Effect of aneurysm size on procedure-related rupture in patients with subarachnoid hemorrhage treated with coil occlusion

Objective: Procedure-related rupture is one of the most feared complications in treating patients with cerebral aneurysm. The primary aim of this study was to estimate the effect of aneurysm size on procedure-related rupture. We also estimated its effect on peri-procedural thromboembolic events. Methods: This observational study was conducted using routinely-collected health data on patients admitted for subarachnoid hemorrhage and treated with aneurysm coil occlusion in the CHU de Québec — Enfant-Jésus hospital from January 1st, 2000 until sample size was reached. Patients were identified from the Discharge Abstract Database using the Canadian Classification of Health codes. Assessment of complications was blind to aneurysm size. Logistic regression models were performed to test associations between aneurysm size and procedure-related rupture or peri-procedural thromboembolic events, and between both procedure-related rupture and thromboembolic events and patients' outcomes. Results: This study included 532 aneurysms treated with coil occlusion in 505 patients. Procedure-related rupture occurred in 34 patients (6.7%) and thromboembolic events in 53 (10.5%) patients. Aneurysms of 2 to 3 mm inclusively were not more significantly associated with procedure-related rupture or thromboembolic events than those larger than 3 mm (OR 1.02, 95% CI: 0.9–1.16, p = 0.78 and OR 1.06, 95% CI: 0.96–1.17, p = 0.3, respectively). However, procedure-related rupture had a significant effect on patient mortality (OR 3.86, 95% CI: 1.42–10.53, p < 0.01). Conclusions: Very small aneurysm size should not preclude aneurysm coil occlusion. Every measure should be taken to prevent procedure-related rupture as it is strongly associated with higher mortality

SyllabO+ : new tool to study sublexical phenomena in spoken Quebec french

Sublexical phonotactic regularities in language have a major impact on language development, as well as on speech processing and production throughout the entire lifespan. To understand the impact of phonotactic regularities on speech and language functions at the behavioral and neural levels, it is essential to have access to oral language corpora to study these complex phenomena in different languages. Yet, probably because of their complexity, oral language corpora remain less common than written language corpora. This article presents the first corpus and database of spoken Quebec French syllables and phones: SyllabO+. This corpus contains phonetic transcriptions of over 300,000 syllables (over 690,000 phones) extracted from recordings of 184 healthy adult native Quebec French speakers, ranging in age from 20 to 97 years. To ensure the representativeness of the corpus, these recordings were made in both formal and familiar communication contexts. Phonotactic distributional statistics (e.g., syllable and co-occurrence frequencies, percentages, percentile ranks, transition probabilities, and pointwise mutual information) were computed from the corpus. An open-access online application to search the database was developed, and is available at www.speechneurolab.ca/syllabo. In this article, we present a brief overview of the corpus, as well as the syllable and phone databases, and we discuss their practical applications in various fields of research, including cognitive neuroscience, psycholinguistics, neurolinguistics, experimental psychology, phonetics, and phonology. Nonacademic practical applications are also discussed, including uses in speech–language pathology

Neoadjuvant sutent induction therapy may effectively down-stage renal cell carcinoma atrial thrombi.

International audienceA 75-yr-old previously healthy woman presented with gross hematuria, European Cooperative Oncology Group 0, and an 11-cm renal mass with right atrial thrombus. The patient refused the sternotomy. She was offered two cycles of sunitinib maleate (Sutent) induction therapy to down-stage the thrombus and to reduce the extent of the surgery

Severe cerebellar hemorrhage following transverse sinus stenting for idiopathic intracranial hypertension.

We report a severe adverse event occurring in the course of a cohort study (ISRCTN13784335) aimed at measuring the efficacy and safety of venous stenting in the treatment of patients with medically refractory idiopathic intracranial hypertension (IIH). The patient was a 41-year-old woman who was not overweight, who presented with severe headache, grade 1 bilateral papilledema and transient tinnitus, refractory to medical treatment. Right transverse sinus stenting was successfully performed. Following surgery, the patient’s state of consciousness decreased acutely with rapid and progressive loss of brainstem reflex. CT scan revealed acute cerebellar and intraventricular hemorrhage with obstructive hydrocephalus. Angioscan revealed normal venous sinus patency and cerebral MRI showed acute mesencephalic ischemia. Mechanical impairment of cerebellar venous drainage by the stent or venous perforation with the large guidewire used in this technique are two logical ways to explain the cerebellar hemorrhage seen in our patient. The risk of such a complication could probably be reduced using alternative tools and technique. However, given the low level of evidence around the safety of transverse sinus stenting in IIH, its formal assessment in clinical trials is required

ATP acts as a survival signal and prevents the mineralization of aortic valve

Calcific aortic valve disease (CAVD) is a disorder related to progressive mineralization of valvular tissue that is a leading cause of heart disease. Thus far, there is no medical treatment to prevent the mineralization of aortic valves. It is generally thought that pathologic mineralization is linked to apoptosis of vascular cells. However, the role of apoptosis during mineralization as well as the survival signals for valvular interstitial cells (VICs), the main cellular component of aortic valves, remains to be identified. Here, through several lines of evidence, we show that bioavailability of extracellular ATP is a signal which determines survival or apoptosis of VICs and, in doing so, plays a major role in the development of CAVD. Specifically, in CAVD and in VIC cultures undergoing mineralization, we found a high level of the ectonucleotidase ENPP1. In addition, a genetic polymorphism in the intron 9 of the ENPP1 gene was associated with CAVD in a case-control cohort as well as with mRNA expression levels of ENPP1 in aortic valves. A high level of ENPP1 in CAVD promoted apoptosis-mediated mineralization of VICs by depleting the extracellular pool of ATP. We then documented that release of ATP by VICs promoted cell survival via the P2Y(2) receptor and the PI3K/Akt signaling pathway. Hence, our results show that level of ENPP1 modulates extracellular concentration of ATP, which is an important survival signal for VICs. These findings may help to develop novel pharmacological treatment for CAVD