Prevalence of oropharyngeal beta-lactamase-producing Capnocytophaga spp. in pediatric oncology patients over a ten-year period

BACKGROUND: The aim of this study was to evaluate the prevalence of beta-lactamase-producing Capnocytophaga isolates in young children hospitalized in the Pediatric Oncology Department of Hôpital Sud (Rennes, France) over a ten-year period (1993–2002). METHODS: In neutropenic children, a periodic survey of the oral cavity allows a predictive evaluation of the risk of systemic infections by Capnocytophaga spp. In 449 children with cancer, 3,053 samples were collected by oral swabbing and plated on TBBP agar. The susceptibility of Capnocytophaga isolates to five beta-lactams was determined. RESULTS: A total of 440 strains of Capnocytophaga spp. were isolated, 309 (70%) of which were beta-lactamase producers. The beta-lactamase-producing strains were all resistant to cefazolin, 86% to amoxicillin, and 63% to ceftazidime. The proportion of strains resistant to third-generation cephalosporins remained high throughout the ten-year study, while susceptibility to imipenem and amoxicillin combined with clavulanic acid was always conserved. CONCLUSION: These results highlight the risk of antibiotic failure in Capnocytophaga infections and the importance of monitoring immunosuppressed patients and testing for antibiotic susceptibility and beta-lactamase production

CuBIC: cumulant based inference of higher-order correlations in massively parallel spike trains

Recent developments in electrophysiological and optical recording techniques enable the simultaneous observation of large numbers of neurons. A meaningful interpretation of the resulting multivariate data, however, presents a serious challenge. In particular, the estimation of higher-order correlations that characterize the cooperative dynamics of groups of neurons is impeded by the combinatorial explosion of the parameter space. The resulting requirements with respect to sample size and recording time has rendered the detection of coordinated neuronal groups exceedingly difficult. Here we describe a novel approach to infer higher-order correlations in massively parallel spike trains that is less susceptible to these problems. Based on the superimposed activity of all recorded neurons, the cumulant-based inference of higher-order correlations (CuBIC) presented here exploits the fact that the absence of higher-order correlations imposes also strong constraints on correlations of lower order. Thus, estimates of only few lower-order cumulants suffice to infer higher-order correlations in the population. As a consequence, CuBIC is much better compatible with the constraints of in vivo recordings than previous approaches, which is shown by a systematic analysis of its parameter dependence

Long-term outcomes of CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) in a consecutive series of 12 patients.

BACKGROUND: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a central nervous system inflammatory disease. OBJECTIVE: To describe the disease course of CLIPPERS. DESIGN: A nationwide study was implemented to collect clinical, magnetic resonance imaging, cerebrospinal fluid, and brain biopsy specimen characteristics of patients with CLIPPERS. SETTING: Academic research. PATIENTS: Twelve patients with CLIPPERS. MAIN OUTCOME MEASURES: The therapeutic management of CLIPPERS was evaluated. RESULTS: Among 12 patients, 42 relapses were analyzed. Relapses lasted a mean duration of 2.5 months, manifested frequent cerebellar ataxia and diplopia, and were associated with a mean Expanded Disability Status Scale (EDSS) score of 4. Besides typical findings of CLIPPERS, magnetic resonance imaging showed brainstem mass effect in 5 patients, extensive myelitis in 3 patients, and closed ring enhancement in 1 patient. Inconstant oligoclonal bands were found on cerebrospinal fluid investigation in 4 patients, with an increased T-cell ratio of CD4 to CD8. Among 7 available brain biopsy specimens, staining was positive for perivascular CD4 T lymphocytes in 5 samples. Thirty-eight of 42 relapses were treated with pulse corticosteroid therapy, which led to improvement, with a mean residual EDSS score of 1.9 (range, 0-7). In 1 patient with untreated relapses, scores on the EDSS progressively increased to a score of 10 at death. Among 5 patients without long-term corticosteroid therapy, the mean annualized relapse rate was 0.5 (range, 0.25-2.8). Among 7 patients taking oral corticosteroids, no relapses occurred in those whose daily dose was 20 mg or higher. No progressive course of CLIPPERS was observed. Four patients with a final EDSS score of 4 or higher had experienced previous severe relapses (EDSS score, ≥5) and brainstem and spinal cord atrophy. CONCLUSIONS: CLIPPERS is a relapsing-remitting disorder without progressive forms. Long-term disability is correlated with the severity of previous relapses. Further studies are needed to confirm that prolonged corticosteroid therapy prevents further relapses.journal article2012 Julimporte

L'autisme infantile dans ses rapports à l'angoisse, concepts et cliniques (approche épistemologique des élaborations psychopathologiques de l'autisme infantile)

Quel que soit le discours tenu, quel que soit le mode d'investigation envisagé, la clinique de l'autisme infantile résiste au savoir, suscitant un questionnement toujours relancé plus avant. Aussi, l'autisme infantile n'a-t-il jamais suscité autant d'ecrits, de réflexions, de questionnements, d'hypothèses et de modèles qui, pris dans un incessant mouvement de substitution, ne suffisent pas à lever la résistance. Face à la profusion conceptuelle et à la confusion des modèles, aussi nombreux que contradictoires, l'approche épistémologique des élaborations psychopathologiques de l'autisme infantile permet une déconstruction des modèles et une élucidation des thérapeutiques. Ce travail d'épure epistemologique met à jour une étrange logique, dévoile une inquiétante convocation que chacun ne cesse de mettre à distance. si l'autiste infantile convoque particulièrement et singulièrement, la seule réponse possible se situe nécessairement du côté du désir du soignant ; ce désir là n'est pas un désir de guérir, de réparer ou de restaurer, au nom de quelque idéal, mais un consentement, à accompagner un sujet au seuil de la symbolisation, là ou la perte a été pour lui impossible. l'acte ne peut être porté que par ce désir inédit d'où il tire à la fois sa > et son >. > sur l'autisme infantile, > dans la pratique et > dans l'expérience clinique sont intrinsèquement noués et pas n'importe comment. s'il existe des nouages entre >, > et >, il n'existe qu'une logique, > de l'autiste. aussi, entre la fascination et l'étrangeté, entre le familier et l'étranger, se situe le seul espace possible où peut se nouer une relation et s'envisager un travail possible...BREST-BU Médecine-Odontologie (290192102) / SudocRENNES2-BU Centrale (352382101) / SudocSudocFranceF

La Creuse d'aujourd'hui, c'est l'Europe dans 20 ans !

Journal de l'Observatoire Régional de l'Habitat en Limousi

E-technologies for e-Health and Assistance for loss of Autonomy: The Important Role of University Networks through International Joint Degrees

International audienceTo face the socio-economic and medico-social problems of elderly and disabled people, many territories in many countries have started local initiatives to find technical, medical, social and economical issues. In this frame, universities clearly have an increasing important role to play through many aspects: - Universities can provide new specific trainings with new diplomas relative to assistive technologies including e-health (telecare and telemedecine) and also ICT systems (including home automation). - Through research and academic exchange programs, universities networks can provide new joint diplomas dealing with common territorial problems, for example through Erasmus and Erasmus Mundus programs. To face the problems of elderly and disabled people in a rural environment, the district of Guéret (department of Creuse in France) has created the "Home automation and Health Pole". The aim is to drive a coherent action plan in terms of comfort, safety, autonomy and communication for the elderly and disabled people. In cunjunction, the University of Limoges now proposes since september 2008, a BSc degree dedicated to "Home automation for elderly and disabled people" based on the use of e-technologies together with home automation techniques. Many industrial partners are involved in the academic program of the BSC to make sure it fits the job market requirements. To emphasize as much as possible the benefit of its diplomas, the University of Limoges is also resolutely committed to expanding its international cooperation, at different levels: - Through students and faculty mobility (through Erasmus and Leonardo programs) - Through educational programs with the development of innovative joint diplomas The objective is to build new educational and research cooperative networks to share experiments and competences in technical and social domains. At the first level, the "Home automation for elderly and disabled people" BSC has set up agreements (mostly through Erasmus) with partner universities to provide work placements abroad : - VIA college university in Horsens, Denmark, - DOMUS laboratory at the University of Sherbrooke, Québec, Canada, - TUSUR Tomsk State University of Control Systems and Radioelectronics in Tomsk, Russia, - Bogazici University (University of Bosphorus) in Istanbul, Turkey. Six of the 24 BSc students will do their internships in these partner universities in 2010. At the second level, the next step is now to build a new international joint Master diploma in the field of "Intelligent decisional systems for people in loss of autonomy". This project has started initially within the frame of the Franco-Norwegian Åsgard program. This program is intended to: * stimulate exchanges between France and Norway in terms of the expertise and scientific competences, * emphasize the initiatives of cooperation in research & development, * enable French and Norwegian researchers to extend their own international networks. In this Master diploma project, several partner universities (from France, Belgium, Denmark and Norway) are now in the process of building together a complete master academic program for a new diploma opening in September 2012. Details of the BSc and MSc academic programs, and examples of scientific and technical experiments will be given at the conference to illustrate the fallout of the university network in terms of educational, social, industrial and research aspects