Fast reconstruction of centre of mass and foot kinematics during a single-legged horizontal jump: A point-cloud processing approach.

Horizontal jumps are discrete, fast, over-ground movements requiring coordination of the centre of mass (CoM) and base of support and are routinely assessed in sports settings. There is currently no biomechanics-based system to aid in their quick and objective large-scale assessment. We describe a practical system combining a single low-cost depth-sensing camera and point-cloud processing (PCP) to capture whole-body CoM and foot kinematics. Fourteen participants performed 10 single-leg horizontal jumps for distance. Foot displacement, CoM displacement, CoM peak velocity and CoM peak acceleration in the anterior-posterior direction of movement were compared with a reference 15-segment criterion model, captured concurrently using a nine-camera motion capture system (Vicon Motion Systems, UK). Between-system Pearson's correlations were very-large to near-perfect (n = 140; foot displacement = 0.99, CoM displacement = 0.98, CoM peak velocity = 0.97, CoM peak acceleration = 0.79), with mean biases being trivial-small (-0.07 cm [0.12%], 3.8 cm [3.5%], 0.03 m·s-1 [1.6%], 0.42 m·s-2 [7%], respectively) and typical errors being trivial-small for displacement (foot: 0.92 cm [0.8%]; CoM: 3.8 cm [3.4%]) and CoM peak velocity (0.07 m·s-1 [4.3%]), and large for CoM peak acceleration (0.72 m·s-2 [15%]). Limits of agreement were -1.9 to 2.0 cm for foot displacement, -11.3 to 3.6 cm for CoM displacement, -0.17 to 0.12 m·s-1 for CoM peak velocity and -2.28 to 1.43 m·s-2 for CoM peak acceleration. The practical system captured CoM and foot kinematics during horizontal jumps with acceptable precision. Further work to improve estimates of CoM accelerations and different populations are warranted.

Can baseball improve balance in blind subjects?

AIM: Baseball, one of the most popular sports in the world, is a fast-moving sport that requires various motor abilities. Baseball is played also by blind subjects that participate in many other sports. In this study, we evaluated the role of the Italian modified version of baseball for blind subjects on balance. METHODS: This modified version of baseball maintains the fast-moving characteristic ensuring the athlete safety. Forty total blind subjects were enrolled: 20 baseball athletes and 20 sedentary participants, as control. The balance was evaluated using the Fukuda Test and Tinetti Test, both in silence and in noise. RESULTS: This baseball game may help to improve the balance ability in blind subjects. The balance was significantly improved in blind athletes as compared with blind sedentary subjects. CONCLUSION: Given the peculiar characteristics of play, this modified version of baseball seems effective in improving various motor skills that, once transferred into daily activities, may significantly ameliorate the quality of life of blind subjects.

Air-Q® versus LMA Fastrach™ for fiberoptic-guided intubation: A randomized cross-over manikin trial. / Estudio aleatorizado cruzado para evaluar la intubación guiada con fibrobroncoscopio a través del dispositivo Air-Q® versus la mascarilla laríngea Fastrach™ en maniquís.

INTRODUCTION: Airway management is still a major cause of anesthesia-associated morbidity and mortality. Supraglottic devices are recommended in difficult airway management guidelines. The aim of this study was to compare the performance of the Air-Q® and the LMA Fastrach™ for fiberoptic guided tracheal intubation. METHODS: Thirty-three anesthesia trainees participated in this randomized crossover study. Time to insert the dedicated airways (insertion of the airway into the manikin and delivery of two breaths), time to tracheal intubation (fiberoptic-guided tracheal intubation), time to remove the dedicated airway (removal of the Air-Q®/LMA Fastrach™ over the tracheal tube) and the opinion of the ease of use of the anesthesia trainees were measured. RESULTS: There was 100% success rate for tracheal intubation with both devices on the first attempt. Time to insert the dedicated device and deliver two breaths was 10±3s for the Air-Q® and 11±3s for the LMA Fastrach™, P=.07. Time taken to intubate the trachea was shorter with the air-Q®, 38±15 s, than with the LMA Fastrach™, 47±19s, P=.017. Overall procedure time was significantly shorter with the Air-Q® as compared with the LMA Fastrach™, with a mean time of 74±21s and 87±28s respectively, P=.002. Air-Q® removal was considered easier than LMA Fastrach™ removal, P=.005. There were no tube dislodgements during the removal of the dedicated airways. CONCLUSIONS: Inexperienced anesthesia residents can perform fiberoptic-guided intubation through Air-Q® and LMA Fastrach™ in a clinically acceptable time with high success.

[Impact of a triage scale in a pediatric emergency department]. / Impact d'une grille de tri à l'accueil d'un service d'urgence pédiatrique.

UNLABELLED: The pediatric nursing staff of the emergency unit has established a list of items for the triage of patients which can be used by the registered nurses. This scale defined 3 stages of severity. OBJECTIVES: 1) to estimate the relevance of this list through the appraisal of the total time necessary to take care of the patients according to their severity stage, and the confrontation of the severity stage determined by the registered nurse and the severity stage determined by the paediatrician; 2) to determine a possible correlation between the severity stage and the rate of hospitalization. METHOD: This prospective study was carried out over a period of 1 month in winter for every child admitted in the pediatric emergency unit for medical reasons (traumatisms excluded). RESULTS: One thousand six hundred and fifty-six children have been included in the study. Among them, 136 have been classified stage I, 1020 stage II and 500 stage III. The children have been taken care of in an average period of 20 min for stage I, 32 min for stage II, 43 min for stage III. The coherence rate between the severity stage determined by the nurse and the severity rate determined by the paediatrician was good. The rate of sub-estimation was low (4,2%). Nevertheless the reception nurses tend to overestimate the stage of severity in 17,6% of the cases. The prediction rate for hospital admittance was good: 68,7% of children classified in stage 1 were admitted, 23,5% of children in stage 2 and only 1,6% of children in stage 3. CONCLUSION: Patients suffering from severe illnesses were taken care without injurious delay which was the main purpose of this list.

Use of Human Cadaveric Mesenchymal Stem Cells for Cell Therapy of a Chronic Radiation-Induced Skin Lesion: A Case Report.

Acute and late radiation-induced injury on skin and subcutaneous tissues are associated with substantial morbidity in radiation therapy, interventional procedures and also are of concern in the context of nuclear or radiological accidents. Pathogenesis is initiated by depletion of acutely responding epithelial tissues and damage to vascular endothelial microvessels. Efforts for medical management of severe radiation-induced lesions have been made. Nevertheless, the development of strategies to promote wound healing, including stem cell therapy, is required. From 1997 to 2014, over 248 patients were referred to the Radiopathology Committee of Hospital de Quemados del Gobierno de la Ciudad de Buenos Aires (Burns Hospital) for the diagnosis and therapy of radiation-induced localized lesions. As part of the strategies for the management of severe cases, there is an ongoing research and development protocol on 'Translational Clinical Trial phases I/II to evaluate the safety and efficacy of adult mesenchymal stem cells from bone marrow for the treatment of large burns and radiological lesions'. The object of this work was to describe the actions carried out by the Radiopathology Committee of the Burns Hospital in a chronic case with more than 30 years of evolution without positive response to conventional treatments. The approach involved the evaluation of the tissular compromise of the lesion, the prognosis and the personalized treatment, including regenerative therapy.

T-lymphocyte clone specific for pancreatic islet antigen.

A cloned T-lymphocyte line, BDC-2.5, was derived from a nonobese diabetic (NOD) mouse and has been found to exhibit specificity for islet cell antigen in vitro and in vivo. This clone is a CD4+ T-lymphocyte that proliferates and makes lymphokine in response to islet cell antigen- and NOD antigen-presenting cells. In an in vivo transplantation system in which islet grafts were made in the presence or absence of the BDC-2.5 T-lymphocytes, it was found that incorporation of the islet-specific T-lymphocytes into the graft site resulted in complete destruction of the transplanted tissue. Similar grafts made with pituitary tissue were not affected by the T-lymphocyte clone. These results suggest that the islet-specific T-lymphocytes mediate islet destruction in a tissue-specific manner.

Non-seminomatous ovarian germ cell tumours in children.

In this study, we report the results of two consecutive protocols. TGM 55 and TGM 90, of the Société Fran¿aise d'Oncologie Pédiatrique ( SFOP) for patients with non-seminomatous germ cell tumours of the ovary and analyse the rationale for surgical indications. neoadjuvant or adjuvant chemotherapy. TGM 55 and 90 both utilised six drugs, bleomycin, cyclophosphamide, vinblastine, dactinomycin, etoposide and either cisplatin (TGM 55) or carboplatin TGM 90). Chemotherapy was given in ease of unresectable or incompletely resected tumour. Patients who had a complete resection of a localised tumour underwent expectant management and were only treated if progression occurred. 63 patients aged less than 18 sears old were enrolled between January 1955 and December 1994. 49 patients had alpha-fetoprotein (alphaFP) +/- beta-human chorionic gonadotropic hormone (betaHCG) secreting tumours and 14 had immature teratomas. Median follow-up for surviving patients is 60 months (range: 19-154). The 5-year overall survival is 85% +/- 5%. 13 out of 14 patients (93%) with immature teratoma are alive, including 3 of 4 patients (75%) who received chemotherapy for advanced disease. 41 patients (54%) with secreting tumours are alive, including 2 patients who required salvage treatment. Most failures occurred amongst patients with high initial alphaFP secretion ( > 15,000 ng/ml). 39 of 41 survivors (95%) in thc non-teratoma group had conservative surgery, allowing the possibility of future pregnancy. High cure rate can he achieved with a conservative approach in non-seminomatous germ cell tumour of the ovary. Whenever possible, fertility should he preserved during the primary operation in children suffering from these tumours.

The pitfall of silent neurosarcoidosis.

Sarcoidosis in childhood is seldom reported. Most cases are observed in older children and preadolescents as bilateral pulmonary disease and eye lesions. Arthritic features are more likely to be observed in infants and children younger than 4 years of age who do not develop pulmonary disease. Neurosarcoidosis is exceptional in this age group and seldom suspected when the neurologic symptoms are present. The authors report a pediatric patient with systemic sarcoidosis who developed a severe but silent neurologic involvement. Numerous masslike lesions were discovered on systematic cranial magnetic resonance imaging. The authors recommend a complete screening of extrapulmonary manifestations in children with sarcoidosis. The proper management of patients with incidentally discovered neurosarcoidosis has yet to be established.

[Atypical mesoblastic nephroma with metastases right away?]. / Néphrome mésoblastique atypique avec métastases d'emblée?

The diagnosis of a metastatic kidney tumor arising in a 2-month infant is discussed between atypical mesoblastic nephroma and clear cell sarcoma. The precocity of distant metastases, their location in bone marrow, liver and thoracic soft tissues, and their association with myelofibrosis set up an original clinical presentation which seems to have never been described elsewhere. Treatment strategy with surgery of the primary followed by a polychemotherapy combining vincristin-etoposide-ifosfamide and the short term follow-up are reported.

[Pain in children: a pediatrician's point of view]. / La douleur chez l'enfant: un point de vue pédiatrique.

The interest in the topic of pain in children is increasing within the paediatric community after a long period of misrecognition, often under-valuation, sometimes negligent or even denial. A lack of knowledge concerning pharmacology and toxicity of antalgic drugs and poorly adapted galenic presentations induced delay and complications in their use in children. The recent progress is supported by a better semiology, development of adequate pain scales, availability of adapted drugs, an effort at education of caregivers and public sensitization. In primary care the objective is to lead the practitioner to identify and consider pain in his/her preventive and curative strategies. In hospitals efforts are needed to improve the use of protocols and evaluations, the systematic practice of preventive analgesia and the quality of interprofessional cooperation within care teams. Managed care organizations are today an effective system to promote these practices.

[Solitary eosinophilic granuloma of the external wall of the orbit]. / Granulome éosinophile isolé de la paroi externe de l'orbite.

Eosinophilic granuloma is a solitary form of histiocytosis X with a usually good prognosis. Sometimes spontaneous healing can even occur. The authors report a case of a 30-month-old boy who presented an eosinophilic granuloma of the lateral orbital wall. The correct diagnosis was obtained after computed tomographic scan followed by fine needle aspiration biopsy with histopathologic examination. The tumor increased rapidly, including a medial displacement of the globe and limitation of the eye movement. So chemotherapy (Vinblastine) with corticotherapy was performed. The clinical course was favorable, with no evidence of recurrence or systemic involvement. The originality of this case was the young age of the patient, the course and the efficacy of treatment. The authors emphasize the management of the disease.

[Refractory pain in children with cancer: role of peridural analgesia]. / Douleurs réfractaires de l'enfant cancéreux: place de l'analgésie péridurale.

BACKGROUND: Adequate treatment of pain in children with cancer is a critical issue, and is of equal importance as discussions concerning chemotherapy, surgery and radiotherapy. OBJECTIVE: To evaluate the treatment of refractory pain by peridural analgesia. METHODS: Seven children (1-15 years) with solid tumors were treated with long term epidural analgesia for refractory pain. Catheters were inserted in epidural space (L1-L2) and infused with sufentanil, bupivacaine and clonidine. RESULTS: Three out of five children with good response to peridural therapy could be discharged. A 12-month-old infant had a poor response. Treatment was discontinued in a teenager boy because of patient refusal. The side effects were: early catheter displacement in two patients and a bacterial contamination in one. Serious adverse effects related to high doses of opiates were not observed. However, toxicity of bupivacaine was observed in three patients leading to treatment discontinuation in one. CONCLUSION: Long-term epidural analgesia looks promising in selected children with refractory pain.

[Allo-immune neonatal thrombopenia in the BaK(a) system. Apropos of 2 familial cases]. / Thrombopénie néonatale allo-immune dans le système BaK a. A propos de 2 observations familiales.

The authors report a case of two siblings who developed a neonatal alloimmune thrombocytopenia (NAITP) due to Bak-System incompatibility. They review the platelet antigen systems involved in NAITP and raise the problem of its present antenatal and postnatal management.

[Spinal hematomas: the spinal apoplexy]. / Hematomas espinales: la apoplejía espinal.

INTRODUCTION: Spinal haematomas (SH) are a rare pathology. They can produce a rapid and irreversible neurological deterioration. METHOD: In this retrospective study, we review 8 cases of SH treated in our centre over the last five years. Data collected were: age, sex, predisposing factors, clinical status, radiological features, treatment and outcome. RESULTS: Five patients were female and three male. Age ranged between 13 and 81 years. Five patients were hypertensive. Four had a coagulation disorder. In three patients SH occurred after physical effort. One case appeared after a lumbar puncture and another was secondary to intramedullary cavernous angioma. All patients presented with pain followed by neurological symptoms. Four cases were epidural, two subdural and two were intramedullary. All epidural SH and one subdural SH, were located dorsal to medulla. Five patients were operated on due to progressive neurological deterioration. Only one of them showed neurological improvement. Patients who were not operated on, had a better neurological status and they improved spontaneously. Two of them were discharged without neurological symptoms. CONCLUSIONS: There is controversy over the physiopathology of SH. The triggering mechanisms are unknown. The vessel (artery or vein) and the anatomical compartment in which SH arise are also unknown. Prompt diagnosis and urgent surgical treatment are needed when the patient has neurological symptoms. In these cases, the most important prognostic factor is the preoperative neurological status.

Estudio aleatorizado cruzado para evaluar la intubación guiada con fibrobroncoscopio a través del dispositivo Air-Q® versus la mascarilla laríngea Fastrach™ en maniquís / Air-Q® versus LMA Fastrach™ for fiberoptic-guided intubation: a randomized cross-over manikin trial

Introducción. Los dispositivos supraglóticos forman parte esencial en el manejo de la vía aérea difícil. El objetivo del presente estudio fue comparar las características de la intubación con fibrobroncoscopio a través del dispositivo Air-Q® versus la mascarilla laríngea Fastrach™ (ML-Fastrach™) por residentes de anestesia en maniquís. Métodos. Estudio aleatorizado y cruzado en el que participaron 33 residentes de anestesia. Se midió el tiempo de inserción (inserción del dispositivo en el maniquí y administración de 2 insuflaciones), el tiempo hasta la intubación traqueal (intubación guiada con el fibrobroncoscopio) y el tiempo para retirar los dispositivos (retirada de la Air-Q®/ML Fastrach™ sobre el tubo endotraqueal). Se evaluó la opinión de la facilidad de utilización. Resultados. Hubo una tasa de éxito del 100% para la intubación traqueal con ambos dispositivos al primer intento. El tiempo de inserción y administración de 2 ventilaciones fue de 10±3s para Air-Q® y de 11±3s para la ML-Fastrach™, p=0,07. El tiempo de intubación traqueal fue más corto con Air-Q®, 38±15s, que con la ML-Fastrach™, 47±19s, p=0,017. El tiempo total fue significativamente más corto con Air-Q® en comparación con la ML-Fastrach™, con un tiempo medio de 74±21 y 87±28s respectivamente, p=0,002. La retirada de la Air-Q® se consideró más fácil que la de la ML-Fastrach™, p=0,005. No se registraron desplazamientos del tubo endotraqueal durante la extracción de los dispositivos. Conclusiones. Los residentes de anestesia pueden realizar la intubación con fibrobroncoscopio a través de la Air-Q® y de la ML-Fastrach™ de forma exitosa y con tiempos clínicamente aceptables (AU)

Introduction. Airway management is still a major cause of anesthesia-associated morbidity and mortality. Supraglottic devices are recommended in difficult airway management guidelines. The aim of this study was to compare the performance of the Air-Q® and the LMA Fastrach™ for fiberoptic guided tracheal intubation. Methods. Thirty-three anesthesia trainees participated in this randomized crossover study. Time to insert the dedicated airways (insertion of the airway into the manikin and delivery of two breaths), time to tracheal intubation (fiberoptic-guided tracheal intubation), time to remove the dedicated airway (removal of the Air-Q®/LMA Fastrach™ over the tracheal tube) and the opinion of the ease of use of the anesthesia trainees were measured. Results. There was 100% success rate for tracheal intubation with both devices on the first attempt. Time to insert the dedicated device and deliver two breaths was 10±3s for the Air-Q® and 11±3s for the LMA Fastrach™, P=.07. Time taken to intubate the trachea was shorter with the air-Q®, 38±15 s, than with the LMA Fastrach™, 47±19s, P=.017. Overall procedure time was significantly shorter with the Air-Q® as compared with the LMA Fastrach™, with a mean time of 74±21s and 87±28s respectively, P=.002. Air-Q® removal was considered easier than LMA Fastrach™ removal, P=.005. There were no tube dislodgements during the removal of the dedicated airways. Conclusions. Inexperienced anesthesia residents can perform fiberoptic-guided intubation through Air-Q® and LMA Fastrach™ in a clinically acceptable time with high success (AU)

Rapid specific identification of group D streptococci by counterimmunoelectrophoresis.

Clinical isolates of group D streptococci have been examined by counterimmunoelectrophoresis (CIE) to determine if this method might be of value in the rapid identification of the members of this group. Group D organisms identified by classical biochemical and serologic procedures were inoculated into Todd Hewitt broth and incubated at 37 degrees C. After 4 hours of incubation, free group D streptococcal antigen was detected in broth cultures from 70 of 70 group D enterococcal strains. Precipitin lines were readily visible immediately after electrophoresis in each case. In contrast, 10 nonenterococcal group D strains failed to produce detectable free group D antigen in the Todd Hewitt broth after 4, 24, or 48 hours incubation. Such antigen was detectable, however, after 48 hours incubation in Mueller Hinton broth containing 10 grams of glucose per liter. Representative strains of group A, C, G, and B streptococi, Streptococcus viridans and Streptococcus pneumoniae grown in Todd-Hewitt broth for 4 hours gave no precipitin lines when reacted against adsorbed monospecific group D antiserum. Group D antigen was also detected in broth cultures of direct swabs and in 18-hour blood culture broths. CIE appears to be a rapid and sensitive procedure for identification of the enterococcal strains of group D streptococci from clinical isolates.