Gestion du paysage en faveur du réseau écologique

Les politiques de conservation de la biodiversité ne concernent plus seulement aujourd’hui des espaces protégés, mais également des réseaux où l’enjeu est de préserver et restaurer les continuités entre habitats des espèces afin de favoriser la circulation de la faune. En France, cette approche se traduit depuis 2007 par la politique Trame verte et bleue. Ce nouveau regard élargit les territoires de la conservation aux espaces de nature ordinaire, tels que les espaces agricoles, où les proces..

Proximal row carpectomy on manual workers: 17 patients followed for an average of 6 years

Proximal row carpectomy (PRC) is indicated for the treatment of SNAC or SLAC wrist with preservation of the midcarpal joint. Our hypothesis was that PRC is not appropriate for treating advanced wrist osteoarthritis in patients who carry out heavy manual work. Twenty-three PRCs were performed on 21 patients, 5 women and 16 men with an average age of 54 years (33-77). All patients performed manual work; 11 of them performed heavy manual work. Etiologies were: SLAC wrist in 14 cases (2 stage III, 11 stage II, and 1 stage I) and SNAC wrist in 9 cases (6 stage IIIB and 3 stage IIB). At an average 75 months' follow-up (24-153), five patients were lost to follow-up. Radiocarpal arthrodesis was performed in one patient 10 years after the PRC. In the 17 remaining patients (18 wrists), pain (VAS) averaged 2.2, with residual pain of 5. Flexion-extension range was similar to preoperative levels (67% of contralateral wrist). Wrist strength was decreased by 34% compared to preoperative. The QuickDASH score averaged 26 points and the PRWE 20 points. Radiocapitate distance decreased by 0.3mm on average with joint line narrowing in 6 patients. The carpal translation index was 0.33mm, which was unchanged relative to preoperative values. Three patients had work-related limitations that required retraining and one patient had to be reassigned. PRC preserved the preoperative range of motion and reduced pain levels. However, significant loss of strength was observed, resulting in 23% of manual workers needing retraining or reassignment

Géographie de la médiatisation de la biodiversité dans ses relations à l’agriculture : étude de la presse nationale et régionale française du début du XXIe siècle

La conservation de la biodiversité est un problème public dont les contours se dessinent par la confrontation d’acteurs au sein d’arènes publiques parmi lesquelles les médias jouent un rôle important. Porter attention aux différentes modalités de médiatisation des relations entre la biodiversité et l’agriculture permet d’apporter un regard nouveau sur les transformations des relations homme-nature. À travers l’étude de sept journaux nationaux et d’un journal régional français (Le Progrès) entre 1999 et 2017, nous confirmons qu’agriculture et biodiversité forment un problème public majeur. Le nombre important d’articles régionaux depuis 2003 montre que la globalisation du problème de la biodiversité s’accompagne également d’un traitement local. Contrastant avec la presse nationale, plus encline à évoquer la crise de la biodiversité, la presse régionale trace les contours d’une image positive de l’agriculture. La dimension spatiale de la relation biodiversité-agriculture est devenue incontournable. Cependant, l’exposition médiatique forte des territoires urbains et naturels rend difficile la mise en lumière des espaces agricoles qui deviennent pourtant aujourd’hui le lieu de nouvelles mesures de conservation.Biodiversity conservation is a major issue of our society and the confrontation of actors in public spheres outlines this public problem. The media plays a role in the agenda-setting and analyzing the media coverage of the relations between agriculture and biodiversity is a fresh look on human-nature relationships. We analyze seven national French newspapers and one regional French newspaper (Le Progrès) from 1999 to 2017. We confirm that agriculture and biodiversity constitute a major public problem. The high number of regional press articles since 2003 shows that the globalization of the biodiversity problem is completed by a local care. On regional newspapers, the articles introduce a positive view of agriculture. The spatial dimension between biodiversity and agriculture is dominant in the last articles. The media exposure of urban and natural territories makes the media coverage of agricultural areas difficult while agricultural landscapes become nowadays the place of news biodiversity conservation measures

Outcomes of bipolar radial head prosthesis to treat complex radial head fractures in 22 patients with a mean follow-up of 50 months

AbstractBackgroundRadial head replacement is indicated to treat complex proximal radial fractures that are not amenable to internal fixation.HypothesisImplantation of a bipolar radial head prosthesis after radial head excision ensures stability of the elbow and forearm, thereby promoting ligament healing and restoring elbow function.Material and methodsTwenty-two patients managed with implantation of a bipolar radial head prosthesis (Guepar®) were evaluated after a mean follow-up of 50 months. The procedure was performed in the acute setting in 16 patients, including 13 with associated injuries; and at the stage of sequelae in 6 patients.ResultsProsthesis removal was required in 4 patients. Of the remaining 18 patients, 14 (77%) had satisfactory Mayo Elbow Performance Score values, 14 (77%) little or no functional impairment, and 11 (61%) little or no pain. Mean motion arcs were 100° in flexion-extension and 143° in pronation-supination. Mean elbow strength in flexion and mean wrist strength were 67% and 86%, respectively, of those on the contralateral normal side. Radio-lucent lines were visible around the prosthesis in 5 patients, radial neck osteolysis in 10 patients, and capitellar erosion in 7 patients. Seven patients each experienced a complication. Early revision surgery to treat elbow instability was required in 6 patients.DiscussionOutcomes after Guepar® bipolar radial head prosthesis implantation were disappointing in patients with complex radial head fractures seen in the acute or chronic setting. The associated injuries to bones and ligaments and the measures taken to repair them influence the prognosis. The complication rate is non-negligible and seems to increase over time.Level of evidenceIV, retrospective study

Current status of the verification and processing system GALILEE-1 for evaluated data

International audienceThis paper describes the current status of GALILÉE-1 that is the new verification and processing system for evaluated data, developed at CEA. It consists of various components respectively dedicated to read/write the evaluated data whatever the format is, to diagnose inconsistencies in the evaluated data and to provide continuous-energy and multigroup data as well as probability tables for transport and depletion codes. All these components are written in C++ language and share the same objects. Cross-comparisons with other processing systems (NJOY, CALENDF or PREPRO) are systematically carried out at each step in order to fully master possible discrepancies. Some results of such comparisons are provided

Peri-lunate dislocation and fracture-dislocation of the wrist: Retrospective evaluation of 65 cases

INTRODUCTION: Peri-lunate wrist dislocations and fracture-dislocations are related to high-energy trauma. Prognosis is often compromised because of the complexity of the lesions. The purpose of this study was to assess outcomes of acute peri-lunate injuries and correlate them with the type of lesion and management. MATERIEL AND METHODS: A monocenter retrospective study has been conducted. Sixty-five patients (65 wrists) were reviewed. According to Herzberg's classification, there were 18 isolated peri-lunate dislocations and 47 peri-lunate fracture-dislocations - 27 with a scaphoid fracture and 20 with an intact scaphoid. The displacement was dorsal in 62 cases. All patients were treated surgically. RESULTS: At an average follow-up of 8 years (2-16) the average Cooney score was 66 points, quick-DASH score 21 points, and PRWE score 28 points. Pain score was 1.3 out of 10 points at rest and 4.3 out of 10 with effort. The flexion-extension arc was 96° with an average strength of 38kg (70±23% of opposite side). Radiographic analysis has shown decrease in carpal height, increase in ulnar translation, and DISI. Sign of wrist arthritis was found in 58.5% of the cases. The rate of osteonecrosis was 7.7%. Regional sympathetic painful syndrome was observed in 12%. In 26% of the cases a secondary surgery was needed. No influence has been found with the final results between fracture-dislocation and isolated dislocation, and delay of treatment. Osteochondral lesions observed at surgery (P=0.035), osteonecrosis at follow-up (P=0.017), and modification of the scapho-lunate angle (P=0.029) were correlated with the occurrence of osteoarthritis. DISCUSSION: Peri-lunate dislocation and fracture-dislocation represent severe wrist trauma with often numerous sequelae with follow-up: pain, stiffness, loss of strength, carpal instability and arthritis. Early diagnosis and anatomic reduction are prerequisite to a satisfactory functional result. Capsulo-ligamentous lesions must be repaired and fractures must be fixed

Distal radius fracture malunion: Importance of managing injuries of the distal radio-ulnar joint.

Background: Distal radius malunion is a major complication of distal radius fractures, reported in 0 to 33% of cases. Corrective osteotomy to restore normal anatomy usually provides improved function and significant pain relief. We report the outcomes in a case-series with special attention to the potential influence of the initial management. Material and methods: This single-centre retrospective study included 12 patients with a mean age of 35 years (range, 14–60 years) who were managed by different surgeons. There were 8 extra-articular fractures, including 3 with volar angulation, 2 anterior marginal fractures, and 2 intra-articular T-shaped fractures; the dominant side was involved in 7/12 patients. Initial fracture management was with an anterior plate in 2 patients, Kapandji intra-focal pinning in 5 patients, plate and pin fixation in 2 patients, and non-operative reduction in 3 patients. The malunion was anterior in 10 patients, including 2 with intra-articular malunion, and posterior in 2 patients. Corrective osteotomy of the radius was performed in all 12 patients between 2005 and 2012. In 11/12 patients, mean time from fracture to osteotomy was 168 days (range, 45–180 days). The defect was filled using an iliac bone graft in 7 patients and a bone substitute in 4 patients. No procedures on the distal radio-ulnar joint were performed. Results: All 12 patients were evaluated 24 months after the corrective osteotomy. They showed gains in ranges not only of flexion/extension, but also of pronation/supination. All patients reported improved wrist function. The flexion/extension arc increased by 40◦ (+21◦ of flexion and +19◦ of extension) and the pronation/supination arc by 46◦ (+13◦ of pronation and +15◦ of supination). Mean visual analogue scale score for pain was 1.7 (range, 0–3). Complications recorded within 2 years after corrective osteotomy were complex regional pain syndrome type I (n = 1), radio-carpal osteoarthritis (n = 3), and restricted supination due to incongruity of the distal radio-ulnar joint surfaces (n = 3). This last abnormality should therefore receive careful attention during the management of distal radius malunion. Discussion: In our case-series study, 3 (25%) patients required revision surgery for persistent loss of supination. The main error in these patients was failure to perform a complementary procedure on the distal radio-ulnar joint despite postoperative joint incongruity. This finding and data from a literature review warrant a high level of awareness that distal radio-ulnar joint congruity governs the outcome of corrective osteotomy for distal radius malunion

Physical therapy under hypnosis for the treatment of patients with type 1 complex regional pain syndrome of the hand and wrist: retrospective study of 20 cases

Type 1 complex regional painful syndrome (CRPS-1) has a complex physiopathology. The aim of this study was to evaluate the effectiveness of physical therapy under hypnotherapy to treat this condition. Twenty patients with CRPS-1 at the wrist and hand were evaluated retrospectively: 13 women and 7 men with an average age of 56 years (34-75). Thirteen patients were in the inflammatory phase and 7 in the dystrophic phase. The main endpoints were pain (VAS, analgesic use), stiffness (wrist and finger range of motion), and strength (pinch and grasp). Secondary endpoints were functional scores (QuickDASH, PWRE), patient satisfaction, return to work, and side effects. Results were satisfactory in all cases after 5.4 sessions on average. VAS decreased by 4 points, PWRE-pain by 4.1 points, and analgesic use was limited to paracetamol upon request. Finger and wrist range of motion increased and the QuickDASH decreased by 34 points, PRWE-function by 3.8 points, pinch strength increased 4 points, and grasp strength by 10 points. Return to work was possible in 80% of the cases. All patients were satisfied or very satisfied with the treatment. Physical therapy under hypnosis appears to be an effective treatment for CRPS-1 at the wrist and hand no matter the etiology

Ageing and endurance training effects on quantity and quality of pulmonary vascular bed in healthy men

International audienceIt has recently been demonstrated that in healthy individuals, peak oxygen consumption is associated with a greater pulmonary capillary blood volume and a more distensible pulmonary circulation. Our cross-sectional study suggests that, in healthy men aged 20 to 60 years (n = 63), endurance sport practice (vigorous-intensity domain of the International Physical Activity Questionnaire) is associated with better quantity (pulmonary capillary blood volume) and quality (slope of increase in lung diffusion for carbon monoxide on exercise) of the pulmonary vascular bed, partly counterbalancing the deleterious effects of ageing, which remains to be demonstrated in a prospective longitudinal design