Significant decrease of facial cellulitis admissions during COVID-19 lockdown in France: A multicentric comparative study.

During the 2020 coronavirus pandemic, a lockdown was imposed in France during the first wave. An apparent decrease in incidence of cellulitis of odontogenic origin was noticed then. This study aimed to compare the incidence of cellulitis during this extraordinary period with the same period in 2018 and 2019, based on retrospective multicentric data. All maxillofacial surgery departments in French public hospitals were contacted. Responders were asked to include all patients admitted for the surgical drainage of a head and neck abscess of odontogenic origin during the first 2020 lockdown period, and in a similar time frame in 2018 and 2019 (control group), based on screening the French diagnostic and therapeutic classification of medical acts. We report a 44% significant nationwide decrease in the incidence of admissions for cellulitis. There were 187 patients in 2020 for 334 and 333 patients in 2018/2019 respectively. The reasons to explain this finding are hypothetical (organizational reasons leading to earlier management, patients' fear to seek for medical management, usual excess in surgical indications or concomitant decrease of non-steroidal anti-inflammatory drugs delivery). Whatever the explanation, it would be of great interest to find it out in order to improve the prevention of cellulitis.

Effects of 1-week sacral nerve stimulation on the rectal intestinal epithelial barrier and neuromuscular transmission in a porcine model.

BACKGROUND: Sacral nerve stimulation (SNS) is a validated treatment for fecal incontinence, although the mechanism of action remains unknown. Short-term effects of SNS on the intestinal epithelial barrier (IEB) have been reported previously. The aim of our study was to assess the impact of a 1-week SNS on the IEB in a preclinical model. METHODS: Fourteen pigs were implanted for bilateral SNS. Seven pigs received 7-day stimulation, whereas the remaining animals received no stimulation. Rectal biopsies were performed before and after SNS. We assessed IEB permeability, mucosal tight junction and cytokine mRNA expression, IL-6 production in an organotypic culture model, and neuromuscular transmission in muscle strips. KEY RESULTS: IEB permeability was not modified after stimulation, as compared with baseline. The PAR-induced increase in IEB permeability and the mucosal ZO-1 mRNA decrease observed in the controls were not observed into the stimulated group. Cytokine overexpression was not observed in the mucosa in either group. SNS decreased IL-6 production in the organotypic culture model. In the stimulated group, the area-under-the-curve of the EFS-induced contractile response was significantly increased. CONCLUSIONS & INFERENCES: The main conclusions of our work are (i) the successful development of a preclinical model of bilateral SNS and (ii) in physiological conditions, 1-week SNS did not lead to functional changes in the mucosa. While under stress-induced conditions, SNS modified the properties of the IEB, leading to a decrease in its permeability. Neuromuscular transmission was modified by SNS, leading to neuronal hyperexcitability. These results add evidence to the reinforcement of the IEB by SNS.

The role of glutathione, membrane sphingomyelin, and its metabolites in oxidative stress-induced calcium "dysregulation" in PC12 cells.

Previous research showed that increasing membrane sphingomyelin (SPH) levels in rat pheochromocytoma (PC12) cells to the same extent as that seen in some brain regions with aging dramatically increases the vulnerability to oxidative stress (OS). These increases in vulnerability were determined by assessing deficits in the ability of these cells to extrude and/or sequester Ca2+ following 30 mM KCl-induced depolarization (recovery). The purpose of the present experiments was to discern whether increasing the levels of particular SPH metabolite(s), i.e., ceramide (Cer), sphingosine (Ssine), or sphingosine-1-phosphate (SPP), or indirectly increasing the concentrations of these metabolites with sphingomylinase (Sase), would interact with the cell's sensitivity to OS induced by low (5 microM) or high (nonlethal, 300 microM) H2O2. In addition, the OS vulnerability was examined as above under decreased SPH levels by exposing the cells to L-cycloserine (Lcc), which prevents SPH synthesis. Both Sase and SPP significantly decreased Ca2+ recovery of PC12 cells after H2O2 exposure. Conversely, Lcc-treated cells showed no further OS-induced decrements in recovery below those seen in controls. SPP significantly decreased glutathione levels (GSH) in the absence of OS. Repletion of GSH with 20 mM N-acetylcysteine significantly attenuated the effect of 5 microM H2O2 on recovery in SPP-treated cells and decreased sensitivity of SPP-treated cells to low doses of OS. Overall, our results suggest a critical role for GSH and SPP in the regulation of OS vulnerability, especially as it relates to Ca2+ homeostasis.

Validity of the McGill Quality of Life Questionnaire in the palliative care setting: a multi-centre Canadian study demonstrating the importance of the existential domain.

This study was carried out in eight palliative care services in four Canadian cities. A revised version of The McGill Quality of Life Questionnaire (MQOL) is compared to a single-item scale measuring overall quality of life (SIS), and the self-administered version of the Spitzer Quality of Life Index (SA-QLI), to obtain evidence of validity. MQOL total score predicts SIS better than does SA-QLI, although much of the variance remains to be explained. The results of principal components analysis of data using this revised version of MQOL are similar to those from previous MQOL studies with different patient populations. The MQOL subscales, constructed on the basis of principal components analysis, demonstrate acceptable internal consistency reliability. The MQOL measures reflecting physical well-being and existential well-being are important for predicting SIS.

Effect of alendronate on fracture healing and bone remodeling in dogs.

To examine the effect of alendronate (4-amino-1-hydroxybutylidene bisphosphonate) on fracture repair, the drug was given to mature beagle dogs orogastrically at 2 mg/kg/day for 9 weeks preceding fracture. 16 weeks after fracture, or both before and after fracture (25 weeks). A transverse mid-diaphyseal fracture of the right radius was surgically induced and was stabilized by external coaptation splinting. Fracture healing and bone remodeling were evaluated by radiography, gross and histological examination, and bone histomorphometry. The mechanical properties of the fracture callus were determined by a four-point bending test. Radiographs and gross and microscopic examination demonstrated normal bone healing at the fracture site in all dogs. In dogs that received alendronate during the fracture healing period, at 16 weeks the calluses were approximately 2-3 times larger than those in dogs that received a placebo during the healing period. This is consistent with slower callus bone remodeling, an expected pharmacological effect of the compound. Bone histomorphometry demonstrated that treatment with alendronate did not inhibit bone formation or mineralization. Mechanical testing showed that the ultimate load at failure and the flexural rigidity of both the fractured and contralateral intact bone were unaffected by treatment with alendronate. Therefore, in this study, treatment with alendronate before or during fracture healing, or both, resulted in no adverse effects on the union, strength, or mineralization of bone in mature beagle dogs.

Contact area and static pressure profile at the plate-bone interface in the nonluted and luted bone plate.

Contact area and pressure between 6-hole broad dynamic compression plates and 20 pairs of equine third metatarsal bones were measured using nonluted and luted plating techniques. Pressure-sensitive film (pressure ranges 10 to 50 MPa and 50 to 130 MPa) was used as the static pressure transducer. Nonluted and one of two luting techniques were tested on each pair of bones; each luting technique was tested on 20 bones. Quantitative determinations of contact area and pressure were made using computerized image processing techniques. Mean (+/- SD) total contact area for nonluted plates was 18.49% +/- 3.5% of the potential plate-bone contact area. Luting increased (P < .05) total contact area to 25.56% +/- 4.0% and 31.29% +/- 6.6% for the respective luting techniques. The effects of luting on contact area were dependent on the contact pressure. At contact pressure ranges 10 to 20 and 21 to 35 MPa, luting increased contact area. In contact pressure ranges 36 to 45 and 50 to 65 MPa, plate-bone contact was inherently greatest and plate luting had no significant effect on contact area. In contact pressure ranges 66 to 99 and 100 to 126 MPa, luting decreased contact area. Contact area was increased at lower contact pressures at the expense of higher pressure contact. Contact in the middle third of the plate was 20% to 40% of the contact at either end of the plate. Plate luting increased contact area best where plate-bone contour was most similar.

[Acute necrotic pancreatitis secondary to asparaginase. Role of drug combinations--early diagnosis and treatment. Apropos of 2 cases]. / Pancréatite aiguë nécrotique secondaire à l'asparaginase. Rôle des associations médicamenteuses--diagnostic précoce et traitement. A propos de 2 observations.

Acute necrotic pancreatitis was diagnosed in two patients treated with asparaginase for, in the first case a highly malignant lymphoma and in the second an acute lymphoblastic leukemia. The diagnosis on clinical findings and amylase assay results was confirmed by LDH and/or C reactive protein values and abdominal CT scans. Both patients recovered after drainage of peripancreatic fluid collections, in the first patient by surgical followed by cutaneous drainage and in the second by cutaneous drainage of a pancreatic pseudocyst. In addition to the frequent pancreatic reaction observed during asparaginase treatment, signs of pancreatic necrosis requiring urgent treatment have to be identified. The necrotic nature of the pancreatitis was confirmed by clinical examination, assay to biologic markers and abdominal CT scans, eliminating other causes of the pancreatitis.

Electromyographic and affective responses of episodic tension-type headache patients and headache-free controls during stressful task performance.

Thirty-four subjects meeting diagnostic criteria for episodic tension-type headache and 42 who rarely experienced headaches participated in two laboratory sessions in which cephalic electromyographic (EMG) activity, electrodermal activity, heart rate, and finger temperature were recorded. Subjects performed relaxation, choice reaction time, psychomotor tracking, voluntary muscle contraction, and cold pressor tasks. Headache subjects showed significantly greater EMG activity than controls during baseline and stressful task performance. During relaxation, both groups reduced EMG activity from baseline levels, and there was no significant difference in EMG level between the groups during relaxation. Headache subjects reported higher levels of subjective anxiety, depression, anger, and stress than controls. Headache subjects also reported higher levels of pain than controls, and headache subjects reported greater pain during stressful task performance relative to baseline and recovery periods.

Testicular function in uremic rats: in vivo assessment of testosterone biogenesis.

The mechanism of testosterone (T) production defect in uremic rats has not yet been clearly defined and hypothalamo-hypophyseal impairment as well as primary testicular dysfunction have been suggested. In 42 rats followed monthly after subtotal nephrectomy up to 7.1 +/- 0.3 months, we observed a progressive significant decline of T and androstenedione (A) compared to control rats. Two months before the terminal phase of chronic renal failure (CRF), T/A ratio abruptly declined. T and its precursors on the 4-ene pathway, A, progesterone (P) and 17-hydroxyprogesterone were evaluated in pampiniform plexus testicular vein (PPTV) and in peripheral blood (PV) in end stage uremic rats (blood urea greater than 30 mmol/l, creatinine clearance less than 0.5 ml/min). Under basal conditions, all steroids but peripheral P were significantly lower in uremic rats than in controls as well as T/P and A/P ratios. After human chorionic gonadotropin (hCG) stimulation, T concentration in PV and PPTV remained highly significantly lower than in controls whereas T precursor concentrations were partially corrected by hCG administration. T/P ratio remained lower than in controls whereas A/P ratio was not significantly lower than in controls. Those data show a decline in all the steps of T biogenesis in uremic rats in basal conditions. The defect in 17 beta-hydroxysteroid dehydrogenase evidenced by T/A decrease at the end stage of CRF seems of primary testicular origin as it is not corrected by hCG administration as shown by T/P and A/P ratios in PPTV and in PV.

A naturalistic study of the relationships among electromyographic activity, psychological stress, and pain in ambulatory tension-type headache patients and headache-free controls.

Twelve subjects who met diagnostic criteria for episodic tension-type headache and nine subjects who rarely or never suffered from headaches wore a computer-controlled electromyographic (EMG) activity recorder in their natural environment for 48 to 96 consecutive hours. EMG activity of the posterior neck or frontal muscles was recorded 24 hr per day. During waking hours, subjects rated their perceived levels of stress, pain, and negative affect at 30-min intervals. The EMG activity of headache and control subjects did not differ significantly, and EMG activity did not covary with stress, pain, or negative affect. Cross-correlations among EMG activity, pain, and stress revealed little evidence of leading, contemporaneous, or lagging relationships. Interrupted time series analysis showed no consistent muscle hyperactivity during a headache attack compared to a headache-free baseline period.

[The role of conjugal relations in the abuse and neglect of children: towards an ecological study]. / Le rôle de la relation conjugale dans l'abus et la négligence d'enfants: vers une étude écologique.

The phenomenon of child abuse and neglect has always existed in Western society. Yet, it is only recently that clinicians and researchers have taken a serious look at these problems. This ever growing interest has come about from not only the stunning number of cases identified each year, but also by the extent and gravity of consequences observed among children. Several professionals interested by the issue have put forward a great number of etiological factors to try to explain abuse and neglect within the family unit. However, when assessing the proposed theoretical models (psychiatric/psychological, sociological, systemic), it appears that certain simple factors can play a large role, for instance the history behind parental development, the quality of marital relations, the child-parent relation, the stress and the extent of the social network, but none of these can clearly differentiate abusive families from non abusive families. It seems however that these different explicative factors would be even more valuable if they were considered in interaction rather than taken individually. Inspired by the ecological framework proposed by Bronfenbrenner (1977, 1979), Belsky (1980, 1984) as well as Cicchetti and Rizley (1981) have also developed a model that simultaneously takes into account all of these factors and their interaction.

[The newborn and the couple: adversaries or partners?]. / La nouveau-né et le couple: adversaires ou partenaires?

We generally accept that the planned arrival of a first child is a source of joy for the new parents and that it provides them with a sense of accomplishment. Traditionally, society welcomes the formation of a family unit and looks forward to this passage into the new role of parenthood. However, not only has research on marital relations set aside the popular imagery of romanticism, but it has increasingly given negative connotations to this crisis-prone transition phase. The objective of this article is therefore to review literature concerning the impact of a newborn child on the marital experience, and to nuance the idea that childbirth can lead to crisis situations within the couple. In conclusion, the authors argue that the concept of marital satisfaction needs to be reformulated. Judging from their brief overview of literature, the authors believe the concept to be too narrowly defined and slightly ambiguous. Indeed, researchers have not yet reached a consensus on the definition of marital satisfaction. Furthermore, they tend to operationalize the concept in very different ways. As a result, there is a lot of conclusion and the fact that many researchers use different terms as a synonym of satisfaction is no help. What's more, the assessment of quality in a relationship should not be limited to measuring the level of satisfaction of the two partners. Other dimensions (e.g. adjustment, commitment, cohesion, etc.) deserve consideration in order to give a more complete image of the changes that occur over the years within the couple.

Anger and hostility in tension-type headache.

A battery of standardized psychometric tests was administered to a group of 47 episodic tension-type headache sufferers and 47 headache-free controls. Compared to controls, headache subjects showed higher levels of anxiety, depression, and anger/hostility. The groups did not differ significantly on a measure of anger expressed toward persons or objects, but headache subjects showed significantly greater levels of suppressed anger. The results provide objective data that are in general agreement with predictions derived from psychosomatic theories about the interrelationships among anxiety,

[Granulocytic sarcoma. Apropos of a case]. / Sarcome granulocytaire. A propos d'un cas.

The authors report a case of orbital granulocytic sarcoma complicating a case of acute myeloblastic leukaemia, which was investigated by CT and MRI. CT revealed a moderately contrast-enhanced orbital mass. The MR signal intensity was identical to that of grey matter on T1-weighted sequences and identical to that of white matter on T2-weighted sequences.

[Normal imaging of facial sinuses]. / Imagerie normale des sinus de la face.

The high spatial resolution of computed tomography allows visualisation of the fine structures of the facial skeleton and gives precise information about the anatomy of the nasal cavity, the paranasal sinuses and their relations with adjacent structures. A detailed knowledge of the normal anatomy, particularly of the nasal cavity and ethmoid, is very useful to provide to the surgeon with a precise pre operative surgical map, before transnasal endoscopic ethmoidectomy or management of paranasal sinuses tumors.

Fatigue fractures in thoroughbred racehorses: relationships with age, peak bone strain, and training.

The North American Thoroughbred racehorse was chosen as a model to study the pathogenesis of fatigue failure of bone. This species has a high incidence of spontaneous fatigue failure of bone (bucked shins) during its early training. In vivo strain gauge studies of the third metacarpal bone of four young racehorses running at racing speeds showed high principal compressive strains [-4,841 +/- 572 (SD) microstrain] while two older horses had lower principal compressive strains (-3,317 microstrain measured at racing speed, -3,250 microstrain extrapolated from a slower speed run). Previously reported inertial property measurements of the third metacarpal bone were related to the difference in bone strains seen in young and older horses. The high strains on the surface of the third metacarpal bone associated with young horses in training may lead to high strain, low cycle fatigue. The changing shape of the third metacarpal bone during maturation may be consistent with the lower strains recorded during high speed exercise in the older animals. This phenomenon may allow for the accumulation of additional strain cycles in older animals before failure occurs.