Hopital Neuchatelois

La Chaux-de-Fonds, Switzerland

Hopital Neuchatelois

La Chaux-de-Fonds, Switzerland
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Laganaro M.,University of Geneva | Croisier M.,Hopital neuchatelois | Bagou O.,University of Geneva | Assal F.,Neurology
Cortex | Year: 2012

We present a 3-year follow-up study of a patient with progressive apraxia of speech (PAoS), aimed at investigating whether the theoretical organization of phonetic encoding is reflected in the progressive disruption of speech. As decreased speech rate was the most striking pattern of disruption during the first 2 years, durational analyses were carried out longitudinally on syllables excised from spontaneous, repetition and reading speech samples. The crucial result of the present study is the demonstration of an effect of syllable frequency on duration: the progressive disruption of articulation rate did not affect all syllables in the same way, but followed a gradient that was function of the frequency of use of syllable-sized motor programs. The combination of data from this case of PAoS with previous psycholinguistic and neurolinguistic data, points to a frequency organization of syllable-sized speech-motor plans. In this study we also illustrate how studying PAoS can be exploited in theoretical and clinical investigations of phonetic encoding as it represents a unique opportunity to investigate speech while it progressively disrupts. © 2011 Elsevier Srl.

Weber P.,Hopital Neuchatelois | Hofmann B.A.,Naturhistorisches Museum der Burgergemeinde Bern | Tolba T.,University of Bern | Vuilleumier J.-L.,University of Bern
Meteoritics and Planetary Science | Year: 2017

The gamma-ray activities of 33 meteorite samples (30 ordinary chondrites, 1 Mars meteorite, 1 iron, 1 howardite) collected during Omani-Swiss meteorite search campaigns 2001–2008 were nondestructively measured using an ultralow background gamma-ray detector. The results provide several types of information: Potassium and thorium concentrations were found to range within typical values for the meteorite types. Similar mean 26Al activities in groups of ordinary chondrites with (1) weathering degrees W0-1 and low 14C terrestrial age and (2) weathering degree W3-4 and high 14C terrestrial age are mostly consistent with activities observed in recent falls. The older group shows no significant depletion in 26Al. Among the least weathered samples, one meteorite (SaU 424) was found to contain detectable 22Na identifying it as a recent fall close to the year 2000. Based on an estimate of the surface area searched, the corresponding fall rate is ~120 events/106 km2*a, consistent with other estimations. Twelve samples from the large JaH 091 strewn field (total mass ~4.5 t) show significant variations of 26Al activities, including the highest values measured, consistent with a meteoroid radius of ~115 cm. Activities of 238U daughter elements demonstrate terrestrial contamination with 226Ra and possible loss of 222Rn. Recent contamination with small amounts of 137Cs is ubiquitous. We conclude that gamma-ray spectroscopy of a selection of meteorites with low degrees of weathering is particularly useful to detect recent falls among meteorites collected in hot deserts. © The Meteoritical Society, 2017.

Cattin V.,University of Lausanne | Spring P.,University of Lausanne | Malinverni R.,Hopital Neuchatelois | Gilliet M.,University of Lausanne
Dermatology | Year: 2013

Sarcoidosis is a systemic granulomatous disorder of unknown origin commonly affecting the lung, the lymphoid system and the skin. We report here two cases of cutaneous sarcoidosis in two former intravenous drug users following interferon (IFN)-α and ribavirin therapy for chronic hepatitis C. Both patients developed skin sarcoidosis along venous drainage lines of both forearms, coinciding with the areas of prior drug injections. The unique distribution of the skin lesions suggests that tissue damage induced by repeated percutaneous drug injections represents a trigger for the local skin manifestation of sarcoidosis. Interestingly, skin damage was recently found to induce the local expression IFN-α, a well-known trigger of sarcoidosis in predisposed individuals. Here we review the literature on sarcoidosis elicited in the context of IFN-α therapy and propose a new link between the endogenous expression of IFN-α and the induction of disease manifestations in injured skin. © 2013 S. Karger AG, Basel.

Rehberg B.,University of Geneva | Wickboldt N.,University of Geneva | Juillet C.,Hopital Neuchatelois | Savoldelli G.,University of Geneva
British Journal of Anaesthesia | Year: 2015

Background The safety of patient-controlled i.v. analgesia (PCA) with remifentanil for obstetrical analgesia remains a matter of concern. The efficacy of remifentanil bolus application, that is, the coincidence between pain and remifentanil effect-site concentration, may be improved by forecasting contractions, but it is not known whether such a technique would also improve safety. Methods We recorded pain intensity during labour continuously using a handheld dynamometer in 43 parturients. Using these data, we compared different models in their ability to predict future contractions. In addition, we modelled remifentanil effect-site concentration using three simulated modes of bolus administration, with and without prediction of future contractions. Results The average duration of pain during contractions recorded by the dynamometer was 45 [14 standard deviation (sd)] s. The time interval between painful contractions was highly variable, with a mean of 151 (31 sd) s during the first and 154 (52 sd) s during the second recording. Using a simple algorithm (three-point moving average), the sd of the difference between predicted and observed inter-contraction intervals can be reduced from 0.95 to 0.79 min. However, the coincidence between remifentanil concentration and pain during contraction is not substantially improved when using these models to guide remifentanil bolus application. Conclusions Because of the large variability of inter-contraction intervals, the use of prediction models will not influence the mean remifentanil concentration in-between contractions. Using models predicting future contractions to improve the timing of remifentanil PCA bolus administration will not diminish the need of continuous clinical surveillance and other safety measures. © 2014 The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved.

Laubscher B.,Hopital Neuchatelois | Laubscher B.,University of Lausanne | Banziger O.,Swiss Disability Insurance | Schubiger G.,Kinderspital
European Journal of Pediatrics | Year: 2013

In 2003, the Swiss guidelines to prevent vitamin K deficiency bleeding (VKDB) were adapted. As two oral doses (2 mg, hour/day 4) of mixed micellar VK preparation had failed to abolish late VKDB, a third dose (week 4) was introduced. This report summarizes the new guidelines acceptance by Swiss pediatricians and the results of a prospective 6-year surveillance to study their influence on the incidence of VKDB. The new guidelines acceptance by Swiss pediatricians was evaluated by a questionnaire sent to all pediatricians of the Swiss Society of Paediatrics. With the help of the Swiss Paediatric Surveillance Unit, the incidence of VKDB was monitored prospectively from July 1, 2005 until June 30, 2011. Over a 6-year period (458,184 live births), there was one case of early and four cases of late VKDB. Overall incidence was 1.09/105 (95 % confidence intervals (CI) 0.4-2.6). Late VKDB incidence was 0.87/105 (95 % CI 0.24-2.24). All four infants with late VKDB had an undiagnosed cholestasis at the time of bleeding; parents of 3/4 had refused VK prophylaxis, and in 1/4, the third VK dose had been forgotten. Compared with historical control who had received only two oral doses of mixed micellar VK (18 cases for 475,372 live births), the incidence of late VKDB was significantly lower with three oral doses (Chi2,Yates correction, P = 0.007). Conclusion VKDB prophylaxis with 3 × 2 mg oral doses of mixed micellar VK seems to prevent adequately infants from VKDB. The main risk factors for VKDB in breast-fed infants are parental VK prophylaxis refusal or an unknown cholestasis. © 2012 Springer-Verlag Berlin Heidelberg.

Darouichi M.,Hopital Neuchatelois | Constanthin P.E.,University of Geneva
Radiology Case Reports | Year: 2016

This article describes an unusual case of Riedel's thyroiditis and discusses its imagery, pathology, and treatment. © 2016 The Authors

Steck A.J.,University of Basel | Kinter J.,University of Basel | Renaud S.,Hopital Neuchatelois
Journal of the Peripheral Nervous System | Year: 2011

DNA microarray analysis is a powerful tool for simultaneous analysis and comparison of gene products expressed in normal and diseased tissues. We used this technique to identify differentially expressed genes (DEGs) in nerve biopsy samples of chronic inflammatory demyelinating polyneuropathy (CIDP) and vasculitic neuropathy (VAS) patients. We found novel previously uncharacterized genes of relevance to CIDP or VAS pathogenesis. Of particular interest in CIDP were tachykinin precursor 1, which may be involved in pain mediation, stearoyl-co-enzyme A (CoA) desaturase, which may be a marker for remyelination, HLA-DQB1, CD69, an early T-cell activation gene, MSR1, a macrophage scavenger receptor, and PDZ and LIM domain 5 (PDLIM5), a factor regulating nuclear factor (NF)-kappa B activity. Genes upregulated in VAS included IGLJ3, IGHG3, IGKC, and IGL, which all function in B-cell selection or antigen recognition of B cells. Other upregulated genes included chemokines, such as CXCL9 and CCR2, as well as CPA3, a mast cell carboxypeptidase. Allograft inflammatory factor-1 (AIF-1), a modulator of immune response was upregulated both in CIDP and VAS. Microarray-based analysis of human sural nerve biopsies showed distinct gene expression patterns in CIDP and VAS. DEGs might provide clues to the pathogenesis of the diseases and be potential targets for therapeutics. © 2011 Peripheral Nerve Society.

Wolter L.,Hopital Neuchatelois | Santa V.D.,Hopital Neuchatelois
Revue Medicale Suisse | Year: 2013

Acute ethanol intoxication is frequent in emergency departments. The clinical presentation is highly variable and ranges from an inebriety to a coma and sometimes an agitated patient. You have to examine completely the patient and to do complementary exams with a capillary glycemia as the minimal standard. We must keep in mind that an acute ethanol intoxication is a diagnosis of exclusion. With trauma patients, we have to keep a low threshold for asking radiological advanced imaging, like cerebro-cervical CT scan. The patient should be reexamined frequently. The treatment is a supportive one. If the patient is agitated, you can give him haloperidol or a benzodiazepine. Before discharge, the patient should see the alcohologic team.

PURPOSE: PET with (68)Ga-DOTATOC allows for imaging and quantitative assessment of somatostatin receptor expression in neuroendocrine tumors (NET). The aim of this retrospective study was to analyze whether pre-therapeutic (68)Ga-DOTATOC PET/CT is able to predict response to Peptide Receptor Radionuclide Therapy (PRRT).PATIENTS AND METHODS: Forty patients with advanced stage NET were treated with a fixed dose of (90)Y-DOTATOC (5550 or 3700MBq). Prior to PRRT, each patient received (68)Ga-DOTATOC PET/CT. Treatment results were evaluated after 3months by CT, tumor marker levels and clinical course and correlated with (68)Ga-DOTATOC uptake (SUVmax) and the assumed uptake of (90)Y-DOTATOC in tumor manifestations (MBq/g). ROC analysis and pairwise comparison of area under the curve (AUC) were performed with pre-treatment uptake of (68)Ga-DOTATOC, assumed uptake of (90)Y-DOTATOC and treatment activity alone and in relation to body weight as continuous variables, and response/no response as classification variable.RESULTS: According to conventional criteria (tumor shrinkage, decrease of tumor markers, improved or stable clinical condition), 20 patients were classified as responders, 16 as non-responders and in four patients findings were equivocal. Using a SUV more than 17.9 as cut-off for favorable outcome, PET was able to predict treatment response of all responders and 15 out of 16 non-responders. All four patients with equivocal findings showed SUV less than or equal to 17.9 and soon experienced tumor progression. The assumed uptake of (90)Y-DOTATOC in tumor manifestations using a cut-off more than 1.26MBq/g as predictor of response was able to correctly classify 19 out of 20 responders, and 14 out of 16 non-responders. In all patients with equivocal findings, the assumed uptake of (90)Y-DOTATOC was below 1.26MBq/g.CONCLUSION: Pre-therapeutic (68)Ga-DOTATOC tumor uptake as well as assumed uptake of (90)Y-DOTATOC are strongly associated with the results of subsequent PRRT. The defined cut-off values should be confirmed by prospective studies and may then provide the rationale for individual dosing and selecting patients with high likelihood of favorable treatment outcome. Copyright © 2013 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Genne D.,Hopital Neuchatelois
Revue Medicale Suisse | Year: 2013

Unprotected fellatio, which has been practiced by all civilizations since mists of time, is now becoming a cause of concern due to the AIDS epidemic. Most of the sexually transmitted infectious diseases are concerned by fellatio and only few medical studies deal with this topic. This paper is therefore a non exhaustive review of risks brought upon by unprotected fellatio. It is almost impossible to assess the exact risk for a given infection because of the complexity of sexual intercourse, which is rarely exclusively oro-genital.

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