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Microplastics (MPs) have been detected in all environmental locations, including the atmosphere. However, few studies have investigated the presence of airborne MPs in the human respiratory system. Our research purpose was to investigate these pollutants in the lower human airways of 44 adult European citizens, using bronchoalveolar lavage fluid (BALF) collection as a minimally invasive method, that enables the detection of these pollutants in living patients. We studied the relationship between the patients' life habits and physiological parameters, based on background information and medical and occupational history, and the concentration of MPs isolated from their respiratory systems. Our results indicate that most MPs were in the form of microfibers (MFs) (97.06%), with an average concentration of 9.18 ± 2.45 items/100 mL BALF, and only 5.88% (0.57 ± 0.27 items/100 mL BALF) were particulate MPs, without a significant relationship with environmental, physiological, or clinical factors. The average size was 1.73 ± 0.15 mm, with the longest dimension (9.96 mm) corresponding to a polyacrylic fiber. Taken together, the results demonstrated the occurrence of MPs in the lower human airway, although more studies are necessary to elucidate the negative effects these pollutants could induce in the human respiratory system and its associated diseases., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Isolated pathology of the long head of the biceps is an indication for biceps tenotomy. To date, needle arthroscopy allows a direct diagnosis of shoulder lesion. We aimed to evaluate the technical feasibility of an in-office biceps isolated tenotomy by needle arthroscopy. Advantages were found in the fast-track process and the high rate of satisfaction in our selected patients. It was also a way to correct the diagnosis of torn biceps missed by the imaging. However, performing this procedure requires previous experience in conventional arthroscopy and should not be performed on anxious patients. Further studies will be necessary to confirm the reproducibility of this promising method, which could be a valuable alternative to heavy in-operating room process., (© 2021 by the Arthroscopy Association of North America. Published by Elsevier.)

Volar plating is one of the most used surgical treatments for dorsally displaced extra-articular distal radius fractures. However, the reduction of the dorsal tilt can be difficult. It usually requires a flexion maneuver of the wrist while maintaining and screwing the plate, which is cumbersome. Plate positioning also is a crucial step and is sometimes difficult because of the large size of the plate relative to the width of the distal radius. We use an epiphysis-first technique. We place all the epiphyseal screws before reduction, and then we take advantage of the anatomical shape of a locking plate to automatically reduce the dorsal tilt by fixing the proximal radius to the plate with cortical compression screws. To ensure easy and accurate positioning of the plate, we drill a distal medial pilot hole in a free-hand fashion 10 mm proximal to the watershed line and 10 mm lateral to the medial rim of the radius, without positioning the plate. This allows a clear view of the location of this first hole. The locking plate is then applied to the distal radius with help of a monocortical non-locking screw, and it is controlled under fluoroscopy. When this medial pilot hole is properly positioned and the plate correctly tilted on the anteroposterior view, the remaining epiphyseal holes are filled with locking screws. Then the plate is fixed on the proximal radius with bicortical compression screws, allowing an automatic reduction of the epiphyseal dorsal tilt. We believe this technique is a safe and reproducible way to position volar plates and to reduce anatomically the dorsal tilt in extra-articular posteriorly displaced distal radius fractures (AO A2 and A3). Furthermore, the automatic fracture reduction provided by this technique decreases operation time and radiation., Competing Interests: Declaration of Competing Interest Dr Chelli has nothing to disclose. Dr Bronsard has nothing to disclose. Pr Gonzalez has nothing to disclose. Dr Blasco has nothing to disclose. Dr Gauci is paid consultant for Wright (USA). Pr Boileau is paid consultant for Wright (USA) and has received royalties for the design of shoulder implants. All the authors, their immediate families and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. No funding was received for this study., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Despite demonstrable safety and efficacy of subdermal contraceptive implants (SCIs), both insertion and removal of SCIs in the arm have been associated with neurovascular complications. The aim of this study was to investigate type and prognosis of nerve injuries associated with SCIs., Methods: We performed a comprehensive search of 4 electronic databases for studies pertaining to patients with nerve injury and concurrent SCI. Studies published between January 1987 and June 2017 were included. Implant location, damaged nerves, clinical presentation, preoperative imaging (x-ray, ultrasound, magnetic resonance imaging), neurologic evaluation (nerve conduction studies, electromyography), and treatment methods were reviewed. To outline management strategies, 2 illustrative cases of major nerve injury caused by SCI removal were presented., Results: We analyzed 10 studies including 12 patients. Fourteen nerve injuries in 12 patients were reported during SCI insertion (n = 1) and removal (n = 11). Medial antebrachial cutaneous (n = 5) and median (n = 5) nerves were primarily affected. Neuropathic pain was the main symptom. Primary reasons for nerve injury were pulling or grasping of the nerve (n = 9) after mistaking it for the implant. Neurapraxia (n = 7) was the most common lesion and was treated with implant removal and clinical surveillance (n = 6). Five patients completely recovered; the remaining patients continued to have motor and/or sensory deficit at mean follow-up of 0.7 year (range, 0-2 years)., Conclusions: Nerve injuries related to SCIs are rare but potentially serious. For nonpalpable SCIs, a multidisciplinary approach, including practitioners with experience treating peripheral nerve injuries, is invaluable., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Many national and international guidelines have been established for venous thromboembolic disease (VTE). Homogeneous management practices could be expected in the different European countries. To verify this hypothesis, we compared practices in France, Italy and Spain., Method: We used data from the international RIETE registry to compare VTE management between France, Italy and Spain., Results: From 2001 January to 2011 January, patients were consecutively included in France (n=1548), Italy (n=2083) and Spain (29,824). All patients received anticoagulant treatment. Low molecular-weight heparin (LMWH) was the most frequently used drug as initial therapy in all three countries, but unfractionated heparin (UFH) was more frequently used in France and Italy than in Spain. In France, the proportion of patients receiving LMWH was lower than the proportion of patients with active cancer (cancer 22.5 %, long-term treatment with LMWH 17.4 %). A vena cava filter was significantly more frequently used in France (5.5 % in France, 3.2 % in Italy and 2 % in Spain, P<0.0001). High bleeding risk because of surgery with recent thromboembolic disease was the most frequent indication in France and Italy for vena cava filter placement (36.4 %, and 31.3 %, respectively)., Conclusion: Despite the publication of national and international guidelines, VTE management differs among the three major European countries included in the RIETE registry, France, Italy and Spain., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

This study characterized the bacteria causing decay of carrots during storage and marketing. Spoilage strains were identified by 16S-amplified rDNA restriction analysis and intergenic transcribed spacer-PCR-restriction fragment length polymorphism (ITS-PCR-RFLP). Genotypic fingerprinting by RFLP-pulsed-field gel electrophoresis was used to assess the genetic diversity of the isolates. A total of 252 Pseudomonas isolates from carrots were identified and classified into eight separate groups. Most strains belonged to group A (Pseudomonas fluorescens, Pseudomonas marginalis, and Pseudomonas veronii) and group B (Pseudomonas putida). The strains identified as Pectobacterium carotovorum subsp. carotovorum, Pectobacterium atrosepticum, Dickeya chrysanthemi, and Erwinia rhapontici were distinguished by ITS-PCR-RFLP. All isolates belonging to the genera Pectobacterium and Erwinia were responsible for carrot spoilage. This work has led to the development of new strategies for the identification and genotyping of vegetable-spoiling strains of Pseudomonas, Pectobacterium, and Erwinia. This is also the first report describing the occurrence of carrot-spoiling E. rhapontici. Early recognition of spoilage bacteria in vegetables is important for the implementation of effective handling strategies. Pectolytic bacteria may cause considerable financial losses because they account for a large proportion of bacterial rot of fruits and vegetables during storage, transit, and marketing.

Study Objectives: To characterize the biochemical and cytologic constituents of pleural effusions secondary to pulmonary embolism., Design: A descriptive clinical study., Setting: A community teaching hospital with 750 beds, which acts as a tertiary referral center for several subspecialties., Patients and Interventions: Patients with pleural effusions secondary to pulmonary embolism who underwent diagnostic thoracentesis during the last 7 years were retrospectively studied. Pleural fluid mesothelial hyperplasia was revised and compared with that found in patients with pleural effusions of different origin., Results: Pleural effusions from all 60 patients with pulmonary embolism were exudates, and in 40 patients (67%) contained erythrocyte counts > 10,000/microL. A bloody appearance was not related to the use of anticoagulant therapy before thoracentesis. Polymorphonuclear leukocytes were predominant in 36 patients (60%); in 11 patients (18%), a proportion of eosinophils > 10% was found. Mesothelial hyperplasia was significantly higher in patients with pulmonary embolism than in patients in the control group (p < 0.01)., Conclusions: In the absence of trauma, a bloody or eosinophilic effusion with a marked mesothelial hyperplasia should prompt a workup to rule out embolism. The finding of transudative pleural fluid chemistries in these patients should not be assumed to be secondary to embolism before ruling out other causes of transudative effusion.

The objective of our study was to determine the safety of transbronchial biopsy (TBB) in nonhospitalized patients. The design was a prospective study of the consecutive cases from July 1987 until September 1988 in the setting of a university hospital of the third level with 1,800 beds. The patients were a consecutive sample of 169 patients who had 184 procedures of fiberoptic bronchoscopy (FOB) with TBB performed. They suffered from different diseases: lung nodules or masses, diffuse interstitial disease, alveolar condensation, etc. An FOB with TBB was performed in immunocompetent outpatients, who were kept under observation for four hours and then had a chest roentgenogram taken afterwards. We contacted them again after 72 hours to rule out delayed complications. In three cases, more than 100 ml of blood were obtained during the FOB, without significant hemoptysis being recorded in those patients during the observation period; chest pain occurred in 15 patients during the TBB; pneumothorax occurred in two patients (1 percent), one of whom required admission to the hospital, without requiring chest tube drainage. Other complications are reported (bronchospasm, parenchymal hemorrhage, and pneumonia). In conclusion, we consider the TBB to be a technique with a low incidence of complications for outpatients, so therefore we do not believe that admission to the hospital is mandatory for this type of patient, although we do recommend a longer observation period.