Sténose hypertrophique du pylore Etude comparative rétrospective post-pyloromyotomie extramuqueuse des modes de réalimentation post- opératoires

Abstract La sténose hypertrophique du pylore (SHP) est une maladie fréquente chez les nourrissons âgés de quelques semaines. Son étiologie reste inconnue. Elle se manifeste par des vomissements en jet et une perte pondérale. Une alcalose hypochlorémique est souvent mise en évidence. Le diagnostic est clinique et est confirmé par une échographie abdominale. Un traitement chirurgical consiste en une pyloromyotomie extramuqueuse. Les nourrissons sont ensuite réalimentés selon un mode progressif ou ad libitum. L'évolution est dans la majorité des cas favorable en 3-5 jours. Le but de l'étude est de définir le mode de réalimentation postopératoire le plus adapté pour les enfants atteints de SHP. Méthodes et population L'étude rétrospective a porté sur 96 patients opérés pour une SHP à l'Hôpital de l'Enfance à Lausanne entre janvier 2000 et décembre 2013. 44 patients ayant été réalimentés selon le mode progressif figurent dans le groupe A et 34 patients réalimentés ad libitum se trouvent dans le groupe B. Les deux groupes ont été comparés sur le plan démographique, préopératoire et du point de vue de l'évolution postopératoire. Résultats Les deux groupes étaient comparables du point de vue démographique et des données préopératoires. Seule une différence entre les groupes A et B pour le ratio G/F (8/1 vs 6/1), le poids de naissance (3268g vs 3529g) et l'épaisseur de la couche musculaire pylorique (5.5mm vs 6mm) est à relever. Concernant les vomissements postopératoires, 25% du groupe A contre 5% du groupe B n'ont pas eu de vomissement. Le pourcentage des patients figurant dans la catégorie 1-2 vomissement(s) était plus ou moins similaire (34% pour le groupe A et 38% pour le groupe B). 23% des patients du groupe A ont présenté 3-5 vomissements contre 41% du groupe B et 18% des patients du groupe A ont eu plus de 6 vomissements contre 6% pour le groupe B. Aucune différence statistiquement significative n'a été observée entre les deux groupes pour le délai pour une alimentation complète per os et pour la durée d'hospitalisation. Conclusion En se basant sur les résultats de cette étude, les deux modes de réalimentation engendrent une évolution postopératoire similaire. Le mode de réalimentation ad libitum semble écourter la durée d'hospitalisation selon la littérature. De plus, ce dernier comporte d'autres bénéfices en terme de simplicité de mise en place et d'économicité. Par conséquent, le mode de réalimentation ad libitum devrait être le protocole de réalimentation de choix pour les enfants opérés pour une SHP

Quantum Key Distribution over 67 km with a plug & play system

We present a fibre-optical quantum key distribution system. It works at 1550nm and is based on the plug & play setup. We tested the stability under field conditions using aerial and terrestrial cables and performed a key exchange over 67 km between Geneva and Lausanne.Comment: 8 pages, 3 figures, 2 tables. Submitted to the New Journal of Physic

Purification of Single-photon Entanglement

Single-photon entanglement is a simple form of entanglement that exists between two spatial modes sharing a single photon. Despite its elementary form, it provides a resource as useful as polarization-entangled photons and it can be used for quantum teleportation and entanglement swapping operations. Here, we report the first experiment where single-photon entanglement is purified with a simple linear-optics based protocol. Besides its conceptual interest, this result might find applications in long distance quantum communication based on quantum repeaters.Comment: Main article: 5 pages, 4 figure

The inflammatory response of primary bovine mammary epithelial cells to Staphylococcus aureus strains is linked to the bacterial phenotype

Staphylococcus aureus is a major mastitis-causing pathogen in dairy cows. The latex agglutination-based Staphaurex test allows bovine S. aureus strains to be grouped into Staphaurex latex agglutination test (SLAT)-negative [SLAT(2)] and SLATpositive [SLAT(+)] isolates. Virulence and resistance gene profiles within SLAT(2) isolates are highly similar, but differ largely from those of SLAT(+) isolates. Notably, specific genetic changes in important virulence factors were detected in SLAT(2) isolates. Based on the molecular data, it is assumed that SLAT(+) strains are more virulent than SLAT(2) strains. The objective of this study was to investigate if SLAT(2) and SLAT(+) strains can differentially induce an immune response with regard to their adhesive capacity to epithelial cells in the mammary gland and in turn, could play a role in the course of mastitis. Primary bovine mammary epithelial cells (bMEC) were challenged with suspensions of heat inactivated SLAT(+) (n = 3) and SLAT(2) (n = 3) strains isolated from clinical bovine mastitis cases. After 1, 6, and 24 h, cells were harvested and mRNA expression of inflammatory mediators (TNF-a, IL-1b, IL-8, RANTES, SAA, lactoferrin, GM-CSF, COX-2, and TLR-2) was evaluated by reverse transcription and quantitative PCR. Transcription (DDCT) of most measured factors was induced in challenged bMEC for 6 and 24 h. Interestingly, relative mRNA levels were higher (P,0.05) in response to SLAT(+) compared to SLAT(2) strains. In addition, adhesion assays on bMEC also showed significant differences between SLAT(+) and SLAT(2) strains. The present study clearly shows that these two S. aureus strain types cause a differential immune response of bMEC and exhibit differences in their adhesion capacity in vitro. This could reflect differences in the severity of mastitis that the different strain types may induce

Fast and Sensitive Multiplex Real-Time Quantitative PCR to Detect Cutibacterium Periprosthetic Joint Infections

Diagnosis of Cutibacterium periprosthetic joint infections (PJIs) is challenging due to a long cultivation time of up to 14 days. Faster culture-independent diagnosis would improve patient care with early and accurate treatment. Specific primers and probes were designed for Cutibacterium acnes, Cutibacterium avidum, and Cutibacterium granulosum and evaluated in a multiplex TaqMan real-time quantitative PCR (qPCR) format on 57 skin swabs and 20 culture-negative cerebrospinal fluid samples. The multiplex qPCR was tested in a PJI cohort of 41 sonication fluid samples from removed implants infected with different pathogens. All five culture-positive Cutibacterium PJIs were detected with the corresponding Cutibacterium-specific probe (100% positive percent agreement). The multiplex qPCR additionally detected C. avidum in two PJI sonication fluid samples that were diagnosed as Staphylococcus species infections according to culture (95% negative percent agreement). The new multiplex qPCR can provide a Cutibacterium PJI diagnosis within 1 day, allowing early and accurate antibiotic treatment. A prospective diagnostic trial in PJI with a high number of Cutibacterium species infections (shoulder PJI) is needed for further evaluation

Acromioplasty during repair of rotator cuff tears removes only half of the impinging acromial bone.

To date, there is no consensus on when and how to perform acromioplasty during rotator cuff repair (RCR). We aimed to determine the volume of impinging bone removed during acromioplasty and whether it influences postoperative range of motion (ROM) and clinical scores after RCR. Preoperative and postoperative computed tomography scans of 57 shoulders that underwent RCR were used to reconstruct scapula models to simulate volumes of impinging acromial bone preoperatively and then compare them to the volumes of bone resected postoperatively to calculate the proportions of desired (ideal) vs. unnecessary (excess) resections. All patients were evaluated preoperatively and at 6 months to assess ROM and functional scores. The volume of impinging bone identified was 3.5 ± 2.3 cm <sup>3</sup> , of which 1.6 ± 1.2 cm <sup>3</sup> (50% ± 27%) was removed during acromioplasty. The volume of impinging bone identified was not correlated with preoperative critical shoulder angle (r = 0.025, P = .853), nor with glenoid inclination (r = -0.024, P = .857). The volume of bone removed was 3.7 ± 2.2 cm <sup>3</sup> , of which 2.1 ± 1.6 cm <sup>3</sup> (53% ± 24%) were unnecessary resections. Multivariable analyses revealed that more extensive removal of impinging bone significantly improved internal rotation with the arm at 90° of abduction (beta, 27.5, P = .048) but did not affect other shoulder movements or clinical scores. Acromioplasty removed only 50% of the estimated volume of impinging acromial bone. More extensive removal of impinging bone significantly improved internal rotation with the arm at 90° of abduction

Antimicrobial susceptibility testing is crucial when treating Finegoldia magna infections

Finegoldia magna is an anaerobic gram-positive bacterium that can cause invasive human infections. Recently, a 52-year-old patient suffering from a periprosthetic joint infection (PJI) due to F. magna was treated with cefepime on hemodialysis; however, treatment failed due to relapse caused by antibiotic-resistant strains. Reports on the antimicrobial susceptibility of F. magna clinical isolates are rare. We collected 57 clinical F. magna isolates from Zurich, Switzerland, between September 2019 and July 2020 and tested their antimicrobial susceptibility to investigate the local resistance pattern. Antimicrobial susceptibility testing (AST) was evaluated for nine antibiotics (benzylpenicillin, amoxicillin/clavulanic acid, cefuroxime, cefepime, levofloxacin, rifampicin, metronidazole, doxycycline, and clindamycin) by E-test according to CLSI guidelines. All F. magna strains were susceptible to benzylpenicillin, amoxicillin/clavulanic acid, and metronidazole, while 75% to clindamycin. F. magna isolates showed MIC values lower than species-unrelated breakpoints for cefuroxime, levofloxacin, and cefepime in 93%, 56%, and 32% of the cases, respectively. MIC values for rifampicin and doxycycline were lower than locally determined ECOFFs in 98% and 72% of the cases, respectively. In summary, we recommend the use of benzylpenicillin, amoxicillin/clavulanic acid, or metronidazole without prior AST as first-line treatment option against F. magna PJI infections. If cefuroxime, cefepime, levofloxacin, rifampicin, doxycycline, or clindamycin are used, AST is mandatory. Keywords: Antimicrobial susceptibility; Cefepime; Finegoldia magna; Periprosthetic joint infectio

Practical private database queries based on a quantum key distribution protocol

Private queries allow a user Alice to learn an element of a database held by a provider Bob without revealing which element she was interested in, while limiting her information about the other elements. We propose to implement private queries based on a quantum key distribution protocol, with changes only in the classical post-processing of the key. This approach makes our scheme both easy to implement and loss-tolerant. While unconditionally secure private queries are known to be impossible, we argue that an interesting degree of security can be achieved, relying on fundamental physical principles instead of unverifiable security assumptions in order to protect both user and database. We think that there is scope for such practical private queries to become another remarkable application of quantum information in the footsteps of quantum key distribution.Comment: 7 pages, 2 figures, new and improved version, clarified claims, expanded security discussio