An Adaptive Observer-Based Algorithm for Solving Inverse Source Problem for the Wave Equation

Observers are well known in control theory. Originally designed to estimate the hidden states of dynamical systems given some measurements, the observers scope has been recently extended to the estimation of some unknowns, for systems governed by partial differential equations. In this paper, observers are used to solve inverse source problem for a one-dimensional wave equation. An adaptive observer is designed to estimate the state and source components for a fully discretized system. The effectiveness of the algorithm is emphasized in noise-free and noisy cases and an insight on the impact of measurements’ size and location is provided

Suivi d'une cohorte de patients atteints du syndrome COVID-19 post-aigu dans un cabinet de médecine familiale belge.

peer reviewedFifty-five patients who suffered from COVID-19, who were still very ill after several months, with extreme fatigue, effort exhaustion, brain fog, anomia, memory disorder, anosmia, dysgeusia, and other multi-systemic health problems have been followed in a family practice setting between May 2021 and July 2022. Data extracted from the medical records of the 55 patients (40 women), mean age 42.4 (12 to 79 years), and a qualitative study of 6 of them using a semi-open-ended questionnaire allowed to highlight the clinical picture described by WHO as post-acute COVID-19 syndrome (PACS) also known as long COVID. We used brain single-photon emission computed tomography (SPECT-CT) in thirty-two patients with a high severity index and a highly impaired functional status, demonstrating vascular encephalopathy in twenty nine patients and supporting the hypothesis of a persistent cerebral vascular flow disorder in post COVID-19 condition. The patients will benefit from the consortium COVID Human Genetic Effort (covidhge.com) to explore the genetic and immunological basis of their problem, as 23/55 cases don't have immunological certainty of a COVID-19 infection. There is no known verified treatment. Analyzing the data from the first 52 patients, three categories of patients emerged over time: 16 patients made a full recovery after 6-8 months, 15 patients were able to return to life and work after 12-18 months with some sequelae, both groups being considered cured. In the third group, 21 patients are still very ill and unable to resume their work and life after 18 months. The biopsychosocial consequences on patients' lives are severe and family doctors are left out in the cold. It is necessary to test the reproducibility of this description, conducted on a small number of patients. Nevertheless, identifying, monitoring and supporting these patients is a necessity in family medicineCinquante-cinq patients atteints de COVID-19, toujours très malades après plusieurs mois, avec une fatigue extrême, un épuisement à l'effort, un brouillard cérébral, une anomie, un trouble de la mémoire, une anosmie, une dysgueusie et d'autres problèmes de santé multisystémiques ont été suivis dans un cabinet de médecine familiale entre mai 2021 et juillet 2022. Les données extraites des dossiers médicaux des 55 patients (40 femmes), d'âge moyen 42,4 ans (12 à 79 ans), et une étude qualitative de 6 d'entre eux à l'aide d'un questionnaire semi-ouvert ont permis de mettre en évidence le tableau clinique décrit par l'OMS comme le syndrome COVID-19 post-aigu (PACS) également appelé long COVID. Nous avons utilisé la tomographie d'émission monophotonique cérébrale (scintigraphie) chez trente-deux patients présentant un indice de gravité élevé et un état fonctionnel très altéré, démontrant une encéphalopathie vasculaire chez vingt-neuf patients et soutenant l'hypothèse d'un trouble persistant du flux vasculaire cérébral dans la maladie post COVID-19. Les patients bénéficieront du consortium COVID Human Genetic Effort (covidhge.com) pour explorer la base génétique et immunologique de leur problème, car 23/55 cas n'ont pas la certitude immunologique d'une infection par le COVID-19. Il n'existe aucun traitement vérifié connu. En analysant les données des 52 premiers patients, trois catégories de patients sont apparues au fil du temps : 16 patients se sont complètement rétablis après 6 à 8 mois, 15 patients ont pu reprendre leur vie et leur travail après 12 à 18 mois avec quelques séquelles, les deux groupes étant considérés comme guéris. Dans le troisième groupe, 21 patients sont encore très malades et incapables de reprendre leur travail et leur vie après 18 mois. Les conséquences biopsychosociales sur la vie des patients sont graves et les médecins de famille sont dans l’incertitude. Il est nécessaire de tester la reproductibilité de cette description, menée sur un petit nombre de patients. Néanmoins, l'identification, le suivi et l'accompagnement de ces patients est une nécessité en médecine de famill

Diagnostic criteria for bruxism: A scoping review

Background: A scoping review was conducted to explore all the methods and criteria used in primary research on bruxism diagnosis. Methods: A pre-defined and validated search was carried out in the PubMed, CINAHL, PsycInfo, Scopus, PeDro, LILACS, and Epistemonikos databases. Primary studies conducted on bruxism as primary condition in the adult population were included. The selection phases were carried out by peers, and conflicts were resolved by a third reviewer or by consensus. Data extraction and manual tracing were done in order to identify the relevant studies. Results: The search and selection strategy identified 472 publications, and after manual tracing, 423 studies were selected for analysis. The results on diagnostic methods were grouped into 10 categories. Different subcategories were described within these categories, resulting in a total of 73 diagnostic methods: physical examination (n = 11), questionnaires (n = 12), polysomnography (n = 13), electromyography (n = 5), the International Classification for Sleep Disorders from the American Association of Sleep Medicine (ICSD-AASM) (n = 3), intraoral devices (n = 10), history (n = 7), audio-video recordings (n = 3), smartphone applications (n = 2), and others (n = 7). In addition, the combinations of methods used in the primary research were also analyzed. The prevalence of use was calculated for all diagnostic categories and subcategories, as well as for the combinations. Conclusion: There was high heterogeneity in primary research regarding the diagnosis of bruxism. There is evidence that not all diagnostic methods are properly validated. Future research should focus on validating these methods and developing the best tool in terms of reliability and cost-effectiveness for the diagnosis of bruxism

Evaluation des granules de phosphate dicalcique di-hydraté-phosphate tricalcique B-gentamicine dans le traitement local de l'ostéite expérimentale à Staphylococcus aureus

Le traitement antibiotique local de l'infection osseuse par le polyméthacrylate de méthyle (PMMA), chargé de gentamicine ou de tobramycine, montre actuellement des limites. Ses inconvénients sont liés à la non résorbabilité du PMMA et à la rétention d'une grande partie de l'antibiotique intégré au PMMA. L association fréquente à l infection de pertes de substance osseuse a favorisé la recherche de vecteurs d antibiothérapie locale, alternative au PMMA, parmi les substituts de comblement osseux résorbables et ostéoconducteurs. Les ciments phosphocalciques (CPC) pourraient devenir parmi les plus performants dans cette utilisation. Ils sont biocompatibles et offrent avec le Dicalcium Phosphate-ß-Tricalcium Phosphate (DCPD-ß-TCP), un CPC, la possibilité d'obtention d'un mélange DCPD-ß-TCP-gentamicine à une température de 43C n'altérant pas l'antibiotique, contrairement aux céramiques phosphocalciques qui sont fabriquées par frittage à très haute température. Le but de notre travail était de tester in vitro (élution d antibiotique) et in vivo (essai de traitement d'ostéite expérimentale) le DCPD-ß-TCP-gentamicine comme alternative possible au PMMA-gentamicine. [...]Local antibiotic treatment of osteomyelitis is based on the use of gentamicin- (or tobramycin-) loaded polymethylmethacrylate (PMMA). These two aminoglycosides are effective against most cultured orthopedic microorganisms, including Staphylococcus aureus, the most frequent cause of infection. The extensive use of PMMA as a Local Antibiotic Delivery System (LADS) has various disadvantages. Firstly, only a small proportion (about 5 to 17%) of the antibiotic is released by the cement (trapping effect). Secondly, the most significant problem is that PMMA is not resorbable and presents a physical obstacle to osteogenesis. A second surgical operation is therefore always required to remove the PMMA and to fill the cavity caused by bone loss with a bone graft or a synthetic substitute. Several absorbable synthetic substitutes, such as calcium phosphate ceramics, calcium sulfate, and polymers of polylactic-polyglycolic acids, have been investigated as antibiotic carriers. These synthetic substitutes are largely underused as LADS in clinical practice. Polymers are not perfectly biocompatible, and ceramics provide a burst release of antibiotics as a consequence of their manufacturing techniques (Antibiotic adsorption onto the carrier, after sintering of the carrier at high temperature, 1000-1200C). We have developed a possible alternative to gentamicin loaded-PMMA for local treatment of osteomyelitis in the form of novel calcium phosphate cement (CPC): dicalcium phosphate dihydrate-b-tricalcium phosphate (DCPD-b-TCP). The biocompatibility of such a cement has been demonstrated experimentally and has been clinically confirmed for the treatment of burst fractures and for filling bone cavities in osteoporotic fractures. DCPD-ß-TCP is made in granules from 2 to 3 mm in diameter to avoid the superficial creeping substitution observed when DCPD-b-TCP is used as a cement block. [...]TOURS-Bibl.électronique (372610011) / SudocSudocFranceF

Estudio descriptivo y narrativo de casos de Covid Largo en la práctica general y el valor diagnóstico de la gammagrafía cerebral. Informe de investigación clínica

La atención primaria está sometida a una gran presión por parte de lospacientes con Covid-19 y los afectados por Covid largo. El tema delCovid Largo, su diagnóstico y el enfoque terapéutico se discuten aquíen detalle. El Covid Largo se describe sobre la base de una revisiónde la literatura, pero también sobre la base de la experiencia clínicaen la práctica general. Se exponen las principales características deveintiún casos (dieciséis mujeres) de Covid Largo encontrados en 2021.La experiencia de seis de ellos se relata a partir de las notas de sushistorias clínicas. Se entrevistó a estos seis pacientes y se les pidió quereleyeran y corrigieran los textos que les afectaban. Se trata, pues, deun estudio descriptivo basado en la experiencia clínica y narrativa,verificada por los pacientes. Long Covid es la primera enfermedad en lahistoria de la medicina que fue descrita por primera vez por los propios pacientes en las redes sociales. Aún no está definida con precisión ylos síntomas multisistémicos pueden ser inespecíficos o variar segúnlos órganos afectados. El diagnóstico se basa en la escucha atenta delhistorial del paciente. La fatiga irreprimible desconocida hasta ahora,la niebla cerebral, los trastornos de la memoria de trabajo con posibleanomia, la anosmia, la disgeusia u otros síntomas múltiples que apa-recen después de Covid agudo son muy característicos de Covid largo.Faltan pruebas biológicas de Covid en diez pacientes. La PCR puede nohaberse realizado o haber sido negativa en la fase aguda de la enferme-dad. Los anticuerpos anti-SARS-CoV-2 no siempre estaban presentes oeran indistinguibles de los anticuerpos post-vacunación. En trece de losveintiún casos presentados, las gammagrafías cerebrales (ECD Tc-99m)pudieron demostrar un trastorno grave de la perfusión cerebral. Dosgammagrafías cerebrales de seguimiento a los tres meses mostraron unamejora significativa. En diez casos, faltaban pruebas de laboratorio. Seespera un ensayo de anticuerpos tisulares (linfocitos B). Un paciente quese presenta varios meses después de un Covid con síntomas inexplicablesdesde el punto de vista médico bien puede ser un Covid largo. No seconoce ningún tratamiento específico. La revalidación neurocognitiva yla fisioterapia pueden ayudar a estos pacientes que necesitan un apoyoempático a largo plazo para afrontar su enfermedad

Étude descriptive et narrative de cas de Long Covid en médecine générale et intérêt diagnostique de la scintigraphie cérébrale. Rapport de recherche clinique

Les soins primaires sont soumis à une forte pression par les patients atteints de Covid-19 et ceux touchés par le Long Covid. La question du Long Covid, son diagnostic et son approche thérapeutique sont abordés ici en détail. Le Long Covid est décrit sur base d'un suivi de la littérature mais aussi de l'expérience clinique accumulée en consultation de médecine générale. Les principales caractéristiques de vingt et un cas (seize femmes) de Long Covid rencontrés en 2021 sont exposées. L'expérience de six d'entre eux est relatée sur base des notes de leur dossier médical. Ces six patients ont été interviewés et invités chacun à relire et corriger les textes les concernant. Il s'agit donc d'une étude descriptive basée sur la clinique et la narration du vécu, vérifiée par les patients. Le Long Covid, première maladie dans l'histoire de la médecine à avoir été décrite d'abord par les patients eux-mêmes sur les réseaux sociaux, n'est pas encore précisément définie et les symptômes multi-systémiques peuvent être non spécifiques ou varier en fonction des organes touchés. Le diagnostic repose sur l'écoute attentive de l'histoire du patient. Une fatigue irrépressible inconnue auparavant, un brouillard cérébral, des troubles de la mémoire de travail avec éventuelle anomie, une anosmie, une dysgueusie ou d'autres symptômes multiples survenant après un Covid aigu sont très caractéristiques du Long Covid. Les preuves biologiques du Covid manquent chez dix patients. La PCR a pu être ne pas être faite ou être négative en phase aiguë de la maladie. Les anticorps anti-SARS-CoV-2 ne sont pas toujours présents ou sont indiscernables des anticorps post-vaccinaux. Dans treize des vingt et un cas présentés, la scintigraphie cérébrale (ECD Tc-99m) a pu mettre en évidence un trouble sévère de la perfusion cérébrale. Deux scintigraphies cérébrales de contrôle à trois mois ont montré une amélioration importante. Dans dix cas, les preuves de laboratoire manquent. Le dosage des anticorps tissulaires (Lymphocytes B) est attendu. Un patient qui présente plusieurs mois après un Covid des symptômes médicalement inexpliqués, peut très bien être un Long Covid. Il n'y a aucun traitement spécifique connu. La revalidation neurocognitive et la physiothérapie peuvent aider ces patients qui ont besoin d'un accompagnement empathique à long terme pour supporter leur éta

Descriptive and Narrative Study of Long Covid Cases in General Practice and Diagnostic Value of Single Photon Emission Computed Tomography

Primary care is under great pressure from patients with Covid-19 and those affected by Long Covid. The issue of Long Covid, its diagnosis and therapeutic approach are discussed here in detail. The Long Covid is described on the basis of a review of the literature and also on the basis of clinical experience in general practice. The main characteristics of thirty four cases (twenty five women) of Long Covid encountered in 2021 and early 2022 are outlined. The experience of six of them is reported on the basis of notes from their medical records. These six patients were interviewed and each was asked to reread and correct the texts concerning them. This is therefore a descriptive study based on clinical and narrative experience, verified by the patients. Long Covid, the first disease in the history of medicine to be described first by patients themselves on social networks, is not yet precisely defined and the multi-systemic symptoms may be non-specific or vary according to the organs affected. Diagnosis is based on careful listening to the patient’s history. Previously unknown irrepressible fatigue, brain fog, working memory disorders with possible anomia, anosmia, dysgeusia or other muli-systemic symptoms occurring after an acute Covid are varying characteristics of Long Covid. Biological evidence of Covid is missing in fourteen patients as PCRs may have been not done or came back negative in the acute phase of the disease. Anti-SARS-CoV-2 antibodies are not always present or are indistinguishable from post-vaccine antibodies. In fourteen severe cases presented, Single Photon Emission Computed Tomography (SPECT) after intravenous administration of Technetium-99m (Tc-99m HM-PAO) were able to demonstrate a disorder of cerebral perfusion. Two follow-up brain SPECT at three months showed significant improvement. Further genetic and immunologic study is ongoing for all patient with the help of the international consortium COVID Human Genetic Effort. A patient who presents after a Covid with medically unexplained symptoms may well be a Long Covid. Despite some interesting hypothesis, there is no known specific treatment. Neurocognitive revalidation and physiotherapy may help those patients who need long-term empathic support to cope with their condition

Improvement of a Long Covid patient after vaccinations, a case report in family practice

peer reviewedSince 2019, primary care has been under great pressure from Covid-19 patients and now from those affected by Long Covid. The issue of this new condition, its diagnosis and available treatments, were investigated on the occasion of an anecdotal and unexpected recovery of a patient with Long Covid. A 48-year-old woman, a single mother of two and patient in our family practice for several years, became sick from Covid-19 in October 2020. She never recovered, and 9 months later was still showing signs of severe Long Covid with somatic, behavioral, cognitive and memory disorders. After her two vaccinations by Comirnaty - Pfizer/BioNTech, she reported severe side effects, followed at day 12 after the first vaccine by an unexpected improvement still present at day 30 and 44 of the Long Covid symptoms from which she had suffered for several months. SARSCoV-2 antibodies were very high and although Magnetic Resonance Imaging were not very contributory, cerebral tomoscintigraphic examination was compatible with a cerebral pathology of vascular type. While no conclusions can be drawn from an isolated case, this case allows us to show that post Covid patients, who may already be highly comorbid, should be accompanied on a long-term basis. The disease is not yet precisely defined and symptoms may be non-specific or may vary depending on the organs affected. Diagnostic procedures are not always helpful. A post Covid heartsink patient with medically unexplained symptoms may well be a Covid long hauler. This makes listening to the patient‘s words and narrative medicine very powerful