Hepcidin, Serum Iron, and Transferrin Saturation in Full-Term and Premature Infants during the First Month of Life: A State-of-the-Art Review of Existing Evidence in Humans.

Neonates regulate iron at birth and in early postnatal life. We reviewed literature from PubMed and Ovid Medline containing data on umbilical cord and venous blood concentrations of hepcidin and iron, and transferrin saturation (TSAT), in human neonates from 0 to 1 mo of age. Data from 59 studies were used to create reference ranges for hepcidin, iron, and TSAT for full-term-birth (FTB) neonates over the first month of life. In FTB neonates, venous hepcidin increases 100% over the first month of life (to reach 61.1 ng/mL; 95% CI: 20.1, 102.0 ng/mL) compared with umbilical cord blood (29.7 ng/mL; 95% CI: 21.1, 38.3 ng/mL). Cord blood has a high concentration of serum iron (28.4 μmol/L; 95% CI: 26.0, 31.1 μmol/L) and levels of TSAT (51.7%; 95% CI: 46.5%, 56.9%). After a short-lived immediate postnatal hypoferremia, iron and TSAT rebounded to approximately half the levels in the cord by the end of the first month. There were insufficient data to formulate reference ranges for preterm neonates

Le sommeil (physiologie et influence des facteurs individuels et socio-environnementaux)

TOURS-BU Sciences Pharmacie (372612104) / SudocSudocFranceF

Management of Anxiety for Ambulatory Hallux Valgus Surgery With a Virtual Reality Hypnosis Mask: Randomized Controlled Trial

International audienceBackground: The purpose of this study was to evaluate the impact of using virtual reality masks for the management of preoperative anxiety and its impact on postoperative and predischarge anxiety as well as postoperative analgesia during outpatient hallux valgus surgery. Methods: From June 2020 to September 2021, preoperative anxiety of patients scheduled for a percutaneous hallux valgus surgery were analyzed using the State Trait Anxiety Inventory (STAI) questionnaire completed during the consultation. All patients with major anxiety, defined as a STAI score above 40, were included in a randomized prospective comparative single-center study. Sixty patients were included in the study and randomized into 2 arms of 30 patients according to whether or not they underwent a preoperative hypnosis session with a virtual reality mask before surgery. Results: There was an improvement in the postoperative (42.5 vs 45.2, P <.04) and predischarge (25.3 vs 30.2 P <.03) anxiety scores in the group that used the mask before the procedure. There was a notable decrease in immediate higher-level postoperative analgesics such as morphine or ketamine (3.3% vs 26.6%, P <.03) in the arm using the mask. Conclusion: In this study cohort undergoing percutaneous hallux valgus surgery, we found that use of a virtual reality hypnosis mask before surgery modestly reduced postoperative and predischarge anxiety as well as early postoperative consumption of higher-level analgesics in adults with significant preoperative anxiety. Level of Evidence: Level II, prospective cohort study

Biomechanical evaluation of the spring ligament and the posterior tibial tendon by shear‐waves elastography: validation of a reliable and reproducible measurement protocol

Abstract Purpose The anatomy of the spring ligament complex, as well as its pathology, is not well known in daily clinical practice. The purpose of this study was to evaluate the shear‐wave elastography properties of the spring ligament and the posterior tibial tendon in healthy adults, and to assess the reliability and reproducibility of these measurements. Methods Shear‐wave elastography was used to evaluate both ankles in 20 healthy patients (10 females/10 males) resting on a hinge support with their ankles in neutral, valgus 20° and varus 30° positions. The stiffness of the spring ligament and posterior tibial tendon was assessed by measuring the speed of shear wave propagation through each structure. Results Posterior tibial tendon and spring ligament reach a maximum estimated stiffness in valgus 20° position (7.43 m/s vs 5.73 m/s, respectively). Flat feet were associated with greater spring ligament stiffness in the 20° valgus position (p = 0.01), but not for the posterior tibial tendon (p = 0.71). The physiologic weightbearing hindfoot attitude had no impact on the stiffness of the posterior tibial tendon or the spring ligament, regardless of the analysis position. Intra‐ and inter‐observer agreements were all excellent for spring ligament stiffness, regardless of ankle position, and were good or excellent for posterior tibial tendon. Conclusions This study describes a protocol to assess the stiffness of tibialis posterior and the spring ligament by shear‐wave elastography, which is reliable, reproducible, and defines a corridor of normality. Further studies should be conducted to define the role of elastography for diagnosis/ evaluation of pathology, follow‐up, or surgical strategies

Balance, barycentremetry and external shape analysis in idiopathic scoliosis: What can the physician expect from it?

Objective: Our objective was to establish a corridor of normality for the external shape 3D parameters and then to assess these variables in adolescent idiopathic scoliosis (AIS). Methods: Adolescent with mild and severe AIS were included prospectively, as well as a control group of asymptomatic subjects. A quasi‐automatic 3D reconstruction of the spine and manual 3D reconstruction of the external envelope was performed from biplanar radiography. The center of mass position, the axial intersegmental moment resulting at the apex and junctional vertebrae, and the coronal trunk balance were automatically computed. A normality corridor of asymptomatic subjects was calculated as the range [5th-95th percentiles] for external shape parameters at each vertebral level. Results: Forty-one asymptomatic subjects (19 females; 22 males; 21 yo, SD=4) and sixty AIS (56 females; 4 males; 13 years old, SD=1.9; 30 mild and 30 severe; 34 thoracic curves and 26 thoraco-lumbar or lumbar curves) were included. All parameters based on the external shape showed differences between AIS and controls, as well as between mild and severe scoliosis. For instance, the intersegmental moment applied to the upper junctional vertebra was above the 95th percentile of controls in 70% of AIS patient. The percentage of severe patients showing parameters higher than the normality corridor was significantly higher than mild patients (p<0.0001). Conclusions: The analysis of center of mass, vertebral intersegmental moment and coronal trunk balance parameters appear to be relevant in characterizing the 3D deformity of adolescent idiopathic scoliosis. The upper junctional intersegmental moment seems to be able to distinguish the different stages of curvature severity

Abnormal sex ratios in human populations: Causes and consequences

In the absence of manipulation, both the sex ratio at birth and the population sex ratio are remarkably constant in human populations. Small alterations do occur naturally; for example, a small excess of male births has been reported to occur during and after war. The tradition of son preference, however, has distorted these natural sex ratios in large parts of Asia and North Africa. This son preference is manifest in sex-selective abortion and in discrimination in care practices for girls, both of which lead to higher female mortality. Differential gender mortality has been a documented problem for decades and led to reports in the early 1990s of 100 million “missing women” across the developing world. Since that time, improved health care and conditions for women have resulted in reductions in female mortality, but these advances have now been offset by a huge increase in the use of sex-selective abortion, which became available in the mid-1980s. Largely as a result of this practice, there are now an estimated 80 million missing females in India and China alone. The large cohorts of “surplus” males now reaching adulthood are predominantly of low socioeconomic class, and concerns have been expressed that their lack of marriageability, and consequent marginalization in society, may lead to antisocial behavior and violence, threatening societal stability and security. Measures to reduce sex selection must include strict enforcement of existing legislation, the ensuring of equal rights for women, and public awareness campaigns about the dangers of gender imbalance