ABSTRACT
OBJECTIVES: Early rehabilitation management of septic arthritis in the native knee is not standardized. In this context, it is necessary to develop and validate an early rehabilitation strategy. MATERIEL AND METHODS: Based on the formalized HAS consensus method, a 4-phase rehabilitation strategy has been developed: recovery of joint amplitudes, muscle recovery without resistance, recovery with technical aid (crutches, canes), continuation of the rehabilitation (pursuit of muscle, articular, proprioceptive and endurance recovery). RESULTS: It was submitted to the opinion of multidisciplinary experts (PMR, general practitioner, rheumatologist, infectiologist, orthopedic surgeon, physiotherapist). Nearly 80% of the items were directly validated, with only five items scoring less than 5/10. Modifications were made in order to obtain a final version of the protocol. CONCLUSION: Use of a rigorous methodology enabled a consensual strategy for early rehabilitation management to be developed. Prospective validation of this strategy is needed to confirm its feasibility and effectiveness.
Subject(s)
Arthritis, Infectious , Knee Joint , Arthritis, Infectious/drug therapy , HumansABSTRACT
BACKGROUND: Arachnoid web (AW) is a rare but probably underestimated cause of spinal cord injury that is complex to diagnose due to subtle MRI findings and similarities to other better-known diseases such as arachnoid cyst (AC) or transdural spinal cord herniation (TSCH). Increased recognition of AW is mandatory since delay in diagnosis can lead to potentially serious neurological sequelae. CASE PRESENTATIONS: We report two additional cases of AW for didactic purposes, with special emphasis on the distinctive MRI and intraoperative findings. Both patients presented with progressively worsening neurological symptoms, including proprioceptive ataxia, motor weakness, numbness and neuropathic pain. The diagnosis of AW was suspected on the basis of specific MRI criteria, especially the so-called "scalpel sign". Formal confirmation of the diagnosis was obtained in two patients that were managed surgically. Postoperative follow-up demonstrated significant functional recovery. DISCUSSION: There is a need for better recognition of AW by the medical community. Careful analysis of MRI semiology is crucial for the distinction between AW, AC and TSCH. Prompt and accurate diagnosis is mandatory to conserve functional prognosis, since appropriate surgical treatment with AW resection is curative, halting or even resolving the neurological symptoms.
Subject(s)
Arachnoid Cysts , Spinal Cord Diseases , Arachnoid Cysts/diagnostic imaging , Arachnoid Cysts/surgery , Humans , Laminectomy , Magnetic Resonance Imaging , Spinal Cord Diseases/surgeryABSTRACT
25 pathologists have used an analytical assessment-form in order to study 78 orchidectomies. An histological pattern of more than 50% embryonal carcinoma appears to be in accordance with the rate of embols, which are the main risk factor even if exclusively intratesticular. This form might be useful for multicentric studies.
Subject(s)
Germinoma/pathology , Testicular Neoplasms/pathology , Embolism/diagnosis , Humans , Male , Methods , Neoplasm Recurrence, Local , Prognosis , Retrospective StudiesABSTRACT
Although the automation of reticulocyte counts was developed in the beginning of the 80's, the reticulocyte modules integrated in the hematology analysers have been only recently made available. The purpose of our study is the evaluation of the reticulocyte module included in the Coulter STKS, performed in the Necker-Enfants-Malades hospital laboratory. Regarding the technical conditions of use, this simple and user-friendly method can be easily adapted to routine use. Results, as compared to those obtained with two reference methods, microscopy and cytofluorometry, are accurate if the operator's attention is drawn by some causes of interferences, generally flagged by the instrument.