Heavy rains control the floating macroplastic inputs into the sea from coastal Mediterranean rivers: A case study on the Têt River (NW Mediterranean Sea)

This study focuses on the relevance of small watersheds in the macroplastic pollution of coastal environments. It aims to identify and quantify in terms of composition, number and mass, current riverine flows of floating macroplastics (>2.5 cm). Estimates are based on 66 visual monitoring of total litter over a 4-year-period (2016-2019) in a small coastal Mediterranean river, the Têt River (NW Mediterranean Sea). The plastic fraction represented 97 % of the observed litter, mainly cigarette butts (20.5 %), polystyrene fragments (18.8 %) and light packaging (16.3 %). The Tet River is characterized by frequent flash-flood events caused by heavy rain, that can induce a sudden rise of the water discharge. Such hydroclimatic forcing greatly influence macroplastic flows, both in terms of their average compositions and loads. We have estimated that 354,000 macroplastic items, corresponding to 0.65 tons, are discharged annually from the Tet River into the sea, and that 73 % of them are released during rain events (∼6 % of the year). The short observation distance from the water surface allowed to exhibit the great abundance of small litter (80 % of them were < 10 cm) and to evaluate to 1.8 g the average mass of floating plastics. Our results suggest that remediation actions must be taken on rainy days and target small litter in order to significantly limit macroplastic inputs from rivers to the sea. Moreover, the large share of cigarette butts in macrolitter inputs demonstrates that reducing ocean pollution cannot be achieved solely by improving waste management, but that changes in social behavior are also needed to stem waste production at the source.

A modified method for a customized harvest of fibula free flap in maxillofacial reconstruction

Mandibular reconstruction using computer-aided design/computer-aided manufacturing cutting guides is currently a common procedure. However, inaccurate positioning of the cutting guide onto the fibular bone may result in osteosynthesis difficulties or imprecision in the reconstruction. A novel way to improve the stability of the cutting guides may be to add pillars in order for them to be suspended from the fibula, avoiding soft tissues interactions. We present the case of a 39-year-old male who needed mandibular reconstruction after a self-inflicted ballistic injury. We designed a customized cutting guide which included a set of 8 pillars allowing a suspension of the cutting guide 8 millimeters above the bone level. The pillars were perpendicular to one another, and allowed the operator to screw the cutting guide to the bone. The orthogonal position of the pillars enabled real stability during the osteotomies. In the operator experience, the length of the pillars was too important, and led to incomplete osteotomies, and the whole device was too bulky. However, with adaptations in the size of the pillars and the size of the whole device, this solution could be useful in cutting guide design to avoid impairments due to the soft tissues surrounding the fibula.

New first-trimester crown-rump length equations from a French general population

INTRODUCTION

The purpose of this study was to obtain precise knowledge of fetal biometric measurements, in particular crown-rump length (CRL). Our results have been carefully compared to equations found in the literature.

MATERIALS AND METHODS

Single-operator measurements of 2,123 spontaneous pregnancies from a general French population provided new statistical relationships between fetal age (FA) and CRL. Comparisons were made with measurements obtained from 402 in vitro fertilizations (IVFs) for which FA were known. Heteroskedastic and robust regressions were compared by cross-validation, and prediction errors were studied. All ultrasound measurements were taken during standard follow-ups of pregnancies, without any additional features.

RESULTS

From a cleaned subsample of 513 spontaneous pregnancies, we reported good modeling of first-term embryonic growth, with equations and predictions of standard deviations agreeing with objective datations for IVFs. Most precise CRL measurements were predicted for FA of 49 days.

DISCUSSION

Our results allow future detection of fetal growth abnormalities using Z-scores throughout the first trimester.

Gonadotropin-associated psychosis in perimenstrual behavior disorder

Sexually provocative and violent behavior have been reported as a result of excess androgens. We now report a temporal relationship between increased gonadotropin levels and behavioral changes in two adolescent girls who presented with a history of aggressive and bizarre sexual behavior coincident with the onset of menarche. We evaluated the possibility of a cyclical hormonal cause with daily measurements of gonadotropins, androgens and estradiol levels and correlated the results with periodic reports on the girls' behavior. We concluded that a correlation exists between periods of extremely violent and sexually provocative behavior and peaks of gonadotropin hormone secretion, even though androgen levels were normal. Treatment with medroxyprogesterone acetate (Depo-Provera) in one case and with leuprolide acetate (Lupron-Depot) in the other suppressed gonadotropin levels, and behavior improved markedly. Thus, the behavioral changes (or psychosis) seen in these girls might have been induced by increased levels of gonadotropins.

[Nonsurgical treatment of pulmonary arteriovenous aneurysms]

Four patients with single or multiple pulmonary arteriovenous aneurysms, including three with Rendu-Osler's disease, were treated by occlusion with metallic spirals of the supplying pedicles during angiography. Results are compared with those of 16 cases treated by the same method and reported in the literature. The technique and its therapeutic indications are discussed based on these 20 cases and a review of documented data concerning 502 other cases with these aneurysms.

[Exploration of major veins by Doppler ultrasonography. Indications and limits (author's transl)]

Doppler ultrasonography is a first-choice, non-invasive, inexpensive and repeatable procedure for exploring major veins and for detecting venous thrombosis, venous insufficiency and arterio-venous fistulae. It also provides invaluable information on post-operative haemodynamics in cases of thrombectomy, venous shunt and vena cava clip, and helps in evaluating the effectiveness of thrombolytic agents. Its sensitivity is satisfactory: in 110 patients with suspected phlebitis, there was an 86,5% agreement between the results of doppler ultrasonography and those of phlebography. False negative results are encountered with distal thromboses and, unfortunately, floating clots (there were 3 cases of undetected iliac vein floating clots in this series). It seems rational to use Doppler ultrasonography in patients with high risk venous diseases. The method will not replace phlebography, but when applied on correct indications, it may substantially reduce the number of negative or unassessable results.