequently found than the dry beriberi in high risk groups like chronic alcoholics. Nevertheless our attention was drawn to an outbreak of 70 cases of dry beriberi which occurred from 1997 to 2005 in the French territories of Reunion and Mayotte islands. It was characterized by an acute or sub-acute sensorimotor polyneuropathy with axonal lesions, affecting the lower limbs and occasionally the upper limbs, sometimes associated with cardiac beriberi. It affected young, non alcoholic individuals from the Mahoran and Comorian community who were in apparent good health when the illness occurred. Our study highlighted the feeding habits which are partly responsible for the development of the disease due to a chronic lack of thiamine and which probably contributed together with multiple cofactors to trigger off the illness. But many elements and mainly biological ones, also lead us to think that there is a genetic predisposition to develop this neuropathy

Etude à Mayotte, 101ème département français, des déterminismes du Béribéri sec chez des patients originaires de l'archipel des Comores Centrale.

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Pulmonary alveolar proteinosis in children on La Réunion Island: a new inherited disorder?

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Hagiographie, Imaginaire, Littérature: Mélanges en hommage à Jean-Pierre Perrot

International audienceÀ l'occasion du départ à la retraite du professeur Jean-Pierre Perrot, ses collègues du Laboratoire LLS ont pris l’initiative de rassembler ces Mélanges auxquels se sont associés de nombreux chercheurs d’autres universités avec lesquels il a eu cœur de travailler sur la Littérature médiévale. Ces spécialistes d’horizons disciplinaires différents ont accepté de partager leurs réflexions sur des thèmes qui lui sont chers : la littérature, l’hagiographie et l’imaginaire. [...]SOMMAIRE : -*-Introduction / Alexandra-Flora Pifarré -**- Bibliographie de Jean-Pierre Perrot -1- Fondements individuels et déstabilisation psychologique de l'identité / Jean-Marie Barthélémy-2- Imaginaire, fin des temps et politique chez Campanella / Pascal Bouvier-3- L'Imaginaire des lieux. Bonnefoy, le vrai lieu et les faux semblants / Jean Burgos -4- De sources en sources : l'usage de la métaphore aquatique dans "La Disme de Penitanche" de Jehan de Journi / Chantal Connochie-Bourgne-5- La « success-story », hagiographie (protestante) des temps modernes ? / Olivier Cosma-6- Du voyage littéraire au siècle des Lumières au voyage immobile de Xavier de Maistre / Jean-Louis Darcel-7- Les modes spécifiques de transmission du patrimoine oral : traditions et perspectives / Jean Derive-8- "Le Roman de la Rose", hymne à l'amour et encyclopédie / Jean Dufournet-9- Saint Julien l'Hospitalier et Robert le Diable / Élisabeth Gaucher-Rémond-10- Arrabal et le Christ : vanité des vanités / Jean-Paul Gavard-Perret -11- La faute à Voltaire ? Le Moyen Âge dans l'Essai sur les mœurs (1764) / Michael Kohlhauer -12- « Mais il set bien que maintes femes sont diable » : étude linguistique et littéraire des termes d’adresse et insultes dans "Le roman de Marques de Rome" (BM Lyon, ms.867) / Dominique Lagorgette-13- Éléments féériques, magiques et merveilleux dans la chanson de geste Fierabras / Marc Le Person -14- La "Vie de sainte Anastasie" dans le légendier de Florence / Anne-Françoise Leurquin-15- Édouard Glissant : littérature antillaise et Moyen Âge européen / Jean-Pol Madou-16- Rêves de flic : le commissaire Montalbano entre rêveries et imaginaire / Barbara Meazzi-17- Le Sens de la répartition des saintes femmes dans un légendier français de la fin du XIIIe siècle / Magali Plattet-18- Échos d’Apollonius de Tyr dans l’hagiographie : les légendes de sainte Marie-Madeleine et des deux marchands / Élisabeth Pinto-Mathie

Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data

Background: General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observational studies compared with patients treated without GA. We assessed functional outcome in ischaemic stroke patients with large vessel anterior circulation occlusion undergoing endovascular thrombectomy under GA, versus thrombectomy not under GA (with or without sedation) versus standard care (ie, no thrombectomy), stratified by the use of GA versus standard care. Methods: For this meta-analysis, patient-level data were pooled from all patients included in randomised trials in PuMed published between Jan 1, 2010, and May 31, 2017, that compared endovascular thrombectomy predominantly done with stent retrievers with standard care in anterior circulation ischaemic stroke patients (HERMES Collaboration). The primary outcome was functional outcome assessed by ordinal analysis of the modified Rankin scale (mRS) at 90 days in the GA and non-GA subgroups of patients treated with endovascular therapy versus those patients treated with standard care, adjusted for baseline prognostic variables. To account for between-trial variance we used mixed-effects modelling with a random effect for trials incorporated in all models. Bias was assessed using the Cochrane method. The meta-analysis was prospectively designed, but not registered. Findings: Seven trials were identified by our search; of 1764 patients included in these trials, 871 were allocated to endovascular thrombectomy and 893 were assigned standard care. After exclusion of 74 patients (72 did not undergo the procedure and two had missing data on anaesthetic strategy), 236 (30%) of 797 patients who had endovascular procedures were treated under GA. At baseline, patients receiving GA were younger and had a shorter delay between stroke onset and randomisation but they had similar pre-treatment clinical severity compared with patients who did not have GA. Endovascular thrombectomy improved functional outcome at 3 months both in patients who had GA (adjusted common odds ratio (cOR) 1·52, 95% CI 1·09–2·11, p=0·014) and in those who did not have GA (adjusted cOR 2·33, 95% CI 1·75–3·10, p<0·0001) versus standard care. However, outcomes were significantly better for patients who did not receive GA versus those who received GA (covariate-adjusted cOR 1·53, 95% CI 1·14–2·04, p=0·0044). The risk of bias and variability between studies was assessed to be low. Interpretation: Worse outcomes after endovascular thrombectomy were associated with GA, after adjustment for baseline prognostic variables. These data support avoidance of GA whenever possible. The procedure did, however, remain effective versus standard care in patients treated under GA, indicating that treatment should not be withheld in those who require anaesthesia for medical reasons