La gangrène de Fournier compliquant un empalement

La gangrène de Fournier (GF) est une fasciite bactérienne nécrosante rapidement progressive du périnée et des organes génitaux externes. Elle est secondaire à une infection polymicrobienne. Elle représente une urgence médico-chirurgicale nécessitant une prise en charge multidisciplinaire. L'étiologie est identifiée dans 95% des cas. La source de l'infection est cutanée, urogénitale ou colorectale. Des facteurs favorisants, comme l'âge, le diabète et l'immunodépression, sont souvent présents. La clinique est fulminante. La mortalité reste élevée, de l'ordre de 20 à 80%, souvent en raison du retard de diagnostic et de prise en charge. Nous rapportons l'observation d'un patient de 44 ans sans antécédents, maçon, qui avait présenté un empalement anorectal accidentel sur une tige de fer à béton. Il a été vu dans un hôpital régional où il a eu simplement des soins locaux. Trois jours plus tard, il consulte pour douleur périnéale. Il était fébrile à 40°C, son état général était très altéré avec tendance au collapsus. Il existait un érythème périnéal, périanal et du scrotum avec des crépitations neigeuses à la palpation. La plaie périanale faisait sourdre du pus de couleur jaune verdâtre et d'odeur nauséabonde. Le diagnostic de GF a été retenu. Une rééquilibration hydro-électrolytique, avec une antibiothérapie à large spectre suivie rapidement par un débridement chirurgical agressif ont été réalisées. A l'exploration, il exsistait une plaie rectale sus-anale qui a été suturée et protégée par une colostomie qui sera fermée six mois plus tard. Des soins locaux ont permis une cicatrisation dirigée obtenue au bout de 3 mois

Hybrid Approach for the Maintenance of Materialized Webviews

In this paper, we have developed an approach to specify when updating materialized webviews. A webview is a web page that is automatically constructed from a structured database. We have introduced a new update policy called “early ondemand” update which is based on the user preferences. Then we have combines this policy with the on-demand one to update the materialized webviews. Our experiments showed that the proposed hybrid approach guarantees strong consistency of data and allows reducing latency of updating webviews. In addition, they prove that our solution decreases the server overload (access+ update cost) significantly better that the on-demand and the immediate policies

Analysis of a dynamic contact problem for electro-viscoelastic materials with Tresca’s friction

We consider a mathematical model which describes the dynamic process of contact between two electro-viscoelastic bodies with damage. The contact is bilateral and is modeled with Tresca’s friction law. The damage of the materials caused by elastic deformations. We derive a variational formulation for the model which is in the form of a system involving the displacement field, the electric potential and the damage. Then we provide the existence of a unique weak solution to the model. We also study the finite element approximations of the problem and derive error estimates. Finally, we present numerical simulation results in the study of a two-dimensional example

As sanções nas RI: uma expressão da política de poder em uma nova ordem mundial: o caso do Sudão

Esta monografia tem como objetivo verificar se as sanções internacionais são expressão da política de poder. Para tanto, analiso os conceitos tradicionais das sanções no campo das Relações Internacionais, e apresento a concepção do uso dessas sanções na estrutura sistêmica desenvolvida após a Primeira Guerra Mundial. Destaco, ainda, a mudança no significado do conceito, influenciada pelo uso das sanções econômicas como instrumento de política externa, principalmente pelos Estados Unidos, após o fim da Guerra Fria. Posteriormente, para analisar o estudo de caso, faço um relato histórico das relações entre os Estados Unidos e o Sudão, da mudança do regime em Cartum, e da imposição das sanções unilaterais contra o último pelo primeiro. Em seguida, trato das políticas externas dos sucessivos governos nos Estados Unidos em relação ao Sudão, e do regime das sanções. Também, faço uma revisão das literaturas do centro e da periferia sobre as sanções contra o Sudão, trazendo à luz, assim, ambas as narrativas. No fim, apresento uma crítica construtivista-pós-colonialista ao campo de estudo ortodoxo das sanções internacionais

Evaluation de la formation des résidents en chirurgie générale et digestive en Tunisie

Introduction: De nombreux moyens sont mis à disposition des résidents en chirurgie générale et  digestive pour assurer leur formation théorique et pratique. Cependant, le niveau d'utilisation de ces différents outils et leur impact sur la formation des résidents n'ont jamais été évalués. L'objectif de notre étude était d'étudier l'état des lieux des moyens de formation utilisés par les résidents pour évaluer leurs degrés de satisfaction et leurs propositions en vue d'améliorer leur formation. Méthodes: Un questionnaire anonyme a été distribué aux résidents de chirurgie générale et digestive de l'année  2012-2013. Ce questionnaire portait sur les caractéristiques démographiques, les ressources   pédagogiques, ainsi que le cursus médical et universitaire. Une évaluation de la formation ainsi qu'un  recueil des propositions faites en vue d'améliorer leurs formations étaient réalisées.Résultats: Cinquante résidents sur 83 ont répondu au questionnaire. L'orientation de carrière la plus  fréquente était l'hospitalouniversitaire dans 70% des cas. La pratique quotidienne et l'internet étaient les deux ressources pédagogiques les plus utilisées. La formation chirurgicale était jugée satisfaisante par  seulement 10% des répondants. Parmi l'ensemble des propositions faites, l'apprentissage sur simulateurchirurgical, l'existence d'un ouvrage national de référence, et l'institution d'un tutorat par un chirurgien  senior recueillaient plus de 80% d'avis favorable.Conclusion: La majorité des résidents jugent leur formation non satisfaisante. Une meilleure information sur les ressources déjà existantes, un renforcement du compagnonnage et un accès plus large à un  apprentissage sur simulateur chirurgical permettraient de diminuer ce sentiment d'insatisfaction.Key words: Résidanat, chirurgie, pédagogie médicale, formation, recherch

Chemical profile and antifungal potential of essential oils from leaves and flowers of Salvia algeriensis (Desf.): A comparative study

Salvia is a plant genus widely used in folk medicine in the Mediterranean area since antiquity. A large number of Salvia essential oils have been reported against diverse microorganisms. In the current study, chemical composition of essential oils from leaves and flowers of Salvia algeriensis (Desf.) was determined using gas chromatography-electron impact mass spectrometry (GC-EIMS) as well as their antifungal activity against phytopathogenic fungi Alternaria solani and Fusarium oxysporum exploring disk method. The GC-EIMS analysis identified 59 compounds (84.8%) in the essential oil obtained from leaves of S. algeriensis. Its major constituents were benzaldehyde (9.7%), eugenol (8.7%) and phenylethyl alcohol (8.4%). In flowers oil, 34 compounds (92.8%) were detected. The main ones were viridiflorol (71.1%) and globulol (8.6%). The essential oil obtained from leaves exhibited the highest antifungal activity, where the effective dose inhibiting 50% of mycelial fungal (ED50) against A. solani was 0.90 μL mL-1 with minimum inhibitory concentration (MIC) equal to 2 μL mL-1, whereas the ED50 and MIC in F. oxysporum culture was 1.84 μL mL-1 and 3 μL mL-1 respectively. The mycelial inhibition by flowers oil varies from 1.77 μL mL-1 (ED50) with A. solani culture (MIC 6.5 μL mL-1) to the lowest effect recorded (ED50 3.00 μL mL-1 and MIC 9.33 μL mL-1) against F. oxysporum. To our best knowledge, this is the first report on S. algeriensis, their leaves oil can constitute an alternative biocontrol against phytopathogenic fungi commonly controlled by chemical fungicides

Viscosity and Rheological Properties of Graphene Nanopowders Nanofluids

The dynamic viscosity and rheological properties of two different non-aqueous graphene nano-plates-based nanofluids are experimentally investigated in this paper, focusing on the effects of solid volume fraction and shear rate. For each nanofluid, four solid volume fractions have been considered ranging from 0.1% to 1%. The rheological characterization of the suspensions was performed at 20°C, with shear rates ranging from 10⁻¹ s⁻¹ to 10³s⁻¹, using a cone-plate rheometer. The Carreau–Yasuda model has been successfully applied to fit most of the rheological measurements. Although it is very common to observe an increase of the viscosity with the solid volume fraction, we still found here that the addition of nanoparticles produces lubrication effects in some cases. Such a result could be very helpful in the domain of heat extraction applications. The dependence of dynamic viscosity with graphene volume fraction was analyzed using the model of Vallejo et al

Asthma and COPD as co-morbidities in patients hospitalised with Covid-19 disease: a global systematic review and meta-analysis

Background: Factors predisposing to increased mortality with COVID-19 infection have been identified as male sex, hypertension, obesity, and increasing age. Early studies looking at airway diseases gave some contradictory results. The purpose of our study was to determine global variation in studies in patients hospitalized with COVID-19 in the prevalence of COPD and asthma; and to determine whether the presence of asthma or COPD affected mortality in the same hospital population. Methods: A systematic review and meta-analysis of the published literature of COPD and asthma as co-morbidities in patients hospitalized with COVID-19 was performed, looking firstly at the prevalence of these diseases in patients hospitalized with COVID-19, and secondly at the relative risk of death from any cause for patients with asthma or COPD. Results: Prevalence of both airway diseases varied markedly by region, making meaningful pooled global estimates of prevalence invalid and not of clinical utility. For individual studies, the interquartile range for asthma prevalence was 4.21 to 12.39%, and for COPD, 3.82 to 11.85%. The relative risk of death with COPD for patients hospitalized with COVID-19 was 1.863 (95% CI 1.640–2.115), while the risk with asthma was 0.918 (95% CI 0.767 to 1.098) with no evidence of increased mortality. Conclusions: For asthma and COPD, prevalence in patients hospitalized with COVID-19 varies markedly by region. We found no evidence that asthma predisposed to increased mortality in COVID-19 disease. For COPD, there was clear evidence of an association with increased mortality. Trial registration: The trial was registered with PROSPERO: registration number CRD42021289886

International initiative to engage Iraq's science and technology community : report on the priorities of the Iraqi science and technology community.

This report describes the findings of the effort initiated by the Arab Science and Technology Foundation and the Cooperative Monitoring Center at Sandia National Laboratories to identify, contact, and engage members of the Iraqi science and technology (S&T) community. The initiative is divided into three phases. The first phase, the survey of the Iraqi scientific community, shed light on the most significant current needs in the fields of science and technology in Iraq. Findings from the first phase will lay the groundwork for the second phase that includes the organization of a workshop to bring international support for the initiative, and simultaneously decides on an implementation mechanism. Phase three involves the execution of outcomes of the report as established in the workshop. During Phase 1 the survey team conducted a series of trips to Iraq during which they had contact with nearly 200 scientists from all sections of the country, representing all major Iraqi S&T specialties. As a result of these contacts, the survey team obtained over 450 project ideas from Iraqi researchers. These projects were revised and analyzed to identify priorities and crucial needs. After refinement, the result is approximately 170 project ideas that have been categorized according to their suitability for (1) developing joint research projects with international partners, (2) engaging Iraqi scientists in solving local problems, and (3) developing new business opportunities. They have also been ranked as to high, medium, or low priority