[Drug-induced acute angle closure glaucoma]. / Quels sont les médicaments à risque de précipiter un glaucome aigu par fermeture de l'angle ?

Acute angle closure glaucoma is an ophthalmic emergency that can lead to blindness in some cases. The presenting signs are often suggestive, like ocular pain and blurred vision accompanied by headache, nausea and vomiting. These symptoms must be recognized as soon as possible, and the patient must be addressed, urgently, to an ophthalmologist for treatment. Many drugs may lead to an acute angle closure glaucoma in patients with risk factors. This article aims to remind the anatomical risk factors as well as the drugs that may induce an acute angle closure glaucoma. For a better understanding, this article will provide a brief reminder of the pathophysiological mechanism of acute angle closure glaucoma.

Le glaucome aigu par fermeture de l'angle, appelé communément crise de glaucome, est une urgence ophtalmologique pouvant potentiellement conduire à la cécité. Les symptômes sont assez bruyants, les manifestations les plus fréquentes sont une douleur oculaire et une vision floue accompagnées de céphalées, de nausées et de vomissements. Ces symptômes doivent être reconnus le plus rapidement possible afin de référer le patient chez un ophtalmologue pour une prise en charge urgente. Plusieurs médicaments peuvent précipiter la survenue d'une crise chez un patient prédisposé. Il convient donc de rappeler les facteurs de risque anatomiques ainsi que les médicaments pouvant précipiter un glaucome aigu par fermeture de l'angle. Pour une meilleure compréhension, cet article fait un rappel succinct des mécanismes physiopathologiques impliqués dans la survenue d'un glaucome aigu par fermeture de l'angle.

Direct oral anticoagulants in the treatment of acute venous thromboembolism in patients with obesity: A systematic review with meta-analysis.

BACKGROUND: Direct oral anticoagulants' (DOAC) pharmacokinetics are affected by obesity. Their efficacy and safety in obesity (BMI≥30 kg/m2) and morbid obesity (BMI≥40 kg/m2) are still unclear in the treatment of venous thromboembolism (VTE). OBJECTIVES: To compare the efficacy/safety of DOAC versus vitamin K antagonist (VKA)/low molecular weight heparin (LMWH) for the treatment of VTE in patients with obesity and morbid obesity. The primary efficacy/safety outcomes were VTE recurrence and major bleeding (MB). Clinically relevant non-MB and mortality were also evaluated. METHODS: A systematic literature search (MEDLINE, EMBASE, CENTRAL, Web of Science) identified studies evaluating DOAC in the treatment of VTE in patients with obesity and reporting one of the outcomes. Relative risks (RR) and 95 % confidence intervals (CI) were estimated using the Mantel-Haenszel method. RESULTS: We included 21 studies (50,360pts) of which 16,150 patients had a BMI≥30 kg/m2 and 6443 patients had a BMI≥40 kg/m2. VTE recurrence was similar with DOAC compared to VKA/LMWH in patients with obesity (RR 1.03;95 %CI 0.93-1.15;p = 0.55) and morbid obesity (RR 1.06;95 %CI 0.94-1.19;p = 0.35). DOAC were also associated with a reduction in MB (RR 0.57;95 %CI 0.34-0.94;p = 0.03 and RR 0.71;95 %CI 0.50-1.00;p = 0.05 in patients with obesity and morbid obesity, respectively). Subgroup analyses comparing randomized controlled trials to observational studies showed consistent results. No difference was observed in regards of clinically relevant non-MB and mortality. CONCLUSION: There is no signal for differences in VTE recurrence in patients with obesity and morbid obesity treated with DOAC compared to VKA/LMWH, while DOAC likely reduce the risk of MB compared to VKA/LMWH.

[Congenital ocular melanocytosis]. / L'image du mois. Mélanocytose oculaire congénitale.

Congenital oculodermal melanocytosis represents a unilateral accumulation of melanocytes in the episclera, sclera and uveal tract. Clinically, it manifests with iris heterochromia, episcleral and scleral pigmented patches, dark pigmentation of the trabecular meshwork and the fundus. This congenital disorder is a predisposing factor for uveal melanoma and chronic glaucoma. We report here the case of a Caucasian woman who presents some of these characteristics.

La mélanocytose oculaire congénitale représente une accumulation unilatérale de mélanocytes au niveau de la sclère, l'épisclère et l'uvée. D'un point de vue clinique, on peut retrouver une hétérochromie irienne, une pigmentation de l'épisclère, de la sclère, du trabéculum et du fond d'œil. Un risque majoré de mélanome uvéal et de glaucome chronique est retrouvé chez ces patients. Nous rapportons ici le cas d'une jeune patiente caucasienne qui présente certaines de ces caractéristiques cliniques de façon tout à fait asymptomatique.

Post-remission therapy of adults aged 60 and older with acute myeloid leukemia in first complete remission: role of treatment intensity on the outcome.

Although complete remission (CR) is achieved in 50 to 70% of older fit patients with acute myeloid leukemia (AML), consolidation therapy in this age group remains challenging. In this retrospective study, we aimed to compare outcome in elderly patients treated with different post-remission modalities, including allogenic and autologous hematopoietic stem cell transplantation (HSCT), intensive chemotherapy, and standard-dose chemotherapy (repeated 1 + 5 regimen). We collected data of 441 patients ≥ 60 years in first CR from a single institution. Median age was 67 years. Sixty-one (14%) patients received allo-HSCT, 51 (12%) auto-HSCT, 70 (16%) intensive chemotherapy with intermediate- or high-dose cytarabine (I/HDAC), and 190 (43%) 1 + 5 regimen. Median follow-up was 6.5 years. In multivariate analysis, allo-HSCT, cytogenetics, and PS had a significant impact on OS and LFS. In spite of a more favorable-risk profile, the patients who received I/HDAC had no significantly better LFS as compared with patients treated with 1 + 5 (median LFS 8.8 months vs 10.6 months, p = 0.96). In transplanted patients, median LFS was 13.3 months for auto-HSCT and 25.8 months for allo-HSCT. Pre-transplant chemotherapy with I/HDAC had no effect on the outcome. Toxicity was significantly increased for both transplanted and non-transplanted patients treated with I/HDAC, with more units of blood and platelet transfusion and more time spent in hospitalization, but no higher non-relapse mortality. This study shows that post-remission chemotherapy intensification is not associated with significantly better outcome as compared with standard-dose chemotherapy in elderly patients for whom, overall results remain disappointing.

[Pseudoxanthoma elasticum revealed by choroidal neovascularization]. / Pseudoxanthome élastique révélé par un néovaisseau choroïdien.

Pseudoxanthoma elasticum is a genetic disease caracterised by calcification and fragmentation of elastic fibers affecting primarily the skin, the eyes and the cardiovascular system. We report a case in which the diagnostic was delayed due to an atypical presentation, allowing us to discuss the clinical signs, especially ocular, as well as the diagnosis criteria of this rare pathology. There is no specific treatment to pseudoxanthoma elasticum. It is essential to diagnose it rapidly in order to avoid potentially dramatic systemic outcomes.

Le pseudoxanthome élastique est une maladie héréditaire caractérisée par la calcification des fibres élastiques du tissu conjonctif touchant particulièrement la peau, les yeux et le système cardiovasculaire. Nous rapportons un cas clinique diagnostiqué plus tardivement suite à sa présentation atypique, ce qui nous permet d'aborder les signes cliniques, particulièrement oculaires, et la prise en charge diagnostique de cette pathologie rare. En effet, il n'existe pas de traitement spécifique du pseudoxanthome élastique. Il est donc essentiel de poser rapidement un diagnostic afin d'éviter la survenue d'atteintes systémiques potentiellement sévères.

Synthesis and Bioactivity of Reduced Chalcones Containing Sulfonamide Side Chains.

The effect on the bioactivity of antibacterial sulfonamide drugs against malaria and tuberculosis via an increase of the lipid solubility groups by condensation with a reduced chalcone was investigated. Sulfonamide derivatives (8a-8d) were obtained via a 1,3-diarylpropane scaffold, prepared by reduction of the relevant chalcones, followed by the addition of a sulfonamide moiety via the Mannich and the Mannich exchange reactions. The ClogP values indicated that the lipophilicities of 8a-8d and intermediate reduced chalcones and N-alkylated reduced chalcones (5a-7a) were much higher than those of the sulfonamides (1a-1c). The N-alkylated reduced chalcone derivatives 6 and 7 exhibited the highest antimalarial (Plasmodium falciparum (NF54 strain)) activity. Addition of the sulfonamide group weakened the activity, even though some ClogP values were higher, while 1a-1c showed no activity. The reduced chalcones 5a and 5 showed potent growth inhibition of Mycobacterium tuberculosis (H37Rv strain), but the sulfonamide derivatives 8a and 8d showed no or insignificant activity (0 and 14%, respectively) against M. tuberculosis, despite high ClogP values. Thus, the possible increase in bioactivity expected from an increase in ClogP values (lipophilicity) might be counteracted by the higher molecular weight of the studied analogues.

[Acute myopic shift call sign of hantavirus infection]. / Myopie aiguë : signe d'appel d'une infection à hantavirus.

Acute myopic shift may be the first symptom of a hantavirus infection. In Belgium, lethal infections are rare, but this illness has to be ruled out in the emergency room. The refractive shift has not clearly been explained yet. The ancillary tests to describe this phenomenon are not always performed. This article may help on how to manage and how to explore this disease.

Une myopisation aiguë peut s'avérer être le premier signe d'appel d'une infection par hantavirus. En Belgique, cette virose est rarement létale, mais elle nécessite une prise en charge hospitalière urgente. Le mécanisme exact du trouble visuel reste encore mal expliqué. Les examens complémentaires qui permettraient de décrire le phénomène ne sont pas toujours réalisés. Deux cas nous permettent de faire la lumière sur une meilleure prise en charge et sur les mécanismes à explorer.

[Insight and psychiatric dangerousness: A review of the literature]. / Insight et dangerosité psychiatrique : revue de la littérature.

INTRODUCTION: Violence committed by individuals with severe mental illness has become an increasing focus of concern among clinicians, policy makers, and the general public, often as the result of tragic events. Research has shown in the past two decades an increased risk of violence among patients with mental disorder. Nevertheless, of those suffering from mental illness, perpetrators of other directed violence form a minority subgroup. The means by which there is this association between mental illness and violence has remained controversial. Factors such as positive psychotic symptoms, medication non-adherence, alcohol or psychoactive substance abuse and antisocial personality were found to be predictive of violence. Overall, literature provides support to the assertion that violent behavior of mentally ill patients is a heterogeneous phenomenon that is driven by multiple inter-related and independent factors. Furthermore, psychiatrists are often asked to predict an individual's future dangerousness, in a medical or a legal context. In the process of risk assessment of dangerousness, more focus has been placed on dynamic risk factor. In this context, lack of insight has established itself both as a part of violence risk models and as a clinical item in structured approaches to measure dangerousness. However, few studies have tested these associations. The main purpose of this paper is to review the literature concerning the relationship between insight and dangerousness and discuss the contributions of the insight in the assessment of dangerousness in patients with mental illness. We included twenty studies that evaluated the association between insight and variable such as physical or verbal violence, aggressiveness, hostility or sexual aggression. RESULTS: According to the findings of this review, the strength and specific nature of this relationship remain unclear due to considerable methodological and conceptual shortcomings, including heterogeneity in the definition and assessment of violence, a minority of prospective studies and the lack of systematic consideration of possible confounding variables. However, the ability of the patient to perceive their illness is an important element to be considered in assessing the dangerousness both medically and legally. Higher belief flexibility and lower confidentiality of individual judgment, which reflect greater cognitive insight, may be associated with a lower incidence of violence, in particular in schizophrenia by decreasing the degree of confidence related to psychotic symptoms. CONCLUSION: In the growing efforts to reduce stigma associated with mental illness, it is important to identify a subgroup of patients at risk of violence and provide them with targeted treatment. In this sense, it seems important in the future to continue in this field of research to determine if the lack of insight is a covariate of a worsened condition or a specific violence risk factor per se.

[Central serous chorioretinopathy following the use of phosphodiesterase 5 inhibitors]. / Le cas clinique du mois. Choriorétinite séreuse centrale après prise d'inhibiteurs de la phosphodiestérase de type 5.

Central serous chorioretinopathy occurs primarily in young caucasian men. It is characterized by the development of a serous detachment of the sensory retina with the apparition of a relative central scotomata. An association with phosphodiesterase 5 inhibitors is reported in some articles. We described two cases of central serous chorioretinopathy following the use of tadalafil and sildenafil.

La choriorétinite séreuse centrale est une pathologie touchant principalement les jeunes hommes caucasiens. Elle se caractérise par un décollement séreux rétinien se traduisant le plus souvent par l'apparition d'un scotome central relatif. Une association avec une prise d'inhibiteurs de la phosphodiestérase de type 5 est relatée dans plusieurs articles. Nous rapportons deux cas de choriorétinite séreuse centrale ayant suivi la prise de tadalafil et sildénafil.

Technical difficulties of left colic artery preservation during left colectomy for colon cancer.

PURPOSE: Low-tie ligation in colorectal cancer surgery is associated with technical difficulties in left colic artery preservation. We aimed to evaluate and classify the anatomical and technical difficulties of left colic artery (LCA) preservation at its origin and along its route at the inferior border of the pancreas. METHODS: A vascular reconstruction computed tomography prospective series of 113 patients was analyzed. The inferior mesenteric artery (IMA) branching pattern according to Latarjet's classification (Type I, separate LCA origin, Type II, fan-shaped branching pattern) and the distances between the IMA and the LCA origins and between the LCA and the Inferior mesenteric vein (IMV) at the inferior border of the pancreas were measured. RESULTS: The IMA branching pattern was Type I in 80 (71 %) patients and Type II in 33 (29 %) patients. The IMA-LCA distance was 39.8 ± 12.2 mm. The LCA-IMV distance at the inferior border of the pancreas was 20.5 ± 21.7 mm. When classified based on this distance, 75 (66 %) patients were classified into the Near subgroup (<20 mm) (7.7 ± 4.1 mm) and 38 (34 %) into the Far subgroup (≥20 mm) (45.6 ± 20.4 mm, p < 0.001). A Type I subgroup F accounted for 27 % of the patients. CONCLUSIONS: Left colic artery preservation is highly feasible at its origin in more than two-thirds of cases due to the separate origin. The addition of a high IMV ligation increases the risk of damage to the LCA at the inferior border of the pancreas because the distance to the IMV is less than 20 mm in two-thirds of cases.

[Diagnosis of chronic retinal detachment following the discovery of a crystalline retinopathy]. / Diagnostic d'un décollement chronique de rétine dans le cadre d'une rétinopathie crystalline.

Crystalline retinopathy is a rare complication of chronic retinal detachment. The observation of crystalline retinal deposits should prompt the search for a chronic retinal detachment. The composition of these crystals is unknown. Some other crystals can be found in other diseases or with drug toxicity. It is essential to make the differential diagnosis and to determine the actual etiology

Anatomical basis of laparoscopic medial-to-lateral mobilization of the descending colon.

In laparoscopic colorectal resection, the medial-to-lateral approach has been largely adopted. This approach can be initiated by the division of either the inferior mesenteric artery (IMA) or the inferior mesenteric vein (IMV). This cadaveric study aimed to establish the feasibility of IMV dissection as the initial landmark of medial-to-lateral left colonic mobilization for evaluating the size of the peritoneal window between the IMV at the lower part of the pancreas and the origin of the IMA (IMA-IMV distance) and the point of origin of the IMA compared to the lower edge of the third part of the duodenum (IMA-D3 distance). These distances were recorded on 30 fresh cadavers. The IMA-D3 distance was 0.4 ± 2.2 cm (mean ± SD). The IMA originated from the aorta at the level of or below the D3 in 21 cases (70%). The IMA-IMV distance was 5.5 ± 1.8 cm and was greater or equal to 5 cm (large window) in 21 cases (70%). IMA-IMV distance was correlated with IMA-D3 showing that a large window was inversely correlated with a low IMA origin (P < 0.001). IMA-D3 distance was not correlated with weight, height and sex. IMA-IMV distance was largerin male (6.7 ± 0.9 vs. 4.9 ± 1.8, P = 0.001) and correlated with weight, (r = 0.60, 95%CI = 0.03-0.10, P < 0.001) and height (r = 0.54, 95%CI = 0.05-0.21, P = 0.002). IMV can be used as the initial landmark for laparoscopic medial-to-lateral dissection in two-thirds of cases. A too-small window can require first IMA division. The choice between the two different medial-to-lateral approaches could be made by evaluating the anatomical relationship between IMA, IMV, and D3.

In vitro melanogenesis inhibitory effects of N-feruloyldopamine.

Tyrosinase is the rate-limiting enzyme in the melanogenesis process. It remains the most efficient way to downregulate melanin production and improve unsightly pigmentary disorders. The aim of our investigations was to find a structurally characterized molecule with better efficacy than existing molecules without cell toxicity. We focused our investigations on compounds that could act as substrate-mimicking inhibitors of tyrosinase and identified N-feruloyldopamine as the best candidate. In vitro, N-feruloyldopamine inhibited human tyrosinase with higher efficacy than the reference inhibitor arbutin without cell toxicity at least up to 100 µM as measured in cultured normal human epidermal melanocytes (NHEMs). Moreover, the inhibition appeared to be specific to mammalian tyrosinases as shown by a very poor inhibition of mushroom tyrosinase, but a significant decrease of total melanin in B16-F10 cells. The antioxidant capacity assessed using DPPH (1,1-diphenyl-2-picrylhydrazyl) assay was comparable to that of vitamin C and finally, N-feruloyldopamine exerted a significant inhibition of Pmel17 gene expression when used at 100 µM on cultured NHEM. Taken together, these results suggest that N-feruloyldopamine is a serious candidate for in vivo application as complexion-brightening ingredient.

[Memory, fluency, and orientation: a five-minute screening test for cognitive decline]. / Memoria, fluidez y orientación: prueba de cribado de deterioro cognitivo en 5 minutos.

BACKGROUND: The prevalence of cognitive impairment (CI) will double in the next 20 years, making early detection a key priority. OBJECTIVES: Validation of a 5-minute CI screening test. METHODS: Adults aged 60 and older were recruited from memory clinics and the community at large in the Santiago, Chile metropolitan area. Based on clinical examination they were categorised as No CI (NCI), Mild CI (MCI) and dementia sufferers (DS). We measured the validity of a new test, MEFO, evaluating memory (5 points), phonetic verbal fluency (2 points) and orientation (6 points) by comparing its results with those from the MMSE. RESULTS: We evaluated 214 subjects, comprising 49 with dementia, 47 with MCI, and 118 with no CI. The MEFO differentiated between all 3 groups whereas the MMSE did not discriminate between the MCI and NCI groups. The area under the ROC curve (AUC) for the MEFO distinguishing NCI subjects from dementia sufferers was 0.97; for NCI vs CI (dementia+MCI), 0.89; and for NCI vs MCI, 0.80. On the MMSE these values were 0.95, 0.84, and 0.73, respectively. A cut-off score of 6/7 on the MEFO identified dementia sufferers with a sensitivity of 86% and a specificity of 96%. A cut-off score of 8/9 distinguished CI from NCI subjects with a sensitivity of 83% and a specificity of 75%. CONCLUSIONS: The MEFO is a valid and reliable test for discriminating between dementia and CI sufferers and subjects with no CI. Its validity is similar to that the MMSE under these conditions, but it is more effective for identifying subjects with MCI and its administration time is shorter.

High tie versus low tie vascular ligation of the inferior mesenteric artery in colorectal cancer surgery: impact on the gain in colon length and implications on the feasibility of anastomoses.

BACKGROUND: There is no demonstrated benefit of high-tie versus low-tie vascular transections in colorectal cancer surgery. OBJECTIVE: The aim of this study was to compare the effects of high-tie and low-tie vascular transections on colonic length after oncological sigmoidectomy, the theoretical feasibility of colorectal anastomosis at the sacral promontory, and straight or J-pouch coloanal anastomosis after rectal cancer surgery with total mesorectal excision. DESIGN: This study is an anatomical study on surgical techniques. SETTINGS: This study was conducted in a surgical anatomy research unit. PATIENTS: Thirty fresh nonembalmed cadavers were randomly assigned to high-tie and low-tie groups (n = 15). INTERVENTIONS: Oncological sigmoidectomy followed by total mesorectal excision was performed. MAIN OUTCOME MEASURES: The distances from the proximal colon limb to the lower edge of the pubis symphysis were recorded after each step of vascular division. RESULTS: The successive mean gains in length in high-tie vs low-tie vascular transections were 2.9±1.2 cm vs 3.1 ± 1.8 cm (p = 0.83) after inferior mesenteric artery division, 8.1 ± 3.1 cm vs 2.5 ± 1.2 cm (p = 0.0016) after inferior mesenteric vein division at the lower part of the pancreas, 8.1 ± 3.8 cm vs 3.3 ± 1.7 cm (p = 0.0016) after sigmoidectomy. The mean cumulative gain in length was significantly higher in high-tie vs low-tie vascular transections (19.1 ± 3.8 vs 8.8 ± 2.9 cm, p = 0.00089). After secondary left colic artery division, the gain in length was similar to that of the high-tie group (17 ± 3.1 vs 19.1 ± 3.8 cm) (p = 0.089). Colorectal anastomosis at the promontory and straight and J-pouch coloanal anastomosis feasibility rates were 100% in the high-tie group, 87%, 53%, and 33% in the low-tie group, but 100%, 100%, and 87% after secondary left colic artery division. LIMITATIONS: This anatomical study, based on cadavers rather than live patients, does not evaluate colon limb vascularization. CONCLUSIONS: The gain in colonic length is 10 cm greater for high-tie vascular transections. With low-tie vascular transections, high inferior mesenteric vein division produced a small additional gain in length, and secondary left colic artery division produced the same length gain as high-tie vascular transections.

Spatial dependency of the PPG morphology at right carotid common artery.

PhotoPlethysmoGraphy (PPG) is ubiquitously employed in wearable devices for health monitoring. Photodiode signal inversion is observed in rare occasions, most of the time when the sensor is pressed against the skin. We report in this article such observations made at the right common carotid artery site. Indeed we have systematically observed a photodiode signal inversion when the PPG sensor is placed where the pulse is the best felt at the carotid. In addition to be inverted, the pulse is steeper during the systolic phase. Such inversion has implications in terms of pulse arrival time (PAT) measurements In our experiments, this causes a difference of 20 ms in the carotid PAT when measured at the absolute maximum slope. The mechanical and optical properties of tissues must be better accounted to explain the PPG signal morphology. Clinical Relevance- Understanding the role of mechanical tissue properties seems relevant in order to obtain more reproducible results in PPG signal analysis.

Assessing the contribution of diazotrophs to microbial Fe uptake using a group specific approach in the Western Tropical South Pacific Ocean.

Diazotrophs are often limited by iron (Fe) availability in the oligotrophic ocean. The Western Tropical South Pacific (WTSP) ocean has been suggested as an intense N2 fixation area due to Fe fertilizations through shallow hydrothermal activity. Yet, the Fe demand of diazotrophs in their natural habitat, where they cohabit with other microbial organisms also requiring Fe, remains unknown. Here we develop and apply a method consisting of coupling 55Fe uptake experiments with cell-sorting by flow cytometry, and provide group-specific rates of in situ Fe uptake by the microbial community in the WTSP, in addition to bulk and size fractionation rates. We reveal that the diazotrophs Crocosphaera watsonii and Trichodesmium contribute substantially to the bulk in situ Fe uptake (~33% on average over the studied area), despite being numerically less abundant compared to the rest of the planktonic community. Trichodesmium had the highest cell-specific Fe uptake rates, followed by C. watsonii, picoeukaryotes, Prochlorococcus, Synechococcus and finally heterotrophic bacteria. Calculated Fe:C quotas were higher (by 2 to 52-fold) for both studied diazotrophs compared to those of the non-diazotrophic plankton, reflecting their high intrinsic Fe demand. This translates into a diazotroph biogeographical distribution that appears to be influenced by ambient dissolved Fe concentrations in the WTSP. Despite having low cell-specific uptake rates, Prochlorococcus and heterotrophic bacteria were largely the main contributors to the bulk Fe uptake (~23% and ~12%, respectively). Overall, this group-specific approach increases our ability to examine the ecophysiological role of functional groups, including those of less abundant and/or less active microbes.

Risk factors for conversion and complications after unilateral laparoscopic adrenalectomy.

BACKGROUND: Laparoscopic adrenalectomy (LA) is the procedure of choice for surgical management of most benign adrenal tumours, with a reported overall complication rate around 10 per cent. The aim of this study was to determine predictive factors for postoperative complications and conversion to open surgery after unilateral LA. METHODS: From 1994 to 2009, consecutive patients undergoing unilateral LA by the lateral transabdominal approach were analysed from a prospectively maintained database. A mass larger than 12 cm in diameter and suspected primary adrenal carcinoma were considered contraindications to LA. Predictive factors for postoperative complications and conversion to open surgery were analysed. RESULTS: Some 462 patients were analysed. There were no postoperative deaths. Postoperative complications occurred in 53 patients (11·5 per cent), medical complications in 28, and surgical complications in 33 patients. Six patients underwent reoperation for complications. Multivariable logistic regression analysis showed that conversion to open surgery (odds ratio (OR) 6·20, 95 per cent confidence interval 2·08 to 18·53; P = 0·001) and left-sided tumour (OR 1·89, 1·02 to 3·52; P = 0·044) were independent predictive factors for overall complications. Conversion to open surgery was the only independent predictive factor for medical complications (OR 12·88, 4·21 to 39·41; P = 0·001), and left-sided LA was the only predictive factor for surgical complications (OR 2·22, 1·01 to 4·89; P = 0·047). No factor was predictive of conversion to open surgery. CONCLUSION: In this single-institution study, conversion to open surgery and left-sided tumours were independent predictive factors for overall complications, but none of the variables analysed was predictive of conversion.

Artefact subspace reconstruction for both EEG and fNIRS co-registred signals.

Combining electroencephalography (EEG) to functional near-infrared spectroscopy (fNIRS) is a promising technique that has gained momentum thanks to their complementarity. While EEG measures the electrical activity of the brain, fNIRS records the variations in cerebral blood flow and related hemoglobin concentrations. However, both modalities are typically contaminated with artefacts. Muscle and eye artefacts, affect the EEG signals, while hemodynamic and oxygenation changes in the extracerebral compartment due to systemic changes (superficial layer) corrupt the fNIRS signals. Moreover, both signals are sensitive to sensor motion artefacts characterized by large amplitude. There are several well-established methods for removing artefacts for both modalities. The objective of this paper is to apply a common approach to denoise both EEG and fNIRS signals. Indeed Artifact Subspace Reconstruction (ASR) method, which is an automatic, online-capable and efficient method for deleting transient or large-amplitude EEG artefacts, can be a good alternative to also denoise fNIRS signals. In this paper, we first propose, a new more comprehensive formulation of ASR. Then, we study the effectiveness of the method in denoising both the EEG and fNIRS signals.

Aliasing affects ActiLife software raw accelerometry to count conversion from different sampling frequencies.

Accelerometry counts are widely used to quantify physical activity in an objective manner. ActiGraph™ accelerometers offer to record acceleration signal with different sampling frequency (fs). Nevertheless additional counts were shown to be computed by ActiLife software from acceleration signal with a sampling frequency fs>30 Hz compared to signal with default fs=30 Hz or multiple. This paper relies on the study of synthetic signals to point out the origin of this error and to recommend an adjusted method. A piecewise-frequency sinus time series (0-15 Hz) was generated at different sampling frequencies (fs=30, 50 and 100 Hz). The artificial acceleration raw signal was resampled to 30 Hz using different antialiasing lowpass filters before ActiLife count computation. The use of an antialiasing filter which did not properly attenuate aliasing replicas was found to induce aliasing frequencies within ActiLife bandpass filter which is the cause of extract activity counts. We were able to reproduce fictitious counts for acceleration around 10 Hz. A simple adjustment of antialiasing filter parameters allowed to avoid this problem. This study reproduces ActiLife counts processing from 50 and 100 Hz sampled signal. Count overestimations from fs=50 and 100 Hz signal were induced because of aliasing in the frequency bandwidth of the ActiLife count filter. This can be corrected by a relevant antialiasing filtering before ActiLife software processing or this can be done in high-level mathematical programing.