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Resume Introduction Le scanner thoracique est essentiel pour le suivi respiratoire des enfants atteints de mucoviscidose, mais sa repetition expose a la toxicite potentielle des radiations ionisantes. L’objectif de cette etude etait de comparer un protocole scanographique complet (acquisition en inspiration helicoidale puis expiration sequentielle) a un protocole ne comprenant que les coupes expirees, en termes d’analyse d’image et de dose delivree de radiations ionisantes. Methodes Sur une cohorte monocentrique de 57 enfants âges de 5 a 18 ans, 78 examens ont ete scores par deux radio-pediatres sur le protocole complet puis uniquement sur les coupes expirees. Resultats La correlation entre les scores radiologiques globaux obtenus selon les deux protocoles etait tres bonne (r = 0,90 pour les deux radiologues) ainsi que pour les scores de bronchectasies (r = 0,72 et 0,86), impactions mucoides (r = 0,87 et 0,83) et trappage expiratoire (r = 0,96 et 0,92). Les parametres d’irradiation etaient reduits, avec un produit dose longueur (DLP) passant de 103,31 mGy.cm (protocole complet) a 3,06 mGy.cm (protocole expiration seule) (p Conclusion Afin d’espacer la realisation de scanners complets plus irradiants, l’utilisation d’un protocole avec seulement des coupes expirees permettrait un diagnostic tomodensitometrique de qualite tout en reduisant l’irradiation chez les enfants atteints de mucoviscidose.

Purpose: To evaluate the incidence of complete lateral meniscal posterior root tears (LMPRTs) repaired at revision as compared with primary anterior cruciate ligament (ACL) reconstruction (PACLR) and to determine whether other demographic or surgical characteristics were associated with LMPRTs needing repair. Methods: A chart review was performed to identify the PACLR and revision ACL reconstruction (RACLR) cohorts. Demographic and surgical characteristics were recorded. Cases with concurrent lateral meniscal posterior root repair were identified. Cases were classified as acute (5 months) based on the time from reported injury to surgery. Tunnel malposition in revision cases was recorded if either tunnel or both tunnels were malpositioned on radiographs and magnetic resonance imaging. Results: Data from 167 cases, 140 PACLR and 27 RACLR cases, were included. The cohorts had similar demographic characteristics including age, sex, and lateral meniscal injury. The overall incidence of lateral meniscal root repair in ACL reconstruction patients was 12.6% (21 of 167 patients). The incidence of LMPRT repair was 7.1% (10 of 140 patients) in the PACLR cohort versus 40.7% (11 of 27 patients) in the RACLR cohort. The revision cohort was significantly more likely to have a chronic injury (66.7% [18 of 27 patients] vs 31.4% [44 of 140 patients]). The most significant predictor of concurrent lateral meniscal posterior root repair was RACLR versus PACLR for both univariate and multivariate logistic regression analyses (χ2 = 20.603; P < .0001; odds ratio, 13.887; 95% confidence interval, 1.531-125.993). Analysis of tunnel positions for the revision group revealed that PACLR tunnel malposition was a significant predictor of LMPRTs (χ2 = 4.91, P = .027). Conclusions: Complete LMPRTs warranting repair are encountered with a significantly greater frequency at RACLR as compared with PACLR. The overall incidence of LMPRT repair at RACLR is high. In this cohort, LMPRT repair in RACLR cases was associated with tunnel malposition of the PACLR. Level of Evidence: Level III, retrospective cohort study.

Purpose To study the sensitivity of an Electronic Portal Imaging Device (EPID) in detecting delivery errors for VMAT lung stereotactic body radiotherapy (SBRT) using the Collapsed Arc method. Methods Baseline VMAT plans and plans with errors intentionally introduced were generated for 15 lung SBRT patients. Three types of errors were introduced by modifying collimator angles and multi-leaf collimator (MLC) field sizes (MLCFS) and MLC shifts by ±5, ±2, and ±1° or millimeters. A total of 103 plans were measured with EPID on an Elekta Synergy Linear Accelerator (Agility MLC) and compared to both the original treatment planning system (TPS) Collapsed Arc dose matrix and the no-error plan baseline EPID measurements. Gamma analysis was performed using the OmniPro-I'mRT (IBA Dosimetry) software and gamma criteria of 1%/1 mm, 2%/1 mm, 2%/2 mm, and 3%/3. Results When the error-introduced EPID measured dose matrices were compared to the TPS matrices, the majority of simulated errors were detected with gamma tolerance of 2%/1 mm and 1%/1 mm. When the error-introduced EPID measured dose matrices were compared to the baseline EPID measurements, all the MLCFS and MLC shift errors, and ±5°collimator errors were detected using 2%/1 mm and 1%/1 mm gamma criteria. Conclusion This work demonstrates the feasibility and effectiveness of the collapsed arc technique and EPID for pre-treatment verification of lung SBRT VMAT plans. The EPID was able to detect the majority of MLC and the larger collimator errors with sensitivity to errors depending on the gamma tolerances.

La ginecologia infantil se dirige sobre todo a las ninas antes de la pubertad o al comienzo de esta. Es una consulta frecuente en medicina privada y tiene algunas especificidades. El tratamiento se basa en el conocimiento del desarrollo ginecologico de la recien nacida y de la nina, asi como del desarrollo puberal clinico y ecografico. En este articulo se describen desde un punto de vista anatomico las afecciones que implican a la vulva y al clitoris, las anomalias congenitas de la vagina y del utero y las masas ovaricas. La observacion clinica del desarrollo somatico y la exploracion ginecologica externa suelen ser los unicos actos esenciales y suficientes en el tratamiento de las ninas. Los metodos de inspeccion de la vulva deben efectuarse sin exigencias, con el consentimiento de la paciente y en presencia del adulto que la acompana. Las vulvitis y vulvovaginitis de la nina son, con mucho, los motivos de consulta mas frecuentes. Su diagnostico es clinico y no necesita toma de muestras. Se detallaran las afecciones infecciosas de la vulva para ayudar al medico a adaptar el tratamiento, detectar la presencia de un cuerpo extrano o tratar de manera correcta una infeccion bacteriana. Algunas afecciones vulvares no infecciosas y las que afectan al clitoris tienen particularidades pediatricas que no deben ignorarse. El estudio por imagen pelvico, representado en primer lugar por la ecografia, es la exploracion decisiva en la deteccion de las anomalias congenitas de la vagina y del utero, asi como para el diagnostico de las masas ovaricas. Estas son infrecuentes, casi siempre benignas, y el sintoma principal es el dolor. El estudio por imagen hace posible la orientacion etiologica. En relacion con las diferentes etiologias, se describen el tratamiento de urgencia de una torsion de anexos, las caracteristicas de un quiste ovarico, el tipo tisular de los tumores organicos y su orden de frecuencia.

Chest computed tomography (CT) is essential to monitor lung disease in children with cystic fibrosis, but it involves recurrent exposure to ionizing radiation. The aim of this study was to compare the current complete CT protocol (volumetric end-inspiratory plus sequential expiratory acquisition) to a sequential expiratory acquisition protocol alone in terms of image analysis and ionizing radiation dose.Seventy-eight CT scans from 57 children aged 5 to 18 years old were scored on the complete protocol images and on the expiratory sequential images only. Each CT protocol was scored independently, using the Brody scoring system, by two paediatric radiologists.Correlations between the Brody global scores of the two different CT protocols were very good (r=0.90 for both observers), for the bronchiectasis score (r=0.72 and 0.86), mucus plugging score (r=0.87 and 0.83), and expiratory trapped air (r=0.96 and 0.92). Total ionizing radiation dose was reduced, with the measured dose length product (DLP) reduced from 103.31mGy.cm (complete protocol) to 3.06mGy.cm (expiratory protocol) (P0.001).An expiratory chest CT protocol was accurate in diagnosing early signs of CF disease and permitted significant reduction of radiation dose. This protocol would allow spacing out of complete CT scanning with its higher radiation dose and should be considered for the monitoring of lung disease severity in children with CF.

Purpose Measurement-based pre-treatment verification with phantoms frequently uses gamma analysis to assess acceptable delivery accuracy. This study evaluates the sensitivity of a commercial system to simulated machine errors for three different institutions’ Volumetric Modulated Arc Therapy (VMAT) planning approaches. Methods VMAT plans were generated for ten patients at three institutions using each institution’s own protocol (manually-planned at institution 1; auto-planned at institutions 2 and 3). Errors in Multi-Leaf Collimator (MLC) field size (FS), MLC shift (S), and collimator angle (C) of −5, −2, −1, 1, 2 and 5 mm or degrees were introduced. Dose metric constraints discriminated which error magnitudes were considered unacceptable. The smallest magnitude error treatment plans deemed clinically unacceptable (typically for a 5% dose change) were delivered to the ArcCHECK for all institutions, and with a high-dose point ion chamber measurement in 2 institutions. Error detection for different gamma analysis criteria was compared. Results Not all deliberately introduced VMAT plan errors were detected using a typical 3D 3%/3 mm global gamma pass rate of 95%. Considering all institutions, gamma analysis was least sensitive to negative FS errors. The most sensitive was a 2%/2 mm global analysis for institution 1, whilst for institution 2 it was 3%/3 mm global analysis. The majority of errors (58/59 for institution 1, 54/60 for institution 3) were detected using ArcCHECK and ion chamber measurements combined. Conclusions Not all clinically unacceptable errors are detected. Combining ion chamber measurements with gamma analysis improved sensitivity and is recommended. Optimum gamma settings varied across institutions.

Ileocolic intussusception in infants and children requires emergency treatment and has a very good prognosis. Abdominal ultrasonography imaging has a high sensitivity and specificity in its detection. Management of ileocolic intussusceptions now requires fewer surgical procedures because interventional radiology is usually efficient. Surgery (laparoscopy or laparotomy) is reserved for failed radiological reductions and advanced or immediately complicated intussusceptions (pneumoperitoneum, acute peritonitis, shock). Radiology teams have two reduction techniques: hydrostatic barium enema under fluoroscopic or sonographic guidance and air enema under fluoroscopic guidance. The superiority of one radiological reduction technique over the other cannot be asserted, and the choice depends on experience and available equipment. Current management of intussusceptions should be performed by pediatric radiology, anesthesiology and surgery teams.

A Monte Carlo model of a novel electronic portal imaging device (EPID) has been developed using Geant4 and its performance for imaging and dosimetry applications in radiotherapy has been characterised. The EPID geometry is based on a physical prototype under ongoing investigation and comprises an array of plastic scintillating fibres in place of the metal plate/phosphor screen in standard EPIDs. Geometrical and optical transport parameters were varied to investigate their impact on imaging and dosimetry performance. Detection efficiency was most sensitive to variations in fibre length, achieving a peak value of 36% at 50 mm using 400 keV x-rays for the lengths considered. Increases in efficiency for longer fibres were partially offset by reductions in sensitivity. Removing the extra-mural absorber surrounding individual fibres severely decreased the modulation transfer function (MTF), highlighting its importance in maximising spatial resolution. Field size response and relative dose profile simulations demonstrated a water-equivalent dose response and thus the prototype's suitability for dosimetry applications. Element-to-element mismatch between scintillating fibres and underlying photodiode pixels resulted in a reduced MTF for high spatial frequencies and quasi-periodic variations in dose profile response. This effect is eliminated when fibres are precisely matched to underlying pixels. Simulations strongly suggest that with further optimisation, this prototype EPID may be capable of simultaneous imaging and dosimetry in radiotherapy.

Albitiazolium is the lead compound of bisthiazolium choline analogues and exerts powerful in vitro and in vivo antimalarial activities. Here we provide new insight into the fate of albitiazolium in vivo in mice and how it exerts its pharmacological activity. We show that the drug exhibits rapid and potent activity and has very favorable pharmacokinetic and pharmacodynamic properties. Pharmacokinetic studies in Plasmodium vinckei-infected mice indicated that albitiazolium rapidly and specifically accumulates to a great extent (cellular accumulation ratio, >150) in infected erythrocytes. Unexpectedly, plasma concentrations and the area under concentration-time curves increased by 15% and 69% when mice were infected at 0.9% and 8.9% parasitemia, respectively. Albitiazolium that had accumulated in infected erythrocytes and in the spleen was released into the plasma, where it was then available for another round of pharmacological activity. This recycling of the accumulated drug, after the rupture of the infected erythrocytes, likely extends its pharmacological effect. We also established a new viability assay in the P. vinckei-infected mouse model to discriminate between fast- and slow-acting antimalarials. We found that albitiazolium impaired parasite viability in less than 6 and 3 h at the ring and late stages, respectively, while parasite morphology was affected more belatedly. This highlights that viability and morphology are two parameters that can be differentially affected by a drug treatment, an element that should be taken into account when screening new antimalarial drugs.

Lactobezoar is a compact mass of undigested milk concretions and mucous secretions in the gastrointestinal tract. It is usually located in the stomach, resulting in various degrees of gastric outlet obstruction. Lactobezoar is the most common type of bezoar in infancy. We report the case of rare and complicated gastric outlet obstruction secondary to lactobezoar. A female infant, 35weeks and 4days' gestation, one of dichorionic, diamniotic twins (birth weight, 1.890kg), was referred to our center at 5days of life for shock and food intolerance. She was on discontinuous oral feedings with a maltodextrin-enriched infant formula. On examination on day 4, there was a tender mass palpable in the left hypochondrium and on day 5, there was abdominal distension with signs of hemodynamic instability and sepsis. Plain abdominal X-ray showed a pneumoperitoneum associated with a heterogeneous mass in a distended stomach, consistent with a bezoar. An emergency laparotomy revealed a gastric perforation secondary to a large lactobezoar, with necrosis of the greater curvature and anterior wall of the stomach. Surgical treatment consisted of extraction of the lactobezoar, partial gastrectomy (resection of necrotic areas), and gastrostomy. Pathological examination confirmed the necrosis of the gastric mucosa. The postoperative course was complicated by prolonged sepsis. The child was kept NPO for 21days. On day 21 postsurgery, an upper gastrointestinal contrast study showed a well-dimensioned stomach, with a good pyloric passage. Gastrostomy and oral feedings were then initiated with good outcome at 6months. Etiopathogenic factors of lactobezoar are prematurity, low birth weight, altered gastric secretions and disturbed gastric emptying, hypercaloric and predominantly casein-based formulas, and inadequate milk composition. Lactobezoar should be considered in infants with symptoms of gastrointestinal obstruction with evocative images. Conservative management with nil per os, parenteral nutrition, and regular saline gastric washes has a good prognosis with rapid resolution of symptoms. Surgical indications are rare, and early and appropriate diagnosis should help limit and reduce the morbidity of lactobezoar.

Resume Les infections de l’os et des parties molles des membres representent une urgence diagnostique et therapeutique quel que soit l’âge. La clinique est souvent non specifique. L’IRM et, dans certains cas, l’echographie permettent un diagnostic precoce et une prise en charge adaptee. Le scanner a des indications bien limitees. La ponction-biopsie n’est pas systematique. Chez l’enfant, les particularites anatomiques expliquent les differentes manifestations morphologiques, variables selon l’âge. Il est important de savoir evoquer le diagnostic d’infection, d’en faire un bilan d’imagerie adapte, de connaitre la semiologie des infections des membres chez l’enfant et l’adulte et de discuter les diagnostics differentiels selon l’âge. Les specificites de l’enfant doivent egalement etre connues.

Resume Nous rapportons l’observation d’un patient âge de 13 ans atteint d’un syndrome de Churg et Strauss (SCS) revele par une atteinte cutanee predominante. Cet adolescent suivi pour un asthme modere depuis l’âge de 6 ans, avait brusquement presente des œdemes tendus et douloureux des membres inferieurs associes a une hypereosinophilie sanguine (9 000/mm 3 ) en l’absence de fievre. La constatation de nodules sous-cutanes violaces avec des lesions purpuriques peripheriques sur la face anterieure des tibias et du dos des pieds avaient justifie la realisation d’une biopsie cutanee. Cet examen montrait une necrose ischemique hypodermique massive en lien avec des lesions de vascularite necrosante a polynucleaires eosinophiles. Les autoanticorps antineutrophiles cytoplasmiques (ANCA) etaient negatifs. L’apparition secondaire de manifestations systemiques neurologiques (allodynie des membres inferieurs), pulmonaires (syndrome interstitiel et pleuresie), digestives (douleurs abdominales), articulaires (polyarthralgies) et genitales (inflammation scrotale) avait permis de poser le diagnostic de SCS. L’etat general etait conserve, aucune atteinte cardiaque ni renale n’avait ete mise en evidence. L’evolution avait ete favorable sous corticotherapie par voie orale. Le SCS, dont les formes pediatriques sont exceptionnelles, doit etre evoque devant l’association d’un asthme, de symptomes de vascularite systemique, atteignant au moins deux sites extrapulmonaires et d’une hypereosinophilie. L’atteinte cutanee est revelatrice dans moins de 25 % des cas chez l’adulte et l’atteinte genitale n’avait jamais ete decrite a notre connaissance auparavant. L’asthme et l’atteinte otorhinolaryngologique (ORL) etaient au second plan dans notre observation. Le pronostic reste reserve chez l’enfant en cas d’atteinte pleurale et cardiaque.

Resume La boiterie chronique ou trainante signe chez l’enfant une cause organique. L’examen clinique cible le type et le siege de la boiterie. Il oriente vers une etiologie neurologique, mecanique ou locoregionale au niveau de la hanche et du bassin. La radiographie et l’echographie de hanche sont les examens d’imagerie de premiere intention. Le diagnostic peut etre retarde, soit par meconnaissance de certaines etiologies propres a l’âge pediatrique, soit en raison de faux positifs ou negatifs du couple radio-echographie. L’IRM est devenue indispensable au diagnostic positif et etiologique. L’analyse de pathologies traumatiques, infectieuses, rhumatismales ou tumorales passe par la realisation d’une IRM dont le champ d’exploration ne doit pas se reduire a l’articulation coxofemorale.

Resume Le passage a la bipedie s’est accompagne d’une verticalisation du rachis et d’une modification de forme des os du bassin : incurvation horizontale et rotation sagittale. La phylogenese du bassin rejoint l’ontogenese : os plats chez le fœtus comme chez le singe, forme plus australopitheque a la naissance, forme « humaine » a partir de sept a huit ans. Ces modifications anatomiques expliquent les caracteristiques propres de la bipedie humaine : stable, econome, avec extension de la hanche et du genou en phase d’appui et faible oscillation laterale. Certaines circonstances pathologiques entrainent une regression vers une forme plus archaique de marche.

International audience; Low velocity impacts on energetic materials induce plastic deformations and sliding friction which can lead to ignition. If some ignition criteria have been proposed, the remaining difficulty is to characterize the mechanical behavior of the material when submitted to the corresponding solicitations (high pressure and high strain rate). Thus, a technique based on the Split Hopkinson Pressure Bars system is proposed to carry out a triaxial compression test. A cylindrical specimen is placed into a confining ring and is compressed by the system of bars. The ring prevents the radial extension of the specimen and creates a lateral confining pressure. The material and dimensions chosen for the ring maintain a constant radial pressure during the test. Some tests were carried out on an inert aggregate material and proved the validity of this experimental device. The experimental data processing shows the influence of both the pressure and the strain rate. The shear stresses, which contribute to thermal dissipation and then to the ignition threshold, increase according to the pressure.

Resume Le sarcome a cellules claires du rein (SCCR) est une tumeur maligne rare de l’enfant, reconnu pour son agressivite, son haut potentiel metastatique osseux et sa tendance a la recidive. Nous rapportons chez un enfant de 48 mois, ayant une volumineuse masse abdominale, une observation de SCCR dont le diagnostic a ete pose sur biopsie, dans la mesure ou l’imagerie restait incertaine quant a l’origine renale de cette masse. Hormis l’aspect histologique, il n’existe actuellement aucun critere permettant son diagnostic. Son pronostic a ete nettement ameliore par l’introduction de nouveaux schemas therapeutiques.

The purpose of this article is to: 1) describe the main plain film, ultrasound and MR imaging features of peripheral involvement in psoriatic arthritis, 2) describe the advantages of ultrasound and MRI at the early stages of the disease; 3) describe how to use MRI and ultrasound in order to assess response to tumor necrosis factor-alpha blocker therapy.

Resume But de l’etude Evaluation de l’utilite d’un depot de sang d’urgence vitale immediate dans un service de dechoquage chirurgical. Patients et methodes Tous les patients ayant beneficie de ce depot sur un an avec analyse des indicateurs disponibles. Resultats Un peu plus de deux utilisations par mois sans dysfonctionnements majeurs. Conclusion Le depot de sang fait partie de la prise en charge des dechoquages hemorragiques mais entraine des contraintes.

High resolution MR imaging of the skin: Normal imaging features Purpose. To describe the qualitative and quantitative MR imaging features of normal skin. Materials and methods. Thirty-one normal subjects underwent MR evaluation on a 1.5 Tesla magnet using a dedicated coil. Several skin sites were evaluated (back at the scapular level, posterior calf and inferior heel). Two pulse sequences were acquired: a SE T1W and a gradient-echo sequence (FIESTA). Qualitative and quantitative analysis was performed for all three sites. Results. In normal subjects, the different skin layers (callus, epidermis, dermis, hypodermis and pilosebaceous follicles) can be separated and measured on MR. Epidermis and hypodermis are hyperintense whereas dermis is hypointense. Our results confirm the presence of qualitative and quantitative variations between different skin regions. In some cases, a differentiation between papillary and reticular dermis can be achieved. Pilosebaceous follicles and the deep vascular network were clearly depicted on the FIESTA sequence. Measurements for each skin layer were compared based on sex, site and MR pulse sequence. Conclusion. MRI provides evaluation of the different skin layers, epidermis, dermis, and hypodermis, and their different components.

Shoulder radiography: useful radiographic views in current practice The purposes of this paper are: 1) to review the different radiographic projections commonly used to explore shoulder pathology; 2) to propose a practical approach for radiographic evaluation of the shoulder, adapted to the main clinical situations; 3) to recognize the different imaging features of the most frequent shoulder diseases.

Different interventional radiology techniques used in the management of the painful shoulder will be reviewed in this article. The etiology of shoulder pain is variable, and several image guided procedures are available, from simple to more complex. US and fluoroscopy guided intra-articular and bursal infiltration techniques will be described. Percutaneous needle removal of calcific deposits and capsular distension/infiltration of adhesive capsulitis will be discussed. Cysts in the spinoglenoid or suprascapular notch may cause impingement of the suprascapular nerve and may be aspirated under US guidance. Finally, percutaneous radio-frequency treatment of symptomatic bone metastases under CT guidance may at times be performed. Musculoskeletal radiologists should be familiar with this spectrum of image guided interventional procedures.

There are two ways of dissolving a polymer in a binary mixture of a solvent and a nonsolvent: direct dissolution or dissolution in the solvent followed by dilution with the nonsolvent. The two methods have been applied to two types of vinylacetochloride copolymers, one containing 6% by weight of hydrolyzed groups, with a series of solvents diluted with polar nonsolvents (butyl alcohol, acetronitrile). The thermodynamic quality of the resulting solutions has been evaluated by intrinsic viscosity measurements. The addition of butyl alcohol to a moderately good solvent greatly improves the solvent power, particularly if solution is effected directly in the mixture. This does not happen with the nonhydroxylated polymer for which results are identical regardless of the mode of dissolution. These phenomena are also observed in some cases with both polymers when acetonitrile is used. None of the above phenomena occurs with a very good solvent regardless of the mode of dissolution.

This investigation deals with the measured seismic response of a six-storey asymmetric structural model with frictional dampers. Its main objective is to experimentally prove the concept of weak torsional balance for mass- and stiffness-eccentric model configurations. The goal is to control the torsional response of these asymmetric structures and to achieve, if possible, a weak form of torsional balance by placing the so-called empirical centre of balance (ECB) of the structure at equal distance from the edges of the building plan. The control of the dynamic response of asymmetric structures is investigated herein by using steel-teflon frictional dampers. As expected from theory, experimental results show that the mean-square and peak displacement demand at the flexible and stiff edges of the plan may be similar in magnitude if the dampers are optimally placed. Frictional dampers have proven equally effective in controlling lateral-torsional coupling of torsionally flexible as well as stiff structures. On the other hand, it is shown that impulsive ground motions require larger frictional capacities to achieve weak torsional balance.

This investigation deals with the torsional balance of the earthquake response and design of elastic asymmetric structures with frictional dampers. Plan asymmetry leads to an uneven lateral deformation demand among structural members and to unbalanced designs with larger capacities in some resisting planes. Frictional dampers are capable of controlling lateral-torsional coupling by placing the so-called empirical center of balance (ECB) of the structure at equal distance from all edges of the building. This rule is developed for single-story systems with linear and inelastic behavior. However, recently obtained theoretical and experimental results demonstrate that this rule carries over to multistory structures. Results show that the peak displacement demand at the building edges and that of resisting planes equidistant from the geometric center may be similar if the damper is optimally placed. It is also shown that torsional amplification of the edge displacements of arbitrary asymmetric structures relative to the displacement of the symmetric counterparts are approximately bound by a factor of 2. Furthermore, frictional dampers are equally effective in controlling lateral-torsional coupling of torsionally flexible as well as stiff structures. Copyright © 2005 John Wiley & Sons, Ltd.

Resume Les syndromes frissons-hyperthermie (SFH) sont les incidents transfusionnels immediats les plus frequents, et doivent etre notifies dans les 48 heures dans le cadre de la reglementation sur l’hemovigilance. Afin d’evaluer la conformite de ces declarations et de rechercher les facteurs associes a une non conformite, nous avons etudie retrospectivement l’ensemble des SFH notifies par les centres volontaires de l’Association inter-regionale du sud-est d’hemovigilance (AIRSEH) du 1 er septembre 1994 au 31 decembre 1999. Sept cent soixante et un SFH ont ete recenses par 10 centres, la majorite (96,5 %) de grade 1 ; 67, 8 % des FIT ont un delai de declaration conforme. En analyse univariee, les FIT non conformes ont significativement plus d’examens biologiques que les FIT conformes (medianes respectives : 4,24 et 2,94 — p = 0,038 —). En analyse multivariee, les deux facteurs associes a une non conformite sont le centre et le grade. Les habitudes de chaque centre, et en particulier l’organisation de l’interface avec l’Etablissement francais du sang, peuvent etre a l’origine de l’effet centre. Par ailleurs, les declarations non conformes concernent quasi-exclusivement les incidents benins. Une separation claire des objectifs d’alerte et de surveillance epidemiologique est proposee par les auteurs comme evolution du systeme declaratif.

Ileocolic intussusception in infants and children requires emergency treatment and has a very good prognosis. Abdominal ultrasonography imaging has a high sensitivity and specificity in its detection. Management of ileocolic intussusceptions now requires fewer surgical procedures because interventional radiology is usually efficient. Surgery (laparoscopy or laparotomy) is reserved for failed radiological reductions and advanced or immediately complicated intussusceptions (pneumoperitoneum, acute peritonitis, shock). Radiology teams have two reduction techniques: hydrostatic barium enema under fluoroscopic or sonographic guidance and air enema under fluoroscopic guidance. The superiority of one radiological reduction technique over the other cannot be asserted, and the choice depends on experience and available equipment. Current management of intussusceptions should be performed by pediatric radiology, anesthesiology and surgery teams.