"Pied de Charcot": un diagnostic à ne pas manquer [Charcot osteoarthropathy: don't miss it!].

Charcot neuropathic osteoarthropathy (CNO) is a destructive process affecting the bone and joint structure of diabetic patients and resulting from peripheral neuropathy. It is a limb threatening condition resulting in dramatic deformities associated with severe morbi-mortality. The diagnosis is mostly made by the observation of inflammatory signs and higlight the importance of prompt foot evaluation. Imaging studies may help confirm the diagnosis and the severity of the condition but lack of specificity. The goal of the treatment is to maintain or achieve structural stability of the foot and ankle to prevent further deformity and plantar dislocation. The scientific evidences aren't strong enough to recommend bisphosphonates or acute surgical treatment. Surgery is unanimusly recommended to prevent secondary ulceration.

Distraction osteogenesis in the management of severe maxillary hypoplasia in cleft lip and palate patients.

The aim of this study was to systematically review literature reporting on the use of external distraction osteogenesis (DO) and internal DO in the treatment of severe maxillary hypoplasia in cleft and palate patients. Literature research has been performed using the PubMed database of the National Library of Medicine and National Institutes of Health from 1966 to August 2007. We used cleft lip and palate and distraction osteogenesis as key words. Of the 104 articles found, we only considered the Anglo-Saxon literature, which reported on the correction of the maxillary hypoplasia with DO techniques. A total of 32 studies reported on anteroposterior external DO (27 studies on rigid external device and 5 on face mask), 17 studies reported on anteroposterior internal DO, and 3 studies reported on transverse internal DO have been retained for this review. Despite the heterogeneity and methodological limitations of most of the studies, results showed that external DO with rigid external device and internal DO resulted to be a more reliable and accurate technique than the face mask in the management of severe maxillary hypoplasia in patients with cleft lip and palate. The current review demonstrated that external and internal DO in the treatment of severe maxillary hypoplasia in cleft and palate patients (1) is a reproducible and valuable alternative to standard orthognathic surgery procedures, (2) allows for a global improvement in facial aesthetic, (3) allows a maxillary correction in patients during the period of mixed dentition, and (4) allows either for an unchanged or better velopharyngeal function.

Modelling leaf development in Oxalis latifolia

This study was carried to develop functions that could explain the growth of Oxalis latifolia, in both early stages and throughout the season, contributing to the improvement of its cultural control. Bulbs of the Cornwall form of O. latifolia were buried at 1 and 8 cm in March 1999 and 2000. Samples were destructive at fixed times, and at each time the corresponding BBCH scale codes as well as the absolute number of growing and adult leaves were noted. Using the absolute number of adult leaves (transformed to percentages), a Gaussian curve of three parameters that explains the growth during the season (R2=0.9355) was developed. The BBCH scale permitted the fit of two regression lines that were accurately adjusted for each burial depth (R2=0.9969 and R2=0.9930 respectively for 1 and 8 cm). The best moment for an early defoliation in Northern Spain could be calculated with these regression lines, and was found to be the second week of May. In addition, it was observed that a burial depth of 8 cm does not affect the growing pattern of the weed, but it affects the number of leaves they produce, which decreases to less than a half of those produced at 1 cm.

Discriminating crop, weeds and soil surface with a terrestrial LIDAR sensor

In this study, the evaluation of the accuracy and performance of a light detection and ranging (LIDAR) sensor for vegetation using distance and reflection measurements aiming to detect and discriminate maize plants and weeds from soil surface was done. The study continues a previous work carried out in a maize field in Spain with a LIDAR sensor using exclusively one index, the height profile. The current system uses a combination of the two mentioned indexes. The experiment was carried out in a maize field at growth stage 12–14, at 16 different locations selected to represent the widest possible density of three weeds: Echinochloa crus-galli (L.) P.Beauv., Lamium purpureum L., Galium aparine L.and Veronica persica Poir.. A terrestrial LIDAR sensor was mounted on a tripod pointing to the inter-row area, with its horizontal axis and the field of view pointing vertically downwards to the ground, scanning a vertical plane with the potential presence of vegetation. Immediately after the LIDAR data acquisition (distances and reflection measurements), actual heights of plants were estimated using an appropriate methodology. For that purpose, digital images were taken of each sampled area. Data showed a high correlation between LIDAR measured height and actual plant heights (R2 = 0.75). Binary logistic regression between weed presence/absence and the sensor readings (LIDAR height and reflection values) was used to validate the accuracy of the sensor. This permitted the discrimination of vegetation from the ground with an accuracy of up to 95%. In addition, a Canonical Discrimination Analysis (CDA) was able to discriminate mostly between soil and vegetation and, to a far lesser extent, between crop and weeds. The studied methodology arises as a good system for weed detection, which in combination with other principles, such as vision-based technologies, could improve the efficiency and accuracy of herbicide spraying.

Pellettien laatu ja ominaisuudet eri raaka-aineilla ja niiden seoksilla

Diplomityö tehtiin osana Vapon toteuttamaa monivuotista pelletin kehitysohjelmaa. Kehitysohjelma koostuu useista pienemmistä osaprojekteista, jotka täydentävät toinen toisiaan. Pellettien raaka-ainepohjan laajentaminen on eräs näistä osaprojekteista. Tutkimustyön tavoitteena oli selvittää erilaisten potentiaalisten bioraaka-aineiden soveltuvuutta pelletointiin joko sellaisenaan tai erilaisina seoksina. Raaka-aineiden pelletoitavuutta tutkittiin kenttäolosuhteissa mobiilipelletointilaitoksella. Laitoksen pääkomponentit muodostivat Kahl C 38–780 tasomatriisipuristin, jäähdytin ja täryseula. Pelletointikokeissa tutkittuja raaka-aineita olivat mäntysahanpuru, männynkuori, harvennusranka, haapa, koivu, jyrsinturve ja ruokohelpi. Raaka-aineiden irtotiheys käyttökosteudessa vaihteli välillä 73–244 kg/m3 ja keskimääräinen kosteuspitoisuus 6,5–15 %. Useissa tapauksissa säkitettyjä raaka-aineita säkkikostutettiin haluttuun kosteuspitoisuuteen ennen pelletointia. Säkkikostutettujen raaka-aineiden kosteuspitoisuudet vaihtelivat tällöin välillä 12–14 m- %. Valtaosa tutkituista raaka-aineista ja niiden seoksista pystyttiin pelletoimaan puristimen matriisilla 8/40 mm, jossa puristuskanavan halkaisija oli 8 mm ja kanavan suoran osan pituus 40 mm. Vaikeuksia tuotti ainoastaan pelkän koivupurun ja ruokohelven pelletointi. Käytetty matriisi oli kanavapituudeltaan liian pitkä koivupurun pelletointiin nostaen puristusvastuksen suureksi. Ruokohelven pelletoinnin vaikeudet johtuivat pääasiassa pelletointiin liian karkeasta raaka-aineesta. Myös matriisia 8/55 mm kokeiltiin, mutta se osoittautui liian ”tiukaksi” valtaosalle puuraaka-aineista. Ainoastaan jyrsinturpeen pelletointi onnistui tällä matriisilla. Männynkuoren pelletointia ei matriisilla 8/55 mm yritetty. Kenttäkokeissa valmistetuista pelleteistä määritettiin erilaisia ominaisuuksia, kuten keskipituus, kosteuspitoisuus, irtotiheys, hienoaineksen määrä ja käsittelykestävyys. Lujuus mitattiin sekä Ligno-testillä että CEN-rummutuslujuuden määrityksellä. Lisäksi pelleteille määritettiin alkuaineanalyysi, tuhkapitoisuus ja lämpöarvo ENAS Oy:n laboratoriossa Jyväskylässä. Ligno-testauksessa parhaimman luokan pelletin tulee yltää arvoon 97,5 %. Pelletoitaessa raaka-aineita ja niiden seoksia tasomatriisikoneella sopivalla matriisilla yllettiin usein näihin tai parempiin tuloksiin. Puumateriaaleilla raaka-aineen optimaalinen lähtökosteus oli välillä 12–14 m- % ja turpeella sekä ruokohelvellä 14–16 m- %. Pelletointi onnistui tällöin vaivattomasti, kunhan sopivat puristimen ajoparametrit oli löydetty. Pellettiä alkoi muodostua matriisin puristuskanavien lämpötilan kohotessa noin 70 ºC. Pellettien lämpötila stabiilitilanteessa heti pelletoinnin jälkeen oli useissa tapauksissa 80–90 ºC. Pelletoinnin aikainen tehontarve vaihteli välillä 90–150 kWh/t, ollen suurimmillaan irtotiheydeltään keveillä materiaaleilla. Raaka-aineen suuri partikkelikoko kasvatti puristimen tehontarvetta. Tämä havaittiin selvästi lisättäessä karkeaa ruokohelpisilppua eri raaka-aineiden joukkoon. Kestävyydeltään erinomaisia pellettejä saatiin, kun raaka-aineena oli jyrsinturve, harvennusranka tai mäntypuru. Varsinkin jyrsinturpeen ja harvennusrangan seoksesta valmistetut pelletit osoittautuivat erittäin kestäviksi. Myös jyrsinturpeen ja ruokohelven sekä mäntypurun ja ruokohelven seoksien pelleteille määritettiin hyviä kestävyysarvoja. Männynkuoresta valmistetut pelletit jäivät Ligno-testauksessa kestävyydeltään alle 97,5 % rajan. Pääsyynä tähän oli kuoren pelletointiin käytetyn matriisin 8/40 mm liian lyhyet puristuskanavat.

CRTC2 polymorphism as a risk factor for the incidence of metabolic syndrome in patients with solid organ transplantation.

NlmCategory="UNASSIGNED">Metabolic syndrome after transplantation is a major concern following solid organ transplantation (SOT). The CREB-regulated transcription co-activator 2 (CRTC2) regulates glucose metabolism. The effect of CRTC2 polymorphisms on new-onset diabetes after transplantation (NODAT) was investigated in a discovery sample of SOT recipients (n1=197). Positive results were tested for replication in two samples from the Swiss Transplant Cohort Study (STCS, n2=1294 and n3=759). Obesity and other metabolic traits were also tested. Associations with metabolic traits in population-based samples (n4=46'186, n5=123'865, n6>100,000) were finally analyzed. In the discovery sample, CRTC2 rs8450-AA genotype was associated with NODAT, fasting blood glucose and body mass index (Pcorrected<0.05). CRTC2 rs8450-AA genotype was associated with NODAT in the second STCS replication sample (odd ratio (OR)=2.01, P=0.04). In the combined STCS replication samples, the effect of rs8450-AA genotype on NODAT was observed in patients having received SOT from a deceased donor and treated with tacrolimus (n=395, OR=2.08, P=0.02) and in non-kidney transplant recipients (OR=2.09, P=0.02). Moreover, rs8450-AA genotype was associated with overweight or obesity (n=1215, OR=1.56, P=0.02), new-onset hyperlipidemia (n=1007, OR=1.76, P=0.007), and lower high-density lipoprotein-cholesterol (n=1214, β=-0.08, P=0.001). In the population-based samples, a proxy of rs8450G>A was significantly associated with several metabolic abnormalities. CRTC2 rs8450G>A appears to have an important role in the high prevalence of metabolic traits observed in patients with SOT. A weak association with metabolic traits was also observed in the population-based samples.The Pharmacogenomics Journal advance online publication, 8 December 2015; doi:10.1038/tpj.2015.82.

De pluviis prodigiosis

Invocatio: D.D.

L'Univers

1870/09/04 (Numéro 1214).

Lentokadettien ammatillisten kunto-ominaisuuksien muutos valintavaiheesta kadettikurssin alkuun 92. kadettikurssilla

Tutkimuksessa selvitettiin kadettikurssi 92. ammatillisten kunto-ominaisuuksien muutosta valintavaiheesta kadettikurssin alkuun. Tähän pyrittiin vastaamaan vertailemalla ensimmäisen ja toisen testin tuloksia keskenään. Testien väli oli yhdeksästä kuukaudesta vuoteen. Testeinä olivat varusmiehen kuntoindeksi (VKI) ja sen osa-alueet, sekä niin sanottu lihaskuntotestistö. Lihaskuntotestistöön kuuluvat seuraavat testit: isometriset voimatestit, anaerobisen tehon testi (hyppytesti), sekä ylä- ja keskivartalon koordinaatio ja voima testi (heittoporttitesti). Yhtenä mittarina käytettiin myös antropometrisistä mitoista painoindeksiä (BMI). Koehenkilöinä toimivat kadettikurssi 92. ohjaajalinjan kadetit. Yhteensä heitä saatiin testistä riippuen testattavaksi 12–14 henkilöä. Tilastollisena menetelmänä on käytetty kahden riippuvan otoksen T-testiä. Myös korrelaatiot on tutkittu kaikkien testien osalta. Lihaskuntotestin osalta ei pystytty tekemään merkittäviä johtopäätöksiä ammatillisten kuntoominaisuuksien muutoksesta, kun taas isometrisistä voimatesteistä saatiin erittäin hyviä tuloksia. Näistä pystyttiin toteamaan, että kadettikurssi 92. ohjaajalinjan kadettien ammatilliset kunto-ominaisuudet ovat pysyneet ainakin samalla tasolla kuin vuotta aikaisemmin ja todennäköisesti kadettien kuntotasot ovat hieman nousseet.

Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes

Diabetic retinopathy is one of the leading causes of blindness in working-age individuals. Diabetic patients with proteinuria or those on dialysis usually present severe forms of diabetic retinopathy, but the association of diabetic retinopathy with early stages of diabetic nephropathy has not been entirely established. A cross-sectional study was conducted on 1214 type 2 diabetic patients to determine whether microalbuminuria is associated with proliferative diabetic retinopathy in these patients. Patients were evaluated by direct and indirect ophthalmoscopy and grouped according to the presence or absence of proliferative diabetic retinopathy. The agreement of diabetic retinopathy classification performed by ophthalmoscopy and by stereoscopic color fundus photographs was 95.1% (kappa = 0.735; P < 0.001). Demographic information, smoking history, anthropometric and blood pressure measurements, glycemic and lipid profile, and urinary albumin were evaluated. On multiple regression analysis, diabetic nephropathy (OR = 5.18, 95% CI = 2.91-9.22, P < 0.001), insulin use (OR = 2.52, 95% CI = 1.47-4.31, P = 0.001) and diabetes duration (OR = 1.04, 95% CI = 1.01-1.07, P = 0.011) were positively associated with proliferative diabetic retinopathy, and body mass index (OR = 0.90, 95% CI = 0.86-0.96, P < 0.001) was negatively associated with it. When patients with macroalbuminuria and on dialysis were excluded, microalbuminuria (OR = 3.3, 95% CI = 1.56-6.98, P = 0.002) remained associated with proliferative diabetic retinopathy. Therefore, type 2 diabetic patients with proliferative diabetic retinopathy more often presented renal involvement, including urinary albumin excretion within the microalbuminuria range. Therefore, all patients with proliferative diabetic retinopathy should undergo an evaluation of renal function including urinary albumin measurements.

Clinical and genetic markers in disease progression – a study among subjects with obstructive lung diseases

Asthma, COPD, and asthma and COPD overlap syndrome (ACOS) are chronic pulmonary diseases with an obstructive component. In COPD, the obstruction is irreversible and the disease is progressive. The aim of the study was to define and analyze factors that affected disease progression and patients’ well-being, prognosis and mortality in Chronic Airway Disease (CAD) cohort. The main focus was on COPD and ACOS patients. Retrospective data from medical records was combined with genetic and prospective follow-up data. Smoking is the biggest risk factor for COPD and even after the diagnosis of the disease, smoking plays an important role in disease development and patient’s prognosis. Sixty percent of the COPD patients had succeeded in smoking cessation. Patients who had managed to quit smoking had lower mortality rates and less psychiatric diseases and alcohol abuse although they were older and had more cardiovascular diseases than patients who continued smoking. Genetic polymorphism rs1051730 in the nicotinic acethylcholine receptor gene (CHRNA3/5) associated with heavy smoking, cancer prevalence and mortality in two Finnish independent cohorts consisting of COPD patients and male smokers. Challenges in smoking cessation and higher mortality rates may be partly due to individual patient’s genetic composition. Approximately 50% of COPD patients are physically inactive and the proportion was higher among current smokers. Physically active and inactive patients didn’t differ from each other in regard to age, gender or comorbidities. Bronchial obstruction explained inactivity only in severe disease. Subjective sensation of dyspnea, however, had very strong association to inactivity and was also associated to low health related quality of life (HRQoL). ACOS patients had a significantly lower HRQoL than either the patients with asthma or with COPD even though they were younger than COPD patients, had better lung functions and smaller tobacco exposure.

Le Petit journal. Supplément du dimanche

1914/02/22 (Numéro 1214).

L'Écho de Paris

1887/07/14 (Numéro 1214).

Recueil de documents concernant Chartres, Courbeville, St-Jean en Vallée, les monnaies sous Philippe le Bel de 1294 à 1307. Copies.

Contient : 1 « Ce est la chartre de la franchise de la cité de Chartres, donnée et otroiée de très excellent et puissant prince monseigneur Charles, filz de roy de France ». Acte de CHARLES, comte DE VALOIS, d'Alençon, de Chartres et d'Anjou, frère de Philippe le Bel, souscrit par sa femme MARGUERITE d'ANJOU, à Paris, en mars 1296-1297, et vidimé par le châtelain de Chartres, le mercredi 23 novembre, jour de St-Clément 1306 ; 2 « Ce est la franchise de la terre dou prieuré de Courbeville et de la joustice doudit prieuré que il ont à Courbeville et illeiq environ ». Acte de « GUILLEAUME DE VIEZPONT, escuier, seigneur de Courbeville », vidimé par PHILIPPE, roi de France, et par MICHEL DE BRAY, bailli de Chartres. La fin manque et par conséquent la date ; 3 « Acte par lequel JEAN DE CHATILLON, comte DE BLOIS et de Chartres, confirme et ratifie la composition accordée entre Mathilde, comtesse de Chartres et dame d'Amboise, et les religieux de St-Jean en Vallée de Chartres. Mars 1265-1266. Vidimé en 1294, le jeudi 9 septembre. En latin ; 4 « Ce est la composicion faite entre très haut et très noble prince monseigneur Charles, filz de roy de France, comte de Chartres, d'une part, et honorables hommes le doen et le chapitre de Chartres, d'autre part ». Chartres, le lundi après la fête St-Mathieu, 26 septembre 1306 ; 5 « Ce est le tencrist de la chartre des franchises aus bourgois de la rivière de Chartres ». Acte de JEAN DE CHATILLON, comte DE BLOIS et sire d'Avesnes. Avril 1268. Vidimé en 1278, « le vendredi après la St-Pierre aus Chevalier » (sic), par GUILLAUME DE St-MESMIN, châtelain de Chartres ; 6 « C'est le tencrist de la chartre des ordenances de la cendre et des dras as bourgois de la rivière de Chartres ». Acte de JEAN DE CHATILLON, comte DE BLOIS et sire d'Avesnes. 1268 en avril ; 7 « C'est le tencrist de la chartre de l'ordenance aus arçonneurs ». Acte de THIBAUT IV, comte DE BLOIS et de Clermont. Août 1214. En latin ; 8 « C'est l'ordenance aus marcheanz de Chartres alanz aus foires, et dou pois de la cendre ». Acte du même comte. Chartres, octobre 1214. En latin ; 9 « C'est l'ordenance des bourgois de la rivière et des dras ». Acte de JEAN, comte DE CHARTRES et seigneur d'Oisy. Mai 1222. En latin ; 10 « C'est le tencrist de la chartre de la mautoste ». Acte, en latin, du même comte. Chartres, janvier 1222-1223 ; 11 « C'est le tencrist de la chartre de la meison de Saint-Cristoffle ». Acte de JEAN « DE ALUYA, dominus Castellorum et Sancti Christofori ». Mai 1225. En latin ; 12 « Item. De la maison de Saint Christoffle ». Acte qui semble être un double du précédent. Mai 1205 (sic). En latin ; 13 « C'est l'ordenance et le tencrist de la chartre de la perrée aus marcheanz qui marchandent en la perrée de Chartres ». Acte de THIBAUT IV, comte DE BLOIS et de Clermont. Janvier 1213-1214. En latin ; 14 « Item. De la maison St-Cristoffle ». Acte de JEAN « DE ALEIA, dominus Castellorum et Sancti Cristofori », accordant aux marchands de draps de Chartres huit toises et demie pour l'augmentation de leur maison en largeur, moyennant 40 sous de cens annuel. Août 1235. En latin ; 15 « C'est le jugement que JEHAN LE BURELIER » chatelain de Chartres, « donna contre Jehan de S. Paier, bourgois d'Orliens ». Il déclare confisqués au profit du comte de Chartres les « aignelins » que ledit bourgeois d'Orléans avait apportés à Chartres ou fait apporter pour les faire teindre. Août 1268 ; 16 « Ce est le jugement que Guillaume de St-Mesmin », châtelain de Chartres, « fist contre Guillaume dou Coing, qui tenait les « molins foulerez ». Il le condamne à rendre à « Jourdain Des Autiex » une pièce de draps perdue. Le samedi après les Brandons, 16 mars 1279-1280 ; 17-19 Ordonnances de PHILIPPE LE BEL sur la valeur des monnaies ; 17 Adressée au sénéchal de Saintonge. Mesy, 4 décembre 1306 ; 18 Adressée « à touz jousticiers » du royaume. Paris, le lundi après la Circoncision N. S. 3 janvier 1306-1307 ; 19 Adressée à tous. Paris, le jeudi après les Brandons, 16 fevrier 1306-7 ; 20 « C'est le pris que le marc d'argent a valu depuis que les tornois doubles et les parisis furent fez ». De la veille de Pâques, 2 avril 1294-1295 au jour de Pâques, 18 avril 1305