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Objective To investigate the intraoral development and kinetics of low-temperature degradation (LTD) in second-generation 3 mol.% yttria-doped tetragonal zirconia polycrystal (3Y-TZP) monolithic prostheses, as well as the influence of masticatory mechanical stress and glaze layer on it. Methods A total of 101 posterior tooth elements were included in a prospective clinical study, which included ex vivo LTD monitoring (at baseline, 6 months, 1 year, and 2 years) using Raman spectroscopy (n = 2640 monoclinic phase measurement points per evaluation time) and SEM. Four types of areas (1–2 mm2 surface, 6 on molars, and 4 on premolars) were analyzed on each element surface: occlusal, axial, glazed, or unglazed. Raman depth mapping and high-resolution SEM were performed on the selected samples. Results LTD developed in 3Y-TZP monolithic restorations 6 months after intraoral placement and progressed with time. After two years, the tetragonal-to-monoclinic transformation was non-uniform, with the presence of localized clusters of transformed grains. In axial areas, the grain aspect was typical of the classical nucleation-growth process reported for LTD, which progresses from the surface to a depth of several tens of microns. However, in occlusal areas, tribological stress generated surface crushing and grain pull-out from the clusters, which induced an underestimation of the aging process when the evaluation was limited to monoclinic phase quantification. Glazing cannot be considered a protection against LTD. Significance If LTD occurs in dental prostheses in the same way as in orthopedic prostheses, its clinical impact is unknown and needs to be further studied.

Assess the feasibility of a randomized controlled trial (RCT) exploring the use of medical imaging as a therapeutic education (TPE) intervention in external radiation therapy.Experimental feasibility trial of "RCT" type carried out in a single-center, between November 2019 and March 2020, following adult patients treated by thoracic radiotherapy. In addition to the information usually given, the experimental group benefited from an intervention consisting in the visualization of their own medical images using the open-source software "Stone of Orthanc".Forty-nine patients were recruited with a refusal rate of 8.16% (4/49). 20 patients were withdrawn from the study for health reasons (COVID), 10 for medical reasons. All the remaining 15 participants completed the process. Although not significant, the experimental group showed a median gain in the perception of knowledge compared to the control group (+ 1.9 (1.6 - 2.2)) vs (+ 1.4 (1.4 - 1.8)), as well as a decrease in scores related to anxiety (- 3.0 (-4.5 - (-2.0)) vs - 1.0 (-5.0 - 0.0)) and emotional distress ((- 5.0 (- 7.5 - (- 3.5)) vs (- 2.0 (- 5.0 - (- 1.0)) A significant reduction (p=0.043) is observed for the depression score ((- 2.0 (-3.0 - (-1.5)) vs (0.0 (0.0 - 0.0)).This study demonstrates the feasibility of the project, with promising preliminary results. Some adaptations in order to conduct a larger-scale RCT are highlighted.

Overweight and obesity are major public health problems of growing concern. Few studies have investigated the representations and perceptions of subjects with overweight and obesity, especially in the general population, as compared to people in a medical weight loss process. The objective of this study was to fill this gap by enabling participants to express their feelings and experience about their overweight, and to assess the extent of the body mass index (BMI) as a determinant of these perceptions.A total of 4155 persons participated in an exploratory study conducted in Wallonia (Belgium). Data were collected by means of a web-based questionnaire. This study investigated the following parameters: sociodemographic and anthropometric factors, perceived health, quality of life, diet perception, enrolment in a weight loss process and weight loss target. The influence of BMI was considered, on one hand, looking at how the above variables evolve according to BMI category, secondly, as a mediation factor in the relationship between socioeconomic level and these same variables.A large majority (87.5%) of subjects were overweight (32.2%) or obese (obese class I 29.9%, class II 14.8%, class III 10.6%). Perceived health was found to deteriorate with the BMI (P0.0001); obese class III had a 5.9-fold risk to present bad perceived health compared to subjects with normal weight. The physical and psychological quality of life reported by the subjects decreased significantly with the BMI (P0.0001) particularly for the physical quality of life. The percentage of poor diet perception (frustration, weight gain, aggressiveness, inefficacy and impossibility) as well as the weight loss targeted by the subjects increased with the BMI. Between overweight subjects and obese class III subjects, weight loss target increased from 13% to 34% of the initial weight. The majority of subjects judged that diet represents "aggressiveness", "weight gain" and "impossibility". A partial mediation role of BMI was identified in the relationship between social status and the variables of interest.This study focused on a sample of people from the general population. It confirmed previous results of others studies. All results gave a feeling of resignation and powerlessness which can seize obese individuals (especially when BMI increases). As a consequence, there is a need for more adapted weight management to achieve a genuine therapeutic alliance.

Introduction L'association entre l'augmentation de l'IMC et la deterioration de la QdV est connue. Nous testons l'hypothese que l'importance accordee a la perception du regard des autres (PRA) et la distorsion de l'image corporelle (DIC) ponderent cette relation. Patients et Methodes 4,155 personnes (69 % femmes ; âge 46,3±13,7 annees ; IMC 31,6±6,7kg/m 2 ) ont participe volontairement a une enquete, via internet (2012, Wallonie, Belgique), relative au vecu vis-a-vis du poids. Les modalites de reponses (echelles comprenant, respectivement, 14 et 4 items sur lesquels les participants devaient se positionner sur une echelle de Likert) ont ete ponderees pour etablir un score moyen de QdV et de PRA pour chaque individu. La DIC a ete calculee en soustrayant l'IMC auto-rapporte a l'IMC auto-estime avec les figurines de Stunkard (une difference negative sous-estime le poids reel). Des tests de correlation ont ete realises entre les differents parametres mesures. Les relations entre QdV, PRA et DCI ont ete testees dans chaque categorie d'IMC. Resultats La QdV est inversement correlee a l'IMC (r=− 0,381 ; p p p p =0,0156 pour IMC>40kg/m 2 ) : plus les personnes sous-estiment leur poids, plus la QdV est bonne. La PRA est inversement correlee a l'IMC ( p p p p Conclusions PRA et DIC sont associees a IMC et QdV, influencant les relations entre IMC et QdV. Ces resultats suggerent de revoir les strategies de prise en charge des patients obeses en orientant davantage vers les dimensions perceptives des individus en vue d'ameliorer leur QdV.

The purpose of the present phase IV multicentre trial was to evaluate general patient tolerance to Omnipaque ® 350 mgI/ml (iohexol) supplied in polypropylene containers compared to that of the same product supplied in routinely used glass vials, with emphasis on allergy-like adverse events. Polypropylene is a pure plastic material with practically no additives, and has been tested in vitro as a contrast medium packaging material for several years. Handling of these containers is easier and safer than handling of glass vials. Iohexol was administered to 1481 patients undergoing urography (741 patients in the glass vial group, 740 in the polypropylene container group), all of whom successfully participated in the trial. Six centres, representing four European countries, participated. Patients were randomized to receive iohexol from either polypropylene containers or traditional glass vials according to a double blind, parallel design. Pre-established inclusion and pre-admission exclusion criteria were followed, as well as routine procedures for preparation of the patients and conduct of the urography examinations at each hospital. Patient tolerance was assessed by recording all adverse events experienced over a period of up to 1 h after the procedure. Allergy-like events were defined as coughing, sneezing, nausea, vomiting, urticaria or itching. No adverse events were experienced by 56.5% of the patients in the glass vial group, nor by 58.0% of those in the polypropylene group. Discomfort (mainly a sensation of warmth) was reported by 39.4% and 38.6% of the patients, and adverse events other than discomfort by 7.4% and 5.9% of the patients, respectively. There seemed to be a correlation between the speed of injection and the frequency of discomfort (an increase with increasing speed), both of which varied a lot between centres. There was no significant difference in the incidence of allergy-like events between the two groups. Such reactions were seen in 2.0% of patients in the glass vial group and 1.9% of those in the polypropylene container group. There was no significant difference between the patients' tolerance to iohexol supplied in traditional glass vials or in polypropylene containers. Therefore, the new polypropylene container can be recommended as a container for Iohexol.

The genus Mycobacterium encompasses over one hundred named species of environmental and pathogenic organisms, including the causative agents of devastating human diseases such as tuberculosis and leprosy. The success of these human pathogens is due in part to their ability to rapidly adapt to their changing environment and host. Recombination is the fastest way for bacterial genomes to acquire genetic material, but conflicting results about the extent of recombination in the genus Mycobacterium have been reported. We examined a data set comprising 18 distinct strains from 13 named species for evidence of recombination. Genomic regions common to all strains (accounting for 10% to 22% of the full genomes of all examined species) were aligned and concatenated in the chromosomal order of one mycobacterial reference species. The concatenated sequence was screened for evidence of recombination using a variety of statistical methods, with each proposed event evaluated by comparing maximum-likelihood phylogenies of the recombinant section with the non-recombinant portion of the dataset. Incongruent phylogenies were identified by comparing the site-wise log-likelihoods of each tree using multiple tests. We also used a phylogenomic approach to identify genes that may have been acquired through horizontal transfer from non-mycobacterial sources. The most frequent associated lineages (and potential gene transfer partners) in the Mycobacterium lineage-restricted gene trees are other members of suborder Corynebacterinae, but more-distant partners were identified as well. In two examined cases of potentially frequent and habitat-directed transfer ( M. abscessus to Segniliparus and M. smegmatis to Streptomyces ), observed sequence distances were small and consistent with a hypothesis of transfer, while in a third case ( M. vanbaalenii to Streptomyces ) distances were larger. The analyses described here indicate that whereas evidence of recombination in core regions within the genus is relatively sparse, the acquisition of genes from non-mycobacterial lineages is a significant feature of mycobacterial evolution.

The study aimed to determine the seroprevalence of transfusion-transmitted infectious (TTI) markers for human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV, HCV) and syphilis among blood donors in Niamey (Niger). The association between seroprevalence of ITT markers and sociodemographic characteristics of blood donors was investigated.A cross-sectional study was conducted in 2010 among 3213 blood donors. Data were collected from a pre-donation questionnaire and from laboratory tests results.The male/female ratio was 4/1. Up to 18.1% of donations had at least one positive marker, in which 2.7% presented a positive test for two or more agents. A seroprevalence of 1.62% (95%CI: 1.21-2.12) was associated with HIV, 15.4% (13.9-16.7) with HBV, 1.18% (0.84-1.62) with HCV, and 0.47% (0.26-0.77) for blood samples reacted with RPR test for syphilis. The HIV seroprevalence was two-fold higher in family than in volunteer donors (OR=2.15, 95%CI: 1.24-3.73). It was also higher in Rhesus D negative donors (OR=2.40, 95%CI: 1.11-5.17). The hepatitis B surface antigen seroprevalence was significantly higher in males than females (OR=1.85, 95%CI: 1.39-2.45) and in first time than in regular donors (P0.0001). The HCV seroprevalence was significantly higher in male donors (OR=4.41, 95%CI: 1.06-18.4) and in donors from rural areas (OR=4.09, 95%CI: 1.42-11.8). Syphilis marker was significantly associated with the marital status (higher seroprevalence in divorced donors, P=0.0085).Prevalence of TTI markers is high and national strategies for safe blood transfusion have to be strengthened. It is essential to recruit and maintain more volunteer donors, while females should be encouraged to donate blood.

To evaluate the accuracy of surface coil gradient-echo (GRE) imaging in the detection of regenerative nodules of hepatic cirrhosis, 53 patients with diffuse liver disease, among whom 31 had cirrhosis, were prospectively investigated. Three GRE sequences acquired with a surface coil were used in the study: a T2*-weighted, a T1-weighted, and a gadopentetate-enhanced sequence. ROC analysis showed that two surface coil GRE sequences were superior to conventional T2-weighted spin-echo imaging acquired with a body coil for the detection of regenerative nodules. The detection of regenerative nodules was also more accurate for the diagnosis of cirrhosis than the measurement of the caudate-to-right lobe ratio. These results suggest that there could be a potential for surface coil GRE imaging in the assessment of the characteristic macroscopic alterations of cirrhosis.

A requirements engineering process must take account of the user, the nature of the work, the environment in which that work is carried out and the resources available to the user. Creativity work is essential when designing future systems but should be carefully linked to the lifecycle of the project. Use cases and scenario authoring, though time consuming, provide benefits, both in completeness of requirements capture and in strength of structure. For a "socio-technical system", system goal modelling. must take account of the human perspective.

Two cases of atypical mesenteric ischemia where color Doppler US demonstration of the underlying arterial abnormality and collateral supply was possible are presented. Significant stenosis of the celiac axis and thrombosis of the SMA were clearly depicted, along with the presence of collateral arterial supply. Endovascular treatment was successful in both cases. These cases confirm the possibility of detecting collateral flow at Doppler imaging in patients with mesenteric ischemia, both for diagnosis of mesenteric ischemia and endovascular treatment planning.

We report a case of multiple and bilateral renal angiomyolipomas demonstrated and followed up by urography, sonography, and computed tomography during a period of 17 years. The diagnosis has been made by computed tomography. Follow-up examinations showed first a stability of the lesions, and afterwards, a rather fast increase of the volume of various masses, without symptoms, followed by a new period of stabilization.

We studied the influence of vessels crossing the ureteropelvic junction and of the grade of hydronephrosis in 86 patients who underwent endoureteropyelotomy. With a follow-up ranging from 1 to 12 years, the presence of crossing vessels had a significant negative influence on the outcome and recurrence rate of the procedure. The success rate was 82% when no vessels were present but only 33% when crossing vessels were documented. In 13 of 15 failures (87%), a crossing vessel was found at open pyeloplasty. The degree of hydronephrosis was a less potent detrimental factor, with an 81% success rate in low-grade and 54% in high-grade hydronephrosis. The best results (90% success) were obtained in patients with no crossing vessels and low-grade hydronephrosis and the worst (30% success) in those with high-grade hydronephrosis in the presence of crossing vessels. Selection of patients according to those prognostic factors is recommended. Conventional intravenous urographic imaging techniques proved insufficient, and only angiography provided diagnostic accuracy; less-invasive methods are desirable.

The aim of our study was to assess the feasibility of using Doppler sonography for the detection of acute intestinal ischemia due to occlusion of the superior mesenteric artery. Between September 1993 and March 1995, abdominal sonography with Doppler imaging of the mesenteric vessels was performed in 770 patients with emergency admissions for acute abdominal pain. In six cases, the diagnosis, based on surgery or arteriography and computed tomography, was acute intestinal ischemia due to complete or localized occlusion of the superior mesenteric artery. Five cases of occlusion of the superior mesenteric artery were correctly detected by Doppler sonography. These results suggest that Doppler sonography may be a feasible method for detecting acute intestinal ischemia due to proximal superior mesenteric artery occlusion.

We present two cases of an extracranial collateral of the internal carotid artery. The descriptions include Doppler recording and colour flow-mapping. The report underlines the epidemiological, embryological and anatomic features (including Doppler characteristics) of the variant, with a view to helping sonographers whenever the carotid examination proves difficult.

A nephrogenic adenoma in a urethral diverticulum has been observed in a 32 years old black woman. The association of both of these abnormalities is relatively uncommon, however symptomatic and source of complications.

We report here on a case of cholesteatoma of the upper urinary tract. This rare, but recurrent disease was managed successfully by means of repeated endourological treatment. Diagnosis was confirmed by histological examination of samples obtained by percutaneous extraction.

To evaluate the accuracy of surface coil gradient-echo (GRE) imaging in the detection of regenerative nodules of hepatic cirrhosis, 53 patients with diffuse liver disease, among whom 31 had cirrhosis, were prospectively investigated. Three GRE sequences acquired with a surface coil were used in the study: a T2*-weighted, a T1-weighted, and a gadopentetate-enhanced sequence. ROC analysis showed that two surface coil GRE sequences were superior to conventional T2-weighted spin-echo imaging acquired with a body coil for the detection of regenerative nodules. The detection of regenerative nodules was also more accurate for the diagnosis of cirrhosis than the measurement of the caudate-to-right lobe ratio. These results suggest that there could be a potential for surface coil GRE imaging in the assessment of the characteristic macroscopic alterations of cirrhosis.

Fourteen percutaneous transhepatic venous samplings of the pancreas were performed in 13 patients. Ten patients undergoing 11 samplings were operated, while 3 patients were not operated. Surgical intervention disclosed a single tumor in 8 patients, a double tumor in 1 patient and diffuse hyperplasia in 1 patient. The method allowed correct localization of 5 insulinomas and correct regionalizing of 4 insulinomas in 9 of 10 small tumoral lesions. In 1 double localization of the pancreatic body percutaneous venous sampling only detected 1 lesion. In 1 case of diffuse hyperplasia of the pancreatic tail, the venous sampling was suggestive for a tumor in the pancreatic tail. The method appears to be highly accurate in diagnosing and localizing insulinomas of the pancreas. However, a need persists for 3-dimensional localization of the lesions to facilitate enucleation. Intraoperative ultrasound could become the method of choice for localization of insulinomas.

We report on 2 cases of posterior urethral valves in young adult males referred for urinary and sexual symptoms.

Objectifs pedagogiques Preciser l’interet et les limites de l’echographie dans la prise en charge des affections abdominales aigues non traumatiques des patients adultes. Messages a retenir Le CT s’est impose comme la premiere technique d’imagerie dans les urgences abdominales de l’adulte. Cet expose est destine a revoir le role de l’echographie dans ce cadre : l’echographie garde sa place dans des situations cliniques specifiques telle que les urgences hepato-biliaires, le choc et les douleurs localisees des fosses iliaques. Son role est aussi d’aider a l’orientation diagnostique dans les situations cliniques difficiles en particulier les patients âges, fragiles et les patients en reanimation.

Objectifs pedagogiques Decrire les elements semeiologiques necessaires a l’approche echographique d’une obstruction intestinale et d’une atteinte ischemique de l’intestin. Presenter les signes echographiques elementaires utiliser pour poser le diagnostic d’occlusion mecanique de l’intestin grele ou du colon, en identifier le lieu et la cause, detecter des signes de gravite. Identifier en echographie les signes d’atteinte ischemique aigue ou chronique de l’intestin, tant en ce qui concerne les parois digestives que les vaisseaux mesenteriques.

Objectifs pedagogiques Decrire la semeiologie echographique a connaitre pour poser le diagnostic d’un syndrome occlusif mecanique et d’une atteinte ischemique de l’intestin. Resume (1) Presentation des signes echographiques necessaires pour poser le diagnostic d’une occlusion mecanique de l’intestin grele ou du colon, et de ses complications eventuelles. (2) Revue des signes echographiques permettant le diagnostic d’une atteinte ischemique aigue ou chronique de l’intestin, tant en ce qui concerne les parois digestives que les gros vaisseaux (arteres et veines). (3) Discussion de cas selectionnes presentes sous forme de videos.

Mycotic aneurysm of the renal graft artery is rarely detected before its rupture. Diagnosis up to now relied on arteriography. We report on a patient whose preoperative diagnosis was made by ultrasonography. Recent progress with this noninvasive procedure should allow earlier recognition of this life-threatening complication.

From a retrospective analysis of 22 cases of pancreatic insulinoma operated in our center, we have determined the predictive value of various pre- and intraoperative localization procedures. In 18 patients, solitary insulinomas were localized by selective arteriography (SA) in 55.5% of cases, by transhepatic catheterization with pancreatic venous sampling (THVS) in 64% of cases, but by ultrasonography (US) and computed tomography (CT) in only 11% of cases. The combination of SA and THVS allowed the preoperative localization of the tumor in 83% of cases. Intraoperative palpation, ultrasonography, and blood glucose monitoring localized a single tumor in all cases. When the insulinomas were multiple, the various preoperative investigations were not reliable. In the 4 cases of multiple insulinoma, various investigations (SA, US, CT, THVS) localized only 8 (28%) tumors of 28. Intraoperative palpation was also unreliable. Only intraoperative ultrasonography and continuous blood glucose monitoring localizeall multiple tumors (the diameter of the smallest tumor was 4 mm). These 2 intraoperative investigations are now the procedures of choice for the detection of small pancreatic insulinomas.

Not longer than 15 years ago the only available morphological information about the pancreas was given by radiographs of the abdomen, the stomach, the duodenum and the biliary system.

The authors report their results with percutaneous drainage of 29 abdominal abscesses in 28 patients. Two types of catheters were used: the pigtail angio-catheter and the trocar-catheter. CT scan and ultrasonography were the diagnostic technics used to localize the majority of these collections (20). Seventeen abscesses (58.6%) were cured by this drainage technique. Surgical drainage was necessary in 10 patients (34.4%). Six patients died: 4 of those had surgical drainage and 2 percutaneous drainage only. The cause of death in all cases was multiple organ failure secondary to a virulent noncontrolled infection. Analysis of the results uncovers 3 poor indications for percutaneous drainage: the digestive fistulous tract abscess, acute necrotic pancreatitis with secondary infection and the multi-loculated abscess. The best results are obtained in the case with a hepatic or left subdiaphragmatic abscess. No serious complication was related to the technique itself.

Of the 1,000 patients addressed to us for intravenous digital angiography (IVDA) of the renal arteries for arterial hypertension, for control of the artery of a transplanted kidney or for preoperative check-up prior to transplantation of a kidney, 738 were examined by a simplified technique. Compared to the standard practice this method simply consists of a manual injection of a standard ionic contrast medium via an antecubital vein punctured with a large catheter needle (caliber 14 G), without preparatory injection of an intestinal antispasmodic. This method has produced a satisfactory arterial opacification in 96% of the cases. The advantages and disadvantages of the technique are discussed. Of the 262 remaining patients, 250 were also examined by the peripheral venous mode, but the technique had to be modified in at least one of its aspects for one reason or another. Only 12 patients were not examined by the peripheral venous mode (7 puncture failures, 4 permanent venous accesses already installed). The IVDA simplified technique appears to be reliable for detecting reno-vascular arterial hypertension and with certain limitations, for the control of kidney grafts. With regard to the preoperative check-up before kidney transplantation, IVDA still does not seem a suitable replacement for the traditional method of angiography.

We investigated 50 patients with a congenital neurogenic bladder secondary to myelomeningocele (38), sacral agenesis (5) and occult spinal dysraphism (7). There were 25 males and 25 females, aged from 1 month to 29 years (mean age at the time of evaluation was 9.2 years). Pressure-Flow-EMG study was obtained in every instance. In addition, 25 patients underwent electrophysiological testing (sacral reflex arc testing and somatosensory evoked potentials from the pudendal nerve). The patients were then classified according to the urodynamic and electrophysiological results. We allocated the patients into a "functional" classification as recommended by Van Gool. This classification is useful in the selection of proper therapy, and in the definition of the risks of upper tracts deterioration.

The third and fourth cases of ureteral wall involvement by idiopathic retroperitoneal fibrosis (IRF) are reported.

We published in 1977 with A. Baert (1) the major contributions of computed tomography (CT) in acute pancreatitis, demonstrating the anatomical lesions occurring in this pathology. Since then we have systematically used CT as a primary investigation in severe cases of acute pancreatitis, at the request of our surgeons and intensive care unit specialists.