Few clinical studies have analyzed the utility of distal interlocking screws in stable and unstable intertrochanteric fractures treated with intramedullary devices. We performed a prospective ...analysis comparing short unlocked versus short dynamic and short static distal locked intramedullary nails.
Nine level-II trauma centres were involved in the study. 240 patients over the age of 65 with a stable (AO/OTA 31-A1) or unstable intertrochanteric fracture (AO/OTA 31-A2) were prospectively investigated. The same type of nail was used in every patient. Patients were randomly divided into 3 groups according to the type of distal locking used. Intra-operative variables were examined and patients were followed clinically and radiographically at 1, 3, 6, 12 months postoperatively. All complications were recorded.
A total of 212 patients completed 1 year of follow-up visits. In the Unlocking Group (UG) the operation time, blood loss, fluoroscopy time, total length of incision were significantly decreased compared to both the Dynamic Group (DG) and the Static Group (SG) (p < 0.05). Conversely, no reliable differences in intraoperative variables were noted between the Dynamic Group and the Static Group (p > 0.05). In terms of time of fracture union we found no differences among the three Groups (p > 0.05). Moreover, no cases of limb shortening >1 cm or varus collapse were detected in any group. The 3 Groups were similar in terms of HHS, SF-12 and Barthel index results at 1-year follow-up (p > 0.05). Finally, no significant differences were demonstrated across the three Groups in terms of major complications.
This clinical study further confirms the hypothesis that short intramedullary nails do not need to be locked for stable and unstable intertrochanteric fractures.
Background
The recent introduction of microarrays for genetic analyses has allowed higher etiological diagnostic rates in patient with intellectual disability (ID), autism spectrum disorders (ASD), ...epilepsy and multiple congenital anomalies (MCA), because of its resolution. This approach still results of high complexity and some limitations have been reported. In fact, it discloses several variants of unknown significance (VOUS) or incidental findings. In all cases, a massive amount of data is generated, because of this, the analysis and the interpretation is very difficult and often without a definitive conclusion.
Method
We analysed an Italian cohort of 343 patients with ID, MCA and ASD by array‐comparative genomic hybridization. The purpose of this work was to consider the proportion of the chromosomal abnormalities in such cohort and to assess the distribution of the different type of the chromosomal abnormalities concerning their pathogenic significance, their origin and their correlation to these clinical phenotypes.
Results
Array‐comparative genomic hybridization analysis revealed 76 positive results. Abnormalities were detected in 27.8% of patients with ID, 11.1% with ASD, 10.7% with epilepsy and 19.4% with multiple congenital anomalies. The anomalies were classified in three major groups: group 1 (27 patients) with pathogenic alterations (P group); group 2 (34 patients) with VOUS potentially pathogenic (PP group); and group 3 (13 patients) with VOUS potentially benign (PB group). As expected, comparing the diagnostic groups, we observed a greater number of deletions in the P group and that all the abnormalities of the PB group were inherited.
Conclusions
Our retrospective study resulted in confirming the high detection rate of microarrays. CNV classification remains a complex procedure. The difficulty in CNV classification points out the importance of the patient selection, helping the interpretation of the molecular cytogenetic results.
La réalité virtuelle à 360° semble être un outil intéressant pour pallier le manque de sensibilisation à certaines professions comme la masso-kinésithérapie et avoir des répercussions, notamment sur ...l’orientation professionnelle des lycéens. L’objectif de l’étude était de comparer la perception du métier de masseur-kinésithérapeute en fonction du support de présentation (réalité virtuelle à 360° ou support papier) chez des lycéens.
Un essai contrôlé randomisé a été réalisé auprès de 93 lycéens de trois établissements scolaires. La perception, la compréhension du métier et le niveau d’information des lycéens ont été évalués au moyen d’un questionnaire complété après l’accès au support.
La réalité virtuelle était supérieure au groupe contrôle (support papier) dans la perception, la compréhension du métier et le niveau d’information des lycéens (P<0,05).
La réalité virtuelle a permis aux élèves de développer une meilleure perception du métier de masseur-kinésithérapeute que le support papier. Il serait intéressant de développer d’autres modules pour sensibiliser aux métiers de la santé et du sport.
2.
360° virtual reality seems to be an interesting tool to overcome the existing lack of awareness of certain professions such as physiotherapy; it has repercussions on the professional orientation of high school students. The objective of this study was to compare the perception of the profession of physiotherapist according to the presentation medium (360° virtual reality or paper format) among high school students.
A randomized controlled trial was conducted in 93 high school students from three schools. Students’ perception, understanding of the profession, and level of information were assessed using a questionnaire completed after accessing the medium of presentation.
Virtual reality was superior to the control group (paper-based format) in the perception, understanding of the profession and the level of information of high school students (P<0.05).
Virtual reality allowed students to develop a better perception of the physiotherapist than the paper format. It would be interesting to develop other modules to raise awareness of the health and sports professions.
2.
Les séquelles motrices subséquentes à un accident vasculaire cérébrale (AVC), notamment au niveau de l’équilibre postural, nécessite la mise en place de programmes de réadaptation. La réalité ...virtuelle, par son aspect immersif et écologique, est de plus en plus utilisé pour la réadaptation des capacités fonctionnelles des patients post-AVC. Néanmoins, l’impact d’un environnement virtuel sur le contrôle postural n’est pas clairement établi. L’objectif de cette étude est d’évaluer l’équilibre postural de patients post-AVC et de participants sains avec et sans environnement virtuel.
Cinq patients post-AVC (61±7 ans) hospitalisés en phase subaiguë et 19 participants sains (57±4 ans) ont réalisé 4 tests posturographiques :
– yeux ouverts (YO) ;
– yeux fermés (YF) ;
– environnement virtuel statique (EVS) dans un appartement sans foule ;
– environnement virtuel dynamique (EVD) dans un centre commercial avec une foule en mouvement.
La vitesse moyenne et la surface du déplacement du centre de pression ont été recueillies via une plateforme stabilométrique.
Alors que nos résultats n’indiquent aucune différence significative des paramètres posturographiques entre les groupes post-AVC et participants sains en condition YO (p>0,05), l’analyse statistique montre une vitesse moyenne et une surface d’oscillation plus importantes pour le groupe post-AVC en comparaison du groupe participants sains en condition YF, EVS et EVD (p<0,05).
La réalité virtuelle semble davantage modifier le contrôle postural de patients post-AVC que de participants sains. Dès lors, l’aspect challengeant de la réalité virtuelle chez cette population nécessite d’être prise en compte dans les programmes de réadaptation.
We report on an 18-month-old boy conceived by assisted reproduction technology with developmental delay, hypotonia, microcephaly, frontal bossing, a mild convergent squint, malformed ears, and a ...short neck. Karyotype analysis revealed a de novo 7q21.1q22.3 duplication characterized by array comparative genomic hybridization (array-CGH) as a segment of 18.69 Mb. Duplications of the long arm of chromosome 7 are uncommon. There are 18 reported cases of different 7q segments with a pure duplication with no additional deletion of other chromosomes. As a consequence, duplications of chromosome 7q have been classified in 4 groups on the basis of the involved region. The present case is included in group 3 which involves interstitial duplications of different sizes. In the literature, only one case with an apparently smaller duplication of the same region has been described. Despite this, the phenotype is different. Moreover, the 2 patients share some phenotypic features, such as psychomotor delay, hypotonia, frontal bossing, short neck, and strabismus. However, the absence of physical characterization in most of the reported cases could justify the lacking phenotype-genotype correlation in patients with partial 7q duplication. Further studies using recent molecular approaches such as array-CGH might permit a more clinically useful grouping of 7q duplications.
Cytogenetic investigations and molecular analysis of the Y chromosome by the polymerase chain reaction amplification of sequence-tagged sites (STS-PCR) technique were performed in 126 patients ...affected by idiopathic oligo-azoospermia following accurate selection of cases. Seventeen patients evidenced an abnormal karyotype. Fourteen patients with a normal karyotype had microdeletions of the Y chromosome within interval 6. In azoospermic patients microdeletions were scattered along different subintervals, while in oligozoospermic patients they were clustered in subinterval 6E. The size of the deletion was not apparently related to the severity of the disease. These results suggest that cytogenetic analysis and the STS-PCR technique can detect a genetic cause of infertility in about one-quarter of patients with idiopathic oligo-azoospermia.
