Use of Hoffman external fixation for extra-articular upper metaphysealtibial fractures

Treatment of extra-articular upper metaphyseal tibial fractures can be difficult. Orthopedic treatment is frequently complicated by second displacement These fractures are inappropriate for locked intra-medullary nailing because of the shorteness of the proximal extremity. Damages of soft tissues. frequently associated with these factures, expose internal osteosynthesis to many risks. For these reasons, we opted for external fixation. Our study was a retrospective analysis of 46 extra-articular metaphyseal tibial fractures treated by external fixation with Hoffman material. The average follow-up was 24 months. Consolidation was obtained within 4 months in average. Septic complications. inherent to the method were uncommon or minor. Functional results were satisfactory in 84% of cases. So, external fixation with Hoffman material. with particular recommandations, is a promising method for the treatment of extra-articular of proximal metaphyseal tibial fractures.     

Study of an interference fit fastener assembly by finite element modelling,analysis and experiment

This paper exploits finite element simulations, analytical approaches and experimental data in a study of interference fit fasteners. The influence of both the friction factor and the interference level on the loss of axial load is investigated. An axisymmetric FE model using Abaqus shows that both parameters greatly influence the results. The study of the axial strain enables the most appropriate positions to be identified for sensors intended to investigate the validity of the finite element analysis results. An analytical study is performed to evaluate the relationship between interference level, friction factor and axial strain all along the screw axis. The axial loss of load and the radial pressure between the screw and the plates are also evaluated analytically.     

Lymphoepithelioma-like carcinoma of the skin in a tunisian patient

Lymphoepithelioma-like carcinoma of the skin (LELCs) is a rare cutaneous neoplasm with histologic features resembling lymphoepitheliomatous tumors of the nasopharynx. The association of lymphoepitheliomas with Epstein-Barr Virus (EBV) at some extracutaneous sites is well documented. In contrast, the presence of EBV in LELCs has never been shown in either Caucasians or Asian patients. We present the first case of LELCs in a Tunisian patient, a 78-year-old woman who presented with a nodule of the right cheek of 2 months' duration. The patient underwent surgical excision and there was no evidence of local recurrence 6 months later. Histologically, the entire dermis was occupied by lobules composed of atypical epithelial cells surrounded by a dense lymphoplasmacytic infiltrate. Immunohistochemical examination showed that the epithelial tumor cells were positive for cytokeratin and epithelial membrane antigen. In situ hybridization investigations for the presence of EBV-encoded RNA showed negative results. Our findings suggest that LELCs is not related to EBV among North African patients.     

International Nosocomial Infection Control Consortium report, data summary for 2002-2007, issued January 2008

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from 2002 through 2007 in 98 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study, using Centers for Disease Control and Prevention (CDC) National Nosocomial Infections Surveillance System (NNIS) definitions for device-associated health care-associated infection, we collected prospective data from 43,114 patients hospitalized in the Consortium's hospital ICUs for an aggregate of 272,279 days. Although device utilization in the INICC ICUs was remarkably similar to that reported from US ICUs in the CDC's National Healthcare Safety Network, rates of device-associated nosocomial infection were markedly higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infections (CLABs) in the INICC ICUs, 9.2 per 1000 CL-days, is nearly 3-fold higher than the 2.4-5.3 per 1000 CL-days reported from comparable US ICUs, and the overall rate of ventilator-associated pneumonia was also far higher, 19.5 vs 1.1-3.6 per 1000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 6.5 versus 3.4-5.2 per 1000 catheter-days. Most strikingly, the frequencies of resistance of Staphylococcus aureus isolates to methicillin (MRSA) (80.8% vs 48.1%), Enterobacter species to ceftriaxone (50.8% vs 17.8%), and Pseudomonas aeruginosa to fluoroquinolones (52.4% vs 29.1%) were also far higher in the Consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 14.3% (CLABs) to 27.5% (ventilator-associated pneumonia).     

Une deuxième épidémie de méningo-encéphalite à virus West Nile en Tunisie

The West Nile virus (WNV) re-emerged in Tunisia in 2003, causing an outbreak of meningoencephalitis.