Éditeur(s) : HAL CCSD
Résumé : International audience
OBJECTIVE: To analyze complications of endoscopic transsphenoidal surgery (ETS) for nonfunctioning pituitary macroadenomas (NFPAs).ăMETHODS: A retrospective study of 300 NFPAs was performed. Complications and factors that could influence these complications were analyzed.ăRESULTS: Visual and pituitary functions worsened in 2.4% and 13.7% of cases, respectively. Postoperative diabetes insipidus was permanent in 6.2% of cases. Postoperative meningitis occurred in 3.3% of patients. Meningitis was strongly associated with intraoperative cerebrospinal fluid (CSF) leaks (P = 0.01), postoperative CSF leaks (P = 0.0001), and operation times longer than 1 hour (P = 0.023). Detection of Staphylococcus aureus and preoperative treatment with mupirocin in the nostrils did not impact the occurrence of meningitis. Two patients with meningitis died (unique causes of death). Postoperative CSF leaks occurred in 2.7% of cases and were associated with intraoperative CSF leaks (P = 0.007) and permanent diabetes insipidus (P = 0.028). The rate of CSF leak decreased from 4% to 0.8% (P = 0.048) after we moved from a soft to hard reconstruction of the sella. The rate of postoperative epistaxis decreased from 6.7% to 1.25% after we stopped using monopolar coagulation (P = 0.013).ăCONCLUSIONS: ETS permits a wide view, allowing good conditions for a satisfactory resection in the majority of NFPAs. Some pitfalls of endoscopy can lead to complications that improve with modification of the operative technique (i.e., CSF leak and postoperative epistaxis). This study confirms an acceptable rate of complications associated with ETS.
World Neurosurgery

hal-01474296
https://hal.archives-ouvertes.fr/hal-01474296
DOI : 10.1016/j.wneu.2016.02.059
PUBMED : 26902781

Éditeur(s) : HAL CCSD Taylor & Francis (Routledge)
Résumé : International audience
The influences of task difficulty (index difficulty: 2-4), input device of different length, range of motion and mode of resistance (joystick or rotorcraft stick), and directions of movement (leftward rightward) on motor patterns in a realistic control situation were examined with a multilevel analysis (joint kinematics and muscular variables, and global task performance). Eight subjects controlled the displacements of a virtual object during a slalom task characterized by a realistic inertial model. Pilots adapted the endpoint kinematic organization to increasing accuracy constraints to preserve task success whatever the device and the direction. However, the rotorcraft stick manipulation remains highly complex in comparison to the joystick due to poorer proprioceptive information, higher inertial constraints, and an asymmetrical muscle control.
ISSN: 0022-2895

hal-01442056
https://hal.archives-ouvertes.fr/hal-01442056
https://hal.archives-ouvertes.fr/hal-01442056/document
https://hal.archives-ouvertes.fr/hal-01442056/file/Fuente%20-%20J%20Motor%20Behav%20-%202013.pdf
DOI : 10.1080/00222895.2013.837424

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Since the Shea, J.B. and Morgan (1979) study, investigators have repeatedly shown that the learning of a set of movement patterns (as evaluated in a retention test) is enhanced when acquisition occurred under a random rather than a blocked schedule of practice. Supposedly, this is the case because a random schedule of practice necessitates more elaborate cognitive activities than a blocked schedule before each acquisition trial can be initiated. Our main objective was to determine whether the advantage for learning found for random practice increases as a function of the number of acquisition trials. During acquisition, the results indicated a general tendency for smaller movement reproduction errors under a blocked rather than a random schedule of practice. However, this effect disappeared with larger amount of acquisition trials. In retention, larger errors were observed when acquisition occurred under a blocked rather than a random schedule of practice. Finally, the disadvantage for learning observed for the blocked schedule of practice disappeared under a block-repeated condition in which each movement pattern was first practiced under a blocked schedule which was then repeated a second time. The results are discussed in terms of the so-called contextual interference effect and indicates some of its limitations.
ISSN: 0001-6918

hal-01662846
https://hal.archives-ouvertes.fr/hal-01662846
DOI : 10.1080/00222895.1994.9941657
PUBMED : 8165923