Premature epiphyseal closure in an adolescent treated by retinoids for acne: An unusual cause of anterior knee pain

Introduction.- Retinoids are effective and widely used for the treatment of severe acne. Their use can be, however, associated with numerous side effects. For example, some rare cases of premature epiphyseal closure were reported.Observation.- A sixteen-year-old soccer player consulted for bilateral progressive anterior knee pain, since two months, evoking a femoro-patellar origin. After physiotherapy, the pain decreases on the right but remained on the left. The history taking brought out the use of isotretinoin for more than 6 months (0.5 mg/kg). Magnetic resonance imaging (MRI) findings showed an irregularity of the growth plate and an important metaphyso-epiphyseal oedema, more marked on the left. The diagnosis of retinoid induced premature ephysieal closure was retained. The treatment was stopped, with a resolution of symptoms within two months. The control MRI of the left knee present persisting small sequelar thumbprint-like growth plate lesion. Eighteen months later, neither limb-length discrepancy nor static disorder was noticed.Discussion.- Premature epiphyseal closure is a rare complication of retinoid treatment of acne. Retinoids induce an invasion of the growth plate by osteoclasts and a decrease in proteoglycans synthesis. The knee seems the most involved joint. The clinical presentation is aspecific, sometimes lightly symptomatic. A careful pharmacological history and an appropriate imaging are necessary. MRI is now the gold standard. It shows an irregularity of the growth plate with an oedema on both sides. In chronic phase, a thumbprint-like image may persist. The symptoms resolution arises in few weeks after the treatment interruption. A single case of static disorder was reported until now. The small size of the growth plate interruptions, insufficient to lead to a growth disorder if the medicament is stopped early enough, explains probably it. This complication being rare, a radiological follow-up of the young patients treated by retinoids is not proposed.

Osobennosti perevoda proizvedenij russkix pravoslavnyx myslitelej na francuzskij jazyk (S.N.Bulgakov, A.F. Losev) [Les spécificités de la traduction des textes des penseurs orthodoxes russes en français (S. Bulgakov, A. Losev)]

This article is attempt to crarify some conceptuel and linguistic problems in the translation (from Russian and French) of philosophical texts written in the first of the 20th century - in particular, those by S. Bulgakov and A. Losev. We consider any transation as a form of cross-cultural communication taking place between the author and the translator(s) of the texte. Any translation involves a complex interaction of different historical and cultural factors that are attempt to combine and to remove cultural and conceptual misunderstandings.

Jornades d'Història de la Medicina a la Garrotxa : Olot, 28 i 29 de març de 1987

Amb aquest número, la revista "Gimbernat" deixa de centrar-se en els Congressos d'Història de la Medicina Catalana i s'obre a altres esdeveniments, també més locals, en aquest cas, les primeres Jornades d'Història de la Medicina a la Garrotxa. En aquest volum trobem el resum de les diferents ponències i comunicacions.

Studia Ramazziniana mediterranea. Vol, 2, 1992

Aquest segon volum de la revista Studia Ramazziniana mediterranea recull les Actes del Primer Congrés Català de Medicina del Treball, cel·lebrat a Barcelona del 4 al 7 d'abril de 1984.Les actes s'ordenen en quatre grups segons la temàtica tractada: Asbestosi, Invalideses, Dermatologia Laboral i Hepatitis.

Santuaris lleidetans amb tradició mèdica

Aquest llibre es publica amb motiu del III Congrés d'Història de la Medicina Catalana, que se celebrà a la ciutat de Lleida durant els dies 4 al 6 de juny de 1981.Possiblement, la raó llunyana per la qual s'han elegit aquestes dates per a publicar-lo, obeeixi al punt de partida extern del llibre, que fou la petita comunicació "Aspectes mèdics del santuari de Butsènit", presentada precisament en un Congrés, el II d'Història de la Medicina Catalana, celebrat l'any 1975 a la reial Acadèmia de Medicina de Barcelona.

Jornades d'Història de la Medicina a la Garrotxa : Olot, 28 i 29 de març de 1987

Amb aquest número, la revista "Gimbernat" deixa de centrar-se en els Congressos d'Història de la Medicina Catalana i s'obre a altres esdeveniments, també més locals, en aquest cas, les primeres Jornades d'Història de la Medicina a la Garrotxa. En aquest volum trobem el resum de les diferents ponències i comunicacions.

Studia Ramazziniana mediterranea. Vol, 2, 1992

Aquest segon volum de la revista Studia Ramazziniana mediterranea recull les Actes del Primer Congrés Català de Medicina del Treball, cel·lebrat a Barcelona del 4 al 7 d'abril de 1984.Les actes s'ordenen en quatre grups segons la temàtica tractada: Asbestosi, Invalideses, Dermatologia Laboral i Hepatitis.

El Pensamiento sanitario y laboral de dos medicos anarquistas del siglo XIX

Amb motiu del I Congrès Català de Medicina del treball, els autors recullen textos dispersos d'autors diversos del segle XIX en què podem observar una mateixa finalitat: la d'estudiar i resoldre problemes mèdico-laborals i de sanitat col·lectiva.

Diccionari biogràfic de metges catalans

Diccionari que recull una petita biografia i esment a les obres dels metges catalans de què es té constància desde l'Edat Mitja fins els temps contemporanis.

Balance del siglo XIX: la medicina

Amb motiu del Quart Congrés d'Història de la Medicina Catalana, es publica aquest recull d'articles del Doctor Robert, aparescuts a La Vanguardia a partir del 1901 i que aporten un testimoni directe d'un moment àlgid de la medicina catalana. Els recopil·ladors, en Josep M. Calbet i en Jacint Corbella, pretenen també destacar la implicació política d'aquest personatge tan rellevant.

Precision of tibial tunnel placement under arthroscopic control alone in posterior cruciate ligament reconstruction: A radiological study

Introduction: Accurate and reproducible tibial tunnel placement minimizing the risk of neurovascular damage is a crucial condition for successful arthroscopic reconstruction of the posterior cruciate ligament (PCL). This step is commonly performed under fluoroscopic control. Hypothesis: Performing the tibial tunnel under exclusive arthroscopic control allows accurate and reliable tunnel placement according to recommendations in the literature. Materials and Methods: Between February 2007 and December 2009, 108 arthroscopic single bundle PCL reconstructions in tibial tunnel technique were performed. The routine postoperative radiographs were screened according to previously defined quality criterions. After critical analysis, the radiographs of 48 patients (48 knees) were enrolled in the study. 10 patients had simultaneous ACL reconstruction and 7 had PCL revision surgery. The tibial tunnel was placed under direct arthroscopic control through a posteromedial portal using a standard tibial aming device. Key anatomical landmarks were the exposed tibial insertion of the PCL and the posterior horn of the medial meniscus. First, the centre of the posterior tibial tunnel outlet on the a-p view was determined by digital analysis of the postoperative radiographes. Its distance to the medial tibial spine was measured parallel to the tibia plateau. The mediolateral position was expressed by the ratio between the distance of the tunnel outlet to the medial border and the total width of the tibial plateau. On the lateral view the vertical tunnel position was measured perpendicularly to a tangent of the medial tibial plateau. All measurement were repeated at least twice and carried out by two examiners. Results: The mean mediolateral tunnel position was 49.3 ± 4.6% (ratio), 6.7 ± 3.6 mm lateral to the medial tibial spine. On the lateral view the tunnel centre was 10.1 ± 4.5 mm distal to the bony surface of the medial tibial plateau. Neurovascular damage was observed in none of our patients. Conclusion: The results of this radiological study confirm that exclusive arthroscopic control for tibial tunnel placement in PCL reconstruction yields reproducible and accurate results according to the literature. Our technique avoids radiation, facilitates the operation room setting and enables the surgeon to visualize the anatomic key landmarks for tibial tunnel placement.