Hemorrhagic stroke resulting from venous malformation at 20 weeks of pregnancy

Background: Stroke in the pregnant patient is not a common occurrence. Despite its relative rarity, stroke during pregnancy is associated with high morbidity and mortality for both mother and infant. We report the case of a patient who experienced a hemorrhagic stroke during pregnancy because of venous cavernoma. Case Report: A 34-year-old patient, gravida 5 para 1-0-3-1, presented to labor and delivery triage at 21 weeks, 0 days’ gestation with the concern of sudden-onset right-sided facial, arm, and leg numbness and weakness. Intracranial imaging via magnetic resonance imaging demonstrated a small left midbrain venous cavernoma in the periaqueductal region of the posterior lateral cerebral peduncle area with evidence of edema and focal hemorrhage. During a 3-day hospital admission, the patient’s deficits slowly improved, and she was discharged home. She subsequently delivered vaginally without incident. Six days postpartum, the patient presented with symptoms that were similar to her initial presentation. She was correctly diagnosed with migraine with aura after the appropriate neuroimaging studies did not show an acute stroke. Conclusion: This case demonstrates the similarities between the perilous diagnosis of stroke and the more routine diagnosis of migraine. The case also highlights the need for caution and for a multidisciplinary treatment approach when the diagnosis of stroke is considered, particularly in the pregnant patient

Inhibitors of Respiratory Syncytial Virus Replication Target Cotranscriptional mRNA Guanylylation by Viral RNA-Dependent RNA Polymerase

Respiratory syncytial virus (RSV) is a major cause of respiratory illness in infants, immunocompromised patients, and the elderly. New antiviral agents would be important tools in the treatment of acute RSV disease. RSV encodes its own RNA-dependent RNA polymerase that is responsible for the synthesis of both genomic RNA and subgenomic mRNAs. The viral polymerase also cotranscriptionally caps and polyadenylates the RSV mRNAs at their 5′ and 3′ ends, respectively. We have previously reported the discovery of the first nonnucleoside transcriptase inhibitor of RSV polymerase through high-throughput screening. Here we report the design of inhibitors that have improved potency both in vitro and in antiviral assays and that also exhibit activity in a mouse model of RSV infection. We have isolated virus with reduced susceptibility to this class of inhibitors. The mutations conferring resistance mapped to a novel motif within the RSV L gene, which encodes the catalytic subunit of RSV polymerase. This motif is distinct from the catalytic region of the L protein and bears some similarity to the nucleotide binding domain within nucleoside diphosphate kinases. These findings lead to the hypothesis that this class of inhibitors may block synthesis of RSV mRNAs by inhibiting guanylylation of viral transcripts. We show that short transcripts produced in the presence of inhibitor in vitro do not contain a 5′ cap but, instead, are triphosphorylated, confirming this hypothesis. These inhibitors constitute useful tools for elucidating the molecular mechanism of RSV capping and represent valid leads for the development of novel anti-RSV therapeutics

Le répertoire de l’Opéra de Paris (1671-2009)

L'Opéra de Paris, loin de l'uniformité qui règne aujourd'hui entre tous les opéras du monde, a longtemps fait cavalier seul : en jouant majoritairement des œuvres anciennes, en se refusant aux langues étrangères, en cultivant jalousement sa propre tradition. Les études réunies ici explorent les principales options qui structurent son répertoire pendant plus de trois siècles : l'ancien et le nouveau, l'équilibre entre opéra et ballet, l'inclusion progressive d'autres genres et d'autres styles, la montée en puissance de la mise en scène. Ce répertoire forme un continent en grande partie englouti, mais il suffit d'en chercher la problématique sous-jacente pour qu'il nous apparaisse sous un jour étrangement familier

Proceedings Of The 23Rd Paediatric Rheumatology European Society Congress: Part Two

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