ISIS trapeziometacarpal arthroplasty: What are the outcomes in male patients?

Trapeziometacarpal arthroplasty is a well-known treatment of thumb basal joint arthritis. However, only a few studies have been done on its use specifically in men, with one of the most recent showing a high implant failure rate. Our study was a retrospective analysis of the ISIS prosthesis exclusively in men. Our hypothesis was that it is a viable therapeutic solution. Between 2010 and 2020, 23 ISIS prostheses were implanted in 19 patients. A radiological and functional analysis was done, combined with a self-evaluation by multiple validated outcome scores (visual analog scale for pain, QuickDASH, PRWE, SF36, and Kapandji scores). The median follow-up was 76 months (13-134) with a median age of 69 years. The mean pain level was 1/10, the QuickDASH was 22.7, the PRWE was 14.2, the SF-36 was 61.1 and the Kapandji score was 8.9. One dislocation occurred in one patient; two patients had to be reoperated for periprosthetic ossifications. Radiolucency was found around the cup in one patient and around the metacarpal shaft in one patient. There was no implant failure and only one case of asymptomatic loosening, with a survival rate of 94% at 111 months. In the medium-term, clinical, and functional outcomes were satisfactory with pain relief similar to that of published studies, with a low rate of complications. ISIS arthroplasty appears to be a suitable treatment for thumb basal joint arthritis in men, although a non-negligible rate of periprosthetic ossifications required revision surgery in half of the cases.

[The incidence of hand trauma the COVID-19 epidemic setting]. / L'incidence des traumatismes de la main dans le contexte épidémique COVID-19.

OBJECTIVES: In France, a lockdown was enforced from March 17 to May 11, 2020. It was renewed with different modalities from April 3 to May 3, 2021. Our objective was to compare the epidemiology of hand and wrist trauma injuries during these periods to a control period, with the hypothesis of a decreased incidence of hand and wrist trauma. METHODS: Patients consulting at a trauma emergency center of a university hospital labeled SOS-Mains were included during lockdowns, and were compared with a control group who consulted during an equivalent period in 2019. We retrospectively collected demographic and clinical data in relation to hand and wrist injuries. RESULTS: During lockdowns, there was an increase in these injuries relative to the total number of patients (from 16% to 22% and 18%). We found a decrease during the first lockdown in the number of fractures, amputations, burns, infections, injuries secondary to a work accident and isolated wounds but a significantly higher proportion of tendon and vasculonervous injuries in the first lockdown (12% vs. 4%). CONCLUSIONS: In first lockdown, the incidence of hand and wrist injuries decreased, but there was an increase in tendon and microsurgical injuries. This may be explained by the change in leisure activities. This underlines the importance of preventive measures concerning the risks related to some activities (use of sharp/motorized tools) in this context of health crisis.

[Genetics of congenital lipodystrophies]. / Génétique des lipodystrophies congénitales.

Congenital lipodystrophies are heterogeneous genetic diseases, leading to the loss of adipose tissue. This loss of adipose tissue can be generalized or partial, thus defining different phenotypes. These lipodystrophies have a major metabolic impact, secondary to lipotoxicity. This lipotoxicity is responsible for insulin resistance, dyslipidemia and hepatic steatosis. The severity of the metabolic impact correlates with the severity of the loss of adipose tissue. Mutations in 15 predisposition genes are currently described; BSCL2 and AGPT2 genes are the major genes in the generalized forms. On the contrary, LMNA and PPARG gene mutations are recovered in partial lipodystrophies forms. These different genes encode for proteins involved in adipocyte physiology, altering adipocyte differentiation, triglycerides synthesis and lysis or playing a major role in the lipid droplet formation. Congenital lipodystrophies treatment is based on the management of metabolic comorbidities but recombinant leptin therapy appears to have promising results. These different points have been recently discussed during the 2015 Endocrine Society Congress, notably by S. O'Rahilly and are highlighted in this review.

Use of intermediate focus for grazing incidence small and wide angle x-ray scattering experiments at the beamline P03 of PETRA III, DESY.

We describe the new experimental possibilities of the micro- and nanofocus X-ray scattering beamline P03 of the synchrotron source PETRA III at DESY, Hamburg (Germany), which arise from experiments with smaller beam sizes in the micrometer range. This beamline has been upgraded recently to perform new kinds of experiments. The use of an intermediate focus allows for reducing the beam size of microfocused hard X-rays while preserving a large working distance between the focusing elements and the focus position. For the first time, this well-known methodology has been employed to grazing incidence small- and wide-angle X-ray scattering (GISAXS/GIWAXS). As examples, we highlight the applications to in situ studies using microfluidic devices in GISAXS geometry as well as the investigation of the crystallinity of thin films in GIWAXS geometry.

In situ X-ray study of the structural evolution of gold nano-domains by spray deposition on thin conductive P3HT films.

Gold (Au) nanoparticles are deposited from aqueous solution onto one of the most used conductive polymers, namely poly(3-hexylthiophene) (P3HT), using airbrush deposition. We report on the structure formation and packing of the Au nanoparticles after a 5 s spray cycle. In situ grazing incidence small-angle X-ray scattering (GISAXS) measurements with 20 ms time resolution allow a real-time observation of the emergence and evolution of the microstructure during a spray cycle and subsequent solvent evaporation. The results reveal multistage nanoscale ordering of the Au nanoparticles during the spray cycle. Further ex situ atomic force microscopy measurements of the sprayed films showed the formation of Au monolayer islands on top of the polymer film. Our study suggests that the solvent-substrate interaction as well as solvent evaporation kinetics are important factors that need to be taken into consideration in order to grow a compact uniform monolayer film for the fabrication of ultrathin films using airbrush deposition.

Mutation analysis of the STRA6 gene in isolated and non-isolated anophthalmia/microphthalmia.

PDAC syndrome [Pulmonary hypoplasia/agenesis, Diaphragmatic hernia/eventration, Anophthalmia/microphthalmia (A/M) and Cardiac Defect] is a condition associated with recessive mutations in the STRA6 gene in some of these patients. Recently, cases with isolated anophthalmia have been associated with STRA6 mutations. To determine the minimal findings associated with STRA6 mutations, we performed mutation analysis of the STRA6 gene in 28 cases with anophthalmia. In 7 of the cases the anophthalmia was isolated, in 14 cases it was associated with one of the major features included in PDAC and 7 had other abnormalities. Mutations were identified in two individuals: one with bilateral anophthalmia and some features included in PDAC, who was a compound heterozygote for a missense mutation and a large intragenic deletion, and the second case with all the major features of PDAC and who had a homozygous splicing mutation. This study suggests that STRA6 mutations are more likely to be identified in individuals with A/M and other abnormalities included in the PDAC spectrum, rather than in isolated A/M cases.

Note: Comparison of grazing incidence small angle x-ray scattering of a titania sponge structure at the beamlines BW4 (DORIS III) and P03 (PETRA III).

Grazing incidence small angle x-ray scattering (GISAXS) is a powerful technique for morphology investigation of nanostructured thin films. GISAXS measurements at the newly installed P03 beamline at the storage ring PETRA III in Hamburg, Germany, are compared to the GISAXS data from the beamline BW4 at the storage ring DORIS III, which had been used extensively for GISAXS investigations in the past. As an example, a titania thin film sponge structure is investigated. Compared to BW4, at beamline P03 the resolution of larger structures is slightly improved and a higher incident flux leads to a factor of 750 in scattered intensity. Therefore, the acquisition time in GISAXS geometry is reduced significantly at beamline P03.

The genetics of paragangliomas.

Over the last decade, it has been clearly established that one-third of all paragangliomas are genetically determined. Genetic testing, guided by the family history and clinical findings, must now be proposed to all subjects undergoing surgery for head and neck paraganglioma. When a mutation is identified on one of the susceptibility genes (SDHD, SDHB, SDHC, SDHAF2, VHL), at-risk subjects should be investigated for the presence of other supra- and infradiaphragmatic paragangliomas and functional catecholamine-secreting paragangliomas and/or phaeochromocytomas. Identification of a germline mutation on the SDHB gene is a high-risk factor for malignancy and poor prognosis and requires close surveillance of subjects carrying this mutation. The diagnosis of hereditary paraganglioma also allows predictive genetic screening in first-degree relatives of the index subject. Genetic testing for paraganglioma is therefore now an important component of the diagnostic and therapeutic management of these patients.

A decade (2001-2010) of genetic testing for pheochromocytoma and paraganglioma.

The identification of 9 susceptibility genes for paraganglioma/pheochromocytoma between 2001 and 2010 has led to the development of routine genetic tests. To study the evolution in genetic screening for paraganglioma/pheochromocytoma over the past decade, we carried out a retrospective study on the tests performed in our laboratory from January 2001 to December 2010. A genetic test for paraganglioma/pheochromocytoma was assessed for 2 499 subjects, 1 620 index cases, and 879 presymptomatic familial genetic tests. A germline mutation in a PGL/PCC susceptibility gene was identified in 363 index cases (22.4%): 269 in SDHx genes (137 in SDHB, 100 in SDHD, 30 in SDHC, 2 in SDHA), 64 in VHL, 23 in RET, and 7 in TMEM127. A presymptomatic paraganglioma/pheochromocytoma test was positive in 427 subjects. Advances in molecular screening techniques led to an increase in the total number of mutation-carriers diagnosed each year. Overall, during the last decade, our laboratory identified a germline mutation in 44.7% of patients with a suspect hereditary PGL/PCC and in 8% of patients with an apparently sporadic PGL/PCC. During the past decade, the discoveries of new paraganglioma/pheochromocytoma susceptibility genes and the subsequent progress of molecular screening techniques have enabled us to diagnose a hereditary paraganglioma/pheochromocytoma in about 22% of patients tested in routine practice. This genetic testing is of major importance for the follow-up of affected patients and for the genetic counselling of their families.

In situ observation of cluster formation during nanoparticle solution casting on a colloidal film.

We present a real-time study of the nanostructuring and cluster formation of gold nanoparticles deposited in aqueous solution on top of a pre-structured polystyrene colloidal thin film. Cluster formation takes place at different length scales, from the agglomerations of the gold nanoparticles to domains of polystyrene colloids. By combining in situ imaging ellipsometry and microbeam grazing incidence small-angle x-ray scattering, we are able to identify different stages of nanocomposite formation, namely diffusion, roughness increase, layer build-up and compaction. The findings can serve as a guideline for nanocomposite tailoring by solution casting.

In vitro susceptibilities of Capnocytophaga isolates to beta-lactam antibiotics and beta-lactamase inhibitors.

The susceptibilities of 43 pharyngeal isolates of Capnocytophaga to beta-lactam antibiotics, alone or in combination with beta-lactamase inhibitors, were tested by an agar dilution method. The 34 beta-lactamase-positive strains were highly resistant to beta-lactams, but the intrinsic activities of clavulanate, tazobactam, and sulbactam against Capnocytophaga, even beta-lactamase producers, indicates that these beta-lactamase inhibitors could be used for empirical treatment of neutropenic patients with oral sources of infection.

Short-term effects of corticosteroids on trabecular bone remodeling in old ewes.

This study was an attempt to develop an animal model of steroid-induced low bone formation, potentially suitable for testing bone forming agents. The short-term effects of corticosteroids on bone remodeling were analyzed in ewes. One group of 16 animals (mean age: 9 +/- 1 years) received a daily intramuscular injection of 16 mg of methylprednisone (MP group) for 3 months. The other group of 16 animals was considered the control group. At the end of treatment, significant decreases of osteoblastic (-50%) and mineralizing (-64%) perimeters and wall width (-5%) were noted in the MP group. The bone formation rate at the tissue level was significantly decreased by 91%. In contrast, at the cell level, there was no reduction in the daily production of matrix by the osteoblasts: Aj.AR was 40% lower than in controls, but the difference was not significant. At the end of the treatment, a significant increase in eroded perimeter (+97%) was associated with a significant decrease of osteoclast number. Biochemical markers of bone formation (osteocalcin and bone-specific alkaline phosphatase) and urinary cAMP were unchanged. Due to the short duration of the treatment, neither bone volume nor microarchitecture parameters were modified. The decreases of both the activation frequency and osteoclast number associated with the increase in eroded surfaces suggest a prolongation of the reversal phase due to an inhibition of osteoblast differentiation. Changes of bone formation in ewes induced by short-term administration of MP were similar to those reported after 3 months of treatment in humans. Thus, corticosteroid-treated ewes may represent a suitable animal model of low bone formation.

Comparison of individual follow-up and computerized record linkage using the Canadian Mortality Data Base.

We compared two methods of ascertaining mortality in a historical prospective mortality study. Computerized Record Linkage (CRL) with the centralized historical Canadian Mortality Data Base (CMDB) was carried out on 2469 men and an attempt was also made to trace the subjects by individual follow-up (IFU). All but 88 were traced and 60 were reported to be dead. CRL was able to locate the deaths of three men who had been untraced by IFU. Contradictory information on vital status was obtained on 5 subjects--in 4 of them, the discrepancy was resolved in favour of CRL. Overall, CRL using the CMDB performed very well. We also consider factors that affect the relative costs of the two methods, which should be balanced against the accuracy of information obtained.