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Résumé: Objectifs: Description des blessures liées à l’escalade en France entre 2004 et 2011. Patients et méthodes: Étude épidémiologique rétrospective des déclarations d’accidents d’escalade recensées par la Fédération française de montagne et d’escalade de 2004 à 2011. Elle incluait les licenciés de cette fédération pratiquant l’escalade en sites naturels et artificiels. Les résultats sont exprimés en nombre, pourcentage et nombre de blessures pour 1000heures de pratique. Résultats: Mille cent vingt-huit accidents ont été identifiés, avec un taux moyen de blessure de 1,49 pour 1000heures de pratique. Le pourcentage de femmes accidentées était de 0,35 % par an, ce pourcentage était plus faible chez les hommes (0,27 %). Les grimpeurs ayant eu un accident étaient âgés de 6 à 75ans. Ceux âgés de 19 à 30ans ont présenté le plus de blessures, 0,37 % par an. Les traumatismes les plus fréquents étaient les fractures et les entorses (respectivement 39 % et 25 % pour les hommes, 30 % et 34 % pour les femmes). Conclusion: La faible incidence des blessures liées à l’escalade remet en cause sa classification parmi les sports à risque. Cela ne doit pas empêcher un renforcement de la prévention pour diminuer le nombre et la gravité des accidents. [Copyright &y& Elsevier]

Introduction/Background Several outcomes could be used to assess return to physical activities (RTPA) after anterior cruciate ligament (ACL) injury: qualitative outcomes like return to main sport or pre-injury level; quantitative outcomes like weekly hours of practice or Tegner score. Performing a relevant clinical assessment is challenging, especially for patients who practice at a moderate sport level. Our objective was to compare the use of different outcomes to assess RTPA after functional and surgical treatment of ACL injury. Material and method Forty patients were included after surgery (group ST; 31.7 ± 10.6 years-old, 15.0 ± 5.0 months after ACL reconstruction);18 after functional treatment (group FT; 38.1 ± 14.8 years-old, 23.0 ± 6.0 months after ACL tear). Qualitative criteria were subjectively assessed answering yes/no when questioned concerning their RTPA. Objective criteria were defined as variations between pre-injury and post-treatment of Tegner score, weekly hours of practice, “Tegner.h” (global volume of activity equal to Tegner score multiplied by weekly hours of practice) for main physical activity (MPA) and global activity (3 MPA included). Results Return to subjective global pre-injury level was 22% for FT group vs. 25% for ST group ( P = 0.999). Return to pre-injury (i) level of MPA was 17 vs. 23% ( P = 0.736); (ii) Tegner score for the MPA was 56 vs. 30% ( P = 0.083); and (iii) global Tegner.h was 61 vs. 18% ( P = 0.002) for FT versus ST group, respectively. Evolution of Global Tegner.h score, MPA Tegner.h score and Global weekly hours of practice were congruent for FT group, but not for ST group. Conclusion We found low RTPA rates with some discrepancies between different outcomes of RTPA. Global Tegner.h could be an interesting alternative to Tegner score of the MPA for assessment of RTPA in non-operated patients who have a moderate physical activity level. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate leg fractures infected with Bacillus cereus in a traumatology–orthopedic ward of a university hospital. Methods: All B. cereus strains isolated from patients with leg fracture hospitalized in the traumatology–orthopedic ward between 1995 and 2004 were included in this retrospective study. Results: Five hundred and four patients had leg fracture during this period. Thirty-four patients were included in this retrospective study. B. cereus strains clinical isolates were mainly isolated from patients who had initially leg fractures with telluric contamination (wound contamination with terrestrial environments) before admission. Betalactam antibiotics used for prophylactic chemotherapy were not effective against B. cereus. Conclusion: In this study, we underscore the significance of Sfar recommendations concerning prophylactic chemotherapy. However, B. cereus could be termed an emerging pathogen and physicians need to be aware of its potential importance in trauma cases. In this purpose, a systematic screening for B. cereus at admission should be necessary in front of patients with open fractures associated with telluric contamination. Furthermore, if B. cereus is isolated, chemotherapy should be based upon ciprofloxacin during 2 or 6 weeks. [Copyright &y& Elsevier]

Vancomycin is always the drug of choice for treatment of infections caused by methicillin-resistant Staphylococcus aureus (MRSA) in spite of his bactericidal kinetic.Background – The aim of this study was to evaluate in vivo the improvement of bactericidal kinetic of vancomycin associated with cefpirom against MRSA infection in critically ill patients.Methods – The prospective cross-over study was carried out in 20 patients with severe pneumonia or bacteriemia. There were randomized to receive vancomycin 2 g per day (Group 1, n= 10) or vancomycin with cefpirom 2 g × 2 (Group 2, n= 10). Clinical recovery, bacteriologic parameters (bactericidal kinetic and bactericidal power in vivo at the peak and the valley), duration of ventilation and stay in ICU were comparatively explorated in both groups.Results – Clinical outcome did not significantly differ between Group 1 and 2. Bactericidal kinetic was better in the Group 2 (40% vs 60% after 6 hours to the dilution for 1/8e) but the difference was not significant. However, bactericidal power in sera was also better in the Group 2 with more bactericidal dilution at 1/16e (68% vs 88.8%: NS) and overall at 1/32e (10.5% vs 50%: p< 0.05) and CRP, an inflammatory marker, was significantly lower in the Group 2 than in the Group 1 (119.5 ± 24 mg/l vs 198.6 ± 78 mg/l: p< 0.05) on the third day. [Copyright &y& Elsevier]