MRI evaluation of articular cartilage in patients with juvenile osteochondritis dissecans (JOCD) using T2∗ mapping at 3T.

OBJECTIVE: Evaluate articular cartilage by magnetic resonance imaging (MRI) T2∗ mapping within the distal femur and proximal tibia in adolescents with juvenile osteochondritis dissecans (JOCD). DESIGN: JOCD imaging studies acquired between August 2011 and February 2019 with clinical and T2∗ mapping MRI knee images were retrospectively collected and analyzed for 31 participants (9F/22M, 15.0 ± 3.8 years old) with JOCD lesions in the medial femoral condyle (MFC). In total, N = 32 knees with JOCD lesions and N = 14 control knees were assessed. Mean T2∗ values in four articular cartilage regions-of-interest (MFC, lateral femoral condyle (LFC), medial tibia (MT), and lateral tibia (LT)) and lesion volume were measured and analyzed using Wilcoxon-rank-sum tests and Spearman correlation coefficients (R). RESULTS: Mean ± standard error T2∗ differences observed between the lesion-sided MFC and the LFC in JOCD-affected knees (28.5 ± 0.9 95% confidence interval [26.8, 30.3] vs 26.3 ± 0.7 [24.8, 27.7] ms, P = 0.088) and between the affected- and control-knee MFC (28.5 ± 0.9 [26.8, 30.3] vs 28.5 ± 0.6 [27.1, 29.9] ms, P = 0.719) were nonsignificant. T2∗ was significantly increased in the lesion-sided MT vs the LT for the JOCD-affected knees (21.5 ± 0.7 [20.1, 22.9] vs 18.0 ± 0.7 [16.5, 19.5] ms, P = 0.002), but this same difference was also observed between the MT and LT in control knees (21.0 ± 0.6 [19.7, 22.3] vs 18.1 ± 1.1 [15.8, 20.4] ms, P = 0.037). There was no significant T2∗ difference between the affected- and control-knee MT (21.5 ± 0.7 [20.1, 22.9] vs 21.0 ± 0.6 [19.7, 22.3] ms, P = 0.905). T2∗ within the lesion-sided MFC was not correlated with patient age (R = 0.20, P = 0.28) or lesion volume (R = 0.06, P = 0.75). T2∗ values were slightly increased near lesions in later-stage JOCD subjects but without statistical significance. CONCLUSIONS: T2∗ relaxations times were not significantly different from control sites in the articular cartilage overlying JOCD lesions in the MFC or adjacent MT cartilage in early-stage JOCD.

Alphabet Soup: Sagittal Balance Correction Osteotomies of the Spine-What Radiologists Should Know.

Global sagittal malalignment has been demonstrated to have correlation with clinical symptoms and is a key component to be restored in adult spinal deformity. In this article, various types of sagittal balance-correction osteotomies are reviewed primarily on the basis of the 3 most commonly used procedures: Smith-Petersen osteotomy, pedicle subtraction osteotomy, and vertebral column resection. Familiarity with the expected imaging appearance and commonly encountered complications seen on postoperative imaging studies following correction osteotomies is crucial for accurate image interpretation.

Mirabel: an integrated project for risk and cost/benefit analysis of peanut allergy.

Food allergy is a major public health issue. However, no regulatory measures exist when allergens are present at trace levels and the different risk components are poorly described. Thus, knowledge on exposure components such as the allergens present in foods and the consumption behaviour of allergic consumers and models to estimate the related risk need to be enriched. Mirabel proposes for the first time studying each risk component using an integrated approach in order to improve the quality of life of the allergic population. Field surveys were conducted in order to fill in the current gaps in unintentional allergen traces in food, allergic consumers' food behaviour, threshold doses of allergic reaction, allergy symptoms and severity. The aim is also to propose methodological and operational tools to quantify allergic risk, to test management scenarios and to produce a cost/benefit analysis. Medical data on the peanut allergies of 785 patients were collected in the MIRABEL survey and 443 patients answered the food consumption questionnaire. The population surveyed was mostly paediatric - 86% were children under 16 years of age, with a high percentage of males (60%). This project will generate tangible results on peanut allergen exposure and risk which could be used in future risk assessment work and particularly to provide science-based guidance to set up concentration limits for peanut traces on packages.

Balancing the risk of dioxins and polychlorinated biphenyls (PCBs) and the benefit of long-chain polyunsaturated fatty acids of the n-3 variety for French fish consumers in western coastal areas.

A study of 401 fish-eating adults living in a coastal region of France was undertaken to establish exposure to dioxins/polychlorinated biphenyls and the intake of long-chain polyunsaturated fatty acids of the n-3 variety. Fish consumption was estimated using food frequency diaries and the dioxin/polychlorinated biphenyl data collected by the French control authorities was used to calculate dietary exposure. The results showed that for a group of adult subjects selected because of their consumption of fish, 60% achieved the nutritional recommendation for long-chain n-3 polyunsaturated fatty acids and 79% were exposed to total dioxins below the toxicological threshold of 14 pg kg(-1) body weight week(-1). Nevertheless, only 41% of these subjects had an optimal balance between the risk and benefit of eating fish, because 19% were meeting the nutritional recommendation but exceeding the toxicological threshold, whereas 38% were exposed below the toxicological threshold but failed to reach the recommended intake of long-chain n-3 polyunsaturated fatty acids. Similar results were found regarding the balance between long-chain n-3 polyunsaturated fatty acids and polychlorinated biphenyls even if a toxicological threshold was not established for these compounds. The results show that meeting the nutritional requirements of 0.5 mg day(-1) of long-chain n-3 polyunsaturated fatty acids is compatible with respect to toxicological thresholds, while an intake higher than 1.5 g day(-1) is likely to lead to a dietary exposure above the provisional tolerable weekly intake for dioxins.

Impact of a risk-benefit advisory on fish consumption and dietary exposure to methylmercury in France.

We designed the CORAI (COnsumer Risk Advisory Inquiry) study to observe consumer reactions' after an advisory revealing risk of methylmercury contamination together with benefits of Long-Chain Poly Unsaturated Fatty Acids of the n-3 variety (LC n-3 PUFA). The message was very close to the ones commonly delivered by national food agencies and included recommendations for women of childbearing age and children below 15 years old. Two groups of subjects including consumers at risk were selected. Participants recorded the frequency of their fish consumption detailed by species for them and their family over a one-month period one month before, a month immediately after and 3 month after the advisory. Results were compared between consumers receiving the advisory and controls. Results show that the message revelation led to a significant decrease in total fish consumption which is greater for children below 6 years old than for the children between 6 and 15 years old and women. The consumption of the most contaminated fish quoted in the advisory, rarely consumed and poorly known by French consumers did not decrease in any group despite the advice to avoid their consumption. The consumption of other fish products quoted in the advisory but frequently consumed and better known, as canned tuna, did decrease and was a major contributor to the overall reduction of exposure for the advised group. Before the information, about 3% of women of childbearing age are exceeding the PTWI for MeHg and both the average and the high percentiles of the exposure to MeHg are decreasing significantly in the advised group. Regarding the number of subjects of the advised group exceeding the PTWI, they were 6, 3 and 2, respectively, in May, June and September. Accompanying questionnaires show that consumers imperfectly memorize most of the fish species quoted in the recommendation. This paper concludes that consumer advisory, which is a major tool for risk management, has a minimal effect under our experimental conditions to reduce the exposure of groups at risk. Messages to be carried to consumers should be carefully tested for long term memorization in order to become more effective.