[Same-eye comparison of pupillary dilation with an intraoperative standardized intracameral combination of mydriatics (Mydrane®) versus a preoperative ophthalmic (Mydriasert®) in standard cataract surgery in non-diabetic patients (French translation of the article)]. / Comparaison intra-individuelle de la dilatation pupillaire par une solution intracamérulaire standardisée combinée de mydriatiques (Mydrane®) en peropératoire versus un insert ophtalmique (Mydriasert®) en préopératoire dans la chirurgie de la cataracte standard de patients non diabétiques.

INTRODUCTION: Cataract surgery is the most commonly performed surgery in the world, and its success depends in part on the quality of mydriasis. PURPOSE: To compare, for the same eye, the pupillary dilation obtained with Mydrane® (standardized intracameral solution of 0.02% tropicamide, combined with 0.31% phenylephrine and 1% lidocaine) intraoperatively versus Mydriasert® (0.28mg tropicamide insert and 5.4mg phenylephrine) with a contact time between 45 and 60 minutes in the preoperative period. METHODS: Single center prospective study from November 2016 to January 2018 at the Laveran Army Instructional Hospital in Marseille. Patients referred for surgery were dilated at the preoperative consultation with Mydriasert®. The pupillary diameter after 45-60 minutes of contact with the insert was manually measured, by two different examiners, through the "iris image" tab of the Pentacam® elevation topography. Patients were dilated on the day of their cataract surgery with 0.2cc of Mydrane® injected in the anterior chamber through a paracentesis. Thirty seconds later, prior to injection of viscoelastic, an eye photograph was taken by screen capture. The pupillary diameter was evaluated by two different examiners with to the Piximeter 5.9 metrology software. The difference in pupil dilation between Mydriasert® and Mydrane® was tested with the paired series Student t-test. RESULTS: In total, 111 eyes of 82 patients were included. Mydriasert® achieved a mean pupillary dilation of 7.21±0.79mm. The mydriasis obtained with Mydrane® averaged 6.35±0.8mm. This difference of 0.86mm was statistically significant (P<0.001) with a confidence interval of 95% [-0.97; -0.74]. CONCLUSION: On average, Mydrane® dilates the pupil less than Mydriasert®. However, the mydriasis obtained with Mydrane® remains comfortable for the performance of the capsulorhexis. It helps save preoperative time and affords additional anesthetic to the cataract surgery. Nevertheless, the use of Mydriasert® is beneficial when extra mydriasis is required.

Same-eye comparison of pupillary dilation with an intraoperative standardized intracameral combination of mydriatics (Mydrane®) versus a preoperative ophthalmic (Mydriasert®) in standard cataract surgery in non-diabetic patients.

INTRODUCTION: Cataract surgery is the most commonly performed surgery in the world, and its success depends in part on the quality of mydriasis. PURPOSE: To compare, for the same eye, the pupillary dilation obtained with Mydrane® (standardized intracameral solution of 0.02% tropicamide, combined with 0.31% phenylephrine and 1% lidocaine) intraoperatively versus Mydriasert® (0.28mg tropicamide insert and 5.4mg phenylephrine) with a contact time between 45 and 60 minutes in the preoperative period. METHODS: Single center prospective study from November 2016 to January 2018 at the Laveran Army Instructional Hospital in Marseille. Patients referred for surgery were dilated at the preoperative consultation with Mydriasert®. The pupillary diameter after 45-60 minutes of contact with the insert was manually measured, by two different examiners, through the "iris image" tab of the Pentacam® elevation topography. Patients were dilated on the day of their cataract surgery with 0.2cc of Mydrane® injected in the anterior chamber through a paracentesis. Thirty seconds later, prior to injection of viscoelastic, an eye photograph was taken by screen capture. The pupillary diameter was evaluated by two different examiners with to the Piximeter 5.9 metrology software. The difference in pupil dilation between Mydriasert® and Mydrane® was tested with the paired series Student t-test. RESULTS: A hundred and eleven eyes of 82 patients were included. Mydriasert® achieved a mean pupillary dilation of 7.21±0.79mm. The mydriasis obtained with Mydrane® averaged 6.35±0.8mm. This difference of 0.86mm was statistically significant (P<0.001) with a confidence interval of 95% [-0.97; -0.74]. CONCLUSION: On average, Mydrane® dilates the pupil less than Mydriasert®. However, the mydriasis obtained with Mydrane® remains comfortable for the performance of the capsulorhexis. It helps save preoperative time and affords additional anesthetic to the cataract surgery. Nevertheless, the use of Mydriasert® is beneficial when extra mydriasis is required.

Retrospective study of two fixation methods for 4-corner fusion: Shape-memory staple vs. dorsal circular plate.

The purpose of this study was to compare the results of two groups of patients with four-corner fusion, one group fixed with shape-memory staples and the other with locked circular plates. This retrospective study compared 52 wrists operated for scaphoid excision and four-corner fusion between 2005 and 2011. The arthrodesis was ensured by a shape-memory quadripodal staple (4Fusion(®), Memometal™) in 37 cases and a locking dorsal circular plate (Xpode(®), Biotech Ortho™) in 15 cases. In the staple group, the mean age was 58.5 years and the average follow-up was 4.3 years. In the circular plate group, the mean age was 58.6 years and the average follow-up was 3.1 years. Pain, range of motion, grip strength, functional scores (QuickDASH and PWRE), fusion of the midcarpal joint, complications (implant fracture and reoperation) and patients' satisfaction were used as outcome measures. There was no pain in 43% of patients in the staple group and 40% of patients in the circular plate group at the follow-up; range of motion and functional scores were similar in both groups. Seventy-five percent of patients in the staple group were satisfied or very satisfied versus 60% in the circular plate group. The implant broke in 24.3% of cases in the staple group and 60% in the circular plate group. Reoperation was needed in 18% of the staple cases and 14% of the plate cases. There was no difference between the implants in terms of pain, range of motion, functional scores and patient satisfactory. The implant fracture rate in the plate group was high. This study brings into question implant reliability for the four-corner fusion procedure.

Perinatal nicotine exposure suppresses PPARγ epigenetically in lung alveolar interstitial fibroblasts.

Due to the active inhibition of the adipogenic programming, the default destiny of the developing lung mesenchyme is to acquire a myogenic phenotype. We have previously shown that perinatal nicotine exposure, by down-regulating PPARγ expression, accentuates this property, culminating in myogenic pulmonary phenotype, though the underlying mechanisms remained incompletely understood. We hypothesized that nicotine-induced PPARγ down-regulation is mediated by PPARγ promoter methylation, controlled by DNA methyltransferase 1 (DNMT1) and methyl CpG binding protein 2 (MeCP2), two known key regulators of DNA methylation. Using cultured alveolar interstitial fibroblasts and an in vivo perinatal nicotine exposure rat model, we found that PPARγ promoter methylation is strongly correlated with inhibition of PPARγ expression in the presence of nicotine. Methylation inhibitor 5-aza-2'-deoxycytidine restored the nicotine-induced down-regulation of PPARγ expression and the activation of its downstream myogenic marker fibronectin. With nicotine exposure, a specific region of PPARγ promoter was significantly enriched with antibodies against chromatin repressive markers H3K9me3 and H3K27me3, dose-dependently. Similar data were observed with antibodies against DNA methylation regulatory factors DNMT1 and MeCP2. The knock down of DNMT1 and MeCP2 abolished nicotine-mediated increases in DNMT1 and MeCP2 protein levels, and PPARγ promoter methylation, restoring nicotine-induced down regulation of PPARγ and upregulation of the myogenic protein, fibronectin. The nicotine-induced alterations in DNA methylation modulators DNMT1 and MeCP2, PPARγ promoter methylation, and its down-stream targets, were also validated in perinatally nicotine exposed rat lung tissue. These data provide novel mechanistic insights into nicotine-induced epigenetic silencing of PPARγ that could be exploited to design novel targeted molecular interventions against the smoke exposed lung injury in general and perinatal nicotine exposure induced lung damage in particular.

23 and 39 GHz low phase noise monosection InAs/InP (113)B quantum dots mode-locked lasers.

Here we report for the first time a passive mode-locking of single section Fabry-Perot (FP) lasers based on InAs quantum dots(QDs) grown on (113)B InP substrate. Devices under study are a 1 and 2 mm long laser diodes emitting around 1.58 µm. Self-starting pulses with repetition rates around 23 and 39 GHz and pulse widths down to 1.5 ps are observed after propagation through a suitable length of single-mode fiber for intracavity dispersion compensation. A RF spectral width as low as 20 kHz has been obtained leading to a low timing jitter RMS.

[Efficacy of prophylactic treatment of intraocular pressure spikes due to intravitreal injections]. / Efficacité d'un traitement prophylactique hypotonisant dans l'hypertonie oculaire induite après injections intravitréennes.

PURPOSE: The purpose of this study was to evaluate intraocular pressure increase after intravitreal injections (IVIs) and the effect of prophylactic pressure-lowering medications. METHODS: A prospective study of 210 anti-vascular endothelial growth factor (VEGF) IVI (0.05 mL of bevacizumab or ranibizumab), that were divided into five groups, group 1: no intraocular pressure (IOP)-lowering medication (n=50); group 2: apraclonidine 1 % one drop 2 hours prior to IVI (n=50); group 3: acetazolamide 250 mg 2 hours prior (n=50); group 4: fixed combination brimonidine+timolol (n=30); group 5: fixed combination dorzolamide+timolol (n=30). IOP was measured before, immediately after (T1), 15 min after (T15) and 45 min after (T45) the IVI using a Perkins tonometer. RESULTS: The mean IOP peak in group 1 was 46.4 ± 4.8 mmHg at T1, 21.7 ± 5.7 mmHg at T15 and 15.4 ± 4.3 mmHg at T45. Apraclonidine 1 % and the fixed combinations produced a significant reduction of IOP at every time point, of around 9 mmHg at T1. The reduction in IOP obtained with acetazolamide was not significant versus group 1 at T1 (-1.6 mmHg, P=0.12), but became significant at T15 and T45 (respectively, P=0.011 and P=0.015). CONCLUSIONS: IOP spikes are high but transient following IVI. Acetazolamide proved to be ineffective in preventing this spike. Topical medications, however, produced a significant reduction in IOP spike as well as in the duration of the increased pressure, with no significant difference between fixed combinations and 1 % apraclonidine at T1. It would seem advisable to prevent this IOP spike in the case of repeated injections, particularly in patients with glaucoma.

[Recurrent unilateral optic neuropathy associated with human immunodeficiency virus (HIV)]. / Neuropathie optique unilatérale récidivante liée au VIH.

HIV-related optic neuropathy is rare compared to optic neuropathies secondary to opportunistic infections in seropositive patients. We report the case of a 39-year-old HIV-positive woman referred for unilateral visual loss leading to the diagnosis of recurrent, unilateral, inflammatory optic neuropathy directly associated with HIV. Despite initial recovery after steroid treatment, she relapsed twice. Absence of any opportunist infections or toxic causes and presence of a very high viral load due to non-compliance with treatment led to the diagnosis of HIV-related optic neuropathy. Steroids and effective anti-retroviral treatment resulted in definitive and complete recovery. Inflammatory, degenerative and/or vascular mechanisms have been hypothesized to explain the occurrence of these rare HIV-related optic neuropathies. This diagnosis remains a diagnosis of exclusion to be considered in the work-up of seropositive patients with optic neuropathies.

[Comparison between Lenstar LS 900 non-contact biometry and OcuScan RXP contact biometry for task delegation]. / Comparaison de la biométrie sans contact cornéen par LENSTAR LS 900 et de la biométrie contact par OCUSCAN RXP dans le cadre de la délégation de tâches.

INTRODUCTION: Non-contact biometers have many advantages including the delegation of tasks to orthoptists. This study analyses the reliability of measurements comparing contact and non-contacts techniques. PATIENTS AND METHODS: Comparative measurements were taken on 86 eyes of 45 patients (mean age: 74 years; 44.4 % males) in preoperative phacoemulsification by three orthoptists with experience in this task. Each patient had non-contact measurements (Lenstar LS 900, Haag-Streit) and contact measurements (corneal biometry and ultrasound pachymetry with OcuScan RXP, Alcon) and a keratometry refractometer (TONOREF II, Nidek). The axial length data, pachymetry, power of the intraocular lens (SRK/T formula), anterior chamber depth, and the average keratometry were analyzed by paired comparisons. RESULTS: The non-contact biometer was ineffective in 5.8 % of cases (Parkinson's disease, two cases; dense posterior subcapsular cataracts, three cases). The non-contact pachymetry was statistically significantly higher (546.4 µm vs. 538.6 µm; p<0.001). The axial length was significantly longer for the non-contact measurement (23.21 mm vs. 23.05 mm; p<0.0001). In 25.9 % of patients, this difference was greater than or equal to 0.3mm and affected the power of the implant chosen. The anterior chamber depth measured on non-contact biometry was statistically greater (3.33 mm vs. 3.03 mm; p<0.0001). However, there was no significant difference regarding the average keratometry (43.82 D vs. 43.78 D; p=0327). CONCLUSION: Besides the infectious benefit for patients, absence of cleaning and decontamination of biometric probes, non-contact measurements using Lenstar are an example of a safe activity that can be delegated to assistants. This technique has been used to optimize the refractive outcome of 25.9 % of our patients undergoing refractive cataract surgery.

[Susac syndrome: variable onset modes and disease courses: two case reports]. / Syndrome de SUSAC. Modes d'entrée et évolutions variables: à propos de deux cas.

INTRODUCTION: Susac syndrome is a rare microangiopathy of unknown etiology, which involves the clinical triad of encephalopathy, visual loss, and hearing loss. Several onset and progression patterns are possible. OBSERVATION: Case 1: a 43-year-old woman developed subacute encephalopathy, which had not been diagnosed and had been evolving for 2 months, as well as left sensorineural hearing loss. The fundus exam found central artery branch occlusion in the left retina. The treatment was based on corticosteroids combined with cyclophosphamide and immunoglobulins. Angiographic monitoring revealed persistent asymptomatic arterial alterations despite positive neurological progression. Case 2: a 27-year-old woman presented visual loss in the right eye after recurrent neurological episodes. The triad was completed by deafness in the right ear. Treatment with corticosteroids led to favorable neurological progression and stabilized the ophthalmologic symptoms. DISCUSSION: This syndrome preferentially affects young women. The nearly constant neurological symptoms can differ. Branch occlusions are frequently bilateral and often come with the appearance of vasculitis. Deafness is bilateral, asymmetrical, and of endocochlear origin. Brain MRI shows lesions of the corpus callosum that are distinctive of the syndrome. The disease mainly evolves in a monocyclic way, self-limited in time, and it rarely becomes chronic. Treatment, which has not been codified to date, is based on corticosteroids and, in severe cases, immunosuppressive drugs. Other therapies have not proved to be effective. CONCLUSION: The diagnosis is based on the triad of neurological, ophthalmic, and ENT damage, but sometimes it can be difficult to formulate because of the chronology of symptom onset. Neurological damage, the first manifestation, will help make therapeutic decisions.

[PET-scan in orbital Malt lymphoma and its value in diagnosis and management: a series of four cases]. / Diversité clinique du lymphome de Malt orbitaire et intérêt du PET-scan. A propos de quatre cas.

INTRODUCTION: The orbital location of mucosa associated lymphoid tissue (Malt) lymphoma (ML) is rare and can appear in very different forms. Biopsy is decisive for diagnosis. Although the positron emission tomography (PET) scan is rarely used in ophthalmology, it appears useful in our experience. We report four cases illustrating the diversity of the orbital localization in ML. Case 1 is a 41-year-old woman presenting unilateral corticosteroid-resistant dacryoadenitis. The PET-scan clearly fixed at the orbit. After anatomopathologic confirmation, a 36-Gy orbital radiotherapy was carried out, leading to the clinical and tomographic remission. CASE REPORTS: Case 2 is a 61-year-old patient, presenting a small cell carcinoma of the lung, initially referred for unilateral exophthalmia. MRI highlighted a bilateral orbital infiltration, with a hot spot on the PET-scan. The clinical suspicion of orbital metastasis was not confirmed: the biopsy concluded in ML. Case 3 is a 64-year-old woman, referred for unilateral and resistant conjunctival hyperemia. Clinical diagnosis was myositis of the superior rectus muscle. The PET-scan did not fix in the orbit but revealed a pleural location. The muscular biopsy concluded once again in ML. Case 4 is a 68-year-old woman who had a history of sinusal ML. Diplopia with a second orbital location, non specific in CT but fixed in PET, was found. The biopsy concluded in ML with transformation toward an aggressive lymphoma. CONCLUSION: Although the lacrimal gland location is well-known, unspecific orbital infiltration and orbital myositis are less common, which highlights the value of a non invasive exploration before biopsy. The advantages of the PET scan in orbital ML has not been sufficiently studied. In our experience, it was useful in these four cases. Orbital ML can take on different aspects that are sometimes misleading. PET is very useful in diagnosis before the biopsy, in therapeutic decisions, and in follow-up after treatment even if it does not always fix in the orbit.

[Plateau iris-like configuration resulting from numerous iridociliary cysts]. / Syndrome d'iris plateau-like secondaire à une polykystose iridociliaire.

INTRODUCTION: The clinical diagnosis of plateau iris most often remains a suspected diagnosis in absence of complementary imaging tests. We report the case of a plateau-like iris configuration resulting from numerous iridociliary cysts and the diagnostic value of ultrasound biomicroscopy (UBM). OBSERVATION: A 35-year-old Caucasian woman with a family history of PAOG presented asymptomatic high intraocular pressure (IOP) (26mmHg RE, 17mmHg LE). She had a normal deep anterior chamber, a narrow iridocorneal angle with sectoral abnormal insertion of the iris and a normal fundus. Laser peripheral iridotomy was performed. One year later, the patient presented again with elevated IOP in the right eye (25mmHg); hypotensive monotherapy was prescribed. Later she reported eye pain in the evening. Gonioscopy found an iridocorneal contact covering more than 200 degrees in the right eye, with less extensive coverage in the left eye. The hypothesis of plateau iris-like syndrome was suggested because of the failure of the iridotomy and UBM was performed. This confirmed the diagnosis of plateau iris configuration secondary to numerous ciliary body cysts. DISCUSSION: UBM provides great diagnostic assistance, superior to anterior segment OCT in the diagnosis of plateau iris syndrome, particularly in imaging the ciliary body. CONCLUSION: The numerous iridociliary cysts can imitate iris plateau syndrome, which explains aggravation over time, depending on their formation. UBM is a highly valuable tool for the diagnosis and the follow-up of this pathology.

[Far-advanced otosclerosis]. / Surdités mixtes profondes par otospongiose.

OBJECTIVES: The aim of this study was to report a series of patients with far-advanced otosclerosis who were unable to benefit from hearing aids. Among patients with profound hearing loss, it is particularly useful to diagnose far-advanced otosclerosis even if relatively rare, because stapes surgery can improve hearing to a level allowing conventional hearing aid use (sometime the only choice before cochlear implant). MATERIAL AND METHODS: We retrospectively reviewed the charts of 7 patients (9 operated ears) in order to highlight diagnostic criteria, surgical indications and results of stapes surgery (stapedectomy or stapedotomy). RESULTS: Diagnosis of far-advanced otosclerosis was based on clinical presentation, course of hearing loss, positive family history of otosclerosis, and results of CT scan which was helpful in all the cases. Obliterative otosclerosis was found in 55% of the cases. Success of stapes surgery was observed in 89%, with no significant difference between stapedectomy or stapedotomy. CONCLUSION: Although rare, far-advanced otosclerosis must be diagnosed because patients can benefit from stapes surgery (and subsequently fitting of appropriate hearing aids).

Inhalation induction using sevoflurane in children: the single-breath vital capacity technique compared to the tidal volume technique*.

The single-breath vital capacity technique is suitable for inhalation induction of anaesthesia, using sevoflurane in children aged > 5 years. The purpose of this randomised trial was to compare the single breath vital capacity technique with the conventional tidal volume technique. Seventy- three ASA 1 or 2 children were instructed during the pre-operative visit in the vital capacity technique. The main criterion measured was time to loss of the eyelash reflex. Induction was performed using a circle-absorber breathing circuit primed with sevoflurane 7% in 50% nitrous oxide/oxygen with 6 l.min(-1) fresh gas flow. Time required for induction, haemodynamic changes, airway tolerance and side-effects were recorded. The children's opinion on the technique used was scored using a visual analogue scale (0-100) and a Smiley scale (0-10). The time to loss of the eyelash reflex was found to be reduced in the vital capacity group compared to the tidal volume group. The time to central myosis, to achieve bispectral index values 60 and 40, haemodynamic changes, respiratory events and side-effect incidences were similar in both groups. However, we found that the vital capacity technique was preferred by the children to the tidal volume technique.

Usefulness of delayed postcontrast magnetic resonance imaging in the detection of residual cholesteatoma after canal wall-up tympanoplasty.

OBJECTIVES/HYPOTHESIS: Imaging takes an increasing place in the follow-up of patients who have undergone surgery for cholesteatoma, with computed tomography (CT) as the first line imaging technique. However, in case of complete opacity of the tympanomastoid cavities, CT is not able to differentiate residual cholesteatoma from postoperative scar tissue. The aim of this study was to assess the usefulness of magnetic resonance imaging (MRI) using delayed postcontrast T1-weighted images for the detection of residual cholesteatoma after canal wall-up tympanoplasty (CWU) in cases where CT was not conclusive. STUDY DESIGN: Prospective study. METHODS: MRI, with delayed postcontrast T1-weighted images (30-45 minutes after contrast injection), was performed before revision surgery in 41 consecutive patients who had undergone CWU for cholesteatoma and presenting with a nonspecific complete opacity of the mastoid bowl on CT. In all the cases, imaging results were compared with operative findings at surgical revision. RESULTS: A residual cholesteatoma was found in 19 of 41 patients at revision surgery and was correctly detected on MRI in 17 patients. In the two remaining cases, cholesteatoma pearls smaller than 3 mm were not seen. There was no false-positive case. Statistics were as follows: sensitivity 90%; specificity 100%; positive predictive value 100%; negative predictive value 92%. CONCLUSION: When postoperative CT is not conclusive because of complete opacity of the tympanomastoid cavities, MRI with delayed postcontrast T1-weighted images is a reliable additional technique for the detection of a residual cholesteatoma when its diameter is at least 3 mm.

[Neuromuscular blockade monitoring at the corrugator supercilii and ocular myasthenia gravis]. / Myasthénie oculaire et monitorage de la curarisation au muscle sourcilier.

A 67-year-old patient suffering from an ocular myasthenia gravis was scheduled for an elective ENT surgery. General anaesthesia was induced intravenously. Neuromuscular responses after train-of-four stimulation were normal at both the adductor pollicis (T(4)/T(1) = 1) and the corrugator supercilii (4 visual responses). Then cisatracurium (0,15 mg kg(-1)) was administered to allow tracheal intubation. The laryngoscopy attempted 45 s after cisatracurium injection (no response at the supercilii, T(1)/T(0) = 1 at the adductor pollicis) was unsuccessful because of closing and moving vocal cords. The second attempt was successful 4 min after cisatracurium injection (no response at the corrugator supercilii, T(1)/T(0) = 0.05 at the adductor pollicis). Residual neuromuscular blockade was antagonized at the end of surgery (1 h long) allowing an uneventful extubation. We concluded that monitoring neuromuscular blockade at the corrugator supercilii to assess the intubating conditions is not recommended in a case of ocular myasthenia gravis.

Influence of medical speciality and experience on interpretation of helicoidal thoracic computed tomography in blunt chest trauma.

OBJECTIVE: To compare the quality of interpretation of chest helicoidal computed tomography (HCT) by physicians with different levels of experience and medical specialty. DESIGN: Prospective observational study. SETTING: Trauma critical care unit at a French university hospital (US equivalent: level 1). PATIENTS: HCT of 50 consecutive patients with blunt chest trauma were assessed by four groups of physicians [residents in anaesthesiology (n=5), residents in radiology (n=5), senior anaesthesiologists (n=5), and senior radiologists (n=5)]. Interpretation from each physician was compared with a grid obtained from an expert interpretation by a senior radiologist and a senior anaesthesiologist. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: No group of observers performed better than another in their interpretation of lung and parietal injuries on HCT. In contrast, senior radiologists were better than anaesthesiologists for the diagnosis of pneumomediastin. However, residents in radiology performed better than other physicians in detecting the presence of gastric and tracheal tubes. CONCLUSIONS: Compared with anaesthesiologists, senior radiologists seem more expert in the diagnosis of HCT mediastinal injuries whereas residents in radiology were better at detecting resuscitation materials in thoracic trauma patients. This article reinforces the usefulness of the interpretation of the HCT by a senior radiologist in the case of blunt chest trauma. This also reinforces the usefulness of an aspect team of radiologists and anaesthesiologists in the case of trauma. The logical usefulness of a systematic interpretation of the images should be borne in mind.

[Analysis of chest radiographs of patients with thoracic trauma is not influenced by a grid nor by the experience of the reader]. / L'analyse du cliché thoracique chez le traumatisé n'est améliorée ni par une grille de lecture ni par l'expérience du lecteur.

OBJECTIVE: To evaluate the interest of a grid and the experience of the interpreter to interpretate the chest radiographs (CRs) of patients with thoracic trauma, the reference is the helicoidal computed tomography (HCT). STUDY DESIGN: Prospective observational study. MATERIAL: CRs and HCT of 50 thorax trauma patients. METHOD: CRs were analysed without a grid (L) and results were compared with those obtained in an anterior study with a grid (G). The interpreter were residents in anaesthesiology (DESAR; G: n = 6/L: n = 4), residents in radiology (DESR; G: n = 3/L: n = 5), senior anaesthesiologists (MAR; G: n = 5/L: n = 4), and senior radiologists (MR; G: n = 3/L: n = 5). The reference was the HCT. The lectors were compared. RESULTS: The interpretation of the CRs was neither influenced by the experience and the specialty of the lector nor by the use of a grid. Perhaps the formation is sufficient for the anaesthesiologists to evaluate the essential lesions in the trauma patient and treat them.