The aim of this study is to evaluate the treatment response of patients with osteoid osteoma (OO) following radiofrequency ablation (RFA) and identify factors influencing the time to complete pain relief post-treatment. This is a retrospective cohort study of patients who underwent RFA for OO between 2010 and 2023. Demographic, clinical data, and time between symptoms onset to diagnosis and RFA were recorded. CTs were reviewed for OO location (upper extremity, lower extremity, spine/pelvis), intra-articular versus extra-articular lesions, nidus size, degree of peripheral bone formation, and presence of vessel sign. Procedural related information included needle approach, RFA active tip length, and number of RFA cycles. Statistical analysis was made on factors and their correlation to complete pain relief. Out of 63 patients included in our study (mean age 19.3 ± 10.6), OO were located in the upper extremity (n = 7, 11
France, one of the principal countries from which fighters leave for Syria, is the primary European target of Islamist terrorists. The majority of the data of the literature indicate that psychiatric disorders are not overrepresented in perpetrators of terrorist acts. Nevertheless, these data do not examine expert opinions regarding the discernment of jihadi terrorists at the time of the offense. We aimed to examine abolition and impairment of discernment in psychiatric expert reports on convicted jihadi terrorists in France, and to study any psychiatric disorders identified by the experts as related to the offenses. Our secondary objective was to describe the sociodemographic, psychopathological and criminological characteristics of convicted jihadi terrorists, the type of offense and the mode of radicalization.In collaboration with the national counter-terrorism prosecutor's office (Parquet National Antiterroriste, PNAT), we carried out a retrospective descriptive study of the data collected in the pre-sentence penal psychiatric reports of individuals definitively convicted of a terrorist offense from 2017 onwards.We studied 100 pre-sentence penal psychiatric expert reports and their corresponding case files. No reports concluded on abolition of discernment at the time of the offenses, and a minority concluded on impairment. The experts observed personality disorders, but little mental illness. Social media had played a major part in the radicalization of our population, which was essentially male and young at the time of the offenses. We may conclude that in jihadi terrorism, the issue is less the presence or absence of mental illness than the psychological mechanisms involved in radicalization and acting out. Preventive actions could be developed through understanding of these mechanisms.
Islamist terrorism is a major preoccupation in France as it poses a serious threat to safety. Pre-release assessment of convicted jihadi terrorists requires high-quality psychiatric expert reports to assist magistrates in deciding on post-sentence follow-up. In the literature, the quality of psychiatric expert reports in France has been questioned. This arises from a discrepancy between the number of expert reports that are requested and the number of experts available. We studied the quality of these reports, focusing on evaluation of dangerousness and the risk of recidivism.In this novel study, quantitative and qualitative data were extracted from 100 post-sentence expert reports, 15 s expert opinions and 10 supplemental reports. These reports were taken from 100 different case files exclusively concerning Islamist terrorism-related offenses. This study was carried out in partnership with the national counter-terrorism prosecutor's office, the Parquet National Antiterrorisme (PNAT).In order to study the quality of these reports, we developed conformity scores based on the general recommendations of the French National Authority for Health (Haute Autorité de Santé, HAS). These general conformity scores concerned the recommendations for all types of expert reports, while specific conformity scores related to post-sentence reports. Lastly, we proposed a list of risk factors for violent radicalization based on the data of the literature, and these enabled us to calculate conformity scores specifically related to Islamist terrorism.The mean conformity score of the expert reports was 86.7%, with scores varying between reports. The score decreased to 82.1% if criteria specific to terrorism were included. The experts often made no reference to a classification when making a diagnosis. They were reticent to use actuarial tools or structured professional judgments to assess the risk of recidivism. Their practice in searching for criteria specific to Islamist terrorism also appeared to vary.There is a need for training and working meetings between psychiatric experts to reach a consensus on the quality of expert reports. Meetings and exchanges between experts and magistrates would help clarify their respective missions.
Islamist terrorism is a major concern because of the security issues it raises. In France, magistrates call on psychiatric experts to evaluate the dangerousness and risk of recidivism of convicted individuals and to inform post-sentencing decisions. We analyzed the responses of the experts and their methodology, focusing on their methods of evaluation and the incidence of the factors observed during examination of the convicted individual. We collected quantitative and qualitative data from 100 post-sentence expert reports taken from different case files. The case files, transferred by the national anti-terrorism prosecutor's office (Parquet National Antiterroriste), related exclusively to islamist terrorist offenses.We found that a majority of experts responded to the question of dangerousness, distinguishing between psychiatric and criminal dangerousness. The evaluations were based on the search for presumed factors of risk, protection or desistance, although these factors are not all identified in the current scientific literature. Structured evaluation tools were not used, whether actuarial tools or structured professional judgment tools. Several factors identified by the experts were correlated with the group considered as dangerous or at risk of recidivism: signs of radicalization, personality structure, insight, attitude to the offenses, behavior in prison, progress since conviction and attitude to treatment. Our findings are an encouragement to improve expert evaluations by offering psychiatric experts training in criminal psychology that is based on evidence-based data, and in particular training in structured evaluation of risk of recidivism.
Both benign and malignant tumors, including metastases, commonly occur in the bones around the knee. During the past few decades, image-guided percutaneous treatments have proved effective for the management of osteoid osteoma as well as for palliation of painful bone metastases. The advent of interventional oncology has led to less invasive and less morbid treatment options when compared with surgery. Clinical indications have therefore been expanded to a variety of painful benign bone tumors beyond osteoid osteoma. In addition, bone metastases and bone sarcoma recurrence in selected patients can now be treated percutaneously with a curative intent. This article aims at providing a unique interdisciplinary perspective on image-guided percutaneous interventions for both benign and malignant bone tumors around the knee, including thermal ablation, intralesional injections, as well as bone consolidation techniques. The expanding range of clinical indications and future directions are herein discussed with an emphasis on the challenges encountered specific to this anatomic region.
