Search

• L'ostéomyélite chronique non bactérienne (OCN) est une maladie osseuse auto-inflammatoire. • Il n'existe pas actuellement de recommandations standardisées concernant le diagnostic ou le traitement de l'OCN. • L'imagerie par résonance magnétique du corps entier peut détecter des lésions infracliniques. • Le traitement par anti-TNF représente une alternative efficace et sûre pour les patients atteints d'OCN. L'ostéomyélite chronique non bactérienne (OCN) est une atteinte osseuse auto-inflammatoire pour laquelle il n'existe actuellement pas de recommandations standardisées concernant le diagnostic ou le traitement. L'objectif de cette étude est de décrire notre expérience de la biothérapie chez des enfants atteints de cette maladie. Revue rétrospective des dossiers de patients atteints d'OCN sous biothérapie suivis dans deux établissements de soins tertiaires entre janvier 2007 et avril 2020. Chez la plupart des patients, la biothérapie instituée a été un traitement ciblant le TNF, instaurée en raison de la persistance de l'activité de la maladie après un traitement standard par au moins deux médicaments (anti-inflammatoires non stéroïdiens et corticoïdes et/ou pamidronate). Vingt cinq dossiers de patients ont été colligés, dont 19 (15 filles) n'ont pas répondu au traitement conventionnel. L'âge moyen au moment du diagnostic était de 8,8 ± 2,9 ans et le délai moyen avant le diagnostic de 6,9 ± 8,3 mois. Tous les patients présentaient des douleurs osseuses et six sur 19 avaient également de la fièvre. Les os touchés étaient, par ordre de fréquence, le fémur (9 patients), la clavicule (6), le tibia (6) et les vertèbres (5). Neuf enfants présentaient des lésions cutanées. La protéine réactive C (CRP) était élevée chez 13 patients sur 19 (moyenne 20,2 ± 11,7 mg/l), et la vitesse de sédimentation (VS) était élevée chez 16 patients sur 19 (moyenne 48 ± 29 mm/h). Tous les patients ont reçu des anti-inflammatoires non stéroïdiens, 15 sur 19 du pamidronate, 10 sur19 des corticoïdes et les19 des anti-TNF. À la dernière visite de suivi, 10 patients sur 19 recevaient toujours une biothérapie (8 de l'adalimumab et 2 de l'infliximab) et 18 patients sur les19 étaient asymptomatiques. En ce qui concerne les effets indésirables, l'un des patients sous infliximab a développé une ostéomyélite à staphylococcus aureus et le second, une leishmaniose cutanée. Cette étude montre que les anti-TNF semblent une alternative efficace et sûre pour les patients atteints d'OCN réfractaire aux traitements conventionnels. [ABSTRACT FROM AUTHOR]

Simulation allows surgical trainees to acquire surgical skills in a safe environment. With the aim of reducing the use of animal experimentation, different alternative nonliving models have been pursued. However, one of the main disadvantages of these nonliving models has been the absence of arterial flow, pulsation, and the ability to integrate both during a procedure on a blood vessel. In the present report, we have introduced a microvascular surgery simulation training model that uses a fiscally responsible and replicable pulsatile flow system. We connected 30 human placentas to a pulsatile flow system and used them to simulate aneurysm clipping and vascular anastomosis. The presence of the pulsatile flow system allowed for the simulation of a hydrodynamic mechanism similar to that found in real life. In the aneurysm simulation, the arterial flow could be evaluated before and after clipping the aneurysm using a Doppler ultrasound system. When practicing anastomosis, the use of the pulsatile flow system allowed us to assess the vascular flow through the anastomosis, with verification using the Doppler ultrasound system. Leaks were manifested as "blood" pulsatile ejections and were more frequent at the beginning of the surgical practice, showing a learning curve. We have provided a step-by-step guide for the assembly of a replicable and inexpensive pulsatile flow system and its use in placentas for the simulation of, and training in, performing different types of anastomoses and intracranial aneurysms surgery. [ABSTRACT FROM AUTHOR]

Abstract The present work reports a numerical investigation of the flow past an oscillatory square cylinder at R e = 100. A fixed finite element immersed technique is proposed to solve the incompressible fluid–rigid body interaction problem. The study encompasses the analyses of the flow over a fixed cylinder and transverse to the flow and streamwise oscillating cylinders. The dimensionless frequency f r , i.e., the ratio between cylinder's oscillation and Strouhal frequencies, and motion amplitude are used to characterize the flow pattern evolution and its action on the cylinder. First, to compute the flow over the cylinder, a mesh size is determined from a mesh sensitivity analysis where the drag and lift coefficients computed using the immersed method are compared with those obtained from a body-fitted mesh. A reasonable numerical convergence is found from such analyses. Second, the oscillating square cylinder cases are studied to describe the synchronization regions. To this end, an oscillating body motion is prescribed varying the frequency of the imposed displacement with a constant amplitude. The synchronization zones are determined when the aerodynamic coefficients exhibit the most significant variations. In particular, the lock-in phenomenon is observed at f r ≈ 1 for transversely oscillating square cylinders, confirming some aspects previously reported in the literature using other numerical techniques. In the present work, lock-in is determined at f r ≈ 2 for streamwise oscillating square cylinders, results is not longer found in the literature. [ABSTRACT FROM AUTHOR]

We give upper and lower bounds for the moments and the uniform moments of Bernstein polynomials. Asymptotically, such bounds are best possible. [ABSTRACT FROM AUTHOR]

Globalization has pushed population movements in the last decades, turning imported diseases into the focus. Due to behavioral habits, children are at higher risk of acquiring parasitosis. This study aims to investigate the prevalence of parasites in migrant children and factors associated with parasitic diseases. Retrospective cross-sectional study (2014–2018) including children diagnosed with parasitosis. The diagnosis was based on serology and/or microscopic stool-sample evaluation. Epidemiological and clinical data were recorded. Out of 813 migrant children screened, 241 (29.6%) presented at least one parasite, and 89 (10.9%) more than one. The median age was 6.6 years (IQR: 3.1–11.9) and 58.9% were males. Most cases were referred for a health exam; only 52.3% of children were symptomatic, but 43.6% had eosinophilia. The most common diagnosis were giardiasis (35.3%), schistosomiasis (19.1%), toxocariasis (15.4%), and strongyloidiasis (9.1%). After the multivariate analysis, African origin and presenting with eosinophilia were the main risk factors for parasitism. parasitosis are frequent among migrant children. Children are often asymptomatic, and thus active screening for parasitosis should be considered among high-risk populations. Eosinophilia can be useful to guide complimentary tests, as well as geographical origin, but normal eosinophil count does not exclude parasitosis. • Screening for parasites is recommended in migrant children. • Serological tests are useful for screening some helminthiasis such as strongyloidiasis, toxocariasis, and schistosomiasis. • The absence of eosinophilia does not exclude parasitosis. [ABSTRACT FROM AUTHOR]

Abstract: For a function , we prove that where denotes a Ditzian–Totik-type modulus of order 2. We apply this result to obtain an asymptotic property for positive linear operators related to Voronovskaja type formulae. [Copyright &y& Elsevier]

Introduction: Chronic non-bacterial osteomyelitis (CNO) represents an autoinflammatory bone disorder. Currently there are no standardized diagnostic or treatment guidelines. The objective of the study is to describe our experience with biological therapy in children with the disease.Methods: Retrospective chart review of patients with CNO treated with biological therapy followed at two tertiary hospitals from January 2007 to April 2020. Biologicals were started in most patients due to persistent disease activity after receiving standard therapy with at least 2 drugs (NSAIDs and corticosteroids and/or pamidronate).Results: Twenty-five patients were diagnosed with CNO. Out of those, 19 patients (15 females) failed conventional therapy. The mean age at diagnosis was 8.8±2.9 years and the mean diagnostic delay was 6.9±8.3 months. All patients presented with bone pain and 6/19 also had fever. The most frequently affected bones were femur (9 patients), followed by clavicle, tibia and vertebrae (6, 6 and 5 patients respectively). Nine children had skin lesions. C-reactive protein was elevated in 13/19 patients (mean 20.2mg/L±11.7) and ESR in 16/19 (mean 48mm/h±29). All patients received nonsteroidal anti-inflammatory drugs, 15/19 pamidronate, 10/19 corticosteroids and 19 anti-TNF-therapy. At the last follow-up visit, 10/19 patients were still on biological therapy (8 adalimumab, 2 infliximab) and 18 out of 19 remained asymptomatic. In regards to adverse effects, one patient receiving infliximab developed S. aureus osteomyelitis and another cutaneous leishmaniosis.Conclusions: This research emphasizes that anti-TNF-therapy represents an effective and safe alternative for patients with CNO refractory to conventional treatments. [ABSTRACT FROM AUTHOR]

During the current global crisis unleashed by the severe acute respiratory syndrome coronavirus 2 outbreak, surgical departments have considerably reduced the amount of elective surgeries. This decrease leads to less time in the surgical room to develop and improve the surgical skills of residents. In this study, we developed a training program to obtain and maintain microsurgical skills at home, using a smartphone camera and low-cost materials, affordable for everyone. Using a smartphone camera as a magnification device, 6 participants performed 5 exercises (coloring grids, grouping colors, unraveling of a gauze, knots with suture threads, and tower of Hanoi), both with the dominant and with the nondominant hand, for 4 weeks. We compared performance at the beginning and at the end of the training process. Each participant filled out an anonymous survey. When we compared the performance at the beginning and at the end of the training process, we found significant improvements (P = 0.05) with the dominant as well as the nondominant hand in all the exercises. All participants were satisfied or very satisfied with the definition of the objectives of the training process, material availability, the exercises performed, the choice of the time to train, and general satisfaction with the training program. We developed a microsurgical skills training program to be performed at home, which can be easily reproduced. It allows residents to improve manual coordination skills and is regarded as a feasible adjunct for ongoing training for surgical residents. [ABSTRACT FROM AUTHOR]

Objective Our objective is to present and asses the utility of three-dimensional (3D) intraoperative imaging as a teaching method for anterior circulation aneurysm surgery. Methods The senior author's experience in anterior circulation aneurysm surgery during a 28-month period was documented and processed as 3D images and compared with two-dimensional (2D) images. Both 2D and 3D sets of images were created, and, along with a specially designed questionnaire, 30 physicians (15 experienced cerebrovascular surgeons and 15 neurosurgical trainees) were asked to answer the query and state the advantages and disadvantages of both methods. Results All physicians interviewed agreed that 3D imaging was better than 2D imaging, and that depth perception improved understanding of surgical tactics and anatomical landmarks. The resident/young trainee group seemed to receive more benefit from this than the experienced group. A total of 40% of residents and 20% of the experienced surgeons acknowledged a change in clipping strategy when comparing both sets. 3D imaging improved understanding of the ophthalmic segment in 66.6% of residents and 33.3% of the experienced group. Conclusion Real 3D imaging in anterior circulation aneurysm surgery is an excellent tool to enhance vascular training. Inexperienced trainees seem to benefit greatly from it. This technique might be of use in the future development of new technologies. [ABSTRACT FROM AUTHOR]

Objective This study sought to show and analyze the main authors' experience (P.R. and J.M.C.) in previously coiled aneurysm surgery as an emerging challenge in today's neurosurgical practice. Methods Twelve female and 8 male patients, whose ages ranged from 32 to 56 years (average 43.5), underwent surgery between April 2009 and September 2012 in 2 centers. Reasons for surgery were 13 partially occluded aneurysms and 7 recanalized aneurysms. Results There was no mortality in this series. Aneurysmal sites were 5 anterior communicating artery aneurysms, 5 posterior communicating artery aneurysms, 3 middle cerebral artery aneurysms, 6 paraclinoid carotid artery aneurysms, and 1 aneurysm in the pericallosal artery. A patient sustained a postsurgical frontal infarction with mild neurological deficit. One of the aneurysms presented with an arterial branch at the level of the aneurysmal neck; therefore, partial clipping and packing was required. Microsurgical clipping in the remaining patients was performed successfully. Eight cases required partial coil removal before clipping. Conclusions Surgical management of previously coiled aneurysms is an emerging challenge in neurosurgery. Incomplete or ineffective embolizations pose an increased risk for the patient, thus requiring surgical treatment. Although not advisable, coil removal might be necessary when in the vicinity of the aneurismal neck in order to place the clip correctly. The authors believe that adequate patient selection and careful preoperative planning are essential to reduce the incidence of patients with unsuccessful coils who will later need surgical treatment. [ABSTRACT FROM AUTHOR]