Facteurs de la variation de la fréquence cardiaque maximale: hypothèse «enképhalinique

To try to explain the decrease in maximal heart rate under different situations (ie, chronic hypoxia, ageing, proteino-energetic malnutrition), cardiac concentration and flow of leucine-encephalin peptide in isolated and perfused hearts were studied in rats. The heart leucine-encephalin concentration which was 301 ± 60 fmol/g before perfusion, increased up to 543 ± 125 fmol/g after perfusion (1 h). The total release during perfusion was four times the initial concentration. Concerning the antagonism of leucine-encephalin on cardiotropic adrenergic effects on isolated cardiomyocytes, it is possible to propose this mechanism to explain totally or partially the decrease in maximal heart rate under particular situations.     

Effets de la dominance oculaire sur la coordination œil–main dans les duels sportifs

Duel sports, such as fencing, boxing and table-tennis, like some “face-to-face” individuals in team sports, give rise to extremely fast visuo-motor interactions. These situations, characterized by a high level of uncertainty in space and time, require a very high level of visual attention from protagonists. Investigations carried out in these sports reveal, at the highest level of world ranking, an over-representation of manual left-handers, the majority of them having a right ocular dominance. Right-handers having a left dominant eye are also represented at a relatively high-rate. Experimental tasks with spatio-temporal uncertainty implemented in the laboratory have made it possible to confirm a visuo-motor advantage, in response time, in subjects having an eye–hand crossed laterality.     

Metachronous pancreatic metastases from renal cell carcinoma: Role of imaging in a review of 17 cases with surgical correlation

Purpose

To describe the imaging features of pancreatic metastases from renal cell carcinoma.

Patients and methods

Retrospective study of 17 patients with isolated metachronous pancreatic metastases from renal cell carcinoma with surgical and pathological correlation.

Results

The preoperative diagnosis was made on ultrasound in 13 cases. Contrast-enhanced CT showed intense tumor enhancement at the arterial phase, mostly homogeneous but sometimes heterogeneous. There were multiple lesions in six cases. Following complete surgical resection, survival was fairly good.

Conclusion

Long-term follow-up with CT obtained in the arterial and portal venous phases is mandatory. The arterial phase acquisition is essential for the diagnosis of pancreatic metastases from renal cell carcinoma.     

Developmental dysplasia of the hip

At one month, the acetabular depth from a standard lateral coronal section is 4.6 ± 1.0 mm. The correlation between experienced and junior radiologists is high (kappa 0.795). A treshhold of 6 mm with a Δ (difference between right and left) less than 1.5 mm provides a sensitivity of 100% for the detection of DDH at one month. Universal US screening at one month of all high-risk infants in 2009 resulted in a reduction of delayed diagnosis of DDH (zero girls, two boys) in Ille-et-Vilaine due to continuous medical education of general radiologists.     

Overtraining syndrome : la piste de la suractivité ?

Introduction

Overtraining is clearly a multifactorial disturbance. We aimed at evaluating the relative importance of overactivity and nutritional imbalances.

Methods

A comparison of 17 footballers with seven subjects with a diagnosis of overtraining evidenced that the two groups differ by energy expenditure resulting from physical activity (1573 ± 378.6 kcal/d from 804.7 ± 184.7 kcal/d) while food intake does not exhibit significant differences.

Conclusion

In this sample of subjects, inadequate food intake is found in both groups, so that overtraining appears rather characterized by a higher level of physical activity. Therefore, a relative energy deficit resulting from overactivity rather than dietary mistakes appears to explain the syndrome in these athletes, who are thus truly “overtrained”.     

Prévention des lésions de l’appareil locomoteur liées à la pratique de l’athlétisme sur piste. Revue des données épidémiologiques

Objectives

Sports injuries have an important impact on the sport and in daily life. Although athletics is known and performed on five continents, few is known about epidemiological data such as frequency, incidence, diagnosis or risk factors of injuries in athletics. In this context, consideration on strategies of sports injury prevention in athletics should be conducted.

Current knowledge

Sports injury surveillance by epidemiological studies is a preliminary step necessary in the clinical research on sports injury prevention. This is permitted by an agreed and validated methodolgy. Currently, the musculoskeletal lesions related to the track and field practice are common. The great diversity of these lesions reflects the diversity of disciplines, the constraints are different between the explosive disciplines (sprints, hurdles, jumps, throws) and endurance disciplines (middle and long distance). There was a predominance of lesions of thigh and hamstrings in the disciplines of sprint/hurdles, the Achilles tendon in jumps and sprints/hurdles, and chronic knee injuries and stress fractures in middle-distance.

Conclusion

Preventive measures which target the most frequent pathologies should be introduced. However, these data appear insufficient to fully understand the specific injury according to disciplines, and to understand the risk factors and injury mechanisms. Therefore, prospective epidemiological studies, and studies focused on specific populations or pathologies, are needed to improve strategies for the prevention of injuries in track and field.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Postnatal evaluation and management of fetal pyelectasis on prenatal ultrasound

Fetal pyelectasis is the most frequently encountered anomaly on prenatal ultrasound. The ultrasound diagnostic criteria are well established: nature of dilated structures, degree of dilatation, ultrasound appearance of the kidneys, volume of amniotic fluid. Ultrasound can also determine if the anomaly is isolated or not, which is important for the management and prognosis of the pregnancy. Ultrasound is the initial postnatal study to evaluate the urinary tract. Further management will be based on suspected diagnosis. In cases of suspected vesico-ureteral reflux, VCUG is performed. In cases of obstructive uropathy or complex malformation (duplications), MRI is performed at 6 months of age to further define the anatomy of the urinary tract. Radionuclide renogram, performed in most cases, allows evaluation of split renal function. Follow-up ultrasound is important to monitor renal development, urinary tract dilatation and appearance of the renal parenchyma. Functional follow-up is assured by radionucline renography. This comprehensive follow-up is recommended to prevent complications and progressive loss of renal function.     

Miocarditis: diagnóstico y seguimiento con resonancia magnética

Myocarditis, inflammation of the myocardium, is usually due to viral infection. Diagnostic confirmation in ordinary clinical practice is difficult because the findings on the clinical history, physical examination, electrocardiogram, and laboratory tests offer scant diagnostic accuracy, and the differential diagnosis is often done with acute myocardial infarction. Cardiac magnetic resonance imaging (CMR) has become the method of choice for the diagnosis of myocarditis. In this article, we describe the CMR findings at diagnosis and during the follow-up of patients with myocarditis, the differential diagnosis with other acute processes like myocardial infarction, and the prognostic factors studied with CMR.     

Hip and pelvic injuries in the elderly

Fractures of the hip and pelvis are frequent and serious injuries in elderly patients. Due to the aging population, their incidence should double by 2050. Therefore, the social and economical implications of these fractures are significant. Delay in diagnosis increases the associated morbidity and mortality. The purpose is to review the imaging features of these fractures, the imaging techniques (projections, CT) to depict them and their classification based on severity.     

Paget's disease of the nipple and differential diagnosis

Clinical evaluation of the nipple-areolar complex is a routine component of the breast screening examination. All persistent unilateral nipple lesion should be viewed with suspicion and Paget's disease of the nipple should be considered. The diagnosis is established by nipple scrape cytology. It is a rare variant of ductal carcinoma in situ. The breast imaging work-up should include a search for an underlying malignancy, present in over 80% of cases, not infrequently multifocal. Preoperative MRI is useful if breast conservative surgery is contemplated because of the high rate of occult malignancy on mammograms and ultrasound. Erosive adenomatosis of the nipple is a benign process that may simulate Paget's disease isolated to the nipple. Less frequently, pagetoid basal cell carcinoma, Bowen's disease and melanoma may be more difficult to differentiate clinically and share the unilateral and chronic features of Paget's disease. Biopsy is needed for diagnosis. Cutaneous extension of a breast cancer is rare but should be suspected in patients with retraction and/or fixed nipple. Eczema is characterized by the bilateral nature of the process, the absence of nipple deformity, the presence of flare-ups and the favorable response to local steroid therapy.     

Vertebra plana Calvé

Summary The differential diagnostic problems of a case of vertebra plana Calvé having a rare location in the cervical spine are discussed. The various theories of aetiology and pathogenesis are considered briefly. The differentiation from inflammatory and tumourous diseases of the vertebral column is of great importance for therapeutic reasons. Skeletal scintigraphy was used for the first time for differential diagnosis in the case presented.

     

Artery of Percheron occlusion: Value of MRI. A review of six cases

Blood supply to the human thalami is complex and multiple variants exist. The artery of Percheron is one of those variants and is characterized by a solitary arterial trunk that branches from one of the proximal segments of either posterior cerebral artery and supplies blood to the paramedian thalami. Its occlusion results in bilateral paramedian thalamic infarction sometimes extending to the midbrain. We report six cases of bithalamic infarction secondary to occlusion of the artery of Percheron. We will illustrate the complex clinical symptomatology and underscore the role of imaging, especially MRI, for diagnosis.     

Estudio de las enfermedades de las trompas de Falopio mediante resonancia magnética

Knowledge about fallopian tube disease is essential in the assessment of the pelvis in female patients. Primary and secondary changes in the tubes vary widely, regardless of whether associated changes in the ovaries are present. Ultrasonography is the initial technique in the study of adnexal disease because it is very sensitive and widely available; however, MRI is also very useful in this context because its high tissue resolution and anatomic detail make it more specific. The morphologic findings and the characteristics of the contents of the tubes on MRI enable a more accurate diagnosis or limit the differential diagnosis, helping to ensure that the most appropriate treatment is provided in each case.     

Thrombosis of the right vein of Labbé: radiological and clinical findings

Summary A rare case of aseptic thrombosis of the right vein of Labbé in a young woman is reported. Cerebral venous thrombosis was suggested by computed tomography and confirmed by angiography. Mild left-sided neurological deficits resolved almost completely. The combination of a nonspecific clinical picture with an atypical lesion on CT may favour the diagnosis of cortical venous thrombosis.     

Activité physique et obésité infantile : dépistage,prévention et prise en charge

Aim

This review is aimed to synthesize current scientific knowledge on the part played by physical activity in prevention and treatment of the paediatric obesity.

Current

The physical activity (and inactivity?) is unanimously recognized like an essential element of the fight against the obesity increase in children and adolescents. In the treatment the last meta-analysis and literature reviews confirm that the best strategy is the reduction of the sedentary behaviours, the increase in the physical activity associated with an education and restriction nutritional. On the other hand, the part played by the physical activity in the prevention interventions although not discussed, must be specified in its association with other elements such as nutritional education according to the age, of the obesity level… The physical activity practice as of the youth is to be associated an early tracking factor of risk. The recommendations of physical activity must be adapted to the required objective and the possibilities physical, physiological, sociological… of the subjects.

Conclusion

Although characteristics of the physical activity to prescribe for each specific objective; prevention, loss of or not taken again body mass weight, remain to be specified for the child and the teenager, an active way of life is one of the major factors of the fight against the increase in the prevalence of obesity.     

Acute mesenteric ischemia: Value of cross-sectional imaging

Acute mesenteric ischemia (AMI) is a life-threatening emergency with prognosis directly correlated with the delay in diagnosis and treatment. Clinical and laboratory findings are nonspecific and it is imperative to look for findings of AMI on CT and ultrasound examinations performed in patients with acute abdomen. Arterial and venous ischemia are different entities with different clinical and imaging features, treatment and prognosis. The main causes of AMI are arterial thromboembolic disease and low-flow state. Venous ischemia is less frequent. Due to its high reported sensitivity (90%), CT should be performed as a firstline imaging modality when AMI is suspected. CT and ultrasound imaging features of AMI include: bowel wall thickness and enhancement abnormalities, pneumatosis, portal venous gas, demonstration of intravascular thrombus, bowel dilatation and ascitis.