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1. Specificities of acute phase stroke management in the elderly

Author

D. Smadja, Pierre Krolak-Salmon, Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon

Subjects
medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Population, Rehabilitation Centers, 03 medical and health sciences, 0302 clinical medicine, Reperfusion therapy, Epidemiology, Humans, Medicine, Dementia, cardiovascular diseases, 030212 general & internal medicine, 10. No inequality, education, Stroke, Neurorehabilitation, Aged, education.field_of_study, Rehabilitation, business.industry, Incidence, medicine.disease, 3. Good health, Neurology, Emergency medicine, Delirium, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Health professionals are currently facing the challenge of managing an increasing number of old patients presenting with acute stroke, due to rapid aging of the population. Compared to their younger counterparts, elderly patients differ in many ways in the setting of acute stroke. Apart from a striking high stroke incidence, which increases exponentially as age increases, cardioembolism also becomes, as patients age, the main cause of ischemic stroke. Delirium, which can challenge the diagnosis, is frequent at the acute phase of stroke, and may be related to an underlying dementia, which is almost exclusively observed in the elderly during stroke. At all levels, management of elderly stroke patients is suboptimal, especially when they are cognitively impaired, with insufficiencies including admission to stroke units, applying standards of care and investigation, reperfusion therapy for ischemic stroke, and finally transfer to rehabilitation centers. A paradigm shift must take place to limit age-related discrimination for acute-phase management of stroke.

Published
2020
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2. Stroke Thrombus Segmentation on SWAN with Multi-Directional U-Nets

Author

Y. L’hermitte, D. Smadja, N. Chausson, Vincent Vigneron, M. Aghasaryan, Elmar Lang, Dominique Fourer, J. Kobold, Ana Maria Tomé, C. Alecu, and Hichem Maaref

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, 02 engineering and technology, medicine.disease, Sagittal plane, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 020204 information systems, Coronal plane, Angiography, Multi directional, cardiovascular system, 0202 electrical engineering, electronic engineering, information engineering, medicine, Segmentation, cardiovascular diseases, Radiology, Thrombus, business, Stroke, 030217 neurology & neurosurgery, circulatory and respiratory physiology
Abstract

The thrombus causing a stroke can be seen on the susceptibility weighted angiography (SWAN) magnetic resonance imaging (MRI) sequence. But it is very small and hard to detect by humans. Up to date the thrombus is identified by trained human experts. But as stroke needs quick treatment, an automatic detection of the thrombus would be useful to speed up the diagnosis of acute stroke. We propose a method for automatic thrombus detection from SWAN using three separate U-Nets which work on the axial, coronal and sagittal planes.

Published
2019
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3. Angioedema associated with thrombolysis for ischemic stroke: analysis of a case-control study

Author

O. Fain, Denis Sablot, C. Héroum, Thomas Ronzière, M. Gaudron, S. Di Legge, A. Lecluse, Olivier Detante, F. Dumont, S. Marcel, Sonia Alamowitch, D. Gobert, Isabelle Boccon-Gibod, Guillaume Marc, D. Smadja, Michael Obadia, D. Launay, S. Lefèvre, M. Sévin, Laurence Bouillet, Laurent Suissa, Stéphane Gayet, M. B. Vlaicu, Emilie Doche, Clara Vigneron, Nicolas Javaud, Igor Sibon, I. Ion, I. Arnaud, and P. Girard‐Madoux

Subjects
0301 basic medicine, Male, medicine.medical_specialty, medicine.medical_treatment, Bradykinin, Angiotensin-Converting Enzyme Inhibitors, 030204 cardiovascular system & hematology, Brain Ischemia, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Sex Factors, Risk Factors, Internal medicine, Internal Medicine, medicine, Humans, Thrombolytic Therapy, Angioedema, Aged, Mechanical ventilation, business.industry, Case-control study, Odds ratio, Thrombolysis, Stroke, 030104 developmental biology, chemistry, Case-Control Studies, Ischemic stroke, Cardiology, Female, France, medicine.symptom, business, Complication
Abstract

BACKGROUND Bradykinin-mediated angioedema (AE) is a complication associated with thrombolysis for acute ischemic stroke. Risk factors are unknown and management is discussed. OBJECTIVES To clarify risk factors associated with bradykinin-mediated AE after thrombolysis for acute ischemic stroke. METHODS In a case-control study conducted at a French reference centre for bradykinin angiœdema, patients with thrombolysis for acute ischemic stroke and a diagnosis of bradykinin-mediated angiœdema, were compared to controls treated with thrombolysis treatment without angiœdema. RESULTS Fifty-three thrombolysis-related AE were matched to 106 control subjects. The sites of attacks following thrombolysis for ischemic stroke mainly included tongue (34/53, 64%) and lips (26/53, 49%). The upper airways were involved in 37 (70%) cases. Three patients required mechanical ventilation. Patients with bradykinin-mediated angiœdema were more frequently women [33 (62%) vs. 44 (42%); P = 0.01], had higher frequency of prior ischemic stroke [12 (23%) vs. 9 (8%); P = 0.01], hypertension [46 (87%) vs. 70 (66%); P = 0.005], were more frequently treated with angiotensin-converting enzyme inhibitor [37 (70%) vs. 28 (26%); P

Published
2019

4. Development of a Thin, Double-Sided Alpha/Beta Detector for Surface-Contamination Measurement

Author

Alon Osovizky, Y. Knafo, Y. Cohen, Aaron Ocherashvili, R. Atias, D. Ginzburg, Y. Yehuda-Zada, L. Carmel, I. Israelashvili, D. Smadja, S. Dadon, T. Mazor, Y. Ifergan, and Yagil Kadmon

Subjects
0301 basic medicine, Physics, Nuclear and High Energy Physics, Scintillation, Physics::Instrumentation and Detectors, business.industry, Detector, Scintillator, Particle detector, 03 medical and health sciences, Full width at half maximum, 030104 developmental biology, Optics, Nuclear Energy and Engineering, Beta particle, Optoelectronics, Figure of merit, Electrical and Electronic Engineering, Photonics, business
Abstract

Low-level radioactive surface-contamination measurements require lightweight, large-area, and high-efficiency detectors. In the previous work, we utilized wavelength shifting (WLS) fibers, coupled to a beta-sensitive plastic scintillator (PS) layer on one side, and to an alpha-sensitive ZnS(Ag) layer on both sides, for detecting both alpha and beta particles. In this work, the main goal was to improve the light collection (maximizing the number of photons reaching the PMT) by optimizing the WLS fibers structure, for getting better signal-to-noise ratio and to minimize the low-energy threshold of the detector. In most cases, improving the light collection mostly influenced the detector resolution. In our case, improving the light collection will improve the detection efficiency by ability to detect more events at low-energy spectrum, which is limited by the noise level. Aiming to improve the scintillation light-collection efficiency, we investigated and compared four different detector configurations. Two of them described in the previous work presents utilization of WLS fibers, with different diameters ( $1~\hbox{mm}\phi $ , $1.5~\hbox{mm}\phi $ ), coupled on the PS. Two other configurations present utilization of WLS fibers ( $1.5~\hbox{mm}\phi $ ) installed into a flat groove on the PS layer, while in one configuration we utilized straight WLS fibers and in the other we utilized bent WLS fibers. It was found that the utilization of WLS fibers in bent configuration gives the highest light-collection efficiency. Additionally, there is improved light collection achieved by using WLS fibers with wider diameter ( $1.5~\hbox{mm}\phi $ ), which maximizes the capture fraction. Additionally, since ZnS(Ag) and PS have different decay times (200 ns and 2.4 ns, respectively), we were able to separate alpha from beta events. An algorithm script was developed to calculate the full width at half maximum (FWHM) of each pulse and a histogram was generated of the FWHM values for the pulse shape discrimination (PSD). Efficient PSD was achieved for alpha energies above 100 keV with figure of merit (FOM) of 1.92. GEANT4 simulation was carried out and compared with experimental results. The results of both were matched, showed that the light-collection efficiency from the bent WLS fibers configuration was the best. The simulation results and the experiments, including full description of the detector structure, ionization stage, and the WLS light collection, are presented.

Published
2016
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5. Utilization of wavelength-shifting fibers coupled to ZnS(Ag) and plastic scintillator for simultaneous detection of alpha/beta particles

Author

T. Mazor, D. Ginzburg, I. Israelashvili, Y. Ifergan, Y. Yehuda-Zada, Y. Knafo, Y. Kadmon, D. Smadja, Y.S Cohen, A. Osovizky, S. Dadon, and E. Gonen

Subjects
Physics, Nuclear and High Energy Physics, Scintillation, Physics::Instrumentation and Detectors, business.industry, Detector, Antenna aperture, Alpha particle, Scintillator, Zinc sulfide, Wavelength, chemistry.chemical_compound, Optics, chemistry, Beta particle, business, Instrumentation
Abstract

Low level radioactive surface contamination measurements require lightweight, large area and high efficiency detector. In most existing scintillation detectors there is a tradeoff between effective area and scintillation light collection. By using wavelength shifting (WLS) fibers the scintillation light may be collected efficiently also in a large area detector. In this study, WLS fibers were coupled to a beta sensitive plastic scintillator layer and to a alpha sensitive silver-activated zinc sulfide ZnS(Ag) layer for detecting both alpha and beta particles. The WLS fibers collect the scintillation light from the whole detector and transfer it to a single PMT. This first prototype unique configuration enables monitoring radioactive contaminated surfaces by both sides of the detector and provides high gamma rejection. In this paper, the detector structure, as well as the detector’s measured linear response, will be described. The measured detection efficiency of 238 Pu alpha particles (5.5 MeV) is ~63%. The measured detection efficiency for beta particles is ~89% for 90 Sr– 90 Y (average energy of 195.8 keV, 934.8 keV), ~50% for 36 Cl (average energy of 251.3 keV), and 35% for 137 Cs (average energy of 156.8 keV).

Published
2015
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6. The prevalence of overweight and obesity, and distribution of waist circumference, in adults and children in the French Overseas Territories: The PODIUM survey

Author

J.-L. Boissin, J.-L. Daigre, G. Jean-Baptiste, D. Smadja, A. Atallah, H. Chevalier, J. Inamo, B. Balkau, and P. Kangambega

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Waist, Adolescent, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Population, Coronary Disease, Overweight, Polynesia, Body Mass Index, Age Distribution, Endocrinology, Surveys and Questionnaires, Epidemiology, Prevalence, Internal Medicine, medicine, Humans, Martinique, Obesity, Sex Distribution, Child, education, Guadeloupe, education.field_of_study, business.industry, General Medicine, medicine.disease, French Guiana, Stroke, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Child, Preschool, Female, Public Health, Waist Circumference, medicine.symptom, business, Body mass index, Demography
Abstract

This study aimed to describe the prevalence of overweight (excluding obesity) and obesity, and distribution of waist circumference, in children and adults in four French Overseas Territories (Guadeloupe, Martinique, French Guiana in the Caribbean and French Polynesia in the Pacific Ocean).The survey was designed to provide a sample representative of the population in each of the four territories. The protocol aimed to evaluate 600 adults (aged ≥ 15 years) and 300 children (aged: 5-14 years) in each territory.In children, the differences were small among the territories in the prevalence of overweight (excluding obesity), as defined by the International Obesity Task Force (IOTF): Guadeloupe, 15.4%; Martinique, 17.0%; French Guiana, 13.2%; and French Polynesia, 17.2% (P = 0.49). Larger, significant, differences were observed for obesity, with prevalences of 7.2%, 7.7%, 5.4% and 15.9%, respectively (P0.002). In adults, the prevalence of obesity also differed significantly among the territories: 22.9%, 22.0%, 17.9% and 33.1% in Guadeloupe, Martinique, French Guiana and French Polynesia, respectively (P0.001, adjusted for age and gender). However, overweight (excluding obesity) was again more homogeneously distributed, with prevalences of 31.7%, 33.6%, 30.3% and 34.4%, respectively (P = 0.43, adjusted for age and gender). Waist circumference was larger in French Polynesia than in the other territories in both genders, and in both children and adults.While the distribution of overweight was relatively homogeneous, the prevalence of obesity differed considerably across the four territories. It was especially high in French Polynesia, and in children and women. Appropriate programmes are urgently needed in these populations, especially in children, to avoid the morbidity associated with obesity.

Published
2012
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7. Thrombotic stroke following snake bites by the 'Fer-de-Lance' Bothrops lanceolatus in Martinique despite antivenom treatment: A report of three recent cases

Author

Yves Plumelle, S. Kaidomar, R. Vignes, N. Chausson, Lian F. Thomas, J. Uzan, D. Smadja, and B. Bucher

Subjects
Adult, Bothrops lanceolatus, Pediatrics, medicine.medical_specialty, Adolescent, Antivenom, Snake Bites, Toxicology, complex mixtures, medicine, Animals, Humans, Bothrops, Child, Envenomation, Stroke, Aged, biology, Antivenins, Bothrops caribbaeus, business.industry, Middle Aged, medicine.disease, biology.organism_classification, Snake bites, Surgery, Intracranial Thrombosis, business, Martinique
Abstract

Backgrounds: The severity of envenoming from Bothrops lanceolatus is determined by the development of cerebral, myocardial or pulmonary infarctions, and occasionnaly by serious local envenoming. Introduction of specific antivenom has resulted in a dramatic improvement in the prognosis of this envenoming. Against this background, we report 3 recent cases of patients bitten by B. lanceolatus who developed cerebral infarctions despite early administration of antivenom. Methods: In 1991 a protocol was designed to apply the same evaluation and treatment to all envenomed patients. The clinical results have been continuously monitored. Results: Between April 1993 and July 2003, 128 envenomed patients (age 6–83 (mean 45) years) were treated. No coagulopathy, thrombotic complication or death occurred in patients who were given early antivenom therapy—up to 6 h following the bite—and 126 patients recovered. Between August 2003 and October 2004, 10 additional patients (18–66 (mean 46) years) were given antivenom at the time of admission at hospital. Of these, 3 developed cerebral infarctions within 24 h. Effectiveness of antivenom was tested on mouse, and found to be lower than specified by the manufacturer. Discussion: Our data shows that recently the antivenom may have lost some of its efficacy. Possible mechanisms include variability in venom composition or loss of activity of the antibodies produced more than 15 years ago. The question is whether we should attempt to produce improved antivenom. This could include activity against the venom of Bothrops caribbaeus from the neighbouring island of St Lucia, which shares a monophyletic group with B. lanceolatus and whose venom produces a similar thrombotic syndrome. Conclusion: Prevention of systemic vessels thrombosis remains the main therapeutic challenge of B. lanceolatus envenoming in Martinique.

Published
2006
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8. Short-term corticosteroids then lamivudine and plasma exchanges to treat hepatitis B virus-related polyarteritis nodosa

Author

Alfred Mahr, V. Loustaud-Ratti, B. Imbert, C. Larroche, P. Cohen, P. Hausfater, P. Petitjean, D. Smadja, Jean Roudier, Loïc Guillevin, P. Bielefeld, and V. Queyrel

Subjects
medicine.medical_specialty, Immunology, medicine.disease_cause, Gastroenterology, Rheumatology, Orthohepadnavirus, Prednisone, Internal medicine, medicine, Immunology and Allergy, Pharmacology (medical), Seroconversion, Hepatitis B virus, biology, Polyarteritis nodosa, business.industry, virus diseases, Lamivudine, Hepatitis B, medicine.disease, biology.organism_classification, digestive system diseases, HBeAg, business, medicine.drug
Abstract

Objective To assess the efficacy and safety of lamivudine, an antiviral agent that strongly inhibits hepatitis B virus (HBV) DNA replication, combined with plasma exchanges after short-term corticosteroids for HBV-related polyartertitis nodosa (PAN). Methods Ten patients (8 men, 2 women, mean ± SD age 50.4 ± 14.4 years) with previously untreated HBV-related PAN were included in a multicenter, prospective, observational trial. Oral prednisone (1 mg/kg/day) was given for 1 week, then tapered and withdrawn within 1 week. Then, lamivudine (100 mg/day or less in the case of renal insufficiency) was started for a maximum of 6 months. Plasma exchanges were performed simultaneously and scheduled as follows: 3/week for 3 weeks, 2/week for 2 weeks, then 1/week until hepatitis B e antigen (HBeAg) to anti-HBe antibody (HBeAb) seroconversion was obtained or until 2–3 months of clinical recovery was sustained. The primary trial endpoint was clinical recovery from HBV-PAN at 6 months. The secondary endpoint was loss of detectable serum HBeAg and HBV DNA, and HBeAg to HBeAb seroconversion at 9 months. Results One death, attributed to catheter-related septicemia, was recorded. At 6 months, all 9 survivors had achieved clinical recovery and by 9 months, 6 of 9 (66%) had seroconverted. Conclusion The strategy of short-term steroids followed by lamivudine and plasma exchanges effectively led to recovery from HBV-PAN. Because of its oral administration and good safety profile, lamivudine should henceforth be considered the antiviral agent of choice to treat HBV-related PAN.

Published
2004
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9. Cotrimoxazole pour la toxoplasmose cérébrale : moins cher et moins toxique ?

Author

A. Foltzer, Sandrine Pierre-François, André Cabié, Guillaume Béraud, and D. Smadja

Subjects
medicine.medical_specialty, biology, business.industry, Sulfamethoxazole, medicine.disease, biology.organism_classification, Trimethoprim, Virology, Toxoplasmosis, Infectious Diseases, Immunopathology, Tropical medicine, Medicine, business, Sida, Encephalitis, medicine.drug, Antibacterial agent
Published
2008
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12. Fourth meeting of the European Neurological Society 25–29 June 1994 Barcelona, Spain

Author

H. Hattig, C. Delli Pizzi, M. C. Addonizio, Michelle Davis, A. R. Giovagnoli, L. Florensa, M. Roth, J. de Kruijk, Francisco Lacruz, Ph. Dewailly, A. Toygar, C. Avendano, P.P. De Deyn, J. F. Hurtevent, F. Lomeila, T. W. Wong, Gordon T. Plant, M. Bud, H. J. Willison, DH Miller, D. W. Langdon, R. Cioni, J. Servan, A. Kaygisiz, E. Racadot, D. B. Schens, E. Picciola, L. Falip, C. Bouchard, J. Jotova, A. Jorge-Santamaria, P. Misra, A. Dufour, C. P. Panagopoulos, A. Venneri, B. Sredni, B. Angelard, M. Janelidze, M. Carreno, J. Obenberger, J. Pouget, H. W. Moser, R. Kaufmann, J. A. Molina, D. Linden, A. Martin Urda, E. Uvestad, A. Krone, J. P. Cochin, J. Mallecourt, A. Cambon-Thomsen, K. Violleau, P. Osschmann, A. M. Durocher, E. Bussaglia, D. M. Danielle, H. Efendi, C. Van Broeckhoven, K. G. Jordan, W. Rautenberg, C. Iniguez, J. M. Delgado, Graham Watson, M. Lawden, Gareth J. Barker, K. Stiasny, James T. Becker, G. Campanella, E. Peghi, A. Poli, A. Haddad, T. Yamawaki, Giacomo P. Comi, S. Sotgiu, B. Ersmark, A. Pomes, M. Ziegler, P. Ferrante, P. Ruppi, H. KuÇukoglu, R. Bouton, U. K. Rinne, P. Vieregge, M. Dary, P. Giunti, Peter J. Goadsby, S. Jung, E. Secor, A. Steinberg, N. Vila, M. A. Hernandez, M. Cursi, A. Enqelhardt, A. Engelhardt, J. Veitch, F. Di Silverio, F. Arnaud, B. Neundörfer, R. Brucher, Dominique Caparros-Lefebvre, B. Meyer, Marianne Dieterich, M. H. Snidaro, R. Gomez, R. Cerbo, M. Ragno, J. M. Vance, S. Nemni, A. Caliskan, F. Barros, I. Velcheva, D. Ceballos-Baumann, V. Barak, A. Avila, N. Antonova, F. Resche, S. Pappata, L. Varela, S. R. Silveira Santos, A. Cammarota, L. Naccache, Y. Nara, E. Tournier-Lasserves, R. Mobner, T. Chase, A. Ensenyat, J. Ulrich, G. Giegerich, M. Rother, M. Revilla, N. Nitschke, K. Honczarenko, E. Basart Tarrats, J. Blin, B. Jacob, J. Santamaria, S. Knezevic, J. L. Castillo, M. Antem, J. Colomer, O. Busse, Didier Hannequin, S. Carrier, J. B. Ruidavets, C. Rozman, J. Bogoussslavsky, J. Pascual Calvet, E. Monros, J. M. Polo, M. Zucconl, Javier Muruzabal, R. R. Allen, R. Rivolta, K. Haugaard, A. Nespolo, K. Hoang-Xuang, G. Bussone, T. Avramidis, E. Corsini, Christiana Franke, T. Vinogradova, H. Boot, K. Vestergaard, G. H. Jansen, N. Argentino, M. Raltzig, W. Linssen, Mark B. Pepys, P. Roblot, L. Lauritzen, E. Fainardi, D. Morin, T. X. Arbizu Urdiain, J. Wollenhaupt, S. Bostantjopoulou, G. Pavesi, A. D. Forman, Giovanni Fabbrini, D. Jean, J. J. Archelos, M. I. Blanchs, M. Del Gobbo, Anna Carla Turconi, Ch. Derouesné, Elio Scarpini, A. Visbeck, P. Castejon, J. P. Renou, F. Mounier-Vehier, G. Potagas, Ch. Duyckaerts, A. Filla, R. Schneider, G. Ronen, K. Nagata, J. P. Vedel, A. Henneberg, G. van Melle, C. Baratti, H. Knott, M. C. Prevett, A. Bes, B. Metin, Jos V. Reempts, L. Martorell, Mefkure Eraksoy, H. O. Handwerker, D. S. Younger, O. Oktem, D. Frongillo, C. Soriano-Soriano, L. Niehaus, F. Zipp, A. Tartaro, S Newman, R. H. Browne, P. Davous, R. Sanchez, M. Muros, M. E. Kornhuber, A. Lavarone, M. Mohr, M. R. Garcia, S. Russell, H. Kellar-Wood, M. R. Tola, B. Ostermeyer, Ch. Tzekov, K. Sartor, E. B. Ringelstein, P. P. Gazzaniga, Paul Krack, H. Fidaner, H. Rico, T. Dbaiss, F. Alameda, E. Torchiana, L. Rumbach, I. Charques, J. M. Bogaard, C. D. Frith, L. J. Rappelle, R. Brenner, A. Joutel, K. Fuxe, G. HÄcker, M. J. Blaser, J. Valls-SolÇ, G. Ulm, M. Alberdi, A. Bock, F. W. Bertelsmann, U. Wieshmann, J. Visa, J. R. Lupski, D. D'Amico, L. M. P. Ramos, A. A. Vanderbark, R. Horn, M. Warmuth, Dietmar Kühne, Mark S. Palmer, C. Ehrenheim, E. Canga, S. Viola, O. Scarpino, P. Naldi, R. Almeida, A. A. Raymond, J. Gamez, Stephan Arnold, A. DiGiovanni, J. Dalmau, C. C. Chari, H. F. Beer, J. C. Koetsier, J. Iriarte, E. Yunis, J. Casadevall, E. Le Guern, E. Stenager, S. R. Benbadis, J. M. Warter, F. Burklin, I. Theodorou, L. Johannesen, G. A. Graveland, X. Leclerc, I. Vecchio, L. Ozelius, G. Nicoletti, R. K. Gherardi, E. Esperet, M. L. Delodovici, F. Cattin, F. Paiau, Giorgio Sacilotto, C. A. J. Broere, D. Chavdarov, J. P. Willmer, C. H. Hawkes, Th. Naegele, E. Ellie, E. Dartigues, M. J. Guardiola, S. Hesse, Z. Levic, Marco Rovaris, P. Saugeir-Veber, B. A. Yaqub, H. F. Durwen, R. Larumbe, J. Ballabrina, M. Sendtner, J. Röther, M. Horstink, C. Kluglein, M.P. Montesi, H. Apaydin, J. Montoya, E. Waubant, Ch. Verellen-Dunoulin, A. Nicolai, J. Lopez-Delval, R. Lemon, G. Cantinho, E. Granieri, A. Zeviani, Wolfgang H. Oertel, U. Ficola, V. Di Piero, V. Fragola, K. Sabev, M. V. Guitera, I. Turki, F. Bolgert, P. Ingrand, J. M. Gobernado, L. M. E. Grimaldi, S. Baybas, B. Eymard, Y. Rolland, Y. Robitaille, Ta. Pampols, P. J. Koehler, A. Carroacedo, J. Vilchez, S. Di Vittorio, I. R. Rise, T. Nagy, M. Kuffner, E. Palazzini, A. Ott, J. Pruim, T. X. Arbizu, E. Manetti, C. Cervera, S. Felber, G. Gursoy, J. Scholz, G. A. Buscaino, M. S. Chen, A. Pascual, J. Hazan, J. U. Gajda, J. G. Cea, G. Bottini, G. Damalik, F. Le Doze, G. Bonaldi, J. M. Hew, C. Messina, A. M. Kennedy, J. M. Carney, N. M. F. Murray, M. Parent, M. Koepp, V. Dimova, D. De Leo, K. Jellinger, G. Salemi, S. Mientus, M. L. Hansen, F. Mazzucchelli, J. Vieth, M. Mauri, E. Bartels, L. Johannsen, C. Humphreys, J. Emile, D. N. Landon, E. Kansu, R. Sanchez-Pernaute, Rsj Frackowiak, M. Gonzalez Torres, L. Oller, C. Machedo, J. Kother, M. Billiard, H. Durak, T. Schindler, A. Frank, A. Uncini, A. Sbriccoli, C. Farinas, D. W. Paty, N. Fast, A. T. Zangaladze, A. Kerkhofs, J. M. Pino Garcia, I. De la Fuente, B. Marini, L. Gomez, I. Rubio, Alessandra Bardoni, C. Brodie, P. Acin, U. Sliwka, S. A. Hawkins, S. Tardieu, F. Vitullo, J. M. Pereira Monteino, R. Gagliardi, T. Jezewski, A. Cano, T. Lempert, F. Abad Alegria, G. Rotondo, D. Ince, C. Martinez Parra, Y. Huang, H. Luders, Y. Steinvil, F. G. A. Van Der Meche, R. Bianchi, A. Sanchez, T. Sevilla, J. M. Ketelslegers, A. Domzal-Stryga, M. Pandolfo, M. O. Josse, K. W. Neff, I. Blanco, G. W. Bruyn, O. W. Witte, J. L. Thibault, G. Andersen, J. Pariset, A. Marcone, R. J. M. Lane, A. Hofman, M. Verin, T. Matilla, P. Bedoucha, J. Roche, M. Lai, M. Collard, A. Ugarte, F. Gallecho, D. Silbersweig, C. Kennard, J. P. Azulay, T. W. Ho, P. L. I. Dellemijn, R. Girardello, F. Baas, B. Voss, F. Rozenberg, E. M. Brocker, V. Stanev, A. A. J. Soeterboek, A. Marra, A. Rey, E. Ertem, M. Sawradewicz-Rybak, J. De Keyser, P. Cavallari, F. Proust, Y. Chevalier, H. C. Hansen, D. Leys, C. A. Davie, K. Hoang-Xuan, C. Bairati, H. van Crevel, Thomas T. Warner, B. Bompais, A. Dobbeleir, T Campbell, C. Macko, C. J. M. Klijn, M. Dussallant, T. P. Berlit, W. Rozenbaum, M. J. van den Bent, W. A. Rocca, M. Muller, H. Hundemer, U. Zifko, M. Campera, F. Drislane, D. Ranoux, T. M. Kloss, Anil Kumar, I. Ruolt, C. Bargnani, B. Marescau, N. A. Losseff, S. Notermans, B. Kint, E. T. Burke, C. Aykut, J. Matias Guiu, P. Maquet, T. Drogendijk, M. Leone, K. von Ammon, M. Pepeliarska, C. Prados, L. DiGiamberardino, T. Logtenberg, G. Lenoir, I. Castaldo, Damhaut, M. Radionova, G. Sirabian, R. 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Frigo, Leif Østergaard, J. L. Munoz Blanco, A. Cruz-Matinez, J. De Reuck, C. Theillet, T. Barroso, V. Oikonen, Florence Lebert, M. Kilinc, C. Cordon-Cardon, G. Stoll, E. Thiery, F. Pulcinelli, J. Solski, M. Schmiegelow, L. J. Polman, P. Fernandez-Calle, C. Wikkelso, M. Ben Hamida, M. Laska, E. Kott, W. Sulkowski, C. Lucas, N. M. Bornstein, D. Schmitz, M. W. Lammers, A. de Louw, R. J. S. Wise, P. A. van Darn, C. Antozzi, P. Villanueva, P. H. E. Hilkens, C. Constantin, W. Ricart, A. Wolf, M. Gamba, P. Maguire, Alessandro Padovani, B. M. Patten, Marie Sarazin, H. Ackermann, L. Durelli, S. Timsit, Sebastian Jander, B. W. Scheithauer, G. Demir, J. P. Neau, P. Barbanti, A. Brand, N. AraÇ, V. Fischer-Gagnepain, R. Marchioli, G. Serratrice, C. Maugard-Louboutin, G. T. Spencer, D. Lücke, G. Mainardi, K. Harmant Van Rijckevorsel, G. B. Creel, R. Manzanares, Francesco Fortunato, A. May, J. Workman, K. Johkura, E. Fernandez, Carlo Colosimo, L. Calliauw, L. Bet, Félix F. Cruz-Sánchez, M. Dhib, H. Meinardi, F. Carrara, J. Kuehnen, C. Peiro, H. Lassmann, K. Skovgaard Olsen, A. McDonald, L. Sciulli, A. Cobo, A. Monticelli, B. Conrad, J. Bagunya, J. Benitez, V. Desnizza, B. Dupont, O. Delrieu, D. Moraes, J. J. Heimans, F. Garcia Rio, M. Matsumto, A. Fernandez, R. Nermni, R. Chalmers, M. J. Marchau, F. Aguado, P. Velupillai, P. J. Martin, P. Tassan, V. Demarin, A. Engelien, T. Gerriets, Comar, J. L. Carrasco, J. P. Pruvo, A. Lopez de Munain, D. Pavitt, J. Alarcon, Chris H. Polman, B. Guldin, N. Yeni, Hartmut Brückmann, N. Wilczak, H. Szwed, R. Causaran, G. Kyriazis, M. E. Westarp, M. Gasparini, N. Pecora, J. M. Roda, E. Lang, V. Scaioli, David R. Fish, D. Caputo, O. Gratzl, R. Mercelis, A. Perretti, G. Steimetz, I. Link, C. Rigoletto, A. Catafau, G. Lucotte, M. Buti, G. Fagiolari, A. Piqueras, C. Godinot, J. C. Meurice, Erodriguez J. Dominigo, F. Lionnet, H. Grzelec, David J. Brooks, P. M. G. Munro, F. X. Weilbach, M. Maiwald, W. Split, B. Widjaja-Cramer, V. Ozturk, J. Colas, E. Brizioli, J. Calleja, L. Publio, M. Desi, R. Soffietti, P. Cortinovis-Tourniaire, E. F. Gonano, G. Cavaletti, S. Uselli, K. Westerlind, H. Betuel, C. O. Dhiver, H. Guggenheim, M. Hamon, R. Fazio, P. Lehikoinen, A. Esser, B. Sadzot, G. Fink, Angelo Antonini, D. Bendahan, V. Di Carlo, G. Galardi, A. F. Boller, M. Aksenova, Del Fiore, V. de la Sayette, H. Chabriat, A. Nicoletti, A. Dilouya, M. L. Harpin, E. Rouillet, J. Stam, A. Wolters, M. R. Delgado, Eduardo Tolosa, G. Said, A. J. Lees, L. Rinaldi, A. Schulze-Bonhage, MA Ron, C. Lefebvre, E. W. Radü, R. Alvarez, M. L. Bots, P. Reganati, S. Palazzi, A. Poggi, N. J. Scolding, V. Sazdovitch, T. Moreau, E. Maes, M. A. Estelies, P. Petkova, Jose-Felix Marti-Masso, G De La Meilleure, N. Mullatti, M. Rodegher, N. C. Notermans, T. A. T. Warner, S. Aktan, J. P. Louboutin, L. Volpe, C. Scheidt, W. Aust, C. M. Wiles, U. Schneider, S. K. Braekken, W. R. Willems, K. Usuku, Peter M. Rothwell, C. Talamon, M. L. Sacchetti, A. Codina, M. H. Marion, A. Santoro, J. Roda, A. Bordoni, D. J. Taylor, S. Ertas, H. H. Emmen, J. Vichez, V. BesanÇon, R. E. Passingham, M. L. Malosio, A. Vérier, M. Bamberg, A. W. Hansen, E. Mostacero, G. Gaudriault, Marie Vidailhet, B. Birebent, K. Strijckmans, F. Giannini, T. Kammer, I. Araujo, J. Nowicki, E. Nikolov, A. Hutzelmann, R. Gherardi, J. Verroust, L. Austoni, A. Scheller, A. Vazquez, S. Matheron, H. Holthausen, J. M. Gerard, M. Bataillard, S. Dethy, V. H. Patterson, V. Ivanez, N. P. Hirsch, F. Ozer, M. Sutter, C. Jacomet, M. Mora, Bruno Colombo, A. Sarropoulos, T. H. Papapetropoulos, M. Schwarz, D. S. Dinner, N. Acarin, B. Iandolo, J. O. Riis, P. R. J. Barnes, F. Taroni, J. Kazenwadel, L. Torre, A. Lugaresi, I. L. Henriques, S. Pauli, S. Alfonso, Pedro Quesada, A. S. T. Planting, J. M. Castilla, Thomas Gasser, M. Van der Linden, A. Alfaro, E. Nobile-Orazio, G. Popova, W. Vaalburg, F. G. A. van der Mech, L. Williams, F. Medina, J. P. Vernant, J. Yaouanq, B. Storch-Hagenlocher, A. Potemkowski, R. Riva, M. H. Mahagne, M. Ozturk, Ve. Drory, N. Konic, C. Jungreis, A. Pou Serradell, J. L. Gauvrit, G. J. Chelune, S. Hermandez, T. Dingus, L. Hewer, Ch. Koch, M. N. Metz-Lutz, G. Parlato, M. Sinaki, Charles Pierrot-Deseilligny, H. C. Diener, J. Broeckx, J. Weill-Fulazza, M. L. Villar, M. Rizzo, O. Ganslandt, C. Duran, N. A. Fletcher, G. Di Giovacchino, Susan T. Iannaccone, C. Kolig, N. Fabre, H. A. Crockard, Rita Bella, M. Tazir, E. Papagiannuli, K. Overgaard, Emma Ciafaloni, I. Lorenzetti, F. Viader, P. A. H. Millac, I. Montiel, L. H. Visser, M. Palomar, P. L. Murgia, H. Pedersen, Rafael Blesa, S. Seddigh, W. O. Renier, I. Lemahieu, H. M. L. Jansen, L. Rosin, J. Galofre, K. Mattos, M. Pondal, G. M. Hadjigeorgiou, D. Francis, L. Cantin, D. Stegeman, M. Rango, A. B. M. F. Karim, S. Schraff, B. Castellotti, I. Iriarte, E. Laborde, T. J. Tjan, R. Mutani, D. Toni, B. Bergaasco, J. G. Young, C. Klotzsch, A. Zincone, X. Ducrocq, M. Uchuya, O. J. Kolar, A. Quattrone, T. Bauermann, Nereo Bresolin, J. Vallée, B. C. Jacobs, A. Campos, Werner Poewe, J. A. Villanueva, A. W. Kornhuber, A. Malafosse, E. Diez-Tejedor, G. Jungreia, M. J. A. Puchner, A. Komiyama, O. Saribas, V. Volpini, L. Geremia, S. Bressi, A. Nibbio, Timothy E. Bates, T. z. Tzonev, E. Ideman, G. A. Damlacik, G. Martino, G. Crepaldi, T. Martino, Kjell Någren, E. Idiman, D. Samuel, J. M. Perez Trullen, Y. van der Graaf, J. O. Thorell, M. J. M. Dupuis, E. Sieber, R. D'Alessandro, C. Cazzaniga, J. Faiss, A. Tanguy, A. Schick, I. Hoksergen, A. Cardozo, R. Shakarishvili, G. K. Wennlng, J. L. Marti-Vilalta, J. Weissenbach, I. L. Simone, Amalia C. Bruni, Darius J. Adams, C. Weiller, A. Pietrangeli, F. Croria, C. Vigo-Pelfrey, Patricia Limousin, A. Ducros, G. Conti, O. Lindvall, E. Richter, M. Zuffi, A. Nappo, T. Riise, J. Wijdenes, M. J. Fernandez, J. Rosell, P. Vermersh, S. Servidei, M. S. C. Verdugo, F. Gouttiere, W. Solbach, M. Malbezin, I. S. Watanabe, A. Tumac, W. I. McDonald, D. A. Butterfield, P. P. Costa, F. deRino, F. Bamonti, J. M. Cesar, C. H. Lahoz, I. Mosely, M. Starck, M. H. Lemaitre, K. M. Stephan, S. Tex, R. Bokonjic, I. Mollee, L. Pastena, M. Gutierrez, F. Boiler, M. C. Martinez-Para, M. Velicogna, O. Obuz, A. Grinspan, M. Guarino, L. M. Cartier, E. Ruiz, D. Gambi, S. Messina, M. Villa, Michael G. Hanna, J. Valk, Leone Pascual, M. Clanet, Z. Argov, B. Ryniewicz, E. Magni, B. Berlanga, K. S. Wong, C. Gellera, C. Prevost, F. Gonzalez-Huix, R. Petraroli, J. E. G. Benedikz, I. Kojder, C. Bommelaer, L. Perusse, M. R. Bangioanni, Guy M. McKhann, A. Molina, C. Fresquet, E. Sindern, Florence Pasquier, M. J. Rosas, M. Altieri, O. Simoncini, M. Koutroumanidis, C. A. F. Tulleken, M. Dary-Auriol, S. Oueslati, H. Kruyer, I. Nishisho, C. R. Horning, A. Vital, G. V. Czettritz, J. Ph. Neau, B. Mihout, A. Ameri, M. Francis, S. Quasthoff, D. Taussig, S. Blunt, P. Valentin, C. Y. Gao, O. Heinzlef, H. d'Allens, C. Coudero, M. Erfas, G. Borghero, P. J. Modrego Pardo, M. C. Patrosso, N. L. Gershfeld, P. A. J. M. Boon, O. Sabouraud, M. Lara, J. Svennevig, G. L. Lenzi, A. Barrio, H. Villaroya, JosÇ M. Manubens, O. Boespflug-Tanguy, M. Carreras, D. A. Costiga, J. P. Breux, S. Lynn, C. Oliveras Ley, A. G. Herbaut, J. Nos, C. Tornali, Y. A. Hekster, J. L. Chopard, J. M. Manubens, P. Chemouilli, A. Jovicic, F. Dworzak, S. Smirne, S. E. Soudain, B. Gallano, D. Lubach, G. Masullo, G. Izquierdo, A. Pascual Leone Pascual, A. Sessa, V. Freitas, O. Crambes, L. Ouss, G. W. Van Dijk, P. Marchettini, P. Confalonieri, M. Donaghy, A. Munnich, M. Corbo, and M. E. L. van der Burg

Subjects
Neurology, business.industry, Media studies, Library science, Medicine, Neurology (clinical), business
Published
1994
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13. Paralysie périodique thyréotoxique: deux nouveaux cas chez des patients de race noire

Author

C Chatot-Henry, R. Longhi, A. Brebion, D Smadja, and G. Sobesky

Subjects
Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, Internal Medicine, Medicine, Thyrotoxic periodic paralysis, Periodic paralysis, business, medicine.disease, West indies
Abstract

Resume Introduction La paralysie periodique thyreotoxique est habituellement decrite au sein des populations asiatiques. Elle est rare chez le caucasien, et exceptionnelle dans la race noire. Exegese Nous rapportons deux cas de tetraplegie hyporeflexique generalisee avec hypokaliemie. Dans le premier cas, l'hyperthyroidie est decouverte a cette occasion, et l'apparition de complications respiratoires et cardiaques conduit a un transfert en reanimation. Dans le second cas, alors que l'hyperthyroidie est connue mais decompensee par insuffisance therapeutique, les signes neurologiques regressent spontanement. Conclusion Devant tout acces paralytique hypokaliemique, un controle des hormones thyroidiennes est requis, meme en l'absence de tous signes peripheriques, et ce quelle que soit la race.

Published
2000
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14. Intérêt de la biopsie de glandes salivaires accessoires pour le diagnostic d'amylose

Author

F. Lepoutre, B. Devulder, D. Bataille, P.Y. Hatron, Eric Hachulla, D. Smadja, H. Masson, A. Janin, and Gosselin B

Subjects
Pathology, medicine.medical_specialty, medicine.diagnostic_test, Salivary gland, business.industry, Amyloidosis, Gastroenterology, medicine.disease, Surgery, medicine.anatomical_structure, stomatognathic system, Monoclonal, Biopsy, Internal Medicine, medicine, In patient, Renal biopsy, business, Nephrotic syndrome, Systematic biopsy
Abstract

There are few reports of amyloidosis diagnosed by deliberate biopsy of accessory salivary glands. Usually, a biopsy performed for dry mouth syndrome reveals an unsuspected amyloidosis. We report the case of 2 patients with lambda-type light chain monoclonal gammapathy complicated by generalized amyloidosis and in whom biopsy of the accessory salivary glands showed signs of amyloidosis. In the first patient accessory salivary gland biopsy was performed because these glands were enlarged, and the monoclonal dysglobulinaemia was subsequently diagnosed by serum immunoelectrophoresis. In the second patient with nephrotic syndrome, renal biopsy could not be carried out owing to the presence of a renal malformation; amyloidosis was confirmed by periumbilical fat aspiration, and a systematic biopsy of accessory salivary glands also showed evidence of amyloidosis. Biopsy of accessory salivary glands seems to be a particularly simple and safe method to detect generalized amyloidosis in patients with chronic inflammatory disease or monoclonal dysglobulinaemia.

Published
1990
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15. Insuffisance rénale aiguë et infarctus cérébral au décours d’un traitement par immunoglobulines intraveineuses à fortes doses

Author

A. Brebion, D Smadja, P Fournerie, G. Sobesky, Hossein Mehdaoui, C Chatot-Henry, and J.N. Drault

Subjects
Gynecology, medicine.medical_specialty, business.industry, Immunopathology, Ischemic stroke, Gastroenterology, Internal Medicine, medicine, Myocardial disease, business, Coronary heart disease
Abstract

Resume Introduction . — Les effets secondaires des immunoglobulines intraveineuses a fortes doses sont le plus souvent benins. Cependant, des cas d’insuffisance renale aigue et plus rarement d’infarctus cerebral ont ete decrits. Il n’y a pas a notre connaissance de cas rapporte cumulant ces deux types de complications severes. Exegese . — Une insuffisance renale aigue severe et un infarctus de l’artere choroidienne anterieure droite sont survenus simultanement 2 jours apres une cure d’immunoglobulines intraveineuses a 2 g/kg chez un patient purpura thrombopenique idiopathique. De plus, l’infarctus cerebral s'est aggrave a la suite d’une seconde cure d’immunoglobulines intraveineuses a 1 g/kg. Une etude clinique et neuroradiologique a ete realisee chez ce patient. Conclusion . — Un traitement par immunoglobulines intraveineuses a fortes doses necessite une surveillance rigoureuse de la fonction renale et la limitation des doses pour eviter la survenue d’un accident thrombotique.

Published
1998
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16. Encéphalomyélite aiguë disséminée précédant un lupus cutané

Author

D. Smadja, D Quist, F Dubreuil, Serge Arfi, and P. Cabre

Subjects
Gynecology, medicine.medical_specialty, Systemic disease, Lupus erythematosus, business.industry, Encephalomyelitis, Gastroenterology, medicine.disease, Connective tissue disease, Central nervous system disease, Immunopathology, Acute disseminated encephalomyelitis, Internal Medicine, Prednisolone, Medicine, business, medicine.drug
Abstract

Resume Sujet de l'etude Un cas d'encephalomyelite aigue disseminee (EAD) precedant l'apparition d'un lupus cutane est rapporte. Objectifs Suggerer un lien physiopathologique entre l'EAD et le lupus cutane. Resume des connaissances actuelles Les complications neurologiques du lupus erythemateux dissemine sont frequentes. Cependant, les manifestations neurologiques centrales de nature demyelinisantes sont rares, limitees a la neuromyelite optique (NMO). La NMO est consideree comme une forme partielle d'EAD. Methodes Une etude clinique, neuroradiologique et immunologique a ete realisee dans notre cas. Resultats Une EAD a ete diagnostiquee chez une jeune femme noire. Trois ans plus tard, elle avait developpe un lupus cutane, sans manifestations systemiques et avec une complementemie normale. Conclusion Un lien morbide entre ces deux entites — EAD et lupus cutane — est suggere. Le taux normal du complement serique a pu constituer un facteur favorisant au developpement d'une EAD.

Published
1998
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17. Unusual form of neurocysticercosis associated with HIV infection

Author

Roger Pradinaud, A. Signate, D. Smadja, M. El Guedj, Pierre Delobel, M. Gueye, and Pierre Couppié

Subjects
Epidural Space, Male, AIDS-Related Opportunistic Infections, Neurocysticercosis, HIV Infections, Albendazole, parasitic diseases, Taenia solium, medicine, Animals, Humans, Cyst, Polyradiculopathy, Anthelmintics, business.industry, Cysts, virus diseases, Cauda equina, Brain, Cysticercosis, Middle Aged, medicine.disease, Epidural space, medicine.drug_formulation_ingredient, medicine.anatomical_structure, Neurology, Immunology, Neurology (clinical), business, medicine.drug
Abstract

Concurrent infection with Taenia solium and HIV would be expected to occur more frequently because of the increasing frequency of HIV infection in endemic areas of cysticercosis. However, little is known about the influence of HIV infection on the frequency and the clinical course of cysticercosis. Giant cysts and racemose forms of neurocysticercosis seem to be more frequent in HIV-infected patients and may be secondary to an uncontrolled parasitic growth because of an impaired cell-mediated immune response. We report an unusual case of epidural spinal racemose neurocysticercosis revealed by compression of cauda equina in an HIV-infected man and discuss the potential interactions between T. solium and HIV infections.

Published
2003

18. Les manifestations neurologiques et systémiques liées au virus HTLV-1

Author

P. Cabre, D. Smadja, J.C. Vernant, and Stéphane Olindo

Subjects
Lung disease, business.industry, Gastroenterology, Internal Medicine, medicine, Sjögren syndrome, medicine.disease, business, Martinique, Molecular biology, West indies
Abstract

le virus HTLV-1 est le premier retrovirus humain. Isole en 1980, sa responsabilite dans la survenue de myelopathies chroniques en milieu tropical fut demontree cinq ans plus tard, en Martinique. La maladie existant en dehors des tropiques, en particulier au Japon, il fut convenu de la nommer TSP/HAM (Tropical Spastic Paraparesis/HTLV-1 Associated Myelopathy). Puis rapidement, d'autres manifestations non neoplasiques furent associees a ce virus, principalement alveolite lymphocytaire, syndrome sec, myosite. uveite et arthrite. Cependant, la physiopathologie de toutes ces manifestations, y compris la TSP/HAM, reste a ce jour mal comprise : la replication virale dans les organes atteints parait infime voire nulle, rendant peu probable une agression virale directe, tandis que les effecteurs cellulaires d'une possible inflammation viro-induite et auto-entretenue sont tres controverses. Cette obscurite pathogenique joue a l'evidence un role dans notre impuissance therapeutique actuelle, aucun progres significatif reel dans ce domaine n'ayant ete obtenu quinze ans apres la description de la TSP/HAM par Vernant.

Published
2000
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20. Ischemic choroidopathy in primary Sjögren's syndrome

Author

D. Smadja, Rapoport P, and Harold Merle

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Azathioprine, Salivary gland biopsy, medicine.disease, Fluorescein angiography, Dermatology, eye diseases, Pathophysiology, Optic neuropathy, stomatognathic diseases, Ophthalmology, stomatognathic system, medicine, KERATOCONJUNCTIVITIS SICCA, Sjogren s, Differential diagnosis, business, medicine.drug
Abstract

Purpose The authors describe a 68-year-old woman in whom ischemic choroidopathy and optic neuropathy developed in association with primary Sjogren's syndrome with central nervous system involvement. Methods Diagnosis of primary Sjogren's syndrome was made upon the association of keratoconjunctivitis sicca, minor salivary gland biopsy and serologic abnormalities. Fluorescein angiography showed signs highly suggestive of ischemic choroidopathy. The authors discuss differential diagnosis and pathophysiology of such choroidal manifestations. Treatment consisted in massive steroid therapy. Secondarily, an immunosuppressant agent (azathioprine) was successfully added because of neurological recurrences. Conclusion Primary Sjogren's syndrome should be considered in the differential diagnosis of ischemic choroidopathy.

Published
1998
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21. IMPACT OF PULSE PRESSURE ON ACUTE STOKE

Author

A. Hars, J. Inamo, D. Smadja, and S. Bravo

Subjects
medicine.medical_specialty, Physiology, business.industry, Internal medicine, Internal Medicine, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business, Pulse pressure
Published
2004
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