Usefulness of a national hospital database to evaluate the burden of primary joint replacement for coxarthrosis and gonarthrosis in patients aged over 40 years

SummaryObjectiveTo evaluate the 2001 French burden of hospital primary joint replacement (PJR) for coxarthrosis and gonarthrosis.MethodsHospital surgical admissions for coxarthrosis and gonarthrosis in people aged over 40 years were selected from the French National Hospital Database. Of the 73,150 and 58,746 admissions for coxarthrosis and gonarthrosis, respectively, only 96 and 73% of them were analysed (exclusion of stays with no respect of coding guidelines). For each, we described the type of osteoarthritis, gender and age group distribution, incidence rate of PJR adjusted on age and gender, the type of joint replacement (total vs partial), the type of hospital (private vs hospital), the mean length of stay (LOS), the percentage of patients transferred to rehabilitation centre and the hospital costs.ResultsWhatever the type of osteoarthritis, PJR was mainly performed for primary osteoarthritis, in the 71–80 years' age group, in private hospital, with a total replacement procedure. The mean LOS were 13 and 12 days, and the transfers to a rehabilitation centre were 33 and 44%, for hip and knee, respectively. The incident rate of PJR increased significantly with age. It was higher in the 71–80 years' age group and decreased thereafter, whatever the gender and the type of osteoarthritis. The whole hospital costs were 591 and 411 millions of euros for hip and knee, respectively.ConclusionThe French National Hospital Database is a useful tool for assessing the burden of primary PJR for coxarthrosis and gonarthrosis. It might be used for international comparisons

Self-Pulsating Semiconductor Lasers: Theory and Experiment

We report detailed measurements of the pump-current dependency of the self-pulsating frequency of semiconductor CD lasers. A distinct kink in this dependence is found and explained using rate-equation model. The kink denotes a transition between a region where the self-pulsations are weakly sustained relaxation oscillations and a region where Q-switching takes place. Simulations show that spontaneous emission noise plays a crucial role for the cross-over.Comment: Revtex, 16 pages, 7 figure

Improved bend waveguide design for terahertz transmission

Bending waveguides with 90 corners based on a two-dimensional photonic crystal with metallic cylinders arranged in a square lattice are studied for THz wave guiding. Considering single- and double-line defects, five different designs are investigated and assessed in terms of their transmission performance. A better structure is proposed by increasing the number of rods in the bending arc, thus achieving superior performance of the transmission characteristics in comparison to that of the former five designs. A comparison of the improved bend waveguide with a linear wave-guide shows a significant reduction of the bending losses. Trans-mission levels of up to 98% within a 2.5 THz bandwidth (from 1.2 to 3.7 THz) have been accomplished

CD4+ T-cell responses to Epstein-Barr virus (EBV) latent-cycle antigens and the recognition of EBV-transformed lymphoblastoid cell lines

There is considerable interest in the potential of Epstein-Barr virus (EBV) latent antigen-specific CD4$^+$ T cells to act as direct effectors controlling EBV-induced B lymphoproliferations. Such activity would require direct CD4$^+$ T-cell recognition of latently infected cells through epitopes derived from endogenously expressed viral proteins and presented on the target cell surface in association with HLA class II molecules. It is therefore important to know how often these conditions are met. Here we provide CD4$^+$ epitope maps for four EBV nuclear antigens, EBNA1, -2, -3A, and -3C, and establish CD4$^+$ T-cell clones against 12 representative epitopes. For each epitope we identify the relevant HLA class II restricting allele and determine the efficiency with which epitope-specific effectors recognize the autologous EBV-transformed B-lymphoblastoid cell line (LCL). The level of recognition measured by gamma interferon release was consistent among clones to the same epitope but varied between epitopes, with values ranging from 0 to 35% of the maximum seen against the epitope peptide-loaded LCL. These epitope-specific differences, also apparent in short-term cytotoxicity and longer-term outgrowth assays on LCL targets, did not relate to the identity of the source antigen and could not be explained by the different functional avidities of the CD4$^+$ clones; rather, they appeared to reflect different levels of epitope display at the LCL surface. Thus, while CD4$^+$ T-cell responses are detectable against many epitopes in EBV latent proteins, only a minority of these responses are likely to have therapeutic potential as effectors directly recognizing latently infected target cells

Analgesic Efficacy of Pfannenstiel Incision Infiltration with Ropivacaine 7.5 mg/mL for Caesarean Section

Background. Pain after Caesarean delivery is partly related to Pfannenstiel incision, which can be infiltrated with local anaesthetic solutions. Methods. A double- blind randomized control trial was designed to assess the analgesic efficacy of 7.5 mg/mL ropivacaine solution compared to control group, in two groups of one hundred and forty four parturients for each group, who underwent Caesarean section under spinal anaesthesia: group R (ropivacaine group) and group C (control group). All parturients also received spinal sufentanil (2.5 μg). Results. Ropivacaine infiltration in the Pfannenstiel incision for Caesarean delivery before wound closure leads to a reduction of 30% in the overall consumption of analgesics (348 550 mg for group R versus 504 426 mg for group C with P < .05), especially opioids in the first 24 hours, but also significantly increases the time interval until the first request for an analgesic (4 h 20 min ± 2 h 26 for group R versus 2 h 42 ± 1 h 30 for group C). The P values for the two groups were: P < .0001 for paracetamol, P < .0001 for ketoprofen and P for nalbuphine which was the most significant. There is no significant difference in the threshold of VAS in the two series. Conclusion. This technique can contribute towards a programme of early rehabilitation in sectioned mothers, with earlier discharge from the post-labour suite

II.5 Where to find the CoRoT data?

This book is dedicated to all the people interested in the CoRoT mission and the beautiful data that were delivered during its six year duration. Either amateurs, professional, young or senior researchers, they will find treasures not only at the time of this publication but also in the future twenty or thirty years. It presents the data in their final version, explains how they have been obtained, how to handle them, describes the tools necessary to understand them, and where to find them. It also highlights the most striking first results obtained up to now. CoRoT has opened several unexpected directions of research and certainly new ones still to be discovered

Quantifying molecular oxygen isotope variations during a Heinrich stadial

International audienceδ 18 O of atmospheric oxygen (δ 18 O atm) undergoes millennial-scale variations during the last glacial period, and systematically increases during Heinrich stadials (HSs). Changes in δ 18 O atm combine variations in biospheric and water cycle processes. The identification of the main driver of the millennial variability in δ 18 O atm is thus not straightforward. Here, we quantify the response of δ 18 O atm to such millennial events using a freshwater hosing simulation performed under glacial boundary conditions. Our global approach takes into account the latest estimates of isotope frac-tionation factor for respiratory and photosynthetic processes and make use of atmospheric water isotope and vegetation changes. Our modeling approach allows to reproduce the main observed features of a HS in terms of climatic conditions , vegetation distribution and δ 18 O of precipitation. We use it to decipher the relative importance of the different processes behind the observed changes in δ 18 O atm. The results highlight the dominant role of hydrology on δ 18 O atm and confirm that δ 18 O atm can be seen as a global integrator of hydrological changes over vegetated areas

Monoketone analogs of curcumin, a new class of Fanconi anemia pathway inhibitors

<p>Abstract</p> <p>Background</p> <p>The Fanconi anemia (FA) pathway is a multigene DNA damage response network implicated in the repair of DNA lesions that arise during replication or after exogenous DNA damage. The FA pathway displays synthetic lethal relationship with certain DNA repair genes such as <it>ATM </it>(Ataxia Telangectasia Mutated) that are frequently mutated in tumors. Thus, inhibition of FANCD2 monoubiquitylation (FANCD2-Ub), a key step in the FA pathway, might target tumor cells defective in ATM through synthetic lethal interaction. Curcumin was previously identified as a weak inhibitor of FANCD2-Ub. The aim of this study is to identify derivatives of curcumin with better activity and specificity.</p> <p>Results</p> <p>Using a replication-free assay in <it>Xenopus </it>extracts, we screened monoketone analogs of curcumin for inhibition of FANCD2-Ub and identified analog EF24 as a strong inhibitor. Mechanistic studies suggest that EF24 targets the FA pathway through inhibition of the NF-kB pathway kinase IKK. In HeLa cells, nanomolar concentrations of EF24 inhibited hydroxyurea (HU)-induced FANCD2-Ub and foci in a cell-cycle independent manner. Survival assays revealed that EF24 specifically sensitizes FA-competent cells to the DNA crosslinking agent mitomycin C (MMC). In addition, in contrast with curcumin, ATM-deficient cells are twofold more sensitive to EF24 than matched wild-type cells, consistent with a synthetic lethal effect between FA pathway inhibition and ATM deficiency. An independent screen identified 4H-TTD, a compound structurally related to EF24 that displays similar activity in egg extracts and in cells.</p> <p>Conclusions</p> <p>These results suggest that monoketone analogs of curcumin are potent inhibitors of the FA pathway and constitute a promising new class of targeted anticancer compounds.</p