Repair of the dorsal capsuloligamentous scapholunate septum during arthroscopic resection of painful dorsal wrist ganglion cyst: Comparative analysis of two techniques.

We compared arthroscopic cyst resection (ACR) of dorsal ganglia of the wrist, either associated to reconstruction of the dorsal capsuloligamentous scapholunate septum (ACR-DCSS) in 66 cases in which the ganglia were painful on exertion, or isolated ACR in 15 pain-free cases. A single-center retrospective study analyzed data for the period April 2013 to May 2021. The main aim was to compare pre- and post-operative functional results (pain at rest (on a numerical rating scale: NRS), pain under effort (NRS), range of motion (°), grip strength (kg)) and recurrence rate between the two techniques. The study hypothesis was that DCSS repair improves recurrence of dorsal ganglion cyst and functional outcome. The ACR-DCSS group showed significant improvement in extension, pronation, supination, radial inclination, ulnar inclination, grip strength, pain at rest and pain on exertion. The ACR group showed significant improvement in pronation, ulnar inclination and pain on exertion. There was a significant difference in recurrence rate, in favor of ACR-DCSS. Recovery was also significantly better for the ACR-DCSS group in terms of extension, supination and pain at rest. Arthroscopic treatment of wrist ganglion cyst is a reliable, minimally invasive and reproducible technique that produces good results in terms of pain and recovery of range of motion, with significantly lower recurrence rate in case of DCSS repair. Level of evidence: Therapeutic III.

Impact of the COVID-19 outbreak on the reporting of adverse drug reactions associated with self-medication.

OBJECTIVES: The primary objective of the present study was to describe the characteristics of adverse drug reactions (ADRs) linked to self-medication that were notified to the French Pharmacovigilance Database (FPVD) during the COVID-19 outbreak in 2020 first wave. The secondary objective was to compare the characteristics of these ADRs in 2020 with those notified during the same calendar period a year previously. MATERIAL AND METHODS: We analyzed ADRs recorded in the FPVD between March 15th and May 31st, 2020 vs. the same dates in 2019. Only ADRs linked to self-medication were analyzed. Descriptive statistics were used to obtain an overview of the types and characteristics of these ADRs. RESULTS: Of 3114 ADRs notified to the FPVD during the COVID-19 period in 2020, 114 (3.7%) were linked to self-medication. The equivalent proportion in 2019 was 1.6% (113 out of 7097). Half of the ADRs notified in 2020 were "serious". The median age of affected patients was 30.5, and 22% of the ADRs concerned children. Of the 114 ADRs linked to self-medication, 107 (66%) were for prescription-only drugs. The three mostly frequently suspected ATC classes were analgesics, psycholeptics, and antibacterials for systemic use. The most frequent ADRs were general disorders, gastrointestinal disorders, and nervous system disorders. The main difference between the non-COVID-19 period and the COVID-19 period was the higher proportion of medication errors during the latter. CONCLUSION: The present study is the first to have reported on ADRs linked to self-medication and notified during a COVID-19 outbreak. Further studies of self-medication patterns and their consequences in a pandemic context are mandatory and effective information on medication use (including self-medication and its dangers) during a pandemic is essential.

[Telemedicine for prostate cancer during long-term radiotherapy follow-up: An opportunity for digital innovation in oncology]. / La téléconsultation pour le suivi après radiothérapie du cancer de la prostate : une place à l'innovation numérique en cancérologie.

PURPOSE: The annual follow-up in radiotherapy for prostate cancer consists of an oral interview with a radiation oncologist. The present study aimed at surveying the target population on their knowledge and perceptions of telemedicine. MATERIALS AND METHODS: A prospective study was conducted at the Lucien Neuwirth Cancer Institute (France) that included patients with prostate cancer undergoing treatment or in follow-up, during spring 2019 (n=158). A specific questionnaire was designed for the study. Patient's self-evaluation of satisfaction and enthusiasm was assessed through visual analog scale (VAS) (0/10 to 10/10). RESULTS: One hundred and fifty-eight patients completed the survey. The vast majority of the population commonly used phone for communication and 56% of patients owned internet connexion. Around 56% of patients declared telemedicine knowledge without having ever experienced telemedicine. If 60.8% of patients would not be against telemedicine with a median enthusiasm VAS of 6/10, patients' opinions were divergent: 48.7% of patients would like to keep a classical follow-up and 48.7% of patients would envision to alternate classical consultation with telemedicine. CONCLUSION: This feasibility study with an aged cohort showed that telemedicine is a valuable option for long-term radiotherapy follow-up, even if therapeutic education and information will be necessary to supervise this novel approach.

A comparison between the effects of ochratoxin A and aristolochic acid on the inflammation and oxidative stress in the liver and kidney of weanling piglets.

Ochratoxin A (OTA) and aristolochic acid (AA) are toxins that can frequently contaminate cereals and cereals-based products. The present study has realized a comparison between the effect of OTA and AA on oxidative stress and inflammation in both the liver and kidney of pigs as major organs involved in the metabolism of xenobiotics. Fifteen pigs (five pigs/group) were randomly distributed in three groups (control, OTA, and AA) and were fed diets contaminated or not with 250 µg toxin/kg for 28 days. Consumption of a diet contaminated with OTA and AA increase the concentration of serum creatinine as compared with the control group. The exposure of piglets to AA decrease the activity of enzymes involved in the oxidative stress response: catalase (CAT), superoxide dismutase (SOD), and glutathione peroxydase (GPx) in the liver and kidney while OTA decrease only GPx activity and only in the kidney. The consumption of the diets contaminated with AA increase in the liver the synthesis of tumor necrosis factor (TNF) alpha, interferon (IFN) gamma, Interleukin (IL)-1 beta, IL-6, and IL-8 synthesis, while IL-4 was increase by OTA and decreased by AA. In the kidney, AA increase the TNF alpha and IFN gamma synthesis as compared with the control. In conclusion, our results have shown that beside the alteration of serum markers, much known indicators for nephropathy, OTA and AA can induce inflammation and oxidative stress. In conclusion, the inflammatory effects were more pronounced for AA and at the liver level, while oxidative stress was induced both in the liver and kidney.

Assessment of the effect of grape seed cake inclusion in the diet of healthy fattening-finishing pigs.

Modulatory capacity of bioactive compounds from different wastes has been scarcely investigated in pigs. This study aimed to evaluate the effects of dietary inclusion of grape seed cakes (GS diet) on performance and plasma biochemistry parameters as health indicators, as well as on several markers related to inflammation and antioxidant defence in the liver of fattening-finishing pigs. Twelve cross-bred pigs (TOPIG) were randomly assigned to one of two experimental diets: control and 5% grape seed cake diet during finishing period (24 days). No effect of GS diet on pig performance and blood biochemistry was observed. However, GS diet decreased significantly (-9.05%, p < .05) the cholesterol concentration (85.71 ± 0.94 mg/dl vs 94.24 ± 2.16 mg/dl) and increased IgA level (+49.90%, p < .05) in plasma (5.04 ± 0.5 mg/ml vs 3.36 ± 0.7 mg/ml). GS cakes decreased the inflammatory response in the liver of pigs fed with GS diet by lowering the Gene expression and protein concentration of pro-inflammatory cytokines (IL-1ß, IL-8, TNF-α and IFN-γ) as well as the mRNA abundances of NF-κB signalling molecules. The antioxidant status was not increased by GS diet. The gene expression and activity of catalase decreased significantly. The gene expression of Nrf2, superoxide dismutase, glutathione peroxidase and heat-shock protein decreased, and no effect on their activity was observed with the exception of catalase activity which decreased. However, TBARS was reduced significantly. GS diet showed a modulatory effect on antioxidative status as well as anti-inflammatory and hypocholesterolic properties without effect on pig performance.

Spasticity and hyperselective neurectomy in the upper limb.

Spasticity is a complex pathology, both in terms of assessment and treatment. This article focuses on the clinical examination (objective, capacity, performance and function), which is key for choosing a treatment and can be helped by botulinum toxin injections. The treatment involves physical therapy, occupational therapy, medications and surgery. Neurectomy has been used in the upper limb since 1912 and is one of the therapeutic options for spasticity. This treatment is usually reserved for nonfunctional hands. Cadaver studies have helped us better understand nerve anatomy and improve the hyperselective neurectomy (HSN) technique. This article describes the history of neurectomy, how anatomical dissections apply to surgery, the HSN technique in the musculocutaneous nerve, median nerve and ulnar nerve and results of preliminary prospective studies. Spasticity, mobility, performance and function were evaluated a few months after HSN and about 12 months later to assess the permanence of the results in children and adult spastic patients. No matter the nerve or function targeted (elbow extension, wrist extension, or supination), spasticity was reduced with improvements in the functional House score and appeared stable at the last follow-up. HSN seems to be a good, reliable therapeutic option for spasticity, including functional hands.

An observational study of driving distractions on urban roads in Spain.

The present research investigated the prevalence of driver engagement in secondary tasks and whether there were any differences by age and gender, as well as day of the week and time of the day. Two independent researchers observed 6578 drivers at nine randomly selected urban locations in Girona, Spain. Nearly 20% of the drivers observed were engaged in some type of secondary task, with the most common being: conversing with a passenger (11.1%), smoking (3.7%) and talking on a handheld mobile phone (1.3%). Surprisingly there were no differences by gender, but there were age-related differences with younger drivers being more frequently observed engaged in a number of different types of secondary tasks while driving (i.e. drinking, talking on a handheld mobile phone, and texting or keying numbers). Logistic regression showed that younger drivers, and to a lesser extent middle-age drivers, were significantly more likely to be observed engaged in a technological distraction than older drivers. Conversely, non-technological distractions were significantly predicted by day of the week, time of the day and location. A substantial number of the drivers observed in this study were putting themselves at an increased risk of becoming involved in a crash by engaging in non-driving related tasks at the same time as driving. Furthermore, the higher crash rate among young drivers may be partially accounted for by their more frequent engagement in some types of secondary tasks while driving.

Burnout and quality of life among Spanish healthcare personnel.

The purpose of this study was to analyse the relationship between perceived quality of life and levels of burnout among healthcare personnel. A sample of 1095 participants (nurses, physicians, nursing assistants and orderlies) from five hospitals in the province of Girona (Spain) were studied (78% women, mean age=36.6 years, SD=8.8) using the 36-item short-form health questionnaire (SF-36) and the Maslach Burnout Inventory. The results showed that health-related quality of life reported by this sample of healthcare personnel was lower than the reference population values, especially in those SF-36 dimensions that comprise the mental component. In comparing the dimensions of the SF-36 by profession, we found that physicians had better perceived health in the dimensions of the physical component than nurses and other professionals (P< 0.01). No statistical differences were observed between profession and the dimensions of the mental component (P>0.05). Moreover, perceived health was worse among those that reported a high level on any of the components of burnout. These results should be taken account when designing a burnout prevention programme in the workplace.

Stages of change and decisional balance for condom use with a romantic partner.

This article examines the relationship between decisional balance and stages of change for consistent condom use with a current romantic heterosexual partner. The sample consisted of 619 undergraduate students (35.1% males; mean of age = 20.31). The results show that the pros and cons of using condoms were significantly related to the stages of change for condom use, but that the pros were more strongly related. Therefore, campaigns for preventing the transmission of the HIV virus and other sexually transmitted diseases should attempt to maximize the perceived advantages of condom use, rather than refuting the cons.

Mechanisms governing the responses to anthracnose pathogen in Juglans spp.

Juglans nigra and Juglans regia are two highly economically important species for wood and fruit production that are susceptible to anthracnose caused by Gnomonia leptostyla. The identification of genotypes resistant to anthracnose could represent a valid alternative to agronomic and chemical management. In this study, we analyzed 72 walnut genotypes that showed a variety of resistance phenotypes in response to natural infection. According to the disease severity rating and microsatellite fingerprinting analysis, these genotypes were divided into three main groups: (40) J. nigra resistant, (1) J. nigra susceptible, and (31) J. regia susceptible. Data on leaf emergence rates and analysis of in vivo pathogenicity indicated that the incidence of anthracnose disease in the field might be partially conditioned by two key factors: the age and/or availability of susceptible leaves during the primary infection of fungus (avoidance by late flushing) and partial host resistance. NBS profiling approach, based on PCR amplification with an adapter primer for an adapter matching a restriction enzyme site and a degenerate primer targeting the conserved motifs present in the NBS domain of NBS-LRR genes, was applied. The results revealed the presence of a candidate marker that correlated to a reduction in anthracnose incidence in 72 walnut genotypes.

Perceived acceptance of condom use by partners, close friends, and parents of Spanish and Mozambican heterosexual adolescents.

PURPOSE: The main aim of the current study was to compare Spanish and Mozambican male and female secondary students, with regard to sexual behaviors and perceptions surrounding the acceptance of condom use. METHOD: The participants were 773 secondary students-412 from Spain and 361 from Mozambique, aged from 15 to 17 years old. Data collection was done using questionnaires. Analysis was carried out using multivariate methods. RESULTS: Spanish adolescents took more precautions than Mozambican adolescents. Furthermore, Spanish adolescents perceived that the acceptance of condom use by their referents were higher than those reported by the Mozambican adolescents. Among Spanish youths, only the perceived acceptance of their current partner predicted condom use in their most recent sexual encounter. DISCUSSION: Differences in the decision-making power of males and females and the type of partner might explain the differences observed in the preventive behavior of the students in both countries.

Vascularized bone graft pedicled on the volar carpal artery from the volar distal radius as primary procedure for scaphoid non-union.

INTRODUCTION: The treatment of scaphoid non-union with non-vascularized bone graft leads to non-union in 10 to 20% of cases and up to 50% in case of proximal pole necrosis. Vascularized bone graft improves consolidation rates, but is generally restricted to secondary scaphoid non-union. HYPOTHESIS: This study assessed the value of a primary vascularized bone graft pedicled on the transverse volar carpal artery from the volar aspect of the distal radius as donor site. PATIENTS AND METHODS: This retrospective study included 111 cases of vascularized bone graft for scaphoid non-union as primary procedure in 73 cases and secondarily in 38. The procedures were performed through a single incision. RESULTS: Mean delay before surgery was 25.5 and 33 months respectively, with union rates of 96% and 89.5%. Results showed improvement in both groups, but were better in primary surgery in terms of range of motion, strength, pain, function, satisfaction and return to work. There were more complications with secondary surgery. DISCUSSION: All reports agree that union is better with vascularized bone graft. This technique performed as a day of admission surgery through a single incision under locoregional anesthesia seems feasible as a primary intervention.

The pedestrian behaviour of Spanish adolescents.

Adolescent pedestrians are a particularly vulnerable group of road users. This research tested the applicability of the recently developed Adolescent Road user Behaviour Questionnaire (ARBQ) amongst a sample of 2006 Spanish adolescents. Confirmatory Factor Analysis of the full scale found that the original three factors did not adequately fit the data, but an acceptable fit was obtained for the shortened 21-item version of the scale. In line with research from the UK, the present study found that males reported more unsafe road crossing behaviour and playing on the roads, but there was no gender difference for engaging in planned protective behaviour. This research also confirmed that unsafe road crossing behaviour increased with age, while dangerous playing on the road and planned protective behaviours both decreased with age. The present study also confirmed that the ARBQ is a useful tool for investigating the safety-related behaviour of adolescents on the road.

[Vascularized bone grafting from the volar distal radius for carpal bones reconstruction]. / Le transfert osseux vascularisé prélevé sur la face antérieure du radius dans la reconstruction des os du carpe.

We report the use of vascularized bone graft harvested from the volar aspect of distal radius for carpal bone reconstruction. This transplant is known and used since 1965, but the technical description of reliable harvesting more recent is presented. The anatomical dissection of 30 corpses found in a constant way the presence of the transverse carpal artery which born from radial artery. This vascularized bone graft was used for the treatment of 112 scaphoid nonunion with an average follow-up of 27.82 months (10-107). Union was obtained in 95.54% of the cases with an average of 6.7 weeks (6-9). We report also the result of this vascularized bone graft for the revascularization of the lunatum in 22 patients with Kienböck's disease with an average follow-up of 74 months (60-124). The postoperative MRI control with a minimum of 8 months showed 17 healing, three stabilizations of lesions and two failures requiring a secondary palliative surgery. The use of a vascularized transplant harvested from the volar aspect of distal radius is now a well codified, meticulous but reliable and sure technique, which requires a single approach for the reconstruction of some carpal bones (scaphoid, lunatum) allowing a locoregional anesthesia and an outpatient basis.

[Is muscle the best coverage for leg Gustilo IIIb fractures? A retrospective comparative study]. / Le muscle est-il la meilleure couverture pour les fractures ouvertes de jambe Gustillo IIIb ? Etude rétrospective comparative.

UNLABELLED: Well-vascularized muscle flaps have been the traditional gold standard for coverage of open fracture of the lower extremity. The last 15 years have brought the fasciocutaneous and perforator flaps and raised the issue of the type of coverage required for open fracture of the lower extremity. In recent years, in selected compromised patient, we have been using nonmuscular flaps for reconstruction. The goal of this study is to compare the results of fasciocutaneous reconstruction to those of classical muscular flaps. PATIENTS AND METHODS: A comparative retrospective study, including all patients from 2002 to 2006 requiring a coverage of a Gustillo III b fracture of the lower extremity, is done. The type of flaps, the fracture localization, the infection rate, the time required for consolidation of the fracture and the complication rate are reviewed. An independent university laboratory verified the statistical analysis. RESULTS: Twenty patients have experienced coverage by muscular flaps and 18 by fasciocutaneous flaps. We found a skin fistula and a chronic infection in the muscular-flap group, and two skin fistulae in the fasciocutaneous flaps group. The overall surgical results were comparable, except the bony union delay shorter in the fasciocutaneous flaps group. CONCLUSION: Muscle coverage is not mandatory to cover bone in the lower leg. The fasciocutaneous flaps can provide a good alternative for muscle-flap coverage. There is no significant difference as far as consolidation and infection are concerned, between the coverage by muscular or fasciocutaneous flaps.

[The metabolic syndrome: marker of cardiovascular risk in hypertensive patients? The importance of definition]. / Le Syndrome métabolique: marqueur de risque chez l'hypertendu? Importance de la définition utilisée.

INTRODUCTION: Metabolic syndrome (MetS) was defined by association of abdominal obesity, hypertension, glucose intolerance and/or dyslipidemia. The objective of this study was to compare the new International Diabetes Federation (IDF) definition and the National Cholesterol Education Program Adult Treatment Panel III (NCEP) definition and their association with cardio-vascular disease in hypertensive patients. POPULATION AND METHOD: Two hundred and thirty hypertensive patients were hospitalized successively for cardio-vascular disease exploration and hs-CRP measurement. The stratification of cardio-vascular risk was made according to the French recommendations. The IDF definition and the NCEP definition were compared according frequency of resistant hypertension and cardio-vascular disease extension. RESULTS: In our study, high cardio-vascular risk hypertension represented 68.5% of patients. Diabetes was present in 23.5% of them and obesity in 45.5%. Patients with cardio-vascular disease represented 60% of our study population. Prevalence of MetS was 38.5% according to the NCEP definition and 59% according to the IDF definition. The NCEP definition was allowed to select subjects with widespread vascular disease and resistant hypertension whereas the IDF definition did not. These results could be explained by lower waist circumference and glycaemia cuts offs according to the IDF criteria. When diabetic's patients were excluded, MetS was not associated with increase of resistant hypertension frequency. Moreover, hs-CRP was independently associated to the extension of the cardiovascular disease and smoking remained the most powerfully factor associated to the cardio-vascular disease extension. CONCLUSION: In hypertensive patients, the NCEP definition seems more adapted to the diagnosis of MetS than the IDF one. Abdominal obesity could be the indispensable element to the MetS diagnosis but according to the NCEP waist circumference cut off. The use of this syndrome seems to be relevant to select the patients presenting an intermediate cardio-vascular risk in order to adapt treatment.

Mobile phone use while driving in a sample of Spanish university workers.

A number of epidemiological studies have reported drivers who use a mobile phone while driving have an elevated risk of being involved in a crash. This is particularly concerning as a survey of drivers in the Spanish region of Catalunya found that approximately 87% own mobile phones. The present study investigated the reported frequency of mobile phone use on Spanish roads (for talking and using SMS), the characteristics of the drivers who use mobile phones while driving and whether they altered their driving behaviour when using a mobile phone. The research found that more than 60% use a mobile phone while driving and that the phone is mostly used for making calls, rather than using SMS. In general, males and females use mobile phones about the same reported frequency, although males were more likely to use a mobile phone to talk on the highway. The pattern for age was the same for both male and female participants, with the younger drivers using SMS more frequently than older drivers. On urban roads almost half of the drivers reported changing their driving behaviour when using a mobile phone, while on the highway this figure was slightly over 41%. The reported frequency of using a mobile phone to talk on urban roads was significantly correlated with crash involvement. However, this affect disappeared once the contributions of the demographic and descriptive variables had been partialled out.

Motivation for change and the pros and cons of smoking in a Spanish population.

Decisional balance and the stage of change have been used to understand the motivation for giving up the habit of smoking. The objective of this study was to find out whether the associations between the pros and the cons of smoking, taking into account the magnitude and delay parameters, and stages of change, can be demonstrated in a sample of Spanish smokers and ex-smokers using a cross-sectional design. The results are compared with the patterns of pros and cons of smoking found in samples of American, Swiss and Dutch smokers. The data confirms that amongst Spanish smokers it is also in the stages of contemplation and preparation that the crossover in the valuation of the pros and cons of smoking takes place: the cons hold more weight than the pros. On the other hand, unexpectedly, the pros of smoking are more highly valued in the stages of action and maintenance than in the rest of the stages.

Quantification and kinetics of the residual brine generation during ham and shoulder pile salting.

Salting is one of the most important stages of the traditional process of cured ham manufacturing. During pile salting a saturated brine is formed and drips through the orifices located at the bottom of the salting containers. The objective of the present work was to quantify the released brine in the ham manufacturing industry in Spain and to relate the brine generation with the salt gained by hams in the process. The total released brine during ham and shoulder salting in Spain was determined theoretically and from the experimental values obtained from the industry (around 38,000 metric tons in 2002). In addition to that, an easy method for the estimation of the NaCl gained by hams and shoulders was developed by using the measurements of the released brine (the estimated NaCl gained differed 3.5% from the experimental data).