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771.
772.
Hjalmar?Jochem?van?Ommen Aurore?Thibaut Audrey?Vanhaudenhuyse Lizette?Heine Vanessa?Charland-Verville Sarah?Wannez Olivier?Bodart Steven?Laureys Olivia?GosseriesEmail author 《Journal of neurology》2018,265(6):1376-1380
Introduction
Resistance to eye opening (REO) is a commonly encountered phenomenon in clinical practice. We aim to investigate whether REO is a sign of consciousness or a reflex in severely brain-injured patients.Methods
We recorded REO in chronic patients with disorders of consciousness during a multimodal diagnostic assessment. REO evaluations were performed daily in each patient and clinical diagnosis of unresponsive wakefulness syndrome (UWS), minimally conscious state with (MCS+) or without (MCS?) preserved language processing was made using the Coma Recovery Scale-Revised (CRS-R).Results
Out of 150 consecutive patients, 79 patients fit inclusion criteria. REO was seen in 19 patients (24.1%). At the group level, there was a significant relationship between the presence of REO and the level of consciousness. We also observed a difference in the repeatability of REO between patients in UWS, MCS? and MCS+. Out of 23 patients in UWS, six showed REO, in whom five showed atypical brain patterns activation.Conclusion
Our findings suggest a voluntary basis for REO and stress the need for multiple serial assessments of REO in these patients, especially since most patients show fluctuating levels of consciousness.773.
A. T. O'Brien G. Torrealba‐Acosta R. Huerta F. Fregni A. Thibaut 《European journal of neurology》2018,25(8):1017-1026
The aim of this study was to determine whether non‐invasive brain stimulation (NIBS) techniques improve fine motor performance in stroke. We searched PubMed, EMBASE, Web of Science, SciELO and OpenGrey for randomized clinical trials on NIBS for fine motor performance in stroke patients and healthy participants. We computed Hedges’ g for active and sham groups, pooled data as random‐effects models and performed sensitivity analysis on chronicity, montage, frequency of stimulation and risk of bias. Twenty‐nine studies (351 patients and 152 healthy subjects) were reviewed. Effect sizes in stroke populations for transcranial direct current stimulation and repeated transcranial magnetic stimulation were 0.31 [95% confidence interval (CI), 0.08–0.55; P = 0.010; Tau2, 0.09; I2, 34%; Q, 18.23; P = 0.110] and 0.46 (95% CI, 0.00–0.92; P = 0.05; Tau2, 0.38; I2, 67%; Q, 30.45; P = 0.007). The effect size of non‐dominant healthy hemisphere transcranial direct current stimulation on non‐dominant hand function was 1.25 (95% CI, 0.09–2.41; P = 0.04; Tau2, 1.26; I2, 93%; Q, 40.27; P < 0.001). Our results show that NIBS is associated with gains in fine motor performance in chronic stroke patients and healthy subjects. This supports the effects of NIBS on motor learning and encourages investigation to optimize their effects in clinical and research settings. 相似文献
774.
Bas Calcoen Nico Callewaert Aline Vandenbulcke Winnie Kerstens Maya Imbrechts Thomas Vercruysse Kai Dallmeier Johan Van Weyenbergh Piet Maes Xavier Bossuyt Dorinja Zapf Kersten Dieckmann Kim Callebaut Hendrik Jan Thibaut Karen Vanhoorelbeke Simon F. De Meyer Wim Maes Nick Geukens 《Viruses》2022,14(6)
To mitigate the massive COVID-19 burden caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), several vaccination campaigns were initiated. We performed a single-center observational trial to monitor the mid- (3 months) and long-term (10 months) adaptive immune response and to document breakthrough infections (BTI) in healthcare workers (n = 84) upon BNT162b2 vaccination in a real-world setting. Firstly, serology was determined through immunoassays. Secondly, antibody functionality was analyzed via in vitro binding inhibition and pseudovirus neutralization and circulating receptor-binding domain (RBD)-specific B cells were assessed. Moreover, the induction of SARS-CoV-2-specific T cells was investigated by an interferon-γ release assay combined with flowcytometric profiling of activated CD4+ and CD8+ T cells. Within individuals that did not experience BTI (n = 62), vaccine-induced humoral and cellular immune responses were not correlated. Interestingly, waning over time was more pronounced within humoral compared to cellular immunity. In particular, 45 of these 62 subjects no longer displayed functional neutralization against the delta variant of concern (VoC) at long-term follow-up. Noteworthily, we reported a high incidence of symptomatic BTI cases (17.11%) caused by alpha and delta VoCs, although vaccine-induced immunity was only slightly reduced compared to subjects without BTI at mid-term follow-up. 相似文献
775.
David Gozalichvili Christine Binquet Cyril Boisson Adeline Guiraud Olivier Facy Pablo Ortega-Deballon 《Colorectal disease》2023,25(4):728-737
Aim
Anastomotic leak results in increased morbidity and affects functional and oncological outcomes after colectomy. Measurement of C-reactive protein (CRP) allows early detection of anastomotic leaks. The aim of this study was to evaluate the benefit to the patient of earlier diagnosis and management of anastomotic leaks, namely avoiding takedown of the anastomosis.Method
Patients with an anastomotic fistula after elective colorectal surgery from 2010 to 2020 were included. Three periods were defined according to progressive adherence to the CRP protocol in our department. A comparison was made between the periods ‘before’ (2010–2013) and ‘after’ (2016–2020) in terms of morbidity, mortality, anastomotic salvage, days spent in hospital within the first postoperative month, timely adjuvant chemotherapy and anastomotic stenosis.Results
Out of 2655 elective colorectal operations, 171 patients presented with an anastomotic leak and 123 patients were included in the study. In univariate analysis, patients in the ‘after’ group had fewer severe complications (Clavien–Dindo Grade III to IV, 66.7% vs. 56.9; p = 0.017); the difference did not reach significance regarding timely postoperative chemotherapy (p = 0.058) and anastomotic stenosis (p = 0.682). In both, univariate and multivariate analysis, the ‘after’ period increased the chances of preserving the anastomosis (OR = 2.37 [1.08–5.17]) and increased the number of days out of hospital (p = 0.0002).Conclusion
A CRP-based protocol for the screening of anastomotic leaks after colorectal surgery was related to increased anastomotic conservation, a decreased impact and severity of the leak and a shorter length of hospital stay. 相似文献776.
Astrid Boulenger de Hauteclocque Loïc Ferrer Damien Ambrosetti Solene Ricard Pierre Bigot Karim Bensalah François Henon Nicolas Doumerc Arnaud Méjean Virginie Verkarre Charles Dariane Stéphane Larré Cécile Champy Alexandre de La Taille Franck Bruyère Morgan Rouprêt Philippe Paparel Stéphane Droupy Alexis Fontenil Jean-Jacques Patard Xavier Durand Thibaut Waeckel Herve Lang Cédric Lebâcle Laurent Guy Geraldine Pignot Matthieu Durand Jean-Alexandre Long Thomas Charles Evanguelos Xylinas Romain Boissier Mokrane Yacoub Thierry Colin Jean-Christophe Bernhard 《BJU international》2023,132(2):160-169