Search

L’allongement de l’aponévrose des gastrocnémiens est réalisé dans le cadre de rétractions d’origine neurologique, post-traumatique et, plus récemment, dans le cadre de certaines pathologies du pied et de la cheville. Ce travail décrit une technique chirurgicale originale d’allongement percutané à l’aiguille et met en évidence des capacités de corrections qui excèdent celles attendues grâce à la fasciotomie simultanée du fascia postérieur du soléaire permettant de surseoir dans certains cas à un allongement du tendon calcanéen.

Many factors can affect the return to pivoting sports, after an Anterior Cruciate Ligament Reconstruction. Prehabilitation, rehabilitation, surgical and psychological aspects play an essential role in the decision to return to sports.

Bony lesions are highly prevalent in anterior shoulder instability and can be a significant cause of failure of stabilisation procedures if they are not adequately addressed. The glenoid track concept describes the dynamic interaction between the humeral head and glenoid defects in anterior shoulder instability. It has been beneficial for understanding the role played by bone defects in this entity. As a consequence, the popularity of glenoid augmentation procedures aimed to treat anterior glenoid bone defects; reconstructing the anatomy of the glenohumeral joint has risen sharply in the last decade. Although bone defects are less common in posterior instability, posterior bone block procedures can be indicated to treat not only posterior bony lesions, attritional posterior glenoid erosion or dysplasia but also normal or retroverted glenoids to provide an extended glenoid surface to increase the glenohumeral stability. The purpose of this review was to analyse the rationale, current indications and results of surgical techniques aimed to augment the glenoid surface in patients diagnosed of either anterior or posterior instability by assessing a thorough review of modern literature. Classical techniques such as Latarjet or free bone block procedures have proven to be effective in augmenting the glenoid surface and consequently achieving adequate shoulder stability with good clinical outcomes and early return to athletic activity. Innovations in surgical techniques have permitted to perform these procedures arthroscopically. Arthroscopy provides the theoretical advantages of lower morbidity and faster recovery, as well as the identification and treatment of concomitant pathologies.

AimTo study the association between player characteristics, technical components of the game and the risk of match injuries during the 2017 Men’s Handball World Championship.MethodsTeam physicians of the participating teams (n=24) were requested to provide injury report forms throughout the Men’s Handball World Championship (France, January 2017). The individual time played, age, number of international matches played and all technical and penalty variables for each player were extracted from the official International Handball Federation (IHF) online database and used as risk factors in a general logistic linear model analysis.ResultsOf 387 players, 49 sustained one or more injuries (93 injuries in total). The total incidence of match injuries was 82.1 injuries per 1000 hours (95% CI 66.2 to 100.5), non-time-loss injury incidence was 40.6 injuries per 1000 hours (95% CI 29.3 to 54.9), while time-loss injury incidence was 30.9 injuries per 1000 hours (95% CI 21.5 to 42.9). Multivariate analysis showed that age (OR 1.1, 95% CI 1.02 to 1.18, p=0.011), player position (backs: OR 6.79, 95% CI 2.25 to 20.54, p=0.001; goalkeepers: OR 5.03, 95% CI 1.15 to 21.94, p=0.031) and 2 min suspensions (1–2 times: OR 2.77, 95% CI 1.27 to 6.04, p=0.011; 3 or more times: OR 2.66, 95% CI 1.18 to 6.38, p=0.029) were significant risk factors for getting injured during competition matches.ConclusionAge, player position (backs, goalkeepers) and 2 min suspensions were associated with match injury. Stricter rule enforcement should be considered to prevent match injuries in elite handball.

ObjectiveTo report the outcomes of cataract surgery performed by non-physician cataract surgeons due to lack of ophthalmologists in remote areas of North Cameroon.DesignProspective cohort study.SettingThe main centre of the non-governmental organisation Ophtalmo Sans Frontières in Lagdo.Participants and interventionsAge-related cataract surgery performed between 28 November 2016 and 17 May 2017.Main outcomes measuresThe main outcome measure was presenting visual acuity (PVA) 1–4 weeks after surgery, classified according to the WHO as good (PVA ≥6/18), borderline (PVA 6/60–6/18) and poor (PVA <6/60). The WHO definition of blindness (visual acuity <3/60) and severe visual acuity (visual acuity 3/60–6/60) was used to assess the proportion of patients with a change in WHO category.ResultsWe included 474 eyes of 474 patients; the mean (SD) age was 63.9 (15) years (42.2% female). At 1–4 weeks after surgery, the surgical outcome was good for 170 patients (41.1%), borderline for 213 (51.5%) and poor for 31 (7.5%). In all, 224 patients (47.2%) had blindness or severe visual impairment before cataract surgery and 22 (5.3%) at 1–4 weeks after surgery. Poor visual outcome was associated with older age (p=0.018), preoperative blindness or severe impairment (p=0.012) and surgical complications (p=0.019).ConclusionBlindness and severe visual impairment were significantly decreased in the early postoperative period. Poor outcomes were associated with older age, low preoperative binocular visual acuity and intraoperative complications. Non-physician cataract surgeons may compensate for the lack of ophthalmologists in remote areas of low-income and middle-income countries.

Epidemiology and prognosis of complications related to allogeneic hematopoietic stem cell transplant (HSCT) recipients requiring admission to intensive care unit (ICU) have not been reassessed precisely in the past few years. We performed a retrospective single-center study on 318 consecutive HSCT patients (2009–2013), analyzing outcome and factors prognostic of ICU admission. Among these patients, 73 were admitted to the ICU. In all, 32 patients (40.3%) died in ICU, 46 at hospital discharge (63%) and 61 (83.6%) 1 year later. Survivors had a significantly lower sequential organ failure assessment (SOFA) score, serum lactate and bilirubin upon ICU admission. Catecholamine support, mechanical ventilation (MV) and/or renal replacement therapy during ICU stay, a delayed organ support and an active graft versus host disease (GvHD) significantly worsen the outcome. By multivariate analysis, the worsening of SOFA score from days 1 to 3, the need for MV and the occurrence of an active GvHD were predictive of mortality. In conclusion, the incidence of HSCT-related complications requiring an admission to an ICU was at 22%, with an ICU mortality rate of 44%, and 84% 1 year later. A degradation of SOFA score at day 3 of ICU, need of MV and occurrence of an active GvHD are main predictive factors of mortality.

New oxovanadium(IV) and cadmium(II) complexes with reduced Schiff bases derived from N,Nʹ- o-phenylenebis(salicylideneimine) have been synthesized and characterized using infrared and UVvisible spectra, ESR, and thermogravimetry. The complexes were identified as [ML] · (H2O) species, where deprotonated ligands are coordinated to metal through N2O2donor atoms. Antioxidant activity of the ligands and complexes was evaluated, revealing that the complexes exhibit a higher scavenging activity than the corresponding ligands. The prepared cadmium complexes showed slightly higher activity than the vanadium ones. Antifungal activity was tested against different human fungi including yeasts of the Candida genus (C. albicans and C. glabrata) and an opportunistic mould Aspergillus fumigatus. The oxovanadium complexes exhibited a very low activity toward C. albicans while the cadmium ones showed a significant growth inhibition of all the fungi tested; mainly of A. fumigatus though this mould is poorly susceptible to current antifungal agents like Itraconazole.

New oxovanadium(IV) and cadmium(II) complexes with reduced Schiff bases derived from N,N′-o-phenylenebis(salicylideneimine) have been synthesized and characterized using infrared and UV-visible spectra, ESR, and thermogravimetry. The complexes were identified as [ML] · (H2O) species, where deprotonated ligands are coordinated to metal through N2O2donor atoms. Antioxidant activity of the ligands and complexes was evaluated, revealing that the complexes exhibit a higher scavenging activity than the corresponding ligands. The prepared cadmium complexes showed slightly higher activity than the vanadium ones. Antifungal activity was tested against different human fungi including yeasts of the Candidagenus (C. albicansand C. glabrata) and an opportunistic mould Aspergillus fumigatus. The oxovanadium complexes exhibited a very low activity toward C. albicanswhile the cadmium ones showed a significant growth inhibition of all the fungi tested; mainly of A. fumigatusthough this mould is poorly susceptible to current antifungal agents like Itraconazole.

En établissement d’hébergement pour personnes âgées dépendantes (EHPAD), la gestion quotidienne des traitements par antivitamines K (AVK) pour arythmie cardiaque par fibrillation auriculaire (ACFA) représente une part importante de l’activité soignante. Elle nécessite une coordination complexe liée à la gestion des International Normalized Ratio (INR), à celle des appels téléphoniques des prescripteurs externes et à l’adaptation thérapeutique des différentes molécules. Ce travail restitue les étapes qui ont conduit à l’élaboration d’un protocole prenant en compte l’ensemble des difficultés rencontrées sur le terrain.

Le syndrome phalloïdien est une urgence médicale responsable de 90 % des décès par ingestion de champignons supérieurs. L’objectif de cette étude rétrospective était de décrire et d’analyser les cas d’intoxications phalloïdiennes et de rechercher des facteurs de risques pouvant influencer la gravité ou la mortalité des patients, afin d’optimiser leur prise en charge.

The coking process is composed of two main stages: drying process and pyrolysis of coal. A heat and mass transfer model was developed to simulate the drying process of coal. The mechanisms of heat and mass transfer described in the model are: conduction through the coal cake; conduction and convection through the gas in pores; generation, flux and condensation of water vapor. The model has been implemented in finite element software. It requires basic data on the coke oven charge properties and oven dimensions as input. These input data were obtained by experiments or from the literature. The proposed model includes condensation and evaporation allowing us to reproduce the temperature plateau observed experimentally.

Dans ce travail, un absorbant saturable est utilisé pour améliorer le taux d'extinction d'un train d'impulsions picosecondes cadencé à 160-GHz et centré sur 1555 nm. Une amélioration du taux d'extinction de 6 dB est observée sur une plage de longueur d'onde de 8 nm.

No Abstract

The idea that foods consumed for pure pleasure could provide health benefits received much recognition in the recent years. Among these foods, cocoa and dark chocolate are particularly rich in procyanidins, one of the major dietary families of polyphenols. We developed the first asymmetric total synthesis of procyanidin B2 and applied it to the preparation of a regioselectively radiolabeled 14Canalogue, which will be used to strengthen our knowledge on the metabolism of procyanidins.© WileyVCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2008

No Abstract

OBJECTIVE: To evaluate the effects of a short interactive training program for general practitioners (GP) on pain management in patients with osteoarthritis (OA). METHODS: A multicenter, parallel-group study. GP were randomized to receive training on relationships and communication, pain evaluation, prescription, and negotiation of a patient contract or to a control group receiving a presentation about obtaining consent in trials. Outcomes were patient assessments of pain and functional ability. We invited 1500 GP to take part in the study. Those who volunteered to receive the training recruited outpatients from May 2001 to April 2002. Patients participating in the evaluation of the effects of the general practitioners' training had lower limb OA and pain on motion ≥ 40 mm on a visual analog scale (VAS)] and had indications for treatment with acetaminophen. The primary endpoint: sum of patient pain relief based on the daily VAS self-evaluation during the 2 weeks of the trial. RESULTS: In total, 180 GP (84 trained, 96 nontrained) enrolled 842 patients (414 and 428, respectively). Mean baseline VAS pain was 63 ± 14 mm. Patients in the trained-GP group had better overall pain relief (316 ± 290 mm/day vs 265 ± 243 mm; p < 0.0001), greater improvement in Lequesne and WOMAC scores (p < 0.0001), and better overall perception of treatment (p = 0.002). Acetaminophen use was slightly higher in the trained group; however, the difference in pain relief remained statistically significant (p = 0.0003) after adjustment for this difference. CONCLUSION: This is the first study to demonstrate a positive effect of physician training on patients with a painful condition.

A first encounter with $$A(\lambda):= \int_0^{+\infty} \{t\}\{\lambda t\} \frac{dt}{t^2}, \lambda > 0$$, a continuous function with a strict local maximum at every rational point.

Human herpesvirus‐8 (HHV‐8) causes Kaposi's sarcoma (KS) and lymphoproliferative disorders in both HIV‐infected and uninfected patients. HHV‐8 has a worldwide occurrence but infection rates vary according to a combination of geographic and behavioral risks. The main transmission route seems to be sexual, nevertheless, nasal secretions, saliva, blood, and organ graft have been proposed. HHV‐8 was postulated as a new infectious agent for screening in blood donors. The aim of this study was to evaluate the prevalence of antibodies against HHV‐8 antigens in blood donors of South America. Serum samples from 2,470 blood donors from Argentina, Brazil, and Chile corresponding to five geographic regions were studied by indirect immunofluorescence assay (IFA). Seroprevalence rate was 3.7% (92/2,470; 95% CI 2.9–4.5) in the entire blood donor population distributed as follows: Argentina, 4.0% (Buenos Aires city, 4.3%; Bahia Blanca, 2.4%; and Córdoba, 4.0%), Campinas (Brazil), 2.8%; and Santiago de Chile, 3.0%. There was no difference (P> 0.05) between men and women or age related, except in Brazil where positive cases were 30–49‐year‐old males. The present study, which includes different geographical areas of multiple countries from South America, has not been done before. The results show similar prevalence rates among the studied zones corresponding to low‐prevalence regions. South America is a large sub‐continent with a wide spectrum of population and geographical characteristics, thus, more HHV‐8 prevalence studies should be necessary to establish possible regional differences. J. Med. Virol. 72:661–667, 2004. © 2004 Wiley‐Liss, Inc.

We report here the first example of an efficient regioselective synthesis of heterobicyclic compounds using thiourea as starting material. The key step in this synthetic process is the preparation of N,N'-bis[(dimethylamino)methylene]thiourea (1), which reacts as thiazadiene, leading to diazadiene heterocycles. These heterocycles give either thiazolopyrimidine 4 or imidazo-1,3-thiazine 7 by a double annulation reaction. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2003)

A series of the title compounds were prepared by the reaction of amidines 2 with α-bromoketones, acid chlorides or acrylic dienophiles. The four steps synthesis reaction from thiourea and full characterisation of 7H-imidazo[2,1-b][1,3]thiazines 4, 2H,6H-pyrimido[2,1-b][1,3]thiazin-6-ones 5, and 2H,6H-pyrimido[2,1-b][1,3]thiazines 6 are described.

Soit Ble sous-espace de H= L2(0, +∞) composé des fonctions ftelles que , pour 1 ≤ k≤ n, où ρ(t) désigne la partie fractionnaire de t. Notons aussi xla fonction caractéristique de l'intervalle ]0,1]. Un résultat bien connu de Nyman et Beurling [Nyman 50, Beurling 551 implique que I'hypothése de Riemann est vraie si et seulement si d(x, B) = 0. Nous présentons ici divers résultats numériques concernant I'approximation de xpar des éléments de B.Let Bbe the subspace of H= L2(0,+∞) consisting of the functions fsuch that , for 1 ≤ k≤ n, where ρ(t) denotes the fractional part of t. We also denote by xthe characteristic function of (0, 1]. A well known result of Nyman and Beurling [Nyman 50, Beurling 55] implies that the Riemann hypothesis holds if and only if d(x, B) = 0. We present several numerical results about the approximation of xby elements of B.

A new and efficient method for the synthesis of 2,3-dihydroimidazo[2,1-b]thiazoles 3, 2,3-dihydro-5H-thiazolo[3,2-a]pyrimidin-5-ones 4 and 2,3-dihydro-5H-thiazolo[3,2-a]pyrimidines 5 has been developed. The reactions of N'-(4,5-dihydrothiazol-2-yl)-N,N-dimethylamidines 1 with α-halogenoketones, acid chlorides or acrylic dienophiles were performed, leading to the title products.

A synthetic methodology to afford unusual glycoconjugate building blocks useful for the solid-phase synthesis of C-linked antifreeze glycoprotein (AFGP) analogues is described. Such compounds are urgently required in order to elucidate the molecular mechanism by which AFGPs function. All reactions are general in nature and accommodate structural variation in the carbohydrate moiety, polypeptide backbone, and amino acid side chain.

Triazapentadienium iodides 2prepared from N'‐thiocarbamoylformamidines 1are efficient intermediates in heterocyclic synthesis. They react with ketenes, sulfenes, phenyl isocyanate or isothiocyanate and dimethyl acetylenedicarboxylate affording the corresponding dihydropyrimidinones 3, thiadiazinedioxides 5, triazinones 6, triazinethiones 7and pyrimidines 9.

The contamination of groundwater by substances, mainly nitrates and pesticides, resulting from agricultural activities depends on three essential factors: - the physical characteristics of the aquifer system: these characteristics play a major role in protecting the groundwater against pollutants (attenuation) and/or in postponing the outbreak of the contamination (delay); - the intensity and mode of groundwater recharge: the infiltrating water is the transfer vector of contaminants towards the groundwater; - the quantities of solutes available for infiltration towards the groundwater, i.e. the quantities not retained by the soil/plant/microorganism system. The paper presents some major characteristics of the main types of aquifer in France, notably with regard to pollution vulnerability, and data on the spatial variability and quantitative importance of infiltration, a mechanism that plays a key role in the pollutant concentrations likely to be reached in the groundwater.

We propose a denitrification process of in-situ treatment. The system has a central drilling from which water is partly pumped out and distributed, the other part is sent in reactors filled up with a mixture of straw and maërl and then reinjected in aquiferous through the soil. Five series of experimentation in-situ have been made. A fall down of the nitrates in aquiferous from 10 to 20 mg.l-1 has been shown very quickly. The water which goes out from reactors contains organic matter, nitrite and micro-organisms but is completely purified by going through the soil. So, the drilling water presents a chemical and biological quality compatible with drinkability norms.

La majorité des décès et des intoxications graves suite à l’ingestion de champignons sont principalement dues à des syndromes mycotoxiques à durée d’incubation longue (>6h après ingestion). Ces derniers sont donc communément redoutés par les cliniciens. Cependant, il a été constaté certaines années, que plus de la moitié des intoxications graves par ingestion de champignons ont été provoquées par des syndromes mycotoxiques de latence courte (<6h après ingestion). Ainsi, l’objectif de ce travail est de décrire et recenser les cas d’intoxication aux champignons de latence courte.

In western Algeria, Thymelaea hirsutaaerial parts are traditionally used topically for the treatment of human skin infections. For a better knowledge of its biological activities, this study aimed at evaluating the in vitro antifungal activity and antiaging properties of several extracts of the aerial parts by in vitro assays. Antifungal activity was investigated by using the reference microbroth dilution method (National Committee for Clinical Laboratory Standards) against the dermatophytes (Microsporum audouinii, Nannizzia gypsea, Trichophyton interdigitale,and Trichophyton rubrum) and the yeast (Candida albicans). Antiaging (inhibition of 1,1-diphenyl-2-picrylhyorazyl radical scavenging and tyrosinase, lipoxygenase, elastase, and hyaluronidase activities) assays were performed in 96-well plates. All the extracts of T. hirsutaexhibited antifungal activity against M. audouinii, T. rubrum, and C. albicans, while no activity was found against N. gypseaand T. interdigitale. The highest activity was observed on M. audouiniifor the aqueous leaf (minimum inhibitory concentration [MIC] of 8 µg/mL) and stem extracts (MIC = 31 µg/mL) and the methanolic leaf extract (MIC = 8 µg/mL). Additionally, some marked morphological alterations were observed on M. audouiniihyphae with all aqueous extracts. Concerning antiage bioassays, the major activity was found against hyaluronidase for the aqueous and methanolic extracts from leaves and the methanolic extract from flowers. Analysis of this last extract by high-performance liquid chromatography, electrospray ionization-mass spectrometry, and nuclear magnetic resonance, allowed us to identify daphnoretin and daphnetin as major components of this extract, and, therefore, responsible for the antiaging activity. In conclusion, this study provides additional experimental data supporting the traditional use of T. hirsutaextracts on some cutaneous dermatophytosis, as well as new perspectives on the potential use of T. hirsutato ensure better healing of the skin.

Dans ce travail, un absorbant saturable est utilis? pour am?liorer le taux d'extinction d'un train d'impulsions picosecondes cadenc? ? 160-GHz et centr? sur 1555?nm. Une am?lioration du taux d'extinction de 6?dB est observ?e sur une plage de longueur d'onde de 8?nm.

A vertical-access passive all-optical gate has been used to improve the extinction ratio of a 160 GHz picosecond pulse train at 1555 nm. An extinction ratio enhancement of 6 dB is observed within an 8 nm bandwidth. Such a device is a promising candidate for low-cost all optical reamplication and reshaping (2R) regeneration at 160 Gbits/s.

Using a series of synthetic azinomycin analogues, it is shown that the efficiency of in vitro DNA interstrand cross-linking is markedly reduced when either the C-5‘ methyl group or both the C-5‘ methyl and C-3‘ methoxy groups are deleted from the naphthalene ring.

The continuous tuning range of a three-section DFB amplifier-filter with a passive centre section can be strongly enhanced by combining the carrier-induced Bragg wavelength shift with the conventional wavelength shift due to the phase shift between the two lateral gain sections. This principle is demonstrated by the fabrication of filters exhibiting a nearly constant gain of 15 dB as well as a 4 GHz filtering bandwidth over a 2.2 nm continuous tuning range.

Depuis plus de 25ans, la consommation de drogues illicites est indissociable des « rave party ». Parmi les drogues les plus utilisées, il faut citer le MDMA, puisque sa consommation est estimée jusqu’à couvrir 85 % des prises de drogues dans ces populations. Pourtant cette utilisation festive se fait au mépris des risques sanitaires et neurologiques de ce produit. Les auteurs rapportent l’observation d’un patient âgé de 31ans qui aura présenté au décours d’une rave party un coma toxique rapporté au MDMA, ayant laissé comme séquelles des troubles neurologiques avec un syndrome korsakovien. L’atteinte préférentielle des noyaux gris centraux, plus particulièrement des thalami et du pallidum, avec un mécanisme initialement vasculaire est discutée avec en appui l’imagerie IRM et le PET au 18FDG. Cette topographie n’est pas surprenante car ce sont des sites d’efférence dopaminergique et sérotoninergique. En effet, le MDMA est réputé pour entraîner un syndrome sérotoninergique en phase aiguë et une destruction des terminaisons dopaminergiques et sérotoninergiques. Le mécanisme lésionnel passe une excitotoxicité ainsi qu’une incapacité réguler le flux des radicaux libres. Des facteurs favorisants aggravants existent comme l’exercice physique (« dance floor ») et l’hyperthermie, laquelle était rapportée chez ce patient. Par certains égards, ces mécanismes physiopathologiques peuvent se rapprocher des conséquences encéphaliques des coups de chaleur d’exercice.

Chaque année, environ 1000 à 2000 cas d’intoxication par les champignons sont enregistrés par les CAPTV français. Jusque dans les années 1990, une douzaine de syndromes relatifs à ces intoxications ont été répertoriés. Depuis cette époque, des syndromes ont émergé, qualifiés de nouveaux, en France ou dans le reste du monde [1]. Ainsi, l’objectif de cette communication est d’informer les médecins et les pharmaciens par un état des lieux de ces nouveaux syndromes d’intoxication par champignons, d’alerter sur les espèces en cause, de faciliter le diagnostic et d’améliorer la prise en charge des patients.

Nous présentons deux cas de syndromes orellaniens validés par des analyses biologiques, cliniques, toxicologiques, et par une expertise mycologique.

La cueillette et la consommation de champignons restent une activité traditionnelle en France responsables de nombreuses intoxications chaque année. L’InVS et le CAPTV d’Angers assurent une veille sanitaire nationale des intoxications par champignons recensées par l’ensemble des CAPTV.