WWW : What a wonderful world

Dans la gestation en cours d’un monde nouveau – à moins qu’il ne s’agisse d’une révolution, au sens physique, de l’ancien –, pour Médecins du Monde comme pour d’autres associations, l’écart semble se creuser entre elles et le monde réel. Pour autant, c’est moins cet écart qui doit inquiéter que la perspective qu’il aille encore et toujours croissant et que, chemin faisant, les associations, faute d’en avoir conscience, ne sachent pas y répondre. À cet égard, la réflexion que Médecins du Monde mène en interne depuis plusieurs mois sur son projet associatif, condensé des valeurs qui fondent l’ONG, peut intéresser l’ensemble du milieu de la solidarité

Profiles of psychological adaptation outcomes at discharge from spinal cord injury inpatient rehabilitation

OBJECTIVE: To evaluate the effect of a newly acquired spinal cord injury (SCI) by identifying profiles of psychological adaptation outcomes at discharge from inpatient rehabilitation, using several outcome measures in parallel and to examine biopsychosocial factors associated with profile membership. DESIGN: Cross-sectional analysis of data from the Swiss Spinal Cord Injury inception cohort study. SETTING: Inpatient rehabilitation. PARTICIPANTS: Individuals 16 years old or older with recently diagnosed SCI who finished clinical rehabilitation in 1 of the 4 major national rehabilitation centers (N=370). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Life satisfaction, general distress, and symptoms of depression and anxiety were assessed using a single item from the International SCI Quality of Life Basic Data Set, the Distress Thermometer, and the Hospital Anxiety and Depression Scale respectively. RESULTS: Using latent profile analysis, 4 profiles of psychological adaptation outcomes were identified displaying different levels of impact, ranging from Minimal to Severe. Regarding covariates associated with profile membership, higher optimism, purpose in life, and self-efficacy indicated a higher probability of having a Minimal impact profile. Additionally, males, individuals with better functional independence, and those with an absence of pain were more likely to show a Minimal impact profile. CONCLUSIONS: Among the participants, 70% showed Minimal or Low impact profiles. Our findings support that individuals can show positive responses across several outcome measures even at an early time after the injury onset (eg, at discharge from inpatient rehabilitation). Moreover, our results indicate that beyond functional independence, improvement, and pain management, a rehabilitation process that strengthens psychological resources might contribute to better adaptation outcomes

Biocompatibility of RealSeal, its primer and AH Plus implanted in subcutaneous connective tissue of rats

OBJECTIVE: This study tested rat connective tissue response to RealSeal, RealSeal primer or AH Plus after 7, 15, 30, 60 and 90 days of implantation. MATERIAL AND METHODS: Thirty Wistar rats had subcutaneous sockets created on their back and received four implants each of polyethylene tubes containing one of the materials tested according to the groups: AH (AH Plus Sealer); RS (RealSeal Sealer); RP (RealSeal Primer); CG (control group - empty tube). After histological processing, sections were analyzed to identify the presence of neutrophils, lymphocytes and plasma cells, eosinophils, macrophages and giant cells, as well as fibrous capsule and abscesses, by an examiner using light microscope. Kruskal-Wallis and multiple-comparisons test were used for statistical analysis. Significance level was set at 5%. RESULTS: Lymphoplasmacytic infiltrate scores significantly higher than those of the control group were observed at 14 and 60 days in AH group, and at 90 days in RS group (p<0.05). There were no differences in terms of presence of macrophages, giant cells, eosinophils, neutrophils or fibrosis. AH Plus group scored higher for abscesses at 7 days than after any other period (p=0.031). RP group scored higher for lymphoplasmacytic infiltrate at 14 days than at 90 days (p=0.04). CONCLUSION: The main contribution of this study was to demonstrate that issues involved with tissue tolerance of a Resilon-containing sealer, RealSeal Sealer, cannot be attributed to its primer content