Telemonitoring in continuous positive airway pressure-treated patients improves delay to first intervention and early compliance: a randomized trial.

OBJECTIVE: Telemonitoring (TM) has been used in continuous positive airway pressure (CPAP)-treated patients to improve compliance, but results have been inconsistent. The purpose of this study was to assess the impact of TM on the delay to the first technical intervention after CPAP initiation. The impact of TM on mean compliance during the first 3 months of treatment was measured as a secondary outcome. METHODS: Patients diagnosed with moderate to severe obstructive sleep apnea syndrome were prospectively included and randomized to receive usual care (UC) or TM. In both arms, an educational session was scheduled 1 month after CPAP initiation, and medical visits were planned after 1.5 and 3 months. In the TM arm, we added a universal TM unit (T4P) to the CPAP device. RESULTS: Delay to first intervention was significantly shorter in the TM group (29 ± 25 vs 47 ± 30 days, p = 0.02). The first intervention in the TM group was motivated by detection of problems by the TM system in 39% of patients. Compliance at 3 months was significantly better in the TM group (5.7 ± 1.6 vs 4.2 ± 1.9 h/night, p = 0.018). CONCLUSION: This is the first randomized study showing that TM reduces delay to first technical intervention in CPAP-treated patients. This early activation of troubleshooting was associated with improved compliance at 3 months. Since CPAP side effects at 1 month have been shown to predict lower 12-month CPAP compliance, TM seems to be an excellent tool for improvement of long-term CPAP acceptance.

[Results of tibial valgus osteotomy for internal femoro-tibial arthritis with an average 8-year follow-up]. / Devenir des ostéotomies tibiales valgisantes pour arthrose fémoro-tibiale interne avec un recul moyen de 8 ans.

One hundred and eighteen knees treated by valgus osteotomy for medial femorotibial osteoarthritis were reviewed with an average follow-up of 8 years (2-23 years). Seventy-four percent of the results were good and excellent after 5 years, 64% at 10 years and 61% after 10 years. The best results were observed in patients younger than 60 years, with femorotibial osteoarthritis not exceeding grade II of Ahlback's classification, and moderate femoropatellar osteoarthritis. The optimal final valgus observed was between 3 and 10 degrees. Four knees have been reoperated by arthroplasty.

[Dupuytren's disease. Review of 326 surgically treated patients]. / Maladie de Dupuytren. Revue de 326 patients opérés.

The COC (Orthopedic Society of Charleroi) has presented an analysis of operated cases. We have taken 326 files into account. The pre-operative evaluation is based upon the classification by Tubiana, Michon and Thomine. The analysis pays special attention to the post-operative results in terms of several factors: the age, the stage of illness, the extent of illness and the improvement. For this final summing up, we put forward criteria which for us are better in the evaluation of the final result.

[Semilunar disease]. / La maladie du semi-lunaire.

In a multicenter study involving the five Orthopaedic Services of the COC, 57 patients with Kienböck's disease were reviewed 90% were treated surgically. The most common operations were ulna lengthening (30 cases) and lunate resection (11 cases). The most frequent indications or surgery were pain and stiffness of the wrist. Radiological changes are classified according to Decoulx. For evaluating post-operative radiological changes, however, the authors use different criteria ulna lengthening and lunate resection improved pain and mobility in 75% of cases. This study shows that lunate resection is a valid operation in the treatment of Kienböck's disease.