Fibromyalgie (état des lieux et enquêtes patients-médecins)

La fibromyalgie est une entité douloureuse chronique reconnue par l'OMS depuis 1992. Pourtant, elle semble mal connue et mal aimée par les médecins et mal reconnue par les instances sociales et administratives françaises. Une première partie retrace, grâce à une étude bibliographique, les différentes étapes du diagnostic et de la prise en charge de la fibromyalgie et rappelle les hypothèses physiopathologiques qui tentent d'expliquer cette maladie. L'analyse de questionnaires adressés à vingt médecins généralistes et à trente quatre patients permet, en complément, d'analyser les prises en charge actuelles de la fibromyalgie et d'en discuter la qualité.NANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Comparaison de 3 séquences de diffusion en IRM 3T dans le diagnostic des lésions ischémiques cérébrales aiguës

L'objectif de notre étude était de comparer 3 séquences de diffusion b1000 3 et 6 directions (b1000 3dir, b1000 6dir) et b2000 6 directions (b2000 6dir) pour la détection des lésions ischémiques récentes en IRM 3T. Trente-neuf patients consécutifs suspects d'accident ischémique aigu (21 AIT<48h et 18 AIC<4h30) ont été explorés par ces 3 séquences de diffusion d'une durée effective de 65s; 107s et 123s. Une analyse qualitative visuelle a été réalisée par 3 lecteurs évaluant le nombre, la localisation des lésions ischémiques, la présence d'artéfacts et la confiance d'interprétation de chaque séquence. Les résultats ont montré que la séquence de diffusion b2000 6dir a permis une augmentation de la détection des lésions ischémiques aiguës de petites tailles en ou au niveau du tronc cérébral. Ces résultats pourraient s'expliquer par une augmentation du contraste entre les lésions ischémiques et le tissu sain et par l'augmentation du volume des lésions visibles en b2000 6dir.RENNES1-BU Santé (352382103) / SudocSudocFranceF

Reflection around diagnostic impact scars based on experiments and analysis of backed bladelets from the Middle Magdalenian Period (la Marche, Vienne and la Grotte Blanchard, Indre)

International audienceReflection around diagnostic impact scars based on experiments and analysis of backed bladelets from the Middle Magdalenian Period (la Marche, Vienne and la Grotte Blanchard, Indre

Reflection around diagnostic impact scars based on experiments and analysis of backed bladelets from the Middle Magdalenian Period (la Marche, Vienne and la Grotte Blanchard, Indre)

International audienceReflection around diagnostic impact scars based on experiments and analysis of backed bladelets from the Middle Magdalenian Period (la Marche, Vienne and la Grotte Blanchard, Indre

The role of RNA interference in the developmental separation of blood and lymphatic vasculature

Background: Dicer is an RNase III enzyme that cleaves double stranded RNA and generates functional interfering RNAs that act as important regulators of gene and protein expression. Dicer plays an essential role during mouse development because the deletion of the dicer gene leads to embryonic death. In addition, dicer-dependent interfering RNAs regulate postnatal angiogenesis. However, the role of dicer is not yet fully elucidated during vascular development. Methods: In order to explore the functional roles of the RNA interference in vascular biology, we developed a new constitutive Cre/loxP-mediated inactivation of dicer in tie2 expressing cells. Results: We show that cell-specific inactivation of dicer in Tie2 expressing cells does not perturb early blood vessel development and patterning. Tie2-Cre; dicerfl/fl mutant embryos do not show any blood vascular defects until embryonic day (E)12.5, a time at which hemorrhages and edema appear. Then, midgestational lethality occurs at E14.5 in mutant embryos. The developing lymphatic vessels of dicer-mutant embryos are filled with circulating red blood cells, revealing an impaired separation of blood and lymphatic vasculature. Conclusion: Thus, these results show that RNA interference perturbs neither vasculogenesis and developmental angiogenesis, nor lymphatic specification from venous endothelial cells but actually provides evidence for an epigenetic control of separation of blood and lymphatic vasculature

Does the left posterior fusiform gyrus play a critical role in fruit and vegetables categorization? Evidence from 19 semantic dementia patients

International audienceNo abstrac

What semantic dementia teaches us about the functional organization of the left posterior fusiform gyrus

International audienceAfter demonstrating the relative preservation of fruit and vegetable knowledge in patients with semantic de-mentia (SD), we sought to identify the neural substrate of this unusual category effect. Nineteen patients with SD performed a semantic sorting task and underwent a morphometric 3T MRI scan. The grey-matter volumes of five regions within the temporal lobe were bilaterally computed, as well as those of two recently described areas (FG1 and FG2) within the posterior fusiform gyrus. In contrast to the other semantic categories we tested, fruit and vegetable scores were only predicted by left FG1 volume. We therefore found a specific relationship between the volume of a subregion within the left posterior fusiform gyrus and performance on fruits and vegetables in SD. We argue that the left FG1 is a convergence zone for the features that might be critical to successfully sort fruits and vegetables. We also discuss evidence for a functional specialization of the fusiform gyrus along two axes (lateral medial and longitudinal), depending on the nature of the concepts and on the level of processing complexity required by the ongoing task

What semantic dementia teaches us about the functional organization of the left posterior fusiform gyrus

International audienceAfter demonstrating the relative preservation of fruit and vegetable knowledge in patients with semantic de-mentia (SD), we sought to identify the neural substrate of this unusual category effect. Nineteen patients with SD performed a semantic sorting task and underwent a morphometric 3T MRI scan. The grey-matter volumes of five regions within the temporal lobe were bilaterally computed, as well as those of two recently described areas (FG1 and FG2) within the posterior fusiform gyrus. In contrast to the other semantic categories we tested, fruit and vegetable scores were only predicted by left FG1 volume. We therefore found a specific relationship between the volume of a subregion within the left posterior fusiform gyrus and performance on fruits and vegetables in SD. We argue that the left FG1 is a convergence zone for the features that might be critical to successfully sort fruits and vegetables. We also discuss evidence for a functional specialization of the fusiform gyrus along two axes (lateral medial and longitudinal), depending on the nature of the concepts and on the level of processing complexity required by the ongoing task

Improving detection of ischemic lesions at 3Tesla with optimized diffusion-weighted magnetic resonance imaging

International audienceBACKGROUND AND PURPOSE: This study compared three different combinations of DWI parameters: three and six diffusion imaging directions (3dir and 6dir, respectively) using b=1000 or 2000s/mm(2) (b1000 or b2000, respectively) to improve detection of recent ischemic lesions at 3Tesla (3T). MATERIALS AND METHODS: A total of 47 consecutive patients underwent three DWI scans: 3dir b1000; 6dir b1000; and 6dir b2000. Qualitative visual analysis was performed by three readers based on evaluation of the number of lesions, presence of artifacts and diagnostic confidence. Interobserver agreement, sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: Forty-five lesions were detected by 3dir b1000, 52 by 6dir b1000 and 56 by 6dir b2000 in 30 patients. The additional lesions identified by 6dir b2000 were either small or located in the posterior fossa. Sensitivity with 6dir b2000 was significantly higher than with 3dir b1000 (98.1% vs 77.4%; P<0.05). CONCLUSION: At 3T, 6dir b2000 DWI detected more acute ischemic lesions than 3dir b1000, particularly small lesions and those located in the brain stem