Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson's disease

Background: Although the short-term benefits of bilateral stimulation of the subthalamic nucleus in patients with advanced Parkinson's disease have been well documented, the long-term outcomes of the procedure are unknown. Methods: We conducted a five-year prospective study of the first 49 consecutive patients whom we treated with bilateral stimulation of the subthalamic nucleus. Patients were assessed at one, three, and five years with levodopa (on medication) and without levodopa (off medication), with use of the Unified Parkinson's Disease Rating Scale. Seven patients did not complete the study: three died, and four were lost to follow-up. Results: As compared with base line, the patients' scores at five years for motor function while off medication improved by 54 percent (P<0.001) and those for activities of daily living improved by 49 percent (P<0.001). Speech was the only motor function for which off-medication scores did not improve. The scores for motor function on medication did not improve one year after surgery, except for the dyskinesia scores. On-medication akinesia, speech, postural stability, and freezing of gait worsened between year 1 and year 5 (P<0.001 for all comparisons). At five years, the dose of dopaminergic treatment and the duration and severity of levodopa-induced dyskinesia were reduced, as compared with base line (P<0.001 for each comparison). The average scores for cognitive performance remained unchanged, but dementia developed in three patients after three years. Mean depression scores remained unchanged. Severe adverse events included a large intracerebral hemorrhage in one patient. One patient committed suicide. Conclusions: Patients with advanced Parkinson's disease who were treated with bilateral stimulation of the subthalamic nucleus had marked improvements over five years in motor function while off medication and in dyskinesia while on medication. There was no control group, but worsening of akinesia, speech, postural stability, freezing of gait, and cognitive function between the first and the fifth year is consistent with the natural history of Parkinson's disease

Antiretroviral-naive and -treated HIV-1 patients can harbour more resistant viruses in CSF than in plasma

Objectives The neurological disorders in HIV-1-infected patients remain prevalent. The HIV-1 resistance in plasma and CSF was compared in patients with neurological disorders in a multicentre study. Methods Blood and CSF samples were collected at time of neurological disorders for 244 patients. The viral loads were >50 copies/mL in both compartments and bulk genotypic tests were realized. Results On 244 patients, 89 and 155 were antiretroviral (ARV) naive and ARV treated, respectively. In ARV-naive patients, detection of mutations in CSF and not in plasma were reported for the reverse transcriptase (RT) gene in 2/89 patients (2.2%) and for the protease gene in 1/89 patients (1.1%). In ARV-treated patients, 19/152 (12.5%) patients had HIV-1 mutations only in the CSF for the RT gene and 30/151 (19.8%) for the protease gene. Two mutations appeared statistically more prevalent in the CSF than in plasma: M41L (P = 0.0455) and T215Y (P = 0.0455). Conclusions In most cases, resistance mutations were present and similar in both studied compartments. However, in 3.4% of ARV-naive and 8.8% of ARV-treated patients, the virus was more resistant in CSF than in plasma. These results support the need for genotypic resistance testing when lumbar puncture is performe

Restauration de la tourbière de Landemarais : 20 années de suivi

International audienc

Restauration de la tourbière de Landemarais : 20 années de suivi

International audienc

PRODUCTION OF ANTI-PMSG ANTIBODIES AND ITS RELATION TO THE PRODUCTIVITY OF RABBIT DOES

[EN] A batch of 100 female rabbits of the Hyplus breed were subjected to artificial insemination (A.I.) for a period of 9 months. With the goal of inducing the sexual receptivity of the does, half of them received systematic doses of 25 1.U .. of PMSG (Ciclogonine PROCHENA), 48 hours before A.I.. The other half were not injected (Control group). Following this experimental period (40 days after the last injection), blood samples of all the does were taken, in order to assay the anti-PMSG antibodies and to study the relationship between the production of antibodies, and the receptivity and productivity of the does observad for the previous litter. For the PMSG group, we classified the results of the does according to their level of immunity which either has a low binding rate (::::; 4 %) ora high one (> 4 %). 30,6% of the does from the group treated with PMSG produced antiPMSG antibodies with a high binding rate. In no way related to the level of production of the antibodies, the PMSG treated does were found to be significantly more receptiva than the does in the control group (respectively 70.6 - 66.7 vs 42.0%, P = 0.023), while the fertility did not appear to have been either improved or decreased by the PMSG treatment. The total number of young born, born alive and weaned rabbits per litter did not vary according to the treatment or the intensity of antibody production. Likewise the weight of the litter and also the individual mean weight of the weaned young did not vary significantly according to the group. However, inside of the group treated with PMSG, the individual weight at weaning was the highest for the young from hyper- immune mothers (710 vs 639g, P = 0.035). For 29 does from the PMSG group, a second blood sample was taken 12 weeks after the previous one. Only 3 does showed a decreased level of antibodies, 4 months after the last injection. The study showed that one third of the does developed an immune reaction following injections of PMSG; however the proportion of antibodies produced did not appear related to either their sexual receptivity or productivity.[FR] Un troupeau de 100 lapines de souche Hyplus a été conduit en insémination artificielle (l.A) pendant 9 mois. Dans l'objectif d'induire la réceptivité sexuelle des lapines, la moitié d'entre elles recevait systématiquement 48 heures avant 1.A, 25 u.i de PMSG (Ciclogonine PROCHENA), l'autre moitié ne recevait aucune injection (Lot témoin). A l'issue de cette période expérimentale (40 jours aprés la derniére injection), un prélévement de sang a été réalisé sur toutes les lapines, afín de doser les anticorps anti-PMSG et d'étudier la relation entre la production d'anticorps, la réceptivité et la productivité des lapines lors de la portée précédente. Pour le lot PMSG, nous avons distingué les résultats des lapines selon leur niveau immunitaire qui se traduit par un taux de liaison faible (f'4 %) ou fort (> 4 %). 30,6 % des lapines du lot traité a la PMSG produisent des anticorps anti-PMSG ayant un taux de liaison fort. Sans relation avec le niveau de production d'anticorps, les lapines traitées sont significativement plus réceptives, que les lapines du lot témoin (respectivement 70,6- 66,7 vs 42,0 %, P = 0,023), la fertilité ne semble ni améliorée, ni détériorée par le traitement PMSG. Le nombre de nés totaux, nés vivants et sevrés par portée ne varia pas selon le traitement ou selon l'intensité de la production d'anticorps. De mame, le poids de portée ainsi que le poids moyen de lapereaux sevrés ne varient pas significativement en fonction du lot. En revancha, au sein du lot traité a la PMSG, le poids moyen au sevrage est plus élevé pour les lapereaux issus de meres hyperimmunes (71 o vs 639 g, p = 0,035). Sur 29 lapines du lot PMSG, un deuxiéme prélévement de sang a été réalisé 12 semaines aprés le précédent. Seules 3 lapines (sur 29 étudiées) ont eu une production d'anticorps diminuée, 4 mois aprés la derniére injection. Ce travail montre qu'un tiers des lapines développe une réaction immunitaire suite a des injections de PMSG cependant, le taux d'anticorps produit ne semble affecter ni la réceptivité sexuelle, ni la productivité des lapines.Lebas, F.; Theau-Clement, M.; Remy, B.; Drion, P.; Beckers, J. (1996). PRODUCTION OF ANTI-PMSG ANTIBODIES AND ITS RELATION TO THE PRODUCTIVITY OF RABBIT DOES. World Rabbit Science. 04(2). https://doi.org/10.4995/wrs.1996.27104

Correlations entre le temps de relaxation nucleaire des protons dans des prelevements biopsiques de tumeurs cerebrales et les caracteristiques physico-chimiques et anatomopathologiques de ces tissus

SIGLECNRS-CDST / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc

Opportunistic infections and AIDS malignancies early after initiating combination antiretroviral therapy in high-income countries

Background: There is little information on the incidence of AIDS-defining events which have been reported in the literature to be associated with immune reconstitution inflammatory syndrome (IRIS) after combined antiretroviral therapy (cART) initiation. These events include tuberculosis, mycobacterium avium complex (MAC), cytomegalovirus (CMV) retinitis, progressive multifocal leukoencephalopathy (PML), herpes simplex virus (HSV), Kaposi sarcoma, non-Hodgkin lymphoma (NHL), cryptococcosis and candidiasis. Methods: We identified individuals in the HIV-CAUSAL Collaboration, which includes data from six European countries and the US, who were HIV-positive between 1996 and 2013, antiretroviral therapy naive, aged at least 18 years, hadCD4+ cell count and HIV-RNA measurements and had been AIDS-free for at least 1 month between those measurements and the start of follow-up. For each AIDS-defining event, we estimated the hazard ratio for no cART versus less than 3 and at least 3 months since cART initiation, adjusting for time-varying CD4+ cell count and HIV-RNA via inverse probability weighting. Results: Out of 96 562 eligible individuals (78% men) with median (interquantile range) follow-up of 31 [13,65] months, 55 144 initiated cART. The number of cases varied between 898 for tuberculosis and 113 for PML. Compared with non-cART initiation, the hazard ratio (95% confidence intervals) up to 3 months after cART initiation were 1.21 (0.90-1.63) for tuberculosis, 2.61 (1.05-6.49) for MAC, 1.17 (0.34-4.08) for CMV retinitis, 1.18 (0.62-2.26) for PML, 1.21 (0.83-1.75) for HSV, 1.18 (0.87-1.58) for Kaposi sarcoma, 1.56 (0.82-2.95) for NHL, 1.11 (0.56-2.18) for cryptococcosis and 0.77 (0.40-1.49) for candidiasis. Conclusion: With the potential exception of mycobacterial infections, unmasking IRIS does not appear to be a common complication of cART initiation in high-income countries. © 2014 Wolters Kluwer Health | Lippincott Williams &amp; Wilkins