Use of "big data" in drug discovery and clinical trials.

Oncology is undergoing a data-driven metamorphosis. Armed with new and ever more efficient molecular and information technologies, we have entered an era where data is helping us spearhead the fight against cancer. This technology driven data explosion, often referred to as "big data", is not only expediting biomedical discovery, but it is also rapidly transforming the practice of oncology into an information science.

Gamma nail in the treatment of closed trochanteric fractures. Results and indications of 121 cases.

The Gamma Nail is the latest advance in the treatment of trochanteric fractures based on intramedullary nailing principles during closed procedures. Its design is based on Küntscher's Y-nail and locking intramedullary (IM) nails. This paper reports the results from the first-ever series of 121 patients operated between 1988 and 1990.

Distal targeting device for long Gamma nail(®). Monocentric observational study.

Introduction: Intramedullary nail distal locking screws make it possible to control length and rotation but include an increased risk of radiation exposure. A distal targeting device was recently developed for long Gamma(®) nails (Stryker(®)). The aim of this practical observational study was to evaluate the reliability of this system.

Critical factors in cut-out complication after Gamma Nail treatment of proximal femoral fractures.

Background: The most common mechanical failure in the internal fixation of trochanteric hip fractures is the cut-out of the sliding screw through the femoral head. Several factors that influence this complication have been suggested, but there is no consensus as to the relative importance of each factor. The purpose of this study was to analyse the cut-out complication with respect to the following variables: patients' age, fracture type, fracture reduction, implant positioning and implant design.

Influence of preoperative cognitive status on propofol requirement to maintain hypnosis in the elderly.

Background: The loss of cholinergic neurones in the basal forebrain has been shown to correlate to the extent of cognitive dysfunction during ageing in humans and to the hypnotic potency of propofol in animal models. We examined how the preoperative cognitive status, as assessed by mini-mental state examination (MMSE), may interact with propofol consumption during anaesthesia in the elderly.

Methods: In a prospective study, we recruited 41 patients (65-99 yr) undergoing surgery for hip fracture.

3066 consecutive Gamma Nails. 12 years experience at a single centre.

Background: Fixation of trochanteric hip fractures using the Gamma Nail has been performed since 1988 and is today well established and wide-spread. However, a number of reports have raised serious concerns about the implant's complication rate. The main focus has been the increased risk of a subsequent femoral shaft fracture and some authors have argued against its use despite other obvious advantages, when this implant is employed.

[Imaging of traumatic injuries of the hip].

Traumatic injuries of the hip, mostly fractures of the proximal femur, are in constant progression. Though morbidity has decreased due to improved surgical and anesthesiologic techniques and postsurgical rehabilitation, mortality from hip fractures remains significant. Radiographs of the hip remain helpful, but MDCT and MRI have become indispensable tools.

Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients.

Background: The treatment of open fractures of the tibial shaft is often complicated by delayed union and nonunion. The objective of this study was to evaluate the safety and efficacy of the use of recombinant human bone morphogenetic protein-2 (rhBMP-2; dibotermin alfa) to accelerate healing of open tibial shaft fractures and to reduce the need for secondary intervention.

Methods: In a prospective, randomized, controlled, single-blind study, 450 patients with an open tibial fracture were randomized to receive either the standard of care (intramedullary nail fixation and routine soft-tissue management [the control group]), the standard of care and an implant containing 0.

Post-traumatic intracranial epidural Aspergillus fumigatus abscess.

We report an intracranial epidural abscess caused by Aspergillus fumigatus in an immunocompetent patient. Infection occurred in a 20-year-old man 2 months after a frontal craniotomy following trauma. The abscess was encapsulated by a thickened dura and although the fungus did not invade the brain, frontal bone was infected and the patient presented with a subcutaneous frontal cellulitis.

[Interlocking nail according to Seidel in recent diaphyseal fractures of the humerus. Review of 41 cases of 48 fractures].

The Seidel's humeral interlocking nail is used in our department since december 1986. We report about the 48 first cases, 41 of them have been reviewed with a mean time follow up of 14 months. The indications were humeral mid-shaft fractures with associated lesions (20 cases), failures of non operative treatment (10 cases) and compound fractures (7 cases).

[Mechanical performance of non slotted small diameter nails of Gross and Kempf].

The goal of this study was to evaluate the mechanical properties of closed section small diameter Grosse-Kempf tibia nails. This type of implant has been advocated for an unreamed nailing of open tibia fractures in order to avoid further damage of bone blood supply and an increased risk for compartment syndrome. Static and dynamic tests were performed on 9 and 10 mm nonslotted Grosse-Kempf (G-K) and Russel-Taylor (R-T) nails.

Open adult femoral shaft fracture treated by early intramedullary nailing.

In two hospitals, 115 consecutive open femoral shaft fractures were treated by meticulous wound excision and early locked (97) or unlocked (18) intramedullary nailing. All the fractures united; union was delayed in four, three of which required bone grafting. The average range of knee flexion at follow-up was 134 degrees (60 to 148).

[Gamma nail in the treatment of closed trochanteric fractures. Results and indications apropos of 121 cases].

The Gamma Nail, developed at the Centre for traumatology and orthopaedics of Strasbourg, is the latest advance in the treatment of trochanteric fractures, based on the intra-medullary principle and on the closed procedure. It was inspired both by the Y nail of Küntscher and by the interloking nail. This is the study of the results of a first series of 121 cases treated between 1988 and 1990 and followed until consolidation.

[Screw fixation of fractures of the odontoid process].

In the year 1981, J. Böhler completed for the first time a screw fixation for unstable fractures of the odontoid process of the axis. This surgical technique preserves the anatomy and the physiology of the articulation between the atlas and the axis, as a guarantee for a good functional recovery.

[Interlocking central medullary nailing of recent femoral and tibial fractures. Statistical study apropos of 835 cases].

Kuntscher's conventional closed intra-medullary nailing represents a good procedure in the treatment of diaphyseal fractures of the femur and the tibia but had a very restricted area (the midshaft) of indications. Thanks to the interlocking technic which consists in the fixation of the nail to the bone by means of transfixing screws either in a static or in a dynamic procedure, the method can be extended to fractures localised between both epiphysis of the long bones. After a first period between 1974 and 1983 of development of the method summarized in a first statistic, a second study was performed between 1984 and 1989 in the Center of Traumatology of Strasbourg with 837 cases of fresh fractures of the femur (385) and the tibia (397) treated by locked intra-medullary nailing.