An analytical model taking feed rate effect into consideration for scallop height calculation in milling with torus-end cutter

International audienceFeed rate effect on scallop height in complex surface milling by torus-end mill is rarely studied. In a previous paper, an analytical predictive model of scallop height based on transverse step over distance has been established. However, this model doesn’t take feed rate effect into consideration. In the present work an analytical expression of scallop height, including feed rate effect, is detailed in order to quantify feed rate effect and thus to estimate more precisely the surface quality. Then, an experimental validation is conducted, comparing the presented model predictions with experimental results. Actually, the share of the scallop height due to feed effect is highly dependent on the machining configuration. However, most of time, the feed effect on total scallop height values is far from being negligible

Performance diagnostique de l'échographie cardio-pulmonaire réalisée par le médecin urgentiste dans la prise en charge d'une dyspnée aiguë

TOULOUSE3-BU Santé-Centrale (315552105) / SudocSudocFranceF

Les particularités de l'infection à VIH chez la personne âgée de 50 ans et plus (étude de cohorte de patients suivis dans le Service des maladies infectieuses et tropicales de l'Hôpital Purpan, 1996-2006)

TOULOUSE3-BU Santé-Centrale (315552105) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Un cas d’arrêt cardiorespiratoire suite à une intoxication volontaire par le pentobarbital

Introduction : Malgré la baisse d’utilisation et de commercialisation des barbituriques à action rapide, des cas d’intoxications graves par ces produits sont encore constatés. Méthode et résultats : Nous rapportons une observation d’arrêt cardiorespiratoire récupéré chez une jeune femme de 25 ans secondaire à une tentative d’autolyse médicamenteuse par le pentobarbital dont la concentration sérique était de 85,1 mg/L (dosage effectué par chromatographie en phase liquide à haute performance) puis diminuée à 2 mg/L après 36 heures d’hémofiltration. L’évolution s’est faite vers un tableau d’éveil sous cortical sur encéphalopathie postanoxique sévère. Conclusion : L’épuration extrarénale peut permettre une baisse plus rapide de la concentration sérique du pentobarbital, mais ses indications doivent répondre à des objectifs thérapeutiques

Diagnostic performance of abdominal point of care ultrasound performed by an emergency physician in acute right iliac fossa pain

Abstract Background Right iliac fossa abdominal pain is a common reason for emergency ward admissions, its etiology is difficult to diagnose. It can be facilitated by an imaging examination, such as a Computerized Tomography scan which exposes the patient to ionizing radiation and implies delays. A bedside ultrasound performed by emergency physicians could avoid these issues. The aim of our study was to assess the performance of ultrasound carried out at the patient’s bedside by an emergency physician compared with a clinical-laboratory examination for the diagnosis of a surgical pathology in right iliac fossa pain. Methods This is a single-center prospective cohort study conducted in an Emergency Department receiving 19,000 patients per year. All patients presenting pain in the right iliac fossa were included by four (out of ten) emergency physicians certified in an ultrasound examination. A full grid pattern scan ultrasound of the abdominal cavity with analysis of the right iliac fossa was performed. The primary outcome was to compare the diagnosis performance of bedside ultrasound and clinical-laboratory examination to detect a surgical pathology. Two emergency physicians who did not participate in the study made the final diagnosis (i.e., surgical or non-surgical pathology) by reviewing the entire medical chart of each patient. Results From January 2011 to July 2013, 158 patients with a median age of 17 [13–32] years were analyzed. The diagnosed cases were: appendicitis (53), non-specific abdominal pain (48), lymphadenitis (22), ileitis (11), complicated ovarian cysts (7), neoplasias (5), inflammatory or infectious colitis (5), inguinal herniations (3), bowel obstructions (2), and salpingitis (2). The accuracy of ultrasound diagnoses was 0.89 (95% CI 0.84–0.94) versus 0.70 (95% CI 0.57–0.82) for diagnoses based on clinical-laboratory examination only (p < 0.001). Conclusion Bedsides, ultrasound allows an accurate diagnosis of a surgical pathology in 89% of cases, which is more efficient than the clinical-laboratory examination

Ultrasound at the patient’s bedside for the diagnosis and prognostication of a renal colic

Abstract Background Diagnosing a ureteral colic is sometimes difficult; however, clinicians should not fail to detect a surgical emergency. This is why diagnostic strategies depend on the imaging examinations, especially ultrasound. Prior studies have investigated the accuracy of Point of Care Ultrasound (PoCUS), but there are relatively few. This study aimed to evaluate the performance of the PoCUS in the diagnosis of renal colic. The secondary objective was to evaluate the relationship between the imaging results and the treatment performed. Methods After the clinical evaluation of patients aged &gt; 18 years with suspected ureteral colic, the Emergency Physician (EP) trained in ultrasound performed PoCUS to conclude whether a diagnosis of “renal colic” should be made. A computed tomography (CT) examination was subsequently performed, to determine whether ureteral or bladder lithiasis was present to diagnose a ureteral colic. The patient’s management was decided according to the to degree of urinary tract dilatation, presence of perinephric fluid, size, and localization of stones. Results Of the 12 Eps in our units, seven met the training criteria for the inclusion of patients. A total of 103 patients were analyzed, and the renal colic diagnosis was retained in 85 cases after the CT examination. The accuracy of PoCUS was 91% (86; 95%) for detecting urinary tract dilatation, 83% (76; 90%) for detecting perinephric fluid, and 54% (44; 64%) for detecting lithiasis. Only high urinary tract stones with ≥ 6 mm diameter were surgically managed (p &lt; 0.01). Conversely, distal ureteral stones with a diameter of &lt; 6 mm were managed with medical ambulatory treatment (p &lt; 0.05). Conclusion PoCUS is a good diagnostic tool, for renal colic, and could help reduce the requirement for the CT examinations and, hence, reduce induced radiation exposure. </jats:sec

Un cas d’arrêt cardiorespiratoire suite à une intoxication volontaire par le pentobarbital

Introduction : Malgré la baisse d’utilisation et de commercialisation des barbituriques à action rapide, des cas d’intoxications graves par ces produits sont encore constatés. Méthode et résultats : Nous rapportons une observation d’arrêt cardiorespiratoire récupéré chez une jeune femme de 25 ans secondaire à une tentative d’autolyse médicamenteuse par le pentobarbital dont la concentration sérique était de 85,1 mg/L (dosage effectué par chromatographie en phase liquide à haute performance) puis diminuée à 2 mg/L après 36 heures d’hémofiltration. L’évolution s’est faite vers un tableau d’éveil sous cortical sur encéphalopathie postanoxique sévère. Conclusion : L’épuration extrarénale peut permettre une baisse plus rapide de la concentration sérique du pentobarbital, mais ses indications doivent répondre à des objectifs thérapeutiques