Définition des critères de jugement de la qualité de réalisation de l'anastomose aortique proximale dans les anévrismes de l'aorte abdominale à partir d'un modèle établi en chirurgie robotique : thèse présentée pour le diplôme d'État de docteur en médecin

Médecine (chirurgie vasculaire

‘‘Seul celui qui y a participe sait ce que signifie la guerre’’. Le Journal de guerre de Matthias Weiskircher,

National audienc

What We Know From Reports on Type III Endoleak in the Literature

Objective: To analyse case reports published on the latest generations of endograft (EG) and understand the mechanisms of type III endoleak (EL) development. Methods: A literature review was undertaken of English language case reports and series that concerned modular junction or component disconnection (type IIIa EL) and fabric perforations (type IIIb EL) after endovascular aneurysm repair. Results: Of the 2 785 studies, 56 full texts were chosen to review 73 cases. Type III EL was diagnosed with computed tomography angiography in 67.1% and digital subtraction angiography in 12.3%; the rest were identified during surgery. Of the 73 EG, 65 (89.0%) were made of polyethylene terephthalate and seven (9.6%) were polytetrafluoroethylene. The type of material was not mentioned in one (1.4%) case report. There were 25 (34.2%) type IIIa and 48 (65.8%) type IIIb EL. The most frequent were trunk–trunk in nine (12.3%) and trunk–limb overlap separations in 14 (19.2%). Type IIIb EL in the trunk area was identified in 27 (37.0%) cases, while 21 (28.8%) defects were found in the limbs. Stent fractures were recognised as an underlying mechanism of type IIIb EL development in one report. A combination of fabric lesions in the trunk and limb area was found in one case. Seven type IIIb EL were related to suture disruption or suture–fabric abrasions. Four cases were related to stent–fabric abrasions, and two developed as a result of fabric fatigue owing to kinking. Information on the mechanisms of degradation was only occasionally and scarcely presented. Given the small number of reports and lack of detailed analysis, no definitive conclusions could be drawn. Conclusion: The available information is scarce and does not allow any definitive conclusions to be drawn on the mechanisms that lead to the development of type III EL. Further explant analyses would be beneficial

Cathédrales en guerre XVIe-XXIe siècle

Édifice religieux monumental, la cathédrale représente un symbole spirituel, patrimonial, culturel et politique. C’est pourquoi elle est confrontée, en temps de guerre, aux effets et à la violence de celle-ci : sa taille la désigne comme un objectif repérable de loin ; sa fonction religieuse en fait un symbole pour rassembler la population ; elle peut susciter au contraire une volonté de destruction, notamment iconoclaste, de la part de l’adversaire ; les cérémonies qui s’y déroulent pendant ou après les conflits implorent la protection divine, demandent la victoire, honorent les morts. Les enjeux politiques se mêlent aux dimensions spirituelles pour élever certaines cathédrales en symboles nationaux. Enfin, l’édifice est un lieu de mémoire des guerres, par ses cicatrices, ses mémoriaux, ses cérémonies du souvenir, voire de réconciliation. La situation des cathédrales en Europe occidentale des guerres de Religion jusqu’à nos jours – une période marquée par de nombreux et amples conflits – en témoigne.A monumental religious building, the cathedral represents a spiritual, heritage, cultural and political symbol. This is why, in times of war, it’s confronted with the effects and violence of war

Clinical reporting following the quantification of cerebrospinal fluid biomarkers in Alzheimer's disease: An international overview

International audienceIntroduction: The current practice of quantifying cerebrospinal fluid (CSF) biomarkers as an aid in the diagnosis of Alzheimer's disease (AD) varies from center to center. For a same biochemical profile, interpretation and reporting of results may differ, which can lead to misunderstandings and raises questions about the commutability of tests.Methods: We obtained a description of (pre-)analytical protocols and sample reports from 40 centers worldwide. A consensus approach allowed us to propose harmonized comments corresponding to the different CSF biomarker profiles observed in patients.Results: The (pre-)analytical procedures were similar between centers. There was considerable heterogeneity in cutoff definitions and report comments. We therefore identified and selected by consensus the most accurate and informative comments regarding the interpretation of CSF biomarkers in the context of AD diagnosis.Discussion: This is the first time that harmonized reports are proposed across worldwide specialized laboratories involved in the biochemical diagnosis of AD