Status epilepticus (SE) is a life-threatening emergency requiring a prompt assessment of patient prognosis to guide management. MRI allows the identification of peri-ictal MRI abnormalities (PMAs) ...and provides insight into brain structural modifications induced by SE. However, little is known about the significance of PMA in SE prognosis. The aim of this study was to determine whether PMAs are associated with an increased mortality in SE and to establish the association between PMA and refractoriness to antiseizure medications, complications encountered, and induced morbidity.
We conducted a retrospective observational cohort study including all eligible consecutive patients over 15 years old and hospitalized with SE at Bordeaux University Hospital (France) between January 2015 and December 2019. The primary end point was in-hospital mortality. A dedicated neuroradiologic reassessment was performed, together with a comprehensive medical review assessing baseline characteristics, in-hospital death, SE characterization, drug refractoriness, and following outcome in survivors.
Of 307 patients included, 79 (26%) showed PMA related to SE. Demographic, functional status at baseline and median delay between SE onset and MRI examination were similar in the PMA-positive and PMA-negative groups. In-hospital death occurred in 15% (45/307) patients and was significantly higher in the PMA-positive group (27%, 21/79 vs 11%, 24/228;
< 0.001). In multivariate analysis, the presence of PMA (odds ratio OR 2.86, 95% CI 1.02-8.18;
= 0.045), together with SE duration (OR 1.01, 95% CI 1.01-1.02;
= 0.007), older age at SE onset (OR 1.05, 95% CI 1.01-1.09;
= 0.013), preexisting ultimately fatal comorbidity (OR 4.01, 95% CI 1.56-10.6;
= 0.004), and acute lesional SE etiology (OR 3.74, 95% CI 1.45-10.2;
= 0.007) were independent predictors associated with in-hospital death. Patients with PMA had a higher risk of refractory SE (71 vs 33%,
< 0.001). Among survivors, delayed-onset epilepsy (40% vs 21%,
= 0.009) occurred more frequently in the PMA-positive group.
PMA-positive cases had a higher mortality rate in the largest cohort so far to assess the prognosis value of PMA in SE. As a noninvasive and easily available tool, PMA represents a promising structural biomarker for developing a personalized approach to prognostication in patients with SE receiving MRI.
Grape canes represent a valuable source of numerous polyphenols with antioxidant properties, whose compositions vary depending on the genotype and environmental factors. Antioxidant activities of ...pure molecules are often reported without considering possible interactions that may occur in complex polyphenol mixture. Using UPLC-MS-based metabolomics and unsupervised classification, we explored the polyphenol variations in grape cane extracts from a collection of European varieties. Antioxidant activities were assessed using ORAC, ABTS, DPPH, FRAP, CUPRAC and chelation assays. Pairwise correlations between polyphenols and antioxidant capacities were performed to identify molecules that contributed more to the antioxidant capacities within a complex mixture of polyphenols.
Seedlessness is greatly prized by consumers of fresh grapes. While stenospermocarpic seed abortion determined by the SEED DEVELOPMENT INHIBITOR (SDI) locus is the usual source of seedlessness in ...commercial grapevine (Vitis vinifera) cultivars, the underlying sdi mutation remains unknown. Here, we undertook an integrative approach to identify the causal mutation. Quantitative genetics and fine-mapping in two 'Crimson Seedless'-derived F1 mapping populations confirmed the major effect of the SDI locus and delimited the sdi mutation to a 323-kb region on chromosome 18. RNA-sequencing comparing seed traces of seedless and seeds of seeded F1 individuals identified processes triggered during sdi-determined seed abortion, including the activation of salicylic acid-dependent autoimmunity. The RNA-sequencing data set was investigated for candidate genes, and while no evidence for causal cis-acting regulatory mutations was detected, deleterious nucleotide changes in coding sequences of the seedless haplotype were predicted in two genes within the sdi fine-mapping interval. Targeted resequencing of the two genes in a collection of 124 grapevine cultivars showed that only the point variation causing the arginine-197-to-leucine substitution in the seed morphogenesis regulator gene AGAMOUS-LIKE11 (VviAGL11) was fully linked with stenospermocarpy. The concurrent postzygotic variation identified for this missense polymorphism and seedlessness phenotype in seeded somatic variants of the original stenospermocarpic cultivar supports a causal effect. We postulate that seed abortion caused by this amino acid substitution in VviAGL11 is the major cause of seedlessness in cultivated grapevine. This information can be exploited to boost seedless grape breeding.
Background
Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is usually associated with a poor response to antiseizure medications. We focused on MTLE-HS patients who were seizure ...free on medication to: (1) determine the clinical factors associated with seizure freedom and (2) develop a machine-learning classifier to better earlier identify those patients.
Methods
We performed a retrospective, multicentric study comparing 64 medically treated seizure-free MTLE-HS patients with 200 surgically treated drug-resistant MTLE-HS patients. First, we collected medical history and seizure semiology data. Then, we developed a machine-learning classifier based on clinical data.
Results
Medically treated seizure-free MTLE-HS patients were seizure-free for at least 2 years, and for a median time of 7 years at last follow-up. Compared to drug-resistant MTLE-HS patients, they exhibited: an older age at epilepsy onset (22.5 vs 8.0 years,
p
< 0.001), a lesser rate of: febrile seizures (39.0% vs 57.5%,
p
= 0.035), focal aware seizures (previously referred to as aura)(56.7% vs 90.0%,
p
< 0.001), autonomic focal aware seizures in presence of focal aware seizure (17.6% vs 59.4%,
p
< 0.001), dystonic posturing of the limbs (9.8% vs 47.0%,
p
< 0.001), gestural (27.4% vs 94.0%,
p
< 0.001), oro-alimentary (32.3% vs 75.5%,
p
< 0.001) or verbal automatisms (12.9% vs 36.0%,
p
= 0.001). The classifier had a positive predictive value of 0.889, a sensitivity of 0.727, a specificity of 0.962, a negative predictive value of 0.893.
Conclusions
Medically treated seizure-free MTLE-HS patients exhibit a distinct clinical profile. A classifier built with readily available clinical data can identify them accurately with excellent positive predictive value. This may help to individualize the management of MTLE-HS patients according to their expected pharmacosensitivity.
Aphis gossypii and Bemisia tabaci are severe hemipteran pests of melon crops and breeding for resistance to both insects is required to reduce pesticide use. Resistance was evaluated for its effect ...on behaviour and biotic potential of both hemipterans in a population of recombinant inbred lines (RILs) derived from the cross Védrantais × PI 161375. Insect variability was considered using two A. gossypii clones and two B. tabaci populations. Two additive QTLs affected the whiteflies. Four additive QTLs and two couples of epistatic QTLs affected the aphids. Amongst them, a major QTL affects both behaviour and biotic potential of A. gossypii and therefore a same R gene induces both antixenosis and antibiosis. This major QTL colocalizes with the Vat gene belonging to the NBS-LRR gene family. No loci affected both aphids and whiteflies contrary to what was observed for the Mi1.2 gene, a NBS-LRR gene in tomato. Original populations with different allelic compositions at QTLs affecting A. gossypii were built by one inter-crossing of RILs used for the mapping process. The genetic background was shown homogeneous between these populations what allowed validating QTLs and investigating the effect of allelic combinations at QTLs. Effects of QTLs were stronger than expected and some QTLs had a wider spectrum than expected. This strategy of validation appeared rapid and low cost.
Management of epilepsia in older Alberti, Agathe; Thomas, Benjamin; Marchal, Cécile
La Presse médicale (1983),
03/2018, Letnik:
47, Številka:
3
Journal Article
Recenzirano
Epilepsy increases in frequency with age, above 60, with consequences in terms of independence. Stroke and dementia are the most frequent etiologies. Clinical diagnostic of epileptic seizure is ...challenging at this age, and a clinical algorithm is proposed. Sleep EEG during one hour seems to be the most useful exam. Interictal and critical discharges can be seen during sleep in dementia ; relation between hyperexcitability and evolution of cognition has to be precised in this pathology. In a therapeutical point of view, it is necessary to bear in mind the pharmacological consequences of aging, polytherapies, and the frequency of adverse events in this age group. Two molecules, lamotrigine and levetiracetam are recommended as first line treatment. Pronostic is good, as the majority of patients are seizure-free in monotherapy.
•Good agreement between patients and proxies on psychiatric comorbidities.•Also good agreement when evaluating sleep disorders and treatment adherence.•Agreement was especially good for respondents ...living with the patient.•In case of SUDEP, level of agreement allows to gather reliable information.
The study aimed to determine the level of agreement between patients with epilepsy and their proxies when assessing psychiatric comorbidities, sleep disorders, and medication adherence using standardized questionnaires.
This agreement study is an ancillary analysis of the PRERIES study, a matched case-control study exploring SUDEP risk factors. Controls aged 15 years and older, with active epilepsy or in remission for less than 5 years were recruited between 01/01/2011 and 03/31/2019. An interview was carried out by a trained psychologist on both the patient and a proxy-respondent. During these independent interviews, the following comorbidities were explored: psychiatric comorbidities using the MINI, the STAI- Y2 and NDDI-E scales, sleep disorders with the SDQ-SA and Epworth scales and medication adherence. Level of agreement between patient and their proxy was estimated using Gwet's AC1&2.
Among the 107 patient–proxy dyads recruited, proxy respondents were mainly family members (65.4%) or spouses (30.8%). Exploration of present major depression showed excellent agreement at 0.81 0.65;0.97, as well as exploration of dysthymia at 0.96 0.61;1. Suicidal risk evaluation had a lesser agreement at 0.77 0.60;0.94. Agreement on anxiety was moderate 0.5 0.38;0.62. For sleep disorder, SDQ-SA presented a better agreement than the Epworth questionnaire with respectively 0.73 0.51;0.95 and 0.45 0.26;0.63. For medication adherence, the overall agreement rate was excellent (0.90 0.78;1).
Exploration of potential risk factors through families can give valuable and relatively robust information, especially if the respondent lives with the patient, and should be retrieved, when possible, in usual clinical setting.
Tomato spotted wilt virus (TSWV; genus Tospovirus, family Bunyaviridae) genetic diversity was evaluated by sequencing parts of the three RNA genome segments of 224 isolates, mostly from pepper and ...tomato crops in southern Europe. Eighty-three per cent of the isolates showed consistent clustering into three clades, corresponding to their geographical origin, Spain, France or the USA, for the three RNA segments. In contrast, the remaining 17% of isolates did not belong to the same clade for the three RNA segments and were shown to be reassortants. Among them, eight different reassortment patterns were observed. Further phylogenetic analyses provided insights into the dynamic processes of the worldwide resurgence of TSWV that, since the 1980s, has followed the worldwide dispersal of the western flower thrips (Frankliniella occidentalis) tospovirus vector. For two clades composed essentially of Old World (OW) isolates, tree topology suggested a local re-emergence of indigenous TSWV populations following F. occidentalis introductions, while it could not be excluded that the ancestors of two other OW clades were introduced from North America contemporarily with F. occidentalis. Finally, estimation of the selection intensity that has affected the evolution of the NSs and nucleocapsid proteins encoded by RNA S of TSWV suggests that the former could be involved in the breakdown of resistance conferred by the Tsw gene in pepper.
Grapevine red blotch virus (GRBV) is a recently identified virus that infects grapevine and has a severe impact on the grape industry in North America. Since the first description of the virus 8 ...years ago, clear progress has been made regarding our understanding of the GRBV pathosystem. However, questions remain regarding the origin of this pathogen and its spread outside North America, especially in Europe. In this study, we present the results of a large-scale GRBV survey in two European repositories; we targeted
Vitis
spp. accessions with diverse geographical origins. Of 816 accessions from different origins (50 different countries around the world), six accessions were infected by GRBV, all of which originated from the United States. We investigated the DNA virome of 155 grapevine accessions from the Swiss grapevine collection using high-throughput sequencing. We observed that virome of the Swiss grapevine collection was composed of several RNA viruses. In contrast, we did not detect any DNA viruses in the 155 Swiss grapevine accessions. This finding suggests that the abundance of DNA viruses infecting grapevines in Switzerland is either very low or non-existent. Our results and the findings of studies published since 2008 show that GRBV most likely originated in North America and subsequently spread to other viticultural areas in the world via unintentional movement of infected cuttings. According to our data, the most plausible scenario for the origin of GRBV is that the virus evolved from non-
Vitis vinifera
hosts and underwent a host jump to
Vitis vinifera
after its introduction to North America in the 1600s.
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