Posttraumatic Stress Disorder in Adolescents with Conduct Disorder: Pre- and Post-Treatment Comparison of Trauma Types

The purpose of this study was to compare pre- and post-treatment differences in posttraumatic stress disorder (PTSD) symptoms in male adolescents with conduct disorder. The Children's PTSD Inventory and the PTSD Reaction Index were used to diagnose PTSD and determine trauma type (Type I single trauma or Type II recurring trauma). Pre- and post-treatment measures included the PTSD Reaction Index, the Children's Depression Inventory, the State-Trait Anxiety Inventory, the State-Trait Anger Expression Inventory, the Dissociative Experiences Scale, and the Youth Self-Report. The six-week, biweekly group treatment included education, exposure, and cognitive elements. Primary hypotheses that the abused group would statistically differ from the non-abused group in terms of pre- and post-treatment levels of avoidance, dissociation, anger/aggression, self-destructiveness, social problems, and overall levels of PTSD symptoms, were not confirmed. Overall, group therapy participants experienced statistically significant decreases in PTSD symptoms over the course of therapy. Results are discussed in light of clinical implications, recommended cautions given the lack of a robust control group, and directions for future research

Computational investigation of fibrinmechanical and damage properties at the interface between native cartilage and implant

Scaffold-based tissue-engineered constructs as well as cell-free implants offer promising solutions to focal cartilage lesions. However, adequate mechanical stability of these implants in the lesion is required for successful repair. Fibrin is the most common clinically available adhesive for cartilage implant fixation, but fixation quality using fibrin is not well understood. The objectives of this study were to investigate the conditions leading to damage in the fibrin adhesive and to determine which adhesive properties are important in preventing delamination at the interface. An idealized finite element model of the medial compartment of the knee was created, including a circular defect and an osteochondral implant. Damage and failure of fibrin at the interface was represented by a cohesive zone model with coefficients determined from an inverse finite element method and previously published experimental data. Our results demonstrated that fibrin glue alone may not be strong enough to withstand physiologic loads in vivo while fibrin glue combined with chondrocytes more effectively prevents damage at the interface. The results of this study suggest that fibrin fails mainly in shear during off-axis loading and that adhesive materials that are stronger or more compliant than fibrin may be good alternatives due to decreased failure at the interface. The present model may be used to improve design and testing protocols of bioadhesives and give insight into the failure mechanisms of cartilage implant fixation in the knee joint

Two stage hybrid approach for complex aortic coarctation repair

<p>Abstract</p> <p>Background</p> <p>Management of an adult patient with aortic coarctation and an associated cardiac pathology poses a great surgical challenge since there are no standard guidelines for the therapy of such complex pathology. Debate exists not only on which lesion should be corrected first, but also upon the type and timing of the procedure. Surgery can be one- or two-staged. Both of these strategies are accomplice with elevate morbidity and mortality.</p> <p>Case report</p> <p>In the face of such an extended surgical approach, balloon dilatation seems preferable for treatment of severe aortic coarctation.</p> <p>We present an adult male patient with aortic coarctation combined with ascending aorta aneurysm and concomitant aortic valve regurgitation. The aortic coarctation was corrected first, using percutaneous balloon dilatation; and in a second stage the aortic regurgitation and ascending aorta aneurysm was treated by Bentall procedure. The patients' postoperative period was uneventful. Three years after the operation he continues to do well.</p

Diagnostic Value of (18)F-Fluorodeoxyglucose Positron Emission Tomography Computed Tomography in Prosthetic Pulmonary Valve Infective Endocarditis

OBJECTIVES: The aim of this study was to assess the diagnostic performances of (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) in congenital heart disease (CHD) patients with pulmonary prosthetic valve or conduit endocarditis (PPVE) suspicion. BACKGROUND: PPVE is a major issue in the growing CHD population. Diagnosis is challenging, and usual imaging tools are not always efficient or validated in this specific population. Particularly, the diagnostic yield of (18)F-FDG PET/CT remains poorly studied in PPVE. METHODS: A retrospective multicenter study was conducted in 8 French tertiary centers. Children and adult CHD patients who underwent (18)F-FDG PET/CT in the setting of PPVE suspicion between January 2010 and May 2020 were included. The cases were initially classified as definite, possible, or rejected PPVE regarding the modified Duke criteria and finally by the Endocarditis Team consensus. The result of (18)F-FDG PET/CT had been compared with final diagnosis consensus used as gold-standard in our study. RESULTS: A total of 66 cases of PPVE suspicion involving 59 patients (median age 23 years, 73% men) were included. Sensitivity, specificity, positive predictive value, and negative predictive value of (18)F-FDG PET/CT in PPVE suspicion were respectively: 79.1% (95% CI: 68.4%-91.4%), 72.7% (95% CI: 60.4%-85.0%), 91.9% (95% CI: 79.6%-100.0%), and 47.1% (95% CI: 34.8%-59.4%). (18)F-FDG PET/CT findings would help to correctly reclassify 57% (4 of 7) of possible PPVE to definite PPVE. CONCLUSIONS: Using (18)F-FDG PET/CT improves the diagnostic accuracy of the Duke criteria in CHD patients with suspected PPVE. Its high positive predictive value could be helpful in routine to shorten diagnosis and treatment delays and improve clinical outcomes.L'Institut de Rythmologie et modélisation Cardiaqu

The Cockayne Syndrome Natural History (CoSyNH) study:clinical findings in 102 individuals and recommendations for care

Purpose: Cockayne syndrome (CS) is a rare, autosomal-recessive disorder characterized by microcephaly, impaired postnatal growth, and premature pathological aging. It has historically been considered a DNA repair disorder; fibroblasts from classic patients often exhibit impaired transcription-coupled nucleotide excision repair. Previous studies have largely been restricted to case reports and small series, and no guidelines for care have been established. Methods: One hundred two study participants were identified through a network of collaborating clinicians and the Amy and Friends CS support groups. Families with a diagnosis of CS could also self-recruit. Comprehensive clinical information for analysis was obtained directly from families and their clinicians. Results and Conclusion: We present the most complete evaluation of Cockayne syndrome to date, including detailed information on the prevalence and onset of clinical features, achievement of neurodevelopmental milestones, and patient management. We confirm that the most valuable prognostic factor in CS is the presence of early cataracts. Using this evidence, we have created simple guidelines for the care of individuals with CS. We aim to assist clinicians in the recognition, diagnosis, and management of this condition and to enable families to understand what problems they may encounter as CS progresses

Interventional cardiac catheterization in children : indications and limits

Thèse de doctorat en sciences médicales (cardioloige pédiatrique) (MED 3) --UCL, 200

A two-dimensional thermoelastic rough surface contact model

By taking into account steady-state heat transfer and surface distortion due to thermal and elastic deformations, a two-dimensional thermoelastic model is developed for rough surface asperity contact, where the thermal influence function connecting the thermal deformation and the contact pressure is derived based on the Dundurs' theorem. The model has been shown to be accurate at low as well as high frictional heating conditions by comparison with published results. As an application of this model, the contact problem of a cylinder on a random rough surface is studied in detail. © 2004 by ASME.link_to_subscribed_fulltex