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Nicolas G, Zaréa A, Lacour M, Quenez O, Rousseau S, Richard AC, Bonnevalle A, Schramm C, Olaso R, Sandron F, Boland A, Deleuze JF, Andriuta D, Anthony P, Auriacombe S, Balageas AC, Ballan G, Barbay M, Béjot Y, Belliard S, Benaiteau M, Bennys K, Bombois S, Boutoleau-Bretonnière C, Branger P, Carlier J, Cartz-Piver L, Cassagnaud P, Ceccaldi MP, Chauviré V, Chen Y, Cogez J, Cognat E, Contegal-Callier F, Corneille L, Couratier P, Cretin B, Crinquette C, Dauriat B, Dautricourt S, de la Sayette V, de Liège A, Deffond D, Demurger F, Deramecourt V, Derollez C, Dionet E, Doco Fenzy M, Dumurgier J, Dutray A, Etcharry-Bouyx F, Formaglio M, Gabelle A, Gainche-Salmon A, Godefroy O, Graber M, Gregoire C, Grimaldi S, Gueniat J, Gueriot C, Guillet-Pichon V, Haffen S, Hanta CR, Hardy C, Hautecloque G, Heitz C, Hourregue C, Jonveaux T, Jurici S, Koric L, Krolak-Salmon P, Lagarde J, Lanoiselée HM, Laurens B, Le Ber I, Le Guyader G, Leblanc A, Lebouvier T, Levy R, Lippi A, Mackowiak MA, Magnin E, Marelli C, Martinaud O, Maureille A, Migliaccio R, Milongo-Rigal E, Mohr S, Mollion H, Morin A, Nivelle J, Noiray C, Olivieri P, Paquet C, Pariente J, Pasquier F, Perron A, Philippi N, Planche V, Pouclet-Courtemanche H, Rafiq M, Rollin-Sillaire A, Roué-Jagot C, Saracino D, Sarazin M, Sauvée M, Sellal F, Teichmann M, Thauvin C, Thomas Q, Tisserand C, Turpinat C, Van Damme L, Vercruysse O, Villain N, Wagemann N, Charbonnier C, Wallon D. Assessment of Mendelian and risk-factor genes in Alzheimer disease: A prospective nationwide clinical utility study and recommendations for genetic screening. Genet Med 2024; 26:101082. [PMID: 38281098 DOI: 10.1016/j.gim.2024.101082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/29/2024] Open
Abstract
PURPOSE To assess the likely pathogenic/pathogenic (LP/P) variants rates in Mendelian dementia genes and the moderate-to-strong risk factors rates in patients with Alzheimer disease (AD). METHODS We included 700 patients in a prospective study and performed exome sequencing. A panel of 28 Mendelian and 6 risk-factor genes was interpreted and returned to patients. We built a framework for risk variant interpretation and risk gradation and assessed the detection rates among early-onset AD (EOAD, age of onset (AOO) ≤65 years, n = 608) depending on AOO and pedigree structure and late-onset AD (66 < AOO < 75, n = 92). RESULTS Twenty-one patients carried a LP/P variant in a Mendelian gene (all with EOAD, 3.4%), 20 of 21 affected APP, PSEN1, or PSEN2. LP/P variant detection rates in EOAD ranged from 1.7% to 11.6% based on AOO and pedigree structure. Risk factors were found in 69.5% of the remaining 679 patients, including 83 (12.2%) being heterozygotes for rare risk variants, in decreasing order of frequency, in TREM2, ABCA7, ATP8B4, SORL1, and ABCA1, including 5 heterozygotes for multiple rare risk variants, suggesting non-monogenic inheritance, even in some autosomal-dominant-like pedigrees. CONCLUSION We suggest that genetic screening should be proposed to all EOAD patients and should no longer be prioritized based on pedigree structure.
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Affiliation(s)
- Gaël Nicolas
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France.
| | - Aline Zaréa
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France
| | - Morgane Lacour
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France
| | - Olivier Quenez
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France
| | - Stéphane Rousseau
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France
| | - Anne-Claire Richard
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France
| | - Antoine Bonnevalle
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France; Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France
| | - Catherine Schramm
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, F-76000 Rouen, France
| | - Robert Olaso
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - Florian Sandron
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - Anne Boland
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - Jean-François Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - Daniela Andriuta
- Service de Neurologie CHU Amiens et Laboratoire de Neurosciences Fonctionnelles et Pathologies, Université de Picardie Jules Verne, Amiens, France
| | - Pierre Anthony
- Department of Neurology, Hôpitaux Civils de Colmar, F-68000 Colmar, France
| | - Sophie Auriacombe
- Univ. Bordeaux, CNRS UMR 5293, Institut des Maladies Neurodégénératives, Bordeaux, France
| | | | | | - Mélanie Barbay
- Service de Neurologie CHU Amiens et Laboratoire de Neurosciences Fonctionnelles et Pathologies, Université de Picardie Jules Verne, Amiens, France
| | - Yannick Béjot
- Department of Neurology, University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Serge Belliard
- Unité de recherche 1077 INSERM-EPHE-UNICAEN Neuropsychologie & Imagerie de la Mémoire Humaine (NIMH), Caen, France; Centre Mémoire Ressources et Recherche Haute Bretagne, CHU Rennes, Rennes, France
| | - Marie Benaiteau
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Karim Bennys
- Memory Ressources Research Center, Department of Neurology, University Hospital of Montpellier, Montpellier, France
| | - Stéphanie Bombois
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | | | - Pierre Branger
- Department of Neurology, Caen University Hospital, Caen, France
| | - Jasmine Carlier
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Leslie Cartz-Piver
- Memory Ressources Research Center, Department of Neurology, University Hospital of Limoges, France Inserm U1094, IRD U270, EPIMACT, Université of Limoges, Limoges, France
| | | | - Mathieu-Pierre Ceccaldi
- Institute of Neurophysiopathology UMR 7051 Aix Marseille Université & Assistance Publique de Marseille, Marseille, France
| | - Valérie Chauviré
- CMRR, CRMR Neurogénétique, Service de Neurologie, CHU d'ANGERS, Angers, France
| | - Yaohua Chen
- Univ Lille, CHU Lille, Inserm 1172, Memory center, CNRMAJ, LiCEND, Labex DistAlz 59000 Lille, France
| | - Julien Cogez
- Department of Neurology, Caen University Hospital, Caen, France
| | - Emmanuel Cognat
- Cognitive Neurology Center, AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Université Paris Cité, UMR-S 1144, INSERM, Paris, France
| | | | - Léa Corneille
- Institute of Neurophysiopathology UMR 7051 Aix Marseille Université & Assistance Publique de Marseille, Marseille, France
| | | | - Benjamin Cretin
- CMRR d'Alsace, Service de Neurologie, CHU Strasbourg, Strasbourg, France
| | | | - Benjamin Dauriat
- Service de Génétique Médicale, Hopital Mère-Enfant, CHU Limoges, Limoges, France
| | - Sophie Dautricourt
- CMRR Lyon, Department of Neurology, University Hospital of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Vincent de la Sayette
- Department of Neurology, Caen University Hospital, Caen, France; Normandie UNIV, UNICAEN, PSL Research University, EPHE, INSERM, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Astrid de Liège
- Service de Neurologie, APHP, Hôpital Avicenne, Université Sorbonne Paris Nord, Bobigny, France
| | - Didier Deffond
- CMRR Clermont-Ferrand, Service de Neurologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Vincent Deramecourt
- Univ Lille, CHU Lille, Inserm 1172, Memory center, CNRMAJ, LiCEND, Labex DistAlz 59000 Lille, France
| | | | - Elsa Dionet
- CMRR Clermont-Ferrand, Service de Neurologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Martine Doco Fenzy
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France; CHU Nantes, Service de Génétique, Nantes, France; CHU Reims, Service de Génétique, Reims, France
| | - Julien Dumurgier
- Cognitive Neurology Center, AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Université Paris Cité, UMR-S 1144, INSERM, Paris, France
| | - Anaïs Dutray
- Service de Neurologie, Centre Hospitalier Perpignan, Perpignan, France
| | | | - Maïté Formaglio
- CMRR Lyon, Department of Neurology, University Hospital of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Audrey Gabelle
- Memory Ressources Research Center, Department of Neurology, University Hospital of Montpellier, Montpellier, France
| | - Anne Gainche-Salmon
- Centre Mémoire Ressources et Recherche Haute Bretagne, CHU Rennes, Rennes, France
| | - Olivier Godefroy
- Service de Neurologie CHU Amiens et Laboratoire de Neurosciences Fonctionnelles et Pathologies, Université de Picardie Jules Verne, Amiens, France
| | - Mathilde Graber
- Centre mémoire ressources et recherche, CHU Dijon, Dijon, France
| | - Chloé Gregoire
- CHU de Bordeaux, Pôle de Neurosciences Cliniques, Centre Mémoire de Ressources et de Recherche, Bordeaux, France
| | - Stephan Grimaldi
- Institute of Neurophysiopathology UMR 7051 Aix Marseille Université & Assistance Publique de Marseille, Marseille, France
| | - Julien Gueniat
- Centre mémoire ressources et recherche, CHU Dijon, Dijon, France
| | - Claude Gueriot
- Institute of Neurophysiopathology UMR 7051 Aix Marseille Université & Assistance Publique de Marseille, Marseille, France
| | | | - Sophie Haffen
- Centre mémoire Recherche Ressources, Service de Neurologie, CHU Besançon, Besançon, France
| | - Cezara-Roxana Hanta
- Centre Mémoire Ressources et Recherche Haute Bretagne, CHU Rennes, Rennes, France
| | - Clémence Hardy
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France
| | | | - Camille Heitz
- Institut du cerveau Trocadero, Paris, France; Neurology Department, Hôpital Universitaire de Nîmes, Nîmes, France
| | - Claire Hourregue
- Cognitive Neurology Center, AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France
| | - Thérèse Jonveaux
- Centre Mémoire de Ressources et de Recherche de Lorraine Service de Neurologie CHRU Nancy, Nancy, France; Laboratoire 2LPN EA 7489 Université de Lorraine, Nancy, France
| | - Snejana Jurici
- Consultation Mémoire, Service de Gériatrie, Centre Hospitalier Perpignan, Perpignan, France
| | - Lejla Koric
- Institute of Neurophysiopathology UMR 7051 Aix Marseille Université & Assistance Publique de Marseille, Marseille, France; Aix-Marseille Univ, UMR 7249, CNRS, Centrale Marseille, Institut Fresnel, Marseille, France
| | - Pierre Krolak-Salmon
- CMRR Lyon, Department of Neurology, University Hospital of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Julien Lagarde
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France; Université Paris-Cité, F-75006 Paris, France; Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, F-91401, Orsay, France
| | | | - Brice Laurens
- CHU de Bordeaux, Pôle de Neurosciences Cliniques, Centre Mémoire de Ressources et de Recherche, Bordeaux, France
| | - Isabelle Le Ber
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | | | - Amélie Leblanc
- Consultations neurologiques, HIA Clermont-Tonnerre, Brest, France; Service de neurologie, CHU Cavale-Blanche, Brest, France
| | - Thibaud Lebouvier
- Univ Lille, CHU Lille, Inserm 1172, Memory center, CNRMAJ, LiCEND, Labex DistAlz 59000 Lille, France
| | - Richard Levy
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | - Anaïs Lippi
- Service de Neurologie, Hopital Gui de Chauliac, CHU de Montpellier, Montpellier, France
| | | | - Eloi Magnin
- Laboratoire de neuroscience, Université de Franche-Comté UFC et Service de Neurologie, CMRR, CHU Besançon, Besançon, France
| | - Cecilia Marelli
- Service de Neurologie, Hopital Gui de Chauliac, CHU de Montpellier, Montpellier, France
| | - Olivier Martinaud
- Department of Neurology, Caen University Hospital, Caen, France; Normandie UNIV, UNICAEN, PSL Research University, EPHE, INSERM, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | | | - Raffaella Migliaccio
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | - Emilie Milongo-Rigal
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Sophie Mohr
- Centre mémoire ressources et recherche, CHU Dijon, Dijon, France
| | - Hélène Mollion
- CMRR Lyon, Department of Neurology, University Hospital of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Alexandre Morin
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France; Département de Psychiatrie, Centre Hospitalier du Rouvray, Université de Rouen, 76000, Sotteville-lès-Rouen, France
| | | | - Camille Noiray
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France; Université Paris-Cité, F-75006 Paris, France; Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, F-91401, Orsay, France
| | - Pauline Olivieri
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France; Université Paris-Cité, F-75006 Paris, France; Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, F-91401, Orsay, France
| | - Claire Paquet
- Cognitive Neurology Center, AP-HP.Nord, Site Lariboisière Fernand-Widal, Paris, France; Université Paris Cité, UMR-S 1144, INSERM, Paris, France
| | - Jérémie Pariente
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Toulouse NeuroImaging Center (ToNIC), INSERM-University of Toulouse Paul Sabatier, Toulouse, France
| | - Florence Pasquier
- Univ Lille, CHU Lille, Inserm 1172, Memory center, CNRMAJ, LiCEND, Labex DistAlz 59000 Lille, France
| | - Alexandre Perron
- Department of Neurology, Hôpitaux Civils de Colmar, F-68000 Colmar, France
| | - Nathalie Philippi
- CMRR d'Alsace, Service de Neurologie, CHU Strasbourg, Strasbourg, France
| | - Vincent Planche
- Univ. Bordeaux, CNRS UMR 5293, Institut des Maladies Neurodégénératives, Bordeaux, France; CHU de Bordeaux, Pôle de Neurosciences Cliniques, Centre Mémoire de Ressources et de Recherche, Bordeaux, France
| | | | - Marie Rafiq
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Toulouse NeuroImaging Center (ToNIC), INSERM-University of Toulouse Paul Sabatier, Toulouse, France
| | | | - Carole Roué-Jagot
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France; Université Paris-Cité, F-75006 Paris, France; Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, F-91401, Orsay, France
| | - Dario Saracino
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | - Marie Sarazin
- Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France; Université Paris-Cité, F-75006 Paris, France; Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, F-91401, Orsay, France
| | - Mathilde Sauvée
- Centre Mémoire de Ressources et de Recherche, Pôle PReNeLe, CHU Grenoble Alpes CS 10226, 38043 Grenoble Cedex 9, France; Unité de recherche mixte Université Grenoble Alpes/Université Savoie Montblanc, CNRS UMR 5115, Laboratoire de Psychologie et Neurocognition (LPNC), 38000 Grenoble, France
| | - François Sellal
- Department of Neurology, Hôpitaux Civils de Colmar, F-68000 Colmar, France; University of Strasbourg, Medicine Faculty, INSERM, U-1118, Strasbourg, France
| | - Marc Teichmann
- AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | - Christel Thauvin
- Genetics Center, University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Quentin Thomas
- Department of Neurology, University Hospital of Dijon, University of Burgundy, Dijon, France; Genetics Center, University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Camille Tisserand
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Cédric Turpinat
- Service de Neurologie, Hopital Gui de Chauliac, CHU de Montpellier, Montpellier, France
| | - Laurène Van Damme
- Service de Neurologie, Centre Hospitalier Perpignan, Perpignan, France
| | | | - Nicolas Villain
- Sorbonne Université, INSERM U1127, CNRS 7235, Institut du Cerveau - ICM, Paris, France; AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer's Disease, Paris, France
| | | | - Camille Charbonnier
- Univ Rouen Normandie, Inserm U1245 and CHU Rouen, Department of Biostatistics and CNRMAJ, F-76000 Rouen, France
| | - David Wallon
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Neurology and CNRMAJ, F-76000 Rouen, France
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El Kadiri W, Perrignon-Sommet M, Delpont B, Graber M, Mohr S, Mouillot T, Devilliers H, Grall S, Lienard F, Georges M, Brindisi MC, Brondel L, Bejot Y, Leloup C, Jacquin-Piques A. Changes in Taste Perception in Patients with Minor and Major Cognitive Impairment Linked to Alzheimer's Disease Recorded by Gustatory Evoked Potentials. J Alzheimers Dis 2023; 96:1593-1607. [PMID: 38007646 DOI: 10.3233/jad-230270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
BACKGROUND The need for early diagnosis biomarkers in Alzheimer's disease (AD) is growing. Only few studies have reported gustatory dysfunctions in AD using subjective taste tests. OBJECTIVE The main purpose of the study was to explore gustatory functions using subjective taste tests and recordings of gustatory evoked potentials (GEPs) for sucrose solution in patients with minor or major cognitive impairment (CI) linked to AD, and to compare them with healthy controls. The secondary objective was to evaluate the relationships between GEPs and the results of cognitive assessments and fasting blood samples. METHODS A total of 45 subjects (15 healthy subjects, 15 minor CI patients, 15 major CI patients) were included to compare their gustatory functions and brain activity by recording GEPs in response to a sucrose stimulation. CI groups were combined in second analyses in order to keep a high power in the study. Correlations were made with cognitive scores and hormone levels (ghrelin, leptin, insulin, serotonin). RESULTS Increased P1 latencies and reduced N1 amplitudes were observed in minor or major patients compared to controls. GEPs were undetectable in 6 major and 4 minor CI patients. Thresholds for sucrose detection were significantly higher in the major CI group than in controls or the minor CI group. No correlation was found with hormone levels. CONCLUSIONS The cortical processing of sensory taste information seems to be altered in patients with minor or major CI linked to AD. This disturbance was identifiable with subjective taste tests only later, at the major CI stage.
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Affiliation(s)
- Wafa El Kadiri
- Center for Taste and Feeding Behavior, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
- Neurology and Clinical Neurophysiology Department, CHU F. Mitterrand, Dijon, France
| | - Manon Perrignon-Sommet
- Center for Taste and Feeding Behavior, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
| | - Benoit Delpont
- Memory Resource and Research Center (CMRR), CHU F. Mitterrand, Dijon, France
| | - Mathilde Graber
- Memory Resource and Research Center (CMRR), CHU F. Mitterrand, Dijon, France
| | - Sophie Mohr
- Memory Resource and Research Center (CMRR), CHU F. Mitterrand, Dijon, France
| | - Thomas Mouillot
- Center for Taste and Feeding Behavior, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
| | | | - Sylvie Grall
- Center for Taste and Feeding Behavior, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
| | - Fabienne Lienard
- Center for Taste and Feeding Behavior, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
| | - Marjolaine Georges
- Center for Taste and Feeding Behavior, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
| | - Marie-Claude Brindisi
- Center for Taste and Feeding Behavior, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
| | - Laurent Brondel
- Center for Taste and Feeding Behavior, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
| | - Yannick Bejot
- Memory Resource and Research Center (CMRR), CHU F. Mitterrand, Dijon, France
| | - Corinne Leloup
- Center for Taste and Feeding Behavior, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
| | - Agnès Jacquin-Piques
- Center for Taste and Feeding Behavior, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, Dijon, France
- Neurology and Clinical Neurophysiology Department, CHU F. Mitterrand, Dijon, France
- Memory Resource and Research Center (CMRR), CHU F. Mitterrand, Dijon, France
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Abstract
INTRODUCTION Although several variants of Guillain-Barré syndrome (GBS) have been described, they are uncommon, and the atypical clinical presentation of patients makes the diagnosis challenging. This article reports a case of acute bulbar palsy plus (ABPp) syndrome. CASE REPORT A 18-year-old patient was admitted to our hospital because of difficulty swallowing, slurred speech, tingling of the extremities of the 4 limbs, and diplopia. He reported abdominal pain and diarrhea 2 weeks earlier. Physical examination showed a low-pitched voice, palsy elevation of the soft palate and complete palsy of the abduction of the left eye. Electromyography and cerebrospinal fluid examination were unremarkable, but Campylobacter jejuni serology was positive, and we found an isolated immunoglobulin G (IgG) anti-GT1a antibodies positivity. A diagnosis of ABPp was finally made, and the patient fully recovered early after receiving polyvalent immunoglobulins infusion. CONCLUSIONS ABPp is classified as subtype of GBS. The most frequent clinical signs of ABPp are ophthalmoplegia, facial palsy, and ataxia. IgG anti-GT1a and/or anti-GQ1b are positive in a majority of patients with ABPp; however, these antibodies are not specific and can found in other subtypes of GBS.
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Affiliation(s)
- Gaël Brun
- Department of Neurology, University Hospital of Dijon, University of Burgundy, Dijon, France
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El Kadiri W, Delpont B, Mohr S, Leloup C, Brondel L, Bejot Y, Jacquin-Piques A. Étude de la gustation chez les patients ayant des troubles cognitifs mineurs ou majeurs de type Alzheimer, par l’analyse des potentiels évoqués gustatifs. Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Duloquin G, Graber M, Baptiste L, Mohr S, Garnier L, Ndiaye M, Thomas Q, Hervieu-Bègue M, Osseby GV, Giroud M, Béjot Y. [Acute management of spontaneous intracerebral hemorrhage]. Rev Med Interne 2021; 43:293-300. [PMID: 34953622 DOI: 10.1016/j.revmed.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/14/2021] [Indexed: 11/16/2022]
Abstract
Intracerebral hemorrhage accounts for approximately 15% of the 115,000 strokes occurring each year in France. Although therapeutic strategies are more limited than for ischemic stroke, major points in the management of intracerebral hemorrhage can reduce short term morbidity and mortality by limiting the expansion of the hematoma and the occurrence of early complications, and long term patients' outcome by reducing the risk of recurrence. This article aims to update the key elements that contribute to improve of the prognosis of intracerebral hemorrhage patients.
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Affiliation(s)
- G Duloquin
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - M Graber
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - L Baptiste
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - S Mohr
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - L Garnier
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - M Ndiaye
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - Q Thomas
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - M Hervieu-Bègue
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - G-V Osseby
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - M Giroud
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France
| | - Y Béjot
- Service hospitalo-universitaire de neurologie, CHU Dijon Bourgogne, Registre Dijonnais des AVC, EA7460, université de Bourgogne, UBFC, Dijon, France.
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Duloquin G, Graber M, Garnier L, Mohr S, Giroud M, Vergely C, Béjot Y. Assessment of Clinical Scales for Detection of Large Vessel Occlusion in Ischemic Stroke Patients from the Dijon Stroke Registry. J Clin Med 2021; 10:jcm10245893. [PMID: 34945188 PMCID: PMC8708038 DOI: 10.3390/jcm10245893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: The limited availability of thrombectomy-capable stroke centres raises questions about pre-hospital triage of patients with suspected stroke (IS) due to large vessel occlusion (LVO). Aims: This study aimed to evaluate the diagnostic accuracy of clinical stroke severity scales available for LVO detection. (2) Methods: Patients with IS were prospectively identified among residents of Dijon, France, using a population-based registry (2013–2017). Clinical signs and arterial imaging data were collected. LVO was defined as an occlusion site affecting the terminal intracranial internal carotid artery, the M1 segment of the middle cerebral artery (MCA), or the basilar artery (restricted definition). A wide definition of LVO also included the M2 segment of the MCA. For each of the 16 evaluated scales, a receiver operator characteristic (ROC) analysis was performed, and the c-statistic representing the area under the ROC curve was evaluated to assess discrimination for predicting LVO. (3) Results: 971 patients were registered, including 123 patients (12.7%) with an LVO according to the restricted definition. The c-statistic for LVO detection ranged between 0.66 and 0.80 according to the different scales, with a sensibility varying from 70% to 98% and a specificity from 33% to 86%. According to the wide definition of LVO (174 patients, 17.9%), the c-statistic was slightly lower, ranging between 0.64 and 0.79. The sensitivity was 59% to 93%, and the specificity was 34% to 89%. (4) Conclusion: The clinical scales failed to combine a high sensitivity and a high specificity to detect LVO. Further studies are needed to determine the best strategy for pre-hospital triage of IS patients.
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Affiliation(s)
- Gauthier Duloquin
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Mathilde Graber
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Lucie Garnier
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Sophie Mohr
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Maurice Giroud
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Catherine Vergely
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
| | - Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University of Burgundy, 21078 Dijon, France; (G.D.); (M.G.); (L.G.); (S.M.); (M.G.); (C.V.)
- Department of Neurology, University Hospital of Dijon, 21000 Dijon, France
- Correspondence:
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Duloquin G, Graber M, Baptiste L, Mohr S, Garnier L, Ndiaye M, Blanc-Labarre C, Hervieu-Bègue M, Osseby GV, Giroud M, Béjot Y. [Management of ischemic stroke in the acute phase]. Rev Med Interne 2021; 43:286-292. [PMID: 34481684 DOI: 10.1016/j.revmed.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/01/2021] [Indexed: 12/24/2022]
Abstract
Ischemic stroke accounts for 80% of overall stroke, and is one of the leading causes of death, disability and dementia in worldwide. Management of patients with acute ischemic stroke dramatically improved over time with the implementation of intensive care stroke units, the development of acute recanalization strategies, the optimization of the management of post-stroke complications, and the prevention of early stroke recurrence. The objective of this article is to provide a general overview of the current management of patients with acute ischemic stroke aiming at improving post-stroke outcome.
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Affiliation(s)
- G Duloquin
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - M Graber
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - L Baptiste
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - S Mohr
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - L Garnier
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - M Ndiaye
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - C Blanc-Labarre
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - M Hervieu-Bègue
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - G-V Osseby
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - M Giroud
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France
| | - Y Béjot
- EA7460, UBFC, registre dijonnais des AVC, service hospitalo-universitaire de neurologie, CHU de Dijon-Bourgogne, université de Bourgogne, Dijon, France.
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Béjot Y, Duloquin G, Thomas Q, Mohr S, Garnier L, Graber M, Giroud M. Temporal Trends in the Incidence of Ischemic Stroke in Young Adults: Dijon Stroke Registry. Neuroepidemiology 2021; 55:239-244. [PMID: 34044406 DOI: 10.1159/000516054] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/22/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Stroke is associated with major consequences in terms of socioeconomic impact and lost disability-adjusted life in young victims, thus justifying a careful surveillance of epidemiological trends. This study aimed to assess changes in the incidence of ischemic stroke in young adults over a long period. METHODS All cases of first-ever ischemic stroke that occurred among adults aged 18-55 years were prospectively recorded using the population-based Dijon Stroke Registry, from 1985 to 2017. Sex-specific annual incidence rates were calculated and were presented according to 6 time periods. Incidence rate ratios (IRRs) were determined to assess sex differences in stroke incidence. RESULTS Over the whole study period, 4,451 patients suffered a first-ever ischemic stroke. Among these patients, 469 (10.5%) were young adults (median age: 46 years, IQR: 39-50; 53.9% men). Incidence rates rose from the study period 2003 to 2007 compared with previous periods and remained stable thereafter, both in men and women. Hence, incidence per 100,000 per year was globally 11.0 (95% CI: 9.4-12.7) before 2003 and 22.9 (20.3-25.6) thereafter. In individuals aged 18-45 years, incidence rates were 5.4 (4.3-6.9) overall, 4.1 (2.7-6.0) in men, and 6.7 (4.9-9.0) in women, before 2003. After 2003, incidence rates rose to 12.8 (10.7-15.1) overall, 12.0 (9.2-15.4) in men, and 13.6 (10.6-17.0) in women. In this age group, the men/women IRR was 0.78 (95% CI: 0.62-1.26, p = 0.08), although sex differences decreased over time (IRR = 0.62; 95% CI: 0.36-1.02, p = 0.046 before 2003, vs. IRR = 0.88; 95% CI: 0.62-1.26, p = 0.48 after 2003). In individuals aged 45-55 years, incidence rates before 2003 were 47 (37-61) in men and 25 (17-35) in women (IRR = 1.90; 95% CI: 1.24-2.97, p < 0.001), and they increased to 82 (67-100) in men and 46 (35-59) in women (IRR = 1.79; 95% CI: 1.29-2.49, p < 0.001) after 2003. CONCLUSIONS The incidence of ischemic stroke in young adults increased during the early 2000s and remained stable thereafter. These results highlight the priority need for dedicated prevention strategies for the young to reduce the burden of stroke.
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Affiliation(s)
- Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Gauthier Duloquin
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Quentin Thomas
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Sophie Mohr
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Lucie Garnier
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Mathilde Graber
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Maurice Giroud
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
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Sauvant M, Thomas Q, Mohr S, Blanc-Labarre C, Béjot Y, Delpont B. Opsoclonus and Neuroborreliosis: Can't See the Forest for the Trees. Neurol Clin Pract 2021; 11:e6-e7. [PMID: 33968479 DOI: 10.1212/cpj.0000000000000824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/26/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Marie Sauvant
- Department of Neurology, University Hospital of Dijon Burgundy, France
| | - Quentin Thomas
- Department of Neurology, University Hospital of Dijon Burgundy, France
| | - Sophie Mohr
- Department of Neurology, University Hospital of Dijon Burgundy, France
| | | | - Yannick Béjot
- Department of Neurology, University Hospital of Dijon Burgundy, France
| | - Benoit Delpont
- Department of Neurology, University Hospital of Dijon Burgundy, France
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Béjot Y, Duloquin G, Graber M, Garnier L, Mohr S, Giroud M. Current characteristics and early functional outcome of older stroke patients: a population-based study (Dijon Stroke Registry). Age Ageing 2021; 50:898-905. [PMID: 33009911 DOI: 10.1093/ageing/afaa192] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND the ongoing growing and ageing population is associated with an increase in older patients suffering a stroke. We aimed to assess the current profile of these patients in a population-based setting. METHODS all patients with acute stroke were prospectively identified among residents of Dijon, France, between 2013 and 2017, using a population-based registry. Characteristics and early outcome of patients were compared according to age groups. RESULTS 1,288 stroke cases were recorded (median age: 81.1 years, interquartile range: 66.1-86.7, 54% women). Patients aged 75-85 years and those >85 years accounted for 27.6 and 33.9% of overall cases. Increasing age was associated with a greater prevalence of vascular risk factors, pre-existing cognitive impairment and handicap, higher initial severity, more frequent cardioembolic ischemic stroke, post-stroke pulmonary infection and delirium. Only 41% of patients aged 75-85 years and 18% of those aged >85 years had a good early recovery. Compared with patients aged <75 years, patients aged 75-85 years [adjusted odds ratio (OR) = 2.61; 95% confidence interval (CI): 1.74-3.93, P < 0.001] and those aged >85 years (adjusted OR = 7.18; 95% CI: 4.58-11.3, P < 0.001) had an increased risk of poor post-stroke functional outcome. Among survivors, the proportion of patients discharged to home was 60% in age group <75 years, compared with 49% in patients aged 75-85 years and 29% in those aged >85 years. Thirty per cent of patients >85 years old required a long-term care institution. CONCLUSION the increasing burden of stroke in older people has major implications for future treatment strategies and need for dedicated care facilities.
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Affiliation(s)
- Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, UBFC, Dijon, France
| | - Gauthier Duloquin
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, UBFC, Dijon, France
| | - Mathilde Graber
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, UBFC, Dijon, France
| | - Lucie Garnier
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, UBFC, Dijon, France
| | - Sophie Mohr
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, UBFC, Dijon, France
| | - Maurice Giroud
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, UBFC, Dijon, France
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Thomas Q, Duloquin G, Mohr S, Osseby GV, Giroud M, Béjot Y. Superficial Siderosis of the Central Nervous System associated with Hemophilia A: A case report. Interdisciplinary Neurosurgery 2021. [DOI: 10.1016/j.inat.2020.100912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Höhn D, Mohr S, Mueller MD, Kuhn A. Sexual function after resection of urethral diverticulum. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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13
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Duloquin G, Graber M, Garnier L, Crespy V, Comby PO, Baptiste L, Mohr S, Delpont B, Guéniat J, Blanc-Labarre C, Hervieu-Bègue M, Osseby GV, Giroud M, Béjot Y. Incidence of Acute Ischemic Stroke With Visible Arterial Occlusion. Stroke 2020; 51:2122-2130. [DOI: 10.1161/strokeaha.120.029949] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose:
Because of several methodological limitations, previous studies focusing on the prevalence of large vessel occlusion in ischemic stroke (IS) patients provided conflicting results. We evaluated the incidence of IS with a visible arterial occlusion using a comprehensive population-based registry.
Methods:
Patients with acute IS were prospectively identified among residents of Dijon, France, using a population-based registry (2013–2017). All arterial imaging exams were reviewed to assess arterial occlusion. Annual incidence rates of IS (first-ever and recurrent events) and IS with a visible occlusion were calculated.
Results:
One thousand sixty cases of IS were recorded (mean age: 76.0±15.8 years, 53.9% women). Information about arterial imaging was available in 971 (91.6%) of them, and only preexisting dementia was independently associated with having missing information (odds ratio=0.34 [95% CI, 0.18–0.65],
P
=0.001). Among these patients, 284 (29.2%) had a visible arterial occlusion. Occlusion site was the anterior circulation in 226 patients (23.3% of overall patients with available data) and the posterior circulation in 58 patients (6.0%). A proximal occlusion of the anterior circulation was observed in 167 patients (17.2%). The crude annual incidence rate of total IS per 100 000 was 138 (95% CI, 129–146). Corresponding standardized rates were 66 (95% CI, 50–82) to the World Health Organization and 141 (95% CI, 118–164) to the 2013 European populations. The crude annual incidence rate of IS with a visible arterial occlusion per 100 000 was 37 (95% CI, 33–41) and that of IS with a proximal occlusion of the anterior circulation was 22 (95% CI, 18–25). Corresponding standardized rates were 18 (95% CI, 10–26) and 10 (95% CI, 8–13) to the World Health Organization population, and 38 (95% CI, 26–50) and 23 (95% CI, 19–26) to the 2013 European population, respectively.
Conclusions:
These results will be helpful to plan the need for thrombectomy-capable stroke center resources.
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Affiliation(s)
- Gauthier Duloquin
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Mathilde Graber
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Lucie Garnier
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Valentin Crespy
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Pierre-Olivier Comby
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Laura Baptiste
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Sophie Mohr
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Benoit Delpont
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Julien Guéniat
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Christelle Blanc-Labarre
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Marie Hervieu-Bègue
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Guy-Victor Osseby
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Maurice Giroud
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
| | - Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), Department of Neurology, University of Burgundy, University Hospital of Dijon, France
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Chaters GL, Johnson PCD, Cleaveland S, Crispell J, de Glanville WA, Doherty T, Matthews L, Mohr S, Nyasebwa OM, Rossi G, Salvador LCM, Swai E, Kao RR. Analysing livestock network data for infectious disease control: an argument for routine data collection in emerging economies. Philos Trans R Soc Lond B Biol Sci 2020; 374:20180264. [PMID: 31104601 DOI: 10.1098/rstb.2018.0264] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Livestock movements are an important mechanism of infectious disease transmission. Where these are well recorded, network analysis tools have been used to successfully identify system properties, highlight vulnerabilities to transmission, and inform targeted surveillance and control. Here we highlight the main uses of network properties in understanding livestock disease epidemiology and discuss statistical approaches to infer network characteristics from biased or fragmented datasets. We use a 'hurdle model' approach that predicts (i) the probability of movement and (ii) the number of livestock moved to generate synthetic 'complete' networks of movements between administrative wards, exploiting routinely collected government movement permit data from northern Tanzania. We demonstrate that this model captures a significant amount of the observed variation. Combining the cattle movement network with a spatial between-ward contact layer, we create a multiplex, over which we simulated the spread of 'fast' ( R0 = 3) and 'slow' ( R0 = 1.5) pathogens, and assess the effects of random versus targeted disease control interventions (vaccination and movement ban). The targeted interventions substantially outperform those randomly implemented for both fast and slow pathogens. Our findings provide motivation to encourage routine collection and centralization of movement data to construct representative networks. This article is part of the theme issue 'Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control'. This theme issue is linked with the earlier issue 'Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes'.
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Affiliation(s)
- G L Chaters
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - P C D Johnson
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - S Cleaveland
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - J Crispell
- 2 School of Veterinary Medicine, University College Dublin , Dublin , Ireland
| | - W A de Glanville
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - T Doherty
- 3 Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh , Easter Bush Campus, Midlothian EH25 9RG , UK
| | - L Matthews
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - S Mohr
- 1 Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G12 8QQ , UK
| | - O M Nyasebwa
- 6 Department of Veterinary Services, Ministry of Livestock and Fisheries, Nelson Mandela Road , Dar Es Salaam , Tanzania
| | - G Rossi
- 3 Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh , Easter Bush Campus, Midlothian EH25 9RG , UK
| | - L C M Salvador
- 3 Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh , Easter Bush Campus, Midlothian EH25 9RG , UK.,4 Department of Infectious Diseases, University of Georgia , Athens, GA 30602 , USA.,5 Institute of Bioinformatics, University of Georgia , Athens, GA 30602 , USA
| | - E Swai
- 6 Department of Veterinary Services, Ministry of Livestock and Fisheries, Nelson Mandela Road , Dar Es Salaam , Tanzania
| | - R R Kao
- 3 Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh , Easter Bush Campus, Midlothian EH25 9RG , UK
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Borras L, Boucherie M, Mohr S, Lecomte T, Perroud N, Huguelet P. Increasing self-esteem: Efficacy of a group intervention for individuals with severe mental disorders. Eur Psychiatry 2020; 24:307-16. [DOI: 10.1016/j.eurpsy.2009.01.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Accepted: 01/18/2009] [Indexed: 10/21/2022] Open
Abstract
AbstractBackgroundIndividuals with psychosis are known to have a lower self-esteem compared to the general population, in part because of social stigma, paternalistic care, long periods of institutionalization and negative family interactions. This study aimed at assessing the efficacy of a self-esteem enhancement program for individuals with severe mental illness and at analyzing the results in their European context.MethodA randomized cross-over study including 54 outpatients with a diagnosis of schizophrenia from Geneva, Switzerland, was conducted. Twenty-four were recruited from an outpatient facility receiving traditional psychiatric care whereas 30 came from an outpatient facility with case-management care. Psychosocial, diagnostic and symptom measures were taken for all the subjects before treatment, after treatment, and at 3-months' follow-up.ResultsResults indicated significant positive self-esteem module effects on self-esteem, self-assertion, active coping strategies and symptom for the participants receiving case-management care. Results were not significant for those receiving traditional care. However, 71% of all participants expressed satisfaction with the module.ConclusionIndividuals with schizophrenia appear to be benefit from the effects of the self-esteem module, particularly when they are involved in a rehabilitation program and followed by a case manager who liaises with the other partners of the multidisciplinary team. This encourages reconsidering the interventions' format and setting in order to ensure lasting effects on the environment and in turn on coping, self-esteem and overall empowerment.
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Graber M, Garnier L, Mohr S, Delpont B, Blanc-Labarre C, Vergely C, Giroud M, Béjot Y. Influence of Pre-Existing Mild Cognitive Impairment and Dementia on Post-Stroke Mortality. The Dijon Stroke Registry. Neuroepidemiology 2019; 54:490-497. [PMID: 31593950 DOI: 10.1159/000497614] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 02/06/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We assessed the association between pre-stroke cognitive status and 90-day case-fatality. METHODS Patients with ischemic stroke (IS) or spontaneous intracerebral hemorrhage (ICH) were prospectively identified among residents of Dijon, France, between 2013 and 2015, using a population-based registry. Association between pre-stroke cognitive status and case-fatality at 90 days was evaluated using Cox regression. RESULTS Seven hundred sixty-two patients were identified, and information about pre-stroke cognitive status was obtained for 716 (92.6%) of them, including 603 IS (84.2%) and 113 ICH (15.8%). Before stroke, 99 (13.8%) patients had mild cognitive impairment (MCI) and 98 (13.7%) had dementia. Patients with cognitive impairment were older, had a higher prevalence of several risk factors, more severe stroke, more frequent ICH, and less admission to stroke unit. Case-fatality rate at 90 days was 11.7% in patients without cognitive impairment, 32.3% in MCI patients, and 55.1% in patients with dementia. In multivariable analyses, pre-existing MCI (hazard ratio [HR] 2.22, 95% CI 1.21-4.05, p = 0.009) and dementia (HR 4.35, 95% CI 2.49-7.61, p < 0.001) were both associated with 90-day case-fatality. CONCLUSION Pre-stroke MCI and dementia were both associated with increased mortality. These associations were not fully explained by baseline characteristics, pre-stroke dependency, stroke severity or patient management, and underlying reasons need to be investigated.
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Affiliation(s)
- Mathilde Graber
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Lucie Garnier
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Sophie Mohr
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Benoit Delpont
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Christelle Blanc-Labarre
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Catherine Vergely
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Maurice Giroud
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France,
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Graber M, Garnier L, Duloquin G, Mohr S, Guillemin S, Ramaget O, Piver A, Tainturier C, Bret-Legrand C, Delpont B, Blanc-Labarre C, Guéniat J, Hervieu-Bègue M, Osseby GV, Giroud M, Béjot Y. Association Between Fatigue and Cognitive Impairment at 6 Months in Patients With Ischemic Stroke Treated With Acute Revascularization Therapy. Front Neurol 2019; 10:931. [PMID: 31555198 PMCID: PMC6724763 DOI: 10.3389/fneur.2019.00931] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/12/2019] [Indexed: 01/01/2023] Open
Abstract
Background: Fatigue is a frequent symptom after stroke. We aimed to determine the association between fatigue and cognitive performance in patients with ischemic stroke who received acute revascularization therapy (IV thrombolysis and/or mechanical thrombectomy). Methods: Seventy patients were prospectively included in the stroke unit of the University Hospital of Dijon, France. A follow-up was performed at 6 months with clinical examination, fatigue assessment by the Fatigue Severity Scale (FSS), and a comprehensive neuropsychological evaluation. Patients with fatigue (FSS score >4) were compared with patients without fatigue. Neuropsychological factors associated with fatigue at 6 months were analyzed using multivariable logistic regression models. Results: Fatigue was reported by 34.3% of patients. Patients with fatigue were older, had more frequent residual handicap, depressive symptoms, and impaired quality of life. They had more frequently low score (<26) on the MoCA scale (79.2 vs. 47.8%, OR = 4.15; 95% CI: 1.32-13, p = 0.015), memory impairment (60 vs. 30.6%, OR = 3.41; 95% CI: 1.09-10.7, p = 0.035), and executive dysfunction (65 vs. 30.8%, OR = 4.18; 95% CI: 1.33-13.1, p = 0.014). In multivariable logistic regression analysis, only memory impairment was independently associated with fatigue (OR = 5.70; 95% CI: 1.09-29.6, p = 0.039). Further analyses restricted to non-depressed patients (n = 58, 84.1%) showed in multivariable models that a score < 26 on MoCA scale (OR 5.12; 95% CI: 1.00-26.2, p = 0.05), and a memory impairment (OR = 6.17; 95% CI: 1.06-35.9, p = 0.043) were associated with fatigue. There was also a non-significant trend toward an association between divided attention deficit and fatigue (OR = 6.79; 95% CI: 0.80-57.6, p = 0.079). Conclusion: The association between fatigue and subtle cognitive impairment including memory or attention deficits could be of interest in elaborating future interventional studies to evaluate the impact of therapeutic strategies, including cognitive rehabilitation, on fatigue.
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Affiliation(s)
- Mathilde Graber
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Lucie Garnier
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Gauthier Duloquin
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Sophie Mohr
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Sophie Guillemin
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Océane Ramaget
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Ariane Piver
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Cécile Tainturier
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Christine Bret-Legrand
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Benoit Delpont
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Christelle Blanc-Labarre
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Julien Guéniat
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Marie Hervieu-Bègue
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Guy-Victor Osseby
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Maurice Giroud
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
| | - Yannick Béjot
- Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France
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Graber M, Mohr S, Baptiste L, Duloquin G, Blanc-Labarre C, Mariet AS, Giroud M, Béjot Y. Air pollution and stroke. A new modifiable risk factor is in the air. Rev Neurol (Paris) 2019; 175:619-624. [PMID: 31153597 DOI: 10.1016/j.neurol.2019.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 12/19/2022]
Abstract
Evidence from epidemiological studies has demonstrated that outdoor air pollution is now a well-known major problem of public health, mainly in low and middle income countries. Contrasting with myocardial infarction, there are few data on the association of air pollution and stroke. METHODS We propose a narrative literature review of the effects and the underlying biological mechanisms of short- and long-term exposure to air pollutants on stroke risk and mortality, using the following key-words: stroke, cerebrovascular events, ischemic and haemorrhage stroke, transient ischaemic attack, mortality, air pollution and air pollutants. RESULTS Twenty-one papers were selected. Air pollution, of which whose small particulate matter are the most toxic, contributes to about one-third of the global burden of stroke. We can identify vulnerable patients with classical neuro-vascular risk factors or a prior history of stroke or transient ischemic attack or persons living in low-income countries. Biological mechanisms of this new morbid association are discussed. CONCLUSION Air pollution should be recognized as a silent killer inducing stroke whose mortality rates remain elevated by its role as a new modifiable neurovascular risk factor, needing public health policies.
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Affiliation(s)
- M Graber
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
| | - S Mohr
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
| | - L Baptiste
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
| | - G Duloquin
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
| | - C Blanc-Labarre
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
| | - A S Mariet
- Clinical investigation center of Dijon (Inserm CIC 1432), university of Burgundy and Franche Comté, Inserm, biostatistique, biomathématique, pharmacoepidemiologie et maladies infectieuses (B2 PHI), UMR 1181, university Hospital of Dijon, Dijon, France
| | - M Giroud
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France.
| | - Y Béjot
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
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Graber M, Baptiste L, Mohr S, Blanc-Labarre C, Dupont G, Giroud M, Béjot Y. A review of psychosocial factors and stroke: A new public health problem. Rev Neurol (Paris) 2019; 175:686-692. [PMID: 31130312 DOI: 10.1016/j.neurol.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/11/2019] [Indexed: 11/15/2022]
Abstract
The role of psychosocial factors (PSF) in increased risk of stroke is a novel public health challenge, but unclear definitions for PSF and the multiple stroke subtypes have led to inconsistent reports. A review of this issue is therefore warranted. METHODS Several databases were used for this narrative systematic review (Medline, Embase and Cochrane Library). Two independent reviewers evaluated articles from between 2001 and 2018 on the themes of PSF and stroke/transient ischemic attack (TIA). PSF criteria were job strain, psychological interpersonal and behavioral stress, and social deprivation. Ischemic and hemorrhagic stroke and TIA subtypes were also identified. RESULTS Forty-five cohorts, five case-control studies and two meta-analyses were included. Despite mixed results, PSF were associated with an increased risk of ischemic and hemorrhagic stroke in populations of all ages, and more predominantly in women. CONCLUSION This broad review shows that the presence of PSF is associated with an increased risk stroke and TIA. As such, PSF must figure in both public health policy and stroke prevention programs, similar to other established metabolic and environmental factors.
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Affiliation(s)
- M Graber
- Service de neurologie générale, vasculaire et dégénérative, Registre Dijonnais des AVC (Inserm, santé publique France, EA7460), university of Burgundy and Franche Comté, CHU Dijon Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France
| | - L Baptiste
- Service de neurologie générale, vasculaire et dégénérative, Registre Dijonnais des AVC (Inserm, santé publique France, EA7460), university of Burgundy and Franche Comté, CHU Dijon Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France
| | - S Mohr
- Service de neurologie générale, vasculaire et dégénérative, Registre Dijonnais des AVC (Inserm, santé publique France, EA7460), university of Burgundy and Franche Comté, CHU Dijon Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France
| | - C Blanc-Labarre
- Service de neurologie générale, vasculaire et dégénérative, Registre Dijonnais des AVC (Inserm, santé publique France, EA7460), university of Burgundy and Franche Comté, CHU Dijon Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France
| | - G Dupont
- Service de neurologie générale, vasculaire et dégénérative, Registre Dijonnais des AVC (Inserm, santé publique France, EA7460), university of Burgundy and Franche Comté, CHU Dijon Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France
| | - M Giroud
- Service de neurologie générale, vasculaire et dégénérative, Registre Dijonnais des AVC (Inserm, santé publique France, EA7460), university of Burgundy and Franche Comté, CHU Dijon Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France.
| | - Y Béjot
- Service de neurologie générale, vasculaire et dégénérative, Registre Dijonnais des AVC (Inserm, santé publique France, EA7460), university of Burgundy and Franche Comté, CHU Dijon Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France
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Mohr S, Bertoux M, Leroy M, Pasquier F, Deramecourt V, Lebouvier T. Les formes temporales non-sémantiques des dégénérescences lobaires fronto-temporales sont majoritairement des taupathies. Rev Neurol (Paris) 2019. [DOI: 10.1016/j.neurol.2019.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hathiramani D, Ali A, Anda G, Barbui T, Biedermann C, Charl A, Chauvin D, Czymek G, Dhard C, Drewelow P, Dudek A, Effenberg F, Ehrke G, Endler M, Ennis D, Fellinger J, Ford O, Freundt S, Gradic D, Grosser K, Harris J, Hölbe H, Jakubowski M, Knaup M, Kocsis G, König R, Krause M, Kremeyer T, Kornejew P, Krychowiak M, Lambertz H, Jenzsch H, Mayer M, Mohr S, Neubauer O, Otte M, Perseo V, Pilopp D, Rudischhauser L, Schmitz O, Schweer B, Schülke M, Stephey L, Szepesi T, Terra A, Toth M, Wenzel U, Wurden G, Zoletnik S, Pedersen TS. Upgrades of edge, divertor and scrape-off layer diagnostics of W7‐X for OP1.2. Fusion Engineering and Design 2018. [DOI: 10.1016/j.fusengdes.2018.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Guéniat J, Brenière C, Graber M, Garnier L, Mohr S, Giroud M, Delpont B, Blanc-Labarre C, Durier J, Giroud M, Béjot Y. Increasing Burden of Stroke: The Dijon Stroke Registry (1987–2012). Neuroepidemiology 2018; 50:47-56. [DOI: 10.1159/000486397] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 12/17/2017] [Indexed: 11/19/2022] Open
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Müller U, Schuermann F, Dobrowolny H, Frodl T, Bogerts B, Mohr S, Steiner J. Assessment of Pharmacological Treatment Quality: Comparison of Symptom-triggered vs. Fixed-schedule Alcohol Withdrawal in Clinical Practice. Pharmacopsychiatry 2016; 49:199-203. [DOI: 10.1055/s-0042-104508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- U. Müller
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany
| | - F. Schuermann
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany
| | - H. Dobrowolny
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany
| | - T. Frodl
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany
| | - B. Bogerts
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany
| | - S. Mohr
- Department of Psychiatry and Psychotherapy at Langenhangen, Hospitals of Hannover Region, Hannover, Germany
| | - J. Steiner
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany
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Huguelet P, Brandt PY, Mohr S. [The assessment of spirituality and religiousness in patients with psychosis]. Encephale 2016; 42:219-25. [PMID: 26806141 DOI: 10.1016/j.encep.2015.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 12/09/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES There is evidence that psychiatrists are rarely aware of how religion may intervene in their patient's life. That is particularly obvious concerning patients with psychosis. Yet, even for patients featuring delusions with religious content, religious activities and spiritual coping may have a favourable influence. Indeed, patients with psychosis can use religion to cope with life difficulties related to their psychotic condition, in a social perspective but also in order to gain meaning in their lives. Also, religion may be part of explanatory models about their disorder with, in some cases, a significant influence on treatment adhesion. PATIENTS AND METHODS This paper describes a prospective randomized study about a spiritual assessment performed by the psychiatrists of patients with schizophrenia. The outpatient clinics in which the sample was collected are affiliated with the department of psychiatry at the university hospitals of Geneva. Eighty-four outpatients with psychosis were randomized into two groups: an experimental group receiving both traditional treatment and spiritual assessment with their psychiatrist and a control group of patients receiving only their usual treatment. Psychiatrists were supervised by a clinician (PH) and a psychologist of religions (PYB) for each patient in the spiritual assessment group. Data were collected from both groups before and after 3 months of clinical follow-up. RESULTS Spiritual assessment was well-tolerated by all patients. Moreover, their wish to discuss religious matters with their psychiatrist persisted following the spiritual assessment. Even though clinicians acknowledged the usefulness of the supervision for some patients, especially when religion was of importance for clinical care, they reported being moderately interested in applying spiritual assessments in clinical settings. Compared to the control group, there were no differences observed in the 3 months' outcome in terms of primary outcome measures for satisfaction with care, yet the attendance at the appointments was significantly increased in the group with spiritual assessment. The same result was found when restricting analyses to patients for whom an intervention was suggested or patients who invested more in religion. Areas of potential intervention were frequent both in a psychiatric and psychotherapeutical perspective. CONCLUSIONS Spiritual assessment appears to be useful for patients with psychosis. This is in accordance with the recommendations of the World Psychiatric Association which promotes considering the whole person in clinical care. Spiritual assessment is quite simple to perform, providing that clinicians do not prescribe or promote religion, and that no critical comments are made concerning religious issues. Clinicians do not need to know in depth the religious domains of each of their patients, as it appears that each patient accommodates his/her religious background his/her own way.
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Affiliation(s)
- P Huguelet
- Département de santé mentale et de psychiatrie, hôpitaux universitaires de Genève, 8, rue du 31-Decembre, 1207 Genève, Suisse.
| | - P-Y Brandt
- Faculty of Theology, Lausanne University, BFSH 2, 1015 Lausanne, Suisse
| | - S Mohr
- Département de santé mentale et de psychiatrie, hôpitaux universitaires de Genève, 8, rue du 31-Decembre, 1207 Genève, Suisse
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Planchette C, Pichler H, Wimmer-Teubenbacher M, Gruber M, Gruber-Woelfler H, Mohr S, Tetyczka C, Hsiao WK, Paudel A, Roblegg E, Khinast J. Printing medicines as orodispersible dosage forms: Effect of substrate on the printed micro-structure. Int J Pharm 2015; 509:518-527. [PMID: 26541301 DOI: 10.1016/j.ijpharm.2015.10.054] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/28/2015] [Accepted: 10/22/2015] [Indexed: 11/18/2022]
Abstract
We present our recent advancements in developing a viable manufacturing process for printed medicine. Our approach involves using a non-contact printing system that incorporates both piezoelectric- and solenoid valve-based inkjet printing technologies, to deliver both active and inactive pharmaceutical materials onto medical-graded orodispersible films. By using two complimentary inkjet technologies, we were able to dispense an extensive range of fluids, from aqueous drug solutions to viscous polymer coating materials. Essentially, we demonstrate printing of a wide range of formulations for patient-ready, orodispersible drug dosage forms, without the risk of drug degradation by ink heating and of substrate damages (by contact printing). In addition, our printing process has been optimized to ensure that the drug doses can be loaded onto the orally dissolvable films without introducing defects, such as holes or tears, while retaining a smooth surface texture that promotes patient adherence and allows for uniform post-coatings. Results show that our platform technology can address key issues in manufacturing orodispersible drug dosage forms and bring us closer to delivering personalized and precision medicine to targeted patient populations.
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Affiliation(s)
- C Planchette
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria; University of Technology, Institute of Fluid Mechanics and Heat Transfer, Graz, Austria.
| | - H Pichler
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria
| | | | - M Gruber
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria
| | - H Gruber-Woelfler
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria; University of Technology, Institute of Process and Particle Technology, Graz, Austria
| | - S Mohr
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria
| | - C Tetyczka
- Karl-Franzens University, Institute of Pharmaceutical Sciences, Department Pharmaceutical Technology, Graz, Austria
| | - W-K Hsiao
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria
| | - A Paudel
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria
| | - E Roblegg
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria; Karl-Franzens University, Institute of Pharmaceutical Sciences, Department Pharmaceutical Technology, Graz, Austria
| | - J Khinast
- Research Center Pharmaceutical Engineering GmbH, Graz, Austria; University of Technology, Institute of Process and Particle Technology, Graz, Austria
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Backhaus K, Roeder N, Bunzemeier H, Mohr S, Leifke C. Strategische Zukunftsplanung mithilfe der Szenarioanalyse. Z Herz- Thorax- Gefäßchir 2015. [DOI: 10.1007/s00398-015-0013-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Huguelet P, Mohr S, Boucherie M, Yaron M, Perroud N, Bianchi-Demicheli F. [An exploration of sexual desire and sexual activities of women with psychosis]. Rev Med Suisse 2015; 11:1691-1695. [PMID: 26591078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Most clinicians avoid discussing sexuality with patients with severe mental disorders. Sexual disturbances can be related to medication, to psychological issues such as self-stigma and anhedonia, and to the social context. We studied desire and sexual practices in women suffering from schizophrenia, in comparison with healthy women. Contrary to previous research, women with schizophrenia featured dyadic and individual desire similar to women of comparable age. Yet, only half of women with psychosis had sexual practice, either alone or with a partner. They were less satisfied with their activity, both in terms of function and psychological issues such as sexual self-esteem. This finding underscores the stigmatization these women suffer from, which prevents the opportunity of a possible improvement in this important interpersonal domain.
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Mohr S, Schott J, Hoenemann L, Feibicke M. Glyceria maxima as new test species for the EU risk assessment for herbicides: a microcosm study. Ecotoxicology 2015; 24:309-320. [PMID: 25380672 DOI: 10.1007/s10646-014-1379-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2014] [Indexed: 06/04/2023]
Abstract
In its recent guidance document on tiered risk assessment for plant protection products for aquatic organisms, the European Food Safety Authority (EFSA) proposed to use Glyceria maxima as monocotyledonous grass species for the testing of special herbicide groups. However, published toxicity data for this species is very limited and there is no test guideline for Glyceria sp. For this reason a microcosm study was conducted in order to gain experience on the degree of sensitivity of G. maxima to the herbicidal substances clodinafop-propargyl (grass herbicide) and fluroxypyr (auxin) in comparison to the already established test organism water milfoil Myriophyllum spicatum and the duckweed species Landoltia punctata. Five concentrations without replicates were tested for each test substance using 10 microcosms and three microcosms served as controls. The experiment was run for 8 weeks. Morphological endpoints were used to determine growth and EC50 values. The results show that M. spicatum was most sensitive to fluroxypyr (37 days EC50 for roots: 62 µg/L) and G. maxima most sensitive to clodinafop-propargyl (22 days EC50 for total shoot length: 48 µg/L) whereas the duckweed species was considerable less sensitive. Hence, G. maxima turns out to be a good candidate for testing grass specific herbicides, supporting its inclusion as an additional macrophyte test for the risk assessment of herbicides as proposed by the EFSA.
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Affiliation(s)
- S Mohr
- Umweltbundesamt, Schichauweg 58, 12307, Berlin, Germany,
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Simoes E, Kronenthaler A, Rieger M, Rall KK, Schäffeler N, Hiltner H, Gröber-Grätz D, Ueding E, Mohr S, Brucker SY. Studie zur Gestaltung der Transitionsversorgung bei Seltenen Erkrankungen am Beispiel von Patientinnen mit genitalen Fehlbildungen – Design und erste Ergebnisse (BMBF Förderkennzeichen 01GY1125). Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Christmann C, Christoph P, Mohr S, Brandner S, Imboden S, Kuhn A. Is obstruction an issue after adjustable sling insertion for recurrent stress urinary incontinence? Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Mohr S, Schott J, Maletzki D, Hünken A. Effects of toxicants with different modes of action on Myriophyllum spicatum in test systems with varying complexity. Ecotoxicol Environ Saf 2013; 97:32-39. [PMID: 23928028 DOI: 10.1016/j.ecoenv.2013.06.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 06/25/2013] [Accepted: 06/27/2013] [Indexed: 06/02/2023]
Abstract
At the international workshop Aquatic Macrophyte Risk Assessment for Pesticides (AMRAP), it was noted that the EU risk assessment under the directive 91/414/EEC for herbicides, based only on algae and the monocotyledonous duckweed species Lemna sp., offers no certain protection against some growth regulating auxins. Therefore, AMRAP members proposed the introduction of the dicotyledonous water milfoil Myriophyllum as additional test species. This study was aimed to compare toxicity results from three test systems (TS) with varying complexity, namely Water TS, Sediment TS and Microcosm TS using Myriophyllum spicatum as test organism. As test substances, the photosynthesis inhibiting herbicide isoproturon, the growth regulating auxins fluroxypyr and 2,4-dichlorophenoxyacetic acid (2,4-D), and the non-specific acting toxicant 3,5-dichlorophenol (3,5-DCP) were chosen. It was assessed if and why the sensitivity of M. spicatum towards the four toxicants varied in the different test systems and if the addition of sucrose to the medium used in the Water TS had an effect on the sensitivity of Myriophyllum. All TS were suitable for detecting negative effects of toxicants with different modes of action on M. spicatum. The lowest variability of endpoints was found in the Water TS with lowest experimental complexity. For auxins, the endpoint weight did not result in robust EC50 values in all TS, whereas root related endpoints, which are also ecologically relevant, turned out to be very sensitive with low variance. Sucrose in the medium of the Water TS did not seem to influence the sensitivity of M. spicatum towards isoproturon and 3,5-DCP but may have increased the sensitivity of M. spicatum roots when exposed to 2,4-D. However, the findings of all TS resulted in similar risk estimations if root endpoints were not considered.
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Affiliation(s)
- S Mohr
- Umweltbundesamt, Schichauweg 58, 12307 Berlin, Germany.
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Böttger R, Schaller J, Mohr S. Closer to reality--the influence of toxicity test modifications on the sensitivity of Gammarus roeseli to the insecticide imidacloprid. Ecotoxicol Environ Saf 2012; 81:49-54. [PMID: 22575057 DOI: 10.1016/j.ecoenv.2012.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 04/09/2012] [Accepted: 04/14/2012] [Indexed: 05/31/2023]
Abstract
Laboratory toxicity test designs are far from reality and therefore extrapolations to field situations may be more difficult. In laboratory experiments with the amphipod Gammarus roeseli exposed to the insecticide imidacloprid it was investigated if test conditions closer to reality influences its sensitivity and if it is possible to extrapolate results from these laboratory tests to results from a stream mesocosm study. Experiments were run by varying medium, temperature, size, and seasonal origin of gammarids. Age and seasonal aspects had strongest effects with juveniles and animals taken from a spring population being most sensitive with an EC₅₀ (96 h) of 14.2 μg L⁻¹ imidacloprid. The test designs closest to the conditions in the stream mesocosms reflected best the results in mesocosms study on basis of LOEC values. However, the EC(x) extrapolation failed to predict the effects of short term imidacloprid pulses in the field.
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Affiliation(s)
- R Böttger
- Umweltbundesamt, Schichauweg 58, 12307 Berlin, Germany.
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Winter J, Mohr S, Pantelis A, Kraus D, Allam JP, Novak N, Reich R, Martini M, Jepsen S, Götz W, Wenghoefer M. IGF-1 deficiency in combination with a low basic hBD-2 and hBD-3 gene expression might counteract malignant transformation in pleomorphic adenomas in vitro. Cancer Invest 2012; 30:106-13. [PMID: 22250586 DOI: 10.3109/07357907.2011.640651] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study investigated the IGF-1-influence on oncological relevant genes in pleomorphic adenomas. Therefore A64-tumor cells were stimulated by recombinant IGF-1. After RNA-extraction, transcript levels of hBD-1, hBD-2, hBD-3, DEFA1/3, DEFA4, S100A4, Psoriasin, DOC-1, EGF, EGFR, and IGFR were analyzed by qRT-PCR at t = 0, 4, 8, 24, 48, and 72 hr. The gene-products were visualized by immunostaining. A64-tumor-cells were deficient for hBD-1 and IGF-1. IGF-1 downregulates hBD-2 and hBD-3 without influencing hBD-1-expression. IGF-1 only slightly affects DEFA1/3-, DEFA4-, S100A4-, Psoriasin-, DOC-1-, EGF-, EGFR-, and IGFR-gene-expression. IGF-1-deficiency combined with low basic hBD-2-gene-expression and hBD-3-gene-expression might counteract, whereas hBD-1-deficiency promotes malignant transformation in pleomorphic adenomas.
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Affiliation(s)
- J Winter
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Welschnonnenstr, Bonn, Germany
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Huguelet P, Mohr S, Gilliéron C, Brandt PY, Borras L. Religious explanatory models in patients with psychosis: a three-year follow-up study. Psychopathology 2010; 43:230-9. [PMID: 20424504 DOI: 10.1159/000313521] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2009] [Accepted: 12/10/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Spirituality and religiousness have been shown to be highly prevalent in patients with psychosis. Yet the influence of religious denomination as it affects coping methods and/or as an explanatory model for illness and treatment remains to be determined. This study aims (1) to investigate if religious denomination is associated with explanatory models, (2) to assess the evolution over time of these explanatory models, and (3) to examine the relationship between these explanatory models and the spiritual vision of treatment and adhesion to such treatment. SAMPLING AND METHODS Of an initial cohort of 115 outpatients, 80% (n = 92) participated in a 3-year follow-up study. The evolution of their religious explanatory models was assessed in order to evaluate if religious denomination, as a meaning-making coping tool, is associated with the patients' explanatory models. Finally, we examined the relationship between these representations and the patients' spiritual visions of treatment and treatment adhesion. RESULTS A spiritual vision of the illness (as part of an explanatory model) was more frequent in patients with psychosis for whom the subjective dimension of religion was important. However, there was no association between the patients' religious denomination and their spiritual vision of the illness. The analyses showed that the various contents of spiritual visions of illness were not positive or negative per se; instead, they depended on how this religious vision was integrated into the person's experience. Examining longitudinal aspects of coping showed that the spiritual vision sometimes changed, but was not associated with clinical or social outcome. CONCLUSIONS For patients with psychosis, explanatory models frequently involve a religious component which is independent of denomination and likely to change over time. Clinicians should address this issue on a regular basis, by asking patients about their explanatory model before trying to build a bridge with the medical model.
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Affiliation(s)
- P Huguelet
- Division of Adult Psychiatry, University Hospital of Geneva and University of Geneva, Rue du 31-Décembre 36, Geneva, Switzerland.
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Mohr S, Schröder H, Feibicke M, Berghahn R, Arp W, Nicklisch A. Long-term effects of the antifouling booster biocide Irgarol 1051 on periphyton, plankton and ecosystem function in freshwater pond mesocosms. Aquat Toxicol 2008; 90:109-120. [PMID: 18817992 DOI: 10.1016/j.aquatox.2008.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Revised: 07/23/2008] [Accepted: 08/03/2008] [Indexed: 05/26/2023]
Abstract
Irgarol is a highly effective biocide used in antifouling coatings to prevent the growth of periphyton. Environmental concentrations of Irgarol in marine and freshwater have often exceeded the effect concentrations of autotrophic organisms tested in the laboratory and give reason for concern that natural periphyton communities may be endangered. A 150 days freshwater mesocosm study in 8 indoor ponds was conducted at nominal concentrations between 0.04 and 5 microgL(-1) in order to investigate the effects of Irgarol on periphyton and plankton. The results demonstrated that periphyton communities were strongly affected after single applications of 1 and 5 microgL(-1) Irgarol. For these concentrations no recovery was observed in the course of the study. For chlorophytes, the EC(50) (nominal, 135 days) was 0.34 microgL(-1). Phytoplankton also decreased in abundance directly after Irgarol application but recovered after a few weeks, as Irgarol concentrations rapidly decreased in the water body and nutrient levels increased due to lack of competition with periphyton and macrophytes. Zooplankton was indirectly affected by Irgarol. Principle response curve analysis revealed a species shift from macrophyte associated zooplankton species to free-swimming species. For species of cyclopoid copepods and ostracods the EC(50) was, respectively, 0.09 and 0.11 microgL(-1). The study simulated a best-case scenario since the mesocosms were dosed only once. Under field conditions, however, permanent exposure of organisms to Irgarol is more likely due to permanent leaching from painted ship hulls. Therefore, the effects presented in this study most likely underestimate the effects under natural conditions.
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Affiliation(s)
- S Mohr
- Federal Environment Agency, Schichauweg 58, 12307 Berlin, Germany.
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Mohr S, Portmann-Lanz BC, Schoeberlein A, Sager R, Surbek DV. Placenta mesenchymal stem cells on a chorion scaffold as a potential osteogenic graft for peripartal bone regeneration. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1088660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Mohr S, Feibicke M, Berghahn R, Schmiediche R, Schmidt R. Response of plankton communities in freshwater pond and stream mesocosms to the herbicide metazachlor. Environ Pollut 2008; 152:530-42. [PMID: 17719156 DOI: 10.1016/j.envpol.2007.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2007] [Revised: 06/18/2007] [Accepted: 07/12/2007] [Indexed: 05/16/2023]
Abstract
Metazachlor is a frequently used herbicide with concentrations in surface waters up to 100 microg L(-1). A long-term mesocosm study was performed in order to investigate effects on stream and pond communities also regarding recovery. Single metazachlor doses of 5, 20, 80, 200, and 500 microg L(-1) were given and the aquatic communities monitored for 140 days. In this paper, special attention is paid to the plankton response and the results of the entire study are summarised. Metazachlor strongly affected the stream and pond mesocosm communities at concentrations higher than 5 microg L(-1). Direct negative effects were most prominent for chlorophytes whereas diatoms and cryptophytes seemed insensitive. The effects on zooplankton were caused by changes in habitat structure due to the strong decline of macrophytes. The slow degradation of metazachlor combined with the absence of recovery in both chlorophytes and macrophytes is likely to cause long-lasting effects on aquatic ecosystems.
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Affiliation(s)
- S Mohr
- Umweltbundesamt, Schichauweg 58, 12307 Berlin, Germany.
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Abstract
The study examined how religious beliefs and practices impact upon medication and illness representations in chronic schizophrenia. One hundred three stabilized patients were included in Geneva's outpatient public psychiatric facility in Switzerland. Interviews were conducted to investigate spiritual and religious beliefs and religious practices and religious coping. Medication adherence was assessed through questions to patients and to their psychiatrists and by a systematic blood drug monitoring. Thirty-two percent of patients were partially or totally nonadherent to oral medication. Fifty-eight percent of patients were Christians, 2% Jewish, 3% Muslim, 4% Buddhist, 14% belonged to various minority or syncretic religious movements, and 19% had no religious affiliation. Two thirds of the total sample considered spirituality as very important or even essential in everyday life. Fifty-seven percent of patients had a representation of their illness directly influenced by their spiritual beliefs (positively in 31% and negatively in 26%). Religious representations of illness were prominent in nonadherent patients. Thirty-one percent of nonadherent patients and 27% of partially adherent patients underlined an incompatibility or contradiction between their religion and taking medication, versus 8% of adherent patients. Religion and spirituality contribute to shaping representations of disease and attitudes toward medical treatment in patients with schizophrenia. This dimension should be on the agenda of psychiatrists working with patients with schizophrenia.
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Mohr S, Berghahn R, Feibicke M, Meinecke S, Ottenströer T, Schmiedling I, Schmiediche R, Schmidt R. Effects of the herbicide metazachlor on macrophytes and ecosystem function in freshwater pond and stream mesocosms. Aquat Toxicol 2007; 82:73-84. [PMID: 17353057 DOI: 10.1016/j.aquatox.2007.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2006] [Revised: 02/06/2007] [Accepted: 02/07/2007] [Indexed: 05/14/2023]
Abstract
The chloroacetamide metazachlor is a commonly used pre-emergent herbicide to inhibit growth of plants especially in rape culture. It occurs in surface and ground water due to spray-drift or run-off in concentrations up to 100 microgL(-1). Direct and indirect effects of metazachlor on aquatic macrophytes were investigated at oligo- to mesotrophic nutrient levels employing eight stream and eight pond indoor mesocosms. Five systems of each type were dosed once with 5, 20, 80, 200 and 500 microgL(-1) metazachlor and three ponds and three streams served as controls. Pronounced direct negative effects on macrophyte biomass of Potamogeton natans, Myriophyllum verticillatum and filamentous green algae as well as associated changes in water chemistry were detected in the course of the summer 2003 in both pond and stream mesocosms. Filamentous green algae dominated by Cladophora glomerata were the most sensitive organisms in both pond and stream systems with EC(50) ranging from 3 (streams) to 9 (ponds) microgL(-1) metazachlor. In the contaminated pond mesocosms with high toxicant concentrations (200 and 500 microgL(-1)), a species shift from filamentous green algae to the yellow-green alga Vaucheria spec. was detected. The herbicide effects for the different macrophyte species were partly masked by interspecific competition. No recovery of macrophytes was observed at the highest metazachlor concentrations in both pond and stream mesocosms until the end of the study after 140 and 170 days. Based on the lowest EC(50) value of 4 microgL(-1) for total macrophyte biomass, it is argued that single exposure of aquatic macrophytes to metazachlor to nominal concentrations >5 microgL(-1) is likely to have pronounced long-term effects on aquatic biota and ecosystem function.
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Affiliation(s)
- S Mohr
- Federal Environment Agency, Schichauweg 58, D-12307 Berlin, Germany.
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Zourob M, Simonian A, Wild J, Mohr S, Fan X, Abdulhalim I, Goddard NJ. Optical leaky waveguide biosensors for the detection of organophosphorus pesticides. Analyst 2007; 132:114-20. [PMID: 17260070 DOI: 10.1039/b612871h] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Organophosphorus (OP) pesticides can be rapidly detected by integrating organophosphorus hydrolase with an optical leaky waveguide biosensor. This enzyme catalyses the hydrolysis of a wide range of organophosphorus compounds causing an increase in the pH. Thus, the direct detection of OP is possible by monitoring of the pH changes associated with the enzyme's activity. This article describes the use of an optical, leaky waveguide clad with absorbing materials for the detection of OP pesticides by measuring changes in refractive index, absorbance and fluorescence. In the most effective configuration, a thick sensing layer was used to increase the amount of immobilized enzyme and to increase the light interaction with the sensing layer, resulting in a greatly enhanced sensitivity. The platforms developed in this work were successfully used to detect paraoxon and parathion down to 4 nM concentrations.
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Affiliation(s)
- M Zourob
- School of Chemical Engineering and Analytical Science, University of Manchester, Manchester, UK.
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Rihn B, Mohr S. 88 Oxidative stress gene modulation in pleural mesothelioma as assessed by microarray in vitro, ex-vivo, and in-situ analysis. Lung Cancer 2006. [DOI: 10.1016/s0169-5002(07)70164-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mohr S, Borras L, Gillieron C, Brandt PY, Huguelet P. [Spirituality, religious practices and schizophrenia: relevance for the clinician]. Rev Med Suisse 2006; 2:2092-4, 2096-8. [PMID: 17073175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Religion (spirituality and religiousness) is salient in the lives of many people suffering from schizophrenia. In order to assess religious coping in schizophrenia, we developed a clinical grid, as no validated questionnaire exists for this population. Religion had a positive effect for 71% and a negative effect for 14% of the 115 patients interviewed. Religion influences the sense of self, symptoms, social functioning, the comorbidity of substance abuse, suicidal attempts and adherence to treatment. Then religion is relevant for treatment and should be evaluated systematically. The forementioned clinical grid is suitable for this purpose. It proved its applicability to a broad diversity of religious beliefs, even pathological ones. Inter-judge reliability and construct validity were high and specific training is not required.
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Affiliation(s)
- S Mohr
- Service de psychiatrie adulte-secteur I, Département de psychiatrie, HUG, Genève.
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Portmann-Lanz CB, Mohr S, Schoeberlein A, Huber A, Sager R, Malek A, Holzgreve W, Surbek DV. Placental mesenchymal stem cells: A novel autologous stem cell graft for peripartum neural regeneration? Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Bollig G, Mohr S, Raeder J. McArdle's disease and anaesthesia: case reports. Review of potential problems and association with malignant hyperthermia. Acta Anaesthesiol Scand 2005; 49:1077-83. [PMID: 16095447 DOI: 10.1111/j.1399-6576.2005.00755.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND McArdle's disease of isolated deficiency in glycogen degradation in skeletal muscles has the potential of creating perioperative anaesthesiological problems; such as hypoglycaemia, rhabdomyolysis, myoglobinuria, acute renal failure and possibly malignant hyperthermia. METHODS Eight patients with McArdle's disease were asked about previous surgery, anaesthesia and perioperative problems, and available hospital records were reviewed. Existing literature was reviewed for reports on McArdle's disease and anaesthesia. RESULTS The eight patients had 35 anaesthesias (23 general anaesthesias, three regional anaesthesias and nine local anaesthesias). Perioperative problems of a non-specific nature were mentioned in three cases of general anaesthesia: two with postoperative nausea/vomiting, and one with an episode of tachycardia and low blood pressure. Three patients were tested for malignant hyperthermia (MH) using the in vitro contracture test (IVCT); two of them with a positive result. The literature search revealed seven case reports of McArdle's disease and anaesthesia. Apart from one report of hyperthermia, pulmonary oedema and rhabdomyolysis; probably not associated with MH, no problems were encountered from the literature search. CONCLUSION McArdle's disease does not seem to cause severe perioperative problems in routine anaesthetic care. However, measures for preventing muscle ischaemia and rhabdomyolysis should be kept in mind, as well as the potential for these patients to develop postoperative fatigue, myoglobinuria and renal failure. Although no clinical association with malignant hyperthermia has been established, many of these patients can have a positive in vitro contracture test, and simple prophylactic measures, as with malignant hyperthermia, may be recommended if otherwise not contraindicated.
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Affiliation(s)
- G Bollig
- Department of Anaesthesiology, Ullevål University Hospital, Oslo, Norway.
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Mohr S, Neuville A, Bottin MC, Micillino JC, Keith G, Rihn BH. Immune Signature of Malignant Pleural Mesothelioma as Assessed by Transcriptome Analysis. Cancer Genomics Proteomics 2005; 2:125-135. [PMID: 31394644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2005] [Accepted: 04/13/2005] [Indexed: 06/10/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is a highly malignant tumor arising in patients previously exposed to asbestos fibers. Its increasing incidence and its social, financial and human impact have become a frequent problem in many industrialized countries. The unresponsiveness of malignant mesothelioma to conventional therapies has led clinicians to develop new treatments. As immunotherapy has been shown to offer promising and targeted treatment of MPM patients, the knowledge of the immunoresistance level of MPM may be a valuable tool for "à la carte" therapy. In a previous work, we profiled the gene expression of two MPM tissues compared to healthy mesothelial cells using a 10K cDNA microarray. Subsequent clustering analysis identified several clusters of differentially-expressed genes among those that are functionally-related to the immune system. In this report, we focus on genes with expression changes that may facilitate tumor escape from immune-mediated rejection. We also analyzed the immune reaction by staining the immunocompetent cells surrounding the tumor. Interestingly, the tumor with the strongest escape response, as shown by the expression of numerous immunoresistance-associated genes, displayed the strongest T cell infiltrate. The main genes conferring immunoresistance are CD74, HLADOA, HLADMB, PTGS1, IGFBP7 and TGFB3, by favoring immune tolerance, and CFLAR, DFFA, TNFRSF6, BNIP3L by impairing apoptosis. These observations have fundamental consequences in the understanding of immunological properties of MPM, and offer a new insight into the mechanisms whereby MPM may circumvent host-mediated immune activities and promotes its own development. For an immunomodulation strategy to cure mesothelioma, it is crucial to characterize the MPM "immune signature" to design adapted immunotherapies.
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Affiliation(s)
- S Mohr
- Institut National de Recherche et de Sécurité, Avenue de Bourgogne, BP27, 54501 Vandoeuvre
- Institut de Biologie Moléculaire et Cellulaire du Centre National de la Recherche Scientifique, UPR 9002, Rue René Descartes, 67084 Strasbourg
| | - A Neuville
- Service d'Anatomie Pathologique, CHU de Hautepierre, 67098 Strasbourg
| | - M C Bottin
- Institut National de Recherche et de Sécurité, Avenue de Bourgogne, BP27, 54501 Vandoeuvre
| | - J C Micillino
- Institut National de Recherche et de Sécurité, Avenue de Bourgogne, BP27, 54501 Vandoeuvre
| | - G Keith
- Institut de Biologie Moléculaire et Cellulaire du Centre National de la Recherche Scientifique, UPR 9002, Rue René Descartes, 67084 Strasbourg
| | - B H Rihn
- INSERM U525, 30 Rue Lionnois, 54000 Nancy, France
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Sturm A, Leite AZA, Danese S, Krivacic KA, West GA, Mohr S, Jacobberger JW, Fiocchi C. Divergent cell cycle kinetics underlie the distinct functional capacity of mucosal T cells in Crohn's disease and ulcerative colitis. Gut 2004; 53:1624-31. [PMID: 15479683 PMCID: PMC1774268 DOI: 10.1136/gut.2003.033613] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Different abnormalities of T cell effector function distinguish Crohn's disease (CD) from ulcerative colitis (UC). Because cell cycling determines effector function, pathogenic events in CD and UC may depend on cell cycle changes unique to each condition. METHODS Cell cycle kinetics, cycle regulatory molecule expression, apoptosis, caspase and telomerase activity, and cellular expansion were evaluated in CD2 and CD3 activated control, CD, and UC lamina propria T cells. RESULTS Compared with normal cells, CD T cells cycle faster, express increased phosphorylated Rb and decreased phosphorylated p53 levels, display less caspase activity but more telomerase activity, die less, and undergo vigorous cellular expansion. In contrast, UC T cells cycle slower, express normal levels of phosphorylated Rb and p53, display more caspase activity but have no telomerase activity, die more, and have a limited capacity to expand. CONCLUSIONS T cell cycle abnormalities in CD indicate a state of hyperreactivity compatible with loss of tolerance, but a hyporeactive state compatible with anergy in UC. Thus distinct and divergent T cell cycle characteristics underlie the pathogenesis of the two main forms of inflammatory bowel disease.
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Affiliation(s)
- A Sturm
- Department of Medicine, University Hospitals of Cleveland, Case Western Reserve University School of Medicine (BRB 425), 10900 Euclid Ave, Cleveland, Ohio, 44106-4952, USA
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Siest G, Jeannesson E, Berrahmoune H, Maumus S, Marteau JB, Mohr S, Visvikis S. Pharmacogenomics and drug response in cardiovascular disorders. Pharmacogenomics 2004; 5:779-802. [PMID: 15469403 DOI: 10.1517/14622416.5.7.779] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
There are a total of 17 families of drugs that are used for treating the heterogeneous group of cardiovascular diseases. We propose a comprehensive pharmacogenomic approach in the field of cardiovascular therapy that considers the five following sources of variability: the genetics of pharmacokinetics, the genetics of pharmacodynamics (drug targets), genetics linked to a defined pathology and its corresponding drug therapies, the genetics of physiologic regulation, and environmental–genetic interactions. Examples of the genetics of pharmacokinetics are presented for phase I (cytochromes P450) and phase II (conjugating enzymes) drug-metabolizing enzymes and for phase III drug transporters. The example used to explain the genetics of pharmacodynamics is glycoprotein IIIa and the response to antiplatelet effects of aspirin. Genetics linked to a defined pathology and its corresponding drug therapies is exemplified by ADRB1, ACE, CETP and APOE and drug response in metabolic syndrome. The examples of cytochrome P450s, APOE and ADRB2 in relation to ethnicity, age and gender are presented to describe genetics of physiologic regulation. Finally, environmental–genetic interactions are exemplified by CYP7A1 and the effects of diet on plasma lipid levels, and by APOE and the effects of smoking in cardiovascular disease. We illustrate this five-tiered approach using examples of cardiovascular drugs in relation to genetic polymorphism.
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Affiliation(s)
- G Siest
- Université Henri Poincaré, INSERM U525, Nancy I, Faculté de Pharmacie, 30 rue Lionnois, 54000 Nancy, France.
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Mohr S, Simon A, Favrod J, Fokianos C, Ferrero F. Validation de la version française du Profil des compétences de vie (Life Skills Profile) chez des personnes atteintes de schizophrénie. Encephale 2004; 30:343-51. [PMID: 15538309 DOI: 10.1016/s0013-7006(04)95446-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Since the discovery of neuroleptics and the reintegration of people with schizophrenia in the community, psycho-social reeducation became an essential part of the treatment. The Life Skills Profile is a tool of reference for assessment of the dimensions, which have an impact on the adaptation in community. Each item describes an observable behavior, written in common language, to allow the care-givers and the family to evaluate it without having a specific formation. The long version (39 items) is recommended for therapeutic interventions with a person and the short one (20 items) for large scale studies on outcome in community. AIM OF THE STUDY In order to dispose of a measure of function and disability in schizophrenia, we have translated the Life Skills Profile (LSP) in French and tested the validity of this translation for the long version (39 items) and the short ones (16 and 20 items). The 4 dimensions of the 16-items version--"withdrawal", "self-care", "compliance" and "antisocial"--were used for people with mental disorders and the 20-items version enhanced with a fifth dimension "bizarre", especially useful for people with schizophrenia. METHOD 175 people suffering of schizophrenia (DSM IV, codes F20.0 to F20.5) were evaluated by their caregivers in 3 settings: psychiatric hospital, ambulatory care and sheltered homes. Confirmatory factorial analyses were performed to test the dimensional models and their psychometric characteristics were established. RESULTS The original structure in 5 dimensions of the long version (39 items) is not confirmed. However, the short versions in 16 and 20 items were confirmed, without any modification. The required psychometric qualities of reliability and validity of the 20-items version were fulfilled. The inter-rater reliability ranged from 0.65 to 0.75 for the 5 dimensions; the test-retest reliability ranged from 0.80 to 0.91 and the internal consistency from 0.67 to 0.81. The validity was evaluated by comparison of the LSP scores upon living arrangements (people living in sheltered homes had lesser scores) and pathologies (19 people with severe major depression had higher scores). CONCLUSION The 39-items version of the Life Skills Profile was not validated in French. However, for clinical practice of social rehabilitation, this tool remains useful for a single person to check specific behaviors, which could hinder his/her integration into the community, to plan specific interventions and to evaluate changes, in addition with other scales. By the validation of the short version of the Life Skills Profile, an instrument is at disposal in French for outcome studies which allow to: 1) quickly assess the social functioning of person suffering of schizophrenia by a caregiver or a family member; 2) to detect insufficient skills in specific domains; and 3) to evaluate therapeutic efficiency.
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Affiliation(s)
- S Mohr
- Hôpitaux Universitaires de Genève, Département de Psychiatrie, Genève, Suisse
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