Subcutaneous phaeohyphomycosis due to Phialemoniopsis ocularis successfully treated by voriconazole

International audienceWe report a case of subcutaneous infection in a 67 year-old Cambodian man who presented with a 5-month history of swelling of the right foot. Histopathology was compatible with phaeohyphomycosis and the hyphomycete Phialemoniopsis ocularis was identified by the means of morphological and molecular techniques. The patient responded well to a 6-month oral treatment with voriconazole alone

Infraspinatus and Teres minor muscles : anatomy, texture analysis in MRI and viscoelastic behavior assessment in ultrasound elastography

Les muscles infraépineux et petit rond sont cruciaux sur le plan fonctionnel et sont altérés dans le cadre des pathologies de la coiffe des rotateurs. La proportion de tissu graisseux dans l’infraépineux est actuellement un critère pronostic du résultat fonctionnel des réparations des lésions tendineuses de la coiffe des rotateurs. Les buts de ce travail sont de caractériser ces muscles sur le plan anatomique, de proposer une meilleure exploration de leur morphologie par IRM, d’utiliser l’analyse de texture informatique pour objectiver leur composition et enfin, d’utiliser l’élastographie ultrasonore pour analyser leur comportement viscoélastique en contrainte. L’infraépineux et le petit rond sont respectivement de conformation tripennée et parallèle. Les critères d’acquisition IRM de routine peuvent être aisément optimisés pour analyser plus précisément les muscles rotateurs externes. L’analyse de texture semble prometteuse pour évaluer la proportion de tissu graisseux dans le muscle squelettique. L’élastographie ultrasonore permet d’appréhender le degré d’anisotropie musculaire, et donc l’état d’organisation du muscle infraépineux.Infraspinatus and teres minor muscles are crucial functionally and are regularly impaired in the context of of the rotator cuff pathology. The proportion of fatty tissue in the infraspinatus is currently a strong prognosis criterion of functional outcomes of rotator cuff tendon repair. The goals of this work are to characterize these muscles anatomically, to provide a better exploration of their morphology by MRI, to use computer texture analysis to objectify their composition and finally to use the ultrasound elastography for analysing their viscoelastic behaviour under stress. Infraspinatus and teres minor muscles have a tripennate and parallel organization, respectively. Routine MRI acquisition criteria can be easily optimized to analyse more precisely the external rotator muscles. Texture analysis seems promising to assess the proportion of fatty tissue in the skeletal muscle. The ultrasound elastography allows us to estimate the degree of muscle anisotropy, and therefore the state of organization of the infraspinatus muscle

Descellements acétabulaires avec perte de substance osseuse (reconstruction par greffe et anneau de soutien)

TOURS-BU Médecine (372612103) / SudocSudocFranceF

Coarse-grained Models of Aqueous Solutions of Polyelectrolytes: Significance of Explicit Charges

International audienceThe structure of polyelectrolytes is highly sensitive to small changes in the interactions between its monomers. In particular, interactions mediated by counterions play a significant role, and are affected by both specific molecular effects and generic concentration effects. The ability of coarse-grained models to reproduce the structural properties of an atomic model is thus a challenging task. Our present study compares the ability of different kinds of coarse-grained models: (i)~to reproduce the structure of an atomistic model of a polyelectrolyte (the sodium polyacrylate), (ii)~to reproduce the variations of this structure with the number of monomers and with the concentration of the different species. We show that the adequate scalings of the gyration radius of the polymer~$R_{\rm g}$ with the number of monomers~$N$ and with the box size~$L_{\rm box}$ are only obtained, first, if the monomer charges and the counterions are explicitely described, and second, if an attractive Lennard-Jones contribution is added to the interaction between distant monomers. Also, we show that implicit ion models are relevant only to the high electrostatic screening regime

Preparation and physicochemical stability of 50 mg/mL hydroxychloroquine oral suspension in SyrSpend(Ⓡ) SF PH4 (dry)

International audienceIn the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, hydroxychloroquine has been proposed as a potential agent to treat patients with COVID-19 (coronavirus disease 2019) caused by SARS-CoV-2 infection. Older adults are more susceptible to COVID-19 and some patients may require admission to the intensive care unit, where oral drug administration of solid forms may be compromised in many COVID-19 patients. However, a liquid formulation of hydroxychloroquine is not commercially available. This study describes how to prepare a 50 mg/mL hydroxychloroquine oral suspension using hydroxychloroquine sulfate powder and SyrSpend(Ⓡ) SF PH4 (dry) suspending vehicle. Moreover, a fully validated stability-indicating method has been developed to demonstrate the physicochemical stability of the compounded hydroxychloroquine oral suspension over 60 days under refrigeration (5 ± 3 °C). Finally, use of the proposed oral suspension provides a reliable solution to perform safe and accurate administration of hydroxychloroquine to patients with SARS-CoV-2 infection

Do the indications, results, and complications of reverse shoulder arthroplasty change with surgeon's experience?

The goal of this study was to compare 2 consecutive series of 240 reverse total shoulder arthroplasties (TSA) in order to evaluate if the increase in surgeon experience modified the indications, clinical and radiographic results, and rate of complications

Drivers of absolute systemic bioavailability after oral pulmonary inhalation in humans

International audienceThere are few studies in humans dealing with the relationship between physico-chemical properties of drugs and their systemic bioavailability after administration via oral inhalation route (Fpulm). Getting further insight in the determinants of Fpulm after oral pulmonary inhalation could be of value for drugs considered for a systemic delivery as a result of poor oral bioavailability, as well as for drugs considered for a local delivery to anticipate their undesirable systemic effects. To better delineate the parameters influencing the systemic delivery after oral pulmonary inhalation in humans, we studied the influence of physico-chemical and permeability properties obtained in silico on the rate and extent of Fpulm in a series of 77 compounds with or without marketing approval for pulmonary delivery, and intended either for local or for systemic delivery. Principal component analysis (PCA) showed mainly that Fpulm was positively correlated with Papp and negatively correlated with %TPSA, without a significant influence of solubility and ionization fraction, and no apparent link with lipophilicity and drug size parameters. As a result of the small sample set, the performance of the different models as predictive of Fpulm were quite average with random forest algorithm displaying the best performance. As a whole, the different models captured between 50 to 60% of the variability with a prediction error of less than 20%. Tmax data suggested a significant positive influence of lipophilicity on absorption rate while charge apparently had no influence. A significant linear relationship between Cmax and dose (R(2) = "0.79) highlighted that Cmax was primarily dependent on dose and absorption rate and could be used to estimate Cmax in humans for new inhaled drugs

Acousto-elasticity of transversely isotropic incompressible soft tissues: Characterization of skeletal striated muscle

Using shear wave elastography, we measure the changes in the wave speed with the stress produced by a striated muscle during isometric voluntary contraction. To isolate the behaviour of an individual muscle from complementary or antagonistic actions of adjacent muscles, we select the flexor digiti minimi muscle, whose sole function is to extend the little finger. To link the wave speed to the stiffness, we develop an acousto-elastic theory for shear waves in homogeneous, transversely isotropic, incompressible solids subject to an uniaxial stress. We then provide measurements of the apparent shear elastic modulus along, and transversely to, the fibre axis for six healthy human volunteers of different age and sex. The results display a great variety across the six subjects. We find that the slope of the apparent shear elastic modulus along the fibre direction changes inversely to the maximum voluntary contraction (MVC) produced by the volunteer. We propose an interpretation of our results by introducing the S (slow) or F (fast) nature of the fibres, which harden the muscle differently and accordingly, produce different MVCs. A natural follow-up on this study is to apply the method to patients with musculoskeletal disorders or neurodegenerative diseases.This work is supported by the Institut du Biom´edicament and by the INCA Plan Cancer BPALP project.peer-reviewe