B Acad Nat Med Paris
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B Acad Nat Med Paris · Dec 2024
[Advances and perspectives in vascularized composite allotransplantation preservation].
Vascularized composite allotransplantation (VCA) involves transplants of the face, upper limb, trachea, penis, abdominal wall and, more recently, uterus. These grafts are unique in that they comprise numerous specialized tissues derived from several embryonic layers, each with its own specific constraints. ⋯ In this review, we outline the challenges imposed by composite tissue allotransplantation, and discuss the latest advances in VCA preservation based on machine perfusion but also on static techniques at negative temperatures. Particular attention is paid to subnormothermic perfusion preservation and supercooling techniques, developed by our team in an attempt to import these optimized techniques from solid organ preservation.
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B Acad Nat Med Paris · Jun 2023
Review[COVID-19: Neurological manifestations and complications during the acute phase of the disease].
The neurological manifestations and complications of the acute phase of COVID-19 are numerous. They mainly concern the central nervous system in the frequent forms of encephalopathy, encephalitis and neurovascular pathologies. ⋯ Most of these manifestations were described during the first wave of the pandemic. The epidemiological, clinical, paraclinical, pathophysiological and therapeutic aspects are addressed in this general review of the literature published from 2020 to early 2023.
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B Acad Nat Med Paris · Jun 2023
Review[Neurological forms of long COVID in adults: Critical approach].
Now recognized by health authorities, long COVID is identified as a frequent condition complicating the evolution of SARS-CoV-2 infection. Its polymorphic and sometimes disconcerting clinical expression raises questions about its mechanism. Patterns of clinical expression suggest extensive involvement of the nervous system through an almost ubiquitous cognitive complaint. ⋯ The studies published until now confronted with the clinical mode of expression, did not make it possible to define a deficit neuropsychological profile at the level of the groups, and evoked more a functional impairment than a lesion. However, each series mentions a small number of patients in whom a cognitive deficit is objectified. The uncertainties about the causes of the prolonged forms of COVID, the heterogeneity of the published studies, and the virtual absence of temporal evolution data should make one cautious about the interpretation of these data but should in no way delay or prevent taking into account care of these patients.
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Even after a mild episode of coronavirus disease 2019 (COVID-19), many patients suffer from persistent symptoms that can impair their quality of life for months. The potential role of psychological mechanisms in this post-COVID-19 condition, often referred to as long COVID, has been discussed early in the pandemic. Evidence supporting this hypothesis is now accumulating. ⋯ Bayesian models of perception can account for these results particularly well within a theoretical framework similar to that advanced for functional somatic disorders, integrating increased symptom expectations with decreased perception of the body internal state (interoception) and intolerance of uncertainty in the context of symptoms initially triggered by an infectious episode. These psychological mechanisms should obviously not be considered as exclusive. However, since they are modifiable, they could be targeted in clinical trials, within an integrative and multidisciplinary approach.