Objective:
We describe a clinico-radiological presentation of inflammatory optic neuropathy that mimicked optic neuritis.
Methods:
Retrospective single-center case series and literature review of ...optic neuropathy without orbital pseudotumor.
Results:
Five local patients fulfilled the inclusion criteria. Clinical presentation revealed rapidly progressive severe unilateral visual loss, retrobulbar pain (n = 4), and paralytic strabismus (simultaneous = 2, protracted = 2) without proptosis. Optic nerve abnormality was not appreciated on initial scan review. Patients did not have any general activity of the granulomatosis with polyangiitis. Upon follow-up magnetic resonance imaging and initial imaging review, all patients revealed orbital apex anomalies. Visual acuity improved in three patients who received high-dose intravenous glucocorticosteroids immediately. Relapse was frequent and visual outcome was poor (final vision > 20/40 in two patients only). Literature review identified 16 well-documented cases of granulomatosis with polyangiitis–related isolated optic neuropathies. Magnetic resonance imaging revealed no abnormality (n = 6), optic nerve and/or sheath involvement (n = 9), apex infiltration (n = 3), and/or pachymeningitis (n = 7).
Conclusion:
Granulomatosis with polyangiitis is a rare yet potentially blinding cause of inflammatory optic neuropathy. Optic neuropathy in granulomatosis with polyangiitis may occur in the absence of systemic symptoms of disease activity and is challenging to distinguish from other inflammatory and non-inflammatory disorders affecting visual acuity. Several clinical and imaging clues suggest that optic neuropathy results from the development of an extravascular granulomatous process within the optic nerve sheath in the orbital apex, a place that is difficult to image. In a granulomatosis with polyangiitis patient with unexplained visual loss and a seemingly normal workup (fundoscopy, biology, and imaging), clinician should keep a high index of suspicion.
Introduction
The aim of this study was to assess the efficacy and safety of fluocinolone acetonide implant (FAci) injected 1 month after the last dexamethasone intravitreal implant (DEXi) in chronic ...diabetic macular oedema (DME) patients.
Methods
Retrospective multicentric study conducted in pseudophakic patients with chronic DME frequently treated with dexamethasone intravitreal implant (DEXi; time to DME recurrence ≤ 6 months), receiving FAci 1 month after the last DEXi, with at least a 6-month follow-up. Best-corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography, intraocular pressure (IOP) and additional treatments were assessed on the day of FAci injection (M0), 1 (M1) and 3 months (M3) later and then every 3 months.
Results
A total of 41 eyes from 34 patients were included. At M0, patients’ mean age was 68.7 ± 9.8 years, the mean DME duration was 63.9 ± 22.9 months, the mean interval between two DEXi was 14.2 ± 3.3 weeks. M12 data were available for 71% of patients. At baseline, the mean BCVA, CMT and IOP were 63.2 ± 16.6 letters, 299.4 ± 103.3 µm, and 16.2 ± 4.5 mmHg, respectively, and remained stable during the follow-up. At M12, 14% of patients required additional intravitreal treatments.
Conclusion
In pseudophakic patients with chronic DME showing good response to DEXi but requiring repeated injections every < 6 months, switching to FAci 1 month after the last DEXi was effective and safe. Further prospective randomized controlled studies are needed to confirm these findings, and to determine the best interval between the last DEXi and the first FAci.
L’ORIGINALITÉ D’UN CÉGEP Jean-Louis Dallaire; Darquise Tardif; Manon Clément ...
Cégep Garneau. 50 ans de vie pédagogique et de passion pour l'excellence,
08/2019
Book Chapter
En 1971, l’option professionnelle de Techniques policières (TP) est acceptée au Collège François-Xavier-Garneau, option à laquelle s’adjoindra un peu plus tard le programme de Techniques ...correctionnelles (TC), aujourd’hui Techniques d’intervention en délinquance (TID). Le Département des techniques auxiliaires de la justice (TAJ) était né. Le programme bouscule et menace l’existence même des écoles de formation policière qui résistent et ne reconnaissent pas la nécessité d’augmenter la formation académique des futurs policiers. Le combat pour la reconnaissance de la formation durera un quart de siècle. Alors qu’au début les candidats admis au programme pouvaient parfois présenter des faiblesses au plan scolaire,
En 2021 devrait ouvrir un nouvel EHPAD au centre de la ZAC Flaubert à Grenoble. Cette infrastructure sera à proximité immédiate du parc. Ainsi, ce voisinage nous a conduit à nous questionner sur ...l’utilisation actuelle de cet espace public par les personnes âgées et la nature de la relation entre le futur EHPAD et le parc Flaubert. Dans ce cadre, nous souhaitions connaître à la fois le degré d’utilisation du parc par des personnes âgées, et recueillir des sentiments, impressions ou simplement ...
Kidney transplant recipients and patients receiving hemodialysis are immunocompromised populations that are prioritized for COVID-19 vaccination but were excluded from clinical trials of SARS-CoV-2 ...mRNA vaccines. Antibody titers and rates of seroconversion after vaccination are lower among patients with CKD and those taking immunosuppressants compared with controls. Data are lacking regarding their humoral response to vaccination to prevent COVID-19.
This investigation of early serological response after COVID-19 vaccination with the Pfizer/BioNTech (BNT162b2) mRNA vaccine included 78 patients undergoing hemodialysis, 74 kidney transplant recipients, and seven healthy controls. We recorded data from the medical file for various clinical parameters, including response to hepatitis B vaccination, and measured antibody titers against SARS-CoV-2 at 0, 14, 28, 36, and 58 days after the first injection.
In controls, we detected antibodies at a positive level (>13 arbitrary units per ml; AU/ml) at day 14 postinjection, which increased progressively to peak at day 36 (1082 AU/ml; interquartile range IQR, 735.0-1662.0). Patients undergoing hemodialysis had lower titers that peaked at day 58 (276 AU/ml; IQR, 83.4-526.0). We detected a positive antibody level in only three transplant recipients at day 36. In patients on hemodialysis, those aged <75 years had a higher antibody response versus those aged >75 years, and serum albumin and Kt/V were positively correlated with serological response (
<0.04 and
<0.0, respectively); nonresponders to HBV vaccine had the lowest anti-SARS-CoV-2 antibody titers.
Our results suggest that the postvaccination humoral response is strongly inhibited by immunosuppressant therapy in kidney transplant recipients, and is reduced by the uremic condition in patients undergoing hemodialysis.
In the coming century, climate change and the increasing human population are likely leading agriculture to face multiple challenges. Agricultural production has to increase while preserving natural ...resources and protecting the environment. Drought is one of the major abiotic problems, which limits the growth and productivity of crops and impacts 1-3% of all land.To cope with unfavorable water-deficit conditions, plants use through sophisticated and complex mechanisms that help to perceive the stress signal and enable optimal crop yield are required. Among crop production, wheat is estimated to feed about one-fifth of humanity, but faces more and more drought stress periods, partially due to climate change. Plant growth promoting rhizobacteria are a promising and interesting way to develop productive and sustainable agriculture despite environmental stress. The current review focuses on drought stress effects on wheat and how plant growth-promoting rhizobacteria trigger drought stress tolerance of wheat by highlighting several mechanisms. These bacteria can lead to better growth and higher yield through the production of phytohormones, osmolytes, antioxidants, volatile compounds, exopolysaccharides and 1-aminocyclopropane-1-carboxylate deaminase. Based on the available literature, we provide a comprehensive review of mechanisms involved in drought resilience and how bacteria may alleviate this constraint.
Diffusion-weighted magnetic resonance imaging provides invaluable insights into in-vivo neurological pathways. However, accurate and robust characterization of white matter fibers microstructure ...remains challenging. Widely used spherical deconvolution algorithms retrieve the fiber Orientation Distribution Function (ODF) by using an estimation of a response function, i.e., the signal arising from individual fascicles within a voxel. In this paper, an algorithm of blind spherical deconvolution is proposed, which only assumes the axial symmetry of the response function instead of its exact knowledge. This algorithm provides a method for estimating the peaks of the ODF in a voxel without any explicit response function, as well as a method for estimating signals associated with the peaks of the ODF, regardless of how those peaks were obtained. The two stages of the algorithm are tested on Monte Carlo simulations, as well as compared to state-of-the-art methods on real in-vivo data for the orientation retrieval task. Although the proposed algorithm was shown to attain lower angular errors than the state-of-the-art constrained spherical deconvolution algorithm on synthetic data, it was outperformed by state-of-the-art spherical deconvolution algorithms on in-vivo data. In conjunction with state-of-the art methods for axon bundles direction estimation, the proposed method showed its potential for the derivation of per-voxel per-direction metrics on synthetic as well as in-vivo data.
The neurocranium of sarcopterygian fishes was originally divided into an anterior (ethmosphenoid) and posterior (otoccipital) portion by an intracranial joint, and underwent major changes in its ...overall geometry before fusing into a single unit in lungfishes and early tetrapods
. Although the pattern of these changes is well-documented, the developmental mechanisms that underpin variation in the form of the neurocranium and its associated soft tissues during the evolution of sarcopterygian fishes remain poorly understood. The coelacanth Latimeria is the only known living vertebrate that retains an intracranial joint
. Despite its importance for understanding neurocranial evolution, the development of the neurocranium of this ovoviviparous fish remains unknown. Here we investigate the ontogeny of the neurocranium and brain in Latimeria chalumnae using conventional and synchrotron X-ray micro-computed tomography as well as magnetic resonance imaging, performed on an extensive growth series for this species. We describe the neurocranium at the earliest developmental stage known for Latimeria, as well as the major changes that the neurocranium undergoes during ontogeny. Changes in the neurocranium are associated with an extreme reduction in the relative size of the brain along with an enlargement of the notochord. The development of the notochord appears to have a major effect on the surrounding cranial components, and might underpin the formation of the intracranial joint. Our results shed light on the interplay between the neurocranium and its adjacent soft tissues during development in Latimeria, and provide insights into the developmental mechanisms that are likely to have underpinned the evolution of neurocranial diversity in sarcopterygian fishes.
Medulloblastoma (MB) is the most common and aggressive paediatric brain tumour. Although the cure rate can be as high as 70%, current treatments (surgery, radio- and chemotherapy) excessively affect ...the patients' quality of life. Relapses cannot be controlled by conventional or targeted treatments and are usually fatal. The strong heterogeneity of the disease (four subgroups and several subtypes) is related to innate or acquired resistance to reference treatments. Therefore, more efficient and less-toxic therapies are needed. Here, we demonstrated the efficacy of a novel inhibitor (C29) of CXCR1/2 receptors for ELR+CXCL cytokines for the treatment of childhood MB. The correlation between ELR+CXCL/CXCR1/2 expression and patient survival was determined using the R2: Genomics Analysis and Visualization platform. In vitro efficacy of C29 was evaluated by its ability to inhibit proliferation, migration, invasion, and pseudo-vessel formation of MB cell lines sensitive or resistant to radiotherapy. The growth of experimental MB obtained by MB spheroids on organotypic mouse cerebellar slices was also assayed. ELR+CXCL/CXCR1/2 levels correlated with shorter survival. C29 inhibited proliferation, clone formation, CXCL8/CXCR1/2-dependent migration, invasion, and pseudo-vessel formation by sensitive and radioresistant MB cells. C29 reduced experimental growth of MB in the ex vivo organotypic mouse model and crossed the blood-brain barrier. Targeting CXCR1/2 represents a promising therapeutic strategy for the treatment of paediatric MB in first-line treatment or after relapse following conventional therapy.
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