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INTRODUCTION: Ocular and orbital trauma is a leading cause of acquired monocular blindness in childhood. These injuries differ from those in adults in some aspects of the management and prognosis, notably the risk of amblyopia. The goal of this study was to analyze the epidemiological, clinical and therapeutic features of ocular trauma in children who consulted in an eye emergency department in Ile-de-France. PATIENTS AND METHODS: This was a descriptive, prospective and longitudinal study. Over a period of 6months, we included children aged 15years old or less, who consulted during calls for ocular trauma. Each child received an ophthalmologic examination as complete as his or her condition and cooperation permitted. Mechanical injuries of the eyeball and chemical ocular burns were distributed respectively according to the Birmingham Eye Trauma Terminology and Dua's classification. The visual prognosis was defined as the best corrected visual acuity of the affected eye, measured at the conclusion of treatment. RESULTS: Among 586children who consulted during the study period, 265 suffered from ocular trauma (45.22%). The male:female ratio was 1.6:1. The main places of occurrence of the injuries were home (64.15%) and school (18.11%). Injuries from finger nail scratch were the most frequent (12.45%). One hundred and fifty-seven patients consulted within 6hours (59.19%). The cornea was the predominant site of the injury (44.40%). Mechanical injuries of the eyeball accounted for 75% of cases. The incidence of ocular chemical burns was 6.41%. Eyelid and orbital injuries were observed in 22.26% and 2.26% of cases respectively. Surgical treatment was required in 6.79% of cases. The incidence of hospitalization was 3.02% with a mean length of stay of 3days. Four children developed sequelae, including 2corneal scars and 2cataracts. No case of blindness was recorded. DISCUSSION: The high frequency of traumatic ocular and orbital pathology in our study may be due to its sudden and accidental onset, leading parents to seek emergency care. Most injuries occurred at home and at school, which reflects the presence in these places of potential hazards, often unrealized or neglected. The low frequency of open-globe injury may be related to the ubiquitous recruitment. Indeed, in studies including only severe trauma, this rate may reach 73.4%. This clinical presentation is associated with a poor prognosis because of the risk of infection and sequelae causing decreased visual acuity and amblyopia. Few children were hospitalized. This could be explained by the predominance of mild to moderate trauma. CONCLUSION: Ocular trauma accounts for nearly half of pediatric conditions encountered in the eye emergency unit. Adequate emergency care improves the visual prognosis. Language: fr

International audience; Electrokinetic extraction is an emerging technology that can be used to remove in situ contaminants from soils or industrial sludge by application of an electric field. Hydrogen evolution at the cell cathode can adversely affect removal of ionic contaminants by formation of non-conducting, solid Al(OH)3: acidic or complexing agents have to be used to avoid this phenomenon. The technique has been investigated for the remediation of potabilization water treatment sludge with a high Al (III) content in a discontinuous threecompartment cell. First tests were achieved with acetic or citric acid introduced in the cathode chamber for neutralization of OH− generated at the electrode, and Al (III) could be recovered near the cathode. The effect of the cell voltage was investigated. In a second series of experiments EDTA was introduced also in the sludge bed. Interpretation of the profiles of pH and Al concentration in the cell after treatment was made considering the speciation diagram of the (Al (III)-chelating agent) systems. Best results were obtained by using 0.1 M acetic acid: up to 80% of the initial Al was recovered near the cathode, with an energy demand close to 7 kWh per kg Al.

Ocular and orbital trauma is a leading cause of acquired monocular blindness in childhood. These injuries differ from those in adults in some aspects of the management and prognosis, notably the risk of amblyopia. The goal of this study was to analyze the epidemiological, clinical and therapeutic features of ocular trauma in children who consulted in an eye emergency department in Île-de-France.This was a descriptive, prospective and longitudinal study. Over a period of 6 months, we included children aged 15 years old or less, who consulted during calls for ocular trauma. Each child received an ophthalmologic examination as complete as his or her condition and cooperation permitted. Mechanical injuries of the eyeball and chemical ocular burns were distributed respectively according to the Birmingham Eye Trauma Terminology and Dua's classification. The visual prognosis was defined as the best corrected visual acuity of the affected eye, measured at the conclusion of treatment.Among 586 children who consulted during the study period, 265 suffered from ocular trauma (45.22%). The male:female ratio was 1.6:1. The main places of occurrence of the injuries were home (64.15%) and school (18.11%). Injuries from finger nail scratch were the most frequent (12.45%). One hundred and fifty-seven patients consulted within 6 hours (59.19%). The cornea was the predominant site of the injury (44.40%). Mechanical injuries of the eyeball accounted for 75% of cases. The incidence of ocular chemical burns was 6.41%. Eyelid and orbital injuries were observed in 22.26% and 2.26% of cases respectively. Surgical treatment was required in 6.79% of cases. The incidence of hospitalization was 3.02% with a mean length of stay of 3 days. Four children developed sequelae, including 2 corneal scars and 2 cataracts. No case of blindness was recorded.The high frequency of traumatic ocular and orbital pathology in our study may be due to its sudden and accidental onset, leading parents to seek emergency care. Most injuries occurred at home and at school, which reflects the presence in these places of potential hazards, often unrealized or neglected. The low frequency of open-globe injury may be related to the ubiquitous recruitment. Indeed, in studies including only severe trauma, this rate may reach 73.4%. This clinical presentation is associated with a poor prognosis because of the risk of infection and sequelae causing decreased visual acuity and amblyopia. Few children were hospitalized. This could be explained by the predominance of mild to moderate trauma.Ocular trauma accounts for nearly half of pediatric conditions encountered in the eye emergency unit. Adequate emergency care improves the visual prognosis.

Objectifs La regulation de la tension arterielle est tres difficile chez les patients hemodialyses. La correction de l’HTA en hemodialyse se fait par la methode du poids sec. L’erreur d'estimation du poids sec chez les hemodialyses chroniques affecte leur morbi-mortalite. L'objectif de notre etude est de comparer les resultats de l'estimation « subjective » du poids sec par la clinique avec les resultats, de l'impedancemetrie, de l'echographie de la veine cave inferieure et du dosage du BNP, en vue de determiner les facteurs de risque d'erreur d'estimation clinique du poids sec. Methodes Il s'agit d'une etude prospective sr 67 patients hemodialyses chroniques. L'estimation de l'etat hydrique des patients a ete evaluee par les trois methodes sus-citees. Nous avons utilise le BCM (Body Composition Monitor). Le taux serique de BNP (peptide natriuretique type B) a ete dose avant et apres dialyse ainsi que le calcul du diametre de la veine cave inferieure. Nous avons compare le poids cible objectif determine par ces methodes et le poids cible subjectif. L'ecart entre les deux poids etait significatif lorsqu'il etait superieur a 1 kg. Resultats L'âge median des patients etait de 40 ± 5 ans, et un sexe ratio homme/femme de 0.84, BMI moyen de 21 ± 3,5 kg /m 2 . Nous avons objective une correlation significative entre les resultats de l'impedancemetrie, du BNP, de l'index de la VCI maximal et minimal. 41,5 % de nos patients ont un exces de volume important (hyperhydratation), alors que 49 % se situaient dans la fourchette normale ou normo hydrates et 8 % des patients etaient deshydrates. Nous avons corrige le poids sec des patients selon le poids determine par les 3 methodes et au bout de 2 mois on a note une equilibration de l'etat d'hydratation des patients ainsi que leurs pressions arterielles. Discussion : La determination du « poids sec » par des arguments cliniques n'est pas suffisamment reproductible. Nos resultats demontrent que l'evaluation clinique du poids sec est correlee aux valeurs du poids sec estimees par BCM, dosage de BNP ainsi que le diametre de la VCI. Conclusion Cette etude est parmi les rares etudes ayant utilise les 3 methodes sus-citees pour evaluer l'etat d'hydratation des hemodialyses chroniques permettant de montrer une bonne correlation entre ces 3 methodes. L'existence d'un ecart entre le poids cible subjectif et objectif suggere l'incessante necessite d'un couplage entre les differentes techniques evaluees selon une strategie adaptee aux particularites de chaque patient.

Background The preparation in advance of anticancer drugs can decrease the waiting time of patients in oncology day units. Purpose To establish a system of phoning patients before their session (D-1 call) to cheque their availability. A year after its deployment, we evaluated the impact of this plan. Materials and Methods The oncologist and a nurse call patients one day before their appointment. The prescriptions are validated when the patient’s condition permits it in the light of the patient’s biological assessment, done in an outside medical analysis laboratory, and an interview using a standardised questionnaire. After pharmaceutical validation, anticancer drugs are prepared in the afternoon for the next day. Indicators of routine monitoring were defined. Results A median of 13 patients with 23 planned day-hospital appointments were called the day before their appointment. An oncologist validated the treatment of 45% of the patients on D-1 and 95% of the cancer treatments were delivered on D1 before 9:00 am. The total time the patients spent in the unit was reduced from 273 minutes to 242 minutes after our plan was adopted. The average time between the end of the medical consultation and the start of the treatment went down from 79 minutes before the D-1 call to 52 minutes. In addition, 2/3 of patients received the treatment only 30 minutes after seeing their doctor. Finally, fewer than 2% of anticipated preparations were not administered. Conclusions The D-1 call requires significant effort, but it enables us to improve the organisation of care in the oncology day unit and the preparation of the anticancer drugs by the pharmacy’s production unit. The workload is more even throughout the day and is not stressful for the staff. All of this contributes to making the system safer. We are hoping to extend the D-1 call to the oncology week unit and evaluate patient satisfaction. No conflict of interest.

The authors report four cases of chronic endophthalmitis following extracapsular cataract extraction with intraocular lens implantation in the posterior chamber. The first attack of intraocular inflammation occurred in the form of recurrent iridocyclitis two to six months after surgery. The first attack usually responded well to local corticosteroids. After many relapses of inflammation, increasingly resistant to medical treatment, a severe attack occurred leading to the decision to treat such endophthalmitis surgically: endocular fluid aspiration, vitrectomy, intraocular injection of antibiotics combined with systemic antibiotics and corticosteroids. It may be very difficult to prove the infectious origin of torpid endophthalmitis. Growing bacteria from endocular fluid aspirates is much more difficult than in acute endophthalmitis. No organisms were found in this series by this method, despite the fact that fluid aspiration was often performed many times in these 4 cases. A bacterium was identified in 3 cases, twice on the implant itself and once after culture of an iridectomy specimen. Intraocular antibiotic injections resulted in the complete recovery of one patient. Following failure of standard treatment, intraocular lens explantation resulted in the disappearance of infectious inflammatory signs in 3 cases. The treatment of chronic endophthalmitis is governed by the same rules as acute endophthalmitis but is not always as successful. Intraocular lens removal is often the only solution and confirms the pathogenic hypothesis that slime production by organisms, their adherence to the intraocular lens and their quiescent state make them less vulnerable to antibiotics and host defences.

Electrokinetics is a developping technology that is intended to separate and extract heavy metals, radionuclides, and organic contaminants from saturated or unsaturated soils, sludges and sediments, and groundwater. The goal of electrokinetic remediation is to effect the migration of subsurface contaminants in an imposed electric field. This technique is known as electrokinetic remediation, electroreclamation, electrochemical decontamination, electrorestoration, electromigration or electrochemical soil processing. Electrokinetics involves the installation of electrodes into the subsurface surrounding the contaminated region. After the electrodes are in place, a low electrical potential is applied across the anode(s) (positively charged electrode) and the cathode(s) (negatively charged electrode). As a result of the electrical gradient, different physico-chemical reactions occur and contaminant transport occurs due to various mechanisms within the soil and groundwater. Generally, for the migration to be significant, the contaminants should be in a soluble form. If they are not soluble, they need to be desorbed, dissolved, and/or solubilized into the pore solution before they can be adequately transported from the soil to an electrode wells/reservoirs. Different types of contaminants have been investigated and research has been conducted to optimize the electrokinetic variables. The present study was undertaken to systematically investigate the effect of initial sludge water content, and heating on the electrokinetic remediation of alumium-contaminated sludge. A total of four laboratory experiments were conducted using drinking water sludge. The first two tests studied the effect of variation of initial sludge water content under an ambient temperature, and the last two tests studied the effect of heating on electrokinetic remediation under conditions of both constant saturation and applied voltage.

The anhydrotic ectodermal dysplasia are malformative syndromes involving the ectodermal components of the organism. They may be associated with very varied ocular manifestations. We described one sporadic case of anhydrotic ectodermal dysplasia in a twenty-four year-old man, involving the following ocular manifestations: severe and bilateral keratopathy corneal hypoesthesia involvement of the lacrymal system horizontal nystagmus and a high rate of antilens antibodies not yet reported a far as we know in the literature.

The authors report one case of traumatic tear in Bruch's membrane which pass close to the fovea in a thirty year old male. Sub retinal neo-vascularization arise from this choroidal rupture four months after trauma. Binocular diplopia was the first symptom of the sub-retinal neo-vascularization. It extends from the tear to involve the macula with reduction in visual acuity to 2/10eme P14. The spontaneous regression of these abnormal vessels allows to improve visual acuity to 6/10eme P2. Compared with reports in the literature, it seems that spontaneous regression of this sub-retinal neo-vascularization can be explained by the fact it grow from healty retina in young patient. There is no conclusive evidence that coagulation therapy is of any benefit in patients developing such lesions.

The authors expose a series of seven cases of ocular trauma due to pellet guns. First, they describe the different kinds of lesions, their treatment, and their development. Then, they study the prognostic points, the mechanism of the secondary complications, and the therapeutic conduct to adopt in front of this type of perforating injuries with non-magnetic intraocular foreign body. They insist on the severity of this type of ocular trauma, and on the necessity of a modification of the law concerning pellet guns.

A case of hemangioma of the retina is reported. Its typical ophtalmoscopic and fluorescein angiographic aspects are studied. The benign evolution is stressed in spite of a possible macular risk checked by argon laser therapy.