Demonstration for cold atmospheric pressure plasma jet operation and antibacterial action in microgravity.

Cold atmospheric pressure plasma (ionized gas) is an innovative medical tool for the treatment of infected wounds thanks to its potential to inactivate drug-resistant microorganisms and promote tissue regeneration and vascularization. The low power consumption, compactness, and versatility of Cold Atmospheric Pressure Plasma (CAPP) devices make them an ideal tool for risk mitigation associated with human spaceflights. This work presents results in microgravity on the operability of CAPP and its antimicrobial effect. The experiments carried out in parabolic flights make it possible to optimize the treatment conditions (i.e., the distance, the gas mixture) and to obtain the rapid inactivation (<15 s) of Escherichia coli samples. Interestingly, the inactivation efficiency of CAPP was higher during parabolic flights than under terrestrial conditions. Overall, these results encourage the further development of CAPP medical devices for its implementation during human spaceflights.

Bicyclist's vulva: Diagnostic and therapeutic aspects.

The authors report a case of a rare vulvar condition in a young cyclist, known as bicyclist's vulva. The diagnosis was based on the clinical context (intensive cycling training with repeated saddle sores, responsible for painless unilateral swelling of the labium majus to a significant size and functional discomfort). Imaging examinations were used to characterize the lesion and its relationship with the pelvic organs. The lesion was composed of connective tissue, poorly demarcated and heavily collagenised without necrotic or hemorrhagic areas. Large cicatricial collagen bundles were observed. The fibroblasts revealed no atypia and just a few scattered undilated vessels ere noted. Special staining did not reveal any amyloid deposits. A complementary immunohistochemical analysis with anti-CD 34 antibody showed vascularization that was homogeneous and morphologically normal. The treatment was surgery, and in our case the cosmetic and functional impact of wide surgical excision of the lesion was improved by in situ injection of autologous fat. The pathology findings enabled us to rule out other perineal tumors such as aggressive angiomyxoma of the vulva and to describe the lesion microscopically.

[Screening for carriage of Staphylococcus aureus prior to mammary reconstruction in the prevention of surgical site infection]. / En reconstruction mammaire: intérêt du dépistage du portage de Staphylococcus aureus dans la prévention de l'infection du site opératoire.

The incidence of prosthesis infections after breast reconstruction is of the order of 4% to 13% according to the literature. In surgical patients, Staphylococcus aureus (S. aureus) is the bacterial species most often responsible for surgical site infections. In cardiac surgery, screening for carriage of S. aureus and preoperative decontamination are carried out routinely before prosthetic surgery. We retrospectively reviewed data from patients at our institution between January 2011 and December 2013. Our series showed that the prosthesis infection rates were in the range of 5.92% in 2008 with an ISO rate of S. aureus 3.61%. Routine screening for prosthetic reconstructions was performed to assess the impact of preoperative decontamination patients in carriers of S. aureus. This screening was done in 381 patients: 17.8% of patients were carriers of S. aureus ; 11 patients have an ISO (or an incidence rate of 2.88%) ; 5 patients have an ISO S. aureus (an incidence of S. aureus ISO 1.3%). The introduction of the screening process, allowed a drop of 5.92% ISO rate at 1.46% with a passage of S. aureus SSI rates of 3, 60% to 0.72%. In the near future, studies are needed to confirm these encouraging results, to demonstrate the efficacy of preoperative decontamination in carriers of S. aureus patients before laying prosthesis.

[Atypical epithelial hyperplasia of the breast: current state of knowledge and clinical practice]. / Hyperplasie épithéliale atypique du sein : bilan des connaissances et pratique clinique.

INTRODUCTION: The diagnosis of atypical epithelial hyperplasia (AEH) increases with breast cancer screening. AEH is divided in three groups: atypical ductal hyperplasia, columnar cell lesions with atypia, lobular neoplasia. The management of women with AEH is not consensual because of uncertainty about their diagnosis related to the type of the biopsy sampling (core needle biopsy or surgical excision) and their controversial clinical signification between risk marker and true precursor of breast cancer. MATERIAL AND METHODS: A systematic review of published studies was performed. Medline baseline interrogation was performed with the following keywords: atypical ductal hyperplasia, columnar cell lesions with atypia, lobular neoplasia, core needle biopsy, breast cancer, precursor lesion, hormonal replacement therapy. For each breast lesion, identified publications (English or French) were assessed for clinical practise in epidemiology, diagnosis and patient management. RESULTS: With immunohistochemistry and molecular studies, AEH seems to be precursor of breast cancer. But, epidemiological studies show low rate of breast cancer in women with AEH. AEH were still classified as risk factor of breast cancer. CONCLUSION: Because of high rate of breast cancer underestimation, surgical excision is necessary after the diagnosis of AEH at core needle biopsy. Surgical oncology rules and collaboration with radiologist are required for this surgery. A second operation was not required due to involved margins by AEH (except with pleiomorphic lobular neoplasia) because local control of breast cancer seems to be unchanged. Besides, hormonal replacement therapy for patient with AEH is not recommended because of lack of studies about this subject.

[Breast cancer prevention: from chemoprevention to prophylactic surgery]. / Prévention des cancers du sein : de la chimioprévention à la chirurgie prophylactique.

INTRODUCTION: The breast cancer prevention is based on mastectomy hormonal deprivation (surgical or chemical) and the use of drugs acting on cell signalization pathways, which provoke the cancerization (these drugs are not officially authorized in France). MATERIAL AND METHODS: Analysis of the literature selected from the Medline base on the keywords: breast cancer; chemoprevention; prophylactic surgery; tamoxifene; raloxifene; BRCA. RESULTS: Four trials on the chemoprevention by tamoxifene show a reduction in the breast cancer incidence from 22% up to 33% in the treated patients, limited to oestrogen-dependant cancers, especially in the populations at risk high (histological or genetic) even in the event of concomitant hormonal replacement therapy. The benefit seems continue in time. Raloxifene and tamoxifene effects are comparable with bone benefits and a less risk of endometrial cancer for raloxifene, but the risk of venous thrombosis is still persisting. The breast prophylactic surgery is effective mainly in case of genetic elevated risk when it is practiced in the young age, and requires a patient agreement (the decision needs to follow the patient advice after complete information). The prophylactic ovariectomy has a positive impact on the mammal risk even in the high genetic risk women. CONCLUSION: The breast cancer prevention requires a better selection of the patients, an adaptation of the type of prevention taking account of the balance risks and benefits (mammals and extramammals) before a clinical use in routine.

To smooth or not to smooth? Bias and efficiency in fMRI time-series analysis.

This paper concerns temporal filtering in fMRI time-series analysis. Whitening serially correlated data is the most efficient approach to parameter estimation. However, if there is a discrepancy between the assumed and the actual correlations, whitening can render the analysis exquisitely sensitive to bias when estimating the standard error of the ensuing parameter estimates. This bias, although not expressed in terms of the estimated responses, has profound effects on any statistic used for inference. The special constraints of fMRI analysis ensure that there will always be a misspecification of the assumed serial correlations. One resolution of this problem is to filter the data to minimize bias, while maintaining a reasonable degree of efficiency. In this paper we present expressions for efficiency (of parameter estimation) and bias (in estimating standard error) in terms of assumed and actual correlation structures in the context of the general linear model. We show that: (i) Whitening strategies can result in profound bias and are therefore probably precluded in parametric fMRI data analyses. (ii) Band-pass filtering, and implicitly smoothing, has an important role in protecting against inferential bias.

Ambiguous results in functional neuroimaging data analysis due to covariate correlation.

In this note we draw attention to a source of potential ambiguity in functional neuroimaging results when data analysis is based on the resolution of a linear model. This ambiguity arises whenever there exists correlation between the model covariates. A single-subject PET activation experiment helps to illustrate to what extent correlation can affect statistical results interpretation, possibly leading to misinterpretation of part of the activation pattern. This note is intended to clarify this point and to suggest the use of a simple and well-known procedure to deal with these situations. In the Appendix, we suggest a convenient mathematical formulation for statistical tests particularly useful in such cases.