Évaluation tridimensionnelle de la reconstruction du ligament croisé antérieur

Le ligament croisé antérieur (LCA) demeure un des ligaments du genou le plus souvent blessé. Un mauvais positionnement des tunnels osseux est souvent mis en cause dans les échecs de reconstructions du LCA. Une meilleure compréhension biomécanique du phénomène devient essentielle. Par l’utilisation de l’imagerie biplanaire stéréoradiographique à faible irradiation EOS , notre groupe a développé une méthode de reconstruction 3D permettant une description morphologique osseuse remarquable. Par l’entremise de ce système, un référentiel permet d’évaluer, de manière automatisée, précise et reproductible, le positionnement tridimensionnel des tunnels osseux. Notre groupe souhaite partager ce référentiel afin d’assister les chirurgiens orthopédistes à restaurer une biomécanique optimale dans les reconstructions du LCA.The anterior cruciate ligament (ACL) remains one of the most injured ligament of the knee. Mispositioning the tunnels remains a common cause of ACL reconstruction failure. A better biomechanical description of this phenomenon is therefore essential. Using the low irradiation biplanar stereoradiographic EOStm imaging system, our group developed a 3D reconstruction method allowing a precise morphologic description of the knee. With this system, the tridimensional positioning of the femoral tunnel can be evaluated in a novel, computerized, precise and reproducible coordinate system. With this referential, our group wish to assist orthopedic surgeons in the restoration of optimal biomechanics in ACL reconstructions

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Revue de l’utilisation des inhibiteurs de la pompe à protons en réanimation pédiatrique et exploration des complications associées

Proton pump inhibitors (ppi) are prescribed in the pediatric intensive care unit (picu) for stress ulcer prophylaxis (sup) and associated upper gastro-intestinal bleeding (ugib). Mechanical ventilation, prism (pediatric risk of mortality) score > 10 or coagulopathy are associated with a higher risk of ugib. Ppi prescription for sup is being questioned because of the lack of evidence regarding efficacy and the potential effect on nosocomial pneumoniae. We realised a single center retrospective study in the picu over a 2 years period, from january 1st 2017 to december 31st 2018. 754 patients were included. 231 (30.6%) received a ppi. Patients who received ppi were older, weighted more and were more likely to have had surgery, a central venous access, parenteral nutrition, coagulopathy, mechanical ventilation and had a longer picu-stay (p 10, ou une coagulopathie seraient des facteurs de risque (FDR) d’UGIB. L’efficacité des IPP dans la SUP est remise en cause et serait associée à une augmentation du risque de pneumopathie nosocomiale. Notre objectif principal est d’analyser les prescriptions d’IPP et de relever les potentielles complications. Nous avons réalisé une étude monocentrique rétrospective en réanimation pédiatrique sur une période de deux ans, du 1er janvier 2017 au 31 décembre 2018. 754 patients ont été inclus. 231 (30,6%) ont recu un IPP. Ces patients étaient plus âgés, plus lourds, ont eu plus de chirurgie, de voie veineuse centrale, de nutrition parentérale, de coagulopathie, de ventilation mécanique et sont restés plus longtemps en réanimation (p<0,05). L’indication la plus fréquente est la SUP (n = 177, 77%) mais seulement 12% (n = 22) présentaient les critères pour recevoir un IPP. Il y a eu 8,2% d’infections nosocomiales (IN) dans le groupe IPP contre 1,7% dans l’autre groupe. Cette différence est statistiquement significative en analyse univariée (rr = 3,40 [ic95% 1,76-6,57], p < 0,05), multivariée (ora = 2,42 [ic95% 1,17-5,14], p=0,02) et grâce au propensity score matching analysis (p = 0,031). L’exposition aux IPP est aussi un FDR de développer une hyponatrémie (rr=5,18 [ic95% 2,16-12,43], p < 0.05). Nous avons donc observé un mésusage des IPP en réanimation pédiatrique, avec un risque associé d’IN et d’hyponatrémie

An Intelligent Decision Support System Inspired by Newton’s Laws of Motion

International audienceThe purpose of this study is to present a novel perspective on decision technology based on classical physics rules, considering risks and opportunities as physical forces deviating systems as an object from their stable states. The forces are created by changing the internal and external characteristics of the system. The ultimate objective is to propose a multi-criteria performance framework within the geometrical space of the system Key Performance Indicators (KPIs) based on classical physics rules by mapping management concepts onto physical notations. The present study is tuned to a model of interaction between the inventory management module and the workforce supply chain to present the main work. In addition, the significance of the study as an intelligent decision system to manage the given model through Newton laws is investigated

Towards a Collaborative and Open Supply Chain Management Operating Services Platform

Part 16: Sentient Immersive Response NetworkInternational audienceSupply Chain (SC) uncertainty perspectives must now be translated into practice. SC entities must accept crises and catastrophes as normal situations and increase significantly their culture of SC risk management. They should adapt their decision-support systems to be able considering disruptions as regular inputs, whether small, large or huge. Collaboration should not be limited to few entities of a SC, but to the whole SC. Concrete tools allowing entities to share vital information to give visibility, ensure synchronization of the material flows, align management of emergencies and use of critical resources must be developed and used. That is the purpose of this paper. Practically, aframework for SC risk and opportunity management and a Collaborative and Open Supply Chain Management Operating Services (COSMOS) platform are presented. An illustrative case is developed to highlight the potential benefits of the proposal on one service example

Large Nodular Fasciitis of the Shoulder Presenting as Soft Tissue Sarcoma: A Case Report

This case report describes a patient who presented with clinical and radiographic features of a soft tissue sarcoma of the shoulder. Despite having a painless and relatively large mass, a biopsy and resection revealed nodular fasciitis (NF).CASEThis case report describes a patient who presented with clinical and radiographic features of a soft tissue sarcoma of the shoulder. Despite having a painless and relatively large mass, a biopsy and resection revealed nodular fasciitis (NF).This is an unusual case of a painless 10 cm mass that histopathologically was diagnosed as NF in the upper extremity with proximity to the axillary nerve and posterior humeral circumflex vessels. The USP6 rearrangement was helpful in confirming the diagnosis. Careful clinical, radiographic, and pathologic correlation is necessary in diagnosing these relatively rare tumors. In cases where there are discordant findings, molecular markers can be very helpful.CONCLUSIONThis is an unusual case of a painless 10 cm mass that histopathologically was diagnosed as NF in the upper extremity with proximity to the axillary nerve and posterior humeral circumflex vessels. The USP6 rearrangement was helpful in confirming the diagnosis. Careful clinical, radiographic, and pathologic correlation is necessary in diagnosing these relatively rare tumors. In cases where there are discordant findings, molecular markers can be very helpful

Screening for cognitive and affective dysfunction in patients suspected of mild cognitive impairment

Objective Disturbances of affect expression and perception, as well as accuracy of predicting memory difficulties, have been reported in various brain dysfunctional groups. Screening tests of higher cerebral functions seldom sample these dimensions. The goal of this study was to determine if patients with mild cognitive impairment (MCI) of the amnestic type would demonstrate impairments in these domains, as well as show expected memory deficits. Methods Thirty-nine French-speaking patients with a clinical diagnosis of MCI were compared with 39 age- and education-matched normal functioning individuals on the French translation of the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS). Patients and controls also made subjective ratings regarding their cognitive and affective functioning in everyday life. Results Patients with MCI performed significantly worse than controls on the BNIS subtests sampling memory, orientation, affect expression and perception, and accurate prediction of memory performance. They did not differ on other subtests of the BNIS, as predicted. Poor self-awareness (i.e., inaccurate prediction of the number of words one could recall after distraction) correlated with self-reported deficits in several areas of cognitive and affective functioning. Conclusion This sample of MCI patients demonstrated disturbances not only in memory but also in self-awareness and affect expression and perception on the BNIS. These dimensions should be included in the neuropsychological assessment of patients suspected of MCI. Copyright © 2014 John Wiley & Sons, Ltd

Peri-operative outcomes of IlluminOss fixation for pelvic metastatic bone disease

Pelvic metastatic bone disease (MBD) leads to significant pain and functional impairment. Managing these lesions through an open approach involves invasive procedures linked to potential morbidity and complications. The IlluminOss system, a UV light-activated polymer implant, has shown efficacy and safety in managing various fractures. This study evaluates the effectiveness of IlluminOss photodynamic bone stabilization system (PBSS) in pelvic MBD. A retrospective cohort review was conducted, including all patients treated with the PBSS system for MBD of the pelvis and acetabulum. Fifteen patients were included with a mean follow-up of 4.97 months (SD 3.05). In the thirteen patients treated with the IlluminOss without concurrent total hip arthroplasty, the mean operative time was 170.4 min (SD 90.6). The mean estimated blood loss was 52.3 mL (SD 73.7). No patients required transfusions. The mean visual analog scale (VAS) pain score at the latest follow-up was 2.29, significantly lower than the preoperative score of 9.07 (p < 0.001). Thirteen patients (92.9 %) had improved functional status at the latest follow-up. PBSS offers similar operative times, reduced blood loss, and decreased need for transfusions compared to open pelvic fixation methods. It also demonstrates significant pain reduction and improved functional outcomes without increased complications