Corticosteroid receptors in cells derived from rat brain microvessels: mRNA identification and aldosterone binding

International audienc

Assessment of adult speech disorders: current situation and needs in French-speaking clinical practice

International audienceIntroduction: Speech assessment methods used in clinical practice are varied and mainly perceptual and motor. Reliable assessment of speech disorders is essential for the tailoring of the patient's treatment plan. Objective: To describe current clinical practices and identify the shortcomings and needs reported by French-speaking clinicians regarding the assessment of speech disorders in adult patients. Methods: Data were collected using an online questionnaire for French-speaking speech and language pathologists (SLPs) in Belgium, France, Switzerland, Luxembourg, and Maghreb. Forty-nine questions were grouped into six domains: participant data, educational and occupational background, experience with speech disorders, patient population, tools and tasks for speech assessment, and possible lacks regarding the current assessment of speech disorders. Results: Responses from 119 clinicians were included in the analyses. SLPs generally use " a la carte" assessment with a large variety of tasks and speech samples. About one quarter of them do not use existing assessment batteries. Those who do mostly use them partially. Pseudo-words are rarely used and are absent from standardized batteries, in contrast to the major use of words and sentences. Perceptual evaluation largely prevails (mainly overall ratings of speech "intelligibility", "severity," and "comprehensibility" and percent-correct phonemes), whereas the recording equipment for acoustic measures is not standardized and only scarcely described by the SLPs. The most commonly used questionnaire to assess the functional impact of the speech disorder is the Voice Handicap Index; one quarter of the SLPs does not use any questionnaire. Overall, the available tools are considered only moderately satisfactory. The main reported shortcomings are a lack of objectivity and reproducibility of speech measures; exhaustiveness and consideration of specific speech parameters (prosody, speech rate, and nasality); practicality of the assessment tools. Conclusion: This study highlights a lack of standardization of the speech assessment in French-speaking adults and the need to offer new reliable tools for an optimized, accurate speech assessment. The automation of these tools would allow for rapid, reproducible, and accurate measures

Récepteur des androgènes : Pathologie moléculaire

Les androgènes sont responsables de la différenciation, du développement et du maintien du phénotype masculin en participant à la régulation de nombreux organes androgéno-dépendants, à travers un récepteur nucléaire, le récepteur des androgènes (RcA). Après liaison de la testostérone ou de la dihydrotestosterone, le RcA se fixe sur des séquences d’ADN spécifiques et active la transcription de gènes-cibles. Des progrès considérables ont été accomplis dans les domaines moléculaires et structuraux du RcA comme dans celui de la régulation transcriptionnelle des gènes androgéno-régulés. Ils permettent d’envisager une meilleure approche de la relation structure/fonction du RcA à partir de l’analyse moléculaire des syndromes d’insensibilité aux androgènes (l’étiologie la plus fréquente des pseudo-hermaphrodismes masculins), des cancers de la prostate hormono-résistants, de l’amyotrophie spinobulbaire (Maladie de Kennedy), de stérilité isolée.La génétique moléculaire permet aujourd’hui d’affirmer le diagnostic de l’une de ces affections par l’identification d’une mutation du gène du RcA, par la confirmation de ses conséquences in vitro après reconstruction de la mutation, par l’analyse tri-dimensionnelle du RcA et des conséquences de la mutation sur la structure du RcA.Dans le domaine des insensibilités aux androgènes, l’absence d’identification de mutation du RcA a fait envisager la responsabilité d’anomalie de cofacteurs transcriptionnels. Dans ce sens, l’analyse du profil d’expression de ces cofacteurs couplée à l’expertise de la fonctionnalité du RcA endogène sur fibroblastes du patient s’avère prometteuse. En réalité, la mise en évidence de gènes-cibles (au niveau des organes génitaux externes) constituera l’étape fondamentale pour évaluer le degré de l’action cellulaire et moléculaire des androgènes

Stereotact Funct Neurosurg

OBJECTIVE: Asleep deep brain stimulation (DBS) for Parkinson's disease (PD) is being performed more frequently; however, motor outcomes and safety of asleep DBS have never been assessed in a prospective randomized trial. METHODS: We conducted a prospective, randomized, noncomparative trial to assess the motor outcomes of asleep DBS. Leads were implanted in the subthalamic nucleus (STN) according to probabilistic stereotactic coordinates with a surgical robot under O-arm© imaging guidance under either general anesthesia without microelectrode recordings (MER) (20 patients, asleep group) or local anesthesia with MER and clinical testing (9 patients, awake group). RESULTS: The mean motor improvement rates on the Unified Parkinson's Disease Rating Scale Part III (UPDRS-3) between OFF and ON stimulation without medication were 52.3% (95% CI: 45.4-59.2%) in the asleep group and 47.0% (95% CI: 23.8-70.2%) in the awake group, 6 months after surgery. Except for a subcutaneous hematoma, we did not observe any complications related to the surgery. Three patients (33%) in the awake group and 8 in the asleep group (40%) had at least one side effect potentially linked with neurostimulation. CONCLUSIONS: Owing to its randomized design, our study supports the hypothesis that motor outcomes after asleep STN-DBS in PD may be noninferior to the standard awake procedure

Efficacy of the Arabic Modified Fluency Shaping Program in the treatment of stuttering

En Abstract Background The goal of fluency-shaping approaches is not to modify stuttering but rather to completely replace it with fluent speech. This is achieved by applying a range of fluency-controlling techniques, usually implemented within a slow-speech framework, which fundamentally changes the way that respiration, phonation, and articulation are coordinated for speech. Aim The present study aimed at evaluating the efficacy of the Arabic Modified Fluency Shaping Program as a valuable treatment approach for Egyptian stutterers. Patients and methods The study design was a prospective longitudinal experimental controlled one. The present work was carried out on 100 stutterers of both sexes in the age range of 8–20 years. The participants were divided into two groups: the study group and the control group. A multidimensional assessment protocol was used for all participants. It included elementary diagnostic procedures (personal interview, visual perceptual assessment, and auditory perceptual assessment), clinical diagnostic aids (Stuttering Severity Instrument for Children and Adults-Arabic version, speech rate, psychometric evaluation, and assessment of feelings and attitudes using speech performance self-reported questionnaire), and additional instrumental measures (spectrographic assessment and Visi Pitch). Therapy program: Participants in the study group were trained using the Arabic Modified Fluency Shaping Program. Results The study group achieved better outcome with the therapeutic program regardless of the age of the patient at the time of therapy. There was marked reduction in mean total score of Stuttering Severity Instrument for Children and Adults-Arabic version in the study group and was 1.48, 1.66, and 2.12, respectively, during post-therapy, first follow-up, and second follow-up evaluations compared with 25.36 during the pretherapy evaluation. As regards spectral analysis, there were higher post-therapeutic values for voice onset time, vowel duration, syllable duration, and shorter sentence duration. As regards Visi Pitch, there were lower post-therapeutic values for percent voiced and percent pause and a higher value for the percent unvoiced, which denotes improvement. The results of speech performance self-reported questionnaire showed an increase in patient’s satisfaction with speech and trust in their abilities as a speaker; there was also a decrease in avoidance of speaking situations and speaking on the phone after therapy. Conclusion The results of this study indicated the efficacy of the Arabic Modified Fluency Shaping Program in rehabilitation of stuttering. The presented program provides participants with strategies that significantly improve their speech behavior and their attitudes toward speech