Un corps étranger trachéo bronchique inhabituel "l’épingle à foulard": présentation et gestion

L'inhalation accidentelle du corps étranger est rare chez les adultes et les adolescents. L'épingle à foulard est un corps étranger particulier de plus en plus fréquent chez les femmes qui portent le voile. Le but de notre travail est de décrire les particularités liées à l'inhalation de cet objet éguisé à conséquences lourdes, et la nécessité d'un programme de sensibilisation et d'éducation. Dix jeunes patientes, toutes voilées, ont été hospitalisées au service de chirurgie thoracique du CHU Mohammed VI d'Oujda entre janvier 2010 et juillet 2014 pour inhalation d'épingle à foulard. La moyenne d'âge a été de 15 ans. L'inhalation a été accidentelle dans tous les cas, alors que les patientes s'initiaient au port du voile. Le syndrome de pénétration a été retrouvé dans tous les cas. L'examen clinique a été normal chez toutes les patientes. La radiographie thoracique a montré le corps étranger sous forme d'une opacité linéaire, localisée au niveau de la trachée dans 3 cas, à droite dans 4 cas, gauche dans 3 cas. La bronchoscopie rigide a réussi à extraire l'épingle dans 8 cas. L'épingle a été rejetée spontanément dans un cas et une patiente a dû être opérée. L'épingle à foulard est un corps étranger particulier de plus en plus fréquent chez les femmes qui portent le voile islamique, il faut souligner la nécessité d'un programme d'éducation de la santé envers cette population. La bronchoscopie rigide reste le principal outil de récupération de ces corps étrangers inhalés

A procedure to analyze nonlinear density waves in Saturn's rings using several occultation profiles

Cassini radio science experiments have provided multiple occultation optical depth profiles of Saturn's rings that can be used in combination to analyze density waves. This paper establishes an accurate procedure of inversion of the wave profiles to reconstruct the wave kinematic parameters as a function of semi-major axis, in the nonlinear regime. This procedure is achieved from simulated data in the presence of realistic noise perturbations, to control the reconstruction error. By way of illustration we have applied our procedure to the Mimas 5:3 density wave. We were able to recover precisely the kinematic parameters from the radio experiment occultation data in most of the propagation region; a preliminary analysis of the pressure-corrected dispersion allowed us to determine new but still uncertain values for the opacity ($K\simeq 0.02$ cm$^2$/g) and velocity dispersion of ($c_o\simeq 0.6$ cm/s) in the wave region. Our procedure constitutes the first step in our planned analysis of the density waves of Saturn's rings. It is very accurate and efficient in the far-wave region. However, improvements are required within the first wavelength. The ways in which this method can be used to establish diagnostics of ring physics are outlined.Comment: 50 pages,13 figures, 2 tables. Published in Icarus

Robotic-assisted internal fixation of femoral fractures

Closed surgical techniques for the internal fixation of femoral fractures require orthopaedic surgeons to work in close proximity to X-rays. In addition to the occupational health risk this imposes, inexperienced surgeons often encounter great difficulty in achieving optimal positioning of fracture repair fixtures. A vision-guided robotic system has been proposed as a possible solution to these problems and an initial investigation involving two exemplar orthopaedic procedures has been undertaken. Robotic surgery assistance imposes rigorous safety-related design constraints, since the orthopaedic robot must operate in close proximity to the patient and operating staff. The design and implementation of a purpose-built robotic system for orthopaedic surgery assistance is described in this paper

A breath controlled AAC system

A breath controlled AAC syste

Les Occlusions Intestinales Par Nœud Ileo-Sigmoïdien : Aspects Diagnostiques, Thérapeutiques Et Pronostiques

Introduction: Ileosigmoid knot (ISK), also known as compound volvulus or double volvulus, is a rare disease and affects mostly male subjects in their fourth decade. Delayed diagnosis often leads to complications with a high incidence of digestive necrosis. Materials and methods: This was a 10-year retrospective, descriptive and analytical study from 1 January 2007 to 31 December 2016, which covered all patients operated emergently for ISK in the surgical and surgical specialty departments at the Niamey National Hospital (NNH). Results: The series involved 8 cases of ISK, representing 0.82% of intestinal obstructions. There were 7 men and 1 woman. The average age of patients was 44.33 years with extremes ranging from 25 to 60 years. The main clinical signs were: abdominal pain (100%), inability to pass gas and stool (100%), vomiting (87.5%) and abdominal meteorism (87.5%). Four patients (50%) had a clear obstructive syndrome and the other 4 patients (50%) had associated signs of peritoneal irritation. Paraclinical diagnosis was difficult because of atypical clinico-radiological signs, but in all cases an abdominal x-ray was performed and showed a double loop of dilated sigmoid shadow in 87.5% of the cases. Laparotomy was the first approach used in all patients and led to a 50% necrosis rate. Hartmann’s colectomy and ideal colectomy were used in identical proportions, with 50% each. Ideal colectomy was characterized by a morbidity rate of 50% and a mortality rate of 25% compared to 0% for Hartmann’s procedure. The overall morbidity was 25% and the overall mortality was 12.5%. The average hospital stay was 65.87 days (range 17 to 128 days). The average time before reestablishment of digestive continuity was 50.37 days (range 31-128 days). Conclusion: Ileosigmoid knot is a rare condition at Niamey national hospital where the diagnostic approach is similar to that of occlusions in general, but remains difficult due to its uncommonness and atypical clinico-radiological signs. Necrosis rates and postoperative complications remain high

Saturn's Equatorial Oscillation: Evidence of Descending Thermal Structure from Cassini Radio Occultations

Ground-based and Cassini CIRS thermal-infrared data have characterized the spatial and temporal characteristics of an equatorial oscillation in Saturn's middle atmosphere above the 100-mbar level. The CIRS data indicate a vertical pattern of alternating warm and cold anomalies at the equator. From the thermal wind equation this implies a concomitant reversal of zonal winds with attitude, relative to the cloud-top winds, with peak-to-peak amplitude approximately 200 meters per second. The ground-based observations do not having the altitude range or vertical resolution of the CIRS observations, but they cover several years and indicate an oscillation cycle of 1 years, roughly half of Saturn's year. Equatorial oscillations in Earth's middle atmosphere have primarily exhibited either quasi-biennial or semi-annual "periodicities," and both types have been extensively observed and modeled. They exhibit a vertical pattern of alternating warmer and cooler zonal-mean temperatures and zonal winds analogous to that described above for Saturn. Moreover, the pattern of winds and temperatures descends with time. Momentum deposition by damped vertically propagating easterly and westerly waves is thought to play a key role in forcing both types of oscillation, and it can plausibly account for the descent. Here we report the direct observation of this descent in Saturn's equatorial atmosphere from Cassini radio occultation soundings in 2005 and 2009. The retrieved temperatures are consistent with a descent of 0.6 x the pressure scale height over this time period. The descent rate is related to the magnitude of the wave forcing, radiative damping, and induced meridional circulations. A simple calculation implies that vertical wave fluxes of zonal momentum approximately 0.05 square meters per square second could account for the observed vertical descent on Saturn, which is comparable to the magnitude of the wave fluxes associated with the terrestrial quasi-biennial oscillation

Invagination Intestinale Aiguë De L’adulte: Aspects Diagnostiqsues, Thérapeutiques Et Étiologiques

Introduction: Acute intussusception is a rare clinical entity in adults where it accounts for only 1-2% of intestinal obstructions. The authors wanted to report cases of acute intussusception in adult patients, their diagnostic aspects, their management, and their etiologies. Patients and Methods: This study is a retrospective study of the medical files of patients of both sexes. They include adults over 15 years of age, operated between January 2010 and December 2014, who were diagnosed with obstruction due to acute intestinal intussusception. Results: Six cases of adult intestinal intussusception were collected. The average age was 26.5 years. The sex ratio was 1 and there were so many men as women. Five out of six patients were unstable on admission. The diagnosis was made preoperative in two cases out of six, 33.3%. Ultrasound revealed a target sign in two cases. The ileo-ileal form was the most frequent (5 cases out of 6) or 83.3%. Also, there were two cases of intestinal necrosis out of six. Intestinal resection was performed in five cases or 83.33%. The cause of intussusception was found in four cases out of six or 66.7%. Here, a tumor was the cause in half of the cases. Immediate surgical follow-up was uncomplicated in all patients. Conclusion: Acute intestinal intussusception of the adult is a very rare condition. The preoperative diagnosis of acute intussusception of the adult remains delicate. The ileo-ileal form is more frequent than the ileo-colic form in adults. Treatment is always surgical in adults

An Evolving View of Saturn's Dynamic Rings

International audienceWe review our understanding of Saturn's rings after nearly 6 years of observations by the Cassini spacecraft. Saturn's rings are composed mostly of water ice but also contain an undetermined reddish contaminant. The rings exhibit a range of structure across many spatial scales; some of this involves the interplay of the fluid nature and the self-gravity of innumerable orbiting centimeter- to meter-sized particles, and the effects of several peripheral and embedded moonlets, but much remains unexplained. A few aspects of ring structure change on time scales as short as days. It remains unclear whether the vigorous evolutionary processes to which the rings are subject imply a much younger age than that of the solar system. Processes on view at Saturn have parallels in circumstellar disks