Idiopathic clubfoot treatment and heterogeneity of current therapeutic strategies: The Ponseti method versus the French functional method (a systematic review).

BACKGROUND: Since Hippocrates, the treatment of idiopathic clubfoot has undergone many changes, with surgical techniques and conservative approaches evolving over the centuries. Today, a wide variety of practices exist in France and throughout the world; consequently, the treatment of idiopathic clubfoot remains controversial, but the Ponseti method and the functional method seem to stand out. Nevertheless, has one of them demonstrated superiority? METHODS: The purpose of this review is to compare these two methods. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 recommendations, this research was conducted on Pubmed, Web of Science, and 1Findr. Only articles concerning patients with moderate or severe idiopathic clubfoot (10-17 on the Dimeglio scale) treated early using the Ponseti method or the functional method were eligible. RESULTS: After reviewing 49 studies, seven published between 2008 and 2018 were selected: five prospective cohort studies, one retrospective cohort study, and one meta-analysis. Each method, according to morphological and kinetic criteria, seems to have advantages that the other does not have. CONCLUSIONS: Although the Ponseti method is becoming the gold standard and appears more appropriate in poor countries, it is impossible to affirm its superiority over the functional method. Therefore, the combination of their advantages deserves attention: a hybrid method could be an appealing prospect for the future.

Comparison between Solanum torvum Sw. and S. melongena L. after Ralstonia solanacearum inoculation.

Bacterial wilt, caused by Ralstonia solanacearum, is one of the most devastating plant diseases, affecting some economically important Solanaceae crops. In contrast, Solanum torvum, also known as wild eggplant, does not wilt when infested with R. solanacearum. In order to describe the mechanism underlying the response of S. torvum, it was compared with the cultivated eggplant, S. melongena, when both were infected with the same R. solanacearum strain. No wilting occurred in S. torvum, although the bacteria colonised roots and stems in both species within the first 24 h. There were marked differences beyond 24 h, consisting of high bacterial mortality in S. torvum. Using the calli model, our investigations revealed an increase in cell wall monoamine oxidase activity in S. torvum after R. solanacearum inoculation, which did not occur in S. melongena.

Base composition of Coffea AFLP sequences and their conservation within the genus.

Amplified fragment length polymorphism (AFLP) is often used for genetic mapping and diversity analysis, but very little information is currently available on their sequence characteristics. Species-specific sequences were analyzed from a single Coffea genome (Coffea pseudozanguebariae) associated with clustered or nonclustered AFLP loci of known genetic position. Compared with the expressed sequence tag (EST) sequence composition, their AT content exhibited a bimodal distribution with AT-poor sequences corresponding mainly to putative coding sequences. AT-rich sequences, apart from the EST distribution, were usually clustered on the genetic map and might correspond to noncoding sequences. Conversion of these AFLP markers into sequence-characterized amplified region (SCAR) anchor markers allowed us to assess sequence conservation within Coffea species with respect to species relatedness.

SSR cross-amplification and variation within coffee trees (Coffea spp.).

Primer sets were developed from 85 Coffea arabica sequences in addition to 25 already published primer sets. They were subsequently used for amplification in six African Coffea species: Coffea canephora (CAN), Coffea eugenioides (EUG), Coffea heterocalyx (HET), Coffea liberica (LIB), Coffea sp. Moloundou (MOL) and Coffea pseudozanguebariae (PSE). The amplification percentages for these 110 primer pairs ranged from 72.7% for LIB to 86.4% for PSE. Good transferability was thus obtained within the Coffea genus. When focusing on the two species CAN and PSE, high genetic diversity, high polymorphic locus rates (above 80%) and a mean allele number per polymorphic locus of more than 3 were noted. The estimated null allele percentage was -11% for PSE and -9% for CAN. Sixty three percent (CAN) and 79.5% (PSE) of the fixation index (Fis) values were positive. The within-species polymorphism information content (PIC) distribution showed two modes for both species. Although the two species shared 30 polymorphic loci, no correlation between CAN and PSE PIC values was obtained. All of these data are discussed in relation to the polymorphism level and the potential use of these SSRs for subsequent analysis of genetic diversity or genetic mapping.

Genome size variations in diploid African Coffea species.

Flow cytometry was conducted to evaluate genome size diversity among African diploid species of the Coffea genus. The study included 15 species and six new taxa from Congolese and Cameroonian forest regions which have yet to be botanically characterized. Between-population differences were also recorded in some cases. These evaluations using an internal standard were highly correlated with previous results obtained with an external standard, but differences of up to 18 % existed for some species, involving stoichiometric errors. Consequently, genome size variation between species and within species are discussed as true genome size differences or stoichiometric errors. Environmental and phenotypic correlations with genome size are also discussed.

AFLP and SSR polymorphism in a Coffea interspecific backcross progeny [( C. heterocalyx x C. canephora) x C. canephora].

An interspecific cross (BC 1) involving a species with one of the largest genomes in the Coffea genus [ Coffea heterocalyx (HET), qDNA = 1.74 pg] and a species with a medium-sized genome [ Coffea canephora (CAN), qDNA = 1.43 pg] was studied using two types of molecular markers, AFLP and SSR. One hundred and eighty eight AFLP bands and 34 SSR primer pairs were suitable for mapping. The total map length was 1,360 cM with 190 loci distributed in 15 linkage groups. The results were compared to those obtained previously on an interspecific BC 1 progeny involving a species with a medium-sized genome ( Coffea liberica var dewevrei, DEW) and a species with one of the smallest genomes ( Coffea pseudozanguebariae, PSE). They are discussed relative to three main points: (1) the relevance of the different marker types, (2) the genomic distribution of AFLP and SSR markers, and (3) the relation between AFLP polymorphism and genome size.

Effects of caffeine and chlorogenic acid on propidium iodide accessibility to DNA: consequences on genome size evaluation in coffee tree.

Estimates of genome size using flow cytometry can be biased by the presence of cytosolic compounds, leading to pseudo-intraspecific variation in genome size. Two important compounds present in coffee trees-caffeine and chlorogenic acid-modify accessibility of the dye propidium iodide to Petunia DNA, a species used as internal standard in our genome size evaluation. These compounds could be responsible for intraspecific variation in genome size since their contents vary between trees. They could also be implicated in environmental variations in genome size, such as those revealed when comparing the results of evaluations carried out on different dates on several genotypes.

Genetic mapping of a caffeoyl-coenzyme A 3-O-methyltransferase gene in coffee trees. Impact on chlorogenic acid content.

Chlorogenic acids (CGA) are involved in the bitterness of coffee due to their decomposition in phenolic compounds during roasting. CGA mainly include caffeoyl-quinic acids (CQA), dicaffeoyl-quinic acids (diCQA) and feruloyl-quinic acids (FQA), while CQA and diCQA constitute CGA sensu stricto (CGA s.s.). In the two cultivated species Coffea canephora and Coffea arabica, CGA s.s. represents 88% and 95% of total CGA, respectively. Among all enzymes involved in CGA biosynthesis, caffeoyl-coenzyme A 3-O-methyltransferase (CCoAOMT) is not directly involved in the CGA s.s. pathway, but rather in an upstream branch leading to FQA through feruloyl-CoA. We describe how a partial cDNA corresponding to a CCoAOMT encoding gene was obtained and sequenced. Specific primers were designed and used for studying polymorphism and locating the corresponding gene on a genetic map obtained from an interspecific backcross between Coffea liberica var. Dewevrei and Coffea pseudozanguebariae. Offspring of this backcross were also evaluated for the chlorogenic acid content in their green beans. A 10% decrease was observed in backcross progenies that possess one C. pseudozanguebariae allele of the CCoAOMT gene. This suggests that CGA s.s. accumulation is dependent on the CCoAMT allele present and consequently on the activity of the encoded isoform, whereby CGA accumulation increases as the isoform activity decreases. Possible implications in coffee breeding are discussed.

Identification and mapping of a major gene (Ft1) involved in fructification time in the interspecific cross Coffea pseudozanguebariae x C. liberica var. Dewevrei: impact on caffeine content and seed weight.

Fructification time was studied in the interspecific cross Coffea pseudozanguebariae x C. liberica var. Dewevrei (PSE x DEW). Parental species, F(1) hybrids and offspring of the first backcross generation (BC(1)), consisting of F(1) x PSE (BCPSE) and F(1) x DEW (BCDEW) plants, were observed. Fructification time can be split into two independent visual phases: the full-growth period, from blooming up to the end of fruit growth, and the maturation phase, defined by the green to red color change. Fructification time was found to be an additive trait. The full-growth period showed a bimodal distribution in the BCDEW hybrid, suggesting the involvement of Ft1, a major gene that was mapped on linkage group E. The main effects of Ft1 were to lower caffeine content and 100-seed weight, without any impact on chlorogenic acid, trigonelline and sucrose contents. Two molecular markers were identified that bracket Ft1 and which could be used for early marker-assisted selection.

Pollen viability restoration in a Coffea canephora P. and C. heterocalyx Stoffelen backcross. QTL identification for marker-assisted selection.

Male fertility of interspecific hybrids was analysed in one F1 and two backcrossed progenies originating from a cross between Coffea canephora and Coffea heterocalyx. Male fertility was tested using pollen stainability with acetic carmine. The results showed a marked decline in fertility at the F1 level, and fertility was almost fully restored after two backcrosses. The computed broad-sense heritability represented 47% of the variance. Quantitative trait loci (QTLs) locations and effects on pollen viability were estimated using an amplified fragment length polymorphism (AFLP) genetic linkage map constructed in the segregating BC1 population. Three significant QTLs (LOD>3 and p < 0.001 by ANOVA) were detected for pollen viability, two of which were responsible for the bimodal distribution of pollen viability in the segregating population. One QTL was involved in fertility variations among fertile BC1 plants. Fertility inheritance is discussed in relation with previously demonstrated chromosomal sterility in Coffea hybrids and the effect of detected QTLs. The potential use of genetic markers to overcome sterility in interspecific hybrids is also discussed.

Introgression of self-compatibility from Coffea heterocalyx to the cultivated species Coffea canephora.

Self-compatibility segregation was assessed in two successive backcross progenies originating from an interspecific cross between Coffea canephora (self-incompatible) and Coffea heterocalyx (self-compatible). After self- and cross-pollination, pollen tube behaviour in styles was observed under ultraviolet fluorescence microscopy and fruit-set was determined at harvesting time. Segregation ratios in the two progenies were consistent with monofactorial control of self-compatibility. Self-compatible plants exhibited higher fruit-set than self-incompatible ones in open-pollination conditions. Segregation of AFLP markers was scored in the first backcross progeny. By molecular linkage analysis, the S locus could be mapped to a short linkage group.

Lateral approach to laparoscopic repair of left diaphragmatic ruptures.

Video-assisted repairs of traumatic diaphragmatic ruptures have been described where thoracoscopy or laparoscopy in the supine position were used. This study aims to validate a new lateral laparoscopic approach for left diaphragmatic repairs. Six consecutive patients were operated on for left diaphragmatic rupture using a lateral approach (Gagner's position). A series of 362 consecutive patients presenting with abdominal or thoracic trauma with or without diaphragmatic rupture over a 2-year period were reviewed retrospectively. Contraindications for immediate or delayed lateral laparoscopic approach were studied. The lateral approach provided complete visibility of the subdiaphragmatic space, easy reduction of herniated organs, easy thoracic inspection and cleaning, the use of low peritoneal pressure, full range of instrumental motion, and rapid diaphragmatic repair. No operative mortality or morbidity was noted. Altogether, 14% to 50% of the patients with diaphragmatic ruptures were candidates for immediate lateral laparoscopic repair. Associated spleen injury in 50% of the cases was the main contraindication. The lateral laparoscopic approach provides better exposure of the diaphragm on the left side and facilitates the diaphragmatic repair especially with a large herniation. Immediate repair is possible in selected cases (14-50%). There is no contraindication in case of delayed diagnosis.

[Managing adolescent and adult victims of extra-familial rape soon after aggression]. / Prise en charge des adolescents et des adultes victimes de viols extra-familiaux dans les suites récentes de leur agression.

Rape victims often experience severe and prolonged symptoms in the aftermath of the assault. Psychological assistance offered rapidly after the assault should mitigate the intensity and moderate the duration of rape-related problems. This paper tried to identify the widely-accepted therapeutic approaches from a review of the current literature; it has its roots in the clinical experience acquired by our mobile crisis service in this type of situation, too. The goal of the following practices concerning the victim and the victim's immediate family is to assist the victim to reclaim control as quickly as possible over what has happened and to return to a normal functioning. The therapist should adopt an empathetic attitude, actively and instructively, even more so, and in an even more flexible way than for other patients. Knowledge of one's potential reactions to that kind of situation is useful since the counter-transference is here particularly intense. Doubting the patient's word is part of these negative reactions and must be avoided. It is better to respect the victim's feelings of guilt in the first instance. The relating of the facts, despite its cathartic value, should not be imposed on the patient. It should be noted that these last two points are controversial. It is also important to give information, during interviews, about the symptoms which can occur, the defence mechanisms that the individual sets up for just such occasions and on the most common difficulties encountered in personal relationships. In particular, the therapist must verify that concrete measures are taken to protect the victim against another attack. As far as the immediate family is concerned, it seems particularly important to involve them and, better still, meet them. Their reaction to the rape has a determining influence on the victim's capacity to cope with the trauma and its consequences. On the one hand, the immediate family should be helped in giving support to the victim by telling them all the details of what the patient could suffer, their potential reaction towards the victim and the victim's potential reactions towards them. The question of security must also be brought up with the family, in particular the risk of suicide which can be great. On the other hand, it is important to meet the family to give them support because they too may have difficulty in coming to terms with the violence of the aggression and its consequences. These approaches are up to now the only guidelines available since no psychotherapeutic technique (based on controlled studies) has proved to be more efficient than another and since the clinical experience of the authors are leading them to opposite therapeutic options. Different psychotherapeutic techniques are recommended: short therapies such as cognitive-behavioural therapies or hypnosis, or longer ones such as psychoanalytic psychotherapy. Several of these different options, to which must be added physical techniques like relaxation and medication, are often used simultaneously and/or in succession. As for drug treatments no controlled study conducted with this population has proved their efficiency on post-traumatic stress disorder. According to us they are essentially useful in order to diminish the intensity of the symptoms of anxiety.

[Latex allergy: diagnostic pitfalls]. / Allergie au latex: pièges diagnostiques.

A 44-year-old woman, native of Martinique, with a history of multiple allergies and severe asthma, sustained an unexplained cardiovascular collapse during surgery under general anaesthesia. The patient recovered normally. Postoperatively, neither additional explorations were undertaken nor informations given to the patient. Later on she had to undergo cholecystectomy. Data obtained from preanaesthetic assessment (history, analysis of medical files) were in favour of a past intraoperative allergic accident. Allergological tests confirmed a latex allergy. This case substantiates the importance of a careful preanaesthetic consideration of patient's history and the value of a systematic allergologic exploration after an unexplained intraoperative event compatible with an anaphylactoid reaction. All such events should be clearly explained and a written document handed to the patient.

Comparative flow cytometric estimation of nuclear DNA content in oil palm (Elaeis guineensis Jacq) tissue cultures and seed-derived plants.

Flow cytometric analysis performed on two different crosses of dura×pisifera oil palm gave an accurate estimation of nuclear DNA content. The genome size of Elaeis guineensis was found to be 2C=3.76±0.09 pg and therefore ca. 3.4×109 bp. Embryogenic calli and plants showed the same ploidy level, but the measured 2C DNA values differed significantly. No variation in the ploidy level between three different types of calli originating from foliar explants, namely nodular compact callus, fast-growing callus and friable callus was observed. Since fast-growing callus (FGC), already identified as a source of `mantled' phenotype variants, did not show any difference in their ploidy level, these results are consistent with the hypothesis of an epigenetic origin for this type of somaclonal variant.

Reliable flow cytometric estimation of nuclear DNA content in coffee trees.

Flow cytometry gave high resolution of genome size in two coffee taxa (Coffea liberica dewevrei and C. pseudozanguebariae). Propidium iodide (PI) and Petunia hybrida were used as dye and internal standard, respectively. Proportionally between the DNA content and the digitized fluorescence signal was checked. Five main results were evident. First, optimal experimental conditions were established for peak location estimation (mean or mode), staining time (at least 2 minutes), high voltage (557 V) for the photomultiplier tube (PMT), and PI concentration (333 micrograms/ml). Second, a parameterization of the effects of high voltage and PI concentration were deduced from curve fitting. Third, two biases in DNA content estimation were recorded for high voltage and PI concentration, and were minimized. Fourth, the genome sizes of C. liberica dewevrei and C. pseudozanguebariae were estimated with accuracy 2C = 1.421 +/- 0.005 pg and 2C = 1.129 +/- 0.005 pg, respectively. Fifth, between-genotype variance was emphasized within each taxon.

Isozyme polymorphism and organization of the agamic complex of the Maximae (Panicum maximum Jacq., P. infestum Anders, and P. trichocladum K. Schum.) in Tanzania.

The tribe Maximae (Panicum maximum Jacq., P. infestum Anders., P. trichocladum K. Schum.) includes two sympatric pools with different modes of reproduction and ploidy levels: an apomictic and tetraploid pool on the one hand, and a smaller, sexual and diploid pool on the other. From an analysis of isozyme polymorphism five main results were evident. First, overall polymorphism is considerable showing that apomixis does not lead to a reduction in diversity. Second, the isozyme polymorphism of the two pools is similar, and this may be explained by reciprocal gene flow (low, but continuous) between these two pools. Third, maximum local polymorphism is due to the simultaneous presence of P. maximum sexuals and P. infestum apomicts. A continuum exists between the two species. Fourth, a high proportion of rare alleles, arising from introgression from P. infestum, characterized the isozyme polymorphism. These rare alleles, strongly counter-selected at the diploid level, are maintained by apomixis; the frequency of triplex or quadruplex genotypes was nevertheless low. Fifth, the heterozygosity level within apomicts is not higher than that of sexuals, showing that the apomixis-polyploidy combination does not lead to a higher frequency of very heterozygous individuals.

[Early management of severe brain injuries]. / Prise en charge initiale d'un traumatisme cranien grave.

Severe head injury (Glasgow Coma Score less than or equal to 7) is associated with high mortality and morbidity which can be improved by early energetic therapy. Such patients must be picked up by prehospital/EMS service with three aims: controlling ventilation, controlling haemodynamics, avoiding any increased intracranial pressure. After initial neurological assessment, management involves endotracheal intubation, mechanical ventilation following benzodiazepine sedation, early compensation of hypovolemia avoiding any overloading, analgesia for painful injuries; according to the clinical status other pharmacological agents can be used. At admission to emergency unit, intensive care must be continued while X-rays and CT-scan are achieved. Imperative indications of transport to neuro-intensive care unit are discussed for hospitals without a neuro-surgeon.

[Technical constraints in rapid vascular fluid replacement]. / Contraintes techniques du remplissage vasculaire rapide.

Rapid fluid infusion remains the cornerstone for therapy of hypovolaemic shock. The principal limitations of flow rate are governed by the four variables of Poiseuille's law: tube internal diameter and length, viscosity of the fluid passing through the tube, and the pressure gradient between the two ends of the tube. Conventional transfusion systems, with wide bore tubing (up to 5.0 mm internal diameter), large bore cannulas (8.5 French introducer catheters), high pressure (up to 300 mmHg) and diluted blood, can result in a maximum flow rate of about 1,000 ml.min-1 (for crystalloid solutions). Specific apparatus for rapid infusion can increase this to 1,500 ml.min-1 (Rapid Infusion System, Haemonetics). Dry-heat warming devices and microfiltration, to remove microaggregates and prevent non haemolytic febrile transfusion reactions, seem necessary when carrying out rapid transfusions. However, the use of microaggregate filters could be avoided by the routine production of leukocyte-poor red blood cell concentrates.