Traitement chirurgical par plaque à compression des fractures de Galeazzi chez l’adulte: À propos de 28 cas

La fracture de Galeazzi associe une fracture diaphysaire du radius ou des deux os de l'avant bras à une luxation de l'articulation radio ulnairedistale. Décrite en 1934, sa fréquence varie chez l'adulte entre 2,7% et 6,8% de l'ensemble des fractures de l'avant bras. Le traitement admis defaçon consensuel chez l'adulte est chirurgical reposant sur une ostéosynthèse stable par une plaque vissée de compression dynamique associée ou non à un embrochage de la radio ulnaire distale. Nous rapportons dans notre étude les résultats cliniques de 28 patients colligés au service de traumatologie et orthopédie A du CHU Hassan II de Fès sur une période de 06 ans. L'âge moyen de nos patients était de 30 ans avecprédominance masculine de 90%; tous nos patients ont présenté un traumatisme de poignet lors d'un accident de sport. Le côté droit était atteint dans 75 % des cas. Le bilan radiologique objectiva une fracture diaphysaire du raduis associée à une luxation radio ulnaire distale; nous avons adopté la classification de de Mansat. Le traitement a consisté en une synthèse par une plaque vissée dynamique associée à un   embrochage transversal chez six patients qui ont présenté une instabilité de la radio ulnaire distale. L'immobilisation par attelle plâtrée postérieure BABP était de mise. Après un recul de 36 mois, nos résultats ont été très satisfaisants suivant le score de Mestdagh, avec bonne récupération de la mobilité du poignet et reprise de toute activité sportive

Effects of Biological Age on Athletic Adaptations to Combined Plyometric and Sprint with Change of Direction with Ball Training in Youth Soccer Players

There is evidence for the effectiveness of youth combined plyometric and sprint with change of direction (COD) training. However, the evidence is not well-known regarding the in-season effects of biological age (peak height velocity—PHV) on the motor adaptive processes following combined plyometric and COD with ball training (P-CODBT) in youth soccer players. This study aimed to examine the in-season effects of P-CODBT (8 weeks and twice a week) on the athletic performances of male youth soccer players, circa- and post-PHV. In a randomized controlled training study with pre-to-post measurements, forty-eight male players were assigned into two experimental (performing P-CODBT; n = 12 × circa-PHV and n = 12 × post-PHV) and two control groups (CONG; n = 12 × circa-PHV and n = 12 × post-PHV). The pre- and post-training participants were assessed for their anthropometric, linear sprinting with and without a ball, COD speed with and without a ball, vertical jump, dynamic balance, and endurance-intensive performances. After the intervention, the experimental condition induced significant (all p < 0.0001) and small to large effect size (ES = 0.263–3.471) additional gains only on explosive measures compared to CONG. Both the experimental (all p < 0.0001; ES = 0.338–1.908) and control (p = 0.011–0.0001; ES = 0.2–1.8) groups improved their athletic performances over the training period. The improvements generated by p-CODBT were not affected by biological age. In-season short-term P-CODBT (twice a week) could be safe way to generate benefits in explosive performances in youth soccer players, which are relevant components of match-winning actions in soccer

Effects of Four Weeks of Plyometric Training Performed in Different Training Surfaces on Physical Performances in School Children: Age and Sex Comparisons

Short- to middle-term plyometric training has been shown to be an effective method to promote youth fitness and health. However, there is no knowledge of previous studies that investigated the sex and age effects on physical fitness following different PT surfaces (i.e., firm vs. sand) in schoolchildren. This study examined the effects of age and sex on explosive and high-intensity responses following plyometric training (4 weeks, twice/week) performed on firm vs. sand surfaces in untrained schoolchildren. Ninety girls and ninety boys (under 8: age = 7.1 ± 0.5 and 7.1 ± 0.4 years; under 10: age = 9.0 ± 0.4 and 9.0 ± 0.5 years; under 12: age = 11.0 ± 0.5 and 11.0 ± 0.5 years, respectively) participated in a randomized and parallel training design with pre-to-post testing. Participants were allocated (i.e., 30 boys and 30 girls for each group) into either two experimental groups (firm group: performing plyometrics on a clay surface and sand group: performing plyometrics on a dry surface of 20 cm deep sand) or a control group (CG, habitual physical education classes) within their corresponding age groups. Children were tested for sprint, jumping and change of direction speed performances before and after 4 weeks of plyometric training. Both experimental groups induced more significant improvements in all assessed variables than CG (p 0.80), whereas both surfaces induced similar improvements (p > 0.05). Older boys achieved better performances than their younger counterparts (p < 0.05) and older girls (p < 0.0001), respectively. This finding showed that age and sex could affect explosive and high-intensity performances during childhood after a short-term plyometric training. In contrast, the training-induced fitness changes were not influenced by the type of surface

Hydatid disease of the ribs: An exceptional location

Background. Hydatid disease is a zoonosis caused by larval stages of cestodes belonging to the genus Echinococcus. The rib location is exceptional. It presents a real diagnostic and therapeutic challenge. Objective. To describe the clinical, serological and radiological features and surgical management of rib hydatidosis. Methods. This is a retrospective study conducted over 4 years, on five cases of rib hydatidosis. We analysed the clinical and radiological presentations and the adopted therapeutic procedure. Results. The average age of our patients was 44 years, without gender predominance. The clinical signs were dominated by the presence of an immobile swelling of fluid consistency without inflammatory sign, accompanied by moderate and intermittent localised pain. The laboratory assessment was nonspecific. The radiological assessment, including chest X-ray and thoracic computed tomography, with and without contrast, was essential in order to assess the extent of the lesion. Thoracic magnetic resonance imaging was requested in one case because of suspicions of a spinal extension. All of our patients underwent a rib excision accompanied by medical treatment of albendazole 24 hours after the surgery. The follow-up ranged from 1 year to 4 years and did not show any recurrence. Conclusion. Hydatidosis of the ribs is an exceptional location of hydatid disease. The diagnosis was based on radiology and intraoperative exploration. The treatment remained essentially surgical by rib excision with anthelmintic drugs to prevent recurrence

Centre selection for clinical trials and the generalisability of results: a mixed methods study.

BACKGROUND: The rationale for centre selection in randomised controlled trials (RCTs) is often unclear but may have important implications for the generalisability of trial results. The aims of this study were to evaluate the factors which currently influence centre selection in RCTs and consider how generalisability considerations inform current and optimal practice. METHODS AND FINDINGS: Mixed methods approach consisting of a systematic review and meta-summary of centre selection criteria reported in RCT protocols funded by the UK National Institute of Health Research (NIHR) initiated between January 2005-January 2012; and an online survey on the topic of current and optimal centre selection, distributed to professionals in the 48 UK Clinical Trials Units and 10 NIHR Research Design Services. The survey design was informed by the systematic review and by two focus groups conducted with trialists at the Birmingham Centre for Clinical Trials. 129 trial protocols were included in the systematic review, with a total target sample size in excess of 317,000 participants. The meta-summary identified 53 unique centre selection criteria. 78 protocols (60%) provided at least one criterion for centre selection, but only 31 (24%) protocols explicitly acknowledged generalisability. This is consistent with the survey findings (n = 70), where less than a third of participants reported generalisability as a key driver of centre selection in current practice. This contrasts with trialists' views on optimal practice, where generalisability in terms of clinical practice, population characteristics and economic results were prime considerations for 60% (n = 42), 57% (n = 40) and 46% (n = 32) of respondents, respectively. CONCLUSIONS: Centres are rarely enrolled in RCTs with an explicit view to external validity, although trialists acknowledge that incorporating generalisability in centre selection should ideally be more prominent. There is a need to operationalize 'generalisability' and incorporate it at the design stage of RCTs so that results are readily transferable to 'real world' practice

Human Cellular Immune Response to the Saliva of Phlebotomus papatasi Is Mediated by IL-10-Producing CD8+ T Cells and Th1-Polarized CD4+ Lymphocytes

Cutaneous leishmaniasis affects millions of people worldwide and is caused by protozoa of the genus Leishmania. The parasite is transmitted during sand fly bites. While probing the skin for a blood meal, vectors salivate into the host's skin. Sand fly saliva contains several components that increase hemorrhage and interfere with the host's inflammatory response. Data obtained in mice originally indicate that immunization against saliva protected from leishmaniasis supporting possibility that leishmaniasis could be prevented by a vaccine based on sand fly saliva. Herein we investigated the nature and the importance of the cellular immune response developed against sand fly saliva by individuals at risk of cutaneous leishmaniasis due to Leishmania major. We demonstrated that the immunity against saliva is dominated by the activation of lymphocytes producing a suppressive cytokine called IL-10. These data may preclude the protective effect of sand fly saliva pre-exposure in humans. Further experiments revealed that the production of IL-10 masked the presence of a second kind of lymphocytes producing IFN-γ, a rather protective cytokine. The latter finding highlights the importance of the identification of the proteins activating the latter lymphocytes in order to develop vaccines based on selected proteins from the saliva of sand flies

Nutritional supplements and infection in the elderly: why do the findings conflict?

BACKGROUND: Most of the randomized placebo-controlled trials that have examined the clinical effects of multivitamin-mineral supplements on infection in the elderly have shown no significant effect. The exceptions are three such trials, all using a supplement with the same composition, and all claiming dramatic benefits: a frequently cited study published in 1992, which reported a 50% reduction in the number of days of infection (NDI), and two 2002 replication studies. Questions have been raised about the 1992 report; a second report in 2001 based on the same trial, but describing effects of the supplement on cognitive functions, has been retracted by Nutrition. The primary purpose of the present paper is to evaluate the claims about the effects of supplements on NDI in the two replication reports. METHODS: Examination of internal consistency (outcomes of statistical tests versus reported data); comparison of variability of NDI across individuals in these two reports with variability in other trials; estimation of the probability of achieving the reported close agreement with the original finding. RESULTS: The standard deviations of NDI and levels of statistical significance reported are profoundly inconsistent. The reported standard deviations of NDI are consistently below what other studies have found. The reported percent reductions in NDI agree too closely with the original study. CONCLUSION: The claims of reduced NDI in the two replication reports should be questioned, which also adds to concerns about the 1992 study. It follows that there is currently no trustworthy evidence from randomized placebo-controlled clinical trials that favors the use of vitamin-mineral supplements to reduce infection in the elderly

Overthrowing the dictator: a game-theoretic approach to revolutions and media

A distinctive feature of recent revolutions was the key role of social media (e.g. Facebook, Twitter and YouTube). In this paper, we study its role in mobilization. We assume that social media allow potential participants to observe the individual participation decisions of others, while traditional mass media allow potential participants to see only the total number of people who participated before them. We show that when individuals’ willingness to revolt is publicly known, then both sorts of media foster a successful revolution. However, when willingness to revolt is private information, only social media ensure that a revolt succeeds, with mass media multiple outcomes are possible, one of which has individuals not participating in the revolt. This suggests that social media enhance the likelihood that a revolution triumphs more than traditional mass media