Progressive dementia associated with ataxia or obesity in patients with Tropheryma whipplei encephalitis

<p>Abstract</p> <p>Background</p> <p><it>Tropheryma whipplei</it>, the agent of Whipple's disease, causes localised infections in the absence of histological digestive involvement. Our objective is to describe <it>T. whipplei </it>encephalitis.</p> <p>Methods</p> <p>We first diagnosed a patient presenting dementia and obesity whose brain biopsy and cerebrospinal fluid specimens contained <it>T. whipplei </it>DNA and who responded dramatically to antibiotic treatment. We subsequently tested cerebrospinal fluid specimens and brain biopsies sent to our laboratory using <it>T. whipplei </it>PCR assays. PAS-staining and <it>T. whipplei </it>immunohistochemistry were also performed on brain biopsies. Analysis was conducted for 824 cerebrospinal fluid specimens and 16 brain biopsies.</p> <p>Results</p> <p>We diagnosed seven patients with <it>T. whipplei </it>encephalitis who demonstrated no digestive involvement. Detailed clinical histories were available for 5 of them. Regular PCR that targeted a monocopy sequence, PAS-staining and immunohistochemistry were negative; however, several highly sensitive and specific PCR assays targeting a repeated sequence were positive. Cognitive impairments and ataxia were the most common neurologic manifestations. Weight gain was paradoxically observed for 2 patients. The patients' responses to the antibiotic treatment were dramatic and included weight loss in the obese patients.</p> <p>Conclusions</p> <p>We describe a new clinical condition in patients with dementia and obesity or ataxia linked to <it>T. whipplei </it>that may be cured with antibiotics.</p

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Impact médical de la filière gériatrique labellisée des centres hospitaliers de Seclin-Carvin sur leur territoire de santé (étude descriptive qualitative menée auprès des médecins généralistes du secteur de Seclin-Carvin)

LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Compréhension et intégration de valeurs humanistes en classe de maternelle. Le conte des "Trois petits lapins recherchent leur frère"

The subject of this dissertation is the story "Trois petits lapins recherchent leur frère" ("Three little rabbits are looking for their brother"), written and illustrated by the teacher Fernand Dunand and his pupils at the Passy school in Haute-Savoie during the 1939-42 war years. A symbol of the Freinet pedagogy, this tale is a pedagogical and didacticsupport for questioning, in a reading comprehension approach, the integration of human values and the development of empathy in nursery school pupils. The pupil is actively involved and placed at the heart of the learning process.Ce mémoire a pour objet d’étude le conte « Trois petits lapins recherchent leur frère », écrit et illustré par l’instituteur Fernand Dunand et ses élèves de l’école de Passy (Haute-Savoie) dans les années de guerre 1939-42. Symbole de la pédagogie Freinet, ce conte est un support pédagogique et didactique pour questionner, dans une démarche decompréhension en lecture, l’intégration de valeurs humanistes et le développement de l’empathie chez l’élève en classe de maternelle. L’élève est actif, placé au coeur des apprentissages

Profil de la population en hôpital de jour gérontologique (étude des patients accueillis au centre hospitalier de Seclin au cours de ses deux premières années d'ouverture)

LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Prise en charge des accidents vasculaires cérébraux (expérience du Centre Hospitalier de Seclin sur une étude prospective de six mois)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF