Introduction La prévalence des hallucinations chez les enfants et les adolescents est de 4,9 % à 9 % 1 . Il s’agit d’un symptôme polysémique dont le repérage précoce reste un enjeu majeur du fait du ...risque évolutif vers un trouble psychotique cependant rare. Observation Nous rapportons deux cas d’hallucinations auditives et cénesthésiques. Dans le premier cas, une adolescente de 13 ans présentait un syndrome de stress post-traumatique suite à une agression. Les hallucinations survenaient lorsqu’elle était seule dans la rue. L’approche systémique du symptôme mettait à jour un mythe familial de menace. En effet, l’agression renforçait un sentiment ancien de persécution par la société, notamment concernant ses parents handicapés par une surdité congénitale. Dans le second cas, un enfant de 9 ans présentait des hallucinations auditives se manifestant par une mélodie agréable et s’inscrivant dans un contexte de violents conflits entre sa mère et son beau-père. Contemporain d’un repli sur soi et de mouvements anxieux et tristes, ce symptôme semblait également traduire une souffrance familiale. Discussion Concomitamment à l’amendement des hallucinations, la mise en perspective relationnelle du symptôme a permis de retrouver une vitalité du lien. En effet, par ce premier lien de vulnérabilité établi avec les soignants, les familles ont retrouvé confiance dans leur capacité à s’ouvrir au monde extérieur offrant ainsi une opportunité pour le changement. Conclusion Une vision intégrative tenant compte non seulement des avancées de l’imagerie et des nombreux modèles neurobiologiques et neurocognitifs 2,3 , mais aussi du contexte relationnel du patient, semble fondamentale à la prise en charge globale des hallucinations de l’enfant et de l’adolescent.
Background and Purpose
The number of clot retrieval attempts required to achieve complete reperfusion by mechanical thrombectomy impacts functional outcome in acute ischaemic stroke (AIS). Complete ...reperfusion expanded Treatment In Cerebral Infarction (eTICI) score = 3 at first pass (FP), is associated with the highest rates of favorable outcome compared to complete reperfusion by multiple passes. The aim of the present study was to investigate the relationship between FP complete reperfusion and infarct growth (IG).
Methods
Anterior AIS patients with baseline and 24‐h diffusion‐weighted magnetic resonance imaging were included from two prospective registries. IG was measured by voxel‐based segmentation of initial and 24‐h diffusion‐weighted imaging lesions. IG and favorable 3‐month modified Rankin Scale (mRS) score (≤ 2) were compared between patients in whom complete reperfusion (eTICI 3) was achieved with a single pass (FP group) and those for whom multiple passes were required (MP group), after matching for confounding factors. Mediation analysis was performed to examine the association between FP and 3‐month mRS score, with IG as mediating variable.
Results
A total of 200 patients were included, of whom 118 (28.9%) had FP complete reperfusion. In case–control analysis, the FP group had lower IG than the MP group 8.7 (5.4–12.9) ml vs. 15.2 (11–22.6) ml, respectively; P = 0.03). Favorable outcome was higher in the FP population compared to a matched MP population (70.9% vs. 53.2%, respectively; P = 0.04). FP compete reperfusion (eTICI 3) was independently associated with favorable outcome in multivariable regression analysis odds ratio 1.86, 95% confidence interval (CI) 1.01–4.39; P = 0.04. The effect of complete reperfusion at FP on functional outcome was explained by limited IG in mediation analysis indirect effect: −0.32 (95% CI −0.47 to −0.09).
Conclusion
Complete reperfusion at FP is independently associated with significant decrease in IG compared to complete reperfusion by multiple attempts, explaining better functional outcomes.
Contribution of muscle MRI for diagnosis of myopathy Venturelli, N.; Tordjman, M.; Ammar, A. ...
Revue neurologique,
January-February 2023, 2023 Jan-Feb, 2023-01-00, 20230101, 2023, Letnik:
179, Številka:
1-2
Journal Article
Recenzirano
Odprti dostop
Inherited myopathies are a group of disease, which, although distinct from a genetic and prognostic point of view, can lead to non-specific clinical pictures due to phenotypic overlap. Acquired ...immuno-mediated myopathies may also pose the problem of clinically accurate etiological orientation. The assessment of fatty infiltration and pathological increase in water volume of the muscle contingent on whole-body muscle MRI is becoming increasingly important in aiding the initial diagnosis of inherited and acquired myopathies. MRI helps orientating the clinical diagnostic hypotheses thanks to the patterns of muscle involved (more or less specific according to the entities), which led to the development of decision-making algorithms proposed in the literature. The aim of this article is to specify the proper MRI protocol for the evaluation of myopathies and the basis of the interpretation and to provide a summary of the most frequently inherited and acquired myopathies described in the literature.
The formation of recess etched Au-free ohmic contacts to an InAlN AlN GaN heterostructure is investigated. A Ta Al Ta metal stack is used to produce contacts with contact resistance (Rc) as low as ...0.14 mm. It is found that Rc decreases with increasing recess depth until the InAlN barrier is completely removed. For even deeper recesses Rc remains low but requires annealing at higher temperatures for contact formation. The lowest Rc is found for contacts where the recess etch has stopped just above the 2D electron gas channel. At this depth the contacts are also found to be less sensitive to other process parameters, such as anneal duration and temperature. An optimum bottom Ta layer thickness of 5-10 nm is found. Two reliability experiments preliminary confirm the stability of the recessed contacts.
ObjectiveIt is still uncertain whether mild primary hyperparathyroidism (PHPT) carries the same risk for increased cardiovascular (CV) morbidity as the more severe symptomatic form. In recent years, ...the even more subtle normocalcemic (NC) variant is being increasingly recognized. We sought to compare the prevalence of CV risk factors in patients with NC- and hypercalcemic (HC)-PHPT, and to examine whether they differ on a battery of non-invasive vascular parameters.Design/subjects/methodsA retrospective study of two cohorts of patients with PHPT in a referral center: 32 subjects with NC-PHPT and 81 subjects with HC-PHPT, compared for the presence of clinical and biochemical risk factors, and CV morbidity. Non-invasive parameters of arterial stiffness (augmentation index; pulse wave velocity; and vascular compliance indices, C1 and C2) were extracted from the data of gender- and age-matched subsets of these patients, and were related to those of a group of matched control subjects.ResultsDespite a similar prevalence of hypertension (∼62%), hyperlipidemia (∼30%), and impaired glucose metabolism in both PHPT groups, CV or cerebrovascular disease was more common in the HC-PHPT group (24.7 vs 3.1%, P=0.007). Arterial stiffness parameters did not differ in the three groups, and were unrelated to serum calcium or parathyroid hormone concentration.ConclusionsNC-PHPT and HC-PHPT subjects exhibit similar high rates of traditional CV risk factors, and have comparable indices of arterial stiffness. The lower clinical CV morbidity observed with NC-PHPT remains unexplained, and requires confirmation. Until then, the CV risk associated with NC-PHPT should not be underestimated.
La spondylodiscite infectieuse (SDI) est une pathologie rare, mais dont l’incidence est en augmentation. Nous présentons un cas illustrant les difficultés diagnostiques et thérapeutiques, en ...particulier en cas de micro-organisme inhabituel. Un homme de 68 ans est hospitalisé pour une SDI diagnostiquée à l’IRM avec 2 hémocultures positives à Bacteroides fragilis. L’évolution était initialement favorablement, mais une majoration des douleurs lombaires a incité, après réalisation d’une IRM, à une ponction biopsie disco-vertébrale (PBDV) qui a documenté un Corynebacterium striatum en quantité significative. Devant cette SDI, initialement à micro-organisme anaérobie, une PBDV initiale aurait pu être discutée en dépit des hémocultures positives. Ce cas clinique illustre la complexité de la prise en charge de la SDI et leur évolution selon les recommandations récentes et permet un rappel des recommandations récentes (place de l’IRM dans le suivi, intérêt de la TEP-TDM au FDG, modalités d’immobilisation, modalités d’administration de l’antibiothérapie).
Vertebral Osteomyelitis (VO) is a rare disease, which has seen a gradual increase in its incidence over the past years. Here, we report a case, showing how difficult it can be to diagnose and manage a therapy in case of atypical microorganism. A 68-year-old man was hospitalized for a VO documented by blood cultures at Bacteroides fragilis. He first progressed favorably, but an increase in lumbar pain prompted, after an IRM, a percutaneous needle biopsy (PNB) that documented a recurrent VO at Corynebacterium striatum. In the face of this multi-microbial VO with atypicals microorganisms, a first PNB could have been discussed despite the positive blood cultures. This case report illustrates the complexity of management of VO, and its evolution according to the latest recommendations (interest of RMI during the follow-up, place of the TEP-scan, terms and conditions of immobilization, antibiotic administration methods).
High-frequency Metal Insulator Semiconductor High-Electron-Mobility Transistors (MIS HEMTs) were fabricated on quaternary InAlGaN/AlN/GaN heterostructures, grown by MOCVD on a 3" SiC substrate. ...Specific studies were performed on SiN ICP-CVD passivation layers. Improved performances were obtained with these optimized devices at 30 GHz as evidenced by CW Load Pull characterization: an output power of 6 W/mm and a power-added efficiency of 42%. A good extrinsic transconductance value higher than 450 mS/mm and a current density up to 1.55 A/mm were also measured on these transistors.
In this work, we have investigated the non‐intentional incorporation of gallium in InAlN layers grown by metal organic vapor phase epitaxy (MOVPE) using two reactors. Atomic force microscopy (AFM) ...and electron dispersive X‐ray spectroscopy (EDS) have been used to characterize the surface morphology and the atomic composition of InAl(Ga)N/GaN structures. The horizontal chamber systematical produces pure ternary layers whereas the close coupled shower head vertical chamber can lead to quaternary alloys. Cleaning the latter significantly reduces the amount of gallium to 1% in the epilayers. Moreover, we show an alternative way to reduce the amount gallium: the use of an intermediate growth pressure typically around 80 Torr drops the inclusion of gallium to 6%. In the presence of such amount of Ga, the growth process appears to be modified and there is a competition between In and Ga for their incorporation, and the Al composition is systematically reduced. The morphology of the layers is also observed to suffer, with the formation of large and closed trenches toward a possible three dimensional growth mode when the layer thickness is increased.
Vertebral Osteomyelitis (VO) is a rare disease, which has seen a gradual increase in its incidence over the past years. Here, we report a case, showing how difficult it can be to diagnose and manage ...a therapy in case of atypical microorganism. A 68-year-old man was hospitalized for a VO documented by blood cultures at Bacteroides fragilis. He first progressed favorably, but an increase in lumbar pain prompted, after an IRM, a percutaneous needle biopsy (PNB) that documented a recurrent VO at Corynebacterium striatum. In the face of this multi-microbial VO with atypicals microorganisms, a first PNB could have been discussed despite the positive blood cultures. This case report illustrates the complexity of management of VO, and its evolution according to the latest recommendations (interest of RMI during the follow-up, place of the TEP-scan, terms and conditions of immobilization, antibiotic administration methods).
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