Impact of COVID-19 on 2020 transplant activity and waiting lists in France✰,✰✰.

The COVID-19 pandemic strongly affected organ procurement and transplantation in France, despite the intense efforts of all participants in this domain. In 2020, the identification and procurement of deceased donors fell by 12% and 21% respectively, compared with the mean of the preceding 2 years. Similarly, the number of new registrations on the national waiting list declined by 12% and the number of transplants by 24%. The 3-month cumulative incidence of death or drop out for worsening condition of patients awaiting a liver transplant was significantly greater in 2020 compared to the previous 2 years. Continuous monitoring at the national level of early post-transplant outcomes showed no deterioration for any organ in 2020. At the end of 2020, less than 1% of transplant candidates and less than 1% of graft recipients - of any organ - had died of COVID-19.

Vestibular neuritis: Evaluation and effect of vestibular rehabilitation.

UNLABELLED: Vestibular neuritis (VN) is a caloric vestibular areflexia that occurs suddenly, and whose compensation can take several weeks, sometimes several months. Usually these patients are rehabilitated, but the most affected patients (cervical vestibular evoked myogenic potential (cVEMP) absent) have a worse prognosis of vestibulo-ocular compensation. Thanks to symptomatic, videographic and posturographic evaluation tools, we objectify and quantify which factors influence the recovery or more accurately the compensation of this type of disorder. EQUIPMENT AND METHOD: We have colligated 34 observations of VN whose beginning could be precisely dated. These 34 unilateral caloric areflexic patients had a symptomatic evaluation (SE) with scales (vertigo symptom scale, dizziness handicap inventory, short form 36), an evaluation of the vestibulo-ocular reflex (VOR) (spontaneous nystagmus, head shaking test, mastoid bone skull vibration test, and finally an evaluation of the vestibulo-spinal function (VSF) on a dynamic posturography platform (DPY). On the other hand were evaluated eight elements supposed to influence (influence factors FI) the care and/or the outcome of the treatment (age, cVEMP absent, duration of deficiency, sports and walk practice, rehabilitation of VOR, rehabilitation of VSF, waiting period before application of rehabilitation, vertigo medications treatment). RESULTS: By comparing averages and with a Fischer's exact test, we can show here that the medical treatment, the waiting period before the application of the rehabilitation, the number of rehabilitation sessions or the type of rehabilitation influence only partially the state of health of neuritis. The age of the patients and absent cVEMP don't have a major influence either. However, patients with the most important physical activity feel better from a symptomatic point of view, over a long period after the episode. The effect of rehabilitation might be temporary if daily activity is minimal. CONCLUSION: The evaluation of the vestibulo-ocular reflex has long remained the main element for the evaluation of the state of health of vestibular neuritis. But if you use in addition posturography and symptomatic scales to assess the state of health, the neuritis considered to be compensated with the VOR will not always be symptomatically compensated. Estimating the functional recovery of neuritis can't be limited to estimating or quantifying the VOR. Rehabilitating neuritis can't be limited to rehabilitating the VOR. Finally we show here that physical activity is probably more necessary than any type of rehabilitation.

Effect of vestibular neuritis on postural control using wavelets and fractal analysis.

OBJECTIVE: What is the status of postural control a few months after an attack of vestibular neuritis (VN)? Using dynamic posturography and stabilometric signal treatment with wavelets and fractal analysis, we tried to answer this question by isolating the pathological postural parameters of VN. MATERIAL AND METHOD: The study involved a group of 15 patients (GP) who suffered from VN and were compared to a group of control subjects (GC). Both groups underwent videonystagmography (VNG), dynamic posturography (PDY), and assessment using symptomatic scales (ES). RESULTS: GP and GC were comparable in terms of age mean, sex-ratio, average height and weight. The differences between GP and GC were the following videonystagmography criteria: Spontaneous nystagmus (NS) (P= 0.005), head shaking test (HST) (p= 0.001), vibratory test (TVO) (p= 0.009). There were also differences in the symptomatic scales scores for the vertigo symptom scale (VSS) (p= 0.011), the dizziness handicap inventory (DHI) (p= 0.001), and the short form 36 (SF36) (p= 0.01). All the 84 new parameters of both GP and GC differ. This difference was significant (p< 0.05) in 16 cases (19%), and highly significant (p< 0.01) in 11 other cases (13%). The condition ("unsteady platforms" was the greatest determinant in both groups while the (closed eyess and (HST> conditions were found to be non-discriminating. CONCLUSION: Vestibular neuritis affects new stabilometric parameters. These parameters are more adapted to the present setup compared to previous parameters which are used to analyse non-periodic oscillations of posture. They are important in follow-up and rehabilitation of patients.