IRM dans le diagnostic des spondyloarthrites axiales: utilité et pièges diagnostiques [MRI of axial spondyloarthritis: diagnostic role and pitfalls].

MRI has become a major tool for the diagnosis of axial spondyloarthritis and provides objective signs based on which therapy can be initiated. In clinical practice, ASAS classification criteria are often applied for the diagnosis of spondyloarthritis at a pre-radiographic stage. However, MRI signs of spondyloarthritis as stated in ASAS criteria lack specificity, and can be encountered in a wide array of diagnoses, in particular degenerative and mechanical conditions. In this article, we will review the role of MRI in the diagnosis and classification of spondyloarthritis, general technical considerations, the elementary MRI signs of axial spondyloarthritis, as well as diagnostic pitfalls. We also provide a practical approach on how to avoid overdiagnosis of spondyloarthritis and to improve the diagnostic value of MRI.

Does hepatocellular carcinoma in non-alcoholic steatohepatitis exist in cirrhotic and non-cirrhotic patients?

Non-alcoholic steatohepatitis (NASH) has been associated with hepatocellular carcinoma (HCC) often arising in histologically advanced disease when steatohepatitis is not active (cryptogenic cirrhosis). Our objective was to characterize patients with HCC and active, histologically defined steatohepatitis. Among 394 patients with HCC detected by ultrasound imaging over 8 years and staged by the Barcelona Clinic Liver Cancer (BCLC) criteria, we identified 7 cases (1.7%) with HCC occurring in the setting of active biopsy-proven NASH. All were negative for other liver diseases such as hepatitis C, hepatitis B, autoimmune hepatitis, Wilson disease, and hemochromatosis. The patients (4 males and 3 females, age 63 ± 13 years) were either overweight (4) or obese (3); 57% were diabetic and 28.5% had dyslipidemia. Cirrhosis was present in 6 of 7 patients, but 1 patient had well-differentiated HCC in the setting of NASH without cirrhosis (fibrosis stage 1) based on repeated liver biopsies, the absence of portal hypertension by clinical and radiographic evaluations and by direct surgical inspection. Among the cirrhotic patients, 71.4% were clinically staged as Child A and 14.2% as Child B. Tumor size ranged from 1.0 to 5.2 cm and 5 of 7 patients were classified as early stage; 46% of all nodules were hyper-echoic and 57% were <3 cm. HCC was well differentiated in 1/6 and moderately differentiated in 5/6. Alpha-fetoprotein was <100 ng/mL in all patients. HCC in patients with active steatohepatitis is often multifocal, may precede clinically advanced disease and occurs without diagnostic levels of alpha-fetoprotein. Importantly, HCC may occur in NASH in the absence of cirrhosis. More aggressive screening of NASH patients may be warranted.

Association of body mass index with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis

The objective of this observational, multicenter study was to evaluate the association of body mass index (BMI) with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis. A total of 339 patients (197 females, 142 males) diagnosed with non-cystic fibrosis bronchiectasis by high-resolution computed tomography were classified into four groups: underweight (BMI<18.5 kg/m2), normal weight (18.5≤BMI<25.0 kg/m2), overweight (25.0≤BMI<30.0 kg/m2), and obese (BMI≥30.0 kg/m2). Clinical variables expressing disease severity were recorded, and acute exacerbations, hospitalizations, and survival rates were estimated during the follow-up period. The mean BMI was 21.90 kg/m2. The underweight group comprised 28.61% of all patients. BMI was negatively correlated with acute exacerbations, C-reactive protein, erythrocyte sedimentation rate, radiographic extent of bronchiectasis, and chronic colonization by P. aeruginosa and positively correlated with pulmonary function indices. BMI was a significant predictor of hospitalization risk independent of relevant covariates. The 1-, 2-, 3-, and 4-year cumulative survival rates were 94%, 86%, 81%, and 73%, respectively. Survival rates decreased with decreasing BMI (χ2=35.16, P<0.001). The arterial carbon dioxide partial pressure, inspiratory capacity, age, BMI, and predicted percentage of forced expiratory volume in 1 s independently predicted survival in the Cox proportional hazard model. In conclusion, an underweight status was highly prevalent among patients with non-cystic fibrosis bronchiectasis. Patients with a lower BMI were prone to developing more acute exacerbations, worse pulmonary function, amplified systemic inflammation, and chronic colonization by P. aeruginosa. BMI was a major determinant of hospitalization and death risks. BMI should be considered in the routine assessment of patients with non-cystic fibrosis bronchiectasis.

Radiographic analysis in castor bean seeds (Ricinus communis L.)

Castor bean cropping has great social and economic value, but its production has been affected by factors such as low quality seeds used for sowing. The quick and precise evaluation of seed quality by x-ray test is known as an effective method to evaluate seed lots, but little is known about the interpretation between of the type of radiographic image and the seed quality correlation. The potential of x-ray analysis as a marker of seed physiological quality and as an initial process for the implementation of the use of computer-assisted image analysis was investigated using castor bean seeds of the different cultivars. The seeds were classified according to internal morphology visualized in the radiography and subjected to the germination test, emergency and seedling growth rate. It was possible to identify the different types of internal tissues, morphological and physical damage in castor bean seeds using the x-ray test. Tissues generating translucent images, embryo deformation, or tissues with less than 50% of endosperm reserves or spotted, negatively affected the physiological potential of the seed lots. Radiographic analysis is effective as an instrument to improve castor bean seed lot quality. This non destructive analysis allows the prediction of seedling performance and enabled the selection of high-quality seeds under the standards of a sustainable and precision agriculture

Validation in-vivo des techniques d’élastographie ultrasonore, invasive et non-invasive, à l’aide d’un modèle porcin

Il est maintenant admis que la composition de la plaque athérosclérotique est un déterminant majeur de sa vulnérabilité à se rompre. Vu que la composition de la plaque affecte ses propriétés mécaniques, l'évaluation locale des propriétés mécaniques de la plaque d'athérome peut nous informer sur sa vulnérabilité. L'objectif est de comparer les techniques d’élastographie ultrasonores endovasculaire (EVE) et non-invasive (NIVE) en fonction de leur potentiel à identifier les composantes calcifiées et lipidiques de la plaque. Les acquisitions intravasculaire et extravasculaire ont été effectuées sur les artères carotidiennes de neuf porcs hypercholestérolémiques à l’aide d’un cathéter de 20 MHz et d'une sonde linéaire de 7.5 MHz, respectivement. Les valeurs de déformation radiale et axiale, rapportés par EVE et NIVE, ont été corrélées avec le pourcentage des zones histologiques calcifiées et lipidiques pour cinq plaques. Nos résultats démontrent une bonne corrélation positive entre les déformations et les composantes calcifiées (r2 = 0.82, P = 0.034 valeur par EVE et r2 = 0.80, P = 0.041 valeur par NIVE). Une forte corrélation entre les déformations axiales et les contenus lipidiques par NIVE (r2 = 0.92, P-value = 0.010) a été obtenue. En conclusion, NIVE et EVE sont des techniques potentielles pour identifier les composants de la plaque et aider les médecins à diagnostiquer précocement les plaques vulnérables.

La survie implantaire suite à une réhabilitation par mise en charge immédiate d’une prothèse totale mandibulaire reliée à deux implants non jumelés : une étude pilote expérimentale

Problématique : Les connaissances théoriques et pratiques au sujet de la mise en charge immédiate d’implants non jumelés chez les édentés sont limitées. Objectifs : Cette étude avait pour but de : (1) déterminer le taux de survie implantaire de 2 implants non jumelés supportant une prothèse totale mandibulaire suite à une mise en charge immédiate, (2) évaluer les changements des niveaux osseux et de stabilité implantaire survenus sur ces 2 implants durant une période de 4 mois et les comparer à un implant témoin, et (3) décrire les complications cliniques associées à ce mode de mise en charge. Méthodologie : Chez 18 individus édentés (âge moyen de 62±7 ans), cette étude de phase I avec un design pré/post a évalué les résultats cliniques suivant la mise en charge immédiate (<48 heures) de 2 implants non jumelés par une prothèse totale mandibulaire. À l’aide de radiographies périapicales, de sondages osseux et d’analyses de la fréquence en résonnance, les niveaux osseux péri-implantaires (en mm) et les niveaux de stabilité implantairte (en ISQ) de ces 2 implants insérés dans la région parasymphysaire ont été évalués à la chirurgie (T0) et au suivi de 4 mois (T1). Un implant non submergé et sans mise en charge inséré dans la région de la symphyse mandibulaire a été utilisé comme témoin. Les données ont été analysées avec des modèles mixtes linéaires, la méthode de Tukey ajustée, l’analyse de variance de Friedman et des tests de rang signés de Wilcoxon. Résultats : De T0 à T1, 3 implants mis en charge immédiatement ont échoué chez 2 patients. Le taux de survie implantaire obtenu était donc de 91,7% (33/36) et, par patient, de 88,9% (16/18). Aucun implant témoin n’a échoué. Les changements osseux documentés radiologiquement et par sondage autour des implants mis en charge immédiatement étaient, respectivement, de -0,2 ± 0,3 mm et de -0,5 ± 0,6 mm. Les pertes d’os de support implantaire n’ont pas été démontrées statistiquement différentes entre les implants avec mise en charge immédiate et les témoins. Les niveaux moyens de stabilité implantaire ont augmenté de 5 ISQ indépendamment de la mise en charge. Les niveaux moyens d’ISQ n’ont pas été démontrés statistiquement différents entre les implants avec mise en charge immédiate et les témoins à T0 ou T1. Cinq des 18 patients n’ont expérimenté aucune complication clinique, alors que 9 en ont eu au moins deux. Hormis les échecs implantaires, aucune de ces complications n’a entraîné de changements au protocole. Conclusion : Les résultats à court terme suggèrent que : (1) le taux de survie implantaire suite au protocole immédiat est similaire à ceux rapportés lors d’un protocole de mise en charge conventionnel (2) les changements d’os de support implantaire et de stabilité ne sont pas différents comparativement à ceux d’un implant témoin, (3) un niveau élevé d’expérience clinique et chirurgicale est requis pour effectuer les procédures et pour gérer les complications associées. Ces résultats préliminaires devraient être confirmés dans une étude clinique de phase II.

Consistent approximate models of the global atmosphere: shallow, deep, hydrostatic, quasi-hydrostatic and non-hydrostatic

We study global atmosphere models that are at least as accurate as the hydrostatic primitive equations (HPEs), reviewing known results and reporting some new ones. The HPEs make spherical geopotential and shallow atmosphere approximations in addition to the hydrostatic approximation. As is well known, a consistent application of the shallow atmosphere approximation requires omission of those Coriolis terms that vary as the cosine of latitude and of certain other terms in the components of the momentum equation. An approximate model is here regarded as consistent if it formally preserves conservation principles for axial angular momentum, energy and potential vorticity, and (following R. Müller) if its momentum component equations have Lagrange's form. Within these criteria, four consistent approximate global models, including the HPEs themselves, are identified in a height-coordinate framework. The four models, each of which includes the spherical geopotential approximation, correspond to whether the shallow atmosphere and hydrostatic (or quasi-hydrostatic) approximations are individually made or not made. Restrictions on representing the spatial variation of apparent gravity occur. Solution methods and the situation in a pressure-coordinate framework are discussed. © Crown copyright 2005.

Non-radial solar wind flows induced by the motion of interplanetary coronal mass ejections

A survey of the non-radial flows (NRFs) during nearly five years of interplanetary observations revealed the average non-radial speed of the solar wind flows to be �30 km/s, with approximately one-half of the large (>100 km/s) NRFs associated with ICMEs. Conversely, the average non-radial flow speed upstream of all ICMEs is �100 km/s, with just over one-third preceded by large NRFs. These upstream flow deflections are analysed in the context of the large-scale structure of the driving ICME. We chose 5 magnetic clouds with relatively uncomplicated upstream flow deflections. Using variance analysis it was possible to infer the local axis orientation, and to qualitatively estimate the point of interception of the spacecraft with the ICME. For all 5 events the observed upstream flows were in agreement with the point of interception predicted by variance analysis. Thus we conclude that the upstream flow deflections in these events are in accord with the current concept of the large scale structure of an ICME: a curved axial loop connected to the Sun, bounded by a curved (though not necessarily circular)cross section.

Implications of non-cylindrical flux ropes for magnetic cloud reconstruction techniques and the interpretation of double flux rope events

Magnetic clouds (MCs) are a subset of interplanetary coronal mass ejections (ICMEs) which exhibit signatures consistent with a magnetic flux rope structure. Techniques for reconstructing flux rope orientation from single-point in situ observations typically assume the flux rope is locally cylindrical, e.g., minimum variance analysis (MVA) and force-free flux rope (FFFR) fitting. In this study, we outline a non-cylindrical magnetic flux rope model, in which the flux rope radius and axial curvature can both vary along the length of the axis. This model is not necessarily intended to represent the global structure of MCs, but it can be used to quantify the error in MC reconstruction resulting from the cylindrical approximation. When the local flux rope axis is approximately perpendicular to the heliocentric radial direction, which is also the effective spacecraft trajectory through a magnetic cloud, the error in using cylindrical reconstruction methods is relatively small (≈ 10∘). However, as the local axis orientation becomes increasingly aligned with the radial direction, the spacecraft trajectory may pass close to the axis at two separate locations. This results in a magnetic field time series which deviates significantly from encounters with a force-free flux rope, and consequently the error in the axis orientation derived from cylindrical reconstructions can be as much as 90∘. Such two-axis encounters can result in an apparent ‘double flux rope’ signature in the magnetic field time series, sometimes observed in spacecraft data. Analysing each axis encounter independently produces reasonably accurate axis orientations with MVA, but larger errors with FFFR fitting.

Childhood trauma: methods for the identification of physeal fractures in non-adult skeletal remains

Objectives Today, fractures at the growth plate (or physis) are common injuries in children, but provide challenges of identification in skeletonized remains. Clinical studies provide detailed information on the mechanisms, locations, age of occurrence, and complications associated with physeal fractures, enabling the development of new criteria for identifying this injury in non-adults. To test these criteria, skeletal remains from five rural and urban medieval cemeteries were examined. Methods The sample consisted of 961 skeletons (0-17 years) with open epiphyses. Macroscopic observation looked for any irregularities of the metaphysis or epiphysis which was consistent with the clinical appearance of physeal fractures or resulting complications. Radiographic examination was applied to identify fracture lines or early growth arrest. Results This study revealed 12 cases of physeal trauma (1.2%). Physeal fractures occurred predominantly at the distal end (75%), and while they were identified in all age categories, they were most frequent in those aged 12-17 years (0.2% TPR). The humerus was the most commonly affected location (3/12 or 25%). Conclusions This study highlights the potential for recognizing physeal fractures in children of all ages, enhancing our understanding of non-adult trauma, and enabling us to assign a more precise age of the injury to build up a picture of their activities in the past.

Wide-band tracheids (WBTs) of photosynthetic and non-photosynthetic stems in species of Cactaceae

ARRUDA, E. AND G. F. A. MELO-DE-PINNA (Departamento de Botanica, Instituto de Biociencias. Universidade de Sao Paulo, Rua do Matao, travessa 14, Cidade Universitaria, Butanta, Caixa Postal 11461, 05422-970. Sao Paulo, SP, Brasil). Wide-band tracheids (WBTs) of the photosynthetic and non-photosynthetic stems in species of Cactaceae. J. Torrey Bat. Soc. 137: 16-29. 2010.-The absence of WBTs and wood polymorphisms in some species of the Caryophyllales may be related to the particular area of plant analyzed. The present research has the objective of studying the photosynthetic and non-photosynthetic stems of different species and stages of differentiation to register wood polymorphisms and to understand the distribution and occurrence of WBTs. Wood polymorphism was observed in the non-photosynthetic stern of young and adult plants of Opuntioideae and Cactoideae and is also found in the photosynthetic stem of young plants of some species of Cactoideae. Cactoideae present WBT/fibrous dimorphic wood that can be related to cambial variation associated with growth habits and plant development. As expected, in the photosynthetic stem of the adult columnar cacti the wood is monomorphic fibrous in which WBTs were not found. This wood contains a great amount of fibers due to necessity of the mechanical support. In contrast, the globular species do not possess fibers in this area of the stem in either adult or young plants. Opuntia monacantha Haw. had non-fibrous wood in which WBTs were observed in the axial system and in the inner parts of the rays. Fiber clusters were present in the axial system. This wood represents a variation in the wood types described for Opuntioideae. Also, in O. monacantha, cells similar to the WBTs were observed in the pith, which can be interpreted as variation in the morphogenic processes during the ontogeny of the plant, probably a case of homeosis. Monomorphic fibrous wood without WBTs was found along the entire stem of Pereskia bahiensis Gurke. This feature has been observed in other pereskias, and in addition to the others, indicates its proximity to the ancestral cacti.

Equine chronic proliferative synovitis (villonodular synovitis): clinical, radiographic and ultrasonographic aspects: relate of case

Doria, R.G.S.; Canola, P.A.; Freitas, S.H. & Canola, J.C. [Equine chronic proliferative synovitis (villonodular synovitis): clinical, radiographic and ultrasonographic aspects: Relate of case.] Sinovite proliferativa cronica (sinovite vilonodular) em equino: aspectos clinicos, radiograficos e ultra-sonograficos: Relato de caso. Revista Brasileira de Medicina Veterinciria 30(3):157-161, 2008. Departamento de Cirurgia, Faculdade de Medicina Veterinaria, Universidade de Cuiaba, UNIC, Av. Antartica 788, Casa 26, Residencial Villas Boas, Ribeirao da Ponte, Cuiaba, MT 78040-500. Brasil. E-mail: redoria@uol.com.brThe development of intracapsullar masses at the dorsal aspect of the metacarpofalangeal joint for a period of several months is commonly secondary to the chronic synovitis. Although it is known as villonodular synovitis in horses probably is better to refer it as chronic proliferative synovitis. The most common causes are the non-treated osteocondral fractures of the dorsal portion of the proximal phalanx. In addition, the development of villonodular masses follows the degenerative process in the joint. A case of a lame animal is reported at the present study. The correct diagnosis and the adequate therapeutic propositions were given based on the clinical examination, therapeutic local-anesthetic test and radioghaphic and ultrasonographic imaging exams. The development of a criterious identification of this disease must be based on clinical findings, radiographic and ultrasonographic exams which assume fundamental importance to the treatment and prognostic. The aim of this study is to describe the clinical, radiographic and ultrasonographic findings' allowing the identification and diagnosis of chronic proliferative synovitis at the thoracic metacarpofalangeal joint in the horse.

Correlation of microcrack fracture size with fatigue cycling on non-crimp fabric/RTM6 composite in the uniaxial fatigue test

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Heat transfer in laminar flow of non-Newtonian fluids in ducts of elliptical section

Laminar forced convection inside tubes of various cross-section shapes is of interest in the design of a low Reynolds number heat exchanger apparatus. Heat transfer to thermally developing, hydrodynamically developed forced convection inside tubes of simple geometries such as a circular tube, parallel plate, or annular duct has been well studied in the literature and documented in various books, but for elliptical duct there are not much work done. The main assumption used in this work is a laminar flow of a power flow inside elliptical tube, under a boundary condition of first kind with constant physical properties and negligible axial heat diffusion (high Peclet number). To solve the thermally developing problem, we use the generalized integral transform technique (GITT), also known as Sturm-Liouville transform. Actually, such an integral transform is a generalization of the finite Fourier transform where the sine and cosine functions are replaced by more general sets of orthogonal functions. The axes are algebraically transformed from the Cartesian coordinate system to the elliptical coordinate system in order to avoid the irregular shape of the elliptical duct wall. The GITT is then applied to transform and solve the problem and to obtain the once unknown temperature field. Afterward, it is possible to compute and present the quantities of practical interest, such as the bulk fluid temperature, the local Nusselt number and the average Nusselt number for various cross-section aspect ratios. (C) 2006 Elsevier. SAS. All rights reserved.

Comparison between laser therapy and non-surgical therapy for periodontitis in rats treated with dexamethasone

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