Highly multimodal structure of high topological charge extreme ultraviolet vortex beams

Optical beams carrying orbital angular momentum are a very active field of research for their prospective applications, especially at short wavelengths. We consider here such beams produced through high-harmonic generation (HHG) in a rare gas and analyze the characterization of their high-charge vortex structure by an extreme ultraviolet Hartmann wavefront sensor. We show that such HHG beams are generally composed of a set of numerous vortex modes. The sensitivity of the intensity and phase of the HHG beam to the infrared laser aberrations is investigated using a deformable mirror.

Hartmann wavefront sensor characterization of a high charge vortex beam in the extreme ultraviolet spectral range

We demonstrate for the first time, to the best of our knowledge, the ability of extreme ultraviolet (XUV) Hartmann wavefront sensors to characterize high charge vortex beams produced by high-order harmonic generation up to the order of 25. We also show that phase matched absorption limited high harmonic generation is able to maintain the high charge vortex structure of the XUV beam even in a rather long (1 cm) generation medium.

Gait analysis and clinical correlations in early Parkinson's disease

The aim of our study was to identify and quantify spatiotemporal and kinematic gait parameters obtained by 3D gait analysis (GA) in a group of Parkinson's disease (PD) patients compared with healthy subjects in order to investigate whether early PD patients could present an abnormal gait pattern. Forty-four patients affected by early-stage PD compared with a control group were analyzed. All participants were evaluated with 3D GA in the gait laboratory. The greatest significance in temporal parameters was found in cadence (102.46 ± 13.17 steps/min in parkinsonian patients vs 113.84 ± 4.30 steps/min in control subjects), followed by stride duration (1.19 ± 0.18 seconds right limb and 1.19 ± 0.19 seconds left limb in PD patients vs 0.426 ± 0.16 seconds right limb and 0.429 ± 0.23 seconds left limb in normal subjects) and stance duration. Marked differences were also found in the swing phase and in swing duration (p<0.05), while the stance phase was not significantly different in patients compared with healthy subjects. A statistically different velocity in PD patients (0.082 ± 0.29 m/s) vs healthy subjects (1.33 ± 0.06 m/s) was shown by spatial parameter analysis. Step width, stride length and swing velocity were highly significant parameters, as was average velocity. Our study highlighted some distinguishing characteristics of gait in early PD. Ambulation disorders may be present in the early stage of PD and their detection allows for early medical treatment and possible rehabilitation.

[The support of the elderly person on hemodialysis]

The ageing of the population is associated with an increase in the incidence of chronic renal failure. Management of the condition must be adapted to the specificities linked to ageing. With end-stage renal failure, haemodialysis is a substitution technique offered under certain conditions. The central role of the caregivers is to support and guide the elderly person along their care pathway. Faced with a reduced life expectancy, the aim of all concerned is to strike a balance between an effective treatment and quality of life.

Nurses' understanding influences comprehension of patients admitted in the observation unit

Comprehension is poor in patients admitted in the emergency observation unit. Teamwork communication gaps could contribute to patients' misunderstanding of their health condition. To determine in patients admitted in the emergency observation unit whether comprehension of diagnosis, prognosis, and management depended on nurses' comprehension, the authors conducted a prospective observational study in a busy adult emergency department of a tertiary teaching hospital in Paris over 2 months. Consecutive patients admitted in the emergency observation unit were included. Patients' and nurses' comprehension of diagnosis, prognosis, and management was compared with the statements of the emergency department attending physicians for these items. The authors observed whether patients' misunderstanding was associated with nurses' misunderstanding. A total of 544 patients were evaluated. For each patient, nurses' and patients' comprehension was available. Patients understood severity in 40%, organ involved in 69%, medical wording in 57%, reason for admission in 48%, and discharge instruction in 67%. In comparison with patients, nurses better understood each item except for discharge instruction. The authors observed that patients' comprehension was better when nurses understood diagnosis (p <.0001), reasons for admission (p =.032) and discharge instructions (p =.002). Nurses' understanding of severity did not modify patients' comprehension. These results support the conclusions that communication gaps in teamwork alter patients' comprehension and that nurses' and patients' misunderstandings are associated. Therefore, improving communication by nurses and physicians to patients may improve patients' understanding.

Combined genotypes of CCR5, CCR2, SDF1, and HLA genes can predict the long-term nonprogressor status in human immunodeficiency virus-1-infected individuals

Human immunodeficiency virus (HIV)-1-infected long-term nonprogressors (LT-NP) represent less than 5% of HIV-1-infected patients. In this work, we tried to understand whether combined genotypes of CCR5-triangle up32, CCR2-64I, SDF1-3'A and HLA alleles can predict the LT-NP status. Among the chemokine receptor genotypes, only the frequency of the CCR5-triangle up32 allele was significantly higher in LT-NP compared with the group of standard progressors. The predominant HLA alleles in LT-NP were HLA-A3, HLA-B14, HLA-B17, HLA-B27, HLA-DR6, and HLA-DR7. A combination of both HLA and chemokine receptor genotypes integrated in a multivariate logistic regression model showed that if a subject is heterozygous for CCR5-triangle up32 and homozygous for SDF1 wild type, his odds of being LT-NP are increased by 16-fold, by 47-fold when a HLA-B27 allele is present with HLA-DR6 absent, and by 47-fold also if at least three of the following alleles are present: HLA-A3, HLA-B14, HLA-B17, HLA-DR7. This model allowed a correct classification of 70% of LT-NPs and 81% of progressors, suggesting that the host's genetic background plays an important role in the evolution of HIV-1. The chemokine receptor and chemokine genes along with the HLA genotype can serve as predictors of HIV-1 outcome for classification of HIV-1-infected subjects as LT-NPs or progressors.

Early protective effect of CCR-5 delta 32 heterozygosity on HIV-1 disease progression: relationship with viral load. The SEROCO Study Group

OBJECTIVE

To determine the influence of heterozygosity for the delta 32 mutant CCR-5 allele on HIV-1 disease progression.

DESIGN

HIV-1 disease progression and serum viral load were analysed according to the C-C chemokine receptor (CCR)-5 genotype in 412 Caucasian patients (319 men and 93 women) with a known date of seroconversion, who were enrolled in the SEROCO cohort (median follow-up, 74 months).

RESULTS

The frequency of heterozygosity for the mutant allele was 17% and did not differ according to sex or risk factor of HIV infection. Heterozygotes were significantly less likely than patients with two functional alleles to have symptomatic primary infection. Their serum viral load was lower during the 6- to 24-month plateau phase after seroconversion. This difference persisted afterwards, although the rate of decline in CD4+ cells was similar. Kaplan-Meier survival curves showed slower progression to clinical AIDS in heterozygotes during the first 7 years following infection (P < 0.02), the two curves tending to join thereafter (overall log-rank test, P = 0.17). However, the interaction term with time did not reach significance in a Cox model. The overall relative risk of progression was 0.67 (95% confidence interval, 0.38-1.18) and was not influenced by adjustment for age at seroconversion or symptomatic primary infection. After adjustment for early viral load the relative risk was 0.83. Pneumocystis carinii pneumonia and toxoplasmosis were less likely to be the first AIDS-defining illness in heterozygotes than in the other patients (0 versus 24.7% of AIDS cases, P = 0.04), despite similar management.

CONCLUSION

Deletion of one CCR-5 gene allele appears to protect against HIV-1 disease progression, mainly during the early years of the infection. Heterozygosity for the deletion leads to persistently lower viral load, and also seems to protect against some opportunistic infections.

Acute-phase proteins in Alzheimer's disease

The main 'acute-phase proteins' were determined in serum of 20 patients with presenile Alzheimer's disease (AD) and compared with values in 18 age-matched healthy control subjects. Following parameters were evaluated: alpha 1-antitrypsin (alpha AT), haptoglobin (HPT), transferrin (TRF), acidic alpha 1-glycoprotein (A alpha G), ceruloplasmin (CER), alpha 2-macroglobulin (alpha MG), C-reactive protein (CRP), albumin (ALB), together with the immunoglobulins IgG, IgM and IgA, and some of the most significant factors of the classic (C3, C4) and alternative (properdin factor B) pathways of complement activation. The results showed a statistically significant increase in the levels of alpha AT (p less than 0.001), CER (p less than 0.001) and of all the complement factors studied (p less than 0.005). The levels of other acute-phase protein (HPT, TRF, A alpha G, alpha MG, CRP, ALB) and immunoglobulins (IgG, IgM, IgA) were similar in AD patients and normal controls. These results give rise the possibility that these elements indicate an altered immunoregulation compatible with chronic cell damage and/or chronic inflammation conditions. Moreover, the increased level of alpha AT can be related to the low production of interleukin-1 (IL-1) reported in AD, which supports the hypothesis of a relative derangement of the macrophage function in presenile AD patients.

[Therapeutic effects of trazodone in the treatment of tremor. Multicentric double-blind study]

A 30 days therapeutical trial with trazodone has been performed in 47 patients suffering from different types of tremor. No significant improvement was detected in patients suffering from parkinsonian syndromes, multiple sclerosis, psycogenic tremor and hyperthyroidism. After the double-blind trial with trazodone, a significant improvement (p less than 0.025) was, instead, evident in 5 out of 6 patients with essential tremor, while the score did not change in the 3 patients with essential tremor who were treated with placebo.

Posttraumatic epidural hygroma with associated subdural spinal fluid collection. Case report

We report a head-injured patient in whom CT scan revealed an extracerebral hypodense fluid collection separated into two compartments by a membrane, which was probably the torn dura mater. We briefly discuss the probable pathogenetic mechanism.