["VigilanSeu.r.se": A new profession?] / « VigilanSeu.r.se ¼ : un nouveau métier ?

In January 2015, in accordance with decades of scientific work based on maintaining contact, was born an innovative device for suicide prevention: VigilanS. To ensure this link, the choice was made to build a team with an equal number of nurses and psychologists, all located within the medical regulation. Nowadays, they are named "VigilanSeur": an original entity that highlights the emergence of this new profession, at the crossroads of several disciplines.

Medial patellofemoral ligament reconstruction for patellar instability following total knee arthroplasty: A review of 6 cases.

INTRODUCTION: Patellar instability is a frequent cause of total knee arthroplasty (TKA) failure. In cases of post-arthroplasty patellar instability, the medial structures may be damaged. The objective of this study was to study the effectiveness of medial patellofemoral ligament (MPFL) reconstruction. We hypothesized that MPFL reconstruction will effectively realign the patella, making it a viable treatment option for managing post-arthroplasty patellar instability. MATERIAL AND METHODS: In this retrospective study of six patients treated by four different surgeons, patients were included if they had a recurring or permanent patellar dislocation after undergoing TKA. Patients were excluded if the patellar instability was painful but did not result in dislocation. Each patient underwent MPFL reconstruction using the gracilis; additional procedures could be performed depending on the diagnosis. One patient required TKA revision because of an abnormally rotated femoral implant. The main outcome measure was the non-recurrence of the dislocation. The IKDC and Kujala functional scores, joint range of motion and patellar tilt on X-rays were analyzed preoperatively and at the last follow-up. RESULTS: At a mean follow-up of 23 months (6-46), none of the patients experienced a recurrence of the patellar dislocation. Only one patient had no improvements in the functional outcome scores. The patellar tilt was reduced in all patients. CONCLUSION: MPFL reconstruction-in isolation or with femoral component revision-is effective at treating post-arthroplasty patellar instability. It has its place in the treatment of patellar dislocation following TKA and its indications must be based on exact analysis of the reasons for the instability. LEVEL OF EVIDENCE: IV - Retrospective cohort study.

Comparative chemical analyses of drug samples: general approach and application to heroin.

The methodology used for the comparative chemical analyses of illicit drug seizures, and its application to a heroin comparison case, is described. The illicit drug sample is subjected to a three-step procedure. The first is the qualitative and quantitative analysis of each sample, i.e. identification and quantitation of major and minor constituents. The second is the analysis of trace level impurities contained in each sample, after isolation from the drug matrix. The last step is the isotopic analysis of each sample, i.e. the determination of the isotopic enrichment of the major constituents. That analytical procedure, applied to heroin, allowed the determination of common batch samples with a high degree of certainty.

[Radionuclide inferior vena cavography and iliac venography (author's transl)]. / Aspects scintigraphiques des thromboses ilio-caves.

Method of detection entirely harmless, the vena cava and iliac phlebography informs us about the degree and the lower level of a venous obstruction. This accuracy as to diagnosis is dependent on a dual imaging requiring the use of a gamma camera connected to a data processing system.

[Investigation of the thrombo-embolic disease by simultaneous lung scintigraphy and lower limb gamma-phlebography (author's transl)]. / Maladie thrombo-embolique. Etude par gamma-phlébographie des membres inférieurs et scintigraphie pulmonaire simultanée.

A venous thrombosis in the territory of the inferior vena cava and a possible embolus of the lung can be detected in one single examination by injecting 99 m Tc microagregates into a dorsal blood flow by this method, which associates radionuclide phlebography of the lower limbs and lung scanning, was carried out 140 times in 127 patients and resulted in the detection of 107 cases obliged us to investigate only one limb, gamma-phlebography appears to be a harmless procedure well suited to the study of the thrombo-embolic disease.

[Recent myocardial infarction. Study of sinus function]. / Infarctus du myocarde récent. Etude de la fonction sinusale.

The ECGs of 70 consecutive patients hospitalised for a first transmural myocardial infarction (MI) (28 anterior, 42 posterior) were analysed prospectively and systematically during the acute phase. Endocavitary electrophysiological studies (EEP) were performed on the 21st day. The following conclusions were drawn: --Sinus bradycardia in the acute phase was observed in 18 cases (26 p. 100). Its cause is uncertain and its occurrence has no relation to the site of infarction. The single case of sinoatrial block (SAB) was recorded in a patient with a posterior MI. --EEP were normal in 18 patients who had sinus bradycardia during the acute phase; EEP was clearly pathological in the case with SAB. --There was no statistical difference in the incidence of pathological EEPs (p greater than 0,05) in anterior (4 out of 28 patients) and posterior (5 out of 42 patients) MI.

[Prostatic carcinoma: metabolic effect of percutaneous beta-estradiol (author's transl)]. / Cancer de la prostate: effets métaboliques des bêta-estradiol par voie percutanée.

Twenty one patients suffering from carcinoma of the prostate, confirmed histologically and previously untreated, received treatment in the form of 17 beta-estradiol administered percutaneously. At a dose of 6 mg of estradiol per day, testosterone levels fell to a mean of 1 ng/ml. No change in lipids, lipoproteins nor cholinesterase were detected.

[Paroxysmal junctional tachycardia with simultaneous supra-nodal and infra-nodal 2/1 block]. / Tachycardie jonctionelle paroxystique avec bloc 2/1 simultané supra et infra-nodal.

It is rare to find 2:1 second degree block in paroxysmal junctional tachycardia. In the case described, atrial stimulation at 200/mn during supra-ventricular tachycardia triggered off simultaneous atrio-ventricular and ventriculo-atrial block. This unusual occurrence was very useful because it localised the re-entry circuit to the junctional region by excluding possible accessory pathways.