Stretching and compression of laser pulses by means of high efficiency volume diffractive gratings with variable period in photo-thermo-refractive glass

High efficiency reflective volume Bragg gratings with chirped gratings recorded in photo-thermo-refractive glass having an absolute diffraction efficiency exceeding 95% in transmitting and reflecting modes are used to stretch and/or compress ultrashort laser pulses with high efficiency. Robustness, compactness, thermal and laser stability along with placement of multiple elements in the same space provides femtosecond laser system with high efficiency of stretching and re-compression of femtosecond pulses

Laser Pulse Temporal, Spectral And Spatial Shaping Devices Based On Volume Diffractive Gratings With Variable Parameters

Recent invention of longitudinally chirped volume Bragg gratings has dramatically changed a design of high power femtosecond lasers. Replacing of bulky pairs of conventional surface gratings with compact and robust chirped volume Bragg gratings for stretching and compression of laser pulses in chirped-pulse-amplification systems enabled decrease of size and weight of those systems by several times. This patent application enables substantial increase of stretching time and compression to shorter pulses along with more complex shaping of laser pulses in both temporal and spectral domains

Actinomadura meyerae osteitis following wound contamination with hay in a woman in France: a case report

<p>Abstract</p> <p>Introduction</p> <p>Mycetoma is a chronic granulomatous infection caused by environmental fungi or bacteria. It affects dermal and subcutaneous tissues, with putative contiguous extension to muscles or bones. While common in tropical and subtropical areas, mycetoma is rare in Europe.</p> <p>Case presentation</p> <p>We describe a case of <it>Actinomadura meyerae </it>osteitis in a 49-year-old Caucasian woman who suffered a tibia open fracture contaminated with hay; to the best of our knowledge the first case of autochthonous <it>A. meyerae </it>infection reported in France. The bacterium was cultivated from a bone biopsy. Following surgical osteosynthesis and six months of treatment with cotrimoxazole, our patient made a full recovery.</p> <p>Conclusion</p> <p>Our case report suggests that <it>A. meyerae </it>is a potential agent of wound infection in farm workers in contact with hay.</p

Communication entre les médecins référents de crèches et les médecins généralistes et pédiatres traitants

Médecine généraleRésumé : notre réflexion a commencé suite à une situation où la mauvaise communication entre le médecin référent de crèche et le médecin traitant avait été délétère pour l’enfant. En effet, cela avait conduit à un retard de diagnostic et donc de prise en charge d’un trouble du développement chez cet enfant. Nous avons décidé d'étudier la communication entre les médecins référents de crèche et les médecins généralistes et pédiatres traitants. Le critère de jugement principal était l'étude de la fréquence, de qualité et des moyens utilisés pour cette communication. Le critère de jugement secondaire était l'intérêt d'une éventuelle amélioration de cette communication. Pour cela, nous avons d'abord réalisé des entretiens avec des médecins généralistes, des pédiatres traitants, des médecins référents de crèche et des directrices de crèche afin d'établir un questionnaire pour les différents médecins autour de l'enfant. Le questionnaire interrogeait les différents groupes de médecins à propos des échanges qu'ils ont eu avec leurs confrères en terme de fréquence, de thèmes abordés, de moyens utilisés ainsi que leur opinion sur l'intérêt d'une amélioration et dans quels domaines serait-ce le plus intéressant. Nous avons pu conclure que dans les différents groupes de médecins, la communication était rare, le moyen le plus utilisé était le téléphone et que la majorité des médecins estimaient qu'une amélioration de la communication entre les médecins référents de crèche et les médecins généralistes et pédiatres traitants serait bénéfique pour la santé de l'enfant. Les thèmes abordés le plus fréquemment étaient : les protocoles de soins, les problèmes de comportement, les problèmes sociaux, le dépistage de maladie, les pathologies aiguës et les vaccinations.Summary : We started our study following an incidence where the poor communication between the nursery doctor and the general practitioner had deleterious effects on the child : late diagnosis and late medical care. Thus, we decided to study the communication between the nursery doctors, general practitioners and pediatricians. The primary endpoint was the evaluation of the frequency and quality of exchanges and the means used for these exchanges. The secondary endpoint was the opinion of the doctors about an improvement of the communication and the benefits that could result from it. For this study, firstly we interviewed nursery doctors, nursery directors, general practitioners and pediatricians to create a questionnaire which would be transmitted to general practitioners, pediatricians and nursery doctors. The questions asked were about the frequency of the exchanges between these doctors, the topics discussed, the means of communication used, and their opinion about the benefit of improving these exchanges. We concluded that these doctors rarely communicated each other, their preferred mean of communication was the telephone and the topics discussed were : medical care protocols, behavioral disorders, social problems, sickness screening, accute diseases and vaccinations

Large-aperture chirped volume Bragg grating based fiber CPA system

A fiber chirped pulse amplification system at 1558nm was demonstrated using a large-aperture volume Bragg grating stretcher and compressor made of Photo-Thermal-Refractive (PTR) glass. Such PTR-glass based gratings represent a new type of pulse stretching and compressing devices which are compact, monolithic and optically efficient. Furthermore, since PTR glass technology enables volume gratings with transverse apertures which are large, homogeneous and scalable, it also enables high pulse energies and powers far exceeding those achievable with other existing compact pulse-compression technologies. Additionally, reciprocity of chirped gratings with respect to stretching and compression also enables to address a long-standing problem in CPA system design of stretcher-compressor dispersion mismatch

Haemodynamic performance of the small supra-annular Trifecta bioprosthesis: results from a French multicentre study

International audienceOBJECTIVES: The St Jude Medical Trifecta bioprosthesis incorporates a single pericardial sheet externally mounted on a titanium stent that provides excellent haemodynamic results. The purpose of this multicentre study was to report on the haemodynamic performance and the expected lower risk of prosthesis-patient mismatch in patient with small aortic annulus diameters. METHODS: The 19- and 21-mm Trifecta valves were implanted in 88 and 266 eligible patients, respectively between 2011 and 2013 at three centres in France (Angers, Rennes and Amiens). The mean age of the population was 78 +/- 7 and 76 +/- 6 years for 19- and 21-mm valve sizes of which 96.6 and 68% were female, respectively. The aortic valve replacement was associated with another surgery in 18.2 and 21.8% in each group, respectively. RESULTS: The mean follow-up was 20.3 +/- 11.9 and 24 +/- 11.4 months for 19- and 21-mm valves, respectively. Early all-cause mortality was 2.5% and late mortality occurred in 5.8% of patients. The mean pressure gradient and the effective orifice area at discharge and at 1 year were respectively 12.4 +/- 4.6 and 14.7 +/- 5.8 mmHg (P = 0.003), 1.5 +/- 0.3 and 1.4 +/- 0.9 cm(2) (P = 0.06) in the 19-mm valve group; 10.4 +/- 3.8 and 11.7 +/- 4.5 mmHg (P = 0.001), 1.8 +/- 0.3 and 1.5 +/- 0.4 cm(2) (P = 0.1) in the 21-mm valve group. At 1 year, only 38 (11%) and 28 (8.1%) patients presented a moderate or severe prosthesis-patient mismatch for the two groups. After univariate analysis, no risk factor of mismatch was found. CONCLUSIONS: The 19- and 21-mm St Jude Medical Trifecta provide excellent haemodynamic performance and the rate of moderate and severe prosthesis-patient mismatch is low