Cognitive Impairments in Children with Nonidiopathic Temporal Lobe Epilepsy

Summary:  Ictal and interictal activities occurring in a mature brain can disorganize the neural network activity involved in one or various specific cognitive processes. In children, the situation might be more complex: the epileptic process occurs in a period when the cortex is still maturing and it may interfere with normal cerebral development. Although neural plasticity in children is greater than it is in adults, greater plasticity does not necessarily mean adaptive plasticity. Studies have shown that temporal lobe epilepsy in children is not systematically associated with global mental retardation. However, various difficulties in specific cognitive domains are more often found in children than in patients with adult-onset epilepsy. Language, memory, socioperceptive competence, and also executive functions, which can be impaired by the disruption of the temporofrontal circuit, are among such cognitive functions that need to be evaluated. Early detection of specific deficits is of primary importance for the implementation of appropriate remediation measures.     

Population-based study on occupational risk factors for preeclampsia and gestational hypertension

OBJECTIVES: Preeclampsia is a leading cause of maternal and perinatal morbidity. Work-related factors may influence the occurrence of this disorder. This case-control study estimated the associations between work-related physical and psychosocial factors and the risk of preeclampsia and gestational hypertension. METHODS: The eligible women consisted of a random sample of the women who delivered a singleton live birth in 1997-1999 in six regions of Quebec and worked during pregnancy. Cases of preeclampsia (N=102) and gestational hypertension (N=99) were compared with normotensive controls (N=4381). Information on occupational exposures at the onset of pregnancy was collected during phone interviews a few weeks after delivery. Detailed information was obtained on work schedule, postures, physical exertion, work organization, noise, vibration, and extreme temperature. Adjusted odds ratios (aOR) were estimated through polytomous logistic regression. RESULTS: Women standing daily at least 1 hour consecutively without walking experienced a higher risk of preeclampsia [aOR 2.5, 95% confidence interval (95% CI) 1.4-4.6], as well as women climbing stairs frequently (aOR 2.3, 95% CI 1.2-4.1) and women working more than 5 consecutive days without a day-off (aOR 3.0, 95% CI 1.0-9.5). Squatting or kneeling, pushing or pulling objects, whole-body vibration, forced pace, job strain, and no control on breaks were positively, but nonsignificantly, associated with preeclampsia. The associations were weaker for gestational hypertension. CONCLUSIONS: These findings suggest that being exposed to physically demanding and stressful occupational conditions at the onset of pregnancy increases the risk of preeclampsia.     

Silent versus cranial giant cell arteritis. Initial presentation and outcome of 50 biopsy-proven cases

BACKGROUND: The objective of the present study was to compare the silent form of giant cell arteritis (GCA) to the classic cephalic form of the disease. METHODS: We conducted a retrospective study based on a chart review of 50 consecutive, biopsy-proven GCA, recorded at a department of internal medicine. We sought to distinguish a silent form, defined by a prolonged inflammatory syndrome or fever of unknown origin with the absence of cephalic signs, polymyalgia rheumatica, or large artery involvement, from an overt "classic" cranial temporal arteritis. RESULTS: The prevalence of the silent form of GCA was 46% in our study. Abnormal temporal arteries were more frequent in the cephalic group. The silent GCA group had higher C-reactive protein levels (p<0.05), a higher platelet count (p<0.05), and lower serum albumin (p<0.05). There was no significant difference in temporal artery specimens in the two groups. Clinical relapses tended to be more frequent, and patients free of corticosteroids tended to be less frequent, in the cephalic group, though the difference was not statistically significant. CONCLUSIONS: The silent and cephalic forms of GCA could have distinct clinical and biological patterns and different outcomes. The limitation of our study was its retrospective design. Further studies are required to determine if this distinction is useful in treating GCA patients.     

Impact of HLA-DPB1 allelic and single amino acid mismatches on HSCT

The interpretation of the role of HLA-DPB1 in unrelated haematopoietic stem cell transplantation (HSCT) is subject to discussion. We have investigated the role of HLA-DPB1 allele matching in HSCT outcomes in 161 recipients who were HLA - A , - B , - C , - DRB1 and - DQB1- matched with their unrelated donors at the allelic level (10/10). In addition, we analysed the association of polymorphic amino acid mismatches of DPB1 molecule with HSCT end-points, and a previously published permissiveness concept. HLA-DPB1 allele mismatches were significantly associated with an increased incidence of acute graft-versus-host disease (aGvHD) and worse overall survival (OS). The mismatch at amino acid position 69 significantly increased the risk for transplant-related mortality (TRM). Risk factors for aGvHD also included mismatches at positions 8, 9, 35, 76 and 84. This is to our knowledge, the first report of an in vivo effect of single amino acid mismatches on HSCT outcomes. In this study, grouping of allelic mismatches into permissive and non-permissive categories and their association with transplantation end-points was relevant for TRM but not for other clinical end-points.     

Time-domain reflectance diffuse optical tomography with Mellin-Laplace transform for experimental detection and depth localization of a single absorbing inclusion

We show how to apply the Mellin-Laplace transform to process time-resolved reflectance measurements for diffuse optical tomography. We illustrate this method on simulated signals incorporating the main sources of experimental noise and suggest how to fine-tune the method in order to detect the deepest absorbing inclusions and optimize their localization in depth, depending on the dynamic range of the measurement. To finish, we apply this method to measurements acquired with a setup including a femtosecond laser, photomultipliers and a time-correlated single photon counting board. Simulations and experiments are illustrated for a probe featuring the interfiber distance of 1.5 cm and show the potential of time-resolved techniques for imaging absorption contrast in depth with this geometry.OCIS codes: (170.3880) Medical and biological imaging, (170.6920) Time-resolved imaging, (170.6960) Tomography, (170.3010) Image reconstruction techniques, (170.7050) Turbid media, (170.4580) Optical diagnostics for medicine     

Safety and immunogenicity of a modified pox vector-based HIV/AIDS vaccine candidate expressing Env, Gag, Pol and Nef proteins of HIV-1 subtype B (MVA-B) in healthy HIV-1-uninfected volunteers: A phase I clinical trial (RISVAC02)

Background

To investigate the safety and immunogenicity of a modified vaccinia virus Ankara vector expressing HIV-1 antigens from clade B (MVA-B), a phase-I, doubled-blind placebo-controlled trial was performed.

Methods

30 HIV-uninfected volunteers at low risk of HIV-1 infection were randomly allocated to receive 3 intramuscular injections (1 × 10⁸ pfu/dose) of MVA-B (n = 24) or placebo (n = 6) at weeks 0, 4 and 16. All volunteers were followed 48 weeks. Primary end-points were adverse events and immunogenicity.

Results

A total of 169 adverse events were reported, 164 of grade 1-2, and 5 of grade 3 (none related to vaccination). Overall 75% of the volunteers showed positive ELISPOT responses at any time point. The magnitude (median) of the total responses induced was 288 SFC/10⁶ PBMC at week 18. Antibody responses against Env were observed in 95% and 72% of vaccinees at week 18 and 48, respectively. HIV-1 neutralizing antibodies were detected in 33% of volunteers.

Conclusions

MVA-B was safe, well tolerated and elicited strong and durable T-cell and antibody responses in 75% and 95% of volunteers, respectively. These data support further exploration of MVA-B as an HIV-1 vaccine candidate.Clinical Trials.gov identifier: NCT00679497.