RESUMEN
PURPOSE: Quadriceps strength and patellar tendon (PT) are directly linked and intimately related to daily activities and lower limb function. However, the correlation between knee extension torque (KT) and PT Young's modulus (E) measured directly is still unknown. METHOD: We used supersonic shearwave imaging (SSI) to evaluate the elastic property of PT in healthy young men and analysed its correlation with KT. Twenty-two healthy young males were included and both knees were examined. The E of the PT in the dominant and non-dominant legs was assessed by SSI elastography. KT in maximal voluntary isometric contraction was measured with an isokinetic dynamometer. RESULT: No correlations between KT and PT E were observed in dominant or non-dominant side (P = 0·458 and 0·126, respectively). No significant differences in KT or PT E were observed between both legs (P = 0·096 and 0·722, respectively). Intra-day ICC was rated good (D1 - 0·886, P<0·001 and 0·88, P<0·001) and excellent (D2 - 0·928, P<0·001 and 0·900, P<0·001) for both legs. Inter-day ICC was rated moderate for both legs (0·651, P = 0·016 and 0·630, P = 0·018, respectively). CONCLUSION: No significant correlations were found between KT and PT E, suggesting that quadriceps strength is not an accurate predictor for PT mechanical properties in subjects with no specific training engagement. Habitual loading pattern can play a determinant role in PT mechanical properties, regardless of quadriceps strength. Further investigation on SSI acquisition protocols should be conducted to guarantee higher inter-day ICC values.
Asunto(s)
Articulación de la Rodilla/fisiología , Contracción Muscular , Ligamento Rotuliano/fisiología , Músculo Cuádriceps/fisiología , Adulto , Fenómenos Biomecánicos , Estudios Transversales , Módulo de Elasticidad , Diagnóstico por Imagen de Elasticidad , Voluntarios Sanos , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Masculino , Fuerza Muscular , Dinamómetro de Fuerza Muscular , Ligamento Rotuliano/diagnóstico por imagen , Valor Predictivo de las Pruebas , Músculo Cuádriceps/diagnóstico por imagen , Reproducibilidad de los Resultados , TorqueRESUMEN
Muitos pesquisadores têm estudado a relação entre a atividade mioelétrica e performance muscular medido como trabalho, torque ou força. No entanto, não existe consenso sobre o melhor parâmetro para este tipo de análise...
Asunto(s)
Humanos , Congresos como Asunto , Electromiografía , Fuerza MuscularRESUMEN
BACKGROUND: Although in utero transfer seems actually the safest option when risk factors are identified, specialized transport teams remain important to consider for the neonatal overall management. SUBJECTS: From January 1988 through December 1992, 692 transports of 838 neonates were prospectively studied to determine effectiveness and safety of the Hospital Lenval's neonatal transport team. RESULTS: Neonatal transports were required respectively for prematurity (46.4%), acute fetal distress (13.8%), respiratory distress (10.1%), intrauterine growth retardation (7.8%), multiple pregnancies (5.2%), perinatal asphyxia (3.1%) and life-threatening congenital abnormalities (2%). Pediatric assistance was unplanned in most of the cases (80%). Assistance with a pediatrician before delivery was performed more frequently (70%) for premature babies (mean gestational age 34.1 +/- 3.1 wk) delivered by cesarean section in 66.4% of the cases; in this group, delivery room resuscitation was less aggressive. Assistance was performed after delivery less frequently (30%), approximately in one-half of the cases for neonatal distress: respiratory (33.9%) or neurologic (17.1%); in this group, delivery room resuscitation was more aggressive. In transit, ventilation support via endotracheal intubation was given to 17.9% of the babies. Neither death nor heavy complication occurred during transport. On arrival in the neonatal intensive care unit, hypothermia was noted in 9.6% of the cases, hypotension in 4.3%, hypoglycemia in 13.1% and metabolic acidosis in 10.4%. In our series, the overall mortality rate was 6%, and incidence of neurologic damage 3.3%. CONCLUSION: A skilled person in neonatal resuscitation available at every referring maternity and regional high-risk obstetric/neonatal combined centre are two recommendations which could provide improved neonatal management.
Asunto(s)
Maternidades/organización & administración , Unidades de Cuidado Intensivo Neonatal/organización & administración , Transporte de Pacientes/organización & administración , Femenino , Maternidades/estadística & datos numéricos , Hospitales Privados , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal/estadística & datos numéricos , Masculino , Embarazo , Estudios Prospectivos , Transporte de Pacientes/estadística & datos numéricosRESUMEN
Asthma is a common pediatric emergency. We report the results of a prospective investigation concerning asthma attacks observed in children aged more than 2 years at Lenval hospital (Nice) during a 12-month period, from September 1993 to September 1994. One hundred and thirty seven asthma attacks were observed in 122 children aged 6.9 +/- 3.4 years, representing 5.2% of children ranged from 2 to 6 years medical emergencies, and 10.3% of children greater than 6 years medical emergencies. In most cases (82.4%) the diagnosis of asthma was already known. The children were first seen, on the average, between 32.3 +/- 38.6 hours after the beginning of the attack, previously self-treated at home in one out of every two cases. Treatment was set in each case on the isolated administration of inhaled beta 2-adrenergic agonist. The decision whether or not to hospitalize was made, at the latest, one half hour after the second administration of the beta 2-agonist. One death occurred before hospital admission. Hospitalization was decided in 38.6% of the cases, two of which were immediately directed for reanimation. A majority of the children (60.7%) were able to return home after metered dose inhalation for 5 of them, after 1 nebulization of beta 2-agonist in 66 cases, after 2 nebulizations in 12 cases. The prevalence of asthma is increasing and can be estimated at approximately 10% in France. The pediatrics emergency wards have an important role to play in the evolution of this illness. They must guarantee the most favorable management of the attack. They must then participate decisively in the initiation of the necessary surveillance to be continued. They play a great part in the knowledge of the epidemiology.
Asunto(s)
Asma/terapia , Enfermedad Aguda , Factores de Edad , Niño , Preescolar , Urgencias Médicas , Servicio de Urgencia en Hospital , Femenino , Francia , Hospitalización , Hospitales Pediátricos , Humanos , Masculino , Prevalencia , Estudios ProspectivosRESUMEN
During 1992, 541 sport injuries (6.3% of the 8641 surgical emergencies) were recorded at Lenval's hospital pediatric emergency ward in Nice. There were a majority of boys (62%), and the mean age was 11.2 years. Thirty one sports were represented, mainly soccer (18.5%), bicycle (12.2%), basketball (9.4%), gymnastics (9.4%), ski (9.2%) and equitation (7.8%). Injuries occurred during competition in 12.7% of the cases, school practice in 36.3%, and free practice in 51%. Lesions concerned head and face in 15.5% of cases, the trunk in 9.2%, and limbs in 75.3% with a majority of twists and benign contusions. The hospitalisation's rate was 14.4%, and a surgical intervention with anesthesia was performed in 7.6% of cases to treat one shoulder dislocation and 42 limb fractures. Thirty percent of children were confirmed sportsmen/women, 40% of them were involved in competitive sports, the most frequently concerned sports being soccer (24.6%), basketball (18%), fighting sports (11.4%; 7.2% = judo), gymnastic (10.1%), tennis (7.9%) and equitation (6.7%). From this study most sports injuries in children appears benign even if some fractures led to hospitalisation and orthopedic surgery; this is possibly related to the quality of education and coaching, particularly during physical training at school.
Asunto(s)
Traumatismos en Atletas/epidemiología , Adolescente , Factores de Edad , Niño , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Humanos , Masculino , Estudios ProspectivosRESUMEN
Between July 3rd 1990 and January 4th 1993, directed blood transfusion was authorized in neonatology in France. In 1991 and 1992, anemia of prematurity was treated at Lenval hospital by directed blood transfusion. 60 preterm infants with non immune mediated anemia received 85 transfusions, 24.7% of them being provided from parental blood. 26.7% of these 60 infants were transfused only with familial blood. Although authors and parents found these preliminary results very encouraging, directed blood transfusion has been forbidden in France since January 4th 1993. It is believed that such a transfusion does not solve many problems (ie: methodological, material, moral, ethical), and the risk of transmitted infections diseases seems not to be decreased. Therefore traditional transfusion using anonymous donors is recommended.