Natural killer(NK)cells are innate cytotoxic lymphoid cells(ILCs)involved in the killing of infected and tumor cells.Among human and mouse NK cells from the spleen and blood,we previously identified by single-cell RNA...Natural killer(NK)cells are innate cytotoxic lymphoid cells(ILCs)involved in the killing of infected and tumor cells.Among human and mouse NK cells from the spleen and blood,we previously identified by single-cell RNA sequencing(scRNAseq)two similar major subsets,NK1 and NK2.Using the same technology,we report here the identification,by single-cell RNA sequencing(scRNAseq),of three NK cell subpopulations in human bone marrow.Pseudotime analysis identified a subset of resident CD56^(bright) NK cells,NK0 cells,as the precursor of both circulating CD56dim NK1-like NK cells and CD56^(bright) NK2-like NK cells in human bone marrow and spleen under physiological conditions.Transcriptomic profiles of bone marrow NK cells from patients with acute myeloid leukemia(AML)exhibited stress-induced repression of NK cell effector functions,highlighting the profound impact of this disease on NK cell heterogeneity.Bone marrow NK cells from AML patients exhibited reduced levels of CD160,but the CD160high group had a significantly higher survival rate.展开更多
This article reports the various methods used to assess diaphragmatic function by ultrasonography.The excursions of the two hemidiaphragms can be measured using two-dimensional or M-mode ultrasonography,during respira...This article reports the various methods used to assess diaphragmatic function by ultrasonography.The excursions of the two hemidiaphragms can be measured using two-dimensional or M-mode ultrasonography,during respiratory maneuvers such as quiet breathing,voluntary sniffing and deep inspiration.On the zone of apposition to the rib cage for both hemidiaphragms,it is possible to measure the thickness on expiration and during deep breathing to assess the percentage of thickening during inspiration.These two approaches make it possible to assess the quality of the diaphragmatic function and the diagnosis of diaphragmatic paralysis or dysfunction.These methods are particularly useful in circumstances where there is a high risk of phrenic nerve injury or in diseases affecting the contractility or the motion of the diaphragm such as neuro-muscular diseases.Recent methods such as speckle tracking imaging and ultrasound shear wave elastography should provide more detailed information for better assessment of diaphragmatic function.展开更多
Macrozoospermia,characterized by the presence of largeheaded spermatozoa usually carrying several flagella,is one of the most severe phenotypes of male infertility.As in most cases,the gametes are chromosomally abnorm...Macrozoospermia,characterized by the presence of largeheaded spermatozoa usually carrying several flagella,is one of the most severe phenotypes of male infertility.As in most cases,the gametes are chromosomally abnormal and cannot be used for assisted reproductive technologies(ART)(Ray et al.,2017).In 2007,subjects from consanguineous families were shown to carry the same homozygous deleterious AURKC variant(NM_001015878.2:c.144delC,later renamed c.145delC,p.Leu49TrpfsTer23),establishing AURKC as the first and main gene associated with macrozoospermia(Dieterich et al.,2007).Using flow cytometry,all spermatozoa from patients homozygous for the c.145delC variant were shown to be tetraploid,highlighting a cytokinesis blockage of the first meiotic divisions thus confirming that ART cannot be successful for these patients(Dieterich et al.,2009).展开更多
Recently,a novel workflow known as the virtual epileptic patient(VEP)has been proposed by a research team from Aix Marseille Universitéin their papers published in Lancet Neurology,Science Translational Medicine ...Recently,a novel workflow known as the virtual epileptic patient(VEP)has been proposed by a research team from Aix Marseille Universitéin their papers published in Lancet Neurology,Science Translational Medicine and Epilepsia.This method involves creating an individualized virtual brain model based on computational modelling,which can facilitate clinical decision-making by estimating the epileptogenic zone and performing the virtual surgery.Here,we summarize brief workflow,strengths,and limitations of VEP,as well as its performance in a retrospective study of 53 patients with drug-resistant focal epilepsy who underwent stereoelectroencephalography.A large-scale clinical trial(NCT03643016)is underway to further assess VEP,which is expected to enroll 356 patients prospectively.As supporting evidence accumulates,the clinical application of VEP has the potential to improve clinical practice,leading to better outcomes and qualities of life of patients.展开更多
AIMTo describe factors associated with treatment failure and frequency of resistance-associated substitutions （RAS）.METHODSHuman immunodefciency virus （HIV）/hepatitis C virus （HCV） coinfected patients starting a...AIMTo describe factors associated with treatment failure and frequency of resistance-associated substitutions （RAS）.METHODSHuman immunodefciency virus （HIV）/hepatitis C virus （HCV） coinfected patients starting a first direct-acting antiviral （DAA） regimen before February 2016 and included in the French ANRS CO13 HEPAVIH cohort were eligible. Failure was defned as： （1） non-response [HCV-RNA remained detectable during treatment, at end of treatment （EOT）]; and （2） relapse （HCV-RNA suppressed at EOT but detectable thereafter）. Sequencing analysis was performed to describe prevalence of drug class-specifc RAS. Factors associated with failure were determined using logistic regression models.RESULTSAmong 559 patients, 77% had suppressed plasmaHIV-RNA 〈 50 copies/mL at DAA treatment initiation41% were cirrhotic, and 68% were HCV treatmentexperienced. Virological treatment failures occurred in22 patients and were mainly relapses （17, 77%） thenundefined failures （3, 14%） and non-responses （29%）. Mean treatment duration was 16 wk overall. Posttreatment NS3, NS5A or NS5B RAS were detected in10/14 patients with samples available for sequencinganalysis. After adjustment for age, sex, ribavirin useHCV genotype and treatment duration, low platelecount was the only factor signifcantly associated with ahigher risk of failure （OR： 6.5; 95%CI： 1.8-22.6）. CONCLUSIONOnly 3.9% HIV-HCV coinfected patients failed DAAregimens and RAS were found in 70% of those failingLow platelet count was independently associated withvirological failure.展开更多
Objective: The purpose of this study was to evaluate a conservative cold-knife section technique for treatment of cervical intraepithelial neoplasia (CIN). This procedure can be adapted to patient age, preservation of...Objective: The purpose of this study was to evaluate a conservative cold-knife section technique for treatment of cervical intraepithelial neoplasia (CIN). This procedure can be adapted to patient age, preservation of childbearing potential and extent of dysplasia. Design: Prospective study. Setting: Gynecological Oncology Department in French Public Hospital. Population: A total of 460 women treated for CIN between 1985 and 1999 were included. Methods: A conservative cold-knife cervical section followed by blanket suture reconstruction was used in all cases. Main outcome measures: Immediate operative results, recurrence and reproductive function were assessed. Results: The mean length of the cervical specimen was 11.4 mm (range, 4-22 mm). Mean specimen thickness was strongly correlated with age: 10.6 ± 4.1 mm in women < 40 years versus 12.1 in women >40 years; p < 0.001. Complete excision was achieved in 395 cases (85.8% ). Post-operative bleeding was observed in 5 cases (1.1% ). The mean duration of follow-up was 62 months (range, 12.3-156.5 months). Recurrences developed in 26 patients (6.6% ) including CIN 1 in 9 cases, CIN 2 in 9 and CIN 3 in 8. No patient developed carcinoma. The actuarial risk of recurrence was 2.4% (± S.D., 0.9) at 24 months and 7.8% (± S.D., 1.9) at 60 months. A total of 52 pregnancies were observed in 39 patients. No case of de novo infertility was reported post-operatively. Amenorrhea was noted in 1 patient (0.1% ) and dysmenorrhea in 1 patient (0.1% ). Conclusions: This conservative cold-knife section technique is effective for treatment of CIN with low morbidity and little adverse effect on childbearing potential. Exposure of the squamo columnar junction (SCJ) greatly facilitates follow-up.展开更多
Correction to:Cellular&Molecular Immunology https://doi.org/10.1038/S41423-020-00574-8,published online 25 November 2020 In the version of this article initially published,two unintended errors were made during ma...Correction to:Cellular&Molecular Immunology https://doi.org/10.1038/S41423-020-00574-8,published online 25 November 2020 In the version of this article initially published,two unintended errors were made during manuscript preparation.(1)The figure legend for Panel 3B was missing;the correct legend is as follows.展开更多
Toscana virus(TOSV) is an arthropod-borne virus, identified in 1971, from Phlebotomus perniciosus and Phlebotomus perfiliewi in central Italy. TOSV belongs to the Phlebovirus genus within the Bunyaviridae family. As o...Toscana virus(TOSV) is an arthropod-borne virus, identified in 1971, from Phlebotomus perniciosus and Phlebotomus perfiliewi in central Italy. TOSV belongs to the Phlebovirus genus within the Bunyaviridae family. As other bunyaviruses, the genome of TOSV consists of 3 segments(S for small, M for Medium, and L for Large) respectively encoding non structural and capsid proteins, envelope structural proteins, and the viral RNA-dependant RNA-polymerase. It is transmitted by sand flies. Therefore its distribution is dictated by that of the arthropod vectors, and virus circulation peaks during summertime when sandfly populations are active. Here, we reviewed the epidemiology of TOSV in the old world. First evidence of its pathogenicity for humans, specifically its propensity to cause central nervous system(CNS) infections such as meningitis and encephalitis, was reported in central Italy. After 2000, it was recognized that TOSV had a much larger geographic distribution than initially believed, and was present in most of the Western European countries located on the northern border of the Mediterranean Sea(Portugal, Spain, France, Greece, Croatia) as well as eastern countries such as Cyprus and Turkey. In the countries where TOSV is present, it is among the three most prevalent viruses in meningitis during the warm seasons, together with enteroviruses and herpesviruses. Up to now, epidemiological data concerning Northern Africa and other countries located south of the Mediterranean are scarce. TOSV must be considered an emerging pathogen. Despite the important role played by TOSV in CNS infections, it remains a neglected agent and is rarely considered by physicians in diagnostic algorithms of CNS infections and febrile illness during the warm season, probably because of the lack of information.展开更多
Since the outbreak of coronavirus disease 2019(COVID-19)in December 2019 in China,various measures have been adopted in order to attenuate the impact of the virus on the population.With regard to spine surgery,French ...Since the outbreak of coronavirus disease 2019(COVID-19)in December 2019 in China,various measures have been adopted in order to attenuate the impact of the virus on the population.With regard to spine surgery,French physicians are devoted to take place in the national plan against COVID-19,the French Spine Surgery Society therefore decided to elaborate specific guidelines for management of spinal disorders during COVID-19 pandemic in order to prioritize management of patients.A three levels stratification was elaborated with Level I:Urgent surgical indications,Level II:Surgical indications associated to a potential loss of chance for the patient and Level III:Non-urgent surgical indications.We also report French experience in a COVID-19 cluster region illustrated by two clinical cases.We hope that the guidelines formulated by the French Spine Surgery Society and the experience of spine surgeons from a cluster region will be helpful in order optimizing the management of patients with urgent spinal conditions during the pandemic.展开更多
We thank Melsen et al.for their interest in our study.Their remarks allow us to clarify key aspects of our work on human bone marrow NK cell biology.1 Our study reports the unsupervised single-cell analysis of NK cell...We thank Melsen et al.for their interest in our study.Their remarks allow us to clarify key aspects of our work on human bone marrow NK cell biology.1 Our study reports the unsupervised single-cell analysis of NK cells from eight healthy donors and eight acute myeloid leukemia(AML)patients.1 First,we detected an adaptive NK cell subset that correlated with the cytomegalovirus(CMV)positivity status of the donors.展开更多
Objective:To evaluate the efficacy of cervix ripening with vaginal controlled-release Propess. Patients and methods:A retrospective study of all women who underwent cervical ripening with Propess during the study peri...Objective:To evaluate the efficacy of cervix ripening with vaginal controlled-release Propess. Patients and methods:A retrospective study of all women who underwent cervical ripening with Propess during the study period from 1st January 2002 to 31st December 2004 was carried out. A total of 130 patients who experienced Propess was compared with the next following patient who delivered spontaneously matched on gestational age. Modes of delivery,failure of labor,maternal morbidity were recorded. Results:Indications for induction of labor were:post-term pregnancies in 18.5%,pre-eclampsia in 20.8%,oligohydroamnios in 18.5%,post-term pregnancy and oligohydramnios in 10.8%,intra-uterine fetal growth in 6.9%,premature rupture of membranes in 6.9%,diminution of fetal mobility in 6.1%and miscellaneous in 11.5%. Failure of cervical ripening was 21.2%. Patients in the Propess group had a 3.5 fold higher risk of Cesarean section 95%CI:1.5-8.3; P < 0.04 . There was no case of maternal or fetal death. There was no difference in incidence of maternal complications,and post-partum haemorrhage. Discussion and conclusion:Use of vaginal pessary Propess does not induce adverse maternal or fetal morbidity. However,it was associated with a higher incidence of Cesarean delivery.展开更多
Objective. To determine risk factors of failed labor in case of fetal macrosomia. Materials and methods. Medical charts of two hundred and forty six women who delivered macrosomic infants ( > 4,000g) between Januar...Objective. To determine risk factors of failed labor in case of fetal macrosomia. Materials and methods. Medical charts of two hundred and forty six women who delivered macrosomic infants ( > 4,000g) between January 2004 and May 2005 were reviewed. Maternal and obstetrical data were analyzed by mode of delivery. Univariate and multivariate (logistic regression analysis) were performed to identify risk factors of failed labor. Results. Rate of cesarean delivery was 18.3% . Indications for cesarean were: failure to progress in 55.6% , arrest in fetal descent in 22.2% , fetal distress in 6.7% , and other in 8.9% . There was a higher risk of failed labor in nulliparous women (p < 0.001), in case of a symphysio-fundal measurements > 34cm (p = 0.004), in nulliparity associated with symphysio-fundal measurements > 34cm (p < 0.001), in case of previous cesarean delivery (p = 0.004), in cases of maternal height < 1.65m (p = 0.02), and with ocytocin use (p = 0.05). In multivariate analysis, nulliparity associated with symphysio-fundal measurements > 34cm (OR = 5.2; CI 1.5- 18.4), previous cesarean section (OR = 3.7; CI 1.1- 12.4) and maternal height < 1.65m (OR = 2.6; CI 1.2- 5.5) were independent factors of failed labor. Conclusion. Failure of labor in case of macrosomia can be predicted in the event of previous cesarean section, shorter maternal height, and association of nulliparity and symphysio- fundal measurements > 34cm.展开更多
Managing familial pancreatic cancer(FPC)is challenging for gastroenterologists,surgeons and oncologists.High-risk individuals(HRI)for pancreatic cancer(PC)(FPC or with germline mutations)are a heterogeneous group of s...Managing familial pancreatic cancer(FPC)is challenging for gastroenterologists,surgeons and oncologists.High-risk individuals(HRI)for pancreatic cancer(PC)(FPC or with germline mutations)are a heterogeneous group of subjects with a theoretical lifetime cumulative risk of PC over 5%.Screening is mainly based on annual magnetic resonance imaging(MRI)and endoscopic ultrasound(EUS).The goal of screening is to identify early-stage operable cancers or high-risk precancerous lesions(pancreatic intraepithelial neoplasia or intraductal papillary mucinous neoplasms with high-grade dysplasia).In the literature,target lesions are identified in 2%-5%of HRI who undergo screening.EUS appears to provide better identification of small solid lesions(0%-46%of HRI)and chronicpancreatitis-like parenchymal changes(14%-77%of HRI),while MRI is probably the best modality to identify small cystic lesions(13%-49%of HRI).There are no specific studies in HRI on the use of contrast-enhanced harmonic EUS.EUS can also be used to obtain tissue samples.Nevertheless,there is still limited evidence on the accuracy of imaging procedures used for screening or agreement on which patients to treat.The cost-effectiveness of screening is also unclear.Certain new EUS-related techniques,such as searching for DNA abnormalities or protein markers in pancreatic fluid,appear to be promising.展开更多
Postoperative visual acuity can be limited by post-keratoplasty astigmatism,even with a clear corneal graft.Astigmatism management can be performed by selective suture removal,adjustment of sutures,optical correction,...Postoperative visual acuity can be limited by post-keratoplasty astigmatism,even with a clear corneal graft.Astigmatism management can be performed by selective suture removal,adjustment of sutures,optical correction,photorefractive procedures,wedge resection,intra-ocular lens implantation,intracorneal ring segments,relaxing incisions with or without compression sutures and repeated keratoplasty.Relaxing incisions can be made in the graft,graft-host interface or host cornea.Despite the unpredictability of the method because the flat and steep meridians are usually not orthogonal after penetrating keratoplasty,with asymmetric power distribution,all the studies showed an overall reduction of refractive,keratometric or topographic astigmatism,ranging from 30%to 72%with manual or femtosecond-assisted techniques.Most patients with astigmatism higher than 6 diopters had residual cylinder less than or equal to 3 diopters,which can be treated by laser excimer ablation or secondary intraocular lens implantation.展开更多
基金supported by a grant from the Fondation de France(DDS Cancer 2017)P.‐Y.D.received a Fondation de France research fellowship.
文摘Natural killer(NK)cells are innate cytotoxic lymphoid cells(ILCs)involved in the killing of infected and tumor cells.Among human and mouse NK cells from the spleen and blood,we previously identified by single-cell RNA sequencing(scRNAseq)two similar major subsets,NK1 and NK2.Using the same technology,we report here the identification,by single-cell RNA sequencing(scRNAseq),of three NK cell subpopulations in human bone marrow.Pseudotime analysis identified a subset of resident CD56^(bright) NK cells,NK0 cells,as the precursor of both circulating CD56dim NK1-like NK cells and CD56^(bright) NK2-like NK cells in human bone marrow and spleen under physiological conditions.Transcriptomic profiles of bone marrow NK cells from patients with acute myeloid leukemia(AML)exhibited stress-induced repression of NK cell effector functions,highlighting the profound impact of this disease on NK cell heterogeneity.Bone marrow NK cells from AML patients exhibited reduced levels of CD160,but the CD160high group had a significantly higher survival rate.
文摘This article reports the various methods used to assess diaphragmatic function by ultrasonography.The excursions of the two hemidiaphragms can be measured using two-dimensional or M-mode ultrasonography,during respiratory maneuvers such as quiet breathing,voluntary sniffing and deep inspiration.On the zone of apposition to the rib cage for both hemidiaphragms,it is possible to measure the thickness on expiration and during deep breathing to assess the percentage of thickening during inspiration.These two approaches make it possible to assess the quality of the diaphragmatic function and the diagnosis of diaphragmatic paralysis or dysfunction.These methods are particularly useful in circumstances where there is a high risk of phrenic nerve injury or in diseases affecting the contractility or the motion of the diaphragm such as neuro-muscular diseases.Recent methods such as speckle tracking imaging and ultrasound shear wave elastography should provide more detailed information for better assessment of diaphragmatic function.
基金funded by the French National Research Agency(ANR)projects MAS FLAGELLA (ANR-14-CE15-0002)+2 种基金FLAGELOME (ANR-19-CE17-0014)the INSERM (Institut National de la Sante et de la Recherche Medicale)Bettencourt Foundation
文摘Macrozoospermia,characterized by the presence of largeheaded spermatozoa usually carrying several flagella,is one of the most severe phenotypes of male infertility.As in most cases,the gametes are chromosomally abnormal and cannot be used for assisted reproductive technologies(ART)(Ray et al.,2017).In 2007,subjects from consanguineous families were shown to carry the same homozygous deleterious AURKC variant(NM_001015878.2:c.144delC,later renamed c.145delC,p.Leu49TrpfsTer23),establishing AURKC as the first and main gene associated with macrozoospermia(Dieterich et al.,2007).Using flow cytometry,all spermatozoa from patients homozygous for the c.145delC variant were shown to be tetraploid,highlighting a cytokinesis blockage of the first meiotic divisions thus confirming that ART cannot be successful for these patients(Dieterich et al.,2009).
基金This work was supported by the National Key R&D Program of China(No.2022YFC2503800)the National Natural Science Foundation of China(No.82071454)Beijing Municipal Science&Technology Commission(No.Z211100002921032).
文摘Recently,a novel workflow known as the virtual epileptic patient(VEP)has been proposed by a research team from Aix Marseille Universitéin their papers published in Lancet Neurology,Science Translational Medicine and Epilepsia.This method involves creating an individualized virtual brain model based on computational modelling,which can facilitate clinical decision-making by estimating the epileptogenic zone and performing the virtual surgery.Here,we summarize brief workflow,strengths,and limitations of VEP,as well as its performance in a retrospective study of 53 patients with drug-resistant focal epilepsy who underwent stereoelectroencephalography.A large-scale clinical trial(NCT03643016)is underway to further assess VEP,which is expected to enroll 356 patients prospectively.As supporting evidence accumulates,the clinical application of VEP has the potential to improve clinical practice,leading to better outcomes and qualities of life of patients.
基金Supported by Inserm-ANRS(French National Institute for Health and Medical Research-ANRS/France REcherche Nord and Sud Sida-hiv Hépatites)
文摘AIMTo describe factors associated with treatment failure and frequency of resistance-associated substitutions （RAS）.METHODSHuman immunodefciency virus （HIV）/hepatitis C virus （HCV） coinfected patients starting a first direct-acting antiviral （DAA） regimen before February 2016 and included in the French ANRS CO13 HEPAVIH cohort were eligible. Failure was defned as： （1） non-response [HCV-RNA remained detectable during treatment, at end of treatment （EOT）]; and （2） relapse （HCV-RNA suppressed at EOT but detectable thereafter）. Sequencing analysis was performed to describe prevalence of drug class-specifc RAS. Factors associated with failure were determined using logistic regression models.RESULTSAmong 559 patients, 77% had suppressed plasmaHIV-RNA 〈 50 copies/mL at DAA treatment initiation41% were cirrhotic, and 68% were HCV treatmentexperienced. Virological treatment failures occurred in22 patients and were mainly relapses （17, 77%） thenundefined failures （3, 14%） and non-responses （29%）. Mean treatment duration was 16 wk overall. Posttreatment NS3, NS5A or NS5B RAS were detected in10/14 patients with samples available for sequencinganalysis. After adjustment for age, sex, ribavirin useHCV genotype and treatment duration, low platelecount was the only factor signifcantly associated with ahigher risk of failure （OR： 6.5; 95%CI： 1.8-22.6）. CONCLUSIONOnly 3.9% HIV-HCV coinfected patients failed DAAregimens and RAS were found in 70% of those failingLow platelet count was independently associated withvirological failure.
文摘Objective: The purpose of this study was to evaluate a conservative cold-knife section technique for treatment of cervical intraepithelial neoplasia (CIN). This procedure can be adapted to patient age, preservation of childbearing potential and extent of dysplasia. Design: Prospective study. Setting: Gynecological Oncology Department in French Public Hospital. Population: A total of 460 women treated for CIN between 1985 and 1999 were included. Methods: A conservative cold-knife cervical section followed by blanket suture reconstruction was used in all cases. Main outcome measures: Immediate operative results, recurrence and reproductive function were assessed. Results: The mean length of the cervical specimen was 11.4 mm (range, 4-22 mm). Mean specimen thickness was strongly correlated with age: 10.6 ± 4.1 mm in women < 40 years versus 12.1 in women >40 years; p < 0.001. Complete excision was achieved in 395 cases (85.8% ). Post-operative bleeding was observed in 5 cases (1.1% ). The mean duration of follow-up was 62 months (range, 12.3-156.5 months). Recurrences developed in 26 patients (6.6% ) including CIN 1 in 9 cases, CIN 2 in 9 and CIN 3 in 8. No patient developed carcinoma. The actuarial risk of recurrence was 2.4% (± S.D., 0.9) at 24 months and 7.8% (± S.D., 1.9) at 60 months. A total of 52 pregnancies were observed in 39 patients. No case of de novo infertility was reported post-operatively. Amenorrhea was noted in 1 patient (0.1% ) and dysmenorrhea in 1 patient (0.1% ). Conclusions: This conservative cold-knife section technique is effective for treatment of CIN with low morbidity and little adverse effect on childbearing potential. Exposure of the squamo columnar junction (SCJ) greatly facilitates follow-up.
文摘Correction to:Cellular&Molecular Immunology https://doi.org/10.1038/S41423-020-00574-8,published online 25 November 2020 In the version of this article initially published,two unintended errors were made during manuscript preparation.(1)The figure legend for Panel 3B was missing;the correct legend is as follows.
文摘Toscana virus(TOSV) is an arthropod-borne virus, identified in 1971, from Phlebotomus perniciosus and Phlebotomus perfiliewi in central Italy. TOSV belongs to the Phlebovirus genus within the Bunyaviridae family. As other bunyaviruses, the genome of TOSV consists of 3 segments(S for small, M for Medium, and L for Large) respectively encoding non structural and capsid proteins, envelope structural proteins, and the viral RNA-dependant RNA-polymerase. It is transmitted by sand flies. Therefore its distribution is dictated by that of the arthropod vectors, and virus circulation peaks during summertime when sandfly populations are active. Here, we reviewed the epidemiology of TOSV in the old world. First evidence of its pathogenicity for humans, specifically its propensity to cause central nervous system(CNS) infections such as meningitis and encephalitis, was reported in central Italy. After 2000, it was recognized that TOSV had a much larger geographic distribution than initially believed, and was present in most of the Western European countries located on the northern border of the Mediterranean Sea(Portugal, Spain, France, Greece, Croatia) as well as eastern countries such as Cyprus and Turkey. In the countries where TOSV is present, it is among the three most prevalent viruses in meningitis during the warm seasons, together with enteroviruses and herpesviruses. Up to now, epidemiological data concerning Northern Africa and other countries located south of the Mediterranean are scarce. TOSV must be considered an emerging pathogen. Despite the important role played by TOSV in CNS infections, it remains a neglected agent and is rarely considered by physicians in diagnostic algorithms of CNS infections and febrile illness during the warm season, probably because of the lack of information.
文摘Since the outbreak of coronavirus disease 2019(COVID-19)in December 2019 in China,various measures have been adopted in order to attenuate the impact of the virus on the population.With regard to spine surgery,French physicians are devoted to take place in the national plan against COVID-19,the French Spine Surgery Society therefore decided to elaborate specific guidelines for management of spinal disorders during COVID-19 pandemic in order to prioritize management of patients.A three levels stratification was elaborated with Level I:Urgent surgical indications,Level II:Surgical indications associated to a potential loss of chance for the patient and Level III:Non-urgent surgical indications.We also report French experience in a COVID-19 cluster region illustrated by two clinical cases.We hope that the guidelines formulated by the French Spine Surgery Society and the experience of spine surgeons from a cluster region will be helpful in order optimizing the management of patients with urgent spinal conditions during the pandemic.
文摘We thank Melsen et al.for their interest in our study.Their remarks allow us to clarify key aspects of our work on human bone marrow NK cell biology.1 Our study reports the unsupervised single-cell analysis of NK cells from eight healthy donors and eight acute myeloid leukemia(AML)patients.1 First,we detected an adaptive NK cell subset that correlated with the cytomegalovirus(CMV)positivity status of the donors.
文摘Objective:To evaluate the efficacy of cervix ripening with vaginal controlled-release Propess. Patients and methods:A retrospective study of all women who underwent cervical ripening with Propess during the study period from 1st January 2002 to 31st December 2004 was carried out. A total of 130 patients who experienced Propess was compared with the next following patient who delivered spontaneously matched on gestational age. Modes of delivery,failure of labor,maternal morbidity were recorded. Results:Indications for induction of labor were:post-term pregnancies in 18.5%,pre-eclampsia in 20.8%,oligohydroamnios in 18.5%,post-term pregnancy and oligohydramnios in 10.8%,intra-uterine fetal growth in 6.9%,premature rupture of membranes in 6.9%,diminution of fetal mobility in 6.1%and miscellaneous in 11.5%. Failure of cervical ripening was 21.2%. Patients in the Propess group had a 3.5 fold higher risk of Cesarean section 95%CI:1.5-8.3; P < 0.04 . There was no case of maternal or fetal death. There was no difference in incidence of maternal complications,and post-partum haemorrhage. Discussion and conclusion:Use of vaginal pessary Propess does not induce adverse maternal or fetal morbidity. However,it was associated with a higher incidence of Cesarean delivery.
文摘Objective. To determine risk factors of failed labor in case of fetal macrosomia. Materials and methods. Medical charts of two hundred and forty six women who delivered macrosomic infants ( > 4,000g) between January 2004 and May 2005 were reviewed. Maternal and obstetrical data were analyzed by mode of delivery. Univariate and multivariate (logistic regression analysis) were performed to identify risk factors of failed labor. Results. Rate of cesarean delivery was 18.3% . Indications for cesarean were: failure to progress in 55.6% , arrest in fetal descent in 22.2% , fetal distress in 6.7% , and other in 8.9% . There was a higher risk of failed labor in nulliparous women (p < 0.001), in case of a symphysio-fundal measurements > 34cm (p = 0.004), in nulliparity associated with symphysio-fundal measurements > 34cm (p < 0.001), in case of previous cesarean delivery (p = 0.004), in cases of maternal height < 1.65m (p = 0.02), and with ocytocin use (p = 0.05). In multivariate analysis, nulliparity associated with symphysio-fundal measurements > 34cm (OR = 5.2; CI 1.5- 18.4), previous cesarean section (OR = 3.7; CI 1.1- 12.4) and maternal height < 1.65m (OR = 2.6; CI 1.2- 5.5) were independent factors of failed labor. Conclusion. Failure of labor in case of macrosomia can be predicted in the event of previous cesarean section, shorter maternal height, and association of nulliparity and symphysio- fundal measurements > 34cm.
文摘Managing familial pancreatic cancer(FPC)is challenging for gastroenterologists,surgeons and oncologists.High-risk individuals(HRI)for pancreatic cancer(PC)(FPC or with germline mutations)are a heterogeneous group of subjects with a theoretical lifetime cumulative risk of PC over 5%.Screening is mainly based on annual magnetic resonance imaging(MRI)and endoscopic ultrasound(EUS).The goal of screening is to identify early-stage operable cancers or high-risk precancerous lesions(pancreatic intraepithelial neoplasia or intraductal papillary mucinous neoplasms with high-grade dysplasia).In the literature,target lesions are identified in 2%-5%of HRI who undergo screening.EUS appears to provide better identification of small solid lesions(0%-46%of HRI)and chronicpancreatitis-like parenchymal changes(14%-77%of HRI),while MRI is probably the best modality to identify small cystic lesions(13%-49%of HRI).There are no specific studies in HRI on the use of contrast-enhanced harmonic EUS.EUS can also be used to obtain tissue samples.Nevertheless,there is still limited evidence on the accuracy of imaging procedures used for screening or agreement on which patients to treat.The cost-effectiveness of screening is also unclear.Certain new EUS-related techniques,such as searching for DNA abnormalities or protein markers in pancreatic fluid,appear to be promising.
文摘Postoperative visual acuity can be limited by post-keratoplasty astigmatism,even with a clear corneal graft.Astigmatism management can be performed by selective suture removal,adjustment of sutures,optical correction,photorefractive procedures,wedge resection,intra-ocular lens implantation,intracorneal ring segments,relaxing incisions with or without compression sutures and repeated keratoplasty.Relaxing incisions can be made in the graft,graft-host interface or host cornea.Despite the unpredictability of the method because the flat and steep meridians are usually not orthogonal after penetrating keratoplasty,with asymmetric power distribution,all the studies showed an overall reduction of refractive,keratometric or topographic astigmatism,ranging from 30%to 72%with manual or femtosecond-assisted techniques.Most patients with astigmatism higher than 6 diopters had residual cylinder less than or equal to 3 diopters,which can be treated by laser excimer ablation or secondary intraocular lens implantation.
