To investigate the short-term clinical outcomes and satisfaction for the first set of patients at our institution receiving in-office needle arthroscopy (IONA) for the treatment of posterior ankle impingement syndrome (PAIS).A retrospective cohort study was conducted to evaluate patients who underwent IONA for PAIS between January 2019 and January 2021. Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS) and Patient-Reported Outcomes Measurement Information System Pain Interference, and Pain Intensity scores. Patient satisfaction was measured at the final follow-up visit with a 5-point Likert scale. The Wilcoxon signed-rank test was performed to compare preoperative and postoperative outcome scores.Ten patients (4 male and 6 female) with a mean age of 41.9 ± 15.5 years (range, 24-66 years) were included in the study. The mean follow-up time was 13.3 ± 2.9 months (range, 11-17 months). All mean preoperative FAOS scores demonstrated improvement after IONA, including FAOS symptoms (71.48 ± 10.3 to 80.3 ± 12.6), pain (69.3 ± 11.0 to 78.2 ± 13.9), activities of daily living (61.7 ± 8.8 to 77.93 ± 11.4), sports activities (55.6 ± 12.7 to 76.0 ± 13.6), and quality of life (46.6 ± 9.2 to 71.1 ± 12.1). There were 7 patients who participated in sports activities before the IONA procedure. Within this group, all patients returned to play at a median time of 4.1 weeks (range, 1-14 weeks). The median time to return to work was 3.4 ± 5.3 days. Patients reported an overall positive IONA experience with a mean rating scale of 9.5 ± 1.5 (range, 5-10).The current study demonstrates that IONA treatment of PAIS results in significant pain reduction, a low complication rate, and excellent patient-reported outcomes. In addition, IONA for PAIS leads to high patient satisfaction with a significant willingness to undergo the same procedure again.IV, therapeutic case series.

La pandémie de Covid-19 a provoqué une crise globale qui préfigure les situations de risques systémiques auxquelles il faut s’attendre à l’avenir. La gestion de cette crise a comporté des points forts et des points faibles qui peuvent servir à mieux se préparer aux crises du futur pour en limiter les impacts. Dans cet article, nous discutons les éléments scientifiques, décisionnels, organisationnels et opérationnels qu’il convient de prendre en compte pour y faire face.

The Covid-19 pandemic has sparked unprecedented scientific mobilization, particularly in epidemiology. Despite this, the health burden is such that one can speak of a public health failure. This article discusses the reasons for this hiatus. It emphasizes the importance of the role of occupational physicians in this context. It presents lessons for the future.

L’Enquête européenne des entreprises sur les risques nouveaux et émergents (ESENER) a montré que les actions préventives sur le lieu de travail sont souvent perçues comme une contrainte réglementaire. Les avantages économiques et sanitaires de la prévention sont mal documentés et laissent la voie libre à une perception négative dominante des efforts à consacrer à la santé et au bien-être au travail comme entraînant des dépenses improductives. L’objectif de cet article est de caractériser au mieux le degré d’implication des entreprises en prévention. La méthodologie utilisée repose à la fois sur une revue de littérature des outils disponibles et d’une étude qualitative conduite en 2018 en France. Cette étude a été réalisée grâce à des entretiens téléphoniques semi-directifs auprès de 5 médecins du travail, 5 DRH et 5 représentants du personnel. Les résultats des entretiens ont permis d’identifier les principales dimensions à documenter dans un questionnaire quantitatif qui, à terme servirait de base de construction d’un score d’implication en prévention. Ces dimensions recouvrent le respect des obligations légales, la qualité du dialogue social, la place de la santé au travail dans la gestion de l’entreprise, et l’existence de moyens dédiés à la prévention.

The European Survey of Enterprises on New and Emerging Risks (ESENER) has shown that preventive action in the workplace is often perceived as a regulatory constraint. The economic and health benefits of prevention are poorly documented and leave the way open for a dominant negative perception of efforts to be devoted to health and well-being at work as leading to unproductive expenditure. The aim of this article is to characterize as best as possible the degree of involvement of enterprises in prevention. The methodology used is based both on a literature review of available tools and a qualitative study conducted in 2018 in France. This study was carried out through semi-directive telephone interviews with 5 occupational physicians, 5 human resources managers and 5 staff representatives. The results of the interviews made it possible to identify the main dimensions to be documented in a quantitative questionnaire which, in the long term, would serve as a basis for constructing a prevention involvement score. These dimensions cover compliance with legal obligations, the quality of social dialogue, the place of occupational health in the management of the company, and the existence of resources dedicated to prevention.

Cet article présente une analyse des contraintes de la décision publique relative à l’épidémie de Covid-19 caractérisée par de nombreuses incertitudes sous trois angles : la stratégie, le commandement et la logistique. En particulier, il discute de l’articulation entre les préfectures et les ARS. Cette dualité a soulevé des difficultés de gestion dont il faut tirer les leçons.

There will be nearly 20 billion smart devices in 2020. These devices and the digital applications they run will be present in all areas of daily life, particularly in health fields, from healthcare to monitoring and aftercare. But is there any scientific evidence of their usefulness, effects, and effectiveness in occupational health and safety? We reviewed the literature to assess how the use of these objects might be envisioned in occupational settings and to examine the available evidence of their health and safety effects. We searched bibliographic reference databases for published articles in English and French that used as their sole study population salaried staff. The selected articles were then systematically analyzed and interpreted, in particular to develop a new typology of the uses of smart devices and digital applications. We identified only 23 relevant articles, a finding that highlights the very wide gap between the mass of publications in the general literature and the number of articles available in the scientific literature. In addition, most publications still assess only the acceptability and feasibility of devices, but not their effectiveness. There are more publications on the effects of digital applications on smartphones, but with limited populations. Finally, many studies use mixed methods to analyze devices and applications, but the randomized trial remains the gold standard for this approach. Finally, research teams have reported only sparse evidence about the effectiveness of smart devices and digital applications in the fields of occupational health and safety. Research/enterprise partnerships could help to improve the quantity and quality of the evidence available.

A concern raised about possible excess mortality among printers led to the completion of a Quantitative Health Risk Assessment (QHRA) aimed at quantifying long-term risks by employees working near the press. The QHRA is a four-step process. The identification of the pollutants present, especially in the inks, made it possible to identify the various sources of associated hazards and then to choose the tracer pollutants to be taken into consideration. The toxicological reference values (TRVs) of these tracers were selected. The analysis of the exposure data was based on an analysis of the work and atmospheric and ink measurements from which exposure scenarios were constructed. The data was then synthesized to characterize the risks. At the end of the risk characterization, any doubt is possible about an excess risk of exposure to PAHs and any danger is shown for reproduction. However, exposure to PM10 reveals an excess of risk the first year. The main result is a significant excess of cancer risk related to PM10 exposure. The TRVs for PAHs are respected. Even though the current PM10 limit values are met, this QHRA shows that workers in the vicinity of presses have a high risk of cancer. This result calls for the implementation of immediate corrective measures, supplemented by regular monitoring of exposure levels. (C) 2018 Elsevier Masson SAS. All rights reserved.