Syndrome de loge chronique de l'avant-bras : proposition d'un test de provocation. À propos de deux observations

Objectives – Proposal a new dynamic test pour clinical diagnostic of chronic compartment syndrome of forearm.Methods – Anterio compartment syndrom of the forearm are not documented in the literature. Two observations of this syndromes are described concerning sportsmen the motocross practising. History and a new provacation test and finally tissue compartment pressure measurement leaded to confirm this pathology. Aponevrotomy was successfully achived, patients went to their previous activities.Conclusion – The this test of provocation impose it on a number of patients of validation of more important.     

Imagerie de la trachée de l'adulte

Imaging of normal and pathologic trachea at the thoracic and cervical levels is described extensively. Beside congenital abnormalities discovered in adulthood, acquired tracheal abnormalities are artificially divided in two subgroups. One group consists of diffuse abnormalities, with all but one diseases associated with a diffuse narrowing of the tracheal lumen. The other group comprises focal abnormalities that lead to tracheal stenoses of various lengths, with a postintubation stenosis as probably the most frequent cause, followed by tumours. The main modality for tracheal imaging is now multidetector-row spiral CT. This technique allows for faster volume coverage and higher spatial and temporal resolution. The improved spatial resolution impacts on both axial images and all reconstructions techniques that have become indispensable for interpretation of a vertical structure such as the trachea. Chest X-ray is no longer the frontline imaging technique. MRI has not yet reached all its potential as compared to CT.     

Percepciones de estudiantes de Medicina sobre el impacto de la inteligencia artificial en radiología

ObjectivesTo analyze medical students’ perceptions of the impact of artificial intelligence in radiology.Material and methodsA structured questionnaire comprising 28 items organized into six sections was distributed to students of medicine in Spain in December 2019.ResultsA total of 341 students responded. Of these, 27 (7.9%) included radiology among their three main choices for specialization, and 51.9% considered that they clearly understood what artificial intelligence is. The overall rate of correct answers to the objective true-or-false questions about artificial intelligence was 70.7%. Whereas 75.9% expressed their disagreement with the hypothesis that artificial intelligence would replace radiologists, only 41.9% disagreed with the hypothesis that the demand for radiologists would decrease in the future. Only 36.7% expressed concerns about the role of artificial intelligence related to choosing radiology as a specialty. A greater proportion of students in the early years of medical school agreed with statements that radiologists accept artificial-intelligence-related technological changes and work with the industry to apply them as well as with statements about the need to include basic training about artificial intelligence in the medical school curriculum.ConclusionsThe students surveyed are aware of the impact of artificial intelligence in daily life, but not of the current debate about its potential applications in radiology. In general, they think that artificial intelligence will revolutionize radiology without having an alarming effect on the employability of radiologists. The students surveyed think that it is necessary to provide basic training about artificial intelligence in undergraduate medical school programs.     

¿Son los sistemas de inteligencia artificial una herramienta útil para los programas de cribado de cáncer de mama?

Population-based breast cancer screening programs are efficacious in reducing the mortality due to breast cancer. These programs use mammography to screen the women who are invited to participate. Digital mammography makes it possible to develop computer-assisted diagnosis (CAD) systems that promise to reduce the workload of radiologists participating in screening programs. However, various studies have shown that CAD results in a high rate of false positive diagnoses. Systems based on artificial intelligence are being more widely implemented, and studies have shown that these systems have better diagnostic performance than traditional CAD systems.This article explains the fundamentals of artificial intelligence systems and an overview of possible applications of these systems within the framework of breast cancer screening programs.     

Influence de la distance de course sur les paramètres cinématiques de nage chez les nageurs avec palmes de haut niveau

Introduction – Finswimming is a new sport activity. The optimization of the leg’s propulsive action is fundamental to improve the performance. The aim of this work is to quantify finswimmer’s movements per race distances, using a kinematic analysis.Fact synthesis – Five elite finswimmers were video recorded during underwater races. The connections between the average velocity of stroke, frequency and range of finswimmers undulation are observed as a fonction of race distance.Conclusion – Finswimmers are shown to adjust and to stabilize instantaneously their movements in terms of race distance.     

Administración de medios de contraste. ¿Existe riesgo de daño renal agudo?

ObjectiveTo determine whether the intravenous administration of iodinated contrast material for computed tomography (CT) is associated with an increase in creatinine levels and acute kidney injury.Material and methodsThis retrospective cohort study included all patients who presented at the emergency department between 2010 and 2015 with baseline creatinine measurement (C1) and follow-up creatinine measurement (C2) between 24 and 72 hours later. The clinical research ethics committee approved the study. The exclusion criteria were age < 18 years, creatinine ≤ 0.4 mg/dl or ≥4.0 mg/dl, and the administration of contrast media within the previous 6 months. The mean number of patients presenting at the emergency department was 105,435.6 per year. Patients who met the inclusion criteria were classified into three groups: those who underwent contrast-enhanced CT (n = 6,642), those who underwent noncontrast CT (n = 6,193), and those who did not undergo CT (n = 33,802). We used the Acute Kidney Injury Network's (AKIN) and the Contrast-induced Nephropathy Consensus Working Panel's (CIN) criteria. Statistical analyses included bivariate statistics and logistic regression. Stata 15 was used for all statistical analyses.ResultsWe analyzed 52,411 patients; after data cleansing: 46,637; mean age: 67.95 years; C1: mean 1.16 mg/dl (SD: 0.61); C2: 1.14 mg/dl (SD: 0.66). With AKIN and CIN criteria: contrast-enhanced CT was not associated with a greater probability of developing nephropathy (odds ratio [OR: 0.90; 95% CI: 0.83–0.99] and [OR 0.89, 95% CI: 0.81–0.98], respectively). The propensity score matching study using both sets of criteria (AKIN + CIN) yielded OR 0.80 [95% CI: 0.77–0.84]. Glomerular filtration rates less than 30 ml/min were not associated with increased kidney damage [OR: 0.66, 95% CI: 0.47–0.91].ConclusionThe administration of intravenous contrast material in the patients studied is not associated with increased acute kidney injury.