Improved acetabular fracture diagnosis after training in a CT-based method.

BACKGROUND: Acetabular fractures remain challenging to diagnose, particularly when they are complex. An accurate diagnosis is nevertheless crucial to select the best surgical strategy. None of the training methods described to date relies on the Letournel classification with a detailed analysis of each abnormality seen by computed tomography (CT). We therefore prospectively assessed a CT-based diagnostic method by (1) determining the rate of correct diagnoses by orthopaedic surgeons before and after training in the method, (2) comparing the times needed to read the CT images before and after training, (3) and assessing the repeatability of the method. HYPOTHESIS: Training in the CT-based diagnostic method significantly increases the rate of correct diagnoses. METHOD: The CT-based diagnostic method involves analysing eight anatomical landmarks in the anterior, posterior, and no man's land zones. From our institutional database (450 cases between 2007 and 2016), we selected 35 acetabular fractures that replicated the overall distribution of fracture types. The images were reviewed by 10 inexperienced and 3 experienced readers before and after they received training in the CT-based diagnostic method. The rates of correct diagnoses and times needed to read the images were compared. Finally, an additional reading was performed to allow an assessment of reproducibility. RESULTS: After training, the rate of correct diagnoses by the unexperienced readers improved by 16.64% for all fractures combined (from 212/350, 60.5% [37-83%] to 270/350, 77.14% [63-86%]; P=0.001) and by 25.9% for associated fractures (from 90/180, 50% [11-89%] to 114/140, 75.6% [61-90%]; P=0.003). Mean time required by the inexperienced readers to interpret the 35 sets of images decreased after training, from 66.1 to 47.6min (i.e., a 1.22-minute decrease per patient, P=0.001). None of the study variables changed significantly after training of the experienced readers (P>0.05). Reproducibility among the inexperienced readers was 0.78. CONCLUSION: Analysing the eight anatomical landmarks located in the anterior, posterior, and no man's land zones is a simple and reproducible method for diagnosing all fracture patterns defined by the Letournel classification. LEVEL OF EVIDENCE: Level III, non-randomised prospective case-control diagnostic study.

Silica-coated liposomes loaded with quantum dots as labels for multiplex fluorescent immunoassay.

This manuscript describes synthesis and followed application of silica-coated liposomes loaded with quantum dots as a perspective label for immunoaasay. The hollow spherical structure of liposomes makes them an attractive package material for encapsulation of multiple water-insoluble quantum dots and amplifying the analytical signal. Silica coverage ensures the stability of the loaded liposomes against fusion and internal leakage during storage, transporting, application and also provides groups for bioconugation. For the first time these nanostructures were employed for the sensitive multiplex immunochemical determination of two analytes. As a model system mycotoxins zearalenone and aflatoxin B1 were detected in cereals. For simplification of multiassay results' evaluation the silanized liposomed loaded with QDs of different colors were used. The IC50 values for the simultaneous determination of zearalenone and aflatoxin B1 were 16.2 and 18 µg kg(-1) for zearalenone and 2.2 and 2.6 µg kg(-1) for aflatoxin B1 in wheat and maize, respectively. As confirmatory method, liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) was used.

[Non necrotizing bacterial cellulitis and bacteriemia due to Shewanella putrefaciens]. / Dermohypodermite bactérienne non nécrosante et bactériémie à Shewanella putrefaciens.

Shewanella putrefaciens is a Gram negative opportunistic pathogen which causes skin and soft tissue infections and bacteriemia in immunocompromized patients. We report a 86-year-old man, who presented with an infectious cellulitis of the leg associated with Shewanella putrefaciens bacteriemia. This patient was treated by mycophenolate mofetil for a bullous pemphigoid resistant to corticotherapy.