Systematic Review of the Impact on Return to Work of Return-to-Work Coordinators.

Purpose We conducted a systematic review to understand the impact that return-to-work coordinators (RTWCs) have on return to work (RTW) outcomes for sick/injured workers. Methods MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and ABI Inform were searched from January 1, 2000 to September 16, 2020. Of 2,927 retrieved and screened citations, 14 quantitative articles fulfilled the eligibility and quality criteria. Quality assessment, data extraction, and evidence synthesis followed article screening. Results We focused on the impact of RTWCs for outcomes of work absence, RTW rates, quality of life, and cost-benefit. Our final synthesis included 14 articles. We found strong evidence that work absence duration was reduced when workers had face-to-face contact with a RTWC. As well, there was strong evidence linking face-to-face RTWC interventions with higher RTW rates and moderate evidence that this reduced intervention costs. RTWC interventions involving the identification of barriers and facilitators to RTW also showed promising results. However, only limited evidence was found that RTWCs improved quality of life for workers. Conclusions Our synthesis identifies key features of RTW interventions that improve RTW outcomes. Future high-quality research should measure long-term outcomes of RTWC interventions to evaluate sustainability and consider the nature of work. They should also focus on RTWC impact on worker quality of life assessments and for older workers and workers with chronic health conditions.

Return to Work for Mental Ill-Health: A Scoping Review Exploring the Impact and Role of Return-to-Work Coordinators.

Purpose This scoping review was completed to explore the role and impact of having a return-to-work (RTW) coordinator when dealing with individuals with common mental ill-health conditions. Methods Peer reviewed articles published in English between 2000 and 2018 were considered. Our research team reviewed all articles to determine if an analytic focus on RTW coordinator and mental ill-health was present; consensus on inclusion was reached for all articles. Data were extracted for all relevant articles and synthesized for outcomes of interest. Results Our search of six databases yielded 1798 unique articles; 5 articles were found to be relevant. The searched yielded only quantitative studies. Of those, we found that studies grouped mental ill-health conditions together, did not consider quality of life, and used different titles to describe RTW coordinators. Included articles described roles of RTW coordinators but did not include information on their strategies and actions. Included articles suggest that RTW interventions for mental ill-health that utilize a RTW coordinator may result in delayed time to RTW. Conclusions Our limited findings suggest that interventions for mental ill-health that employ RTW coordinators may be more time consuming than conventional approaches and may not increase RTW rate or worker's self-efficacy for RTW. Research on this topic with long-term outcomes and varied research designs (including qualitative) is needed, as well as studies that clearly define RTW coordinator roles and strategies, delineate results by mental health condition, and address the impact of RTW coordinators on workers' quality of life.

[Imaging features of Takayasu's arteritis]. / Imagerie de l'artérite de Takayasu.

Takayasu's arteritis is the most frequent inflammatory arteritis in young patients. It is characterized by the presence of giant cells and typically involves specific vascular sites: aorta and its main branches and pulmonary arteries. Inflammatory arterial involvements leads to stenosis, aneurysm, occlusion and arterial wall thickening. Diagnosis relies mainly on imaging, namely Doppler US, CT, and MRI. The imaging features of this disease are reviewed based on a retrospective review of 36 patients imaged over a 13 year period.

[Hepatic epithelioid hemangioendothelioma: review of 3 cases]. / Hémangioendothéliome épithélioïde hépatique: à propos de 3 cas.

Hepatic epithelioid hemangioendothelioma (EHE) is a rare neoplasm of vascular origin. EHE is an intermediate-grade malignancy, between benign hemangioma and angiosarcoma, with variable aggressiveness. Involvement often is multinodular simulating metastases from a primatry extra-hepatic malignancy leading to delays in diagnosis. We report the imaging features in three cases of histologically proven hepatic EHE. The imaging features suggestive of EHE will be emphasized, especially for multinodular lesions suggesting liver metastases in patients with no known primary.

Extraskeletal Ewing sarcoma of the abdominal wall.

Ewing sarcoma is most commonly a bone tumour which has usually extended into the soft tissues at the time of diagnosis. Exceptionally, this tumour can have an extraskeletal origin. Clinical or imaging findings are non-specific and diagnosis is based on histology. We report a case of an extraskeletal Ewing sarcoma developed in the soft tissues of the abdominal wall in a 35-year-old woman who presented a painful abdominal wall tumefaction. Ultrasongraphy and computed tomography showed a large, well-defined soft tissue mass developed in the left anterolateral muscle group of the abdominal wall. Surgical biopsy was performed and an extraskeletal Ewing sarcoma was identified histologically.

[Imaging features of xanthogranulomatous pyelonephritis]. / Imagerie de la pyélonéphrite xantogranulomateuse.

Pseudotumoral xanthogranulomatous pyelonephritis is a rare chronic renal infection. Preoperative diagnosis is difficult because of its non-specific presentation. The purpose of this retrospective review of 8 cases is to assess the value of different imaging techniques in the evaluation of this pathology. Six males and 2 females, aged 29 to 75 years were included. The right kidney was involved in 5 cases and the left kidney was involved in 3 cases. Involvement was upper polar in 2 cases and lower polar in 6 cases. A kidney stone was present in 3 cases. US showed a heterogeneous hypoechoic lesion in 3 cases, a homogeneous hypoechoic lesion in 3 cases, and isoechoic lesion in 1 case and a cystic lesion in 1 case. CT showed a focal solid lesion with peripheral enhancement in 4 cases and a cystic mass with peripheral enhancement in 3 cases. US features are non-specific. CT shows a non-specific renal mass, the presence of obstruction and demonstrates perirenal involvement. Preoperative MRI, not performed in our patient population, demonstrates specific changes in the perirenal fat that suggests the diagnosis. The diagnosis of pseudotumoral xanthogranulomatous pyelonephritis can be suspected on a constellation of clinical and laboratory findings combined with non-specific features on CT and US and specific MRI features of perirenal fat changes. Percutaneous biopsy may be needed in selected cases to confirm diagnosis.

[Abnormality of hepatic perfusion secondary to superior vena cava obstruction: three case reports]. / Troubles de la perfusion hépatique secondaires à une thrombose cave supérieure: à propos de trois cas.

The aim of this study was to evaluate the altered flow dynamics of liver perfusion that can be observed during superior vena cava obstruction. Through the description of three case reports of patients with SVC obstruction, the authors discuss the different collateral pathways used that result in systemic portal venous shunting creating this altered flow dynamics and their appearance in computed tomography.

[Screw fixation without bone graft of calcaneal joint fractures: 35 cases]. / Résultats de l'ostéosynthèse par vissage sans greffe osseuse des fractures articulaires du calcaneus: à propos de 35 cas.

PURPOSE OF THE STUDY: The prognosis of calcaneal joint fractures is less favorable than fractures without joint involvement. Surgical treatment is frequently recommended. The type of fixation and the usefulness of a bone graft remain subjects of debate. The purpose of this work was to present the functional and anatomic results obtained with simple screw fixation without bone grafting in a retrospective series of 35 displaced joint fractures of the calcaneus. MATERIAL AND METHODS: The series included 31 patients (four bilateral fractures), 86% men. Mean age was 36 years (17-60 years). Using the Duparc classification, there were 12% type III fractures and 88% type IV fractures. Horizontal joint impaction was observed in 36% of patients, vertical impaction in 8%, and mixted impaction in 56%. The mean Bohler angle was 2 degrees (range -25 degrees to 15 degrees ). According to the Utheza classification, 70% of the fractures had two sagittal fracture lines, 16.5% one sagittal fracture line, and 13.5% comminutive fractures. Incongruency of the subtalar joint was noted in 70%, with a conflict with the lateral malleolus in 50%. Mean time to surgery was 12 days (7-30 days). The sub- and retromalleolar approach was used to achieve simple screw fixation. Bone grafts were not used. Mean follow-up was two years (range 12-38 months). RESULTS: There were no serious complications. Functional outcome was analyzed with the Kitaoka scale, mean score 74.3 +/- 1.1 (range 46-98), with 16% excellent outcome, 56% good outcome, 25.2% fair outcome, and 2.5% poor outcome. There was a correlation between functional outcome and age, etiology, and type of fracture. Anatomic results were assessed with the Babin scale and were very good in 24%, good in 8%, fair in 28%, and poor in 40%. Secondary loss of the initial heightening of the joint surface was noted in 48% of the cases, 3 degrees on average. DISCUSSION: This series confirms the value of surgical treatment compared with conservative treatment. Compared with plate fixation, screw fixation exposes the patient to less risk of skin and infectious problems. Simple screwing generally provides satisfactory results with acceptable stability. In light of the present results, adjunction of a bone graft would not be necessary since the loss of correction of the joint surface height was often minimal. CONCLUSION: Screw fixation of calcaneal joint fractures is a reliable technique. Adjunction of a bone graft does not appear to be necessary.

[Pituitary and ovarian mass syndrome in primary hypothyroidism]. / Syndrome de masse hypophysaire et kystes ovariens dans un cas d'hypothyroïdie périphérique.

INTRODUCTION: Hyperprolactinemia and a pituitary mass syndrome can occur in patient with primary hypoyhroidism. In young women, hypothyroidism can be associated with ovarian cysts. EXEGESIS: We report a case of a 30 year-old women who was treated for an anemia. She had clinical and biological signs of primary hypothyroidism with hyperprolactinemia at the biology. Pituitary MRI showed a pituitary mass. The pelvic ultrasound examination and CT scan showed a right ovarian cyst. The subsequent thyroid hormone replacement was associated with a clinical, a biological and radiological resolution. It was a pituitary and ovarian mass syndrome secondary to primary hypothyroidism. CONCLUSION: The recognition of these associations may eliminate unnecessary surgery and lead to the choice of hormone replacement therapy.

[A patient with a diaphragmatic mass]. / A propos d'une masse diaphragmatique.

Cystic teratoma of the diaphragm is a rare, generally asymptomatic, disease. We report a case which was disclosed by the development of fever and pain in the left hypochondria. Imaging ruled out surgical emergency and led to the diagnosis, describing the relations of the tumor.

Evidence for the involvement of sucrose phosphate synthase in the pathway of sugar accumulation in sucrose-accumulating tomato fruits.

To better understand the mechanism of sugar unloading and sugar concentration in hexose- and sucrose-accumulating tomato fruits (Lycopersicon chmielewskii and L. esculentum, respectively) and to determine the causes of the late accumulation of sucrose present in sucrose-accumulating tomato fruits, the assimilation of [(3)H](fructosyl)-sucrose was studied. Key enzymes involved in carbohydrate metabolism were also assayed. The results demonstrated that the low level of sucrose present in young fruits accumulates directly without undergoing hydrolysis, suggesting a symplastic pathway for sucrose unloading. By contrast, the large quantity of the sucrose present in ripe sucrose-accumulating fruits originates from hydrolysis and resynthesis, suggesting an apoplastic pathway for sucrose unloading. The increase in sucrose level observed in sucrose-accumulating fruits is associated with a gradual decline in invertase activity and an increase in sucrose phosphate synthase activity. This latter enzyme seems to play a key biochemical role in the accumulation of sucrose and the establishment of a high sugar content in tomato fruits.