Skin preparation before hip replacement in emergency setting versus elective scheduled arthroplasty: Bacteriological comparative analysis

SummaryIntroductionHip arthroplasty needs to be performed in an emergency setting after intracapsular femur neck fracture, whereas pain makes preoperative skin preparation of the limb difficult and it may therefore be incomplete. To date no study has analyzed the patient's skin bacteriological status in these surgical conditions.HypothesisThe skin's bacterial flora is quantitatively and qualitatively different in the trauma context compared to an elective scheduled arthroplasty for chronic hip disease.Materials and methodsTwo groups of patients, undergoing hip arthroplasty and having the same preparation at the time of surgery but different skin preparation procedures the day before and the day of surgery, were prospectively compared: 30 patients operated on in an emergency setting for fracture (group A) had no skin preparation and 32 patients operated on in scheduled surgery (group B). Group A had no skin disinfection before going into surgery, whereas group B followed a predefined protocol the day before surgery. Skin samples were taken on gelose at three different stages of skin preparation at the time of surgery (before and after detersive cleaning, and at the end of the surgery) and on two sites (inguinal and greater trochanter). The bacteriological analysis took place after 48hours of incubation.ResultsBefore detersive cleaning, group A had 3.6times more bacteria than group B in the trochanter region and 2.7times more in the inguinal area. After detersive cleaning, the contamination rate in the trochanter area was similar in both groups (group A: 10%; group B: 12.5%), but different in the inguinal region (group A: 33%; group B: 3%; P=0.002). At the end of the surgery, no difference was identified. Coagulase-negative Staphylococcus and Bacillus cereus accounted for 44% and 37%, respectively, of the bacteria isolated. In addition, the frequency of pathogenic non-saprotrophic bacteria was higher in group A (38%) compared to group B (6%). At a mean follow-up of 9.7months (range: 8–11months), no infection of the surgical site was identified.ConclusionThe dermal flora is more abundant and different when the patient is managed in an emergency context. Although effective in the trochanter area, cutaneous detersive cleaning in the operating room is insufficient in the inguinal area and the frequency of pathogenic bacteria warrants identical rigor in preoperative preparation in all situations.Level of evidenceIII. Prospective case – control study

Scientific rationale of a Saturn probe mission

We describe the main scientific goals to be addressed by future in situ exploration of Saturn

Observation of water vapor in the stratosphere of Jupiter with the Odin Space Telescope.

International audienceThe water vapor line at 557 GHz has been observed with the Odin space telescope with a high signal-to-noise ratio and a high spectral resolution on November 8, 2002. The analysis of this observation as well as a re-analysis of previously published observations obtained with the SubmillimeterWavelength Astronomy Satellite seem to favor a cometary origin (Shoemaker-Levy 9) for water in the stratosphere of Jupiter, in agreement with the ISO observation results. Our model predicts that the water line should become fainter and broader from 2007. The observation of such a temporal variablity would be contradictory with an IDP steady flux, thussupporting the SL9 source hypothesis

Coherent detection of metal-metal terahertz quantum cascade lasers with improved emission characteristics

Coherent detection of emission from quantum cascade lasers with metal-metal waveguides is demonstrated through free-space coupling of a THz pulse to the sub-wavelength waveguide. We implement a simple, monolithic planar horn antenna design on the metal-metal waveguide that reduces the impedance mis-match to the waveguide. The resulting devices show up to 10 times more directed output power than conventional metal-metal waveguides. This enhanced coupling to free-space allows a more efficient injection of broad-band THz pulses into the waveguide. Through this, we are able to seed the laser emission and coherently detect the laser emission by electro-optic sampling

First results on Martian carbon monoxide from Herschel/HIFI observations

We report on the initial analysis of Herschel/HIFI carbon monoxide (CO) observations of the Martian atmosphere performed between 11 and 16 April 2010. We selected the (7-6) rotational transitions of the isotopes ^{13}CO at 771 GHz and C^{18}O at 768 GHz in order to retrieve the mean vertical profile of temperature and the mean volume mixing ratio of carbon monoxide. The derived temperature profile agrees within less than 5 K with general circulation model (GCM) predictions up to an altitude of 45 km, however, show about 12-15 K lower values at 60 km. The CO mixing ratio was determined as 980 \pm 150 ppm, in agreement with the 900 ppm derived from Herschel/SPIRE observations in November 2009.Comment: Accepted for publication in Astronomy and Astrophysics (special issue on HIFI first results); minor changes to match published versio

Optical sideband generation up to room temperature with mid-infrared quantum cascade lasers

Room temperature sideband generation on an optical carrier is demonstrated using midinfrared quantum cascade lasers. This is achieved via an enhancement of the nonlinear susceptibility via resonant interband and intersubband excitations, compensating the large phase-mismatch

What is bacterial colonisation of cystic fibrosis children toothbrushes?

Pseudomonas aeruginosa or Staphylococcus aureus toothbrushes contamination in cystic fibrosis (CF) patients is unknown. The objective of this pilot study was to determine prevalence of those germs on toothbrushes of CF and healthy children, and define if toothbrushes may be involved in pulmonary infection

Ice giant systems: the scientific potential of orbital missions to Uranus and Neptune

Uranus and Neptune, and their diverse satellite and ring systems, represent the least explored environments of our Solar System, and yet may provide the archetype for the most common outcome of planetary formation throughout our galaxy. Ice Giants will be the last remaining class of Solar System planet to have a dedicated orbital explorer, and international efforts are under way to realise such an ambitious mission in the coming decades. In 2019, the European Space Agency released a call for scientific themes for its strategic science planning process for the 2030s and 2040s, known as Voyage 2050. We used this opportunity to review our present-day knowledge of the Uranus and Neptune systems, producing a revised and updated set of scientific questions and motivations for their exploration. This review article describes how such a mission could explore their origins, ice-rich interiors, dynamic atmospheres, unique magnetospheres, and myriad icy satellites, to address questions at the heart of modern planetary science. These two worlds are superb examples of how planets with shared origins can exhibit remarkably different evolutionary paths: Neptune as the archetype for Ice Giants, whereas Uranus may be atypical. Exploring Uranus' natural satellites and Neptune's captured moon Triton could reveal how Ocean Worlds form and remain active, redefining the extent of the habitable zone in our Solar System. For these reasons and more, we advocate that an Ice Giant System explorer should become a strategic cornerstone mission within ESA's Voyage 2050 programme, in partnership with international collaborators, and targeting launch opportunities in the early 2030s

Bacterial colonization status of cystic fibrosis children's toothbrushes: a pilot study

Pseudomonas aeruginosa and Staphylococcus aureus toothbrush contamination in cystic fibrosis (CF) is unknown. This pilot study aimed to determine their prevalence and the potential involvement of toothbrushes in pulmonary infection. Methods. Toothbrush bacteriological analysis for children aged 8–18 years was conducted on 27 CF patients, 15 healthy siblings, and 15 healthy children from the general population. Results : S. aureus was detected on 22% of the patients’ toothbrushes, and 13% of healthy children's toothbrushes and P. aeruginosa on 15% of patients’ toothbrushes and 0–13% of healthy children's toothbrushes. There was no statistical correlation between pulmonary colonization and toothbrush contamination. P. aeruginosa genotyping showed two identical clones on the patients’ toothbrushes and in their sputum, and between one patient's sputum and his sibling's toothbrush. Conclusion : S. aureus and P. aeruginosa can colonize CF patients’ toothbrushes. The impact on pulmonary colonization remains unknown. Toothbrush decontamination methods need to consider these bacteria in CF patients