Risks and benefits of sharing patient information on social media: a digital dilemma.

Social media (SoMe) has witnessed remarkable growth and emerged as a dominant method of communication worldwide. Platforms such as Facebook, X (formerly Twitter), LinkedIn, Instagram, TikTok, and YouTube have become important tools of the digital native generation. In the field of medicine, particularly, cardiology, attitudes towards SoMe have shifted, and professionals increasingly utilize it to share scientific findings, network with experts, and enhance teaching and learning. Notably, SoMe is being leveraged for teaching purposes, including the sharing of challenging and intriguing cases. However, sharing patient data, including photos or images, online carries significant implications and risks, potentially compromising individual privacy both online and offline. Privacy and data protection are fundamental rights within European Union treaties, and the General Data Protection Regulation (GDPR) serves as the cornerstone of data protection legislation. The GDPR outlines crucial requirements, such as obtaining 'consent' and implementing 'anonymization', that must be met before sharing sensitive and patient-identifiable information. Additionally, it is vital to consider the patient's perspective and prioritize ethical and social considerations when addressing challenges associated with sharing patient information on SoMe platforms. Given the absence of a peer-review process and clear guidelines, we present an initial approach, a code of conduct, and recommendations for the ethical use of SoMe. In conclusion, this comprehensive review underscores the importance of a balanced approach that ensures patient privacy and upholds ethical standards while harnessing the immense potential of SoMe to advance cardiology practice and facilitate knowledge dissemination.

Gut microbiota promoting propionic acid production accompanies caloric restriction-induced intentional weight loss in cats.

Rodent models and human clinical studies have shown gut microbiota-derived short-chain fatty acids (SCFAs) play roles in obesity and insulin resistance. These roles have been minimally explored in cats, where in the USA an estimated 60% of cats are overweight or obese. Overweight/obese research cats (n = 7) were transitioned from a maintenance diet to a reduced calorie diet fed ad libitum for 7 days, then calories were restricted to achieve 1-2% weight loss per week for an additional 77 days. Cats then received their original maintenance diet again for 14 days. Significant intentional weight loss was noted after calorie restriction (adjusted p < 0.0001). 16S rRNA gene amplicon sequencing and targeted SCFA metabolomics were performed on fecal samples. Fecal microbial community structure significantly differed between the four study phases (PERMANOVA p = 0.011). Fecal propionic acid was significantly higher during caloric restriction-induced weight loss (adjusted p < 0.05). Repeated measures correlation revealed the relative abundances of Prevotella 9 copri (correlation coefficient = 0.532, 95% CI (0.275, 0.717), p = 0.0002) significantly correlated with propionic acid composition. Like humans, obese cats experienced an altered microbial community structure and function, favoring propionic acid production, during caloric restriction-induced weight loss.

Applicability of 'Toolkit for Safety Assessment' tool to interventional radiology using probabilistic risk assessment techniques.

Interventional radiology brings extensive benefits to patients. Nevertheless, certain procedures may result in high doses of radiation, leading to health risks to occupationally exposed individuals (OEIs). Therefore, a more comprehensive risk analysis is essential to ensuring safety and minimising radiation exposures for all OEIs. The Toolkit for Safety Assessment (TOKSA) tool performs risk assessments based on the concepts described in 'General Safety Requirements' Part 3 (Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards) and Part 4 (Safety Assessment for Facilities and Activities). This tool was developed based on the 'Ibero-American Forum of Radiological and Nuclear Regulatory Agencies' risk models and can promote the use of the risk assessment processes by OEIs. The aim of this study was to experimentally analyse the applicability of the TOKSA tool in interventional radiology with the use/support of probabilistic risk assessment techniques. The results were used to reduce the risks associated with a hemodynamics room in a hospital in Belo Horizonte, Brazil.

Gut microbiota promoting propionic acid production accompanies diet-induced intentional weight loss in cats.

Rodent models and human clinical studies have shown gut microbiota-derived short-chain fatty acids (SCFAs) play roles in obesity and insulin resistance. These roles have been minimally explored in cats, where in the USA an estimated 60% of cats are overweight or obese. Overweight/obese research cats (n = 7) were transitioned from a maintenance diet to a reduced calorie diet fed ad libitum for seven days, then calories were restricted to achieve 1-2% weight loss per week for an additional 77 days. Cats then received their original maintenance diet again for 14 days. Significant intentional weight loss was noted after calorie restriction (adjusted p < 0.0001). 16S rRNA gene amplicon sequencing and targeted SCFA metabolomics were performed on fecal samples. Fecal microbial community structure significantly differed between the four study phases (PERMANOVA p = 0.011). Fecal propionic acid was significantly higher during diet-induced weight loss (adjusted p < 0.05). Spearman correlation revealed the relative abundances of Prevotella 9 copri (ρ = 0.6385, p = 0.0006) and Blautia caecimuris (ρ = 0.5269, p = 0.0068) were significantly correlated with propionic acid composition. Like humans, obese cats experienced an altered microbial community structure and function, favoring propionic acid production, during diet-induced weight loss.

The ALR-RSI score can be used to evaluate psychological readiness to return to sport after acute Achilles tendon tear.

PURPOSE: The return to sport is one of the main goals following Achilles tendon tear repair. Several psychological factors influence the return to sport after a sports injury. The traditional tools to assess the return to sport do not take into account psychological factors. The ankle ligament reconstruction-return to sport injury (ALR-RSI), validated for ankle instability, is a score to evaluate psychological readiness to return to sport. The goal of this study was to validate the ALR-RSI score for the assessment of the readiness to return to sport after Achilles tendon repair. METHODS: The ALR-RSI score, adapted from the anterior cruciate ligament-return to sport injury (ACL-RSI) score used following knee ligament reconstruction, was validated according to the international COSMIN methodology. Patients operated for Achilles tendon repair responded to the questionnaire during the rehabilitation period. The EFAS, FAAM and VISA-A scores were used as reference questionnaires. RESULTS: A total of 50 patients were included. The ALR-RSI score was strongly (r > 0.5) correlated to the EFAS score: r = 0.68 [0.50-0.80] the FAMM sport score: r = 0.7 [0.52-0.84] the FAAM AVQ score (r = 0.6 [0.35-0.78]), and the VISA-A score (r = 0.54 [0.26-0.76]). The discriminant validity was good with the ALR-RSI, which was significantly lower in the patients that did not return to sport: 60.7 (40-81.4) compared to those that did: 83.2 (64.3-100) p = 0.001. Reproducibility was excellent with an intra-class correlation coefficient ρ of 0.99 [097-1.00]. The internal consistency was excellent (alpha coefficient = 0.95). CONCLUSION: The ALR-RSI score provides a valid, reproducible assessment of the psychological readiness to return to sport in patients who undergo surgical Achilles tendon suture repair. LEVEL OF EVIDENCE: III.

Characterization of controlled trials on probiotic supplementation to dairy calves: A scoping review.

The objective of this scoping review was to identify, describe, and characterize the literature on probiotic supplementation in dairy calves. Eligible studies were nonrandomized, quasi-randomized and randomized controlled trials in English, Spanish, or Portuguese that evaluated the effect of probiotic supplementation on growth and health of dairy calves. The search strategies were based on a modification of the PICO (Population, Intervention, Comparator, Outcome) framework and used synonyms and words related to "dairy calves" (population), "probiotics" (intervention), and "growth and health measurements" (outcomes). No restrictions for publication year or language were applied. Searches were conducted in Biosis, CAB Abstracts, Medline, Scopus, and the Dissertations and Theses Database. In total, the search identified 4,467 records, of which 103 studies (110 controlled trials) met the inclusion criteria. The studies were published between 1980 and 2021 and originated from 28 countries. Trials were randomized (80.0%), nonrandomized (16.4%), and quasi-randomized (3.6%), ranging in sample size from 5 to 1,801 dairy calves (mode = 24; average = 64). Enrolled calves were frequently Holstein (74.5%), males (43.6%), and younger than 15 d at the beginning of probiotic supplementation (71.8%). Often, trials were conducted in research facilities (47.3%). Trials evaluated probiotics with single or multiple species of the same genus: Lactobacillus (26.4%), Saccharomyces (15.4%), Bacillus (10.0%), Enterococcus (3.6%), or multiple species of various genera (31.8%). Eight trials did not report the probiotic species used. Lactobacillus acidophilus and Enterococcus faecium were the species most supplemented to calves. The duration of probiotic supplementation ranged from 1 to 462 d (mode = 56; average = 50). In trials with a constant dose, it ranged from 4.0 × 106 to 3.7 × 1011 cfu/calf per day. Most probiotics were administered mixed solely into feed (88.5%; whole milk, milk replacer, starter, or total mixed ration) and less frequently orally as a drench or oral paste (7.9%). Most trials evaluated weight gain (88.2%) as a growth indicator and fecal consistency score (64.5%) as a health indicator. Our scoping review summarizes the breadth of controlled trials evaluating probiotic supplementation in dairy calves. Differences in intervention design (mode of probiotic administration, dose, and duration of probiotic supplementation) and outcomes evaluation (type and methods) justify future efforts toward standardized guidelines in clinical trials.

Higher preoperative range of motion is predictive of good mid-term results in the surgical management of osteochondral lesions of the talus: a prospective multicentric study.

INTRODUCTION: Osteochondral lesions of the talus (OLT) are a frequent cause of pain in young patients and a new CT arthrographic classification system of OLT was recently proposed to help guide the choices of and standardize the indications for surgical treatment. The primary hypothesis was that this algorithm would result in a postoperative AOFAS score of ≥ 80/100. The secondary hypothesis was to identify the preoperative factors of successful surgery. METHODS: This was a prospective observational multicenter study. Eighty-six patients who underwent surgery for OLT after at least 6 months of unsuccessful conservative management were included for a mean follow-up of 15 months (12-36). Forty-nine patients with stage 1 OLT underwent microperforation, 2 patients with stage 2 OLT underwent a lift, drill, fill, and fix graft procedure with screw fixation, and 35 patients with stage 3 OLT were treated with mosaicplasty. RESULTS: After a follow-up of at least 1 year, 56 patients (65%) had an AOFAS score > 80 and the mean AOFAS score was 82 (16-100). A lower BMI (p = 0.038), a higher preoperative range of motion in the ankle (p = 0.033), higher preoperative AOFAS and FAOS scores (p = 0.001 and p = 0.011), and the presence of a preoperative bone bruise on MRI (p = 0.020) were good prognostic factors on univariate analysis. The presence of grade 1 osteoarthritis on the Van Dijk classification was predictive of a poor prognosis (p = 0.044). Multivariate analysis showed that a good preoperative range of motion (OR = 1.080 [1.020-1.150] p = 0.01) was predictive of a positive outcome, while grade 1 osteoarthritis was predictive of a poor outcome (OR = 0.147 [0.036-0.603] p = 0.008). The postoperative AOFAS decreased in six patients and 17 patients had at least one complication: six dysthesias of the superficial fibular nerve, two of the sural nerve, and nine stage 1 complex regional pain syndromes. CONCLUSION: The new algorithm for OLT resulted in a postoperative AOFAS score of ≥ 80/100 in 65% of cases. The positive predictive factors of a successful postoperative outcome were the presence of a good preoperative range of motion and the absence of preoperative osteoarthritis. LEVEL OF EVIDENCE: Level II.

Marginal and Internal Adaptation of Cervical Restorations Using Direct, Direct-indirect, and Indirect Techniques.

OBJECTIVE: This study aimed to evaluate the external and internal adaptations of cervical restorations using different restorative techniques. METHODS: Forty extracted and intact human premolars received standardized cervical preparations to simulate non-carious cervical lesions. The teeth were randomly divided into four groups (n=10) according to the restorative technique: D, direct composite restoration without a base (Palfique LX5, Tokuyama Dental Corp Inc, Tokyo, Japan); DB, direct composite restoration with a flowable composite liner (Estelite Flow Quick -High Flow, Tokuyama Dental Corp Inc); DI, direct-indirect composite restoration bonded with flowable composite; and I, indirect restoration bonded with flowable composite. Marginal adaptation of the restorations was observed in different segments of the margins using a scanning electron microscope. Analyses of internal adaptation were performed using micro-computed tomography. The Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis of the data (α=5%). RESULTS: No significant differences were found in the marginal adaptation of the groups (p>0.05), although a significantly higher percentage of continuous margin was found in the proximal segment than in the cervical segment (p<0.05). No significant differences were detected between the groups in terms of internal adaptation (p>0.05). CONCLUSION: All the restorative techniques evaluated for the restoration of cervical lesions performed similarly in terms of marginal and internal adaptation.

Assessment of the Ability of Desensitizing and Conventional Mouth Rinses to Promote Dentin Tubule Occlusion.

This study aimed to evaluate the effect of desensitizing and conventional mouth rinses on dentin tubule occlusion. Dentin hypersensitivity was simulated by EDTA application for five minutes. The specimens were randomly allocated into the following groups: desensitizing mouth rinses (Colgate Sensitive, Elmex Sensitive Professional, Listerine Advanced Defense Sensitive, Sensodyne Cool Mint); conventional mouth rinses (Colgate Plax, Elmex Caries Protection, Listerine Anticaries, Sensodyne Pronamel); a negative control (C-: distilled water); and Clinpro XT Varnish was the positive control (C+). Subsequently, the specimens were submitted to an erosive or abrasive challenge (performed separately) and to an erosive/abrasive cycling for five days (n=10 for each challenge). After treatment, challenges, and cycling, the specimens were analyzed in an environmental scanning electron microscope to verify the number of open dentin tubules (ODTs), counted by using Image J software (National Institutes of Health, Bethesda, MD, USA). Data were analyzed by the Kruskal-Wallis, Friedman and Dunn tests, with Bonferroni correction (α=0.05). Groups did not differ at baseline (p>0.05). At the post-treatment, erosion and abrasion stages, C+ was the only group that showed a reduction in ODTs compared to C-(p<0.05). In the other groups, numbers did not differ significantly from C- (p>0.05). After cycling, none of the groups exhibited significant reduction in ODTs other than C- (p>0.05); however, C+, Listerine Anticaries, and Colgate Plax had a lower number of ODTs than Listerine Sensitive and Sensodyne Pronamel. No mouth rinse was able to promote significant occlusion of the dentin tubules after treatment and the challenges. C+ was the only product that effectively promoted tubular occlusion, but this effect did not withstand several erosive and abrasive challenges.

Needle arthroscopy in anatomical reconstruction of the lateral ankle: a report of three cases with a parallel comparison to the standard arthroscopy procedure.

PURPOSE: This study evaluates the use of the needle arthroscopy in anatomical reconstruction of the lateral ankle. We hypothesized that the needle arthroscopy would allow anatomical reconstruction to be performed under arthroscopy. METHODS: Three patients underwent treatment of chronic ankle instability. The comparative procedure was performed in the following four steps: 1) anteromedial articular exploration (medial/lateral gutter/anterior chamber/syndesmosis); 2)creation of the talar tunnel via the anteromedial arthroscopic approach; 3) anterolateral fibular tunneling; and 4) positioning of the graft by the anteromedial arthroscopic approach. For each of these steps, the planned procedure using the needle arthroscope was compared to the standard arthroscope. For each step, the planned procedure using the needle arthroscopy was compared to the standard arthroscope and the act was classified based on level of difficulty: facilitated, similar, complicated and impossible. RESULTS: The exploration of the medial and lateral gutter, the creation of the tunnel of the talus and graft positioning were not accomplished using the needle arthroscope. While the syndesmosis visualization was facilitated by the needle arthroscope in comparison to the standard arthroscope. CONCLUSION: The anatomical reconstruction of the lateral ankle, using the needle arthroscopy-only approach, was impossible in all three cases, regarding: ankle joint exploration, creation of the tunnel of the talus and graft positioning. The needle arthroscope should not be considered as a "mini arthroscope" but as a new tool with which it is necessary to rethink procedures to take advantage of the benefits of this instrument.

Machine learning-based prediction of insufficient contrast enhancement in coronary computed tomography angiography.

OBJECTIVES: Patient-tailored contrast delivery protocols strongly reduce the total iodine load and in general improve image quality in CT coronary angiography (CTCA). We aim to use machine learning to predict cases with insufficient contrast enhancement and to identify parameters with the highest predictive value. METHODS: Machine learning models were developed using data from 1,447 CTs. We included patient features, imaging settings, and test bolus features. The models were trained to predict CTCA images with a mean attenuation value in the ascending aorta below 400 HU. The accuracy was assessed by the area under the receiver operating characteristic (AUROC) and precision-recall curves (AUPRC). Shapley Additive exPlanations was used to assess the impact of features on the prediction of insufficient contrast enhancement. RESULTS: A total of 399 out of 1,447 scans revealed attenuation values in the ascending aorta below 400 HU. The best model trained using only patient features and CT settings achieved an AUROC of 0.78 (95% CI: 0.73-0.83) and AUPRC of 0.65 (95% CI: 0.58-0.71). With the inclusion of the test bolus features, it achieved an AUROC of 0.84 (95% CI: 0.81-0.87), an AUPRC of 0.71 (95% CI: 0.66-0.76), and a sensitivity of 0.66 and specificity of 0.88. The test bolus' peak height was the feature that impacted low attenuation prediction most. CONCLUSION: Prediction of insufficient contrast enhancement in CT coronary angiography scans can be achieved using machine learning models. Our experiments suggest that test bolus features are strongly predictive of low attenuation values and can be used to further improve patient-specific contrast delivery protocols. KEY POINTS: • Prediction of insufficient contrast enhancement in CT coronary angiography scans can be achieved using machine learning models. • The peak height of the test bolus curve is the most impacting feature for the best performing model.

Annulus flooding detection system in flexible pipes using gamma rays transmission technique.

Flexible pipes are modular constructions made up of several layers. They are broadly employed in oil & gas industry, playing an important role in the Brazilian Pre-Salt production. Under specific conditions, seawater can ingress and this contact with metallic middle layers can significantly lead to a service life reduction of these layers, especially due to a mechanism known as CO2 Stress Corrosion Cracking (SCC-CO2). Therefore, it becomes mandatory that inspection systems suitable for submarine use in order to detect annulus flooding before the failure of the flexible pipe become available. This paper presents an inspection system based on the gamma rays transmission focused on detecting such flood condition, possibly overcoming limitations of other inspection systems available in the market. The reliability of this solution was statistically evaluated as presented herein, showing great robustness based on the numerous available trials.

Effects of stress exposure in captivity on physiology and infection in avian hosts: no evidence of increased Borrelia burgdorferi s.l. infectivity to vector ticks.

Exposure to environmental stressors, an increasingly recurring event in natural communities due to anthropogenic-induced environmental change, profoundly impacts disease emergence and spread. One mechanism through which this occurs is through stress-induced immunosuppression increasing disease susceptibility, prevalence, intensity and reactivation in hosts. We experimentally evaluated how exposure to stressors affected both the physiology of avian hosts and the prevalence of the zoonotic bacteria Borrelia burgdorferi sensu lato (s.l.), in two model species-the blackbird Turdus merula and the robin Erithacus rubecula captured in the wild, using xenodiagnoses and analysis of skin biopsies and blood. Although exposure to stressors in captivity induced physiological stress in birds (increased the number of circulating heterophils), there was no evidence of increased infectivity to xenodiagnostic ticks. However, Borrelia detection in the blood for both experimental groups of blackbirds was higher by the end of the captivity period. The infectivity and efficiency of transmission were higher for blackbirds than robins. When comparing different methodologies to determine infection status, xenodiagnosis was a more sensitive method than skin biopsies and blood samples, which could be attributed to mild levels of infection in these avian hosts and/or dynamics and timing of Borrelia infection relapses and redistribution in tissues.

Brief International Cognitive Assessment for Multiple Sclerosis scores are associated with the cortical thickness of specific cortical areas in relapsing-remitting patients.

BACKGROUND: Cognitive impairment is frequent and disabling in multiple sclerosis (MS). The Brief International Cognitive Assessment in MS (BICAMS) is a recent short battery usable in clinical practice for cognitive evaluation of MS patients. OBJECTIVE: To find cortical areas or brain volumes on magnetic resonance imaging (MRI) structural sequences associated with BICAMS scores in MS. METHODS: In this cross-sectional single-center study (NCT03656055, September 4, 2018), 96 relapsing remitting-MS patients under natalizumab and without recent clinical or radiological inflammation were included. Patients underwent brain MRI and the three BICAMS tests, evaluating information processing speed (SDMT), visuo-spatial memory (BVMT-R), and verbal memory (FVLT). RESULTS: Cortical thickness in the left frontal superior and the right precentral gyri was associated with BVMT-R scores whereas cortical thickness in the left Broca's area and the right superior temporal gyrus was associated with FVLT scores. We observed associations between white matter inflammatory lesions connected to these cortical regions and BICAMS subscores. CONCLUSIONS: BICAMS scores are associated with specific cortical areas, the cognitive domain matching the known functions of the cortical area. Specific cognitive impairments in MS may be associated with specific cortical regions, themselves influenced by white matter inflammatory lesions and demographical parameters (age, sex, education level).

Effects of postpartum milking strategy on plasma mineral concentrations and colostrum, transition milk, and milk yield and composition in multiparous dairy cows.

The effects of postpartum milking strategy on plasma mineral concentrations, blood ß-hydroxybutyrate (BHB) concentration, and colostrum, transition milk, and first monthly test milk yield and composition were evaluated in 90 multiparous Jersey and Jersey × Holstein crossbreed cows from a commercial farm. Before first postpartum milking, cows were randomly assigned to the following milking strategies, implemented during the first 2 d postpartum: twice-a-day milking (M2, standard industry practice, milking every 12 h; n = 22), once-a-day milking (M1, milking every 24 h; n = 24), restricted milking (MR, 3-L milking every 12 h; n = 21), and delayed milking (MD, no milking for the first 24 h, and milking every 12 h afterward; n = 23). Blood samples for total plasma Ca, P, and Mg determination were collected from enrollment every 4 h up to 48 h, and at 3 d in milk. Blood BHB concentration was determined at 3 and 11 d in milk. Colostrum and transition milk yields were recorded, and samples were collected at each study milking for IgG and somatic cell count (SCC) determinations. Information for first monthly test milk yield and composition was obtained from the Dairy Herd Improvement Association. Statistical analyses were conducted using generalized multiple linear and Poisson regressions with Dunnett adjustment and M2 as reference group for mean comparisons. Overall, plasma Ca concentration within 48 h after enrollment was higher for MD (2.17 mmol/L), tended to be higher for MR (2.15 mmol/L), and was similar for M1 (2.09 mmol/L) compared with M2 cows (2.06 mmol/L). No statistically significant differences compared with M2 cows were observed for plasma P and Mg concentrations. Colostrum and transition milk and total Ca harvested within 48 h after enrollment were lower for M1, MR, and MD compared with M2 cows. The MD strategy prevented harvesting colostrum with >50 g of IgG/L. No statistically significant effects were detected on plasma mineral concentrations at 3 DIM, blood BHB concentration, colostrum and transition milk SCC within 48 h after enrollment, or milk yield, energy-corrected milk yield, and SCC at first monthly test. Our results suggest that postpartum plasma Ca concentration may be influenced by postpartum milking strategy, without interfering with future milk yield and udder health. Further studies should evaluate whether the proposed milking strategies in early postpartum affect production, reproduction, or health.

Use of antimicrobials in the treatment of calf diarrhea: a systematic review.

The objective of this study was to conduct a systematic review of the scientific literature evaluating the efficacy and comparative efficacy of antimicrobials (AMs) for the treatment of diarrhea in calves. Eligible studies were non- and randomized controlled trials evaluating an AM intervention against a positive and negative control, with at least one of the following outcomes: fecal consistency score, fever, dehydration, appetite, attitude, weight gain, and mortality. Four electronic databases were searched. Titles and abstracts (three reviewers) and full texts (two reviewers) were screened. A total of 2899 studies were retrieved; 11 studies met the inclusion criteria. The risk of bias was assessed. Most studies had incomplete reporting of trial design and results. Eight studies compared AMs to a negative control (placebo or no treatment). Among eligible studies, the most common outcomes reported were diarrhea severity (n = 6) and mortality (n = 6). Eligible studies evaluated very different interventions and outcomes; thus, a meta-analysis was not performed. The risk of bias assessment revealed concerns with reporting of key trial features, including disease and outcome definitions. Insufficient evidence is available in the scientific literature to assess the efficacy of AMs in treating calf diarrhea.

Epidemiology And Outcomes Of Radiator Burns At A High Throughput Burns Centre.

Indoor radiator burns can cause significant morbidity and mortality, especially in vulnerable patients. However, the epidemiology and clinical outcomes are poorly characterized. A retrospective study of all radiator burns referred to a tertiary regional burns centre between 2013-2019 was conducted. Four hundred and forty-seven patients (median age 25.6 years, male:female ratio 1.4:1) were referred; 109 (24%) admitted, 201 (45%) managed in outpatients and 137 (31%) managed locally. The incidence of burns leading to referral was 0.65/100,000/year, but increased annually. Contact burns consisted of 99.6%. Age distribution was bimodal: <5 years (43%), >65 years (27%), although all ages were affected. Median TBSA was 0.75% (0.1-11.5%), but 79% had injuries <2%. Childhood burns were predominantly superficial dermal grab injuries, usually manageable as outpatients. Elderly patients had larger burns usually secondary to falls or impaired sensorium, and were more likely to die (p<0.05). Burns due to impaired sensorium were deeper and more likely to require surgery (p<0.05). Sixty-three (14%) patients required surgery. Thirty-day mortality was 1.1%. Age was the only significant predictor of mortality. This study quantifies the epidemiology and outcomes of a growing problem. It identifies at risk populations (extremes of age), and important features of the clinical assessment.

Les brûlures en milieu clos liées à un radiateur peuvent être responsables de morbidités et de mortalité non négligeables, particulièrement chez les patients fragiles. Toutefois, l'épidémiologie et l'évolution en sont mal connues. Nous avons étudié rétrospectivement les 447 brûlures (âge médian des patients 25,6 ans ; 1,4 hommes pour 1 femme) liées à ces appareils adressées dans un CTB de référence entre 2013 et 2019. Parmi celles- ci, 109 (24%) ont été hospitalisées, 201 suivies par nous en externe et 137 (31%) pris en charge dans une structure non spécialisée. L'incidence annuelle est de 0,65/100 000/an, en augmentation régulière. Quasiment toutes (99,6%) sont dues à un contact. Bien que tous les âges puissent être affectés, on observe 2 pics d'incidence, avant 5 ans (43% des patients) et après 65 ans (27%). La surface atteinte s'étendait de 0,1 à 11,5% (médiane 0,75%), 79% des brûlures touchant moins de 2% SCT. Les enfants souffraient le plus souvent de brûlures superficielles, suivies en externe, après avoir empoigné le matériel. Chez les sujets âgés, les brûlures, consécutives à une chute ou à contact prolongé en raison de troubles sensoriels (ces dernières plus souvent profondes et nécessitant un traitement chirurgical ­ p< 0,05), sont plus étendues et plus souvent mortelles (p< 0,05). Soixante- trois (14%) patients ont eu besoin de chirurgie, la mortalité à 30 jours était de 1,1% ; l'âge étant le seul facteur prédictif de mortalité. Cette étude précise l'épidémiologie et l'évolution d'un problème émergeant, la population à risque (âges extrêmes) et met en avant certaines particularités cliniques.

Functional connectivity and cognitive changes after donepezil treatment in healthy participants.

RATIONALE: Donepezil is a potent, noncompetitive, reversible, clinically effective acetylcholinesterase inhibitor. The effects of this drug on healthy brains have seldom been investigated. OBJECTIVES: The primary objective of the present study was to identify possible functional connectivity markers of the effect of donepezil in healthy young adult volunteers. METHODS: The study had a double-blind, randomized, crossover design. 30 healthy adult volunteers underwent resting-state MRI scans during 15 days of donepezil or placebo treatment, in accordance with the design. RESULTS: Results showed significant differences in intrinsic functional connectivity between donepezil and placebo, mainly in the right executive control network (RECN). More specifically, we found a decrease in the connectivity of the right inferior parietal node with other RECN nodes. Analysis using the cingulate cortex and parahippocampal regions as seeds also revealed complex modulation of functional connectivity in the donepezil condition. CONCLUSIONS: In conclusion, donepezil treatment for 15 days may result in reorganization of resting-state networks, compared with placebo.