Oskar Bordeaux
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Orthop Traumatol Surg Res
No full textINTRODUCTION: The diagnosis of pseudoarthrosis is based on imaging and clinical exam findings. The standard for pseudarthrosis diagnosis remains post-operative observation through computer tomography (CT) and patient's symptoms. This can be further augmented by dynamic x-ray imaging or nuclear positron emission tomography (PET) CT to demonstrate an absence of fusion by showing a persistence of mobility. However, there is not a uniform diagnostic approach that is a standard of care amongst spine practioners. The aim of this study is to describe the timeline and diagnostic analysis for pseudoarthrosis between the initial surgery and follow-up procedure. METHODS: This is a single-center retrospective observational study. The aim was to enroll patients reoperated for pseudarthrosis after 1 or 2 level lumbar fusions, between August 1, 2008 and August 1, 2018.The exams were reviewed by one surgeon and one radiologist, defining a status either in favor of pseudarthrosis, or against it, or inconclusive, based on the radiological criteria mentioned below.We then investigated different combinations of exams and their specific chronology before a diagnosis was established. RESULTS: 44 patients were included, 70.5% male and with a mean age of 47.3 years. The median time between the 2 surgeries was 23.7 months. Plain X-rays supported the diagnosis in 38.7% of cases, dynamic X-rays showed hypermobility in 50% of cases. The CT scan demonstrated pseudarthrosis in 94,4% of cases. A MODIC 1 signal was observed in 87,2% of cases on MRI. SPECT-CT showed a tracer uptake in 70% of cases. CONCLUSION: Reducing the time to reintervention is a key objective for improving the management and clinical outcomes of these patients. We suggest that MRI is an additional tool in combination with CT in the assessment of suspected mechanical pseudarthrosis, in order to optimize the diagnosis and shorten the time to revision surgery. LEVEL OF EVIDENCE: IV
Contrariété à l’ordre public international d’un jugement étranger d’adoption insuffisamment motivé
No full textTrois mois, trois jours et trois mots : Débat sur le point de départ du délai pour conclure de l'intimé
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Development and validation of a bioanalytical method for the determination of encorafenib application to patient plasma
No full textLes thérapies ciblées représentent une révolution dans la prise en charge de nombreux cancer. Les protéines kinases font partis des cibles de choix de ces médicaments. De nombreux inhibiteurs de protéines kinases sont apparus au cours de ces deux dernières décennies. Ils possèdent des indications dans de nombreux cancer. Le suivi thérapeutique pharmacologique de ces médicaments est primordial afin d’améliorer la prise en charge des patients. Parmi ces inhibiteurs, certains possèdent une indication dans le traitement du mélanome métastatique et quatre d’entre eux (le binimétinib, le cobimétinib, le dabrafénib et le tramétinib) sont actuellement dosés au CHU de Bordeaux. L’encorafénib est l’inhibiteur de protéines kinases qui a été autorisé le plus récemment dans le traitement du mélanome métastatique. Il n’existe à l’heure actuelle pas de concentrations cible ni de concentration toxique pour cette molécule. L’objectif principal de cette thèse est d’implémenter la méthode existant initialement pour le dosage des autres inhibiteurs de protéines kinases utilisés dans le traitement du mélanome métastatique afin de mieux connaître les propriétés de l’encorafénib. Afin de procéder à cette mise en place, plusieurs méthodes ont été explorées et seront développées dans ce manuscrit.Targeted therapies represent a revolution in the treatment of many cancers. Protein kinases are the targets of choice for these medicines. During the last two decades, many protein kinase inhibitors have appeared. They have indications in numerous cancers. The therapeutic pharmacological follow-up of these drugs is essential to improve patient quality of life. Some of these inhibitors are indicated for the treatment of metastatic melanoma, and four of them (binimetinib, cobimetinib, dabrafenib and trametinib) are currently dosed at Bordeaux University Hospital. Encorafenib is the most recently approved protein kinase inhibitor for the treatment of metastatic melanoma. At the moment, there are no target or toxic concentrations for this molecule. The main aim of this thesis is to implement the existing method for the dosage of other protein kinase inhibitors used in the treatment of metastatic melanoma, in order to gain a better understanding of the properties of encorafenib. To achieve this implementation, several methods have been explored and will be developed in this manuscript
Faire parler les artefacts et les vestiges mobiliers pour les recherches de provenance. Formalisation des données
No full textGeneration of metabolomic-informed models of metabolism in complex microbial communities
No full textLa génération de réseaux métaboliques à l'échelle du génome est devenue une analyse de routine pour des organismes individuels ou des communautés. Cependant, ces réseaux métaboliques générés automatiquement sont incomplets car ils sont construits sur la base de la combinaison de l'annotation des gènes et des réactions disponibles dans des bases de données génériques (Metacyc, BIGG, ModelSEED...). Ces bases de données sont orientées vers des organismes bien connus ou des organismes modèles et passent à côté de fonctions importantes du métabolisme secondaire. Nous proposons de combiner l'analyse de données métabolomiques, la modélisation métabolique et l'annotation métabolique et la modélisation métabolique et l'annotation minière pour construire des modèles de haute qualité du métabolisme microbien avec l'objectif à long terme d'une meilleure compréhension des communautés microbiennes.En termes d'application des méthodes aux communautés microbiennes végétales, nous espérons que les modèles nouvellement développés permettront de mieux comprendre le processus de recrutement microbien par la plante : fonctions métaboliques impliquées, micro-organismes associés à ces fonctions.The generation of genome-wide metabolic networks has become a routine analysis for individual organisms or communities communities. However, these automatically generated metabolic networks are incomplete because they are constructed by based on the combination of gene annotation and reactions available in generic available in generic databases (Metacyc, BIGG, ModelSEED...). These are oriented towards well-known organisms or organisms or model organisms and miss out on important functions secondary metabolism. We propose to combine metabolomic data analysis, metabolic modelling and annotation metabolic modelling and annotation mining to build high-quality models of high quality models of microbial metabolism with the long-term aim of better understanding of microbial communities.In terms of application of the methods to plant microbial communities, we hope that the plant microbial communities, we hope that the newly developed models will provide a better understanding of the process of microbial recruitment by the plant: metabolic functions involved, micro-organisms associated with these functions.Computationel models of crop plant microbial biodiversit
Droit pénal et accidents collectifs
No full textConférence organisée par les master 2 Droit pénal approfondi, avec l'intervention de Jean-Christophe Saint-Pau et Loïs Raschel, Procureur de la République de Libourn
Curr Med Res Opin
No full textBiomedical research cannot function without the trust of peers and society. The truthfulness of claims made by knowledge-producing agents, such as authors of research, is a prerequisite for their trustworthiness, and violations of truthfulness are rightly seen as a threat to the existence and validity of such research. While most reflection on the lack of truthfulness has focused on fake research, little attention has been paid to how sting operations and hoaxes arguably pose an equally great risk to the ethical integrity of publishing. This paper posits that sting operations, like fake research, are examples of breaches of truthfulness. We also argue that for both fake research, as well as stings and hoaxes, the lack of respect for the ethical criterion of truthfulness makes those researchers who engage in them untrustworthy. Sting operations are akin to fighting fire with fire, further undermining trust in biomedical research. From a deontological perspective, we also argue that the reliance on anonymity in sting operations makes them just as bad, if not worse, than fake research. We advocate for critical scholarship as an alternative to hoaxes and sting operations to expose fake research, in order to promote truthfulness rather than violate it. Finally, we argue that journalists reporting on sting operations should insist less on their entertainment and sensationalist value, and focus more on their unethical nature