Contribution of shear wave elastography in evaluation of the deltoid in reverse shoulder arthroplasty: reproducibility study and preliminary results

Aims: The current difficulty of reverse shoulder arthroplasty (RSA) is soft tissue management, and adequate deltoid tension and at present there is no consensus and available tools (X-ray, MRI, EMG) remain difficult to apply in clinical follow-up. The objective of this study was (1) to determine reliability and feasibility of deltoid elasticity assessment using ultrasound elastographyand (2) to assess the change of deltoid stiffness after RSA by comparing shear wave speed (SWS) between healthy and RSA shoulders. Material and methods: Twenty-six healthy (native shoulder, painless and complete range of motion) subjects and twelve patients with RSA were included. Two independent investigators performed 3 measurements on each segment. Measurements were bilateral. Anterior segment was also evaluated at 45° and 60° of passive abduction. Reliability and feasibility have been assessed (ISO5725-standard). Results: Coefficient of measurements variation was less than 6.1% and 0.13 m/s. In the healthy group, SWS was not significantly different between anterior and middle segments; however, the SWS of the posterior segment was significantly lower than others (p<0.0001). In abduction position, compared to the rest position, SWS of the anterior segment decreased at 45° abduction (p=0.0003) and increased at 60° abduction (p<0.0001). Variability of measurement was higher in the RSA group. No significant difference was found between the SWS measurement of the operated and non-operated side. SWS measurements of the operated side of the anterior and middle segment were significantly higher compared to the healthy group. In abduction position, compared to rest position, no difference in SWS of the anterior segment was found at 45° abduction (p=0.71) and nor at 60° abduction (p=0.75). Conclusion: This study demonstrated feasibility and reliability of shoulder assessment with shear wave elastography. Reference values for asymptomatic patients can already be used in future studies on shoulder pathology and surgery

VALEUR COMPAREE DE LA CHOLANGIO-PANCREATOGRAPHIE PAR RESONANCE MAGNETIQUE ET DE LA CHOLANGIO-PANCREATOGRAPHIE PER ENDOSCOPIQUE AU COURS DES MALADIES PANCREATIQUES (ETUDE PROSPECTIVE EN DOUBLE AVEUGLE DE 44 OBSERVATIONS)

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Respective Roles of Culturable and Viable-but-Nonculturable Cells in the Heterogeneity of Salmonella enterica Serovar Typhimurium Invasiveness▿

The existence of Salmonella enterica serovar Typhimurium viable-but-nonculturable (VBNC) cells is a public health concern since they could constitute unrecognized sources of infection if they retain their pathogenicity. To date, many studies have addressed the ability of S. Typhimurium VBNC cells to remain infectious, but their conclusions are conflicting. An assumption could explain these conflicting results. It has been proposed that infectivity could be retained only temporarily after entry into the VBNC state and that most VBNC cells generated under intense stress could exceed the stage where they are still infectious. Using a Radioselectan density gradient centrifugation technique makes it possible to increase the VBNC-cell/culturable-cell ratio without increasing the exposure to stress and, consequently, to work with a larger proportion of newly VBNC cells. Here, we observed that (i) in the stationary phase, the S. Typhimurium population comprised three distinct subpopulations at 10, 24, or 48 h of culture; (ii) the VBNC cells were detected at 24 and 48 h; (iii) measurement of invasion gene (hilA, invF, and orgA) expression demonstrated that cells are highly heterogeneous within a culturable population; and (iv) invasion assays of HeLa cells showed that culturable cells from the different subpopulations do not display the same invasiveness. The results also suggest that newly formed VBNC cells are either weakly able or not able to successfully initiate epithelial cell invasion. Finally, we propose that at entry into the stationary phase, invasiveness may be one way for populations of S. Typhimurium to escape stochastic alteration leading to cell death

Dried blood spot sampling for hepatitis B virus serology and molecular testing.

BACKGROUND AIMS: Dried blood spots (DBS) on filter paper have been successfully used to diagnose and monitor several infectious diseases. The aim was to investigate the performance of DBS in hepatitis B virus (HBV) diagnosis using commercial tests in comparison to standard methods. METHODS: Paired DBS and plasma samples were collected from 200 patients: 100 patients with HBsAg negative status and 100 patients with HBsAg positive status. In the latter patient, HBeAg reactivity was tested. Ten samples of anti-HBs were collected from people vaccinated against HBV. We also studied 50 patients with positive HBV DNA viral load in plasma and 10 HBV DNA negative patients. HBV genotypes and gene polymerase mutations were determined in 10 randomly selected HBV-infected patients. The DBS sample consisted of 50 µL of whole blood, i.e. a 12-mm paper card. RESULTS: The sensitivity thresholds of HBsAg and anti-HBs antibody were 0.30 ± 0.08 IU/mL and 18.11 ± 6.05 IU/mL, respectively, for DBS with 98% sensitivity and 100% specificity. Sensitivity was 98% and specificity 100% for the detection of HBV DNA on a blotter, considering an HBV DNA threshold of 914.1 ± 157.8 IU/ml. Ten patients had an HBeAg positive status in plasma, all were detected positive using DBS. HBV genotyping and mutation detection were successfully performed on DBS, with full concordance between the 10 paired DBS and plasma samples. CONCLUSION: This study shows DBS is a reliable alternative to plasma specimens for quantifying and detecting HBsAg, anti-HBs, HBeAg and genotyping. DBS may increase the opportunities for HBV testing and treatment follow-up in hard-to-reach individuals

HBV Genotype characterization in DBS and plasma samples.

<p>HBV Genotype characterization in DBS and plasma samples.</p

Regression analysis and Bland-Altman representation of titer differences in DBS and plasma of HBsAg levels and HBV DNA levels.

<p>(A) Linear regression analysis of HBsAg levels for the 100 matched DBS-plasma pairs analyzed by immunoassay. (B) Bland-Altman analysis was used to determine the agreement between the HBsAg titer by plotting the differences between the two samples against the averages of the two techniques. (C) Linear regression analysis of HBV DNA levels for the 50 matched DBS-plasma pairs analyzed by real-time PCR quantitative assay. (D) Bland-Altman analysis of HBV DNA.</p

Evaluation of DBS storage relative to titer in HBsAg and anti-HBs tested by immunoassay.

<p>DBS samples were tested after storage at room temperature during 1, 3, 7, and 14 days. Each line represents 5 positive samples (black symbols) and 3 negative samples (white symbols). The dotted line represents the positive cutoff value for each parameter. (A) Evaluation of DBS storage relative to titer in HBsAg (IU/mL). (B) Evaluation of DBS storage relative to titer in anti-HBs (IU/mL).</p