Synthèse du colloque

Les évolutions considérables survenues durant les dernières décennies du XXe siècle, tant dans les domaines économiques que politiques, culturels et scientifiques, sont en passe de révolutionner en profondeur, dans le monde entier, les modes d’organisation, de pensée, de vie. Ces évolutions, parce qu’elles touchent les individus et le monde dans lequel ils vivent, auront, et ont déjà, un impact énorme sur l’éducation d’une manière générale, qu’elle soit formelle ou non formelle, à tous les ni..

La politique européenne d’éducation et de formation

Le 24 mars 2000 prenait fin le Conseil européen spécial de Lisbonne, durant lequel les chefs d’États et de gouvernements s’étaient penchés sur une « Europe de l’innovation et de la connaissance ». Leurs conclusions signaient une nouvelle étape, marquante, dans la construction d’une politique européenne d’éducation et de formation. Les États membres s’engageaient sans tambours ni trompettes dans la voie d’une mise en cohérence des systèmes éducatifs, ou tout du moins vers l’acceptation d’un po..

Pediatric seatbelt injuries: unusual Chance's fracture associated with intra-abdominal lesions in a child

The authors report the case of a 7-year-old child involved in a motor vehicle accident. She sustained an unusual flexion-distraction vertebral injury. This spinal injury was related to seatbelt use and was associated with intra-abdominal lesions. The spinal lesion consisted of a posterior ligamentous disruption with widening of the posterior intervertebral space at two adjacent lumbar levels. The purpose of this case report is to describe an atypical and perhaps often unrecognized spinal lesion and to explain our approach to diagnosis and treatmen

Banque mondiale : un séminaire en français « Choix stratégiques en matière de réformes éducatives »

Le premier séminaire en français sur le thème des « choix stratégiques en matière de réformes éducatives », organisé par l’Institut de la Banque mondiale et le Bureau de la Banque mondiale Moyen-Orient/Afrique du Nord (MENA), avec le concours du CIEP et de l’Institut international de planification de l’éducation (IIPE), s’est tenu au CIEP du 4 au 15 février 2002. Depuis une quinzaine d’années, la Banque mondiale accompagne le développement du secteur de l’éducation dans les pays pauvres et à ..

Botulinum toxin treatment of spasticity in diplegic cerebral palsy : a randomised, double-blind, placebo-controlled, dose-ranging study

This study evaluated the efficacy and safety of three doses of botulinum toxin A (BTX-A; Dysport®) in 125 patients (mean age 5.2 years, SD 2; 54% male)with dynamic equinus spasticity during walking. Participants were randomized to receive Dysport (10, 20, or 30 units/kg) or placebo to the gastrocnemius muscle of both legs. Muscle length was calculated from electrogoniometric measurements and the change in the dynamic component of gastrocnemius shortening at four weeks was prospectively identified as the primary outcome measure. All treatment groups showed statistically significant decreases in dynamic component compared with placebo at 4 weeks. Mean improvement in dynamic component was most pronounced in the 20 units/kg group, being equivalent to an increase in dorsiflexion with the knee extended at 19°, and was still present at 16 weeks. The safety profile of the toxin appears satisfactory

Are the medio-lateral joint forces in the lower limbs different between scoliotic and healthy subjects during gait?

INTRODUCTION: The quantification of internal joint efforts could be essential in the development of rehabilitation tools for patients with musculo-skeletal pathologies, such as scoliosis. In this context, the aim of this study was to compare the hips joint mediolateral forces during gait, between healthy subjects and adolescents with left lumbar or thoracolumbar scoliosis (AIS), categorized by their Cobb angle (CA). MATERIAL AND METHODS: Twelve healthy subjects, 12 AIS with CA between 20° and 40° and 16 AIS in pre-operative condition (CA : > 40°) walked at 4 km/h on an instrumented treadmill. The experimental set-up include six infrared cameras allow the computation of the tridimensional (3D) angular displacement and strain gauges located under the motor-driven treadmill allow the computation of ground reaction forces (GRF). The hips joint mediolateral forces were calculated using a 3D inverse dynamic of human body. One-way ANOVA was performed for the maximum, the minimum and the range of medio-lateral forces at each joint of the lower limbs. When appropriate, a Tukey's post hoc was performed to determine the differences. RESULTS: The mediolateral forces were significantly lower at the right hip for AIS with CA between 20° and 40° compared to healthy subject. CONCLUSION: The spinal deformation leads to a reduced medio-lateral force at the right hip, which could gradually change the scheme of postural adjustments for AIS during gait. Further research on the quantification of the joint lower limb efforts should include the knee and ankle joints to evaluate the impact of spinal deformation on the lower limb dynamic behaviour in AIS patients

Genetics determine bone susceptibility to fluoride

Nowadays it is increasingly accepted that interactions with environmental factors must play an important role in determining bone quality and that these interactions must be influenced by genetics. Nevertheless, to date, only few animal studies explore an underlying genetic basis for extrinsic factors effect such as fluoride (F-) effect on bone metabolism. This study assessed the effect of increasing F- doses on the bone properties in three inbred mouse strains that demonstrate different susceptibilities to developing enamel fluorosis (A/J a “susceptible” strain, 129P3/J a “resistant” strain and SWR/J an “intermediate” strain). Fluoride concentrations were determined in femora and vertebral bodies. Bone mineral density was evaluating through DXA (Dual energy X-ray Absorptiometry). Three-point bend testing of femora, compression testing of vertebral bodies and femoral neck-fracture testing were performed to evaluate mechanical properties. Bone microarchitecture was quantified with microcomputed tomography and strut analysis. Bone formation was evaluated by static histomorphometry. Bone mineralization was quantified with backscattered electron (BSE) imaging and powder x-ray diffraction. Microhardness measurements were taken from the vertebral bodies (cortical and trabecular bone) and the cortex of the distal femur. Increasing doses of F- had different effects on the bone properties in the three inbred mouse strains. Although significant increases of bone F- concentration could be demonstrated, and no significant effects on bone macroarchitecture and BMD were found in the three strains, mechanical testing showed significant degradation of bone mechanical properties in the “susceptible” A/J strain, whereas moderate degradation in the “intermediate” SWR/J strain and no effect in the “resistant” 129P3/J strain were observed. Evaluation of the structural and material properties of the bone in the three strains showed that this different effect of F- on bone mechanical properties could be explained by an alteration of the mineral-organic interfacial bonding and/or bone matrix proteins, interfering with bone crystal growth inhibition on the crystallite faces as well as bonding between the mineral and organic interface. The smaller bone crystallites of the 129P3/J (resistant) strain may indicate a stronger organic-inorganic interface, reducing crystallite growth rate and increasing interfacial mechanical strength.(MED 3) -- UCL, 200