Myofascial pain associated to trigger points: A literature review. Part 2: Differential diagnosis and treatment

During the last decades the advance in knowledge of myofascial pain has been constant in the medical and dental community. However, although several aspects have been clarified in relation to its epidemiology, clinical characteristics and etiopathogenesis, many uncertainties remain. Many clinical conditions are included in the differential diagnosis of myofascial pain associated to trigger points. A good anamnesis and clinical exploration is thus required in order to ensure correct diagnosis and treatment. Among the numerous treatments used in application to trigger points, the spray-and-stretch technique and direct injection targeted to such trigger points have been found to be the most effective options. In chronic cases, psychosocial intervention is required, due to the high incidence of mood disorders and/or anxiety observed in these patients, who in turn present a poorer prognosis. This underscores the importance of early diagnosis and treatment.

An inertial sensor-based system for spatio-temporal analysis in classic cross-country skiing diagonal technique.

The present study proposes a method based on ski fixed inertial sensors to automatically compute spatio-temporal parameters (phase durations, cycle speed and cycle length) for the diagonal stride in classical cross-country skiing. The proposed system was validated against a marker-based motion capture system during indoor treadmill skiing. Skiing movement of 10 junior to world-cup athletes was measured for four different conditions. The accuracy (i.e. median error) and precision (i.e. interquartile range of error) of the system was below 6ms for cycle duration and ski thrust duration and below 35ms for pole push duration. Cycle speed precision (accuracy) was below 0.1m/s (0.005m/s) and cycle length precision (accuracy) was below 0.15m (0.005m). The system was sensitive to changes of conditions and was accurate enough to detect significant differences reported in previous studies. Since capture volume is not limited and setup is simple, the system would be well suited for outdoor measurements on snow.

Laparoscopic technique to perform a true Stamm gastrostomy in children.

PURPOSE: A surgical gastrostomy is mandatory in cases where a PEG is not feasible. Various minimally invasive techniques have been described, but many involve unusable materials in small children and/or have risk of disunion. We describe a technique for true Stamm gastrostomy performed by laparoscopy (LSG) with a purse string suture and four points of attachment onto the wall. METHOD: We reviewed 20 children who underwent an LSG from 2010 to 2013. After incision of the skin at the location planned for the gastrostomy, using three 3-5mm ports the stomach is fixed to the wall by three suspension stitches, which are entered and then emerged subcutaneously. A fourth stitch of attachment is used to make an award on the stomach and tie around the gastrostomy tube. RESULTS: Mean age was 4.2years, with 70% aged <2years. All children were malnourished, most often severely. All but two underwent a concomitant fundoplication. Feeding through the gastrostomy started on D0 or D1. Total feeding by gastrostomy was achieved in a mean duration of 2.9day. Mean hospital stay was 4.5days. There was no perioperative complication. Mean follow-up was 14months. Once, the balloon was accidently deflated and reinflated in the wall leading to its necrosis. Five peristomial granulomas were noticed. It was always possible to replace the tube by a gastrostomy device at least 6weeks after surgery. CONCLUSION: This new technique for true Stamm gastrostomy by laparoscopy reproduces exactly the one done by laparotomy, without special equipment. It can be made since the neonatal period, in all the circumstances when a laparoscopy is possible.

Annuaire de la papeterie française et étrangère (technique, industriel et commercial, fondé en 1865)

Variante(s) de titre : Annuaire général de la papeterie française et étrangère

Annuaire de la papeterie française et étrangère (technique, industriel et commercial, fondé en 1865)

1865 (A1).

Gamma Knife Surgery versus Linac for Brain Metastasis: Which Technique for Which Patient? Analysis of an Historical Cohort of 63 Consecutive Patients Harboring 130 Lesions

Objectives: We present the retrospective analysis of a single-institution experience for radiosurgery (RS) in brain metastasis (BM) with Gamma Knife (GK) and Linac. Methods: From July 2010 to July 2012, 28 patients (with 83 lesions) had RS with GK and 35 patients (with 47 lesions) with Linac. The primary outcome was the local progression-free survival (LPFS). The secondary outcome was the overall survival (OS). Apart a standard statistical analysis, we included a Cox regression model with shared frailty, to modulate the within-patient correlation (preliminary evaluation showed a significant frailty effect, meaning that the correlation within patient could be ignored). Results: The mean follow-up period was 11.7 months (median 7.9, 1.7-22.7) for GK and 18.1 (median 17, 7.5-28.7) for Linac. The median number of lesions per patient was 2.5 (1-9) in GK compared with 1 (1-3) in Linac. There were more radioresistant lesions (melanoma) and more lesions located in functional areas for the GK group. The median dose was 24 Gy (GK) compared with 20 Gy (Linac). The LPFS actuarial rate was as follows: for GK at 3, 6, 9, 12, and 17 months: 96.96, 96.96, 96.96, 88.1, and 81.5%, and remained stable till 32 months; for Linac at 3, 6, 12, 17, 24, and 33 months, it was 91.5, 91.5, 91.5, 79.9, 55.5, and 17.1%, respectively (p = 0.03, chi-square test). After the Cox regression analysis with shared frailty, the p-value was not statistically significant between groups. The median overall survival was 9.7 months for GK and 23.6 months for Linac group. Uni- and multivariate analysis showed a lower GPA score and noncontrolled systemic status were associated with lower OS. Cox regression analysis adjusting for these two parameters showed comparable OS rate. Conclusions: In this comparative report between GK and Linac, preliminary analysis showed that more difficult cases are treated by GK, with patients harboring more lesions, radioresistant tumors, and highly functional located. The groups look, in this sense, very heterogeneous at baseline. After a Cox frailty model, the LPFS rates seemed very similar (p < 0.05). The OS was similar, after adjusting for systemic status and GPA score (p < 0.05). The technical reasons for choosing GK instead of Linac were the anatomical location related to highly functional areas, histology, technical limitations of Linac movements, especially lower posterior fossa locations, or closeness of multiple lesions to highly functional areas optimal dosimetry with Linac

Photocatalytic Activity of Nanostructured Anatase Coatings Obtained by Cold Gas Spray

This article describes a photocatalytic nanostructured anatase coating deposited by cold gas spray (CGS)supported on titanium sub-oxide (TiO22x) coatings obtained by atmospheric plasma spray (APS) onto stainless steel cylinders. The photocatalytic coating was homogeneous and preserved the composition and nanostructure of the starting powder. The inner titanium sub-oxide coating favored the deposition of anatase particles in the solid state. Agglomerated nano-TiO2 particles fragmented when impacting onto the hard surface of the APS TiO22x bond coat. The rough surface provided by APS provided an ideal scenario for entrapping the nanostructured particles, which may be adhered onto the bond coat due to chemical bonding; a possible bonding mechanism is described. Photocatalytic experiments showed that CGS nano-TiO2 coating was active for photodegrading phenol and formic acid under aqueous conditions. The results were similar to the performance obtained by competitor technologies and materials such as dip-coating P25 photocatalysts. Disparity in the final performance of the photoactive materials may have been caused by differences in grain size and the crystalline composition of titanium dioxide.

A digital holography technique for generating beams with arbitrary polarization and shape

A method for generating beams with arbitrary polarization and shape is proposed. Our design requires the use of a Mach-Zehnder set-up combined with translucent liquid crystal displays in each arm of the interferometer; in this way, independent manipulation of each transverse beam components is possible. The target of this communication is to develop a numerical procedure for calculating the holograms required for dynamically encode any amplitude value and polarization state in each point of the wavefront. Several examples demonstrating the capabilities of the method are provided.

Forensic aspects of the weathering and ageing of spray paints

This paper presents a preliminary study on the degradation of spray paint samples, illustrated by Optical, FTIR and Raman measurements. As opposed to automotive paints which are specifically designed for improved outdoor exposure and protected using hindered amine light absorbers (HALS) and ultra-violet absorbers (UVA), the spray paints on their side are much simpler in composition and very likely to suffer more from joint effects of solar radiation, temperature and humidity. Six different spray paint were exposed to outdoor UV-radiation for a total period of three months and both FTIR and Raman measurements were taken systematically during this time. These results were later compared to an artificial degradation using a climate chamber. For infrared spectroscopy, degradation curves were plotted using the photo-oxidation index (POI), and could be successfully approximated with a logarithmic fitting (R2 > 0.8). The degradation can appear after the first few days of exposure and be important until 2 months, where it stabilizes and follow a more linear trend afterwards. One advantage is that the degradation products appeared almost exclusively at the far end (∼3000 cm−1) of mid-infrared spectra, and that the fingerprint region of the spectra remained stable over the studied period of time. Raman results suggest that the pigments on the other side, are much more stable and have not shown any sign of degradation over the time of this study. Considering the forensic implications of this environmental degradation, care should be taken when comparing samples if weathering is an option (e.g. an exposed graffiti compared to the paint from a fresh spray paint can). Degradation issues should be kept in mind as they may induce significant differences between paint samples of common origin.

Aortic Annulus Stabilization Technique for Rapid Deployment Aortic Valve Replacement.

NlmCategory="UNASSIGNED">Rapid deployment aortic valve replacement (RDAVR) with the use of rapid deployment valve systems represents a smart alternative to the use of standard aortic bioprosthesis for aortic valve replacement. Nevertheless, its use is still debatable in patients with pure aortic valve regurgitation or true bicuspid aortic valve because of the risk of postoperative paravalvular leak. To address this issue, an optimal annulus-valve size match seems to be the ideal surgical strategy. This article describes a new technique developed to stabilize the aortic annulus and prevent paravalvular leak after RDAVR. To confirm the feasibility, this technique was performed in six patients with severe symptomatic aortic stenosis who were scheduled to undergo aortic valve replacement at our center. All patients survived surgery and were discharged from the hospital. There were no new intracardiac conduction system disturbances observed, and a permanent pacemaker implantation was not required in any of the patients. The intraoperative and postoperative echocardiogram confirmed successful positioning of the valve, and no paravalvular leak was observed. In this preliminary experience, RDAVR through a full sternotomy or an upper hemisternotomy approach with the use of aortic annulus stabilization technique was safe, and no leak was observed. Future studies on large series of patients are necessary to confirm the safety and effectiveness of this technique in preventing paravalvular leak in patients with true bicuspid aortic valves or pure aortic regurgitation.

Parcours de vie, récit et moments forts : entre défis et ressources. Une recherche-intervention à l'Ecole Technique de Ste-Croix

La littérature sur les transitions, en particulier entre l'école obligatoire et l'école professionnelle ou l'école et la vie professionnelle, attire l'attention sur le fait que les parcours personnels sont aujourd'hui moins linéaires. Les transitions professionnelles sont alors décrites comme des moments de difficultés, de ruptures, de vulnérabilité pour les jeunes (Pagnossin & Armi, 2011 ; Rastoldo, Amos & Davaud, 2009). Dans notre domaine en psychologie « socioculturelle », si ces aspects ne sont pas négligés, l'accent est mis sur l'importance du travail de construction de sens par la personne : indépendamment des zigzags de sa vie, l'important est la mise en cohérence, les liens de sens qu'elle peut reconstruire entre les différentes sphères d'expériences qui constituent son identité. Et pour cela, les ressources sociales et institutionnelles (parents, enseignants, groupes de pairs, dispositifs de formation...) mais aussi matérielles et culturelles (chansons, poèmes, films, romans, récits, etc.) peuvent être très importantes (Masdonati & Zittoun, 2012 ; Zittoun, 2012). L'étude-intervention qui sera présentée dans ce document, réalisée auprès d'une classe d'apprentis de l'Ecole technique de Ste-Croix par un groupe d'étudiants en Master en psychologie (UniL), s'inscrit dans un mouvement plus large qui cherche à rendre compte du point de vue des acteurs (Muller Mirza & Perret-Clermont, 2015) liés à la question des transitions des jeunes : il s'agira ici de celui des apprentis eux-mêmes, de manière à explorer ce qu'ils vivent en termes de difficultés, de ressources utilisées et d'apprentissages réalisés, ainsi que celui des personnes qui les accompagnent dans ces processus, les enseignants. Cette étude visait non seulement à recueillir des informations auprès de ces personnes mais également à réaliser un travail de type réflexif, par la mise en place d'activités en classe destinées aux apprentis, basées sur le « récit de vie » comme outil psychologique.

Step-by-step of ultrasound-guided core-needle biopsy of the breast: review and technique

Ultrasound-guided core-needle biopsy has high sensitivity in the diagnosis of breast cancer. The present study is aimed at detailing the main steps of such procedure, including indications, advantages, limitations, follow-up and description of the technique, besides presenting a checklist including the critical steps required for an appropriate practice of the technique. In the recent years, an increasing number of patients have required breast biopsy, indicating the necessity of a proportional increase in the number of skilled professionals to carry out the procedures and histological diagnoses. A multidisciplinary approach involving the tripod clinical practice-radiology-pathology is responsible for the highest rate of accuracy of the technique and must always be adopted.