Suitability of infrared spectroscopy for drug checking in harm reduction centres.

Drug checking is a service for people who use drugs that includes product analysis and an individual interview including results feedback and harm reduction counselling. It uses different analytical methods but few studies demonstrate their value in current practice. The main objective of this work is to compare the analytical performance of IR spectroscopy to laboratory reference method in the context of drug checking in a harm reduction centre. The secondary objectives are to carry out a description of the people who use drugs requesting a product analysis, and to compare the assumed compositions of products purchased with their real compositions. During 2018, all requests for drug testing analysis were included for on-site analysis by IR spectrometry in a harm reduction center and verified by the reference method (UPLC-HRMS) at Bordeaux University Hospital Center. Socioeconomic and product data were also collected. One hundred and thirty-six samples were collected. The results obtained with IR and UPLC-HRMS were compared. IR spectrometry results did not match with reference method in 8 % (n=11) of cases, corresponding to blotters, cannabis and some psychoactive substances present in mixture or in small quantities. Among the products collected, only 5.1 % (n=7) did not correspond to the declared product, either alone or with adulterants. The IR spectrometer allows a simple and rapid detection of at least one molecule, most often the one of interest. However, it is limited to powder and tablet type matrices and is not suitable for blotters, cannabis, mixed or low content substances for which high resolution mass spectrometry remains the reference method.

Transvaginal sonographic assessment of cervical length and wedging for predicting outcome of labor induction at term: a systematic review and meta-analysis.

OBJECTIVE: To perform a systematic review and meta-analysis to assess the predictive capacity of transvaginal sonographic assessment of the cervix for the outcome of induction of labor. METHODS: We searched MEDLINE, EMBASE and the Cochrane Library, and manually searched reference lists of review articles and eligible primary articles. Studies in all languages were eligible if published in full. Two reviewers independently selected studies and extracted data on study characteristics, quality and test accuracy. We then calculated pooled sensitivities and specificities (with 95% CIs) and summary receiver-operating characteristics (sROC) curves. Outcome measures were test accuracy of sonographically measured cervical length and cervical wedging for Cesarean section, not achieving vaginal delivery within 24 h and not achieving active labor. RESULTS: We included 31 studies reporting on both cervical length and outcome of delivery. The quality of the included studies was mediocre. Sensitivity of cervical length in the prediction of Cesarean delivery ranged from 0.14 to 0.92 and specificity ranged from 0.35 to 1.00. The estimated sROC curve for cervical length indicated a limited predictive capacity in the prediction of Cesarean delivery. Summary estimates of sensitivity/specificity combinations of cervical length at different cut-offs for Cesarean delivery were 0.82/0.34, 0.64/0.74 and 0.13/0.95 for 20, 30 and 40 mm, respectively. For cervical wedging in the prediction of failed induction of labor summary point estimates of sensitivity/specificity were 0.37/0.80. CONCLUSIONS: Cervical length and cervical wedging as measured sonographically at or near term have moderate capacity to predict the outcome of delivery after induction of labor.

Low-temperature reaction of trialkoxysilanes on silica gel: a mild and controlled method for modifying silica surfaces.

The room temperature reaction of 4-(triethoxysilyl)butyronitrile, 4-TBN ((C2H5O)3Si(CH2)3CN), on weakly hydrated silica samples pretreated at 393 K has been studied by desorption experiments and by diffuse reflectance infrared Fourier transform (DRIFT) spectroscopy at different aging times under various water partial pressures. The reaction is demonstrated by the decrease of desorption of 4-TBN with time and the simultaneous disappearance of the 2980 and 1394 cm(-1) signals in the DRIFT spectra, assigned to the CH3 moiety of the ethoxy functions. Water partial pressure is shown to have a crucial effect on the rate and efficiency of the process as, after 6 days, for samples kept at room temperature under vacuum, ca. 50% of the silane has reacted, while for those kept in a water-saturated atmosphere the silane reaction reaches 96%. Although the silane appears to be irreversibly bonded to the surface, no definite conclusion may be drawn from these preliminary results as to the nature of the bonding (grafting or coating). These samples are compared to modified silicas prepared according to conventional methods. The same extent of silane reaction (50%) is achieved for preadsorbed samples kept under vacuum and either cured at 473 K for 30 h or kept at room temperature for 6 days. A mild and controlled modification of silica by triethoxysilanes can thus be achieved by first physisorbing known amounts of the modifying silanes from an organic solvent on pretreated silica and then letting the samples mature for a few days at room temperature in a water-saturated atmosphere.

[Absence of the radial artery: case report and review of the literature]. / Absence d'artère radiale. A propos d'un cas et revue de la littérature.

PURPOSE OF THE STUDY: We report a case of complete unilateral absence of the radial artery in the forearm and reviewed the pertinent literature. CASE REPORT: An 18-year-old girl was admitted for multiple fractures after a car accident. She presented with a comminuted fracture of the left distal humerus, an open grade I fracture according to the Gustilo classification involving the right ulna and radius, a mediodiaphyseal fracture of the right femur and an open grade II fracture of the proximal and distal left tibia. After open reduction and internal fixation of the bones of the right forearm, she presented transient ischemia of her right hand, the radial pulse not being detectable at the end of surgery. An arteriography showed a complete absence of the right radial artery, which was thought to be caused by arterial thrombosis. Surgical exploration evidenced the complete absence of the radial artery. DISCUSSION: Absence of the radial artery is observed in radial preaxial hemimelia, in specific genetic and chromosomal disorders (Fanconi's anemia, Holt-Oram syndrome) and in association with other malformations. Unilateral absence of the radial artery has been described in association with other vascular abnormalities such as a larger anterior interosseous artery or the presence of a medial artery. Our case presented an isolated anatomical variation of the radial artery. This vascular anomaly was asymptomatic and discovered fortuitously. The incidence of this anatomic anomaly may be underestimated in the general population.

Proximal fractures of the fifth metacarpal: a retrospective analysis of 25 operated cases.

The clinical and radiological outcomes of 25 surgically treated fractures of the proximal third of the fifth metacarpal were retrospectively analysed. Many different methods of osteosynthesis were used. At follow-up after a mean of 3.3 years, 15 of 25 patients had no pain. Most patients regained a nearly full range of motion in the adjacent joints and more than 90% of the contralateral grip strength. X-ray signs of degenerative arthritis in the metacarpohamate joint were observed in 10 of 25 patients. Pain was found to be directly correlated with the presence of degenerative changes.

Nine cases of osteonecrosis in elderly patients following arthroscopic meniscectomy.

We report nine cases of osteonecrosis of the knee after arthroscopic meniscectomy between 1992 and 1996. In five women and four men aged between 58 and 82 years (mean 69 years), magnetic resonance imaging (MRI) demonstrated a meniscal tear for which arthroscopic meniscectomy was performed. MRI was done between 3 days and 72 weeks after the onset of symptoms. Signs of osteonecrosis were not present on the initial MRI scan. Postoperatively, all patients experienced persistent knee pain and joint effusion. A repeat MRI scan 6-48 weeks after meniscectomy confirmed the diagnosis of osteonecrosis. In eight patients osteonecrosis was located on the medial, in one patient on the lateral femoral condyle. Our report supports the results of recent studies which have related osteonecrosis to arthroscopic meniscectomy. Further studies need to be undertaken to determine the aetiology of the osteonecrosis related to this procedure in the elderly. Until the results of these studies are available, we recommend considering carefully before performing arthroscopic procedures in the elderly.