A collaborative environment for knowledge sharing governed by ABAC policies

H. Ould-Slimane, M. Bande, H. Boucheneb, WiseShare, ?A Collaborative Environment for Knowledge Sharing Governed by ABAC Policies?, 8th IEEE International Conference on Collaborative Computing: Networking, Applications and Worksharing (CollaborateCom), October 2012

Impact of assessment of bone status before corrective surgery of lumbar spine in patients over 50 years old

Christopher Banse,1,2 Mourad Ould-Slimane,3 Emmanuel Foulongne,3 Alexis Perez,4 Gilles Avenel,1 Alain Daragon,1 Olivier Vittecoq11Rheumatology Department, Rouen University Hospital, 76000 Rouen, France; 2Rheumatology Department, Polyclinique Saint Côme, 60200 Compiègne, France; 3Department of Orthopaedic Surgery, Rouen University Hospital, 76000 Rouen, France; 4Department of Neurosurgery, Rouen University Hospital, 76000 Rouen, FranceBackground and objective: There is absence of data on the prevalence of osteoporosis before corrective surgery of the lumbar spine. We do not know the impact of bone assessment before corrective spine surgery, regarding the prevalence of osteoporosis, risk factors for osteoporosis, and prescription of osteoporotic treatment. Our objective was to evaluate the impact of assessment of bone status before corrective surgery of the lumbar spine.Methods: This retrospective study was conducted over a period of 30 months. Patients included were over 50 years old and had been referred to rheumatology consultation prior to corrective surgery of the lumbar spine with osteosynthesis, for scoliosis or spondylolisthesis. Assessment of bone status consisted in looking for risk factors for osteoporotic fracture, performing bone densitometry with the calculation of TBS (trabecular bone score) and the possible introduction of treatment for osteoporosis. Data were collected on complications related to bone fragility during follow-up.Results: Twenty-eight patients with a median age of 71.2 years (55.5–84.8) were included; 89% were women. T score was <−2.5 in 14.3% (4/28) and −1 to −2.5 in 42.9% (12/28) on at least one of the three sites analyzed. Fifty percent of patients had a TBS <1.2, a history of more than four falls per year, a duration of more than 20 s in the Timed Up and Go Test, and/or sedation treatment. Vitamin-calcium supplementation and treatment for osteoporosis were prescribed in 71.4% and 17.8% of cases, respectively. During follow-up, 3 patients had one or more osteoporotic vertebral fractures and 4 patients had loosening of implanted devices.Conclusion: Despite a low prevalence of densitometric osteoporosis and therapeutic management, one in four patients had a bone complication, suggesting the superiority of TBS as an indicator of bone status.Keywords: osteoporosis, spine surgery, bone evaluation, fracture, TB

Crizotinib-induced osteitis mimicking bone metastasis in a stage IV ALK-rearranged NSCLC patient: a case report

International audienceBACKGROUND:Targeted therapies are a standard of care for first-line treatment of Anaplastic lymphoma kinase (ALK)-rearranged non small cell lung cancer (NSCLC). Giving the rapid pace of drug discovery and development in this area, reporting of adverse effects of ALK inhibitors is crucial. Here, we report a case of osteitis induced by an ALK inhibitor mimicking bone metastasis, a previously undescribed side effect of crizotinib.CASE PRESENTATION:A 31-year-old woman with stage IV ALK-rearranged NSCLC presented with back pain after 3 months of crizotinib treatment. Diagnostic work-up showed osteitis on the 4th and 5th thoracic vertebrae, anterior soft tissue infiltration and epiduritis, without any sign of infection. Spinal cord decompression, histological removal and osteosynthesis were performed. Histologic examination showed necrosis with abundant peripheral neutrophils, no microorganism nor malignant cell. Symptoms and Computarized Tomography-abnormalities rapidly diseappeared after crizotinib withdrawal and did not recur after ceritinib onset.CONCLUSIONS:This is the first report of crizotinib-induced osteitis. Crizotinib differs from other ALK inhibitors as it targets other kinases as well, which may have been responsible for the osteitis. Crizotinib can induce rapidly extensive osteitis, which can mimic tumor progression

Étude des facteurs associés à un risque d’atteinte neurologique sévère dans les spondylodiscites infectieuses dans une cohorte de 329 cas

Les spondylodiscites infectieuses (SPI) sont des infections du disque intervertébral et des vertèbres adjacentes potentiellement sévères, en particulier du fait d’un risque de complications neurologiques déficitaires survenant dans environ 9,2 % selon l’étude SPONDIMMO. Seules deux études françaises ont étudié les facteurs de risque d’atteinte déficitaire qui sont : la présence d’un abcès épidural, une atteinte cervicale ou thoracique, une CRP > 150 mg/L et une SPI à S. aureus. L’objectif de cette étude monocentrique, rétrospective, était de décrire les caractéristiques des patients présentant une SPI déficitaire et de déterminer les facteurs associés à la survenue d’un tel déficit