Multidisciplinary Prospective Study of Mother-to-Child Chikungunya Virus Infections on the Island of La Réunion

In a prospective study on the island of La Réunion, Marc Lecuit and colleagues find frequent transmission of Chikungunya virus by viremic mothers giving birth during an outbreak, resulting in serious infant illness

Anévrysmes intracrâniens traités par embolisation (à propos des 4 premières années de pratique à La Réunion)

POITIERS-BU Médecine pharmacie (861942103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Chikungunya virus-associated encephalitis: a cohort study on La Réunion island, 2005-2009

International audienceObjectives: To estimate the cumulative incidence rate (CIR) of Chikungunya virus (CHIKV)-associated Central Nervous System (CNS) disease during the La Réunion outbreak, and assess the disease burden and patient outcome after three years.Methods: CHIKV-associated CNS disease was characterized retrospectively in a cohort of patients with positive CHIKV RT-PCR or anti-CHIKV IgM antibodies in the cerebrospinal fluid and fulfilling International Encephalitis Consortium criteria for encephalitis or encephalopathy. Neurological sequelae were assessed after three years.Results: Between September 2005 and June 2006, 57 patients were diagnosed with CHIKV-associated CNS disease, including 24 with CHIKV-associated encephalitis, the latter corresponding to a CIR of 8.6 per 100,000 persons. Patients with encephalitis were observed at both extremes of age categories. CIR per 100,000 persons were 187 and 37 in patients below 1 year and over 65 years, respectively, both far superior to those of cumulated causes of encephalitis in the USA in these age categories. The case fatality rate of CHIKV-associated encephalitis was 16.6% and the proportion of children discharged with persistent disabilities estimated between 30% and 45%. Beyond the neonatal period, the clinical presentation and outcomes were less severe in infants than in adults.Conclusions: In the context of a large outbreak, CHIKV is a significant cause of CNS disease. As with other etiologies, CHIKV-associated encephalitis case distribution by age follows a U-shaped parabolic curve

Mutation in a primate-conserved retrotransposon reveals a noncoding RNA as a mediator of infantile encephalopathy

International audienceThe human genome is densely populated with transposons and transposon-like repetitive elements. Although the impact of these transposons and elements on human genome evolution is recognized, the significance of subtle variations in their sequence remains mostly unexplored. Here we report homozygosity mapping of an infantile neurodegenerative disease locus in a genetic isolate. Complete DNA sequencing of the 400-kb linkage locus revealed a point mutation in a primate-specific retrotransposon that was transcribed as part of a unique noncoding RNA, which was expressed in the brain. In vitro knockdown of this RNA increased neuronal apoptosis, consistent with the inappropriate dosage of this RNA in vivo and with the phenotype. Moreover, structural analysis of the sequence revealed a small RNA-like hairpin that was consistent with the putative gain of a functional site when mutated. We show here that a mutation in a unique transposable element-containing RNA is associated with lethal encephalopathy, and we suggest that RNAs that harbor evolutionarily recent repetitive elements may play important roles in human brain development

Children characteristics related to perinatal mother-to-child Chikungunya virus infection, CHIMERE cohort, Reunion Island, 2008.

<p>Data are means, standard errors, numbers and percentages. <i>P</i> values are given for Kruskal-Wallis and Fisher exact tests comparing the three groups.</p>†<p>This propensity score is derived from maternal population (see table 2 of ref. <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002996#pntd.0002996-Fritel1" target="_blank">[12]</a>) assigning positive or negative points to rounded-value beta coefficients associated with categories of maternal origin, education, marital status, parity and body mass index;</p>‡<p>gestational age <37 weeks;</p>#<p><10^th percentile of AUDIPOG network growth charts;</p><p>*corrected for 24 months postnatal age.</p

Study population.

<p>− : seronegative for CHIKV-specific IgM and IgG antibodies ; + : seropositive for CHIKV-specific IgG antibodies; M24: 24^th month, end of follow-up ; Unexposed - Uninfected and Exposed - Uninfected children were pooled as the Uninfected group (grey lozenge) and compared with Exposed - infected children as the Infected group (white lozenge) for RBL (Revised Brunet-Lézine) performance.</p

Neurocognitive outcomes related to the clinical presentation of perinatal mother-to-child Chikungunya virus infection, CHIMERE cohort, Reunion Island, 2008.

<p>DQ: development quotient. DQ scores were measured between 15.8 and 27 months of age. Developmental delay is moderate if. ^†85≤DQ ≤70, severe if. ^‡DQ score <70.</p><p>Data are means and 95% confidence intervals. <i>P</i> values are given for Kruskal-Wallis or Fisher exact tests comparing the three groups; Mann-Whitney or Fisher exact test comparing encephalopathic <i>versus</i> non encephalopathic children:</p>##<p><i>P</i> value<0.01;</p>#<p><i>P</i> value<0.05;</p><p>Mann-Whitney or Fisher exact test comparing non encephalopathic infected <i>versus</i> uninfected children:</p><p>**<i>P</i> value<0.01;</p><p>*<i>P</i> value<0.05.</p

Two-year MRI scan features of CHIKV-related white matter injury in eight children with perinatal mother-to-child Chikungunya virus infection, CHIMERE cohort, Reunion Island, 2008.

<p>Age at neuropsychological evaluation (months); GDQ: global development quotient; HC:</p><p>*head circumference is corrected for 24 months of postnatal age;</p><p>SD: standard deviation; WM: white matter; NA: not assessed. Diffuse includes frontal plus two or more lobes; CC: <i>corpus callosum</i> ; OC: ovale centrum ; VC: ventricular crossroads.</p><p>↓NAA : reduction of N-acetyl-aspartate peak indicative of white matter hypometabolism or axonal loss;</p

Revised Brunet-Lezine development quotient scores related to perinatal mother-to-child Chikungunya virus infection, CHIMERE cohort, Reunion Island, 2008.

<p>DQ: development quotient. DQ scores were measured between 15.8 and 27 months of age. Developmental delay is moderate if. ^†85≤DQ ≤70, severe if. ^‡DQ score <70.</p><p>Data are means and 95% confidence intervals. <i>P</i> values are given for Kruskal-Wallis or Fisher exact tests comparing the three groups:</p>##<p><i>P</i> value<0.01 for Fisher exact test comparing unexposed uninfected <i>versus</i> infected children:</p><p>**<i>P</i> value<0.01 for Fisher exact test comparing exposed uninfected <i>versus</i> infected children.</p

Antithrombotic therapies for neurointerventional surgery: a 2021 French comprehensive national survey

International audienceBackground Neurointerventionists lack guidelines for the use of antithrombotic therapies in their clinical practice; consequently, there is likely to be significant heterogeneity in antithrombotic use between centers. Through a nationwide survey, we aimed to obtain an exhaustive cross-sectional overview of antithrombotic use in neurointerventional procedures in France. Methods In April 2021, French neurointerventional surgery centers were invited to participate in a nationwide 51-question survey disseminated through an active trainee-led research collaborative network (the JENI-RC). Results All 40 centers answered the survey. Fifty-one percent of centers reported using ticagrelor and 43% used clopidogrel as premedication before intracranial stenting. For flow diversion treatment, dual antiplatelet therapy was maintained for 3 or 6 months in 39% and 53% of centers, respectively, and aspirin was prescribed for 12 months or more than 12 months in 63% and 26% of centers, respectively. For unruptured aneurysms, the most common heparin bolus dose was 50 IU/kg (59%), and only 35% of centers monitored heparin activity for dose adjustment. Tirofiban was used in 64% of centers to treat thromboembolic complications. Fifteen percent of these comprehensive stroke centers reported using tenecteplase to treat acute ischemic strokes. Cangrelor appeared as an emergent drug in specific indications. Conclusion This nationwide survey highlights the important heterogeneity in clinical practices across centers. There is a pressing need for trials and guidelines to further evaluate and harmonize antithrombotic regimens in the neurointerventional field