Should CT scan be performed when CRP is elevated after colorectal surgery? Results from the inflammatory markers after colorectal surgery study.

Summary Introduction Serum concentration of C-reactive protein (CRP) that exceeds a pre-defined threshold between the 3rd and 5th postoperative day is a reliable marker of infectious complications after colorectal surgery. However, the optimal strategy to follow when a high CRP is found has not been defined. The aim of this study was to analyze the usefulness of computed tomography (CT) scan in this situation in a prospective cohort of patients following colorectal surgery. Methods Between November 2011 and April 2015, patients at two surgical centers who had undergone elective colorectal resection with anastomosis and who had a CRP > 12.5 mg/dL on the 4th postoperative day (POD) were prosp…

Du verney : un anatomiste éloquent du XVIIe siècle

But etudier la vie et l’œuvre de Joseph-Guichard du Verney, anatomiste du xvii e siecle et evaluer son influence sur la culture et les sciences de son epoque. Materiel et methodes etude biographique. Resultats Ne en 1648 d’une lignee de medecins a Feurs, dans le Forez, Joseph-Guichard du Verney fit de etudes de medecine a Avignon. Il fut recu Docteur en 1667. Rapidement, il se distingua par une eloquence hors du commun. Parvenu a Paris, il devint anatomiste a la mode. Ses lecons d’anatomie sortirent des ecoles de Medecine pour les salons mondains. Il fut charge d’enseigner l’anatomie au Dauphin. Il s’interessa a l’anatomie comparee, a la physiologie et la botanique. Il laisse un traite sur …

Patterns of recurrence of obstructing colon cancers after surgery for cure: a population-based study.

Aim Little is known about patterns of recurrence in obstructing colon cancer (OCC) at a population level. The aim of this study was to determine the risk of recurrence following potentially curative surgery in OCC compared with that in uncomplicated colon cancer (CC). Method Data were obtained from the population-based digestive cancer registry of Burgundy (France). Local and distant failure rates were calculated using actuarial methods. A multivariate analysis was performed using a Cox model. Results Obstructing colon cancer represented 8.5% of all colon cancers resected with curative intent (n = 3375). The 5-year cumulative local recurrence rate was 14.2% for OCC and 7.6% for nonobstructi…

Rôle de l’artère auriculaire postérieure dans la vascularisation de la portion extra – crânienne du tronc du nerf facial

But de l’etude plusieurs observations de paralysies faciales ont ete rapportees lors de la cure d’oreilles proeminentes, technique impliquant le sacrifice du muscle et parfois de l’artere auriculaires posterieurs. Le but de notre etude est d’evaluer l’importance de l’artere auriculaire posterieure dans la vascularisation de la portion extra-crânienne du nerf facial. Materiel et Methodes nous avons injecte selectivement au bleu de methylene 30 arteres auriculaires posterieures sur 15 sujets frais. Le nerf facial etait aborde par voie cervicale. Puis l’artere auriculaire posterieure etait dissequee prudemment jusqu’au-dessus du pavillon de l’oreille en preservant toutes ses branches collatera…

Analyse biomécanique du foie lors des décélérations frontales et latérales : étude expérimentale sur cadavres et simulation numérique

But ce travail, mene sur cadavres puis par simulation numerique avait pour but de caracteriser le comportement biomecanique du foie, conserve dans son environnement anatomique, soumis a une deceleration frontale, laterale gauche ou laterale droite. Materiel et methodes onze troncs, sectionnes a partir de corps, ont ete soumis sur un banc de chute libre a des vitesses de 4, 6 et 8 metres par seconde puis a une deceleration frontale ou laterale. Des accelerometres etaient places dans les deux lobes du foie, dans la veine cave retro hepatique, au contact du duodeno-pancreas, de la rate et en regard de la vertebre L2. La meme experience etait simulee virtuellement, a l’aide d’un logiciel de sim…

Mesure de l’orientation de la glène de la scapula : méthode du triangle scapulaire

Processus coracoïde : étude des variabilités morphologiques en tomodensitométrie avec reconstruction 3D

Contribution de l’artère auriculaire postérieure à la vascularisation du nerf facial dans l’espace préstylien : étude anatomique et conséquences chirurgicales

INTRODUCTION: The aim of our study was to establish a systematization of collateral branches originating from posterior auricular artery to facial nerve in prestylian space. MATERIALS AND METHODS: Thirty posterior auricular arteries were studied on 15 fresh cadavers after selective patent blue injection. We observed subsequent colouration of facial nerve. Number and topography of collateral branches were highlighted. RESULTS: Posterior auricular artery supplied facial nerve in 67%. Collateral branches dedicated to facial nerve could be classified into three types: type 1 corresponded to one artery in prestylian space, type 2 to several branches in prestylian space; finally type 3 featured s…

Trends in Frequency and Management of Obstructing Colorectal Cancers in a Well-Defined Population

Few population-based studies investigate obstructing colorectal cancers. This study was designed to describe trends in their frequency and management. Data were obtained for 13,331 colorectal cancers registered by the population-based cancer registry of Burgundy, France, between the years 1976 and 2000. Obstructing cancers represented 8.3 percent of all colorectal cancers. This proportion was stable throughout the study. Resection for cure increased from 54.9 percent (1976–1980) to 71.4 percent (1996–2000; P = 0.011). Using multivariate analysis, site of cancer and period of diagnosis were the only factors significantly associated to a curative resection. Postoperative mortality for obstruc…

Adjuvant treatments for gastric cancer: From practice guidelines to clinical practice

Abstract Background For gastric cancers, the benefits of adjuvant radiochemotherapy and of perioperative chemotherapy have been demonstrated since 2001 and 2006 respectively. The aim of this study was to evaluate the diffusion of adjuvant treatments in a French population. Methods 334 incident gastric cancers UICC Stage IB, II, III or IVM0 resected for cure and recorded in the Burgundy digestive cancer registry were retrospectively included. Patients were classified as having received an effective adjuvant treatment if they had been treated by adjuvant radiochemotherapy since 2001 or perioperative chemotherapy since 2006. Results The proportion of patients treated with an effective adjuvant…

Malignant transformation of presacral mass in Currarino syndrome

International audience

Immunologic effects of rituximab on the human spleen in immune thrombocytopenia

Abstract Immune thrombocytopenia (ITP) is an autoimmune disease with a complex pathogenesis. As in many B cell–related autoimmune diseases, rituximab (RTX) has been shown to increase platelet counts in some ITP patients. From an immunologic standpoint, the mode of action of RTX and the reasons underlying its limited efficacy have yet to be elucidated. Because splenectomy is a cornerstone treatment of ITP, the immune effect of RTX on this major secondary lymphoid organ was investigated in 18 spleens removed from ITP patients who were treated or not with RTX. Spleens from ITP individuals had follicular hyperplasia consistent with secondary follicles. RTX therapy resulted in complete B-cell de…

Incontinence anale : ne pas baisser les bras !

Incontinence anale : ne pas baisser les bras !. Printemps médical de Bourgogne

Articulation du trapèze avec le second métacarpien : étude anatomique et intérêts cliniques

Resume Introduction Confrontes a une association inedite de luxations etagees de la colonne du pouce et d’une fracture de la base du deuxieme metacarpien, les auteurs presentent une etude cadaverique de l’articulation trapezosecond metacarpien. Materiels et methodes Trente dissections de pieces formolees (15 mains droites et 15 mains gauches) et 15 pieces fraiches (huit mains droites et sept mains gauches), soit au total 45 dissections, ont permis d’observer les liens articulaires, ligamentaires et tendineux entre le trapeze et la base du deuxieme metacarpien en se focalisant sur les structures palmaires. Resultats L’articulation entre le trapeze et le deuxieme metacarpien a ete constamment…

Faut-il réaliser un scanner quand la protéine C réactive est élevée après chirurgie colorectale ? Résultats de la cohorte IMACORS

Resume Introduction Les concentrations seriques de proteine C reactive (CRP) en deca d’un seuil predefini entre le 3e et le 5e jour postoperatoire sont un marqueur fiable de l’absence de complication infectieuse apres chirurgie colorectale. Cependant, la strategie a mettre en place en cas de CRP elevee n’est pas codifiee. Le but de ce travail etait d’analyser l’utilite du scanner dans cette situation au sein d’une cohorte prospective de chirurgie colorectale reglee. Methodes Entre novembre 2011 et avril 2015, les patients ayant une CRP > 125 mg/L au 4e jour postoperatoire d’une resection colorectale reglee dans l’un des 2 centres participants ont ete inclus prospectivement dans une base. To…

Anatomical basis for the interposition of a gastric pouch between the ileum and the anus after total proctocolectomy.

After a total proctocolectomy, ileoanal continuity is achieved by an ileal pouch–anal anastomosis. This anastomosis is not possible when the ileum cannot reach the anus. To avoid definitive ileostomy in this circumstance, we devised a gastric pouch, taken from the left half of the vertical portion of the stomach, vascularized by the right gastroepiploic pedicle, then interposed it between the ileum and the anus. The aim of this anatomical study on seven cadavers was to estimate the capacity of this gastric pouch to reach the anus. The distance between the caudal edge of the pubic symphysis and the apex of the pouch was measured. It is accepted that an ileal pouch always reaches the anus wit…