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This datasheet on Erwinia amylovora covers Identity, Overview, Distribution, Dispersal, Hosts/Species Affected, Diagnosis, Biology & Ecology, Environmental Requirements, Natural Enemies, Impacts, Uses, Prevention/Control, Further Information.

At birth, thoracosacral spinal cord networks in mouse can produce a coordinated locomotor-like pattern. In contrast, less is known about the cervicothoracic networks that generate forelimb locomotion. Here we show that cervical networks can produce coordinated rhythmic patterns in the brain stem-spinal cord preparation of the mouse. Segmentally the C5 and C8 neurograms were each found to be alternating left-right, and the ipsilateral C5 and C8 neurograms also alternated. Collectively these patterns were suggestive of locomotor-like activity. This pattern was not dependent on the presence of thoracosacral segments because they could be evoked following a complete transection of the spinal cord at T5. We next demonstrated that activation of thoracosacral networks either pharmacologically or by stimulation of sacrocaudal afferents could produce rhythmic activity within the C5 and C8 neurograms. On the other hand, pharmacological activation of cervical networks did not evoke alternating cervical rhythmic activity either in isolated cervicothoracic or -sacral preparations. Under these conditions, we found that activation of cervicothoracic networks could alter the timing of thoracosacral locomotor-like patterns. When thoracosacral networks were not activated pharmacologically but received rhythmic drive from cervicothoracic networks, a pattern of slow bursts with superimposed fast synchronous oscillations became the dominant lumbar neurogram pattern. Our data suggest that in neonatal mice the cervical CPG is capable of producing coordinated rhythmic patterns in the absence of input from lumbar segments, but caudorostral drive contributes to cervical patterns and rhythm stability.

Misdirection of axons after nerve injury impairs successful regeneration of adult neurons. Investigations of axon guidance in development have provided an understanding of pathfinding, but their relevance to regenerating adult axons is unclear. We investigated adult mammalian axon guidance during regeneration after peripheral nerve injury and focused on the effects of the prototypic guidance molecule nerve growth factor (NGF). Adult rat sensory neurons from dorsal root ganglia that expressed the NGF receptor tropomyosin-related kinase A (trkA) were presented with a point source of NGF in vitro. Naive trkA neurons had no net turning response to NGF, but if they had been preconditioned by a peripheral nerve transection in vivo before culturing, their growth cones were attracted toward the NGF gradient. A laminin substrate was required for this behavior and an anti-trkA antibody interrupted turning. These data demonstrate that injured adult mammalian axons can be guided as they regenerate. Moreover, despite the downregulation of trkA mRNA and protein levels within the dorsal root ganglion after injury, sensory neurons retain and increase trkA protein at the injury site where the regenerating axons are found. This may enhance the axonal response to NGF and allow guidance along an NGF gradient created in vivo in the distal nerve stump.

Objective: To describe the spectrum of diseases that may give rise to fever of unknown origin in elderly patients and to delineate the diagnostic approach in these patients. Design: Subgroup analysis of a prospectively collected case series followed more than 2 years. Setting: General Internal Medicine Service based at University hospital, Leuven, Belgium. Patients: Forty-seven consecutive patients, older than 65 years, meeting the classic criteria of fever of unknown origin. Measurements: The final diagnosis established and the clinical value of diagnostic procedures. Results: Infections, tumors and multisystem diseases (encompassing rheumatic diseases, connective tissue disorders, vasculitis including temporal arteritis, polymyalgia rheumatica, and sarcoidosis) were found in 12 (25%), six (12%) and 15 patients (31%), respectively. Drug-related fever was the cause in three patients (6%), miscellaneous conditions were found in five patients (10%), and six patients (12%) remained undiagnosed. Microbiologic investigations were diagnostic in eight cases (16%), serologic tests yielded one diagnosis, immunologic investigations had a diagnostic value in four cases, standard X-rays yielded a diagnostic contribution in 10 cases, ultrasonography and computed tomography were diagnostic in 11 cases, Gallium scintigraphy had a diagnostic contribution in 17 cases, and biopsies yielded the final diagnosis in 18 cases. Conclusions: Multisystem diseases emerged as the most frequent cause of fever of unknown origin in the elderly, and temporal arteritis was the most frequent specific diagnosis. Infections, particularly tuberculosis, remain an important group. The percentage of tumors was higher in our elderly patients than in the younger ones but still clearly lower than in other recent series of FUO in adults. The number of undiagnosed cases was significantly lower in elderly patients than in younger individuals (P ≤ 0.01). The investigation of elderly patients with FUO should encompass routine temporal artery biopsy and extensive search for tuberculosis if the classic tests such as blood count, chemistry, urinalysis, cultures, chest X-rays, and abdominal ultrasonography do not yield any clue. Gallium scintigraphy should be considered as the next step and not as a last-resort procedure.

National audience; L’objectif de cette étude consiste à évaluer la qualité de vie de la fratrie du point de vue des parents et des frères et sœurs de l’enfant atteint de mucoviscidose. Trente familles participent à cette étude. Les parents et leurs enfants ont rempli un questionnaire de qualité de vie (le Profil de santé de Duke). Les parents ont également répondu au Child Behavior Checklist, qui est un questionnaire conçu pour évaluer les problèmes comportementaux et émotionnels de leurs enfants. Il apparaît que la qualité de vie est évaluée différemment par les parents et par les enfants non malades. Les parents ont tendance à surestimer la santé physique de leurs enfants non malades et à ne pas évaluer correctement les risques de souffrance exprimée de façon différente par leurs garçons ou par leurs filles.; Objectives. – The impact of the presence of a child with cystic fibrosis in the family on the siblings is rarely studied. Moreover, the availableempirical data are not clear. This study aims at evaluating the siblings’ quality of life according to the assessments performed by, on the one hand,the parents and, on the other hand, the brothers and/or the sisters of the sick child.

The considerable progress that has been made in the treatment of cystic fibrosis has significantly increased life expectancy. The multi-disciplinary approach is now considered to be a priority by centers providing care for adults with cystic fibrosis. The aim of this study was to investigate three psychological morbidities that are commonly present with this disease: depression, anxiety and poor coping mechanisms for stress. Sixteen subjects (aged 19 to 37 years) participated in this study and were divided in three groups according to the severity of their pulmonary disease. Assessments of depression and anxiety were made from two perspectives: 1) the subject's own perception of his/her depressive and anxious state; 2) a psychologist's assessment of the patients depressive and anxious state. Then, reactions to stress were explored by analyzing "coping" strategies employed. Results indicate that patients underestimated the level of their depressive and anxious state when compared to the psychologists assessment. The majority of them exhibited "coping" strategies based on emotional responses. Levels of anxiety and depression did not show any relationship with the severity of pulmonary disease suggesting that the major determinant of emotional well-being lies with the individual's own perception of their state and of the support available to them.

info:eu-repo/semantics/published

We describe a series of 45 patients with episodic fever of unknown origin (FUO) who meet the classic criteria for FUO. Recurrent or episodic fever is defined as cyclical fever with seeming remission of the disease and fever-free intervals of at least 2 weeks. The traditional mix of infections, malignancies, and inflammatory diseases (multisystem diseases) represent only 20% of the causes of episodic FUO, in contrast to 60 to 70% in cases of continuous fever. The "miscellaneous" group of patients with episodic FUO is the most numerous and about half of the cases remain undiagnosed. This spectrum of causative diseases resembles the spectrum of so-called "prolonged" FUO, i.e., a feverish illness lasting at least half a year. Follow-up of the undiagnosed cases revealed a good prognosis. Only 1 patient died and only 1 more required continuous treatment with corticosteroids. Seven of the 21 undiagnosed cases required intermittent short-term treatment with either nonsteroidal anti-inflammatory drugs or corticosteroids. The remaining 14 seem to be "cured". Diagnosis was frequently based on the clinical course and on exclusion of other diseases. Gastrointestinal investigation was useful, but serologic and immunologic tests yielded only minimal benefit. Ultrasonography, computerized tomographic scans, and gallium scintigraphy were diagnostically useful. Invasive procedures are rarely required, and careful ambulatory follow-up is probably the best approach in cases of unresolved episodic FUO.

We performed a multicenter retrospective study in 166 consecutive patients shunted for presumed normal-pressure hydrocephalus (NPH) in the four neurosurgical departments of Amsterdam. Overall improvement occurred in 36%, substantial improvement in 21%. In the subgroup of idiopathic NPH (N = 127), marked improvement was only 15%. The incidence of shunt-responsive NPH in our area was 2.2/million/year. The rate of severe and moderate shunt-related complications was 28%, leading to death or severe residual morbidity in 7%. The substantial benefit/serious harm ratio in the whole group was only three (21%/7%), decreasing to 1.7 in idiopathic NPH. By excluding patients at high surgical risk, this ratio might have risen to 10 in the whole group and to six in idiopathic NPH. Our experience is much less favorable than that encountered in the literature, reporting overall improvement in 74% and marked improvement in 55% of the shunted patients. We conclude that NPH is probably a very rare and still overdiagnosed syndrome and that the overall morbidity rate for each patient demonstrating meaningful improvement is high.

Three patients in whom the first symptoms of the tarsal tunnel syndrome (TTS) emerged after an acute event proximal to but not affecting the ankle are described. These patients suggest that a pre-existing asymptomatic TTS may become manifest after a mechanism akin to that described in the "double crush" syndrome.

To determine the relative proportions of the diagnostic categories in patients with fever of unknown origin who were examined in the 1980s.Prospective case series.General Internal Medicine Service based at University Hospital, Leuven, Belgium.One hundred ninety-nine consecutive patients meeting the classic criteria of fever of unknown origin who were treated in the 1980s.The final diagnosis established at discharge or during follow-up.Infections were found in 45 patients (22.6%), tumors were found in 14 (7%), multisystem diseases were found in 42 (21.5%), drug-related fever was found in six (3%), factitious fever was found in seven (3.5%), habitual hyperthermia was found in five (2.5%), miscellaneous diseases were found in 29 (14.5%), and no diagnosis was reached in 51 (25.6%).Tumors were a less important cause of fever of unknown origin in the 1980s. The same holds true for some infectious diseases, such as abscesses and hepatobiliary disorders. Multisystem diseases were more frequently found, and the number of undiagnosed cases increased. Although these shifts in the disease spectrum in fever of unknown origin most probably resulted from a constellation of factors, we suspect that these changes are mainly due to easy and early diagnosis by new diagnostic modalities, such as ultrasonography and computed tomography, of previously common causes of fever of unknown origin.

info:eu-repo/semantics/published

Forty six Dutch neurologists and neurosurgeons were interviewed to evaluate the clinical value of research articles on normal pressure hydrocephalus (NPH). From this survey it appears that most clinicians still limit investigations to psychometry, CSF-tap test(s), and cisternography. The main reasons for not using other techniques were: their invasiveness, technical complexity, poor availability, lack of time and doubt on their additional predictive value. There is an obvious discrepancy between the quantity of publications on NPH and their impact and their ability to assist clinicians in selecting potential NPH patients for a shunt.

Objective. To determine the relative proportions of the diagnostic categories in patients with fever of unknown origin who were examined in the 1980s. Study Design. Prospective case series. Setting. General Internal Medicine Service based at University Hospital, Leuven, Belgium. Patients. — One hundred ninety-nine consecutive patients meeting the classic criteria of fever of unknown origin who were treated in the 1980s Main Outcome Measurement. The final diagnosis es tablished at discharge or during follow-up. Results. Infections were found in 45 patients (22.6%), tumors were found in 14 (7%), multisystem diseases were found in 42 (21.5%), drug-related fever was found in six (3%), factitious fever was found in seven (3.5%), habitual hyperthermia was found in five (2.5%), miscellaneous dis eases were found in 29 (14.5%), and no diagnosis was reached in 51 (25.6%). Conclusions. Tumors were a less important cause of fe ver of unknown origin in the 1980s. The same holds true for some infectious diseases, such as abscesses and hepatobil iary disorders. Multisystem diseases were more frequently found, and the number of undiagnosed cases increased. Al though these shifts in the disease spectrum in fever of un known origin most probably resulted from a constellation of factors, we suspect that these changes are mainly due to easy and early diagnosis by new diagnostic modalities, such as ultrasonography and computed tomography, of previ ously common causes of fever of unknown origin. ( Arch Intern Med . 1992;152:51-55)

The environment and particularly the glial sheath of the spinal ganglion neurons was systematically studied by light and electron microscopy in the young and senescent rat. Experiments using radioactive tracers tested the consequences of the functional perturbations associated with structural impairments. The results suggested the possibility that the glial sheath and the neuron aged differently. Whereas the glial sheath maintained its functional capacity relatively intact, neuronal performance was markedly and more rapidly impeded. The morphology and volume of the extracellular space were unchanged. Therefore, impairment of the glioneuronal units in the spinal ganglion during aging cannot be assigned to environmental and vascular phenomena.

The chronology of the alterations impairing the cytology of the spinal ganglion neurons was analysed in 3- to 32-month-old male rats. A type neurons are impaired earlier and more severely than B neurons. Ageing alterations occur during two successive periods. During the first period, beginning at about 3 months, lipofuscin pigments gradually accumulate in the neurons. During the second period, beginning at about 24 months, various kinds of inclusions appear (granulofilamentous bodies, nematosomes,...); some of which could be originating from altered microtubules and/or filaments. At the same time, lipofuscin pigments are more heterogeneous. This period might be the onset of real senescence and of the gradual deterioration of the neuronal function.