Search

Pre-registration of scoping review

Dans cet article, nous abordons un cas de fermeture prématurée du cartilage de croissance du radius distal comme complication tardive d’une fracture du poignet. Six ans après une fracture du radius distal de type Salter-Harris II, un jeune garçon de 13 ans présente une déformation prononcée du poignet, avec un radius raccourci, une angulation palmaire de la métaphyse radiale et une subluxation dorsale secondaire du cubitus. Un suivi minutieux par radiographie est indiqué chez les enfants victimes d’une fracture de Salter-Harris. Si une fermeture prématurée du cartilage de croissance est suspectée, il est recommandé de procéder à une évaluation supplémentaire par imagerie par résonance magnétique ou tomodensitométrie afin de déterminer la stratégie de traitement.

Dans cet article, nous nous intéressons au défect dorsal de la patella, une lésion rare découverte de manière fortuite à l’occasion d’un examen d’imagerie du genou et qui ne doit pas être confondue avec une tumeur osseuse ou une lésion ostéochondrale. Sa localisation typique dans le quadrant supéro-latéral de la rotule et son aspect radio-transparent bien défini sur les clichés radiologiques standard constituent les clés d’un diagnostic correct.

International audience; Resistance to extended-spectrum cephalosporins (ESC) is a global health issue. The aim of this study was to analyze and compare plasmids coding for resistance to ESC isolated from 16 avian commensal and 17 avian pathogenic Escherichia coli (APEC) strains obtained respectively at slaughterhouse or from diseased broilers in 2010–2012. Plasmid DNA was used to transform E. coli DH5alpha, and the resistances of the transformants were determined. The sequences of the ESC-resistance plasmids prepared from transformants were obtained by Illumina (33 plasmids) or PacBio (1 plasmid). Results showed that 29 of these plasmids contained the bla CTX-M-1 gene and belonged to the IncI1/ST3 type, with 27 and 20 of them carrying the sul2 or tet(A) genes respectively. Despite their diverse origins, several plasmids showed very high percentages of identity. None of the bla CTX-M-1-containing plas-mid contained APEC virulence genes, although some of them were detected in the parental strains. Three plasmids had the bla CMY-2 gene, but no other resistance gene. They belonged to IncB/O/K/Z-like or IncFIA/FIB replicon types. The bla CMY-2 IncFIA/FIB plasmid was obtained from a strain isolated from a diseased broiler and also containing a bla CTX-M-1 IncI1/ST3 plasmid. Importantly APEC virulence genes (sitA-D, iucA-D, iutA, hlyF, ompT, etsA-C, iss, iroB-E, iroN, cvaA-C and cvi) were detected on the bla CMY-2 plasmid. In conclusion , our results show the dominance and high similarity of bla CTX-M-1 IncI1/ST3 plasmids, and the worrying presence of APEC virulence genes on a bla CMY-2 plasmid.

International audience; BACKGROUND:In the context of the national Cancer Plans of France that have changed the healthcare landscape, it has become necessary to better document and assess the related actions, and to promote research and understanding. The national cancer cohort, an exhaustive population-based cohort, was set up on the basis of the National Health Data System (SNDS) by the French National Cancer Institute.OBJECTIVES:The aim is to describe the French national cancer cohort.METHODS:All people living in France (67 million population) with universal insurance coverage and diagnosed, treated or followed up for a cancer, such as survivors, are included and will be followed up for 25 years. It contains all healthcare consumptions and reimbursements (i.e. hospitalization, outpatient care, medication…) since 2010. Every year, around 650 000 new cases are included.RESULTS:From 2010 to 2015, 6.2 million subjects have been included. Most subjects were entered in 2010, in 2015 it concerned 0.6 million. In 2015, the median age was 65 [54-76]; 51% were women. The primary cancer organ could be attributed with certitude to 87% of the people. The most frequent locations were skin (16%), breast (15%), prostate (12%), colon-rectum (11%) and lung (9%). In 2015, 40% of included subjects underwent surgery for cancer, 16% chemotherapy at hospital and 11% at least one session of radiotherapy.CONCLUSION:Based on SNDS, the cancer cohort has been designed to study cancer care use in the short-, medium- and long-term, and evaluate healthcare and public health policies.

Over the past decades, the dichotomy between innate and adaptive immune responses has largely dominated our understanding of immunology. Upon primary encounter with microbial pathogens, differentiation of adaptive immune cells into functional effectors usually takes several days or even longer, making them contribute to host protection only late during primary infection. However, once generated, antigen-experienced T lymphocytes can persist in the organism and constitute a pool of memory cells that mediate fast and effective protection to a recall infection with the same microbial pathogen. Herein, we challenge this classical paradigm by highlighting the “innate nature” of memory CD8+ T cells. First, within the thymus or in the periphery, naïve CD8+ T cells may acquire phenotypic and functional characteristics of memory CD8+ T cells independently of challenge with foreign antigens. Second, both the “unconventional” and the “conventional” memory cells can rapidly express protective effector functions in response to sets of inflammatory cytokines and chemokines signals, independent of cognate antigen triggering. Third, memory CD8+ T cells can act by orchestrating the recruitment, activation, and licensing of innate cells, leading to broad antimicrobial states. Thus, collectively, memory CD8+ T cells may represent important actors of innate immune defenses., SCOPUS: ar.j, info:eu-repo/semantics/published

Convenience, taste, and prices are the main determinants of food choices. Complying with dietary recommendations therefore imposes a “taste cost” on consumers, potentially hindering adoption of those recommendations. The study presents and applies a new methodology, based on economic theory, to quantify this taste cost and assess the health and welfare effects of different dietary recommendations. Then, by comparison of those effects, we identify socially desirable recommendations that are most compatible with consumer preferences (i.e., that best balance health benefits against”taste cost”) and should be prioritized for promotion. The methodology proceeds in three-steps: first, an economic-behavioral model simulates how whole diets would change if consumers complied with dietary recommendations; second, an epidemiological model estimates the number of deaths avoided (DA) due to the dietary change; third, an efficiency analysis weighs the health benefits against the taste and policy costs of each recommendation. The empirical model is calibrated using French data.We find that recommendations to reduce consumption of red meat and soft-drinks, or raise consumption of milk products and fish/seafood impose relatively moderate taste costs. By comparison, recommendations related to F&V consumption and, to a lesser extent, butter/cream/cheese, snacks, and all meats impose larger taste costs on consumers. The F&V recommendation is the costliest for consumers to comply with, but it also reduces diet-related mortality the most, so that a large budget could be allocated to promoting F&V consumption while keeping this policy cost-beneficial. We conclude that promotion of most dietary recommendations improves social welfare. Our framework complements the programming models available in nutrition and public health: those models are best used to identify dietary targets, following which our framework identifies costbeneficial ways of moving towards those targets.

The surgeons patiently practised a laborious and unnecessary ritual for the sake of the better results.”1 The quote is not about the surgical safety check routine but about the introduction of Listerism by Thomas Roddick to the Montreal General Hospital. The observation was made by William Osler in a report published in the Canadian Medical Association Journal (CMAJ) regarding the 1912 funeral of Joseph Lister in Westminster Abbey. Osler concluded that as “with everything that is worth preserving in this life there has been evolution, but from the great underlying principle on which Lister acted there has been no departure.” CMAJ had been founded a year before through the amalgamation of the Montreal Medical Journal and the Maritime Medical News, both of which had been established in 1888. Canada had a robust medical publishing industry with multiple journals competing for a relatively small audience. As a young graduate Osler contributed articles and editorials to Canadian journals. He continued his contributions throughout his career in the United States and England. His article on Lister was 1 of 16 that Osler published in the early years of CMAJ under the banner “Men and Books.” Just as the New England Journal of Medicine started life as the New England Journal of Medicine and Surgery, the early Canadian journals addressed both sides of the medical house. Medical publishing was initially dominated by surgery until overtaken by medical articles in the 20th century. In 1957, the Canadian Journal of Surgery (CJS) was founded to redress the imbalance. Just as Osler helped CMAJ establish roots, leaders of Canadian surgery published frequently in the CJS. In contrast, I was told recently that the young presenter of a very modest project declined the opportunity to publish in CJS because it would be considered the death knell of his research. The comment must be analyzed, not dismissed. The impulse that established the CJS was essentially protectionist. Medical articles were preferentially published in generalist journals because they were of higher quality. CJS was to be a safe place to publish surgical articles especially from Canada. For a while, we tried to rationalize that surgery required a different reporting format than medical science. The impact factor (IF) for CJS diminished to a nadir of 0.5; only 1 of every 2 articles published in the preceding 2 years received a single citation. From the beginning, CJS has been a professionally produced, perfectly copyedited journal. It has observed improvements in style as they were developed, such as standardized formats for references and standard units of measurement. The journal introduced authorship regulation and participated in programs to eliminate bias and fraud. Low-impact articles, such as case reports or historical essays, were refused. The number of citations generated by CJS articles has quadrupled over the last decade but the journal’s IF remains resolutely in the second tier of surgical journals at 1.5. While subspecialty surgical journals tend to have a higher IF than generalist journals, the current score does not reflect the quality of Canadian surgery. In recent years the journal has concentrated on its Canadian impact rather than its IF. The founding collaboration between the Chairs of Surgery, the Royal College of Physicians and Surgeons of Canada and the Canadian Medical Association has been revived. Subscription has been supplemented by an institutional academic program generously supported by the founders and specialty societies led by the Canadian Association of General Surgeons. This has allowed the circulation to grow so that every surgeon in Canada receives the journal. Articles are publicized widely via social media and are available by immediate open access via direct links on scientific registries, such as PubMed, and popular search engines, such as Google. Important developments in Canadian surgery, such as the impact of resident work hour restrictions2 or the future of generalist general surgery in Canada,3 are highlighted. A process to develop and report consensus has been developed by the journal.4 To answer the challenge made by our young colleague, the only factor limiting the impact of articles published in CJS is the content of each report. The next phase of development will be to raise the standards for reporting surgical research. Reports will only have an impact if they are transparent, accurate and convincing. CJS will promote compliance with the reporting guidelines of the EQUATOR network (www.equator-network.org), an international initiative that seeks to improve the reliability of health research reporting.

Depuis 2005, une politique d’amelioration de la prise en charge de la douleur chronique se met progressivement en place en Belgique. Trois types de structures existent actuellement : 73 fonctions algologiques, 36 equipes multidiscplinaires de la douleur chronique et neuf centres de reference multidisciplinaires de la douleur chronique. A la demande du ministere de la Sante publique, une equipe interuniversitaire a realise en 2010–2011 un travail d’evaluation de ces structures et formule des recommandations pour le futur. Leurs observations et conclusions sont resumees dans cet article.

This article presents follow-up data from the first patient in whom Mycobacterium ulcerans infection (MUI) was documented by PCR, genotyping and culture in the Republic of Congo-Brazzaville. Findings show the importance of regular clinical and microbiological evaluation for the disseminated form of the disease. The patient was probably infected in Pointe Noire where MUI has been described but never documented. Culture of specimens collected before antibiotic treatment showed that the bacterium was sensitive to the antibiotics being administered (streptomycin and rifampin) and was identical to isolates from Atlantic-coast regions of West Africa where MUI is endemic. The patient was treated with streptomycin and rifampin for 12 weeks in association with surgery. During treatment clinical examination was performed every day and microbiological analysis every two weeks. The duration of follow-up from the end of specific antibiotic treatment was 26 months. Medical treatment failed to prevent bone involvement and fistulae that were treated by surgery. However medical treatment may have limited dissemination of the disease. Serial microbiological evaluation was useful to detect bone involvement in this patient, but persistent positive gene amplification is not a proof of active disease. This study confirms that MUI is still endemic in the region of Pointe Noire. This finding underlines the need to optimize epidemiologic surveillance, laboratory diagnostic capabilities, and therapeutic management in the Republic of Congo-Brazzaville., • Ce travail qui présente le 1er cas d’infection à Mycobacterium ulcerans (IMU) confirmée par PCR avec identification de M. ulcerans et génotypage en République du Congo-Brazzaville montre l’intérêt d’un suivi clinique régulier et microbiologique répété devant une forme disséminée de la maladie. Le patient a probablement été contaminé à Pointe Noire où la maladie avait déjà été décrite mais non confirmée biologiquement. M. ulcerans, cultivé à partir de prélèvements effectués sur ce patient avant antibiothérapie, est sensible aux antimycobactériens administrés (streptomycine et rifampicine) et la souche est identique aux souches isolées des régions d’Afrique de l’ouest en contact avec l’Atlantique et endémiques pour l’IMU. Le patient a été traité par la combinaison streptomycine et rifampicine pendant 12 semaines associée à la chirurgie, avec un suivi clinique journalier et microbiologique toutes les 2 semaines. Le recul post-thérapeutique est de 26 mois partant de la fin de l’antibiothérapie spécifique. Le traitement médical n’a pas empêché la survenue des complications osseuses avec fistules qui ont été traitées par la chirurgie. Il est néanmoins possible que ce traitement médical ait contrôlé la dissémination de la maladie. L’intérêt d’un suivi microbiologique répété a été nécessaire afin de confirmer l’atteinte osseuse de ce patient. D’autre part, la persistance d’une positivité de l’amplification génique ne signifie pas l’activité de la maladie. Cette étude confirme qu’à l’heure actuelle, la région de Pointe Noire en République du Congo-Brazzaville est toujours endémique pour l’IMU. L’émergence de la maladie dans ce pays impose l’optimisation des mesures de surveillance épidémiologique, de diagnostic biologique et de prise en charge thérapeutique afin d’évaluer l’ampleur actuelle de l’IMU dans ce pays