Introduction: Loco regional persistence or recurrence of differentiated thyroid cancer (DTC) is frequent despite initial thyroidectomy and radioactive iodine therapy (RAI). The aim of this study was to analyze the impact of a complementary adjuvant RAI (Ad-RAI) on disease recurrence following re-operation on patients with locally persistent or recurrent DTC. Patients and Methods: A retrospective study of 85 patients with DTC was conducted. All patients were initially treated with total thyroidectomy and RAI, and re-operated for a locally persistent or recurrent disease. Propensity score was calculated to predict the impact of Ad-RAI on survival after reoperation, and to reduce the bias of the limited sample size and the prognostic tests. Results: 49 (58%) patients were re-treated with Ad-RAI after re-operation while 36 (42%) were only followed up. Disease recurrence after re-treatment (re-operation ± Ad-RAI) was detected in 31 patients (36.5%). In multivariate analysis, age >55 years (HR: 3.9 [1.6; 9.5]; p < 0.00001) was the main poor prognostic factor for recurrence-free survival. Three parameters independently influenced the decision to administer ad-RAI: low number of previous RAI administrations, Nx before re-operation, and pTg > 30 µg/l. These parameters were incorporated in the Propensity score calculation. If ad-RAI tended to improve recurrence-free survival (median survival 17.4 vs. 10.9 months), adjustment using the Propensity score removed any difference between the groups (p = 0.54), confirming the limited value of ad-RAI. Conclusion: In patients with locally persistent or recurrent DTC, age is the main independent prognostic factor. Adjuvant RAI does not improve recurrence-free survival of DTC patients.
Seizures are very common in the Emergency Department (ED). We present here a case of a young woman with neurocysticercosis ; a worldwide and nearly endemic cause of seizure in the southern hemisphere. Clinical manifestations are very different between patients from asymptomatic to life-threatening hydrocephalus. Diagnosis is based on a combination of clinical presentation, neuroimaging (CT and MRI) findings, history of exposure, and serologic testing.
Les convulsions sont un motif fréquent de consultation aux urgences. Nous présentons ici le cas d'une jeune patiente qui illustre une cause rare de convulsions en Europe : la neurocysticercose. La présentation initiale de cette maladie souvent hétérogène rend son diagnostic difficile pour le clinicien. Celui-ci repose sur un ensemble d'arguments clinico-immunologiques associé à un séjour en zone d'endémie de cysticercose. La neuro-imagerie (scanner et IRM) joue un rôle prépondérant dans le diagnostic et le suivi des différentes phases de la maladie.
Magnetic Resonance Imaging/methods , Neurocysticercosis/diagnosis , Seizures/parasitology , Tomography, X-Ray Computed/methods , Adult , Emergency Service, Hospital , Europe , Female , Humans , Neurocysticercosis/complications , Neuroimaging/methods , Seizures/diagnosis
A six-component handrim dynamometer (HRD) is a dynamometer that rotates around the wheel axle during measurements. For this kind of dynamometer, static zero level calibration is insufficient because the proportion of the forces (i.e. handrim weight and centrifugal force) measured by each sensor varies according to the angular position and velocity of the dynamometer. The dynamic calibration presented in this paper is based on the direct correction of the sensor signals using Fourier's polynomials that take into account the influences of both the handrim weight distribution on the sensors with respect to the wheel's angular position and the effect of the wheel's angular velocity. When these corrections were applied to the signals produced by the sensors while the HRD was rotating and no effort was being exerted on the handrim, the calculated forces and torques remained close to zero, as expected. Based on these results, the wheel dynamometer can be confidently used for studying manual wheelchair locomotion under various real conditions. The method could also be applied in other situations in which a dynamometer rotates during measurements.
Wheelchairs , Biomechanical Phenomena , Calibration , Equipment Design , Motion , Torque
The objective of this study was to validate a new stabilometric force platform (SFP). For this, three steps have been established: a) to determine the force threshold to reach an acceptable level of accuracy of the centre of pressure (CoP) measurement by the application of single point load; b) to determine the accuracy of the CoP measurement in the application of distributed load simulating the human feet; c) to verify the concurrent validity of the SFP by comparing it with a commercial force platform (FP). The tests performed in steps "a" and "b" were conducted by applying loads on the SFP using a universal testing machine. In the application of single point load, the mean force threshold presented by the SFP was 315.6 ± 140.5 N. The CoP measurement error in the points near the centre of the SFP was 1.04 ± 0.80 mm in medial-lateral (ML) and 1.31 ± 0.99 mm in anterior-posterior (AP) direction. In the points near the edges of the plate, the error was 2.03 ± 0.91 mm (ML) and 1.54 ± 0.96 mm (AP). In the test with distributed loads, errors of less than 1 mm were found. Additionally, no differences were found in the CoP parameters between SFP and the FP. The CoP measurement signal presented high correlation between both equipments in AP (r = 0.997 ± 0.001) and ML (r = 0.988 ± 0.003) directions. These findings suggest that the SFP can be used in scientific investigations of balance in quiet standing.
O objetivo deste estudo foi validar uma nova plataforma de forças estabilométrica (PFE). Para isso, três etapas foram estabelecidas: a) determinar o limiar de carga para chegar a um nível aceitável de exatidão da medida do centro de pressão (CP) pela aplicação de cargas pontuais; b) determinar a exatidão da medida do CP na aplicação de cargas distribuídas que simulam os pés humanos; c) verificar a validade concorrente da PFE comparando-a com uma plataforma de forças comercial (PF). Os testes das etapas "a" e "b" foram realizados pela aplicação de cargas sobre a PFE, utilizando uma máquina de ensaios universal. Na etapa de aplicação de carga pontual, a média do limiar de carga apresentado pela PFE foi de 315.6 ± 140.5 N. Os erros de medida do CP nos pontos próximos ao centro da PFE foram de 1.04 ± 0.80 mm na direção medio-lateral (ML) e 1.31 ± 0.99 mm na direção ântero-posterior (AP). Nos pontos próximos aos cantos da chapa, foram encontrados erros de 2.03 ± 0.91 mm (ML) e 1.54 ± 0.96 mm (AP). No teste com cargas distribuídas, os erros foram menores que 1 mm. Adicionalmente, não foram encontradas diferenças nos parâmetros do CP entre a PFE e a PF. O sinal do CP apresentou alta correlação entre os dois equipamentos, tanto na direção AP (r = 0.997 ± 0,001) quanto na direção ML (r = 0.988 ± 0,003). Os resultados sugerem que a PFE pode ser utilizada em estudos científicos do equilíbrio em postura ereta.
