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Introduction: Les fractures du calcanéus sont des fractures fréquentes, touchant l’homme jeune à la suite d’un mécanisme à haute énergie. Les complications en sont le pied plat valgus et l’arthrose sous-talienne. Différents traitements sont possibles. L’ostéosynthèse par plaque verrouillée permet de restaurer l’architecture du calcanéus. L’objectif principal de ce travail était d’étudier les complications cutanées et infectieuses de l’ostéosynthèse par plaque des fractures du calcanéus. Les objectifs secondaires étaient d’évaluer les résultats fonctionnels ainsi que la survenue d’arthrose sous-talienne. Notre hypothèse était que le taux de complications était peu élevé.Matériels et méthodes: Il s’agit d’une étude monocentrique rétrospective incluant les ostéosynthèses par plaque verrouillée du calcanéus (février 2008 à mars 2015) à l’exclusion des patients atteints d’une comorbidité sévère.Résultats: La série comprend 26 ostéosynthèses : 23 patients majoritairement masculins (82,6 %) et jeunes (âge moyen : 39 ans), avec un recul moyen de 32 mois. Vingt-trois fractures ont été analysées. Nous avons relevé cinq complications cutanées ou infectieuses, dont trois ont nécessité une reprise chirurgicale. Elles étaient corrélées au tabagisme (p < 0,05). Le score AOFAS moyen était de 74,2 : [33–95]. Les résultats fonctionnels étaient excellents dans 22 % et bons dans 44 % des cas. L’accident du travail, le tabagisme, les fractures de type Duparc V, et les variantes propagées étaient des facteurs de mauvais pronostic. Il y avait dix cas d’arthrose soustalienne au dernier recul. Six cas de grades quatre étaient corrélés à des scores fonctionnels péjoratifs. Cinq patients ont dû subir une arthrodèse sous-talienne.Discussion: Nous avons retrouvé un taux de complications légèrement moins élevé que dans la littérature corrélées au tabagisme. Les scores fonctionnels étaient légèrement inférieurs. Les dysesthésies du nerf sural sont une complication relativement fréquente. L’arthrose sous-talienne survient dans près d’un cas sur deux. Un taux élevé de complications et des résultats parfois modestes poussent à réfléchir sur la technique chirurgicale et son indication. Les abords miniinvasifs ou la chirurgie percutanée pourraient être une alternative.Conclusion: La prise en charge des fractures du calcanéus doit être une chirurgie à la carte, tenant compte des lésions associées, de l’état cutané et du patient, car les complications liées à une chirurgie à foyer ouvert ne sont pas négligeables.

La traumatologia pediatrica e un’area particolarmente delicata in termini di diagnosi. Se la presentazione clinica non e molto diversa da quella dell’adulto, l’interpretazione dei dati della diagnostica per immagini puo rivelarsi delicata a causa della matrice cartilaginea molto importante nel bambino. Cio e particolarmente vero per il gomito, regione anatomica in cui sono presenti molti nuclei di ossificazione epifisari. Il buon supporto diagnostico di queste lesioni impone al professionista una conoscenza precisa dell’evoluzione dello scheletro in accrescimento. La gestione iniziale deve comportare una contenzione e un’analgesia efficaci. La gestione terapeutica e molto consensuale su queste grandi linee. A causa dell’elevato potenziale di rimodellamento nei bambini, una gran parte e lasciata al trattamento ortopedico. I limiti della correzione spontanea dei difetti residui devono essere noti fin dalla fase iniziale, per evitare modificazioni secondarie della strategia, fonti di perdita di tempo e di fiducia da parte della famiglia. Le principali urgenze sono il trauma vascolare dell’arteria omerale al gomito e poplitea al ginocchio. Esse possono passare inosservate a causa della ricchezza della rete collaterale del bambino. Queste complicanze devono essere sistematicamente ricercate in caso di frattura sovracondilica del gomito e di frattura femorale distale.

Introduction Depuis 2016, le NIFT-P, anciennement carcinome papillaire de variante folliculaire encapsule, a ete reclasse en tumeur a faible risque evolutif, dont la prise en charge se limite a une exerese chirurgicale, avec guerison sans recidive dans la majorite des cas. L’identification preoperatoire de ces tumeurs pourrait permettre la realisation d’un geste limite. Objectifs Decrire les caracteristiques preoperatoires d’une cohorte de NIFT-P et l’impact de cette nouvelle classification sur la prise en charge. Patients et methodes 106 patients operes entre 2005 a 2019 avec diagnostic histologique de NIFT-P unifocal et supra-centimetrique ont ete identifies retrospectivement. Les donnees preoperatoires, chirurgicales, histologiques, et de suivi ont ete recueillies. Resultats Les patients (76,4 % de femmes) avaient un âge moyen de 48 ans [21-80]. La TSH moyenne etait de 1,45mUI/L (10 % de TSH Conclusion Les NIFT-P sont principalement des tumeurs solides hypoechogenes EU-TIRADS 4 avec TSH normale. La cytologie ne permet pas d’orienter le diagnostic preoperatoire. La definition de la nouvelle entite NIFT-P a modifie les prises en charge chirurgicale et isotopique depuis 2016.

With the publication of the DSM-5, the alcoholic disease becomes Alcohol-use disorders taking into account dependence and damages according to a gradient of severity. This conceptual evolution should improve the screening of people affected by this chronic and progressive disease associated with a heavy impact on morbidity and mortality. This identification is provided by the clinical interview and examination. Its sensitivity can be improved by questionnaires and biological markers. Damage and related pathologies have to be systematically revealed. In this context, the MoCA test allows the early detection of cognitive disorders. Care management aims for a change in consumption and consists in supporting the patient in his/her approach. Care management should be personalized, appropriated to the patient's informed choice and graded according to disorders' severity. This includes a psychosocial intervention which can be associated with drugs. Abstinence is no longer the only alternative: decreasing consumption with the aim of regulation has been shown interesting in the reduction of harmful consumption. When therapeutic withdrawal turns out to be necessary, use of a treatment should not be systematic. If necessary, benzodiazepines remain the first-line treatment with a limited duration of prescription. According to his/her profile, the patient can receive a long-term treatment to help to maintain abstinence, prevent relapse or reduce consumption. There is evidence that identifying and involving patients in their care significantly improve their health. Effective treatments are available for treating alcohol-use disorders. However, only a relatively small number of patients receive specific management appropriated to their needs and according to concrete goals.

Depuis 1998, differents programmes nationaux d’action contre le suicide ont ete promulgues afin de reduire le nombre de personnes mettant fin « volontairement » a leurs jours. Ces 15 annees ont aussi permis de considerer le suicide et la tentative de suicide autrement. Si l’Organisation mondiale de la sante definit le suicide comme un « acte delibere », la modelisation de la crise suicidaire en 2000 a permis de mettre l’accent non plus seulement sur le passage a l’acte, mais sur la periode de crise qui conduit le sujet a considerer le suicide comme la solution ultime pour mettre fin a une tension psychique elevee, a une vie devenue insupportable.

According to self-determination theory, when the social context is autonomy supportive, people are motivated to internalize the regulation of important activities, and whereas when the context is controlling, self-determined motivation is undermined. A model that incorporates perceptions of coaches' interpersonal behaviors (autonomy support vs. control), 5 forms of regulation (intrinsic motivation, identified, introjected and external regulation, and amotivation), and persistence was tested with competitive swimmers (N = 369) using a prospective 3-wave design. Analyses using structural equation modeling revealed that experiencing relationships as controlling fostered non–self-determined forms of regulation (external regulation and amotivation). Greater levels of self-determined motivation occurred when relationships were experienced as autonomy supportive. Individuals who exhibited self-determined types of regulation at Time 1 showed more persistence at both Time 2 (10 months later) and Time 3 (22 months later). Individuals who were amotivated at Time 1 had the highest rate of attrition at both Time 2 and Time 3. Introjected regulation was a significant predictor of persistence at Time 2 but became nonsignificant at Time 3. External regulation was not a significant predictor of behavior at Time 2, but became negatively associated with persistence at Time 3. The findings are discussed in light of the determinants of the internalization process and the consequences of different forms of self-regulation for psychological functioning.

One major problem with research conducted on sportsmanship is the absence of an accepted definition. The purpose of this study was to attempt to derive a definition of sportsmanship by applying premises from social psychological theories and research. A major assumption of this perspective is that sportsmanship meanings and labels attached to given behaviors are learned through interpersonal interactions with various sport participants and that eventually a consensual agreement develops regarding the nature of sportsmanship. It thus follows that a meaningful definition of sportsmanship should be obtained through the athletes themselves. In this study, 1056 male and female athletes completed a questionnaire which contained various items pertaining to sportsmanship. Results from a factor analysis revealed the presence of 5 factors corresponding to the respect and concern for: a) one's full commitment toward sport participation, b) the rules and officials. c) social conventions, d) the opponent, as ...

Resume Cet article presente les resultats de trois etudes qui avaient pour but de construire et de valider un nouvel instrument mesurant la motivation vis-a-vis des loisirs. Cet instrument, l'Echelle de Motivation vis-a-vis des Loisirs (EML), s'inspire de la theorie de l'autodetermination (Deci & Ryan, 1985). L'EML comprend 7 sous-echelles mesurant trois types de motivation intrinseque (MI; MI a la connaissance, MI a l'accomplissement et MI a la stimulation), trois types de motivation extrinseque (ME; ME par regularisation externe, ME par regularisation introjectee et ME par regularisation identifiee) et l'amotivation. Dans l'ensemble, les resultats des trois etudes revelent que les sous-echelles de l'EML possedent un niveau de coherence interne satisfaisant ainsi qu'une stabilite temporelle elevee. Les resultats d'analyses factorielles exploratoire et confirmative (LISREL VII) confirment la pertinence d'une structure a 7 facteurs pour l'EML. Finalement, la validite de construit de l'EML est soutenue par ...

A new measure of motivation toward sport has been developed in French, namely the Echelle de Motivation vis-à-vis les Sports. Two studies were conducted to translate and validate this new measure in English. The Sport Motivation Scale (SMS) consists of seven subscales that measure three types of Intrinsic Motivation (IM; IM to Know, IM to Accomplish Things, and IM to Experience Stimulation), three forms of regulation for Extrinsic Motivation (Identified, Introjected, and External), and Amotivation. The first study confirmed the factor structure of the scale and revealed a satisfactory level of internal consistency. Correlations among the subscales revealed a simplex pattern confirming the self-determination continuum and the construct validity of the scale. Gender differences were similar to those obtained with the French-Canadian version. The more self-determined forms of motivation were associated with more positive responses on related consequences. In a second study, the SMS was administered on two occasions and revealed adequate test-retest reliability.

NiTi single and multilayers were prepared in a triode sputtering machine. The thickness of the Ti layers were varied between 5 and 100nm and the H2 partial pressure between 5 × 10−7 and 5 × 10−5mbar. The samples were characterized by various nuclear methods. It was found that for H2 partial pressures below 5 × 10−5mbar the ratio of H:Ti atoms was 40±12 at.% for Ti thickness above 10nm. For smaller thickness this ratio decreases to 20 at.%. H2 partial pressures above 7 × 10−4mbar allow an H:Ti ratio of 1 to be reached for Ti layers thicker than 40 nm.

A new measure of motivation toward education has been developed in French, namely the "Echelle de Motivation en Education" (EME). The EME is based on the tenets of self-determination theory and is composed of seven subscales assessing three types of intrinsic motivation (intrinsic motivation to know, to accomplish

A new measure of motivation toward education has been developed in French, namely the Echelle de Motivation en Education (EME). The EME is based on the tenets of self-determination theory and is composed of 28 items subdivided into seven sub-scales assessing three types of intrinsic motivation (intrinsic motivation to know, to accomplish things, and to experience stimulation), three types of extrinsic motivation (external, introjected, and identified regulation), and a motivation. The purpose of this investigation was to cross-culturally validate in English the EME. The EME was translated in English through appropriate methodological procedures and completed by university students. Results revealed that the English version of the scale renamed the Academic Motivation Scale (AMS), has satisfactory levels of internal consistency (mean alpha value = .81) and temporal stability over a one-month period (mean test-retest correlation = .79). In addition, results of a confirmatory factor analysis (LISREL) confirmed the seven-factor structure of the AMS. Finally, gender differences obtained with the EME were basically replicated with the AMS. In sum, the present findings provide adequate support for the factorial validity and reliability of the AMS and support its use in educational research on motivation.

Recent research has shown that individuals high in private self-consciousness generally make more self-attributions following hypothetical outcomes than those low in private self-consciousness. The purpose of this study was to replicate and extend past research in assessing the attributional responses of such individuals in real outcome and no-outcome conditions. French-Canadian female college students (N = 62) performed an achievement task and were then informed that they had done well (success outcome) or were not informed at all (no outcome). The subjects then rated the perceived causal dimensions of the attributed cause of the outcome. Results of an ANOVA revealed the presence of an interaction. Subjects high in private self-consciousness who had been informed that they had done well (success outcome) made more internal, stable, and controllable attributions than subjects low in private self-consciousness. Subjects low in private self-consciousness tended to make more internal, stable, and co...

The purpose of this study was to assess the significance and structure of life domains of college students and to explore the patterns of gender differences on different indices of significance. Four hundred fifty-seven college students rated 21 life domains in terms of degree of importance, frequency of involvement, and level of impact. They also responded to a measure of global life satisfaction. Gender differences on significance indices were investigated by means of three types of analyses. First, gender mean ratings on 21 life domains were compared via one-way multivariate analyses of variance. Second, the underlying dimensions of the 21 domains for each gender were compared via exploratory factor analyses. Third, the correlation patterns between perceived positive impact of each life domain and life satisfaction were calculated separately for men and women. Within-group comparisons revealed that men and women shared the same nine most significant domains: education, friends, biological needs, leisure, family, health, couple, esthetics, and physical activities. However, several gender differences were consistently found in the three types of analyses. The results indicated that although traditionally feminine domains are rated as more significant to women than men, traditional masculine domains were rated as equally significant by men and women. Domains considered sex role neutral (e.g., personal planning) were rated as more significant by women than men. In general, women appear to experience greater cognitive, affective, and behavioral aspects of significance in a wider spectrum of activities and as well perceive their general life satisfaction as deriving from a broader range of sources. Results also highlight the importance of assessing the degree of significance of life domains as an initial step in the development of multidimensional self-related constructs.

Histopathological and genetic studies support the hypothesis that aberrant crypt foci (ACF) represent one of the earliest events in colon carcinogenesis. The purpose of this study is to make use of 1H MRS in conjunction with multivariate methods of analysis to ascertain the validity of the above mentioned hypothesis.ACF, colonic mucosa and tumor samples taken from thirty-two carcinogen (azoxymethane)-treated Sprague Dawley rats, and of colon mucosa taken from ten healthy animals, were investigated ex vivo by 1H MRS and analyzed using multivariate methods of analysis.The 1H magnetic resonance peak intensities and areas of ACF lie between those from normal and carcinogen- treated mucosa samples and tumors. Multivariate analysis classification of the spectra suggests that the ACF exhibit biochemical characteristics intermediate between the control and AOM-mucosa samples and the tumor groups.The use of sophisticated methods of data classification has enabled us to support the hypothesis that ACF represent preneoplastic lesions of the colon.

Proton nuclear magnetic resonance spectroscopy (1H NMR) can be used to study skeletal muscle metabolism. The mdx mouse is a unique animal for studies of muscle regeneration, and models the disease of Duchenne muscular dystrophy (DMD). The goals of this study were to determine the potential of 1H NMR spectroscopy as an alternative to conventional histology in monitoring: (1) normal growth in control muscle and the progression of dystrophy in mdx muscle, and (2) beneficial treatments (glucocorticoids) on mdx dystrophy. Ex vivo 1H NMR spectra of limb and diaphragm muscles were obtained from different ages of control and mdx mice, and from mice which were treated with prednisone or deflazacort. Peaks with contributions from creatine, taurine and lipids were examined. Lower levels of taurine and creatine characterized predystrophy and active dystrophy intervals in mdx muscle compared to control. Levels of taurine increased with stabilization of the disease by repair. A measure of accumulated muscle repair, fiber centronucleation and many spectral peaks were highly and significantly correlated. Greater amounts of lipids were found in the diaphragm compared to limb spectra. Treatment of dystrophy, which improved muscle phenotype, resulted in greater levels of taurine and creatine, especially in the limb muscle. Therefore, 1H NMR differentially discriminates: (1) control and mdx muscle; (2) the progression of mdx dystrophy and developmental stages in normal growth; (3) mild and severe dystrophic phenotypes (diaphragm vs limb); and (4) changes associated with improved muscle phenotype and regeneration (due to treatment or injury). The results focus on monitoring muscle repair, not degeneration. We conclude that 1H NMR is a reliable tool in the objective investigation of muscle repair status during muscular dystrophy.

Introduction Les osteites a Staphylococcus aureus sont une complication frequente (10 a 60 %) et grave des plaies du pied chez le diabetique. Le but de cette etude etait d’evaluer les clones de S. aureus circulants en France dans cette pathologie. Patients et methodes 57 patients diabetiques (63 % d’hommes, âge median 67 ans), ayant une osteite du pied ont ete inclus du 1/01/08 au 31/12/10 dans 12 CHU en France. Apres preparation de la plaie, un prelevement etait realise par biopsie osseuse. Les prelevements monomicrobiens a S. aureus etaient conserves pour etude genotypique par biopuces a ADN (StaphyType96 ® , Alere) detectant 333 genes de virulence/resistance et assignant l’origine clonale de la souche. Resultats 61 souches de S. aureus ont ete isolees (4 patients ayant 2 types de S. aureus de morphotypes differents). La prevalence des SARM etait de 19,7 %. Treize complexes clonaux connus et 4 singletons ont ete identifies. Le clone ST398 (d’origine animale notamment porcine) etait le plus frequemment detecte (n = 20, 33 %) representant 41 % des souches sensibles a la meticilline. Ces souches ont ete isolees dans 10 hopitaux sur 12. Aucun lien n’a pu etre demontre entre les differents patients, suggerant une propagation nationale de ce clone. Ces souches ont la particularite d’etre productrices de penicillinase et sensibles aux autres antibiotiques. Conclusion Cette etude multicentrique montre pour la premiere fois l’emergence et la dissemination du clone ST398 dans les osteites du pied diabetique en France. L’adaptation d’un clone passe de l’animal a l’homme est un probleme alarmant necessitant une surveillance accrue.

Introduction A female spouse homicide occurs in France every two days, in majority of cases after an episode of physical violence against the woman. Our objective was to determine socio-demographic, clinical and criminological characteristics of the male authors of a spouse homicide. Methods We have studied 210 records of psychiatric expertise of homicides perpetrated between 1995 and 2005 in West of France. We have analyzed the socio-demographic, clinical and criminological characteristics of the authors of a female intimate partner homicide (n = 30) and compared to the authors of a non female intimate partner homicide (n = 180). Results The authors of a female intimate partner homicide were older (38.4 years old (yo) versus 32.7 yo, p = .019) and had significantly more frequently a personal history of violence (50% versus 28%, p = .045) than the authors of a non-female intimate partner homicide. Compared to the non-female spouse homicides, female spouse homicides were not associated with other criminal behaviours (6.7% versus 21.7%, p = .055). A mental disorder was found in the minority of cases (13.3% versus 18,.3%, p = .506). Paranoid delusional disorder was the most frequent severe mental disorder in the authors of female intimate partner homicide (10%). Conclusion Our results confirm the general and the specific risk factors of violence in female intimate-partner homicide. Legal and health care professionals should be aware that women are vulnerable to intimate partner violence and homicide from both nonmarital and former partners as well as from current husbands. The history of domestic violence should be researched by the clinicians.

IntroductionAround thirty of cases of public self-immolation occurred in Czechoslovakia, Poland and Lithuania between 1968 and 1972 in the background of protest movement against the Soviet ledinvasion. Rather than an act of a political protest, in a moment of absurdity of the existence, or a rational solution aimed to finish a desperate life situation, could a self-immolation also testify a suicidal behaviour and a failure of adaptation mechanisms of the victims concomitant a mental disorder?MethodWe have selected and studied four most mediated cases of this period. Press articles available in English, French and Czech, biographical writings and czech archived data concerning Palach J. R. Kalanta, J. Zajic and R. Siwiec allowed us to retrospectively analyse the circumstances of the acting out, their apparent or hidden motivations and identify their suicidal risk factors.ResultsAll the four victims were men, young single students, aged between 18 and 21 years, excepted from R. Siwiec, aged 60 years. None had a psychiatric history or abuse of alcohol. All four, in the opposition of the communist system, were surrounded by a supporting family background. The public character of their act highlights the opposition against a totalitarian system and is questionning the possible intentionality of their behavior or the identification process of the young adults in post-adolescence.ConclusionImmolation by fire of Soviet opponents in Central Europe should be revised in the light of the likely depression and narcissistic vulnerabilities of these subjects.

On decrit un appareil permettant aux travailleurs manipulant des produits radioactifs de controler rapidement sur leurs mains, chaussures et vetements toute trace de contamination. Le principe utilise permet de realiser un appareil economique, d'un fonctionnement sur et d'une grande commodite d'utilisation.