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Adèle Demain G. W. Max Westby Sara Fernandez-Vidal Carine Karachi Fabrice Bonneville Manh Cuong Do Christine Delmaire Didier Dormont Eric Bardinet Yves Agid Nathalie Chastan Marie-Laure Welter 《Journal of neurology》2014,261(1):196-206
The pathophysiology of gait and balance disorders in elderly people with ‘higher level gait disorders’ (HLGD) is poorly understood. In this study, we aimed to identify the brain networks involved in this disorder. Standardised clinical scores, biomechanical parameters of gait initiation and brain imaging data, including deep white matter lesions (DWML) and brain voxel-based morphometry analyses, were assessed in 20 HLGD patients in comparison to 20 age-matched controls. In comparison to controls, HLGD patients presented a near-normal preparatory phase of gait initiation, but a severe alteration of both locomotor and postural parameters of first-step execution, which was related to ‘axial’ hypokinetic-rigid signs. HLGD patients showed a significant grey matter reduction in the mesencephalic locomotor region (MLR) and the left primary motor cortex. This midbrain atrophy was related to the severity of clinical and neurophysiologically determined balance deficits. HLGD patients also showed a reduction in speed of gait, related to ‘appendicular’ hypokinetic-rigid signs and frontal-lobe-like cognitive deficits. These last two symptoms were correlated with the severity of DWML, found in 12/20 HLGD patients. In conclusion, these data suggest that the gait and balance deficits in HLGD mainly result from the lesion or dysfunction of the network linking the primary motor cortex and the MLR, brain regions known to be involved in the control of gait and balance, whereas cognitive and ‘appendicular’ hypokinetic-rigid signs mainly result from DWML that could be responsible for a dysfunction of the frontal cortico-basal ganglia loops. 相似文献
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Diane Paris MD David Rousset MD Fabrice Bonneville MD PhD Nelly Fabre MD Stanislas Faguer MD PhD Françoise Huguet-Rigal MD Claire Larcher MD Charlotte Martin MD Diane Osinski MD François Gaussiat MD Louis Delamarre MD David Brauge MD Olivier Fourcade MD PhD Thomas Geeraerts MD PhD Ségolène Mrozek MD PhD 《Headache》2020,60(10):2583-2588
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Fabrice Compain Ana Babosan Sylvain Brisse Nathalie Genel Jennifer Audo Florent Ailloud Najiby Kassis-Chikhani Guillaume Arlet Dominique Decré 《Journal of clinical microbiology》2014,52(12):4377-4380
A single multiplex PCR assay targeting seven virulence factors and the wzi gene specific for the K1 and K2 capsular serotypes of Klebsiella pneumoniae was developed and tested on 65 clinical isolates, which included 45 isolates responsible for community-acquired severe human infections. The assay is useful for the surveillance of emerging highly virulent strains. 相似文献
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Marlène Amara Stéphane Bonacorsi Jér?me Bedel Jean-Paul Mira Virginie Laurent Koryna Socha Fabrice Bruneel Béatrice Pangon Jean-Pierre Bédos David Grimaldi 《Journal of clinical microbiology》2014,52(12):4404-4406
We describe an exceptional case of life-threatening group A Escherichia coli-induced purpura fulminans. Genotyping of common polymorphisms in genes involved in innate immunity or coagulation did not reveal known susceptibility to such a manifestation. Genetic analysis of the strain revealed an unusual conserved virulence plasmidic region, pointing out its potential virulence. 相似文献
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Antoine Néel Benoit Henry Sebastien Barbarot Agathe Masseau François Perrin Claire Bernier Xavier Kyndt Xavier Puechal Pierre-Jean Weiller Olivier Decaux Jacques Ninet Arnaud Hot Achille Aouba Leonardo Astudillo Jean-Marie Berthelot Fabrice Bonnet Jean-Marie Brisseau Bérangère Cador Fabienne Closs-Prophette Thomas Dejoie Jean-Dominique de Korwin Robin Dhote Renato Fior Bernard Grosbois Eric Hachulla Pierre-Yves Hatron Henry Jardel David Launay Adrien Lorleac'h Pierre Pottier Guillaume Moulis Jacques Serratrice Amar Smail Mohamed Hamidou 《Autoimmunity reviews》2014,13(10):1035-1041
The aim of this study is to assess the long-term effectiveness and safety of IL1Ra in Schnitzler syndrome (SchS). Between 2010 and 2012, we performed a nationwide survey among French internal medicine departments to identify SchS patients. We retrospectively analyzed the long-term efficacy and safety of IL1Ra and the outcome of patients that did not receive this treatment. Forty-two patients were included in the study, 29 of whom received IL1Ra. The mean age at disease onset was 59.9 years. Disease manifestations included urticaria (100%), fever (76%), bone/joint pain (86%), bone lesions (76%), anemia (67%), and weight loss (60%). The monoclonal gammopathy was overwhelmingly IgM kappa (83%). The mean follow-up was 9.5 years (range: 1.6-35). Two patients developed Waldenström's macroglobulinemia and one developed AA amyloidosis. All of the 29 patients who received IL1Ra responded dramatically. After a median follow-up of 36 months (range: 2-79), the effectiveness remained unchanged. All patients remained on anti-IL-1 therapy. Twenty-four patients (83%) went into complete remission and five (17%) into partial remission. Three patients experienced grade 3-4 neutropenia. Six patients developed severe infections. No lymphoproliferative diseases occurred while on IL1Ra. When last seen, all patients without anakinra had an active disease with variable impact on their quality of life. Their median corticosteroids dosage was 6 mg/d (range: 5-25). IL1Ra is effective in SchS, with a sharp corticosteroid-sparing effect. Treatment failures should lead to reconsider the diagnosis. Long-term follow-up revealed no loss of effectiveness and a favorable tolerance profile. The long-term effects on the risk of hemopathy remain unknown. 相似文献