Les comptages vélos dans les villes suisses

Depuis 2000, une augmentation des déplacements à vélo est observée dans les villes suisses. Les comptages vélos représentent une source intéressante, mais jusqu’ici inexploitée, pour analyser cette évolution. Nous avons d’abord établi une vision d’ensemble des comptages dans les villes suisses réalisés depuis 2010. Notre étude dénombre pour l’année 2017 un total de 18 villes suisses qui comptent régulièrement les vélos. Pour comparer l’évolution du nombre de vélos aux différents postes, le taux cumulé annuel moyen (TCAM) est calculé. Il en résulte une augmentation importante : dans les huit plus grandes villes suisses, 26 postes sur les 55 retenus affichent un TCAM de 5% ou plus. Cependant, les comptages systématiques restent peu nombreux et l’absence d’une méthode unifiée ainsi que la localisation et les périodes prises en compte rendent les données difficilement comparables

USPIO-enhanced magnetic resonance imaging of the knee in asymptomatic volunteers

The aim of this study was to compare signal characteristics of the synovium in knees of asymptomatic volunteers before and after intravenous administration of ultrasmall superparamagnetic iron oxide particles (USPIO). Ten knees of 10 asymptomatic volunteers were examined before and 36h after intravenous administration of USPIO on a 1.5-T MR system using T1-weighted spin-echo, T2-weighted fast spin-echo, T2*-weighted gradient-echo (GRE), and short inversion time inversion-recovery sequences. In addition, synovial perfusion was measured using Gd-enhanced GRE imaging during the first imaging session. Images were analyzed qualitatively for any visual changes before and after USPIO administration. Signal-to-noise ratios (SNR) of the synovium were determined on unenhanced and USPIO-enhanced sequences. All MR images were reviewed for presence of any degenerative changes. Qualitative image analysis revealed no visually detectable changes of any knee joint before and after USPIO administration. The SNR values of the synovium on T1w, T2w, and T2*w images before and after USPIO administration showed no significant difference (T1, P = 0.86; T2, P = 0.95; T2*, P = 0.86). None of the volunteers showed any relevant degenerative changes of the knee and synovial perfusion was within normal limits. In knees of asymptomatic volunteers without any relevant degenerative changes and normal synovial perfusion neither visual changes nor changes of SNR values of the synovium can be depicted after USPIO administration. This means that USPIO-enhanced MRI may be used for assessment of knee disorders with increased macrophage activit

Transvenous Biopsy of Cavo-Atrial Tumors with the Quick-Core Needle

A variant application of the renal Quick-Core needle in 3 patients with cavo-atrial tumors is reported. In all 3 patients either a transjugular or transfemoral venous biopsy approach with this device yielded sufficient tissue for histological diagnosis at the first attempt. Bioptic diagnoses were confirmed either by surgery or radiological and clinical response to a specific chemotherapy. There were no procedure-related complication

Somatostatin-based radiopeptide therapy with [177Lu-DOTA]-TOC versus [90Y-DOTA]-TOC in neuroendocrine tumours

Purpose: Somatostatin-based radiopeptide treatment is generally performed using the β-emitting radionuclides 90Y or 177Lu. The present study aimed at comparing benefits and harms of both therapeutic approaches. Methods: In a comparative cohort study, patients with advanced neuroendocrine tumours underwent repeated cycles of [90Y-DOTA]-TOC or [177Lu-DOTA]-TOC until progression of disease or permanent adverse events. Multivariable Cox regression and competing risks regression were employed to examine predictors of survival and adverse events for both treatment groups. Results: Overall, 910 patients underwent 1,804cycles of [90Y-DOTA]-TOC and 141 patients underwent 259cycles of [177Lu-DOTA]-TOC. The median survival after [177Lu-DOTA]-TOC and after [90Y-DOTA]-TOC was comparable (45.5months versus 35.9months, hazard ratio 0.91, 95% confidence interval 0.63-1.30, p = 0.49). Subgroup analyses revealed a significantly longer survival for [177Lu-DOTA]-TOC over [90Y-DOTA]-TOC in patients with low tumour uptake, solitary lesions and extra-hepatic lesions. The rate of severe transient haematotoxicities was lower after [177Lu-DOTA]-TOC treatment (1.4 vs 10.1%, p = 0.001), while the rate of severe permanent renal toxicities was similar in both treatment groups (9.2 vs 7.8%, p = 0.32). Conclusion: The present results revealed no difference in median overall survival after [177Lu-DOTA]-TOC and [90Y-DOTA]-TOC. Furthermore, [177Lu-DOTA]-TOC was less haematotoxic than [90Y-DOTA]-TOC

Accuracy of dual-source CT coronary angiography: first experience in a high pre-test probability population without heart rate control

The aim of this study was to assess the diagnostic accuracy of dual-source computed tomography (DSCT) for evaluation of coronary artery disease (CAD) in a population with extensive coronary calcifications without heart rate control. Thirty patients (24 male, 6 female, mean age 63.1±11.3 years) with a high pre-test probability of CAD underwent DSCT coronary angiography and invasive coronary angiography (ICA) within 14±9 days. No beta-blockers were administered prior to the scan. Two readers independently assessed image quality of all coronary segments with a diameter ≥1.5 mm using a four-point score (1: excellent to 4: not assessable) and qualitatively assessed significant stenoses as narrowing of the luminal diameter >50%. Causes of false-positive (FP) and false-negative (FN) ratings were assigned to calcifications or motion artifacts. ICA was considered the standard of reference. Mean body mass index was 28.3±3.9 kg/m(2) (range 22.4–36.3 kg/m(2)), mean heart rate during CT was 70.3±14.2 bpm (range 47–102 bpm), and mean Agatston score was 821±904 (range 0–3,110). Image quality was diagnostic (scores 1–3) in 98.6% (414/420) of segments (mean image quality score 1.68±0.75); six segments in three patients were considered not assessable (1.4%). DSCT correctly identified 54 of 56 significant coronary stenoses. Severe calcifications accounted for false ratings in nine segments (eight FP/one FN) and motion artifacts in two segments (one FP/one FN). Overall sensitivity, specificity, positive and negative predictive value for evaluating CAD were 96.4, 97.5, 85.7, and 99.4%, respectively. First experience indicates that DSCT coronary angiography provides high diagnostic accuracy for assessment of CAD in a high pre-test probability population with extensive coronary calcifications and without heart rate control

Prevalence and morphology of coronary artery ectasia with dual-source CT coronary angiography

To assess the prevalence and morphological characteristics of coronary artery ectasia (CAE) with CT coronary angiography (CTCA) in comparison to conventional catheterangiography (CCA). Dual-source CTCA examinations from 677 consecutive patients (223 women; median age 57 years) were retrospectively evaluated by two blinded observers for the presence of CAE defined as a diameter enlargement >/=1.5 times the diameter of adjacent normal coronary segments. Vessel diameters and contrast attenuation within and proximal to ectatic segments were measured. CCA was used to compare measurements obtained from CTCA with the coronary flow velocity by using the thrombolysis in myocardial infarction (TIMI) frame count. CTCA identified CAE in 20 of 677 (3%) patients. CCA was performed in ten of these patients. CAE diameter measurements with CTCA (10.0 +/- 5.4 mm) correlated significantly (r = 0.92, p < 0.001) with the CCA measurements (8.8 +/- 4.9 mm), but had higher diameters (levels of agreement: -1.0 to 3.4 mm). Contrast attenuation was significantly lower in the ectatic (343 +/- 63 HU) than in the proximal (394 +/- 60 HU) segments (p < 0.01). The attenuation difference significantly correlated with the CAE ratio (r = 0.67, p < 0.01) and the TIMI frame count (r = 0.58, p < 0.05). The prevalence of CAE in a population examined by CTCA is around 3%. Contrast attenuation measurements with CTCA correlate well with the flow alterations assessed with CCA